Which of the following is most important for an SLP to do when assessing a child who has an acquired brain injury?

• A. Evaluate pragmatics through a structured language test
• B. Compare premorbid performance with present performance
• C. Ensure administration of an intelligence test
• D. Compare nonverbal performance with verbal performance

Answer: (B)

When assessing a child with an acquired brain injury, comparing premorbid performance with present performance is crucial because it allows the speech-language pathologist (SLP) to understand the extent of the impact that the injury has had on the child's communication abilities. This comparison provides a benchmark of the child’s abilities before the injury, which is essential for identifying specific areas of deficit that may have arisen due to the injury.

This assessment can help guide the development of an individualized treatment plan that addresses the child's unique needs, taking into account their prior functioning. It also aids in setting realistic goals and expectations for recovery. Understanding the child's baseline abilities prior to the injury informs the SLP of the typical language and communication patterns the child exhibited, which can be invaluable in deciding the course of intervention.

In contrast, assessing pragmatics through a structured language test focuses on a specific aspect of language use, rather than the overall impact of the injury. While intelligence testing and comparing nonverbal to verbal performance can provide useful information, they may not give a complete picture of how the injury has affected the child's communication in relation to their previous state. Thus, the most comprehensive approach during this assessment phase is to look at how the child's abilities have changed since the brain injury occurred.