Guest Editorial: Cognitive-communication rehabilitation for combat-related mild traumatic brain injury.

INTRODUCTION Over 2 million servicemembers (SMs) have served in two theaters of operation in Iraq (Operation Iraqi Freedom [OIF]), which ended in December 2011, and Afghanistan (Operation Enduring Freedom [OEF]). Improvements in body armor and advances in medical care have resulted in the highest survival rate of wounded military personnel compared with any previous conflict in U.S. history [1]. Traumatic brain injury (TBI) is among the most common injuries and has been called the "signature injury" of the Global War on Terror [2-3]. Data based on self-reports indicate that approximately 15 to 22 percent of SMs deployed in OIF/OEF may have sustained mild TBI (mTBI) as a result of exposure to improvised explosive devices [4-7]. The true incidence of mTBI among SMs remains largely unknown, because many SMs either do not seek immediate medical care or receive a diagnosis long after the injury, when the details of the event are more difficult to establish [8]. Studies with non-combat-related mTBI populations suggest that initial symptoms generally resolve within weeks or months following the injury. However, these findings cannot be assumed to generalize to combat veterans who typically sustain repeated injuries in the context of chronic stress and life-threatening situations in the battlefield environment [9]. Effective interventions are needed for the growing number of wounded SMs returning from combat with persistent symptoms and functional limitations associated with mTBI and its comorbidities [8]. In May 2007, the U.S. Army Medical Department and the Office of the Army Surgeon General established the Proponency Office for Rehabilitation and Reintegration (PRR problems participating in social communication; disorganized verbal expression; dysfluent speech; word-retrieval problems; and difficulties with planning, problem solving, judgment, and decision making (Table) [14-17]. SLPs play a major role in the evaluation and management of cognitive-communication disorders following TBI [18]. The SLP CMG is intended to address cognitive-communication rehabilitation for SMs and veterans who (1) are [greater than or equal to] 18 years old, (2) have a history of concussion and/or mTBI, and (3) are [greater than or equal to] 3 months postinjury with persistent cognitive-communication symptoms. It does not address (1) interventions for moderate or severe TBI managed in an inpatient setting or (2) concussion and/or mTBI in the acute phase (