Performance-Based Measures for Objective Monitoring of Functional Strategy Carryover in a Case of Mild Acquired Brain Injury

Research

Objectives: To investigate use of performance-based measures as a method for monitoring strategy use carryover. To explore the relationship between cognitive task performance and successful outcomes for daily function outside the clinic environment.

Design: This was a retrospective case study design with data being collected from speech sessions conducted from April 2021 until November 2022 for 23 in clinic sessions. A follow-up session was held one and a half years post-injury with additional weekly 20-minute virtual meetings for five months.
Setting: Research was conducted on the campus of Saint Mary’s College Speech Clinic
Participants: 21-year-old male with a diagnosis of acquired brain injury. College student preparing for his senior year. Unremarkable medical history. Mild neurocognitive impairment.
Interventions: Restorative cognitive communication skill retraining using cognitive software programs. Compensatory strategy use including internal and external techniques were trained. Use of collaboration to determine goals and performance-based measures that were specific to the patient.
Main Outcome Measures: Computerized cognitive software training scores, successful use of strategy techniques, and successful performance-based outcomes.

Results: Improved cognitive functioning and successful carryover of strategy techniques. The client graduated from college and self-reported improved engagement in his life. Use of external systems continued to benefit him as they alerted need for internal strategies. He reported integration of predict-perform and external alarm and calendar systems allowing him to consider goals after college.

Conclusions: Traditional cognitive therapy such as computer software programs have a place in brain injury intervention. Structured activities assist with restoration of skills and compensatory training. However, the inclusion of highly specific tasks that meaningfully impact an individual’s life, may promote carryover of integrated skills for improved outcomes for the individual. In our view, to this point research is not clear as to whether there is a direct relationship between high level cognitive impairment and functional recovery by use of standardized testing alone. Additional research is recommended to focus on cognitive performance and performance-based measures for mild levels of impairment.
Author(s) Disclosures: No conflicts to disclose