BACKGROUND: Meta-cognitive strategies have a positive effect on the rehabilitation of executive dysfunction. However, achieving generalization to daily life remains a challenge. We believe that providing rehabilitation in the person's own physical environment and using self-identified tasks will enhance the benefits of meta-cognitive training and promote generalization. PURPOSE: This pilot study tested the applicability of the Cognitive Orientation to Occupational Performance (CO-OP) approach for use with adults with executive dysfunction arising from traumatic brain injury (TBI). METHODS: A single-case design was used with 3 adults, 5 to 20 years post-TBI and their self-identified significant others. Assessments included neuropsychological tests and the Canadian Occupational Performance Measure. The intervention entailed guiding participants to use a meta-cognitive problem-solving strategy to perform self-identified daily tasks that they needed and wanted to do and with which they were having difficulties. The intervention occurred over 20 one-hour sessions in participants' environments. FINDINGS: Performance improved to criterion (2-point positive change) on 7 of 9 trained goals and on 4 of 7 untrained goals (self-report). Improvement was maintained at a 3-month follow-up assessment. IMPLICATIONS: The CO-OP approach has the potential to improve performance in daily functioning for adults with executive dysfunction following TBI.
BACKGROUND: Meta-cognitive strategies have a positive effect on the rehabilitation of executive dysfunction. However, achieving generalization to daily life remains a challenge. We believe that providing rehabilitation in the person's own physical environment and using self-identified tasks will enhance the benefits of meta-cognitive training and promote generalization. PURPOSE: This pilot study tested the applicability of the Cognitive Orientation to Occupational Performance (CO-OP) approach for use with adults with executive dysfunction arising from traumatic brain injury (TBI). METHODS: A single-case design was used with 3 adults, 5 to 20 years post-TBI and their self-identified significant others. Assessments included neuropsychological tests and the Canadian Occupational Performance Measure. The intervention entailed guiding participants to use a meta-cognitive problem-solving strategy to perform self-identified daily tasks that they needed and wanted to do and with which they were having difficulties. The intervention occurred over 20 one-hour sessions in participants' environments. FINDINGS: Performance improved to criterion (2-point positive change) on 7 of 9 trained goals and on 4 of 7 untrained goals (self-report). Improvement was maintained at a 3-month follow-up assessment. IMPLICATIONS: The CO-OP approach has the potential to improve performance in daily functioning for adults with executive dysfunction following TBI.
Authors: Elizabeth R Skidmore; Deirdre R Dawson; Ellen M Whyte; Meryl A Butters; Mary Amanda Dew; Emily S Grattan; James T Becker; Margo B Holm Journal: Clin Rehabil Date: 2013-10-10 Impact factor: 3.477
Authors: Jarrad H Van Stan; Marcel P Dijkers; John Whyte; Tessa Hart; Lyn S Turkstra; Jeanne M Zanca; Christine Chen Journal: Arch Phys Med Rehabil Date: 2018-09-27 Impact factor: 3.966
Authors: Juleen Rodakowski; Charles F Reynolds; Oscar L Lopez; Meryl A Butters; Mary Amanda Dew; Elizabeth R Skidmore Journal: J Appl Gerontol Date: 2016-04-22
Authors: Elizabeth R Skidmore; Deirdre R Dawson; Meryl A Butters; Emily S Grattan; Shannon B Juengst; Ellen M Whyte; Amy Begley; Margo B Holm; James T Becker Journal: Neurorehabil Neural Repair Date: 2014-12-11 Impact factor: 3.919
Authors: Elizabeth R Skidmore; Margo B Holm; Ellen M Whyte; Mary Amanda Dew; Deirdre Dawson; James T Becker Journal: Neuropsychol Rehabil Date: 2011-04 Impact factor: 2.868