Comparison of remedial and compensatory interventions for adults with acquired brain injuries.
OBJECTIVE
To examine the effects of a compensatory intervention versus a remedial intervention for deficits in visual processing of adults with acquired brain injuries (ABI).


METHODS
A cognitive rehabilitation program at a large comprehensive rehabilitation hospital in the New York City metropolitan area.


METHODS
Thirty adults with ABI were matched according to severity of injury, gender, age, and time post-injury, and randomly assigned to the remedial or compensatory group.


METHODS
The remedial intervention consisted of four 45-minute sessions (once weekly) of participation in computer tasks without instruction in compensatory strategies. The compensatory intervention consisted of four 45-minute sessions of instruction in the use of three internal compensatory strategies, including verbalization, chunking, and pacing.


METHODS
Pretest/posttest measures included three functional computer tasks. Weekly measures included a computerized version of the Paced Auditory Serial Addition Task (PASAT) and two computerized matching tasks.


RESULTS
Both groups exhibited statistically significant improvement of comparable degree on posttests and weekly measures. Further analysis revealed that 80% of both groups used compensatory strategies, regardless of intervention method. Those who used strategies demonstrated better performance than those who did not.


CONCLUSIONS
The ability to use internal compensatory strategies may be a significant confound in research examining the effects of the various cognitive rehabilitation intervention methods.
Dirette
D K
DK
Occupational Therapy Department, Western Michigan University, Kalamazoo, Michigan 49008-5051, USA.
Hinojosa
J
J
Carnevale
G J
GJ
D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D015986:Confounding Factors, Epidemiologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007858:Learning; D008297:Male; D008568:Memory; D008875:Middle Aged; D013850:Thinking; D013997:Time Factors; D014584:User-Computer Interface; D014705:Verbal Behavior