Abstract:
The ability to formulate and carry out goals and intentions is impaired in TBI due to characteristic difficulties with memory, attention and executive function. Difficulties inhibiting socially inappropriate or unsafe behaviors may also interfere with the attainment of personal goals and increase the affected person.s dependence on others. The current study extends a line of research in which use of hand-held electronic devices was shown to enhance memory for therapy goals at the verbal level. The current project, which incorporated extensive consumer input in the planning process, uses Goal Attainment Scaling and objective behavioral monitoring to assess the efficacy of the electronic strategy compared to traditional paper-and-pencil strategies. Forty persons who are 1 month into post-acute treatment for TBI or other acquired brain injury, will be randomly assigned to either Electronic or Paper strategies for reminding themselves to work on increasing or decreasing specific behaviors relevant to self-selected personal goals. The primary outcome will be Goal Attainment Scale scores completed by therapists and/ or family members at the end of a 4-week treatment period. Secondary analyses will compare self- and other-ratings on the GAS scales per group and will examine the trajectory of treatment effects via analysis of weekly changes. An additional study component will explore the relationship between neuropsychological function and successful/unsuccessful use of AT. We will also evaluate the impact of use of AT during the project on both participants and clinicians, using qualitative methodology.