Biomedical subjects

M M Sohlberg

Publications and source records attributed to M M Sohlberg.

14 recordsLinked to original sources

PubMed2005

TEACH-M: A pilot study evaluating an instructional sequence for persons with impaired memory and executive functions.

PRIMARY OBJECTIVE: The purpose of this pilot study was to evaluate an instructional package that facilitates learning and retention of multi-step procedures for persons with severe memory and executive function impairments resulting from traumatic brain injury. RESEARCH DESIGN: The study used a multiple baseline across participants design. METHODS AND PROCEDURES: Four participants, two males and two females, ranging in age from 36-58 years, were taught a 7-step e-mail task. The instructional package (TEACH-M) was the experimental intervention and the number of correct e-mail steps learned was the dependent variable. MAIN OUTCOMES AND RESULTS: Treatment effects were replicated across the four participants and maintained at 30 days post-treatment. Generalization and social validity data further supported the treatment programme. CONCLUSIONS: The results suggest that individuals with severe cognitive impairments are capable of learning new skills. Directions for future research include application of the instructional package to other multi-step procedures.

Adult↗

PubMed2005

Making electronic mail accessible: perspectives of people with acquired cognitive impairments, caregivers and professionals.

The primary objective of this study was to better understand the technology needs, barriers and strategies of individuals with acquired cognitive impairments (ACI) in order to design and modify technologies with potential for alleviating the diminished independence and social isolation common in this population. The authors hypothesized that (1) higher rates of computer use would be reported by younger, more highly educated individuals with ACI, those with less severe injuries and those with previous computer experience; (2) A low percentage of survey respondents would own their own computers; and (3) People with ACI would experience social isolation and report low frequency of connecting with important people who live far away. A total of 133 individuals with ACI, professionals and care providers completed the survey. To gain more specific information, seven focus groups were conducted with 66 individuals with ACI and 20 care providers. Finally, 10 current email users participated in structured conversations, detailing their strategies for using email. The survey revealed that 80% of subjects with ACI reported owning a computer. Age and education were not predictors of computer use, but individuals whose ACI was the result of more severe injuries were less likely to use computers. As expected, respondents reported that maintaining contact with distant loved ones is problematic. The focus groups and conversations provided more detail about the communication needs of the population and the relative advantages and disadvantages of email compared with telephone and mail. Participants also identified barriers to email use they had encountered or feared they would encounter when using email. A number of accommodations to overcome these barriers were suggested. The results of the survey, focus groups and conversations confirmed the utility of email and other technologies for people with ACI and the need to make these technologies more accessible. The results and suggestions provided by the focus groups and interviews are being used in the design of Think and Link, an email interface for use by individuals with ACI.

Adult↗

PubMed2001

What does it take to collaborate with families affected by brain injury? A preliminary model.

BACKGROUND: Collaboration refers to a process in which family expertise is acknowledged and used to direct selection, implementation, and evaluation of treatment plans. Although the skills required to create collaborative partnerships with families are a mainstay of practice for certain rehabilitation disciplines, others have traditionally worked in client-clinician dyads that emphasize the role of the professional as responsible for client change. In addition, the existing collaborative models for working with families affected by brain injury require intensive resources and supports, making collaborative partnerships difficult to create within today's clinical and educational service delivery environments. RESULT: In this article, we report our efforts to create an accessible set of collaboration procedures for rehabilitation professionals working in clinical and educational settings with individuals with brain injury and their families. A 2-year, qualitative study with eight families led to the development of a preliminary model and prescriptive manual for applying collaborative principles to practice. CONCLUSION: We review the components of the model and implications for practice.

Adolescent↗

PubMed2001

Improving attention and managing attentional problems. Adapting rehabilitation techniques to adults with ADD.

Research and clinical experience in the field of brain injury rehabilitation have focused quite extensively on the need and potential to retrain attentional skills that are commonly affected by acquired brain injury. Four approaches to managing attention impairments that have emerged from this literature include attention process training, training use of strategies and environmental support, training use of external aids, and the provision of psychosocial support. Most often, several of these will be used in combination. For example, a therapy regimen might include attention process training emphasizing specific components of attention (e.g., sustained attention), in conjunction with training in pacing techniques, and psychosocial support, where the client keeps behavioral logs and discusses insights gained from tracking attention successes and attention lapses. Although there are as yet little data with regard to the effectiveness of these approaches in adults with developmental disorders of attention, there is a growing literature suggesting they may be effective in children and adolescents with ADHD. Further investigation of the application of such techniques in adults with a wide variety of attention disorders, including developmental disorders, would be valuable.

Adaptation, Psychological↗

PubMed2000

Assessing and managing unawareness of self.

Awareness deficits present challenges to recovery and barriers to the rehabilitation process. This paper provides a clinical framework for assessing and managing awareness deficits. It begins with a review of several theoretical and clinical models of awareness in order to identify important characteristics of awareness disorders. A variety of methods for measuring awareness are reviewed. Questions to guide the assessment process are described along with sources for answering the questions. Considerations for implementing three different intervention approaches are also detailed. These interventions include an Individual Awareness Enhancement Program, Procedural Training and Environmental Support, and Caregiver Training and Education. The associated awareness literature is reviewed. An actual case study illustrating the assessment and intervention approaches is provided at the end of the paper.

Agnosia↗

PubMed2000

Evaluation of attention process training and brain injury education in persons with acquired brain injury.

Fourteen patients with stable acquired brain injuries exhibiting attention and working memory deficits were given 10 weeks of attention process training (APT) and 10 weeks of brain injury education in a cross-over design. Structured interviews and neuropsychological tests were used prior to rehabilitation and after both treatments to determine the influence of the interventions on tasks of daily life and performance on attentional networks involving vigilance, orienting, and executive function. The overall results showed that most patients made improvements. Some of these gains were due to practice from repetitive administration of the tests. In addition, the type of intervention also influenced the results. The brain injury education seemed to be most effective in improving self-reports of psychosocial function. APT influenced self-reports of cognitive function and had a stronger influence on performance of executive attention tasks than was found with the brain injury education therapy. Vigilance and orienting networks showed little specific improvement due to therapy. However, vigilance level influenced the improvement with therapy on some tests of executive attention. We consider the implications of these results for future studies of the locus of attentional improvement and for the design of improved interventions.

Activities of Daily Living↗

PubMed1999

Defining abstract entities: development in pre-adolescents, adolescents, and young adults.

Students ages 12, 15, 18, and 23 (n = 60 per group) wrote definitions for 16 abstract nouns (e.g., pride, courage, realization). Responses were analyzed for the Aristotelian style, a type of definition that mentions both the superordinate category term and one or more characteristics of the word (e.g., "Pride is a sense of delight about a possession or accomplishment"). This response type was of interest because it is a sophisticated and literate defining style that is modeled in classrooms, textbooks, and dictionaries-a style that is informative, concise, and efficient. The results indicated that a number of important changes occur in the ability to provide Aristotelian definitions for abstract nouns during the developmental period from late childhood to early adulthood. Specifically, there was an increasing tendency for students to mention the appropriate category to which a word belongs, core features of the word, and subtle aspects of meaning. The study contributes to the knowledge base concerning the nature of language development in pre-adolescents, adolescents, and young adults.

Adolescent↗

PubMed1998

Improvement during baseline: three case studies encouraging collaborative research when evaluating caregiver training.

The trend in cognitive rehabilitation toward reduced services, which provide more functionally relevant outcomes and the recognition of limited maintenance and generalization with many existing interventions, challenges current research models. There is a need to develop and evaluate interventions that can be implemented by persons other than rehabilitation professionals and that are well suited to naturalistic settings. The researchers responded to these challenges by designing a series of single subject experiments evaluating the effectiveness of training caregivers to provide appropriate cognitive support to persons with brain injury within their own natural living environments. The goal of the original research project included evaluating a collaborative mode of interaction with the subjects and their support persons (as opposed to traditional directive treatment models) where the caregivers and subjects were instrumental in designing the intervention and collective performance data. This paper presents the data from the initial three subject/caregiver groups all of whom demonstrated improvement in the target behaviours during the baseline period. It appeared that the act of measuring client performance changed the behaviours of the support persons and resulted in positive changes in baseline levels. The research and clinical implications of these findings are discussed.

Accidents, Traffic↗

PubMed1998

Awareness intervention: who needs it?

It is widely accepted that awareness deficits present challenges to recovery and should be addressed as part of rehabilitation programming. Response to awareness intervention is commonly inferred from measurements that rely on reports by subjects and significant others. This article describes the findings from a pilot study that examined the relationship among a variety of awareness indicators in three individuals with brain damage over a 9-month period. Results suggest a dissociation between behavioral and perceptual indices of awareness. Changes in behavioral indicators of awareness selected by caregivers were not related to changes in self- or caregiver ratings. The clinical and research implications of the findings are discussed.

Activities of Daily Living↗

PubMed1991

Interventions based on the multiple connections model of reading for developmental dyslexia and acquired deep dyslexia.

This paper deals with intervention strategies for developmental and acquired dyslexia. In Study 1 two alternative strategies for developmental surface dyslexia (dysfunctional connection between the whole word orthographic code and the phonetic or name code) were compared. In both the initial study and replication study, a modification of the selective reminding technique was superior to a traditional multisensory technique in beginning readers, presumably because it facilitated word finding or prelexical access to a phonetic code. In Study 2 an adolescent with acquired deep dyslexia (dysfunctional connection between letter and phonemic codes) who had had his angular gyrus (site of grapheme-phoneme correspondence) surgically removed, recovered reading function after a four-month phonemic analysis training program. Further research is needed to evaluate the efficacy of theory-based intervention strategies in children with developmental reading disorders unrelated to focal lesions and in adults with acquired reading disorders related to focal lesions.

Journal Article↗

PubMed1989

Training use of compensatory memory books: a three stage behavioral approach.

A systematic, structured training sequence for teaching individuals with severe memory impairments to independently utilize a compensatory memory book is reviewed. The training sequence is theoretically motivated, incorporating both principles of learning theory as well as aspects of memory known to be preserved in many patients with even severe amnestic disorders. This paper describes the components of a functional memory book system as well as the three-stage behavioral training procedure. An illustrative case study reviewing the training and resultant effective use of a memory book system for daily living and employment in a severely memory-impaired patient is provided.

Adult↗

PubMed1987

Effectiveness of an attention-training program.

Attention Process Training (APT), a hierarchical, multilevel treatment program, was designed to remediate attention deficits in brain-injured persons. The program incorporates current theories in the experimental attention literature. Four brain-injured subjects, varying widely in both etiology of injury and time post onset, underwent intensive cognitive remediation including 5 to 10 weeks of specific attention training. Results are displayed using a single subject multiple baseline across behaviors design. All four subjects demonstrated significant gains in attention following the initiation of attention training. Remediation of another cognitive function (visual processing) was not associated with alterations in attention behavior. The merits of a process-specific approach to cognitive rehabilitation are discussed.

Adult↗

PubMedDate not supplied

Background and initial case studies into the effects of prospective memory training.

Two preliminary case studies are presented introducing the technique of Prospective Memory Training (PMT) as a potential means to manage severe memory impairments. PMT involves repetitive administration of prospective memory tasks in which the patient is asked to initiate a specific action at a future designated time. Background information relevant to the concept of prospective memory is presented. Possible theoretical foundations for PMT are also discussed.

Adult↗

PubMedDate not supplied

An investigation of the effects of prospective memory training.

A within-subject operant design was used to evaluate the efficacy of prospective memory training in a 51-year-old brain-injured male with a severe memory impairment. Training consisted of repetitive administration of prospective memory tasks whereby the subject was given actions to perform at specified future times. The length of time between task administration and task execution was systematically lengthened. Probes were taken evaluating generalization to performance on naturalistic, real-life prospective memory tasks and to performance on retrospective memory or recall measures. Results suggested a significant and steady increase in the subject's prospective memory ability over time; however, changes were not experimentally controlled, thus the data are descriptive in nature. Methodological limitations and issues pertinent to the future investigation of prospective memory are discussed at length, in the hope of encouraging further evaluation of this preliminary, promising technique.

Activities of Daily Living↗