Theory driven rehabilitation of executive functioning: improving planning skills in people with traumatic brain injury through the use of an autobiographical episodic memory cueing procedure

Abstract

Traumatic brain injury (TBI) frequently leads to the development of a 'dysexecutive syndrome'. The associated difficulties with problem solving (including specific impairments in planning, initiation/plan-implementation and self-monitoring) represent a major challenge to functional recovery and adaptation following brain injury and serve as an important target for rehabilitation. Previous research suggests that one reason people with TBI are poor at everyday planning is that they fail to spontaneously use specific autobiographical memories to support planning in unstructured situations. In this study, we examined whether a self-instructional technique involving self-cueing to recall specific autobiographical experiences would improve performance on a planning task. Two groups of 15 participants who had suffered a closed traumatic brain injury carried out the Everyday Descriptions Task (Dritschel, B. (1991). The role of autobiographical memory in describing how to perform everyday activities. In Paper presented at the European Cognitive Society Conference.), in which they were asked to describe how they would plan eight common unstructured activities, i.e. activities that could be solved in a variety of ways. Group 1 was then asked to describe how to plan a second set of eight unstructured activities. Prior to completing their second set of eight activities, Group 2 underwent training in a procedure aimed at prompting the retrieval of specific memories to support planning. The results suggested that the intervention was effective at increasing the number of specific memories recalled, with a corresponding increase in the effectiveness of the plan and number of relevant steps in the plan. Potential applications of the technique are discussed.