S. Bennett, C. Travers, J. Liddle, Sandra Smith, L. Clemson, M. O’Reilly, Michelle L. Allen, K. Laver, E. Beattie, L. Low, Claire M. C. O’Connor, L. Gitlin
Abstract Objectives: The Tailored Activity Program (TAP) is an evidence-based occupational therapist-led intervention for people living with dementia and their care partners at home, developed in the USA. This study sought to understand its acceptability to people living with dementia, their care partners, and health professionals, and factors that might influence willingness to participate prior to its implementation in Australia. Methods: This study used qualitative descriptive methods. Semi-structured interviews were conducted with people living with dementia in the community (n = 4), their care partners (n = 13), and health professionals (n = 12). People living with dementia were asked about health professionals coming to their home to help them engage in activities they enjoy, whereas care partners’ and health professionals’ perspectives of TAP were sought, after it was described to them. Interviews were conducted face-to-face or via telephone. All interviews were recorded and transcribed. Framework analysis was used to identify key themes. Results: Analysis identified four key themes labelled: (i) TAP sounds like a good idea; (ii) the importance of enjoyable activities; (iii) benefits for care partners; and (iv) weighing things up. Findings suggest the broad, conditional acceptability of TAP from care partners and health professionals, who also recognised challenges to its use. People living with dementia expressed willingness to receive help to continue engaging in enjoyable activities, if offered. Discussion: While TAP appeared generally acceptable, a number of barriers were identified that must be considered prior to, and during its implementation. This study may inform implementation of non-pharmacological interventions more broadly.
{"title":"Acceptability and willingness to participate in the Tailored Activity Program: perceptions of people living with dementia, their care partners and health professionals","authors":"S. Bennett, C. Travers, J. Liddle, Sandra Smith, L. Clemson, M. O’Reilly, Michelle L. Allen, K. Laver, E. Beattie, L. Low, Claire M. C. O’Connor, L. Gitlin","doi":"10.1017/BrImp.2020.15","DOIUrl":"https://doi.org/10.1017/BrImp.2020.15","url":null,"abstract":"Abstract Objectives: The Tailored Activity Program (TAP) is an evidence-based occupational therapist-led intervention for people living with dementia and their care partners at home, developed in the USA. This study sought to understand its acceptability to people living with dementia, their care partners, and health professionals, and factors that might influence willingness to participate prior to its implementation in Australia. Methods: This study used qualitative descriptive methods. Semi-structured interviews were conducted with people living with dementia in the community (n = 4), their care partners (n = 13), and health professionals (n = 12). People living with dementia were asked about health professionals coming to their home to help them engage in activities they enjoy, whereas care partners’ and health professionals’ perspectives of TAP were sought, after it was described to them. Interviews were conducted face-to-face or via telephone. All interviews were recorded and transcribed. Framework analysis was used to identify key themes. Results: Analysis identified four key themes labelled: (i) TAP sounds like a good idea; (ii) the importance of enjoyable activities; (iii) benefits for care partners; and (iv) weighing things up. Findings suggest the broad, conditional acceptability of TAP from care partners and health professionals, who also recognised challenges to its use. People living with dementia expressed willingness to receive help to continue engaging in enjoyable activities, if offered. Discussion: While TAP appeared generally acceptable, a number of barriers were identified that must be considered prior to, and during its implementation. This study may inform implementation of non-pharmacological interventions more broadly.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"64 1","pages":"259 - 273"},"PeriodicalIF":0.8,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90778747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Scott, J. Liddle, R. Sidhu, G. Mitchell, E. Beattie, L. Gustafsson, N. Pachana
Abstract Objective: Driving and stopping driving present challenging issues for older people living with memory problems and the family members supporting them. Changes to driving status impact the individual stopping driving and their family members. CarFreeMe is an existing, effective driving cessation program for older people that may be applicable to older people living with dementia. The purpose of this study was to adapt the program and explore feasibility and key stakeholder perspectives. Methods: The Medical Research Council guidelines for conducting research into complex interventions guided the development, acceptability and feasibility piloting. A multidisciplinary approach was taken, and key stakeholders were involved throughout the process. This included an adaptation process, followed by expert reference group feedback and case series pilot study. Results: The background research indicated that some key changes were required to meet the needs of people living with dementia. Aspects of the content, language, format and activities were adapted and an additional module was created for family members – whose involvement was identified as important. A more personalized, flexible approach was recommended. The expert reference group [psychologists (n = 2), occupational therapists (n = 3) and dementia behavior consultants (n = 2)] indicated the program was appropriate and needed, and made recommendations for feasibility. Pilot testing with three families indicated acceptability. Conclusion: A driving cessation program adapted for use with people living with dementia and their families required some changes to meet the needs and situations based on feedback from key stakeholders. Future studies will evaluate implementation outcomes across a range of settings.
{"title":"Adaptation of the CarFreeMe driver retirement intervention to provide driving cessation support to older people living with dementia","authors":"T. Scott, J. Liddle, R. Sidhu, G. Mitchell, E. Beattie, L. Gustafsson, N. Pachana","doi":"10.1017/BrImp.2020.16","DOIUrl":"https://doi.org/10.1017/BrImp.2020.16","url":null,"abstract":"Abstract Objective: Driving and stopping driving present challenging issues for older people living with memory problems and the family members supporting them. Changes to driving status impact the individual stopping driving and their family members. CarFreeMe is an existing, effective driving cessation program for older people that may be applicable to older people living with dementia. The purpose of this study was to adapt the program and explore feasibility and key stakeholder perspectives. Methods: The Medical Research Council guidelines for conducting research into complex interventions guided the development, acceptability and feasibility piloting. A multidisciplinary approach was taken, and key stakeholders were involved throughout the process. This included an adaptation process, followed by expert reference group feedback and case series pilot study. Results: The background research indicated that some key changes were required to meet the needs of people living with dementia. Aspects of the content, language, format and activities were adapted and an additional module was created for family members – whose involvement was identified as important. A more personalized, flexible approach was recommended. The expert reference group [psychologists (n = 2), occupational therapists (n = 3) and dementia behavior consultants (n = 2)] indicated the program was appropriate and needed, and made recommendations for feasibility. Pilot testing with three families indicated acceptability. Conclusion: A driving cessation program adapted for use with people living with dementia and their families required some changes to meet the needs and situations based on feedback from key stakeholders. Future studies will evaluate implementation outcomes across a range of settings.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"45 1","pages":"247 - 258"},"PeriodicalIF":0.8,"publicationDate":"2020-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80470560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. MacLeod, L. Surgenor, W. Levack, J. Hackney, A. Theadom, R. Siegert, N. Silverberg, D. Snell
The Cognition Battery of the National Institute of Health (NIH) Toolbox for Assessment of Neurological and Behavioural Function is a computerised neuropsychological battery recommended for clinical practice, neurological research and clinical trials. We investigated the utility of the NIH Toolbox Cognition Battery (NIHTB-CB) for people with concussion.In this small qualitative study, semi-structured interviews were conducted with five adults with concussion who were participating in a larger study using the NIHTB-CB. Three clinician participants and two cultural advisors familiar with the tool were also interviewed. Interview transcripts were analysed using a general thematic approach and qualitative description.Participants described both positive and negative experiences with the NIHTB-CB and using qualitative description, their experiences were organised into three broad themes: (1) using technology for cognitive testing made sense, (2) there were some cultural relevance questions and (3) cognitive testing after concussion could have challenges. They were positive about the computerised format and range of domains assessed for the concussion context but identified the contextual relevance of some content as having potential to impact on performances.This was a small study examining the experiences of a select group of participants, but nevertheless does suggest a need for future research validating the NIHTB-CB for use in different cultural and clinical contexts.
{"title":"Patient and clinician experiences of a computerised cognitive battery for use after concussion: a preliminary qualitative study","authors":"C. MacLeod, L. Surgenor, W. Levack, J. Hackney, A. Theadom, R. Siegert, N. Silverberg, D. Snell","doi":"10.1017/brimp.2020.14","DOIUrl":"https://doi.org/10.1017/brimp.2020.14","url":null,"abstract":"The Cognition Battery of the National Institute of Health (NIH) Toolbox for Assessment of Neurological and Behavioural Function is a computerised neuropsychological battery recommended for clinical practice, neurological research and clinical trials. We investigated the utility of the NIH Toolbox Cognition Battery (NIHTB-CB) for people with concussion.In this small qualitative study, semi-structured interviews were conducted with five adults with concussion who were participating in a larger study using the NIHTB-CB. Three clinician participants and two cultural advisors familiar with the tool were also interviewed. Interview transcripts were analysed using a general thematic approach and qualitative description.Participants described both positive and negative experiences with the NIHTB-CB and using qualitative description, their experiences were organised into three broad themes: (1) using technology for cognitive testing made sense, (2) there were some cultural relevance questions and (3) cognitive testing after concussion could have challenges. They were positive about the computerised format and range of domains assessed for the concussion context but identified the contextual relevance of some content as having potential to impact on performances.This was a small study examining the experiences of a select group of participants, but nevertheless does suggest a need for future research validating the NIHTB-CB for use in different cultural and clinical contexts.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"24 1","pages":"1-16"},"PeriodicalIF":0.8,"publicationDate":"2020-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77382680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kirstine Shrubsole, Rachelle Pitt, K. Till, Emma Finch, Brooke J Ryan
Background:Parental acquired communication disability has long-lasting impacts on children, including increased child stress and behavioural problems. However, speech-language pathologists' (SLPs) current practice in providing information, education and counselling support to these children is unknown. Therefore, we explored SLPs' perceived needs, current practices and barriers and facilitators to working with children of people with acquired communication disability (PwCD).Methods:An online survey sought information on Australian SLPs' current practices in providing education and counselling to children of PwCD. Perceived barriers and facilitators were mapped to the COM-B, a model that considers Capability, Opportunity and Motivation as domains that influence behaviour.Results:75% of participants (n = 76) perceived a need to provide both information and counselling, but 'never' or 'rarely' provided either aspect of care. Barriers relating to 'Opportunity' were most frequently identified, such as not having access to children in therapy and lack of parental support/engagement. Capability (e.g., knowledge and skills) and Motivation (e.g., confidence) barriers were also identified.Conclusions:There is potential for SLPs to provide services to children of PwCD either directly through information and/or counselling-type interactions or indirectly through referral to other services. This study highlights the need for more research into these areas of practice.
{"title":"Speech language pathologists’ practice with children of parents with an acquired communication disability: A preliminary study","authors":"Kirstine Shrubsole, Rachelle Pitt, K. Till, Emma Finch, Brooke J Ryan","doi":"10.1017/brimp.2020.11","DOIUrl":"https://doi.org/10.1017/brimp.2020.11","url":null,"abstract":"Background:Parental acquired communication disability has long-lasting impacts on children, including increased child stress and behavioural problems. However, speech-language pathologists' (SLPs) current practice in providing information, education and counselling support to these children is unknown. Therefore, we explored SLPs' perceived needs, current practices and barriers and facilitators to working with children of people with acquired communication disability (PwCD).Methods:An online survey sought information on Australian SLPs' current practices in providing education and counselling to children of PwCD. Perceived barriers and facilitators were mapped to the COM-B, a model that considers Capability, Opportunity and Motivation as domains that influence behaviour.Results:75% of participants (n = 76) perceived a need to provide both information and counselling, but 'never' or 'rarely' provided either aspect of care. Barriers relating to 'Opportunity' were most frequently identified, such as not having access to children in therapy and lack of parental support/engagement. Capability (e.g., knowledge and skills) and Motivation (e.g., confidence) barriers were also identified.Conclusions:There is potential for SLPs to provide services to children of PwCD either directly through information and/or counselling-type interactions or indirectly through referral to other services. This study highlights the need for more research into these areas of practice.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"31 1","pages":"1-17"},"PeriodicalIF":0.8,"publicationDate":"2020-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76586905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana Ramirez-Hernandez, R. Stolwyk, T. Ownsworth, Dana K. Wong
Background: The uptake of smartphones as external compensatory memory aids following an acquired brain injury (ABI) in rehabilitation settings is low. Potential reasons for this include professionals not having evidence-based guidelines regarding the best methods to train smartphone use and prospective users not being familiar with technology and/or having memory and learning difficulties. This paper describes the protocol of a study that aims to compare the efficacy of three training methods (Systematic Instruction, Error-based Learning and Trial-and-Error) for training the use of a smartphone reminder app, in people with ABI presenting with memory complaints. Methods/Design: This is a three-armed, assessor-blinded, Phase II randomised controlled trial. The estimated sample size is 51 participants aged >18 years, who are equally randomised to one of the three training groups. They are seen across four sessions: one to conduct baseline measures; one for training the use of an app and two for follow-up assessments (1- and 6-weeks post-training). The main outcome measure is proficiency of performance in tasks with the trained app. Secondary outcomes include generalisation of skills to other apps, number of errors committed while attempting the tasks, frequency of smartphone usage in general and as a memory aid and confidence in smartphone use and memory self-efficacy. Outcome measures are collected by an independent blinded assessor. Proficiency of performance, generalisation of skills and error commission are measured immediately post-training and at the two follow-up sessions. The other secondary measures are taken pre-intervention and at the two follow-up sessions. Discussion: This study will provide initial evidence regarding the efficacy of three different methods to train ABI survivors with memory difficulties in how to use smartphone apps as compensatory memory aids. The results could inform a larger Phase III trial and advance knowledge concerning the advantages or disadvantages of using error-reducing and trial-and-error techniques. Further, the findings could determine the potential of error-based learning as an emerging training method for people with memory impairment within rehabilitation.
{"title":"A comparison of systematic instruction, error-based learning and trial and error to train the use of smartphone memory apps after acquired brain injury: A three-armed phase II randomised controlled trial study protocol","authors":"Diana Ramirez-Hernandez, R. Stolwyk, T. Ownsworth, Dana K. Wong","doi":"10.1017/brimp.2020.10","DOIUrl":"https://doi.org/10.1017/brimp.2020.10","url":null,"abstract":"Background:\u0000The uptake of smartphones as external compensatory memory aids following an acquired brain injury (ABI) in rehabilitation settings is low. Potential reasons for this include professionals not having evidence-based guidelines regarding the best methods to train smartphone use and prospective users not being familiar with technology and/or having memory and learning difficulties. This paper describes the protocol of a study that aims to compare the efficacy of three training methods (Systematic Instruction, Error-based Learning and Trial-and-Error) for training the use of a smartphone reminder app, in people with ABI presenting with memory complaints.\u0000\u0000Methods/Design:\u0000This is a three-armed, assessor-blinded, Phase II randomised controlled trial. The estimated sample size is 51 participants aged >18 years, who are equally randomised to one of the three training groups. They are seen across four sessions: one to conduct baseline measures; one for training the use of an app and two for follow-up assessments (1- and 6-weeks post-training). The main outcome measure is proficiency of performance in tasks with the trained app. Secondary outcomes include generalisation of skills to other apps, number of errors committed while attempting the tasks, frequency of smartphone usage in general and as a memory aid and confidence in smartphone use and memory self-efficacy. Outcome measures are collected by an independent blinded assessor. Proficiency of performance, generalisation of skills and error commission are measured immediately post-training and at the two follow-up sessions. The other secondary measures are taken pre-intervention and at the two follow-up sessions.\u0000\u0000Discussion:\u0000This study will provide initial evidence regarding the efficacy of three different methods to train ABI survivors with memory difficulties in how to use smartphone apps as compensatory memory aids. The results could inform a larger Phase III trial and advance knowledge concerning the advantages or disadvantages of using error-reducing and trial-and-error techniques. Further, the findings could determine the potential of error-based learning as an emerging training method for people with memory impairment within rehabilitation.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"3 1","pages":"1-16"},"PeriodicalIF":0.8,"publicationDate":"2020-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76996614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Providing evidence-based services in areas with emerging or low-level evidence is a challenge for many clinicians. The aim of the current study was to apply a newly designed novel methodology to develop and describe a new intervention for cognitive-communication reading comprehension deficits in early acquired brain injury rehabilitation. Methods: An emergent multi-phase mixed methods design allowed phases of different research activity to build an evidence base of quantitative and qualitative data. A pragmatic clinical framework was developed to combine these traditional research findings with principles from knowledge translation and implementation science, evidence-based practice and intervention development models, clinical contextual practice guidelines and the Medical Research Council’s guidelines for developing and evaluating complex interventions, to create an evidence-based contextually driven clinical intervention. Results: The resulting reading comprehension intervention and service delivery model is presented and involves a multiple-strategy intervention across increasing level of reading comprehension complexity. In areas where traditional methodologies provide low-level evidence, this method provides an alternate way to conduct evidence-based clinical research.
{"title":"Developing an evidence-based reading intervention for early brain injury rehabilitation","authors":"Kerrin Watter, Anna Copley, Emma Finch","doi":"10.1017/brimp.2020.8","DOIUrl":"https://doi.org/10.1017/brimp.2020.8","url":null,"abstract":"Introduction: Providing evidence-based services in areas with emerging or low-level evidence is a challenge for many clinicians. The aim of the current study was to apply a newly designed novel methodology to develop and describe a new intervention for cognitive-communication reading comprehension deficits in early acquired brain injury rehabilitation. \u0000 \u0000Methods: An emergent multi-phase mixed methods design allowed phases of different research activity to build an evidence base of quantitative and qualitative data. A pragmatic clinical framework was developed to combine these traditional research findings with principles from knowledge translation and implementation science, evidence-based practice and intervention development models, clinical contextual practice guidelines and the Medical Research Council’s guidelines for developing and evaluating complex interventions, to create an evidence-based contextually driven clinical intervention. \u0000 \u0000Results: The resulting reading comprehension intervention and service delivery model is presented and involves a multiple-strategy intervention across increasing level of reading comprehension complexity. In areas where traditional methodologies provide low-level evidence, this method provides an alternate way to conduct evidence-based clinical research.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"57 1","pages":"1-24"},"PeriodicalIF":0.8,"publicationDate":"2020-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90466581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
People with acquired brain injury (ABI) have traditionally experienced low employment rates, compared with the national average and others with disability in Australia. To positively impact mainstream economic participation following ABI, a co-design approach was used to investigate open employment pathways available and consider necessary pathway features to enable employment for people with ABI.A qualitative focus group methodology was used with four groups: people with ABI; health professionals working with this group; employers providing work for people with ABI and social and injury insurers funding employment services. The project was delivered in two phases: (1) review existing work pathways in Australia and gather knowledge about enablers and barriers to employment following ABI and (2) use ABI lived experience, employers’ experience and allied health and social insurer expertise to develop a new pathway to mainstream employment.Co-design helped to identify enablers and barriers to employment of people with ABI, as well as practical strategies to facilitate workplace diversity and inclusion. Enablers included replacing interviews with an onsite assessment to meet key staff and trial work tasks, employer education on ABI, the use of compensatory cognitive aides and graded on-the-job support. This guided the development of a new employment pathway, tailored for people with ABI, called ‘Employment CoLab’.The Employment CoLab pathway, when coupled with person-centred collaborative and effective social disability insurance approaches, offers opportunities to build inclusive, sustainable and scalable economic participation and mainstream wages for people with ABI.
{"title":"A co-design approach to examine and develop pathways to open employment for people with acquired brain injury","authors":"E. Bould, L. Callaway","doi":"10.1017/brimp.2020.9","DOIUrl":"https://doi.org/10.1017/brimp.2020.9","url":null,"abstract":"People with acquired brain injury (ABI) have traditionally experienced low employment rates, compared with the national average and others with disability in Australia. To positively impact mainstream economic participation following ABI, a co-design approach was used to investigate open employment pathways available and consider necessary pathway features to enable employment for people with ABI.A qualitative focus group methodology was used with four groups: people with ABI; health professionals working with this group; employers providing work for people with ABI and social and injury insurers funding employment services. The project was delivered in two phases: (1) review existing work pathways in Australia and gather knowledge about enablers and barriers to employment following ABI and (2) use ABI lived experience, employers’ experience and allied health and social insurer expertise to develop a new pathway to mainstream employment.Co-design helped to identify enablers and barriers to employment of people with ABI, as well as practical strategies to facilitate workplace diversity and inclusion. Enablers included replacing interviews with an onsite assessment to meet key staff and trial work tasks, employer education on ABI, the use of compensatory cognitive aides and graded on-the-job support. This guided the development of a new employment pathway, tailored for people with ABI, called ‘Employment CoLab’.The Employment CoLab pathway, when coupled with person-centred collaborative and effective social disability insurance approaches, offers opportunities to build inclusive, sustainable and scalable economic participation and mainstream wages for people with ABI.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"8 1","pages":"1-17"},"PeriodicalIF":0.8,"publicationDate":"2020-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90351150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julieta Moreno-Villagómez, G. Yáñez-Téllez, Belén Prieto-Corona, Ana Natalia Seubert-Ravelo, Antonio García
Craniosynostosis is defined as a premature fusion of one or more cranial sutures. Several studies have revealed cognitive deficits in some children who had undergone surgery to treat craniosynostosis. However, no general distinction has been drawn in the cognitive abilities between the various types of craniosynostosis. The purpose of the present study was to analyze if there is a difference in cognitive and motor function among the different types of non-syndromic craniosynostosis in preschool children.Twenty-seven children with different types of non-syndromic craniosynostosis were assessed using the Wechsler Preschool and Primary Scale of Intelligence – Third Edition, as well as the Quantitative, Memory and Motor scales of McCarthy Scales of Children’s Abilities (MSCA). The children were aged between 3 and 5 years and 11 months. The various types of craniosynostosis were compared.The unicoronal synostosis group performed significantly worse than the multisuture synostosis group on the MSCA Motor scale. No differences in cognitive functions were found between the various types of craniosynostosis.Children with unicoronal synostosis may experience impaired motor skills and screening of their motor ability is recommended.
{"title":"Cognitive performance of preschool children with different types of non-syndromic craniosynostosis","authors":"Julieta Moreno-Villagómez, G. Yáñez-Téllez, Belén Prieto-Corona, Ana Natalia Seubert-Ravelo, Antonio García","doi":"10.1017/brimp.2020.7","DOIUrl":"https://doi.org/10.1017/brimp.2020.7","url":null,"abstract":"Craniosynostosis is defined as a premature fusion of one or more cranial sutures. Several studies have revealed cognitive deficits in some children who had undergone surgery to treat craniosynostosis. However, no general distinction has been drawn in the cognitive abilities between the various types of craniosynostosis. The purpose of the present study was to analyze if there is a difference in cognitive and motor function among the different types of non-syndromic craniosynostosis in preschool children.Twenty-seven children with different types of non-syndromic craniosynostosis were assessed using the Wechsler Preschool and Primary Scale of Intelligence – Third Edition, as well as the Quantitative, Memory and Motor scales of McCarthy Scales of Children’s Abilities (MSCA). The children were aged between 3 and 5 years and 11 months. The various types of craniosynostosis were compared.The unicoronal synostosis group performed significantly worse than the multisuture synostosis group on the MSCA Motor scale. No differences in cognitive functions were found between the various types of craniosynostosis.Children with unicoronal synostosis may experience impaired motor skills and screening of their motor ability is recommended.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"33 1","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2020-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78923633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jai Carmichael, Amelia J. Hicks, K. Gould, T. Feeney, Penelope Analytis, J. Ponsford
Individuals with acquired brain injury (ABI) may present with challenging behaviours (CB) that place themselves and others at risk of harm and impact their community integration. It is crucial for community ABI therapists to successfully train in and implement behaviour interventions. The current study aimed to investigate community ABI therapists’ experiences of using, training in and implementing behaviour interventions. An additional aim was to determine these therapists’ understanding of Positive Behaviour Support (PBS), one approach to addressing CB with a focus on improving quality of life.Semi-structured interviews were conducted with 24 Australian community ABI therapists about their experiences of using, training in and implementing behaviour interventions and understanding of PBS. Inductive thematic analysis and content analysis were performed on interview transcripts.The thematic analysis resulted in the generation of six themes which described the difficulties participants faced in training in and delivering behaviour interventions and identified their training and implementation needs. The content analysis resulted in 10 categories that characterised participants’ understanding of PBS, which centred around the absence of consequences, a focus on antecedents, person-centred practice and encouraging prosocial alternatives to CB.The findings highlight a need and desire for more practical and interactive clinician training in behaviour interventions for individuals with ABI. Moreover, the findings suggest a limited understanding of PBS amongst community ABI therapists. Important considerations for the development of clinician training in ABI behaviour interventions and subsequent implementation into community practice are discussed.
{"title":"‘We struggle and muddle.’ A qualitative study exploring community ABI therapists’ experiences of using, training in and implementing behaviour interventions","authors":"Jai Carmichael, Amelia J. Hicks, K. Gould, T. Feeney, Penelope Analytis, J. Ponsford","doi":"10.1017/brimp.2020.6","DOIUrl":"https://doi.org/10.1017/brimp.2020.6","url":null,"abstract":"Individuals with acquired brain injury (ABI) may present with challenging behaviours (CB) that place themselves and others at risk of harm and impact their community integration. It is crucial for community ABI therapists to successfully train in and implement behaviour interventions. The current study aimed to investigate community ABI therapists’ experiences of using, training in and implementing behaviour interventions. An additional aim was to determine these therapists’ understanding of Positive Behaviour Support (PBS), one approach to addressing CB with a focus on improving quality of life.Semi-structured interviews were conducted with 24 Australian community ABI therapists about their experiences of using, training in and implementing behaviour interventions and understanding of PBS. Inductive thematic analysis and content analysis were performed on interview transcripts.The thematic analysis resulted in the generation of six themes which described the difficulties participants faced in training in and delivering behaviour interventions and identified their training and implementation needs. The content analysis resulted in 10 categories that characterised participants’ understanding of PBS, which centred around the absence of consequences, a focus on antecedents, person-centred practice and encouraging prosocial alternatives to CB.The findings highlight a need and desire for more practical and interactive clinician training in behaviour interventions for individuals with ABI. Moreover, the findings suggest a limited understanding of PBS amongst community ABI therapists. Important considerations for the development of clinician training in ABI behaviour interventions and subsequent implementation into community practice are discussed.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"63 1","pages":"1-16"},"PeriodicalIF":0.8,"publicationDate":"2020-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74407648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Block, Stacey George, S. Milanese, J. Dizon, H. Bowen-Salter, Felicity Jenkinson
To synthesise the current best evidence on both pharmacological and non-pharmacological behaviour management interventions for adult patients in the acute hospital setting with traumatic brain injury (TBI) or post-traumatic amnesia (PTA).A comprehensive search of 10 electronic databases was completed.Systematic reviews (SRs) published in English before September 2018 were included. Initial search resulted in 4604 citations, 2916 for title and abstract screening with duplicates removed, and 2909 articles failed to meet the inclusion criteria leaving seven reviews for inclusion. Five reporting pharmacological management approaches, two reporting non-pharmacological management approaches, and one reporting both pharmacological and non-pharmacological management approaches.Methodological quality was assessed independently by two reviewers using the Critical Appraisal Skills Programme Tool for SRs. Data were extracted from the studies based on the recommendations of the Joanna Briggs Institute (JBI) Methodology for JBI Umbrella Reviews.The SRs were of low-to-moderate quality overall. High-quality SRs were characterised by low numbers of studies and significant biases. The evidence relating to pharmacological interventions demonstrates low level and variable quality. The evidence relating to non-pharmacological interventions was limited and of low quality.The current evidence for the management of challenging behaviours in patients with acute TBI/PTA is generally equivocal, potentially reflecting the heterogeneity of patients with TBI and their clinical behaviours. More studies with rigorous methodologies are required to investigate the most suitable pharmacological and non-pharmacological behavioural interventions for the acute phase of TBI or PTA.
{"title":"Evidence for the management of challenging behaviours in patients with acute traumatic brain injury or post-traumatic amnesia: An Umbrella Review","authors":"H. Block, Stacey George, S. Milanese, J. Dizon, H. Bowen-Salter, Felicity Jenkinson","doi":"10.1017/brimp.2020.5","DOIUrl":"https://doi.org/10.1017/brimp.2020.5","url":null,"abstract":"To synthesise the current best evidence on both pharmacological and non-pharmacological behaviour management interventions for adult patients in the acute hospital setting with traumatic brain injury (TBI) or post-traumatic amnesia (PTA).A comprehensive search of 10 electronic databases was completed.Systematic reviews (SRs) published in English before September 2018 were included. Initial search resulted in 4604 citations, 2916 for title and abstract screening with duplicates removed, and 2909 articles failed to meet the inclusion criteria leaving seven reviews for inclusion. Five reporting pharmacological management approaches, two reporting non-pharmacological management approaches, and one reporting both pharmacological and non-pharmacological management approaches.Methodological quality was assessed independently by two reviewers using the Critical Appraisal Skills Programme Tool for SRs. Data were extracted from the studies based on the recommendations of the Joanna Briggs Institute (JBI) Methodology for JBI Umbrella Reviews.The SRs were of low-to-moderate quality overall. High-quality SRs were characterised by low numbers of studies and significant biases. The evidence relating to pharmacological interventions demonstrates low level and variable quality. The evidence relating to non-pharmacological interventions was limited and of low quality.The current evidence for the management of challenging behaviours in patients with acute TBI/PTA is generally equivocal, potentially reflecting the heterogeneity of patients with TBI and their clinical behaviours. More studies with rigorous methodologies are required to investigate the most suitable pharmacological and non-pharmacological behavioural interventions for the acute phase of TBI or PTA.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"13 1","pages":"1-19"},"PeriodicalIF":0.8,"publicationDate":"2020-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83031287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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