Long-term compensatory treatment of organizational deficits in a patient with bilateral frontal lobe damage

TY - JOUR

T1 - Long-term compensatory treatment of organizational deficits in a patient with bilateral frontal lobe damage

AU - Fish, Jessica

AU - Manly, Tom

AU - Wilson, Barbara A

PY - 2008/1

Y1 - 2008/1

N2 - Evans et al. (1998) described compensatory strategy use in R.P., a patient with executive dysfunction following bilateral frontal lobe damage who had difficulty acting upon her intentions. A pager was used to remind R.P. of regularly scheduled activities, along with a checklist that aimed to moderate a perseverative routine. Although successful, 10 years after the original intervention, the strategies were no longer used, and considerable everyday problems were evident. In the current study, we conducted a follow-up assessment to examine potential reasons for this deterioration. No change in neuropsychological functioning was evident. Whereas the previous study introduced the two strategies together, and examined effects upon separate goals, in the current study we reintroduced the two strategies separately, and examined effects on three common goals. In addition to prompting specific activities, we aimed to support completion of more general goals (those that could be enacted within a wider window of time). The paging intervention had a dramatic effect on all three measured behaviors, at a much more consistent level than the checklist. We suggest that, in addition to direct reminders, the pager can cue a process of goal monitoring that bridges the gap between intention and action.

AB - Evans et al. (1998) described compensatory strategy use in R.P., a patient with executive dysfunction following bilateral frontal lobe damage who had difficulty acting upon her intentions. A pager was used to remind R.P. of regularly scheduled activities, along with a checklist that aimed to moderate a perseverative routine. Although successful, 10 years after the original intervention, the strategies were no longer used, and considerable everyday problems were evident. In the current study, we conducted a follow-up assessment to examine potential reasons for this deterioration. No change in neuropsychological functioning was evident. Whereas the previous study introduced the two strategies together, and examined effects upon separate goals, in the current study we reintroduced the two strategies separately, and examined effects on three common goals. In addition to prompting specific activities, we aimed to support completion of more general goals (those that could be enacted within a wider window of time). The paging intervention had a dramatic effect on all three measured behaviors, at a much more consistent level than the checklist. We suggest that, in addition to direct reminders, the pager can cue a process of goal monitoring that bridges the gap between intention and action.

KW - Brain Injuries

KW - Cognition Disorders

KW - Communication Aids for Disabled

KW - Female

KW - Frontal Lobe

KW - Humans

KW - Longitudinal Studies

KW - Memory Disorders

KW - Middle Aged

KW - Neuropsychological Tests

U2 - 10.1017/S1355617708080120

DO - 10.1017/S1355617708080120

M3 - Article

C2 - 18078543

SN - 1355-6177

VL - 14

SP - 154

EP - 163

JO - Journal of the International Neuropsychological Society

JF - Journal of the International Neuropsychological Society

IS - 1

M1 - N/A

ER -