Writing Changes and Perceptions After Traumatic Brain Injury: "Oh, by the way, I can't write".

Purpose: Language and cognitive disruptions following traumatic brain injury (TBI) can negatively affect written expression and may result in increased difficulty achieving academic, vocational, social, and personal goals; however, scarce literature exists about TBI's effect on writing abilities. The purpose of this qualitative study was to describe the experiences and perceptions of people with TBI regarding their engagement in writing activities. Method: A transcendental phenomenological design structured the research. Data collection from 11 adults with TBI included gathering demographic and background information, completion of a TBI Symptom Checklist, and engagement in semistructured interviews. Results: Four major themes and 21 subthemes about postinjury writing recovery and current writing status emerged from the data analysis. Participants reported the extent to which writing difficulties interfered with daily activities and identified support strategies used to address persistent challenges. Conclusion: Understanding the writing experiences and perceptions of people with TBI can guide professionals in designing assessments and interventions to facilitate educational, vocational, social, and personal success following injury.

Ecologically Valid Assessment of Prospective Memory for Task Planning and Execution by Adults With Acquired Brain Injury.

PURPOSE: Individuals with acquired brain injury (ABI) often struggle due to inadequate planning and execution skills for completing nonroutine tasks. This study's purpose was to pilot ecologically valid procedures to assess planning for and execution of prospective daily activities. METHOD: Participants included 9 adults with histories of severe ABI and 9 controls. Data collection included both prospective task planning and execution. First, participants created a plan for later execution of daily tasks in accordance with preestablished rules. Over the subsequent 10 days, participants independently attempted task completion. Differences within and between participant groups regarding planning and task performance were evaluated statistically and through examiner observation. RESULTS: Participants with ABI implemented minimal planning strategies. They demonstrated highly variable performance and displayed substantially greater difficulty initiating and successfully executing tasks in adherence to rules than participants without ABI. CONCLUSIONS: Evaluating planning strategies and execution of novel prospective tasks is a crucial but often neglected aspect of assessment following ABI. Implementing ecologically valid procedures to evaluate this aspect of functioning can reveal individual strengths and challenges and provide guidance for developing effective intervention programs. Examining potential roles played by planning and strategy execution provides critical assessment information relating to independent living.

Functional assessment of immediate task planning and execution by adults with acquired brain injury.

BACKGROUND: Individuals with acquired brain injury (ABI) often struggle planning and executing tasks outside daily routines. Given the pervasive effects executive functioning challenges have on independent living, professionals need methods of assessing these skills. OBJECTIVE: This study's purpose was to evaluate an ecologically-valid procedure to assess novel task planning and execution by adults with ABI. METHODS: The researchers implemented a single group design across two phases. Participants included nine adults with severe ABI. In the first experimental phase, participants created a plan for executing tasks that required adherence to pre-determined rules; in the second phase, participants executed the tasks. The researchers tallied information units recorded during the planning phase, performed momentary time-sampling to document observations about participant behaviors, and collected speed, accuracy, and rule violation data about task completion. RESULTS: Planning strategies implemented by most participants were limited to word-for-word copying of some or all of the specified tasks. On average, participants attempted and accurately performed less than half the required tasks and exhibited high rule violation rates. CONCLUSIONS: Given further development and refinement, the implemented procedures may serve as a basis for developing an ecologically-valid tool for evaluating executive functioning in adults with ABI.