Effects of video modelling on emerging speech in an adult with traumatic brain injury: preliminary findings.

PRIMARY OBJECTIVE: Research has shown that traumatic brain injury (TBI) can affect a person's ability to perform previously learned skills. Dysexecutive syndrome and inattention, for example, alongside a number of other cognitive and behavioural impairments such as memory loss and lack of motivation, significantly affect day-to-day functioning following TBI. This study examined the efficacy of video modelling in emerging speech in an adult male with TBI caused by an assault. RESEARCH DESIGN: In an effort to identify functional relations between this novice intervention and the target behaviour, experimental control was achieved by using within-system research methodology, overcoming difficulties of forming groups for such an highly non-homogeneous population. METHODS AND PROCEDURES: Across a number of conditions, the participant watched a videotape in which another adult modelled a selection of 19 spoken words. When this modelled behaviour was performed in vivo, then generalization across 76 other words in the absence of a videotape took place. MAIN OUTCOMES AND RESULTS: It was revealed that video modelling can promote the performance of previously learned behaviours related to speech, but more significantly it can facilitate the generalization of this verbal behaviour across untrained words. CONCLUSIONS: Video modelling could well be added within the rehabilitation programmes for this population.

A new integrated model of clinical reasoning: development, description and preliminary assessment in patients with stroke.

PURPOSE: The main objective was the development and collection of preliminary data on the application of a new integrated clinical reasoning model (Anadysis) with patients suffering a stroke or Transient Ischemic Attack (TIA). METHOD: Twelve healthcare professionals working in the neurological and the Accident and Emergency (A&E) units of an acute general hospital participated and experimental control was achieved by employing a pre-test post-test control group experimental design. Members of the control group used the current reasoning model of their discipline whereas the new integrated model was used by the members of the experimental group irrespective of their professions. Outcomes were measured by scoring on a protocol derived from the UK National Clinical Guidelines for Stroke divided into the three main clinical reasoning processes. RESULTS: Collectively, data from 186 protocols based on the medical records of 49 patients showed that median percentages of correct responses in clinical reasoning were substantially higher for the experimental group by using the new integrated model. CONCLUSIONS: This study will inform the healthcare professionals about a new effective integrated clinical reasoning model which incorporates the complex processes of diagnosis, planning and treatment as a whole. This study may also become an important consideration in the further development of clinical decision support systems within the scientific area of health informatics.