Evaluation of a computer-based prompting intervention to improve essay writing in undergraduates with cognitive impairment after acquired brain injury.

This study evaluated a computer-based prompting intervention for improving expository essay writing after acquired brain injury (ABI). Four undergraduate participants aged 18-21 with mild-moderate ABI and impaired fluid cognition at least 6 months post-injury reported difficulty with the writing process after injury. The study employed a non-concurrent multiple probe across participants, in a single-case design. Outcome measures included essay quality scores and number of revisions to writing counted then coded by type using a revision taxonomy. An inter-scorer agreement procedure was completed for quality scores for 50% of essays, with data indicating that agreement exceeded a goal of 85%. Visual analysis of results showed increased essay quality for all participants in intervention phase compared with baseline, maintained 1 week after. Statistical analyses showed statistically significant results for two of the four participants. The authors discuss external cuing for self-monitoring and tapping of existing writing knowledge as possible explanations for improvement. The study provides preliminary evidence that computer-based prompting has potential to improve writing quality for undergraduates with ABI.

Management of Persistent Cognitive Symptoms After Sport-Related Concussion.

PURPOSE: This case review examines treatments speech-language pathologists at our clinic delivered to middle school, high school, and college students for the management of persistent cognitive symptoms after sport-related concussion. The goal is to examine a range of treatment options, describe clinical rationale for selecting those treatments, and report outcomes in order to identify feasible interventions for systematic evaluation through efficacy research. METHOD: Review of clinic intake data identified 63 cases referred for cognitive rehabilitation over a 36-month period. Twenty-four cases (14 women and 10 men) met selection criteria, including documented sport-related concussion, postconcussion symptoms persisting at least 2 months with deleterious effect on school performance, and enrollment in secondary or postsecondary education. The authors independently coded demographics, treatment approaches, functional goal domains, and outcomes. RESULTS: Treatment approaches fell into 4 broad categories: direct attention training, metacognitive strategy training, training assistive technology for cognition, and psychoeducational supports. Eighty-three percent of clients achieved self-selected functional goals. CONCLUSIONS: Research has focused primarily on return to play and provision of academic accommodations in the initial weeks following concussion. Findings from this case series suggest that speech-language pathologists can deliver individualized interventions that lead to positive clinical outcomes. The authors hope findings encourage efficacy research.