Rehabilitation of emergent awareness of errors post traumatic brain injury: A pilot intervention

ABSTRACT

Impaired awareness of errors is common following traumatic brain injury (TBI) and can be a barrier to successful rehabilitation. The objective of this study was to develop and evaluate a computer-based intervention programme aimed at improving error awareness in individuals with TBI. A further aim was to explore its effects on metacognitive awareness and variability of performance. Participants were 11 individuals with TBI and impaired error awareness who performed a sustained attention task twice-weekly for four weeks. The intervention consisted of audio-visual feedback-on-errors during the sustained attention task. Six participants received audio-visual feedback-on-error, five did not receive feedback. Emergent and metacognitive awareness were measured pre- and post-intervention. Between-groups comparisons of emergent awareness from pre- to post-intervention showed that audio-visual feedback-on-error improved emergent awareness compared to no feedback-on-error. Some changes in metacognitive awareness of executive behaviours as a result of feedback were observed. Audio-visual feedback-on-error improved emergent awareness in individuals with TBI following a four-week/eight-session intervention. This improvement was not observed in the no-feedback group. This pilot intervention is not a stand-alone treatment but it has potential to be usefully incorporated into cognitive or clinical rehabilitation programmes to improve emergent awareness.

KEYWORDS:

• Awareness
• Brain injury
• Intervention
• Feedback
• Emergent awareness

Acknowledgements

The authors extend their special thanks to the patients of the National Rehabilitation Hospital, Dublin, Ireland and their families for taking part in this research.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by grants from the Health Research Board of Ireland [Grant Number PA-06-17], the National Rehabilitation Hospital Trust, University College Dublin Seed Fund, and the National Disability Authority of Ireland awarded to Dr. Simone Carton and provided to Dr. Mary FitzGerald to conduct the research.