Goal Management Training improves everyday executive functioning for persons with spina bifida: Self-and informant reports six months post-training

Abstract

Executive dysfunction accounts for significant disability for many patients with spina bifida (SB), thus indicating the need for effective interventions aimed at improving executive functioning in this population. Goal Management Training™ (GMT) is a cognitive rehabilitation approach that targets disorganised behaviour resulting from executive dysfunction, and has received empirical support in studies of other patient groups. The purpose of this study was to determine if GMT would lead to perceived improved executive functioning in the daily lives of patients with SB, as evidenced by reduced report of dysexecutive problems in daily life on self- and informant questionnaires. Thirty-eight adults with SB were included in this randomised controlled trial (RCT). Inclusion was based upon the presence of executive functioning complaints. Experimental subjects (n = 24) received 21 hours of GMT, with efficacy of GMT being compared to results of subjects in a wait-list condition (n = 14). All subjects were assessed at baseline, post-intervention, and at six-month follow-up. Self-report measures indicated that the GMT group's everyday executive functioning improved significantly after training, lasting at least 6 months post-treatment.

There were no significant effects on informant-report questionnaires. Overall, these findings indicate that executive difficulties in everyday life can be ameliorated for individuals with congenital brain dysfunction.

Keywords:

• Executive functioning
• Cognitive rehabilitation
• Brain injury
• Goal management
• Evidence-based.

The authors would like to thank all patients, caregivers and staff, especially Astri Andersen, Lisbeth Brøndberg, Gunnar Riemer, Lena Haugen, Karen Grimsrud, Brede Dammann, Pål-Erik Plaum, Helene Barder, Per Frydenborg and Solveig Skou who helped to carry out the study. We also thank Marianne Løvstad and Jan Egil Nordvik for discussions concerning this study.This work was supported by the South-Eastern Norway Regional Health Authority (grant number 2011041).