The feasibility and acceptability of goal management training of executive functions in children with spina bifida and acquired brain injury

ABSTRACT

Executive dysfunction causes significant real-life disability for children with spina bifida (SB) and acquired brain injury (ABI), and efficient interventions are needed. Goal Management Training (GMT) is a cognitive rehabilitation intervention for improving executive function (EF) that has received empirical support in studies of adults with SB and ABI. The purpose of this study was to determine the feasibility and acceptability of a newly developed pediatric GMT protocol (pGMT). Thirteen children (7 boys, 10–16 years) with SB (n = 4), traumatic brain injury (n = 8), and encephalitis (n = 1) were included, based upon the presence of EF problems as described by parents. The participants received 21 h of pGMT, using inpatient intervention periods, followed by 4 h of pGMT outpatient guidance over 8 weeks. Notably, pGMT was found to be both feasible and acceptable, with satisfactory compliance for the children, parents and teachers, in addition to being considered acceptable by all participants. Furthermore, a reliable change in daily life EF was reported by the parents for 2 children. And, some children obtained scores below clinical cut-off on a measure of parent reported real-life EF after intervention. Hence, findings suggest that a randomized controlled trial of pGMT, with a larger sample size, should be conducted.

KEYWORDS:

• Executive functioning
• Cognitive rehabilitation
• Brain injury
• Goal management
• Child

Acknowledgements

The authors thank the participants, and the staff at the TRS National Resource Centre for Rare Disorders, and the children’s clinics at Sunnaas Rehabilitation Hospital and St. Olavs Hospital.

Disclosure statement

No potential conflict of interest was reported by the author(s).