Wilson et al. (2009)

United Kingdom

RCT

PEDro=5

N=12

Population: ABI: TBI=6, Developmental Deficits=5, Anoxia=1; Mean Age=13.58yr; Gender: Male=10, Female=2.

Intervention: Patients were randomised into two groups: One group received a pager (n=4), and the other was put on a waiting list (n=8). Patients with the pager received messages containing memory and planning cues for 7wk with self-report diaries completed for the last 2wk of the intervention. Cues included necessary items for school, homework reminders, hygiene, and medication. Waiting list patients completed diaries at the same time as the pager group. Groups crossed over at the end of the first phase. Assessments were completed at baseline, post-treatment, and post-treatment after crossover.

Outcome Measure: Number of Target Behaviours Accomplished.

1.       The pager group achieved 92% of their target behaviours at post-treatment indicating a significant gain from baseline (p<0.001).

2.       After crossover, those in the pager group were still able to meet 81% of their target behaviours. Although this represented a significant decrease from during the intervention (p<0.001), this was still a significant improvement from baseline (p=0.003).

3.       The waiting list group did not demonstrate any improvements from baseline to intervention (p=0.260) but after crossover, the waiting list group achieved 80% of their target behaviours with the pagers (p<0.001).

4.       All participants demonstrated significant improvements in target behaviours completed over the entirety of the study (p<0.050).

Melchers et al. (1999)

Germany

RCT

PEDro=2

N=45

Population: TBI; Experimental Group (n=21): Median Age=11.5yr; Gender: Male=11, Female=10; GCS Score=<8. Controls (n=19): Median Age=11yr; Gender: Male=14, Female=5; GCS Score=<8. Escape (n=5): Median Age=13yr; Gender: Male=3, Female=2; GCS Score=<8.

Intervention: Patients were randomized to receive stimulation during coma and neuropsychological rehabilitation upon awakening, or routine treatment. Stimulation included visual (coloured lights and objects), tactile (soft touches and massage), auditory, olfactoric (food and drink) and gustatory (salty, sour, sweet water) if not being ventilated. Stimulation was performed for 45 min, 2x/d during coma followed by neuropsychological rehabilitation for 9 wk. Follow-ups were conducted at 6 mo, 12 mo and 24 mo.

Outcome Measure: Kaufman-Assessment Battery for Children (K-ABC), Intelligenz Struktur Test (IST-70), Enzephalopathie-Fragebogen (E-F).

1.       After K-ABC and IST-70 scores were combined, preliminary results at 6mo follow-up revealed that the experimental group had regained average intellectual abilities while the control group were still at the same low level.

2.       At 12 mo follow-up, K-ABC + IST-70 combined intelligence scores in the experimental group had returned to age-average levels but the controls demonstrated further decline.

3.       Non-verbal learning scores improved in both groups at 6 mo follow-up, more so for controls. At 12 mo follow-up, the experimental group continued to improve but the controls declined slightly from their 6 mo scores.

4.       Psychopathological changes according to the E-F were stable for the experimental group but were worse for the controls at 6mo and 12 mo follow-ups.

Ho et al. (2011)

Australia

Pre-Post

N=15

Population: ABI=12, Stroke=3; Mean Age=13.43 yr; Gender: Male=7, Female=8; Mean Time Post-Injury=5.79 yr; Mean GCS=9.33.

Intervention: All participants underwent a memory rehabilitation program consisting of 6 1.5 hr sessions involving self-instruction and diary entry training. Outcome measures were completed at baseline, post-treatment, and 2 wk follow-up.

Outcome Measure: Parent Memory Questionnaire (PMQ), Child Memory Questionnaire (CMQ), weekly diary entries, Creature Counting, Sky Search Divided Task, Sky Search, Child Behaviour Checklist (CBCL), Youth Self Report (YSR), Rey Auditory Verbal Learning Test (RAVLT).

1.       Significant increase in perceived memory (PMQ/CMQ) from pre to post-treatment (p<.050) but not at follow-up.

2.       Increased number of diary entries correlated with improved perceived memory (CMQ; p<.050).

3.       PMQ significantly correlated with the number of correct answers on the Creature Counting (p<0.010) and the Sky Search Divided Task (p<0.050).

4.       CMQ significantly correlated with time and attention on the Sky Search (all p<0.010) as well as the internalising problems on the CBCL and YSR (all p<0.050).

5.       Weekly number of diary entries significantly correlated with the time portion of the Sky Search and Creature Counting (all p<0.050) as well as with the externalising problems of the YSR (p<0.050).

6.       PMQ, CMQ and weekly diary entries did not correlate with RAVLT (p>0.050).

Brett & Laatsch (1998)

USA

Pre-Post

N=10

Population: ABI: TBI=9, Viral Encephalopathy=1; Mean Age=16.2yr; Gender: Male=6, Female=4; Mean Time Post Injury=6.6 yr.

Intervention: Patients received cognitive rehabilitation therapy biweekly with each session lasting approximately 40 min. The therapy focused on alertness, attention, concentration, perception, memory skills, and problem solving. Assessments were completed at baseline and post-treatment.

Outcome Measure: Wide Range Assessment of Memory and Learning (WRAML), Test of Nonverbal Intelligence-2 (TONI-2), Benton Visual Form Discrimination Test (BVFDT), Tower of London (ToL), Wisconsin Card Sorting Test (WCST), Stroop Test, Wechsler Intelligence Scale for Children-III-Freedom from Distractibility Scale (WISC-III FDS), WISC-III Picture Completion Subtest (WISC-III PCS).

1.       Of all the mental functioning measures, only WRAML memory scores significantly improved post-treatment (p=0.025).

2.       Patients were observed utilising verbal memory skills during post-treatment testing.

3.       No significant improvements were found on any of the other measures including TONI-2 (p=0.200), BVFDT (p=0.075), ToL (p=0.077), WCST (p=0.906), Stroop Test (p=0.137), WISC-III FDS (p=0.114), and WISC-III PCS (p=0.115).