Journal of the International Neuropsychological Society

Table of Contents - 2008 - Volume 14, Issue 01  


NEUROBEHAVIORAL GRAND ROUNDS

Long-term compensatory treatment of organizational deficits in a patient with bilateral frontal lobe damage

JESSICA  FISH  a1 c1 , TOM  MANLY  a1 and BARBARA A.  WILSON  a1 a2
a1 Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom
a2 The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, United Kingdom

Article author query
fish j   [PubMed][Google Scholar] 
manly t   [PubMed][Google Scholar] 
wilson ba   [PubMed][Google Scholar] 

Abstract

Evans et al. (1998) described compensatory strategy use in R.P., a patient with executive dysfunction following bilateral frontal lobe damage who had difficulty acting upon her intentions. A pager was used to remind R.P. of regularly scheduled activities, along with a checklist that aimed to moderate a perseverative routine. Although successful, 10 years after the original intervention, the strategies were no longer used, and considerable everyday problems were evident. In the current study, we conducted a follow-up assessment to examine potential reasons for this deterioration. No change in neuropsychological functioning was evident. Whereas the previous study introduced the two strategies together, and examined effects upon separate goals, in the current study we reintroduced the two strategies separately, and examined effects on three common goals. In addition to prompting specific activities, we aimed to support completion of more general goals (those that could be enacted within a wider window of time). The paging intervention had a dramatic effect on all three measured behaviors, at a much more consistent level than the checklist. We suggest that, in addition to direct reminders, the pager can cue a process of goal monitoring that bridges the gap between intention and action. (JINS, 2008, 14, 154–163.)

(Received October 6 2006)
(Revised July 18 2007)
(Accepted July 18 2007)


Key Words: Brain Injuries; Rehabilitation; Activities of Daily Living; Intention; Goals; Prospective Memory.

Correspondence:
c1 Correspondence and reprint requests to: Jessica Fish, MRC Cognition and Brain Sciences Unit, Box 58 Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ. E-mail: jessica.fish@mrc-cbu.cam.ac.uk

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