Putting the Pieces Together: Preliminary Efficacy of a Web-Based Family Intervention for Children with Traumatic Brain Injury

Wade, Shari L.; Wolfe, Christopher R.; Brown, Tanya M.; Pestian, John

doi:10.1093/jpepsy/jsi067

Cited by 146 publications

(214 citation statements)

References 21 publications

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“…One possible explanation for the lack of significant findings on burden may be that the mean baseline scores as well as those found post-implementation were in the average/non-distressed range, suggesting that there may have been a floor effect. Wade, Michaud, and Brown (2006) in their study on effects of a family problem-solving intervention for children with TBI found similar results for parental distress. In a more distressed sample, decreases in aggression might have been associated with greater improvements in nurses' burden.…”

Section: Discussionmentioning

confidence: 70%

Effects of a behaviour management technique for nursing staff on behavioural problems after acquired brain injury

Winkens

Heugten

Pouwels

et al. 2017

Neuropsychological Rehabilitation

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The ABC method is a behaviour management technique for use by nurses. ABC refers to the identification of Antecedent events, target Behaviours, and Consequent events. In this longitudinal intervention study with double baseline measurements we evaluated the effectiveness of the ABC method in patients with behavioural problems after acquired brain injury. Fifty-six patients participated in this study. Outcome was measured in terms of overall neuropsychiatric problem behaviour, aggression, apathy and emotional burden experienced by nurses. A process evaluation was performed to investigate usability and acceptability of the method and identify factors that influenced effectiveness. Friedman's ANOVA showed a small significant reduction over time in overall neuropsychiatric problem behaviour and aggression. The reduction was most prominent between the first baseline measurement and the post-implementation and follow-up measurements, not between the second baseline measurement and the post-implementation or followup measurements. This first group study on the effects of the ABC method could not prove this technique is effective for patients with behavioural problems after acquired brain injury. Nurses indicated that the ABC method was not fully implemented in their daily routines. This may have influenced results and makes it yet premature to draw firm conclusions on the effects of the ABC method.

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Section: Discussionmentioning

confidence: 70%

Effects of a behaviour management technique for nursing staff on behavioural problems after acquired brain injury

Winkens

Heugten

Pouwels

et al. 2017

Neuropsychological Rehabilitation

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“…Indeed, telerehabilitation for MANUSCRIPT ACCEPTED -BRAIN INJURY: 02 FEBRUARY 2017 17 people with TBI featured in 38 of the included papers (see Table 2), comprising 2 systematic reviews [39,79], 22 group comparison trials [23][24][25]30,35,52,58,74,77,82,84,[98][99][100][104][105][106][108][109][110][111]113], 9 case series [28,50,80,83,93,97,101,102,107] Importantly, no statistically significant differences were found between the tele-practice and face-to-face intervention delivery methods [39,79].…”

Section: Telerehabilitationmentioning

confidence: 99%

Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI)

et al. 2017

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distinct from motor speech impairments or primary language impairments (e.g. aphasia), in that the impairments arise from the diffuse axonal injuries which occur in frontal and prefrontal areas of the brain [6]. These impairments can be defined as any aspect of communication that result from underlying deficits in cognition [4,5,7].Communication difficulties after a TBI can affect how a person hears, listens, understands, speaks, reads, writes, and how they engage in conversation and social communication [5]. The underlying deficits of cognition that affect these communicative functions can include slowed information processing; impaired working memory and attention; disorientation and disorganisation; executive function problems including rigidity, poor conceptualization, planning, and problem solving; and poor self-control or selfregulation of cognition or behaviour [4,5]. As a result of these changes in cognitivecommunicative processes, people with TBI have been described as 'overtalkative, inefficient, tangential or drifting from topic to topic, or lacking in language output. ' [4] (p.354). These cognitive-communication impairments can restrict a person's ability to communicate, live independently, return to work or education, participate in society, and build or maintain relationships after their TBI [8].The International Cognitive (INCOG) guidelines for the management of a person's cognitive rehabilitation following TBI highlight that assessment of cognitive-communication skills should incorporate performance in everyday social activities [4]. Adolescents and young adults, the group most at risk of TBI, use digital and online communication MANUSCRIPT ACCEPTED -BRAIN INJURY: 02 FEBRUARY 2017 4 technologies from a young age [9] and, following TBI, involvement in social, academic, and societal situations may be reduced with difficulties using technology and social media [5]. As a result, people with cognitive-communication impairments resulting from a TBI face challenges in accessing information independently and engaging effectively in social networks [8]. However, little is known about how people with cognitive-communication impairments after TBI use and experience digital communication and the internet.Furthermore, clinical guidelines for the assessment of cognitive-communication skills following a TBI do not provide guidance on the use of social media, or of assistive technologies (AT) to support cognitive-communication rehabilitation [4,5].In order to review the existing literature on technology it is essential to consider which types of technology appear in relation to TBI and cognitive-communication. In this study, we considered three major categories of technology: (i) Assistive Technology (AT), being 'any item, piece of equipment, or product, whether it is acquired commercially, includes technology such as email, the internet, and mobile phones [13] which enable users to access, store, transmit, and manipulate information [14]. The multiple purposes of the different types of technology selected ...

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“…21 Problem-solving training has demonstrated promise in various clinical populations [22][23][24][25][26] ; however, it has only been preliminarily explored in pediatric TBI. [27][28][29][30][31][32][33][34] In a small randomized trial of children aged 5 to 17 years (N = 32), findings showed that family-centered online problem-solving therapy improved internalizing behavioral problems after severe TBI. 32 Initial evidence suggests that problem-solving interventions can also be delivered effectively through a web-based portal directly to children with TBI.…”

Section: Discussionmentioning

confidence: 99%

“…[27][28][29][30][31][32][33][34] In a small randomized trial of children aged 5 to 17 years (N = 32), findings showed that family-centered online problem-solving therapy improved internalizing behavioral problems after severe TBI. 32 Initial evidence suggests that problem-solving interventions can also be delivered effectively through a web-based portal directly to children with TBI. 35 In a small randomized-controlled trial of adolescents aged 11 to 18 years (n = 35), teendirected online problem-solving improved both parent-and self-reported behavioral problems 33 but only improved self-ratings, not parent-ratings, of executive dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Online Problem-Solving Therapy for Executive Dysfunction After Child Traumatic Brain Injury

2013

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT:Cognitive and behavioral problems after pediatric traumatic brain injury lead to poor functioning across multiple settings and can persist long-term after injury. Executive dysfunction is particularly common; however, there is a paucity of evidence-based interventions to guide treatment. WHAT THIS STUDY ADDS:This study is among the largest randomized controlled trials performed in pediatric traumatic brain injury. It demonstrates the ability to use an online problemsolving-based intervention to improve caregiver ratings of executive dysfunction within 12 months after injury. abstract OBJECTIVE: Executive dysfunction after traumatic brain injury (TBI) in children is common and leads to significant problems in functioning across multiple settings. The objective of this study was to evaluate the efficacy of a web-based counselor-assisted problem solving (CAPS) intervention compared with an Internet resource comparison (IRC) for treatment of executive dysfunction within 12 months after complicated mild to severe TBI in adolescents. We hypothesized that CAPS would significantly improve parent ratings of executive dysfunction compared with an IRC. METHODS:Participants included 132 adolescents aged 12 to 17 years who sustained a complicated mild to severe TBI within 1 to 6 months before study enrollment. Study design was a multisite, assessorblinded, randomized controlled trial. Study sites included 3 tertiary pediatric hospitals and 2 tertiary general medical centers. The main outcome measure was primary caregiver Behavioral Rating Inventory of Executive Function Global Executive Composite at baseline and 6-month follow-up. Generalized linear models that controlled for baseline scores were used to compare the CAPS and IRC scores. RESULTS:In older teens, the CAPS group showed significant improvement in executive function behaviors at 6-month follow-up compared with the IRC group (F = 6.74, P = .01, Cohen' s d = 0.63). CONCLUSIONS:Findings indicate that web-based CAPS improves primary caregiver-rated executive functioning within the first 12 months after TBI in older adolescents. Future research needs to define the optimal timing after injury for delivery of CAPS and characteristics of individuals and families who are most likely to benefit from CAPS. Pediatrics 2013;132:e158-e166 AUTHORS:

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Putting the Pieces Together: Preliminary Efficacy of a Web-Based Family Intervention for Children with Traumatic Brain Injury

Cited by 146 publications

References 21 publications

Effects of a behaviour management technique for nursing staff on behavioural problems after acquired brain injury

Effects of a behaviour management technique for nursing staff on behavioural problems after acquired brain injury

Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI)

Online Problem-Solving Therapy for Executive Dysfunction After Child Traumatic Brain Injury

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