Attention and EF Interventions

Question 1

What is the evidence-based guideline for ABI?

Answer 1

Cicerone reviews, most recent 2019

Question 2

What is the evidence-based guideline for TBI?

Answer 2

INCOG, most recent 2023.

Question 3

What is the Cicerone (2019) practice standard for treatment of attention?

Answer 3

Treatment needs to incorporate both direct-attention training and metacognitive strategy after TBI/stroke

Question 4

What is the Cicerone (2019) practice standard for EF?

Answer 4

Metacognitive strategy training (self-monitoring and self-regulation) is recommended for mild-moderate EF impairments. For severe EF deficits, a practice option is errorless learning for specific functional tasks

Question 5

What are some of the level A evidence for INCOG (2023) attention recommendations?

Answer 5

• Metacognitive strategy should be used in TBI, esp for mild-mod attention impairment
• Training in dual-tasking in TBI is useful for only the tasks similar to those trained
• Mindfulness-based meditation is not recommended for attention deficits post TBI
• Methylphenidate is recommended in adult with TBI to enhance info processing speed

Question 6

What are some of the level A evidence for INCOG (2023) EF recommendations?

Answer 6

• Monitoring and feedback
• Self-awareness training (e.g. video feedback)
• Metacognitive strategies
• Strategies to improve reasoning skills
• Group-based interventions
• Rhythmical/music therapy
• VR

Question 7

What is self-instructional training?

Answer 7

The regulation of sustained attention through self-instructional techniques (e.g. verbal cue to ‘focus’).