American Speech-Language-Hearing Association

EBP Compendium: Summary of Systematic Review

Academy of Neurologic Communication Disorders and Sciences; American Speech-Language-Hearing Association; Department of Veterans Affairs
Intervention for Executive Functions after Traumatic Brain Injury: A Systematic Review, Meta-Analysis and Clinical Recommendations

Kennedy, M., Coelho, C., et al. (2008).
Neuropsychological Rehabilitation, 18(3), 257-299.

Indicators of Review Quality:

The review addresses a clearly focused question Yes
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality Yes
Quality assessments are reproducible Yes

Description: This is a review of quantitative studies investigating the effect of executive function treatments targeting problem solving, planning, organizing and multitasking following traumatic brain injury. Treatments were categorized by those using 1) metacognitive strategy instruction (MSI), 2) training strategic thinking/verbal reasoning and 3) training multi-tasking.

Question(s) Addressed:

  1. What should intervention look like to be efficacious or effective?
  2. Who is the best candidate for this intervention, as described by the research evidence?
  3. What outcomes should be expected from this intervention, are they maintained over time and generalized to untrained activites or other contexts?

Population: Adults with traumatic brain injury

Intervention/Assessment: Executive function interventions focusing on problem solving, planning, organizing and multi-tasking.

Number of Studies Included: 15

Years Included: Through 2004

Findings:

Conclusions:

  • Treatment
    • Cognition
      • Metacognitive Treatments
        • Sufficient evidence was found to support the use of MSI treatments using step-by-step training procedures to improve organization and problem solving. Effect sizes after MSI treatment and control treatment both improved significantly on measures of impairment. However compared to controls, effect sizes after MSI treatments were significantly larger for activity/participation outcomes.
        • Insufficient data was provided to determine the maintenance effects of MSI; “although maintenance effects were generally positive” (p. 258). The authors found insufficient evidence for treatments that utilized verbal reasoning or multi-tasking approaches, but suggested these interventions were promising.

Keywords: Brain Injury, Executive Function

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Added to Compendium: January 2012

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