American Speech-Language-Hearing Association

EBP Compendium: Summary of Systematic Review

Academy of Neurologic Communication Disorders and Sciences
Self-Regulation after Traumatic Brain Injury: A Framework for Intervention of Memory and Problem Solving

Kennedy, M. R., & Coelho, C. (2005).
Seminars in Speech and Language, 26(4), 242-255.

Indicators of Review Quality:

The review addresses a clearly focused question No
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 No
Quality assessments are reproducible N/A

Description: This is a review of intervention studies investigating self-regulation or self-awareness of memory, learning, and problem solving following traumatic brain injury.

Question(s) Addressed:

Question not specifically stated.

Population: Individuals with traumatic brain injury.

Intervention/Assessment: Interventions focusing on self-regulation or self-awareness of memory, learning, and problem solving.

Number of Studies Included: Over 30 studies

Years Included: Through 2004

Findings:

Conclusions:

  • Treatment
    • Cognition (Adults)
      • Metacognitive Treatments
        • Interventions targeting self-regulation or self-monitoring were limited. However, the authors consider these treatments to be promising based on the documented efficacy of other treatments using step-by-step training procedures to improve problem solving which include the use of self-monitoring or self-checking systems.
        • The authors concluded that individuals with traumatic brain injury "will be successful at regulating behavior to the extent that their internal feedback (i.e., self-monitoring) is accurate" (p. 252), and the clinician incorporates these situations into treatment.
        • The authors also suggest that the "connection between self-monitoring and strategy decisions should be made explicit for the client through instruction" (p. 252).
        • Finally, generalization of self-regulation should be facilitated for individuals with traumatic brain injury as there is no evidence to support spontaneous generalization for this population.
    • Cognitive-Communication (Children)
      • Self-Regulated Learning
        • “The first step in this self-monitoring approach is to identify conditions, situations, tasks, and an activity in which self-monitoring is likely to be accurate or inaccurate” (p. 252).
        • “If feedback is provided by clinicians, a necessary step would be to identify situations, conditions, and tasks in which the client’s own feedback (e.g., self-predictions) is accurate and educate the client about these conditions before training the use of this feedback to make strategy decisions” (p. 252).
        • “The connection between self-monitoring and strategy decisions should be made explicit for the client through instruction” (p. 252).
        • The current evidence suggests “we should facilitate generalization by providing multiple opportunities to practice the strategies in various contexts and under constrained and unconstrained conditions. During this application phase, individuals should actively self-monitor their performance and compare what they predicted with their actual performance” (p. 253).

Keywords: Brain Injury, Problem Solving, Executive Function, Memory

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Added to Compendium: March 2012

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