Development and evaluation of a pictorial-based analogical problem-solving programme for people with traumatic brain injury.

BACKGROUND: People with traumatic brain injury (TBI) must often deal with cognitive problems, including social problem-solving. The study reported herein evaluated the effectiveness of a newly developed pictorial-based analogical problem-solving skills training programme. It is hypothesized that the programme can help people with TBI to learn better problem-solving skills through systematic, theoretically driven learning strategies. METHOD: Based on the instrumental enrichment model and the hierarchy of daily problem-solving as suggested by Holloran and Bressler, analogical problem-solving training software was developed. Thirty subjects with TBI then attended a 20-session interactive analogical problem-solving skills training programme. Another 20 subjects with TBI and of similar demographics formed the control group. The outcome measures included session-based quizzes on analogical problem-solving, the Category Test of the Halstead Reitan Test Battery (HRTB) and the Lawton IADL Scale. FINDINGS: The analogical problem-solving training strategies were found to be effective in improving problem-solving skills. The subjects generally demonstrated a selective improvement in their functional and overall problem-solving skills, but not in their basic problem-solving skills. The subjects in the control group showed stable problem-solving skills over a 4-week interval (no statistically significant changes). The findings indicated the therapeutic significance of the training programme. CONCLUSIONS: The results of the study suggested that innovative cognitive rehabilitation programmes can be customized to match the needs of clients with TBI. The applicability and implications of the interactive pictorial-based analogical problem-solving skill-training programme that was used in the study and possibilities for future study in this research area are also discussed.

A pilot study on the effectiveness of tele-analogy-based problem-solving training for people with brain injuries.

People with brain injuries must often deal with cognitive problems, including social problem solving. The present study evaluated the effectiveness of a 20-session, online, interactive, skill-training programme on the solving of problems using analogies. It was hypothesized that the programme could help people with brain injuries learn better problem-solving skills through systematic, theoretically driven learning strategies. Fifteen Hong Kong-Chinese with brain injuries participated in this pilot study. They were randomly assigned to an online programme, a computer-assisted programme or a therapist-administered programme. The three programmes had a similar structure and contents, including basic components problem solving, reflective sessions and functional problem solving. Outcome measures included the Category Test of Halstead-Reitan Test Battery, and a daily problem-solving performance and self-efficacy checklist. The results showed that the subjects of the three programmes generally demonstrated higher post-training self-efficacy and basic problem-solving skills. The group using the online programme, however, showed better and quicker improvements in problem-solving performance, and demonstrated a general trend towards making fewer errors in complex problem-solving tasks. In conclusion, people with brain injuries can use the successful problem-solving experiences obtained in the training programmes with different delivery modes to solve daily living problems that are similar in nature. However, the generalizability of the effects of the programme is still to be determined.