We reviewed 3 class I95 and 96 or Ia97 studies, 2 class II studies,98 and 99 and 14 class III studies100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112 and 113
addressing the remediation of executive functioning, including training in metacognitive strategies to increase awareness. Two of the class I and Ia studies95 and 97 compared an awareness-training protocol with conventional occupational therapies after moderate or severe TBI (n=33) or stroke (n=8). In 1 of these studies,97 the awareness-training protocol incorporated feedback selleckchem to increase participants’ awareness of their abilities, with experiential exercises requiring participants to predict, self-monitor, and self-evaluate their performance. Improvements in awareness, performance of IADLs, and overall function were evident for both
groups. The awareness intervention was associated with greater increase in self-awareness of deficits after VE-822 price treatment, but not with better performance of IADLs or general functioning compared with conventional rehabilitation. The second class I study95 employed self-awareness and verbal self-regulation strategies during performance of IADLs tasks. Participants were asked to define their performance goals, predict task performance, anticipate difficulties, select a strategy to circumvent difficulties, assess the amount of assistance required to successfully perform the task, and self-evaluate performance. Participants in the control condition performed the same IADLs tasks as the treatment group, but received conventional practice without the awareness intervention. Participants who received the awareness intervention demonstrated significant improvements in self-regulation skills and cognitive aspects of IADLs performance when compared with participants receiving conventional therapy, whose performance either did not improve or decline. No differences between groups were evident
on either general or task-specific measures of awareness or a measure of community integration after the 6 treatment sessions. Phosphoglycerate kinase A number of single-case studies support the benefits of metacognitive training and suggest that the most consistent benefits of this treatment are apparent on participants’ online monitoring, awareness of errors, and error management.104 and 108 One class I study96 evaluated the use of autobiographical memory cuing to improve performance on a planning task by people with TBI. Participants in the experimental group received a single session of instruction on the use of specific examples from their memory of similar activities in order to solve a functional problem situation (eg, planning a vacation). The intervention was successful in increasing the recall of specific memories and effectiveness of functional planning, suggesting that this procedure might be an effective component of training on problem-solving techniques.