Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-17T05:16:48.374Z Has data issue: false hasContentIssue false
  • English
  • Français

Do Old Errors Always Lead to New Truths? A Randomized Controlled Trial of Errorless Goal Management Training in Brain-Injured Patients

Published online by Cambridge University Press:  08 September 2015

Dirk Bertens ,
Roy P.C. Kessels ,
Eleonora Fiorenzato ,
Danielle H. E. Boelen  and
Luciano Fasotti
Dirk Bertens*
Affiliation:
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
Roy P.C. Kessels
Affiliation:
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands Radboud University Medical Center, Department of Medical Psychology, Nijmegen, The Netherlands Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
Eleonora Fiorenzato
Affiliation:
University of Padova, Department of General Psychology, Padova, Italy
Danielle H. E. Boelen
Affiliation:
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands Rehabilitation Medical Centre Groot Klimmendaal, Arnhem, The Netherlands
Luciano Fasotti
Affiliation:
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands Rehabilitation Medical Centre Groot Klimmendaal, Arnhem, The Netherlands
*
Correspondence and reprint requests to: Dirk Bertens, Montessorilaan 3, 6500 HE Nijmegen, The Netherlands. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Both errorless learning (EL) and Goal Management Training (GMT) have been shown effective cognitive rehabilitation methods aimed at optimizing the performance on everyday skills after brain injury. We examine whether a combination of EL and GMT is superior to traditional GMT for training complex daily tasks in brain-injured patients with executive dysfunction. This was an assessor-blinded randomized controlled trial conducted in 67 patients with executive impairments due to brain injury of non-progressive nature (minimal post-onset time: 3 months), referred for outpatient rehabilitation. Individually selected everyday tasks were trained using 8 sessions of an experimental combination of EL and GMT or via conventional GMT, which follows a trial-and-error approach. Primary outcome measure was everyday task performance assessed after treatment compared to baseline. Goal attainment scaling, rated by both trainers and patients, was used as secondary outcome measure. EL-GMT improved everyday task performance significantly more than conventional GMT (adjusted difference 15.43, 95% confidence interval [CI] [4.52, 26.35]; Cohen’s d=0.74). Goal attainment, as scored by the trainers, was significantly higher after EL-GMT compared to conventional GMT (mean difference 7.34, 95% CI [2.99, 11.68]; Cohen’s d=0.87). The patients’ goal attainment scores did not differ between the two treatment arms (mean difference 3.51, 95% CI [−1.41, 8.44]). Our study is the first to show that preventing the occurrence of errors during executive strategy training enhances the acquisition of everyday activities. A combined EL-GMT intervention is a valuable contribution to cognitive rehabilitation in clinical practice. (JINS, 2015, 21, 639–649)

Keywords

RehabilitationChronic brain injuryLearningActivities of daily livingExecutive functionRandomized controlled trial
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 21 , Issue 8 , September 2015 , pp. 639 - 649
Copyright
Copyright © The International Neuropsychological Society 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baddeley, A. (1992). Implicit memory and errorless learning: A link between cognitive theory and neuropsychological rehabilitation? In L.R. Squire & N. Butters (Eds.), Neuropsychology of memory (2nd ed., pp. 309–314). New York: Guilford Press.Google Scholar
Baddeley, A., & Wilson, B.A. (1994). When implicit learning fails: Amnesia and the problem of error elimination. Neuropsychologia, 32, 53–68.CrossRefGoogle ScholarPubMed
Bertens, D., Fasotti, L., Boelen, D.H., & Kessels, R.P.C. (2013). A randomized controlled trial on errorless learning in goal management training: Study rationale and protocol. BMC Neurology, 13, 64.CrossRefGoogle ScholarPubMed
Bertens, D., Frankenmolen, N., Boelen, D.H.E., Kessels, R.P.C., & Fasotti, L. (2015). Validity of an adapted scoring method for a Modified Six Elements Test in individuals with brain injury. Archives of Clinical Neuropsychology, 30, 122–129.CrossRefGoogle ScholarPubMed
Boelen, D.H., Spikman, J.M., Rietveld, A.C., & Fasotti, L. (2009). Executive dysfunction in chronic brain-injured patients: Assessment in outpatient rehabilitation. Neuropsychological Rehabilitation, 19, 625–644.CrossRefGoogle ScholarPubMed
Bovend’Eerdt, T.J., Botell, R.E., & Wade, D.T. (2009). Writing SMART rehabilitation goals and achieving goal attainment scaling: A practical guide. Clinical Rehabilitation, 23, 352–361.CrossRefGoogle ScholarPubMed
Brazier, J.E., Harper, R., Jones, N.M., O’Cathain, A., Thomas, K.J., Usherwood, T., &Westlake, L. (1992). Validating the SF-36 health survey questionnaire: New outcome measure for primary care. British Medical Journal, 305, 160–164.CrossRefGoogle ScholarPubMed
Broadbent, D.E., Cooper, P.F., FitzGerald, P., & Parkes, K.R. (1982). The Cognitive Failures Questionnaire (CFQ) and its correlates. British Journal of Clinical Psychology, 21, 1–16.CrossRefGoogle ScholarPubMed
Burgess, P.W., & Shallice, T. (1997). The Hayling and Brixton tests. Bury St. Edmunds, UK: Thames Valley Test Company.Google Scholar
Burgess, P.W., & Simons, J. (2005). Theories of frontal lobe executive function: Clinical applications. In P.W. Halligan & D. Wade (Eds.), Effectiveness of rehabilitation for cognitive deficits (pp. 211–213). Toronto: Oxford University Press.CrossRefGoogle Scholar
Cicerone, K., Levin, H., Malec, J., Stuss, D.T., & Whyte, J. (2006). Cognitive rehabilitation interventions for executive function: Moving from bench to bedside in patients with traumatic brain injury. Journal of Cognitive Neuroscience, 18, 1212–1222.CrossRefGoogle ScholarPubMed
Clare, L., & Jones, R.S. (2008). Errorless learning in the rehabilitation of memory impairment: A critical review. Neuropsychological Review, 18, 1–23.CrossRefGoogle ScholarPubMed
Cohen, M., Ylvisaker, M., Hamilton, J., Kemp, L., & Claiman, B. (2010). Errorless learning of functional life skills in an individual with three aetiologies of severe memory and executive function impairment. Neuropsychological Rehabilitation, 20, 355–376.CrossRefGoogle Scholar
Dawson, D.R., Binns, M.A., Hunt, A., Lemsky, C., & Polatajko, H.J. (2013). Occupation-based strategy training for adults with traumatic brain injury: A pilot study. Archives of Physical Medicine Rehabilitation, 94, 1959–1963.CrossRefGoogle ScholarPubMed
De Werd, M., Boelen, D., Olde Rikkert, M.G.M., & Kessels, R.P.C. (2013). Errorless learning of everyday tasks in people with dementia. Journal of Clin Interventions in Aging, 8, 1177–1190.Google ScholarPubMed
Dechamps, A., Fasotti, L., Jungheim, J., Leone, E., Dood, E., Allioux, A., &Kessels, R.P.C. (2011). Effects of different learning methods for instrumental activities of daily living in patients with Alzheimer’s dementia: A pilot study. American Journal of Alzheimer Disease and Other Dementias, 26, 273–281.CrossRefGoogle ScholarPubMed
Duncan, J. (1986). Disorganization of behavior after frontal-lobe damage. Cognitive Neuropsychology, 3(3), 271–290.CrossRefGoogle Scholar
Evans, C., Margison, F., & Barkham, M. (1998). The contribution of reliable and clinically significant change methods to evidence-based mental health. Evidence Based Mental Health, 1, 70–72.CrossRefGoogle Scholar
Fish, J.E., Evans, J.J., Nimmo, M., Martin, E., Kersel, D., Bateman, A., & Manly, T. (2007). Rehabilitation of executive dysfunction following brain injury: “Content-free” cueing improves everyday prospective memory performance. Neuropsychologia, 45, 1318–1330.CrossRefGoogle ScholarPubMed
Fish, J.E., Manly, T., Kopelman, M.D., & Morris, R.G. (2015) Errorless learning of prospective memory tasks: An experimental investigation in people with memory disorders. Neuropsychological Rehabilitation, 25, 159–188.CrossRefGoogle ScholarPubMed
Graff, M.J.L., Vernooij-Dassen, M.J.M., Thijssen, M., Dekker, J., Hoefnagels, W.H.L., & Olde Rikkert, M.G.M. (2006). Community based occupational therapy for patients with dementia and their care givers: Randomised conotrolled trial. British Medical Journal, 333, 1196.CrossRefGoogle ScholarPubMed
Grant, M., Ponsford, J., & Bennett, P.C. (2012). The application of Goal Management Training to aspects of financial management in individuals with traumatic brain injury. Neuropsychological Rehabilitation, 22, 852–873.CrossRefGoogle ScholarPubMed
Hammer, A., Mohammadi, B., Schmicker, M., Saliger, S., & Munte, T.F. (2011). Errorless and Errorful Learning modulated by transcranial direct current stimulation. BMC Neuroscience, 12, 72.CrossRefGoogle ScholarPubMed
Hammer, A., Tempelmann, C., & Münte, T.F. (2013). Recognition of face-name associations after errorless and errorful learning: An fMRI study. BMC Neuroscience, 14, 30.CrossRefGoogle ScholarPubMed
Hart, T., & Evans, J. (2006). Self-regulation and goal theories in brain injury rehabilitation. Journal of Head Trauma Rehabilitation, 21, 142–155.CrossRefGoogle ScholarPubMed
Jacobson, N.S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.CrossRefGoogle ScholarPubMed
Kessels, R.P.C., & De Haan, E.H.F. (2003). Implicit learning in memory rehabilitation: A meta-analysis on errorless learning and vanishing cues methods. Journal of Clinical and Experimental Neuropsychology, 25, 805–814.CrossRefGoogle ScholarPubMed
Kiresuk, T.J., & Sherman, R.E. (1968). Goal attainment scaling: A general method for evaluating comprehensive community mental health programs. Community Mental Health Journal, 4, 443–453.CrossRefGoogle Scholar
Krasny-Pacini, A., Chevignard, M., & Evans, J. (2014). Goal management training for rehabilitation of executive functions: A systematic review of effectiveness in patients with acquired brain injury. Disability and Rehabilitation, 36, 105–116.CrossRefGoogle ScholarPubMed
Levine, B., Robertson, I.H., Clare, L., Carter, G., Hong, J., Wilson, B.A., &Stuss, D.T. (2000). Rehabilitation of executive functioning: An experimental-clinical validation of goal management training. Journal of the International Neuropsychological Society, 6, 299–312.CrossRefGoogle ScholarPubMed
Manly, T., Hawkins, K., Evans, J., Woldt, K., & Robertson, I.H. (2002). Rehabilitation of executive function: Facilitation of effective goal management on complex tasks using periodic auditory alerts. Neuropsychologia, 40, 271–281.CrossRefGoogle ScholarPubMed
Middleton, E.L., & Schwartz, M.F. (2012). Errorless learning in cognitive rehabilitation: a critical review. Neuropsychological Rehabilitation, 22, 138–168.CrossRefGoogle ScholarPubMed
Miotto, E.C., Evans, J.J., De Lucia, M.C., & Scaff, M. (2009). Rehabilitation of executive dysfunction: A controlled trial of an attention and problem solving treatment group. Neuropsychological Rehabilitation, 19, 517–540.CrossRefGoogle ScholarPubMed
Nelson, H.E., & O’Connell, A. (1978). Dementia: The estimation of premorbid intelligence leverls using the National Adult Adult Reading Test. Cortex, 14, 234–244.CrossRefGoogle Scholar
Pitel, A.L., Beaunieux, H., Lebaron, N., Joyeux, F., Desgranges, B., & Eustache, F. (2006). Two case studies in the application of errorless learning techniques in memory impaired patients with additional executive deficits. Brain Injury, 20, 1099–1110.CrossRefGoogle ScholarPubMed
Robertson, I.H. (1996). Goal management training: A clinical manual. Cambridge: Psyconsult.Google Scholar
Sartori, G., Colombo, L., Vallar, G., Rusconi, M.L., & Pinarello, A.T.I.B. Test di intelligenza breve per la valutazione del quoziente intellettivo attuale e pre-morboso. Professione di Psicologo. Giornale dell’Ordine degli Psicologi, 4, 1995.Google Scholar
Schiehser, D.M., Delis, D.C., Filoteo, J.V., Delano-Wood, L., Han, S.D., Jak, A.J., & Bondi, M.W. (2011). Are self-reported symptoms of executive dysfunction associated with objective executive function performance following mild to moderate traumatic brain injury? Journal of Clinical and Experimental Neuropsychology, 33, 704–714.CrossRefGoogle ScholarPubMed
Schmand, B., Groenink, S.C., & Van den Dungen, M. (2008). Letterfluency: Psychometrische eigenschappen en Nederlandse normen. [Letter fluency: Psychometric properties and Dutch normative data]. Tijdschrift voor Gerontologie en Geriatrie, 39, 64–76.CrossRefGoogle Scholar
Schmand, B., Lindeboom, J., & Harskamp, F. (1992). De Nederlandse leestest voor volwassenen. [The Dutch reading test for adults]. Lisse, Netherlands: Swets & Zeitlinger.Google Scholar
Schulz, K.F., Altman, D.G., & Moher, D. (2010). CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials. BMC Medicine, 8, 18.CrossRefGoogle ScholarPubMed
Sherer, M., Bergloff, P., Levin, E., High, W.M., Oden, K.E., & Nick, T.G. (1998). Impaired awareness and employment outcome after traumatic brain injury. Journal of Head Trauma Rehabilitation, 13, 52–61.CrossRefGoogle ScholarPubMed
Spikman, J.M., Boelen, D.H., Lamberts, K.F., Brouwer, W.H., & Fasotti, L. (2010). Effects of a multifaceted treatment program for executive dysfunction after acquired brain injury on indications of executive functioning in daily life. Journal of the International Neuropsychological Society, 16, 118–129.CrossRefGoogle ScholarPubMed
Spinella, M. (2005). Self-rated executive function: Development of the executive function index. International Journal of Neuroscience, 115, 649–667.CrossRefGoogle ScholarPubMed
Steenbeek, D., Meester-Delver, A., Becher, J.G., & Lankhorst, G.J. (2005). The effect of botulinum toxin type A treatment of the lower extremity on the level of functional abilities in children with cerebral palsy: Evaluation with goal attainment scaling. Clinical Rehabilitation, 19, 274–282.CrossRefGoogle ScholarPubMed
Stuss, D.T. (2011). Functions of the frontal lobes: Relation to executive functions. Journal of the International Neuropsychological Society, 17, 759–765.CrossRefGoogle ScholarPubMed
Turner-Stokes, L. (2009). Goal attainment scaling (GAS) in rehabilitation: A practical guide. Clinical Rehabilitation, 23, 362–370.CrossRefGoogle ScholarPubMed
Turner-Stokes, L., & Williams, H. (2010). Goal attainment scaling: A direct comparison of alternative rating methods. Clinical Rehabilitation, 24, 66–73.CrossRefGoogle Scholar
Van Hooren, S.A., Valentijn, S.A., Bosma, H., Ponds, R.W., van Boxtel, M.P., Levine, B., &Jolles, J. (2007). Effect of a structured course involving goal management training in older adults: A randomised controlled trial. Patientient Education and Counseling, 65, 205–213.CrossRefGoogle ScholarPubMed
Vlagsma, T.T., Koerts, J., Fasotti, L., Tucha, O., Van Laar, T., Dijkstra, H., &Spikman, J.M. (2015). Parkinson’s patients’ executive profile and goals they set for improvement: Why is cognitive rehabilitation not common practice? Neuropsychological Rehabilitation. doi:10.1080/09602011.2015.1013138Google Scholar
Wechsler, D. (1997). Wechsler Adult Intelligence Scale (3rd ed.). San Antonio, TX: The Psychological Corporation.Google Scholar
Wilson, B.A., Alderman, N., Burgess, P.W., Emslie, H., & Evans, J.J. (1996). Behavioural assessment of the dysexecutive syndrome. Bury St. Edmunds, UK: Thames Valley Test Company.Google Scholar
Wilson, B.A., Greenfield, E., Clare, L., Baddeley, A., Cockburn, J., Watson, P., &Nannery, R. (2008). Rivermead Behavioural Memory Test (3rd ed.). Toronto: Pearson.Google Scholar
Wilson, B., Cockburn, J., Baddeley, A., & Hiorns, R. (1989). The development and validation of a test battery for detecting and monitoring everyday memory problems. Journal of Clinical and Experimental Neuropsychology, 11, 855–870.CrossRefGoogle ScholarPubMed
Zimmermann, P., & Fimm, B. (2007). Test for Attentional Performance (TAP). Version 2.1, Operating Manual Herzogenrath. Germany: PsyTest.Google Scholar