4.9 Rehabilitation of Learning and Memory Deficits Post ABI

Design a program for this patient’s learning and memory deficits.

  1. Cognitive rehabilitation should include the use of self instructional training/internal training (e.g. self cueing, self talk).
     
  2. Cognitive rehabilitation should include the use of errorless learning for task specific learning for people with severe memory impairment. 
     
  3. The evidence for external aids is not very impressive.
     
  4. Pharmacological interventions do not appear to be overly impressive – the two drugs with some evidence of benefit include the anti-cholinesterases and methylphenidate.
  • Not all patients respond equally to all intervention strategies.
     
  • Technology has increased the availability of external aids, although some seem more feasible to use than others (e.g., cell phones or hand-held recorders). 
     
  • Most studies examined only tasks of word list recall and paired-associate learning suggesting that the mnemonic strategies reviewed may not generalize to other types of information(particularly real-world or functional information outside the laboratory). 
     
  • Errorless learning appears to be one procedure that can be used to enhance learning conditions.
     
  • Frequency of intervention has an impact on learning and retention,although the exact parameters of this are unclear at the present time.  The optimal duration of a program is also open for speculation.  No studies reviewed examined the number of sessions required for memory groups to be effective and only one study evaluated a difference in effectiveness between mild and severely impaired individuals after sessions.
     
  • Pharmacologic interventions do not appear to be overly effective in improving learning and memory deficits, with perhaps the exception of anti-cholinergic esterase inhibitors.

     

For a more detailed discussion on Learning and Memory deficits post ABI please see ERABI/Cognition Interventions Post ABI.

According to ABIKUS Recommendations  27

Learning and Memory

Cognitive rehabilitation should include the use of self instructional training/internal training (e.g. self cueing, self talk).  (ABIKUS A) (G37-p.22)

Cognitive rehabilitation should include the use of errorless learning for task specific learning for people with severe memory impairment.  (ABIKUS B) (G38-p.22)