Evaluation of the effectiveness of two clinical training procedures to elicit yes/no responses from patients with a severe acquired brain injury: a randomized single-subject design

• Published in: Brain injury Vol. 17; no. 12; p. 1065
• Main Authors: Barreca, Susan, Velikonja, Diana, Brown, Lynn, Williams, Lynne, Davis, Lori, Sigouin, Christopher S
• Format: Journal Article
• Language: English
• Published: England 01.12.2003
• Subjects: Adolescent; Adult; Aged; Analysis of Variance; Brain Injury, Chronic - psychology; Brain Injury, Chronic - rehabilitation; Communication; Cross-Over Studies; Cues; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Treatment Outcome
• ISSN: 0269-9052
• DOI: 10.1080/0269905031000110535

Thirteen (10 males) participants with severe acquired brain injuries (ABI) were randomly assigned to two treatments, A or B (ABAB, BABA) in a crossover study to determine which treatment approach elicited more consistent and reliable yes/no responses. Treatment A consisted of an enriched stimulus environment, collaborative multidisciplinary interventions and additional yes/no response training, while Treatment B consisted of the standard hospital environment and interventions. An ANOVA showed no order effect (AB vs BA; p=0.60), but a trend (A vs B;p=0.07) towards statistical significance for increased responsiveness with treatment A. Inter-raterreliability (n=10) ranged from fair-to-good, intra class correlation (ICC) 0.51; 95% confidence interval (CI) (0.29-0.93). Post-hoc analyses showed statistically significant increased responsiveness for four participants with treatment A (p<0.001). Evidence is provided that enhanced communication strategies can improve responsiveness in a sub-group of participants with severe acquired brain injuries.