Treatment to improve self-awareness in persons with acquired brain injury

Aim: To examine the effects of an awareness training protocol embedded within the practice of instrumental activities of daily living ( IADLs) in participants with acquired brain injury on levels of self-awareness and functional performance. Methods: This study used a randomized control trial design: 10 participants with moderate-to-severe brain injury received six sessions of the self-awareness training while they performed IADLs ( experimental group) and 10 participants performed the same IADLs but received conventional therapeutic practice ( control group). In the experimental group, participants were asked to predict their performance before each task performance and to estimate their performance level after the performance. Outcome measures: Pre- and post-intervention outcome measures taken from the two groups were compared. Instruments were standardized measures of ` general' self-awareness with collateral reports by informants ( e. g. Awareness Questionnaire); ` task-specific' self-awareness ( e. g. Assessment of Awareness of Disability) and Self-Regulation Skills Inventory ( SRSI). Performance on IADLs was assessed using the Assessment of Motor and Process Skills ( AMPS). Results: Compared to the control group, the intervention significantly improved IADL performances and self-regulation. No significant treatment effect was observed for task-specific self-awareness, general self-awareness or community integration. Conclusions: The self-awareness intervention significantly but selectively improved self-awareness during IADL task performance as well as functional performance. The need for a larger study with more treatment sessions is discussed.