Content-Free Cueing and ‘Remembering Goals’ Training: The Rehabilitation of Prospective Memory Deficits in a Paediatric Population
Thesis or dissertation
University of Exeter
Reason for embargo
The literature review for this thesis is being submitted for publication in the Journal of the International Neuropsychological Society. The empirical paper in this thesis is being submitted for publication in Developmental Medicine and Child Neurology
Background: It is often considered that, following paediatric acquired brain injury (pABI) and epilepsy, higher-level cognitive deficits, such as prospective memory (PM), are impaired and may only become apparent over time when these abilities are expected to develop and mature in a typically developing child. Interventions supporting PM have the potential to increase independence and enhance social participation. Despite research indicating PM difficulties in children and adolescents with pABI and epilepsy, and also in children with PM difficulties with unknown aetiology, currently, there is a limited evidence-base for interventions, although previous research has attempted to address this following pABI (Rous, 2011). Objective: The objective of this empirical paper was to build upon the work of Rous (2011) and optimise the effectiveness of brief metacognitive ‘Remembering Goals’ Training (RGT) and external content-free cueing (in the form of “STOP” text messages) on PM task performance and the achievement of real-life goals. Method: The research employed a single-case series design with a randomised, alternating treatment (Barlow & Hayes, 1979). Eight participants (aged 10-15 years) completed the study. Three participants had an ABI, two participants had epilepsy, and three participants experienced PM difficulties with unknown aetiology. The PM task required participants to send three text messages at set times and to complete three real-life goals each working day for a four-week period. After a baseline period, participants completed brief RGT via Skype twice during the study (once following baseline, and again half way through the study). The brief RGT facilitated metacognitive skills and participants learnt to associate texts reading “STOP” with mentally reviewing their goals and tasks for that day. Six “STOP” text messages (cues) were sent at random times on half of the days of the intervention. The number and accuracy of texts messages, and the achievement of real-life goals, were compared across cued and un-cued days to evaluate the efficacy of the intervention for each participant. Results: Five participants demonstrated improved PM text message performance and seven participants demonstrated improved performance in real-life goals. Most of the participants reported positive gains in self-reported PM abilities, and most parents of children with acquired neurological conditions reported reduced levels of family stress and burden following the intervention. Conclusions: This research offers some evidence in support of the efficacy of content-free cueing and RGT for facilitating PM abilities. The majority of participants engaged in more frequent and accurate PM tasks and, most importantly, achieved more of their real-life goals as a result of the intervention.
Doctor of Clinical Psychology