Effective occupational therapy intervention with adults demonstrating agitation during post-traumatic amnesia

Abstract

Objective: To investigate the effectiveness of occupational therapy (OT) with adults demonstrating agitation and post-traumatic amnesia (PTA) following brain injury.Design: Single-system experimental design (ABAB) across subjects.Methods: Eight subjects were recruited during acute rehabilitation. Current OT intervention was alternated with the experimental Perceive, Recall, Plan and Perform (PRPP) System approach over 4-weeks. Therapy was conducted daily. Information processing capacity during occupational tasks was measured using the PRPP System of Task Analysis. PTA status was monitored with the Westmead PTA Scale.Experimental intervention: The PRPP System is a dynamic assessment and intervention approach that directly links results of cognitive task analysis with strategies for intervention. PRPP Intervention adopts an information processing approach that simultaneously focuses on task training, strategy training and strategy application within occupational performance.Results: Seven subjects significantly improved in their application of processing strategies during the PRPP Intervention in comparison to current OT Intervention phases. Large treatment effects favoured the PRPP Intervention. Subjects demonstrated improved information processing strategy use both prior to and following emergence from PTA.Conclusions: Occupational therapy intervention based upon the PRPP System of Task Analysis and Intervention improved subjects’ ability to apply information processing strategies during occupational performance when compared to current intervention approaches.