Historical review of computer-assisted cognitive retraining.

Abstract

This article details the introduction and development of the use of microcomputers as adjuncts to traditional cognitive rehabilitation of persons with acquired brain injury. The initial application of video games as therapeutic recreation in the late 1970s was soon followed in the early 1980s by the use of the first personal computers and available educational software. By the mid-1980s, both the IBM PC and Macintosh platforms were established, along with simplified programming languages that allowed individuals without extensive technical expertise to develop their own software. Several rehabilitation clinicians began to produce and market specially written cognitive retraining software for one or the other platform. Their work was detailed and reviewed, as was recently released software from commercial sources. The latter discussion included the latest developments in the rehabilitation applications of personal digital assistants and related organizing, reminding, and dictation devices. A summary of research on the general and specific efficacy of computer-assisted cognitive retraining illustrated the lingering controversy and skepticism that have been associated with this field since its inception. Computer-assisted cognitive retraining (CACR) can be an effective adjunct to a comprehensive program of cognitive rehabilitation. Training needs to be focused, structured, monitored, and as ecologically relevant as possible for optimum effect. Transfer or training or generalizability of skills remains a key issue in the field and should be considered the key criterion in evaluating whether to initiate or continue CACR.