Teaching action sequences after brain injury: a comparison of modelling and moulding techniques

Abstract

Objective: To compare the relative effectiveness of a modelling and a moulding instructional technique for teaching action sequences to participants with brain injury in rehabilitation settings. Design: Randomized crossover design. Setting: Regional Neurological Rehabilitation Unit. Subjects: Sixteen participants with an acquired brain injury undergoing early inpatient rehabilitation. Intervention: Participants were instructed to recall two different sequences of seven hand movements after a short (5 minutes) and longer delay (30 minutes). Participants were taught the sequences using moulding and modelling techniques. Main outcome measure: Participants’ recall of the sequence measured after the short and longer delay for each instructional technique. Results: Participants recalled the sequence after the longer delay (30 minutes) significantly more accurately (Z = 1.91, P =0.028) when taught using the modelling instructional technique (mean 2.63, SD 1.55) compared to the moulding technique (mean 1.56, SD 1.63). There were no significant differences between the participants’ recall scores after a short delay. Participants who scored lower on a delayed memory subtest of a neuropsychological test benefitted more from the modelling technique. Conclusion: The use of a modelling instructional technique to teach brain-injured participants an action sequence during their rehabilitation may be more effective for their longer term performance than a moulding instructional technique.