Includes bibliographical references. / Background and aims. Executive function (EF), defined as a set of interrelated skills and behavioural competencies required for independent, purposeful, goal-directed activity, are particularly susceptible to impairment following traumatic brain injury (TBI). Despite this knowledge, data concerning the rehabilitation of executive dysfunction in pediatric populations is lacking to date. A Goal Management Training (GMT) intervention, based on Duncan et al.’s (1996) theory of goal neglect, has been successfully implemented for the remediation of EF in adults. The current study adapted the GMT to a healthy South African sample and evaluated the efficacy in a pediatric TBI sample. Method. The study comprised of 3 parts. Part 1 involved the translation and adaptation of the pediatric GMT (pGMT) intervention so that it was suitable for use with South African children. This included the implementation of various health professionals’ evaluations of these adaptations. Part 2 involved evaluating the pGMT by implementing the programme with 3 healthy control participants. Lastly, Part 3 involved evaluating the efficacy of the revised pGMT with 3 children who had sustained a moderate to severe TBIs. For Parts 2 and 3 I employed a multiple case study approach. Data for parts 2 and 3 were analyzed using the Reliable Change Index (RCI; Jacobson & Truax, 1991) . The RCI distinguished between three levels of change, each at confidence levels of 68.2%, 95% and 99%. Outcomes were based on neuropsychological test outcomes, changes in everyday behaviour, self-report measures, and reports from parents and teachers. Results. Regarding the cognitive measures for the TBI group, all three participants did not show improvement on the same domains. Positive changes from pre- to post-intervention on a number of attention and executive function measures at confidence intervals of 68.26% to 99% were evident. Regarding the behavioural measures parents/guardians and/or teachers reported significant positive changes for all of the participants on at least one index at confidence intervals of 68.26% to 99%. In terms of real world generalization, only one participant’s teacher and parents commented on her improvements academically, behaviourally, and socially. No significant real world behavioural changes were reported for the other two participants. Results indicated that the adapted pGMT was successfully applied to the South African context for both healthy and TBI samples, although levels of success, in terms of post-intervention outcomes, varied with each TBI individual. Conclusions. These results suggest that the pGMT intervention could be an efficacious cognitive rehabilitation tool for the remediation of everyday behaviours associated 9 with executive dysfunction in South Africa. However, the variability in the results do not provide conclusive evidence at this stage. Individual, injury-related and familial factors need to be considered and may affect outcome. In addition, limitations such as the small sample size and uncontrolled confounding effects (e.g., practice or maturation effects) could also contribute to seemingly positive effects. Greater evidence from future, larger and more controlled studies, is required
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uct/oai:localhost:11427/13690 |
| Date | January 2015 |
| Creators | Mahomed, Aqeela |
| Contributors | Schrieff-Elson, Leigh |
| Publisher | University of Cape Town, Faculty of Humanities, Department of Psychology |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Master Thesis, Masters, MA |
| Format | application/pdf |
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