REHABILITATION OF FRONTAL EXECUTIVE IMPAIRMENTS IN SCHIZOPHRENIA/

Objective: A relatively high prevalence of deficits in cognitive flexi bility, working memory and planning ability has been reported in schiz ophrenia patients. The objective was to develop a rehabilitation train ing program in an attempt to improve these specific cognitive function s. Method: The deficits in cognitive flexibility, working memory and p lanning ability were interpreted as reflecting executive cognitive pro cessing impairments secondary to prefrontal neural system dysfunction. Following the 'process specific' approach, it was considered importan t to develop tasks that hypothesised the exercise of these cognitive a bilities and the more molecular information processes thought to be fu ndamental to these abilities. Care was taken to ensure that all tasks involved the practice of processes thought to activate frontal/prefron tal neural systems. Attentional, visual, verbal, conceptual, motor and fine motor tasks were considered important for each process area in o rder to involve as many functional modalities as possible. Results: A program comprising cognitive shift, working memory and planning module s was developed. Conducted over 11 weeks, four modules were of 2 weeks ' duration, and the fifth of 3 weeks' duration. Four individual 1 hour training sessions were conducted each week. Core elements of the modu les are described. Conclusion: Consisting predominantly of pencil and paper information processing exercises, all of the training exercises are presented in the volumes of the Frontal/Executive Program. The pro gram appears to be user-friendly with therapists now successfully deli vering the program, in its entirety, to schizophrenia patients. Should future studies replicate preliminary findings of improved neurocognit ive performance following training with the program, such findings wou ld have important implications for the treatment of schizophrenia.