Memory remediation in long-term acquired brain injury: two approaches in diary training

This study investigated the remediation and assessment of everyday memory i mpairment in a sample of long-term acquired brain injury (ABI) subjects. Th e Rivermead Behavioural Memory Test (RBMT) and subtests of the Wechsler Mem ory Scale-Revised (WMS-R) were selected to measure global memory performanc e. A memory questionnaire and a daily memory checklist were developed from a review of existing self-report questionnaires. The interrelationships amo ng self-report measures and standardized psychometric tests of memory were examined and the findings suggest that self-report measures may be used to obtain relatively accurate information about everyday memory performance. A baseline across groups' design evaluated the relative effectiveness of two different approaches in training subjects to use a diary to compensate for memory problems. There was a Diary Only (DO) approach, which emphasized co mpensation based upon task specific learning, and a Diary and Self-instruct ional Training (DSIT) approach, which taught compensation using higher cogn itive skills of self-awarenes and self-regulation. The results obtained sho w that, during the treatment phase, the DSIT group more consistently made d iary entries, reported less memory problems, and made more positive ratings associated with treatment efficacy. The implications arising from the curr ent study are that: (1) the choice of memory assessment procedures need to be guided by the patients' real daily living needs; and (2) an approach bas ed upon self-instructional training has greater ecological validity than an approach that focuses on task specific learning. In general, successful as sessment and rehabilitation of memory deficits requires a well-established theoretical basis and sound ecological validity.