Intervention for Executive Functions After Traumatic Brain Injury: A Systematic Review, Meta-Analysis and Clinical Recommendations
Neuropsychological Rehabilitation
Kennedy, M., Coelho, C., et al. (2008).
Neuropsychological Rehabilitation, 18(3), 257-299.
This systematic review and meta-analysis investigates the effect of executive function treatments (e.g., metacognitive strategy instruction, strategic thinking/verbal reasoning training, and multi-task training) on problem solving, planning, organizing, and multitasking in individuals with traumatic brain injury (TBI). The review is part of a series by the Academy of Neurologic Communication Disorders and Sciences Practice devoted to the management of TBI.
Academy of Neurologic Communication Disorders and Sciences; American Speech-Language-Hearing Association; Department of Veterans Affairs
Through 2004
Quantitative intervention studies
15
<div>Overall, the effect of experimental executive functioning treatments was large, but variable (Cohen's d= 0.9, Hedge's g= 0.83). Specific results were as follows:</div>
<ul>
<li>Both metacognitive strategy instruction (MSI; Z= 8.73 for impairment; Z= 11.69 for activity/participation) and variable control metacognitive treatments (Z= 6.43 for impairment; Z= 6.42 for activity/participation) were associated with improved executive functioning and quality of life (e.g., activity/participation outcomes) when compared to chance.</li>
<li>MSI and control techniques did not have significantly different outcomes when compared to control groups regarding executive functioning skills (MSI M= 0.41, SE= 0.002 versus control treatment M= 0.37, SE= 0.003).</li>
<li>MSI techniques (M= 0.57, SE= 0.002) were associated with improved activity/participation when compared to control interventions (M= 0.38, SE= 0.004).</li>
<li>Sixty percent of studies reported large, positive maintenance effects (effect size range= 0.82-4.30).</li>
</ul>
<div>Limitations to this review include an overall paucity of research and small sample sizes.</div>
