Does the use of compensatory cognitive strategies improve employment outcomes in people with an acquired brain impairment?

Prepared by:

Rosamaria Coster
Rehabilitation Consultant (OT) , CRS Australia

Date:

December 2002

Review Date:

December 2004

Clinical Question:

“Does the use of compensatory cognitive strategies improve employment outcomes in people with and acquired brain impairment?”

Clinical Scenario:

Compensatory cognitive strategies (eg memory retraining, planning and organisation skills) are often recommended and used as part of a vocational rehabilitation program for individuals with acquired brain impairment (ABI). What is the effectiveness of this type of intervention in resulting in improved employment outcomes for this population?

Clinical Bottom Line:

Currently, there is no published evidence that demonstrates that the use of compensatory cognitive strategies improves employment outcomes in people with acquired brain impairment
In regards to other functional outcomes, however, there are:

1. High levels of evidence that support the use of compensatory cognitive devices (diaries, notebooks, etc) in people with TBI, to reduce incidents of memory failure.
2. High levels of evidence that compensatory memory strategies training (eg mnemonics, rehearsal etc) are recommended for individuals with mild memory impairments from TBI.
3. High levels of evidence that practice in visual scanning (using large apparatus) improves compensation for visual neglect after right hemisphere stroke, and can translate to everyday activities that require visual scanning.
4. Lower levels of evidence that support other practices eg teaching self-regulation; teaching formal problem solving in individuals with TBI.

Current evidence can neither support nor refute the functional outcome of treating memory deficits or alertness deficits in people who have suffered from a stroke.

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