Cognitive-behavioural stimulation protocol for severely brain-damaged patients in the post-acute stage in developmental age

• Published in: Disability and rehabilitation 2008, Vol.30 (4), p.275-285
• Main Authors: Liscio, Mariarosaria, Adduci, Annarita, Galbiati, Susanna, Poggi, Geraldina, Sacchi, Daniela, Strazzer, Sandra, Castelli, Enrico, Flannery, Jeanne
• Format: Article
• Language: English
• Subjects: Brain damage; Child; Child, Preschool; Children; Cognitive behaviour therapy; Cognitive Therapy - methods; Cognitive-behavioural techniques; Female; Glasgow Coma Scale; Goals; Humans; Hypoxia, Brain - classification; Hypoxia, Brain - rehabilitation; Male; multisensory stimulation; Paresis - classification; Physical Stimulation; Rehabilitation; Severity of Illness Index; Speech therapy; Stimulation; Treatment Outcome
• ISSN: 0963-8288; 1464-5165
• DOI: 10.1080/09638280701257023

Purpose. To present a cognitive-behavioural stimulation (CBS) protocol designed to help severely damaged patients in the early post-acute stage by describing the underlying methodology and assessing its efficacy compared to traditional rehabilitation methods. This protocol combines multisensory stimulation and cognitive-behavioural techniques to elicit and intensify the occurrence of adaptive responses and reduce maladaptive behavioural patterns. Methods. A control group and an experimental group - both evaluated with the Levels of Cognitive Functioning Assessment Scale (LOCFAS) - were compared at the beginning of the rehabilitation programme and at the end of it. The control group consisting of patients assessed and treated before receiving the CBS protocol was enrolled in a traditional rehabilitation programme (only physical therapy and speech therapy). Besides the traditional therapy, the experimental group also received the CBS protocol. Results. Patients on the CBS protocol show a greater improvement and are therefore more responsive than the control group after the 16-week remediation programme. The mean LOCFAS improvement of the experimental group is more marked during the first month of rehabilitation and is associated to the entry LOCFAS level, while in the control group the improvement on LOCFAS is considered to be 'spontaneous' and is associated to the aetiology of the brain damage. Conclusions. Our results show a better initial outcome for patients receiving the CBS protocol.