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KEY WORDS
* adolescent
* brain injuries
* cognitive therapy
* consciousness
* mobility limitation
* self-care
PURPOSE. The highest proportion of traumatic brain injuries (TBIs) occurs among adolescents. This study examines the effectiveness of a therapeutic protocol for rehabilitation of adolescents with TBI. This protocol is based on Toglia's (1998, 2005) Dynamic Interactional Model and Expanded Awareness Model (Toglia & Kirk, 2000).
METHOD. Explanatory case studies presenting 2 adolescents (ages 16-17) with mild to moderate TBI are combined with qualitative and quantitative data assessing self-care, mobility, and graphomotor abilities as well as deficit awareness in these domains. Outcome measures include the FIM(TM), the Canadian Occupational Performance Measure, the Computerized Penmanship Object Evaluation Tool, and the Awareness of Mobility Deficits Questionnaire. Graphic data analysis compared outcome measures before, during, and after intervention.
RESULTS. The Dynamic Interactional Model was effective in improving self-care, mobility, and graphomotor abilities and identified awareness of deficits in these domains.
CONCLUSION. These research findings contribute to our theoretical knowledge in rehabilitation and promote adopting this approach for rehabilitation of adolescents with TBI.
Zlotnik, S., Sachs, D., Rosenblum, S., Shpasser, R., & Josman, N. (2009). Use of the dynamic interactional model in selfcare and motor intervention after traumatic brain injury: Explanatory case studies. American Journal of Occupational Therapy, 63, 549-558.
One professional practice area in occupational therapy is rehabilitation after traumatic brain injury (TBI). TBI can occur in an instant but is a life-changing experience involving a lengthy journey from rehabilitation to recovery. It has been estimated that TBI affects >10 million people annually worldwide, leading to either mortality or hospitalization (Hyder, Wunderlich, Puvanachandre, Gururaj, & Kobusingye, 2007). According to the World Health Organization (2001), TBI will surpass many diseases as a major cause of death and disability by the year 2020.
Recently, interest in the relationship between cognitive deficits and occupational performance has grown. This interest can be seen in the increasing number of therapeutic models in which cognitive function is considered to be a major skill that influences occupational performance (Averbuch & Katz, 1998). Cognitive- perceptual difficulties, such as those that result in TBI, can significantly affect a person's ability to perform everyday tasks, fulfill usual roles, and maintain personal and social relationships. Independent self-care significantly influences participation in...