A memory retraining program for the head injured

Abstract

Memory impairment is a common feature of post head injury symptomatology. Moreover memory impairment continues to be complaint for a considerable period following the head injury and hence represents a particular area of concern to professionals involved in the rehabilitation of head injured patients. There are few reports of progra1ns for remediation of organic memory impairment and this lack is probably a reflection of both the incomplete knowledge of the nature of the memory impairment in the head injured as well as the massive demands on a clinician's time for preparation and delivery of a comprehensive program. A review of research into organic memory disorders and normal memory function, plus an examination of the features of brain disturbance in a head injury, yielded a number of hypothetical explanations of the nature of the memory deficits in the head injured. factors were considered also. Some behavioral factors were considered also. A program was devised on a cost benefit basis aimed at improving the over-all memory function of the head injured by tackling as many of the proposed modes of disturbance as practicable. The program was orientated towards improving memory efficiency, so that a patient might remember important things better. The major exercise involved in the program was the construction of a personal hierarchy of items that need to be re1nembered for the head injured patient to cope successfully with his everyday contacts with people. This exercise emphasised the development of active mental processes to reinstate memory function and relied on current knowledge of the limits of human information processing. A good understanding of memory function at both cognitive and behavioral levels was developed. Guidance on how to use the hierarchy was an integral part of the program and practical exercises to familiarise the patients with the use of the hierarchy were incorporated. Follow-up reappraisal of any difficulties in using the new memory system was seen as essential also. Clinical use of the program with head injured patients on an individual basis and with a group of temporal lobe epileptics has shown promising results despite the difficulties involved in assessment of the program's effectiveness. Provision of the program material in a form demanding minimal preparation on the clinician's part should make the program viable for widespread use. Show more