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External cueing systems in the rehabilitation of executive impairments of action.
EVANS, J.J., EMSLIE, H., & WILSON, B. A.
Journal of the International Neuropsychological Society, 4, 399-408.
Year of publication:
The use of a mnemonic cueing system (NeuroPageÂ®) and a paper and pencil checklist in the rehabilitation of executive problems in a 50 year old woman are described. Following a CVA seven years earlier, the patient, despite intact general intellectual and memory functioning, had specific executive impairments of attention, planning, realising intended actions and also exhibited behavioural routines similar in form to obsessive-compulsive rituals. In a series of ABAB single case experimental designs, the efficacy of two external cueing systems in prompting appropriately timed action is demonstrated. It is argued that the combination of external control and increased sustained attention to action were critical to the success of NeuroPage with this patient. Furthermore it is hypothesised that the checklist was effective in facilitating the patient's ability to 'lookahead' and recognise the consequences of her actions, which in turn had an impact on the probability of her changing those same actions.