Objectives: Neuropsychological assessment of memory disorders is an important prerequisite in the treatment of patients with alcohol-related cognitive disorders. Although many memory tests are available in clinical practice, a question remains regarding which test is most appropriate for this purpose. Our study's goal was to evaluate the discriminative power of indices of a standard memory test (the California Verbal Learning Test; CVLT) versus the subtests of an ecologically valid everyday memory test (the Rivermead Behavioural Memory Test; RBMT) in patients with alcohol-use disorder.

Method: The patients included 136 with Korsakoff's syndrome (KS), 73 alcoholics with cognitive impairment (CI) not fulfilling the criteria for KS, and 24 cognitively unimpaired alcoholics (ALC).

Results: KS patients performed significantly lower on all RBMT and CVLT variables than CI patients. ALC patients performed significantly better than CI patients on only one RBMT subtest, and had a significantly lower rate of forgetting and higher scores on free recall on CVLT. A combination of RBMT subtests and CVLT indices was able to discriminate KS patients from CI and ALC patients. The RBMT subtests could not significantly distinguish ALC from CI patients. Both rate of forgetting and a comparison between free and cued recall testing on the CVLT showed the largest between-group differences.

Conclusion: Although the RBMT provides information about everyday memory performance, the CVLT indices are better able to distinguish between uncomplicated alcoholics and those with cognitive impairment or KS.

Aim: To evaluate factors that may contribute to the decision of the consultant medical officer (CMO) to: (1) admit a person with stroke to inpatient rehabilitation from acute hospitalisation; and (2) continue or cease inpatient rehabilitation.

Methods: A web-based survey of CMOs practising in Queensland Australia, who were members of the Australian and New Zealand Society of Geriatric Medicine (n ~ 90) or the Queensland Stroke Clinical Network (n ~ 30) was completed. The survey contained two sections to explore factors that could: (1) favour or disfavour admission to inpatient rehabilitation from acute hospitalisation; and (2) favour continuation or cessation of inpatient rehabilitation. Open and closed questions were used.

Results: Twenty-one CMOs (13–20% response rate, 43% geriatrician) completed the survey. Factors related to physical function, along with the presence of social supports favoured admission, while the presence of behavioural and cognitive impairments and a lack of staff capacity disfavoured admission. Improvements in function favoured continuation of inpatient rehabilitation, while a lack of improvement favoured cessation.

Conclusion: Factors related to the patient, their social support network and the organisation were found to influence the decision of the CMO to admit a person with stroke to inpatient rehabilitation from acute hospitalisation. Once in rehabilitation, demonstration of benefit was consistently reported to indicate continued service need.

We report on the development of a new assessment tool to monitor recovery after severe traumatic brain injury (TBI). Although a number of scales exist to identify such recovery, most are limited if one is interested in monitoring small changes or in setting goals for rehabilitation. This is due to the fact that items are too broad, they may cross more than one dimension (e.g. cognition and motor functioning) and there is a danger that recording of responses may be too subjective. The Wessex Head Injury Matrix (WHIM) was developed to avoid these problems. We observed 88 people with severe TBI. These were consecutive admissions to two hospitals. Mean coma duration was 14 days and mean duration of post traumatic amnesia (PTA) was 56 days. Of 145 behaviours observed, we selected 62 and each behaviour was compared to every other behaviour to determine a likely order of recovery. The resulting WHIM is an observational tool to assess and monitor cognitive recovery after severe head injury. It can be used with patients who are in coma, just out of coma or who are minimally conscious. Two case examples are provided.

Background: A previous clinical trial of training communication partners of people with traumatic brain injury (TBI) demonstrated positive outcomes [Togher, Power, McDonald, Tate, & Rietdijk (2009). Brain Impairment, 10(2), 188-204]. Adapting communication partner training for delivery via telehealth could improve access to this intervention.

Objectives: To compare outcomes across in-person communication partner training, telehealth communication partner training and a control group

Method: Protocol for a partially randomised controlled trial. People with moderate-severe TBI will be allocated to either an in-person or telehealth-based training program. Comparison data will be drawn from the original trial control group, which was recruited using the same eligibility criteria as this protocol. Outcomes after training will be compared between the in-person training group, the telehealth training group and the historical control group.

Discussion: This protocol uses specific design features with the aim of maximising the study’s power, including a partially randomised allocation process and a historical control group. The results will inform about the feasibility and effectiveness of delivering TBI rehabilitation via telehealth.

Trial registration: Australian and New Zealand Clinical Trials Registry: ACTRN12615001024538.

This article is concerned with patients in coma, the vegetative, or minimally conscious states. Studies addressing the issue of assessment and management of these patients are described. These include (a) the development of an assessment tool (Wessex Head Injury Matrix, WHIM); (b) use of the WHIM to assess the effects of posture on arousal, showing that some 75% of patients show more behaviours when assessed while they are in a standing frame than when supine; (c) a comparison of the WHIM with the Glasgow Coma Scale, demonstrating that the WHIM is more sensitive than the GCS for measuring the behavioural repertoire of people in states of reduced consciousness; (d) a discussion of situations when neuro-imaging techniques are required to assess residual functioning; and (e) the long term outcome of one of the first vegetative patients to be scanned with Positron Emission Tomography (PET). We conclude with a discussion about neuropsychology and patients in states of impaired consciousness.

The Austin Maze is a neuropsychological assessment tool used to measure cognitive function. A computerised version of the tool has recently been developed and shown to be equivalent to the conventional version in terms of performance. However, controversy remains regarding which specific cognitive constructs the conventional and computer versions of the Austin Maze purport to measure. The aim of this study was to investigate which cognitive constructs are associated with Austin Maze performance and whether these constructs remain equivalent across conventional and computer versions. Sixty-three healthy people completed both conventional and computerised versions of the Austin Maze in addition to a number of established measures of planning, error utilisation, working memory, visuospatial ability and visuospatial memory. Results from a series of regression analyses demonstrated that both versions of the Austin Maze were predominantly associated with visuospatial ability and visuospatial memory. No executive measures, including those of planning, error utilisation or working memory, significantly contributed to any Austin Maze performances. This study complements previous research and supports equivalency of the conventional and computer versions of the Austin Maze.

Introduction: The Paediatric Care and Needs Scale (PCANS) was developed to address the dearth of scales currently available for measuring support needs of children with acquired brain injury (ABI). The scale assesses environmental supports (both supervision and physical assistance) across 14 domains of everyday activities from support for personal hygiene to participation in leisure and social activities. This study aimed to determine support needs in typically developing children using the PCANS in a normative sample of Australian children. Methods: Participants were parents of typically developing children aged 5–14 years (N = 300) recruited from a range of schools in metropolitan Melbourne. Children with ABI, diagnosis of a neurological or developmental disorder, or significant medical condition were excluded. Thirty parents of children in each of 10 age levels, with approximately equal sex ratio were recruited. Results: Findings suggest that support needs vary according to age of the child (p < .01) but not sex of child or occupational status of the parent. Additionally, children were found to have significantly higher support needs for supervision compared with physical assistance across most of the domains of the PCANS (p < .01). A greater number of age differences across PCANS domains were also found in younger children (5 to 7 and 8 to 11 years) compared to the older age group (age 12–14 years). Conclusions: This study reports normative data for the PCANS using a sample of children stratified by age. Findings will provide an essential point of reference to help guide clinical interpretation of the PCANS for assessing support needs of children with ABI.

Objective: To describe the development of a functional communication assessment. A secondary aim is to illustrate a process for identifying functional communication outcomes in clients with traumatic brain injury (TBI). The TBI Index for Social and Vocational Communication Outcomes (SAVCO) is designed to identify limitations to everyday communication activities that may present following TBI. It was constructed by anchoring communication activities derived from studies within New Zealand into an internationally recognised theoretical construct, the International Classification of Functioning, Disability and Health (ICF). Four key principles: authenticity of the items, attention to context, collaboration and transparency, underpin the assessment. Main outcomes: The article describes the process of developing a TBI measure that is authentic to an intended population. It provides a preliminary description of the SAVCO, its different constructs and the rationale for their inclusion. The SAVCO is an assessment that highlights everyday activities that are relevant targets for intervention for the individual. The client's performance on the identified activities is explored according to the efficiency and manner of executing the activity. The scope and level of the activity are also determined. Conclusions: The development of the SAVCO illustrates a process for identifying relevant and important functional communication activity items and promotes the use of the ICF framework and rating scales. The preliminary findings suggest that the SAVCO has clinical relevance providing speech–language therapists with a functional communication assessment that leads to the identification and measurement of client-centred therapy outcomes.

The Austin Maze has declined in use in both clinical and research contexts due to difficulties in accessing the conventional button-box form of the test. Computer-based versions of the Austin Maze offer a potential means of making the test more accessible, but as yet there is limited evidence regarding the equivalence of computer and conventional versions of the Austin Maze. The present study compared performance on a computer version of the Austin Maze by Bray and McDonald with performance on the traditional button maze in 63 participants aged 18–27 years. The results showed no differences between the computer and conventional versions in terms of mean scores and distributions, and performances on the two versions were significantly correlated. Examination of correlates found no relationship between Austin Maze performance and years of education or age for either version of the Austin Maze performance. Intellectual function was modestly associated with performance on the conventional version but not the computer version. Overall, these findings suggest that scores on the Bray and McDonald computer version of the Austin Maze produces comparable scores to the conventional form of the test and can be interpreted using existing normative data.

The environment, and assistive technologies as part of this, can play an important role in supporting the participation and wellbeing of people living with dementia. If not considered, environments can be overwhelming and disempowering. Disability approaches including environmental considerations and assistive technology were often not offered routinely with people living with dementia. Concerned by this, dementia advocates aimed to create change in this area. The Environmental Design-Special Interest Group (ED-SiG) of Dementia Alliance International was developed as an international consumer-driven community of practice bringing together people with different relevant expertise including living experience (people living with dementia, care partners), architecture and design, occupational therapy, rehabilitation and care provision. This practice opinion piece provides an overview of dementia, the need for collaborative practices within practice with people living with dementia, and the considerations of assistive technology, environmental design and the global context. The reflection provides insights into this international community of practice, with personal reflections of members with living experience of dementia, and benefits and opportunities in considering environmental design and assistive technology from the perspectives of members. This work demonstrates and advocates collaborations that centre the perspectives and expertise of people living with dementia.

The frontal lobes, if damaged, may lead to a host of divergent abnormalities, depending on the extent, site, depth, and laterality of the damage. Because of the extensive connections which exist between the frontal lobes and the other systems of the brain, damage to a more remote system may cause frontal system disorder through disconnection. The Hand Movement Test (HMT, Kaufman & Kaufman, 1983) is thought to be sensitive to damage affecting these systems, although the test was developed for use with children rather than adults. This paper examines the effects of three diverse neuropsychological disorders, where damage to the frontal lobes or to their interconnections has been implicated, on hand movement sequencing performance in adults. The three groups studied included patients diagnosed with alcohol-related brain damage (n = 57), patients diagnosed with mild traumatic brain injury (n = 21), and patients diagnosed with age-related dementia (n = 30). HMT performance was significantly poorer in all three clinical groups relative to controls, supporting the addition of this brief, paediatric test in neuropsychological evaluations assessing these disorders.

People with severe traumatic brain injury (TBI) often have poor psychosocial outcomes. Poor memory may contribute to this because it impedes the ability to share experiences and reminisce about past experiences. This study was designed to determine whether photographic partial reminders would improve recall of incidentally learned complex events in people with severe TBI. Two groups of 10 people with severe TBI viewed videotapes of everyday events. One group was shown photographic reminders of half the events shown two days later on 3 occasions separated by 10 minutes. Twenty minutes after the last review (or control activity) both groups were tested for free recall and recognition of the videotape events. The reminder group recalled a greater percentage of reviewed events and objects per events recalled, but a similar number of actions per event recalled, compared to the control group. Photographic review did not decrease recall of nonreviewed events or affect recognition of reviewed or nonreviewed events.

There is no research on the assessment or treatment of help-seeking behaviours for individuals with traumatic brain injury (TBI). This paper describes the development of a protocol, NICE (Noticing you have a problem, Identifying the information you need for help, Compensatory strategies, Evaluating progress) to train help-seeking for adults with TBI when lost. Theoretical and treatment components from three empirically validated interventions that target social problem-solving and communication skills were adapted to develop NICE: the Group Interactive Structured Treatment for Social Competence (GIST), the Problem Solving Group Protocol (PSG) and Interpersonal Recall (IPR). Preliminary pilot data evaluating the efficacy are presented for three adult persons with TBI. All three participants improved on the Executive Function Route Finding Task (EFRT) and help-seeking behaviours when wayfinding. Help-seeking is a constitutive factor in the wayfinding process capable of improvement. Preliminary evidence supports further investigation of this group intervention.

We are pleased to bring you this special issue of Brain Impairment on quantitative data analysis, an area of increasing complexity and sophistication. In planning the special issue, our intention was to bring together a set of articles covering diverse and topical areas in the field, with the idea of having the volume serve as a ‘go-to’ resource. The special issue is aimed at researchers, clinicians engaged in research, and advanced students all of whom may have passing familiarity with a particular data analytic technique, but wish to know more about it and how to apply it. Accordingly, our aim is to equip the reader with concrete, hands-on information that can be applied in the day-to-day world of research. The authors of the articles comprising the special issue, each of whom is an expert in his/her field, were charged with the task of writing a practical guide and providing worked examples to illustrate the application of their selected technique/s. The papers in the special issue cover three domains: the single-case method, between-groups design, and psychometric aspects of instrument development.