On 29 January at 2020 15:00 Marianne Saard will defend her doctoral thesis „Developing Modern Cognitive Intervention Techniques in Paediatric Neurorehabilitation for Children with Acquired Brain Injury“.
Supervisor:
associate professor of pediatric neuropsychologyt Anneli Kolk (PhD (psühholoogia)), UT Institute of Clinical Medicine).
Opponent:
Professor of Neuropedia Ulrich Stephani (PhD), dekaan, arstiteaduskond, Christian-Albrechts-Universität zu Kiel, Germany.
Summary
Children with acquired brain injury (ABI) need diagnosis of accompanying cognitive and socio-emotional deficits and neurorehabilitation to enhance their future academic success and quality of life. Neurorehabilitation is a systematic intervention designed to compensate for or remediate the impairments caused by brain injury.
The main aim of the thesis was implementing new computer-based programmes, multitouch-multiuser tabletops and virtual reality in cognitive neurorehabilitation for children with ABI. Rehabilitation designs were developed for the treatment of attention, visuospatial, and social competence deficits.
59 children aged 8–12 years with ABI diagnosis (epilepsy, traumatic brain injury or tic disorder) and 47 healthy controls participated. Study group patients completed 10 training sessions guided by therapists. Pre-intervention assessments, and outcome assessments immediately and 1.31 years after the rehabilitation were carried out. ForamenRehab computer-programme was adapted to children and intervention protocols were created for attention and visuospatial function remediation. For social deficit remediation, the structured neurorehabilitation model was created, composed of the main components of social competence with evaluation and intervention tools: Snowflake Multiteach Tabletop, Diamond Touch Table and virtual reality programmes.
Pre-intervention assessments showed that children with ABI had significant deficits in attention, visuospatial abilities and social competence functions. Computer-based and virtual reality programs were effective in the remediation of cognitive deficits in patients. After training, the patients had improved performance in two attention (complex attention and tracking) and three visuospatial components (visual organization, visual attention and visuospatial perception). The positive training effect had preserved after 1.3 years in follow-up assessments. Additionally, after social deficit rehabilitation, the patients showed improvements in Theory of Mind and emotion recognition, and they used more cooperation, communication, and pragmatic skills. The patients’ compliance was 100% and feedback was positive for all three interventions.
In sum, the developed evidence-based intervention protocols and new technology-based rehabilitation methods are important in the remediation of specific cognitive deficits in children.