An Overview of the Attention Improvement Management (AIM) Program With Outcomes for Three Pilot Participants Direct attention training (DAT) and metacognitive strategy instruction have been employed to treat the cognitive deficits associated with traumatic brain injury (TBI) in children and are supported by an emerging evidence base (e.g., Butler et al., 2008; Galbiati et al., 2009; Luton, Reed-Knight, Loiselle, O’Toole, & Blount, 2011; van’t Hooft ... Article
Article  |   October 01, 2012
An Overview of the Attention Improvement Management (AIM) Program With Outcomes for Three Pilot Participants
Author Affiliations & Notes
  • Jaime Lee
    University of Oregon, Communication Disorders & Sciences, Eugene, OR
  • Beth Harn
    University of Oregon, Special Education, Eugene, OR
  • McKay Moore Sohlberg
    University of Oregon, Communication Disorders & Sciences, Eugene, OR
  • Shari L. Wade
    Cincinnati Children's Hospital Medical Center and The University of Cincinnati College of Medicine, Cincinnati, OH
  • Disclosure: Jaime Lee has no financial or nonfinancial relationships related to the content of this article.
    Disclosure: Jaime Lee has no financial or nonfinancial relationships related to the content of this article.×
  • Disclosure: Beth Harn has no financial or nonfinancial relationships related to the content of this article.
    Disclosure: Beth Harn has no financial or nonfinancial relationships related to the content of this article.×
  • Disclosure: McKay Moore Sohlberg has no financial or nonfinancial relationships related to the content of this article.
    Disclosure: McKay Moore Sohlberg has no financial or nonfinancial relationships related to the content of this article.×
  • Authors
    Authors×
    Jaime Lee is a doctoral student at the University of Oregon and a clinical supervisor at the University of Oregon Speech-Language-Hearing Center. Lee has worked as an inpatient rehabilitation clinician and has research experience in the utilization of computer technology to provide intensive therapy to individuals with aphasia. Her research interests include the investigation of evidence-based interventions for individuals with cognitive-communication and language disorders and the clinical applications of emerging technology.
    Jaime Lee is a doctoral student at the University of Oregon and a clinical supervisor at the University of Oregon Speech-Language-Hearing Center. Lee has worked as an inpatient rehabilitation clinician and has research experience in the utilization of computer technology to provide intensive therapy to individuals with aphasia. Her research interests include the investigation of evidence-based interventions for individuals with cognitive-communication and language disorders and the clinical applications of emerging technology.×
    Beth Harn is an associate professor within the Department of Special Education and Clinical Sciences at the University of Oregon. She teaches classes in special education, including instructional design, educational assessment, introduction to learning disabilities, and systems level academic interventions. Expertise areas include early identification, assessment, and designing and delivering effective reading interventions. Her research interests focus on early intervention for students with reading difficulties by implementing schoolwide, coordinated instructional and assessment practices and designing intensive interventions.
    Beth Harn is an associate professor within the Department of Special Education and Clinical Sciences at the University of Oregon. She teaches classes in special education, including instructional design, educational assessment, introduction to learning disabilities, and systems level academic interventions. Expertise areas include early identification, assessment, and designing and delivering effective reading interventions. Her research interests focus on early intervention for students with reading difficulties by implementing schoolwide, coordinated instructional and assessment practices and designing intensive interventions.×
    McKay Moore Sohlberg is the Hedco Endowed Professor in the Communication Disorders & Sciences program at the University of Oregon. Her work in developing and evaluating cognitive rehabilitation programs for adolescents and adults with brain injury is well known internationally. She has authored numerous journal articles, two leading texts in the field, and a number of widely used evidence-based clinical programs. Sohlberg has been the Principal Investigator on a number of funded projects developing methods to help people with chronic long-term impairments following brain injury integrate into the community, particularly through the use of assistive technology.
    McKay Moore Sohlberg is the Hedco Endowed Professor in the Communication Disorders & Sciences program at the University of Oregon. Her work in developing and evaluating cognitive rehabilitation programs for adolescents and adults with brain injury is well known internationally. She has authored numerous journal articles, two leading texts in the field, and a number of widely used evidence-based clinical programs. Sohlberg has been the Principal Investigator on a number of funded projects developing methods to help people with chronic long-term impairments following brain injury integrate into the community, particularly through the use of assistive technology.×
    Shari Wade is a pediatric rehabilitation psychologist and professor at Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine. She is director of the Rehabilitation Research and Training Center for Pediatric TBI Interventions, which is supported by the National Institute on Disability and Rehabilitation Research. Wade has engaged in research on recovery from TBI in children for over two decades. Her research interests include the effects of TBI on families, the relationship of social environmental factors to child recovery, and investigation of cognitive-behavioral and family interventions to facilitate child and family adaptation.
    Shari Wade is a pediatric rehabilitation psychologist and professor at Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine. She is director of the Rehabilitation Research and Training Center for Pediatric TBI Interventions, which is supported by the National Institute on Disability and Rehabilitation Research. Wade has engaged in research on recovery from TBI in children for over two decades. Her research interests include the effects of TBI on families, the relationship of social environmental factors to child recovery, and investigation of cognitive-behavioral and family interventions to facilitate child and family adaptation.×
  • Disclosure: Shari L. Wade has no financial or nonfinancial relationships related to the content of this article.
    Disclosure: Shari L. Wade has no financial or nonfinancial relationships related to the content of this article.×
Article Information
Attention, Memory & Executive Functions / Traumatic Brain Injury / Articles
Article   |   October 01, 2012
An Overview of the Attention Improvement Management (AIM) Program With Outcomes for Three Pilot Participants
SIG 2 Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, October 2012, Vol. 22, 90-105. doi:10.1044/nnsld22.3.90
SIG 2 Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, October 2012, Vol. 22, 90-105. doi:10.1044/nnsld22.3.90

Direct attention training (DAT) and metacognitive strategy instruction have been employed to treat the cognitive deficits associated with traumatic brain injury (TBI) in children and are supported by an emerging evidence base (e.g., Butler et al., 2008; Galbiati et al., 2009; Luton, Reed-Knight, Loiselle, O’Toole, & Blount, 2011; van’t Hooft et al., 2007). The importance of treatment intensity is well established for DAT (Sohlberg et al., 2003), yet restrictions in the delivery and funding of rehabilitation services, the availability of well-trained interventionists, and access by geographic locale remain critical barriers to the provision of intensive services. Computer-delivered treatments that incorporate a home practice component address the gulf between the intensive, daily practice suggested by the efficacy research and these clinical delivery constraints. The purpose of this paper is to (a) review the literature evaluating the integration of DAT and metacognitive facilitation to treat children and adolescents with traumatic brain injury (TBI); (b) present the rationale and description of a computerized program, Attention Improvement Management (AIM); (c) detail the program components; and (d) present outcome data from three pilot participants who completed the intervention. A specific and growing subset of children with TBI have attention impairments following mild brain injuries or concussions (Schatz & Scolaro Moser, 2011) and served as the pilot participants in this study. Pilot participants demonstrated clinically meaningful improvements on attention outcome measures and generalization of the metacognitive strategies trained within the program to contexts outside of therapy, including both academic and social settings. Though initial results are promising, further research is needed to evaluate the efficacy of the AIM intervention to treat the attention and executive function impairments associated with pediatric TBI.

Acknowledgments
This project was supported in part by grants from the Department of Education's National Institute on Disability and Rehabilitation Research (Center on Interventions for Children and Youth with Traumatic Brain Injury; Grant number H133B090010-10) and the Ohio Department of Public Safety Emergency Medical Services Program. This material does not necessarily represent the policy of these agencies, nor is the material necessarily endorsed by the Federal Government. Additionally, the authors would like to recognize the contributions of Jason Prideaux for his extraordinary programming of the intervention.
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