Poster 23: Examining the Usability of a Computerized Cognitive Training Program in People with Traumatic Brain Injury: A Pilot Study

Objective: To evaluate the feasibility and utility of a program of computerized cognitive exercises as an intervention for people with traumatic brain injury (TBI). Design: Pilot pre-post study. Setting: Participants' homes in an urban community. Participants: 8 individuals with mild to severe TBI who were 8 months to 22 years post- injury (M=125.75 months, SD=36.6). Interventions: Individual training with InSight, a software program designed to improve processing speed, attention, memory, and visual precision. InSight involves a graduated series of structured exercises. It has been shown to improve cognitive functioning in adults with cognitive impairments. Participants were asked to use the software for 40 minutes per day, 5 days per week for 6 weeks; they received daily reminders to do their training and progress was monitored. Main Outcome Measures: Automated Neuropsychological Assessment Metrics (ANAM 4), a validated computerized neuropsychological battery that tests processing speed, working memory, attention, encoding, spatial processing, and accuracy. Cognitive Failures Questionnaire (CFQ), Frontal Systems Behavior Scale (FRSBE), User Experience Survey (UES). Results: All participants were able to use the software. On the UES, participants reported improvements in concentration, executive function, visual processing, memory, and cognitive stamina. Main obstacles were technical difficulties with the software and/or participants' own computers and participants' inability to complete the requested amount of training in the specified time period. On five of seven ANAM 4 measures, small to medium effect sizes were noted (Cohen d of .18 to .44). On the CFQ, effect sizes varied from medium to large (.37 to 1.85) and on the FRSBE from small to large (.23 to .82). Conclusions: Computerized speed and attention training may be a viable intervention for outpatients with TBI. The intervention can be delivered in patients' homes with support provided remotely. Further study in randomized trials is warranted.