Assessment of executive function impairments in adults with acquired brain injury across single-case experimental design: A scoping review of primary outcomes

ABSTRACT

The use of single-case experimental design (SCED) to evaluate cognitive remediation is growing. SCEDs require rigorous methodology and appropriate choice of primary outcomes. To review primary outcomes that assess executive function impairments in patients with acquired brain injury (ABI). A scoping review was conducted using the Arksey and O’Malley framework and the PRISMA extension for scoping review (PRISMA-ScR). Five databases were searched resulting in the inclusion of twenty-one studies. Primary outcomes were extracted and classified according to the type of measure, ecological setting and sources of possible bias. A wide variety of primary outcomes were identified; the majority of which evaluated behavioural performance during a real-life activity or in a real-life simulated setting. The most frequent bias observed across outcomes was the coaching effect. The findings of this scoping review highlight the importance of selecting appropriate outcomes for repeated measures in SCED studies. Direct observation of the target behaviour is a potential gold standard for assessing the effectiveness of a cognitive intervention.

KEYWORDS:

• Cognitive rehabilitation
• Single-case experimental design
• Executive functions
• Target behaviour assessment
• Acquired brain injury

Acknowledgements

We would like to thank Dr Quentin Chenot, Ines Bigarre and the Occupational Therapy Team at the Physical Medicine and Rehabilitation Department (Alizée Lelièvre, Corentin Bidou, Emilie Catella, Magali Martin and Baptiste Gentilhomme) for their help and for comments, expertise and insight on this review.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the French National Research Agency (ANR) and the Defence Procurement Agency (DGA), ASTRID program [grant number ANR-17-ASTR-0005]. The first Author also gratefully acknowledges financial support from “Fondation des Gueules Cassées” [grant numbers 52-2020; 46-2021 and 47-2022].