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Purpose:  To investigate if a metacognitive goal-based intervention (IMPACT) improves self-awareness (SA) in adults with cognitive-communication disorders (CCDs) following acquired brain injury (ABI). It was hypothesized that following the intervention, participants would exhibit improved SA and thus would perceive a higher frequency of communication difficulties. Method:  A post-hoc analysis of two pre–post pilot trials was conducted in this study to investigate changes in the level of SA in 16 community-dwelling adults with CCDs following ABI. The treatment, IMPACT, contained three components: individual goal-based therapy, group therapy and significant other facilitated home practice. Results:  Whilst the intervention programme did not elicit a significant change in participants’ self-assessment of communication ability ( p  = .310), it did produce a statistically significant improvement in overall SA ( p  = .021) and emergent awareness ( p  = .034). Changes in participants’ level of intellectual awareness approached statistical significance ( p  = .059). Participants achieved a statistically significant improvement in GAS T-score ( p &lt; .001), with the majority of participants achieving all of their individualized treatment goals. Conclusions:  Metacognitive strategy instruction (MSI) appears effective at improving impaired self-awareness (ISA) in adults with CCDs following ABI. To strengthen the conclusions of the current investigation, further research involving a standardized treatment protocol, a stable measure of communication ability, a larger sample size and the inclusion of participants with more significant ISA is recommended.

speech, language and hearing

Does metacognitive strategy instruction improve impaired self-awareness in adults with cognitive-communication disorders following an acquired brain injury?