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The case below describes how NeuroPage can help clients to establish a routine.
George was 16 when he sustained a severe traumatic brain injury in a car accident, which caused particular difficulties with memory and attention.
Seven years later, he was in the process of leaving his parents’ house to live in his own flat when he entered into a research trial evaluating the effectiveness of NeuroPage. Together with his parents and a researcher, a set of behavioural targets was identified to monitor throughout the research trial – over a baseline phase, a 7-week trial period with NeuroPage, and a follow-up period without the pager.
George received messages prompting him to:
(1) wake him up in the morning,
(2) prompt him to wash and shave,
(3) take tablets and record that this had been done,
(4) complete household tasks (varied day-to-day),
(5) prepare his evening meal, (6) remind him of social and leisure activities, and
(7) check his memory diary.
With NeuroPage, George was much more likely to complete the targeted activities compared with his baseline level of performance. For example, he prepared his meals 100% of the time compared with 50% of the time, and he remembered his medication 100% of the time compared with 0% previously. Overall, he completed 48% of his target activities at baseline, 87% of them when using NeuroPage, and 70% after using NeuroPage. That George maintained some of the improvements after using the pager indicated that some routines had been established. After the research trial, George and his team planned a more comprehensive set of messages to establish other routines related to independence. This was evaluated over a three-month period, with the message schedule being refined on a week-by-week basis. The approach was highly effective. Where he had previously had two support workers providing 24-hour care, after using the pager this was reduced to one support worker during daytimes. In his words, “I’m able to get things done, organise my life, plan and prioritize”.
This case is reported fully in:
Wilson, B.A., Emslie, H., Quirk, K., & Evans, J. (1999). George: Learning to live independently with NeuroPage®. Rehabilitation Psychology, 44(3): 284-296.