Research Faculty
Dr. Adina Hartman-Maeir
Prof. Noomi Katz
Dr. Yehuda Pollak
Dr. Uri Feintuch
Asnat Bar-Chayim Erez
RATIONALE
Acquired and developmental neurological dysfunction (such as acquired brain injury, stroke and ADHD) are often accompanied by cognitive deficits, such as disturbances in attention, memory and awareness. These deficits have been shown to be a significant obstacle for participation in meaningful occupations and negatively influence quality of life. There is a need for the development of theoretically grounded interventions which will enhance the quality of life of individuals with cognitive disabilities. The focus of our research is on studying the effectiveness of interventions for these populations.
RESEARCH PROJECTS
1. Goal Management Training (GMT)
Population: Individuals with mild-to-moderate neurological dysfunction
Goal: GMT is a strategy-training approach for individuals with cognitive dysfunction. We are testing generalized goal management strategies within an occupation-based, client centered context. Initial research with clients with mild to moderate disability levels, shows successful acquisition of executive skills using these training strategies. However, further research is necessary to assess the effectiveness of these interventions in a wide variety of populations with neurological dysfunction.
2. Computerized training for executive function deficits in individuals with attention deficit hyperactivity disorder (ADHD)
Population: People with ADHD
Goal: The underlying mechanism of executive dysfunction in ADHD is a core inhibition deficit. We are developing a computerized training protocol that targets various types of inhibition control. We are studying the responses of healthy populations to the program in order to examine the feasibility of this kind of training with individuals with ADHD in order to establish whether or not people improve with training and what intensity of stimulation is required to achieve an effect. This information can then be used to train people with ADHD to inhibit inappropriate behavioral responses.
3. Awareness Enhancement Program (AEP)
Population: People with Acquired Brain Injury (ABI)
Goal: AEP is a treatment designed to improve the awareness levels of individuals with acquired brain injury, since awareness is a prerequisite for effective strategy training and implementation in the rehabilitation process. The program comprises educational and experiential components, providing clients with the tools to discover the consequences of brain injury within a supportive, activity-based setting. We are researching awareness and strategy use before and after intervention in order to examine the effectiveness of AEP with adults attending inpatient and outpatient neuro-rehabilitation programs.
4. Development of ecologically valid cognitive assessments
Population: All populations with cognitive deficits
Goal: Ecologically valid cognitive assessments that can predict the daily needs of individuals with cognitive deficits need to be developed. In order to provide rehabilitation services for individuals with cognitive deficits there is a need for assessments that will measure the direct manifestations of cognition in occupational performance. These measures will enable the prediction of functional status and provide the basis for treatment planning along with the traditional neuropsychological measures. We are currently developing and examining the reliability and validity of several measures designed for this purpose, including “The Cognitive-Functional Screening Test”, "The Executive Functions Performance Test”, "The Unilateral Neglect in Activities of Daily Living checklist” and "The Online Awareness Assessment.”
5. Development and evaluation of treatment methods for individuals with unilateral spatial neglect (USN)
(in collaboration with the Virtual Reality laboratory)
Population: People with USN
Goal: USN is a common and disabling cognitive deficit that commonly occurs after right hemisphere stroke. Individuals with USN have difficulty attending to stimuli on the side opposite the brain lesion and therefore have difficulty with many activities of daily living that require bilateral attention, such as reading both sides of a page, eating from both sides of a plate, ambulating in the environment and driving. Some innovative treatment methods have been developed, such as “phasic alerting” and “limb activation” yielding promising initial results, however additional research is required to examine their rehabilitation potential (i.e. ability to bring about significant change in the daily occupations and quality of life of individuals with USN). We intend to refine the treatment protocols and conduct clinical trials with this population.
6. Outcome evaluation of rehabilitation programs
(in collaboration with the Rehabilitation Throughout the Lifespan laboratory)
Population: People with Acquired Brain Injury (ABI)
Goal: We intend to assess the outcome of rehabilitation programs for individuals with acquired brain injury (inpatient and outpatient.) The most common model of rehabilitation in Israel is a hospital-based short-term (1-3 months) program. Long-term community-based intervention is scarce. We are investigating the long term outcomes of the differing interventions in order to assess the functional outcomes of individuals after rehabilitation as well as the cost effectiveness of the different approaches.
IMPLICATIONS FOR TARGET POPULATIONS
The implications of our research are widespread for all individuals with cognitive deficits. We hope that our research will lead to the development of a remedial program for people who suffer from ADHD. Such a program could be used together with pharmaceutical interventions or implemented with individuals who are not able to benefit from medication.
In addition, our research will lead to the development of intervention protocols for individuals with deficits in higher cognitive level functions (awareness and executive functions). These protocols will improve everyday functioning, safety and independence after acquired brain injury and, as such, improve quality of life. In addition, these intervention protocols have the potential to prevent secondary regression common in these populations, such as accidents, depression, decreased participation and an increased caregiver burden.
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