
Contents
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Introduction Introduction
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Goal-Directed Functioning With TBI-PTS—The Importance of Cognitive-Emotional Functioning Goal-Directed Functioning With TBI-PTS—The Importance of Cognitive-Emotional Functioning
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Targeting Core Self-Regulatory Control Functions Involved in TBI-PTS Targeting Core Self-Regulatory Control Functions Involved in TBI-PTS
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Increasing Access to Care Through Innovations in Service Delivery Increasing Access to Care Through Innovations in Service Delivery
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Brain State Regulation—A Fundamental Target for Improving Goal-Directed Functioning Brain State Regulation—A Fundamental Target for Improving Goal-Directed Functioning
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Targeting Gateway Functions That Underlie Successful Goal-Directed Functioning Targeting Gateway Functions That Underlie Successful Goal-Directed Functioning
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What Skills Need to be Trained to Improve Goal-Directed Functioning? What Skills Need to be Trained to Improve Goal-Directed Functioning?
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How Might We Train the Ability to Regulate Brain State to Best Achieve Goals? How Might We Train the Ability to Regulate Brain State to Best Achieve Goals?
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What Would the Ideal Training Approach Look Like? Building Generalizable Neurocognitive Skills in a Nonideal World What Would the Ideal Training Approach Look Like? Building Generalizable Neurocognitive Skills in a Nonideal World
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Potential Contributions of Technology to Enhancing Skill Training and Addressing Service Delivery: How Might Games be Useful in Augmenting Cognitive Training? Potential Contributions of Technology to Enhancing Skill Training and Addressing Service Delivery: How Might Games be Useful in Augmenting Cognitive Training?
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Technology to Aid in Application and Transfer of Skill Use Technology to Aid in Application and Transfer of Skill Use
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Technology Can Support Training Across A Range of Cognitive Contexts Technology Can Support Training Across A Range of Cognitive Contexts
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Experience Delivered Through Digital Technology Can Support Intensity and Calibration of Training Experience Delivered Through Digital Technology Can Support Intensity and Calibration of Training
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Technology Assistance Can Support Scenario-Based Experiential Learning Technology Assistance Can Support Scenario-Based Experiential Learning
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Digital Scenario-Based Game Experiences Can Augment The Power of Coaching Digital Scenario-Based Game Experiences Can Augment The Power of Coaching
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Technology Can Extend Therapist Reach and Patient Access Technology Can Extend Therapist Reach and Patient Access
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Brain-Training Games as A Stand-Alone Approach to Cognitive Training Brain-Training Games as A Stand-Alone Approach to Cognitive Training
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Technology-Assisted Training Systems for Guided Experiential Learning of Goal-Directed Brain State Regulation Technology-Assisted Training Systems for Guided Experiential Learning of Goal-Directed Brain State Regulation
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Summary of Training Approach Summary of Training Approach
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Principles of the Design of Technology-Assisted Neurocognitive Skill Training Principles of the Design of Technology-Assisted Neurocognitive Skill Training
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Theory-Driven, Patient-Centered Intervention Development Theory-Driven, Patient-Centered Intervention Development
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Augmenting Training With Technology-Assisted Learning Experiences (The Neural Pathfinder Series) Augmenting Training With Technology-Assisted Learning Experiences (The Neural Pathfinder Series)
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Working Your Way Up as an Apprentice in Cognitive Rehabilitation Working Your Way Up as an Apprentice in Cognitive Rehabilitation
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Game Scenarios Game Scenarios
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Distractions and Disruptions Distractions and Disruptions
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Training Protocol Training Protocol
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To What Extent Were Individuals With Brain Injury Able To Learn Basic Game Play? To What Extent Were Individuals With Brain Injury Able To Learn Basic Game Play?
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To What Extent Did Participants Demonstrate Understanding of Target Cognitive Processes? To What Extent Did Participants Demonstrate Understanding of Target Cognitive Processes?
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To What Extent Did Participants Demonstrate Use of The Trained Skills During Game Play? To What Extent Did Participants Demonstrate Use of The Trained Skills During Game Play?
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To What Extent Did Participants Find The Distractors Disruptive? To What Extent Did Participants Find The Distractors Disruptive?
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Were Trainees Able to Prospectively Generate Real-Life Situations Where Skills and Strategies Could be Applied? Were Trainees Able to Prospectively Generate Real-Life Situations Where Skills and Strategies Could be Applied?
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Did Trainees Report Applying Skills and Strategies to Real-Life Situations? Did Trainees Report Applying Skills and Strategies to Real-Life Situations?
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To What Extent Did Each Participant Perceive Changes in Personal Goal-Related Functioning? To What Extent Did Each Participant Perceive Changes in Personal Goal-Related Functioning?
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The Apprentice Project The Apprentice Project
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Moving from Start-up to CEO Moving from Start-up to CEO
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Game Design to Facilitate Strategic Skill Application Game Design to Facilitate Strategic Skill Application
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Coaching Opportunities in CEO Coaching Opportunities in CEO
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Ongoing Studies of Guided Experiential Learning With CEO Ongoing Studies of Guided Experiential Learning With CEO
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Training Experience Training Experience
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Changes to Cognitive Performance Changes to Cognitive Performance
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Self-Reported Benefits of Training Self-Reported Benefits of Training
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Implications of Guided Experiential Learning Implications of Guided Experiential Learning
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Reaching Farther: Technology in Support of Service Delivery in Neurocognitive Rehabilitation Reaching Farther: Technology in Support of Service Delivery in Neurocognitive Rehabilitation
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Tele-Rehabilitation Tele-Rehabilitation
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Feasibility of Implementation and Plausibility of Benefits Feasibility of Implementation and Plausibility of Benefits
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Implications For Tele-Rehabilitation Implications For Tele-Rehabilitation
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Reaching Veterans in School Reaching Veterans in School
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Conclusion Conclusion
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References References
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32912 Technological Innovations to Enhance Neurocognitive Rehabilitation
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Published:May 2017
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Abstract
In an instant, a brain injury can cause changes that affect a person for a lifetime. Although traumatic brain injury (TBI) can result in almost any neurological deficit, the most common and persistent deficits tend to affect neurocognitive functioning. Functional issues may produce a tremendous chronic burden on individuals, families, and healthcare systems (Thurman, Alverson, Dunn, Guerrero, & Sniezek, 1999; Yu et al., 2003). The far-reaching impact of these seemingly “invisible” deficits is often not recognized. Individuals who have suffered a TBI may also be at increased risk for developing cognitive changes later in life (Mauri et al., 2006; Schwartz, 2009; Van Den Heuvel, Thornton, & Vink, 2007). Military veterans report even higher rates of persistent issues, especially in the context of posttraumatic stress (PTS) (Polusny et al., 2011). Despite their importance, chronic neurocognitive dysfunctions are often poorly addressed. A long-term view on care-oriented research and development is needed (Chen & D’Esposito, 2010). Even as we get deeper into the 21st century, there continue to be many gaps in the rehabilitation of neurocognitive functioning after brain injury. There is a need for increased effort to advance rehabilitation care and delivery. There are two major gaps in care that could benefit from neuroscience research and technology-assisted intervention development. First, there remains a major need for theory-driven approaches to cognitive training, accompanied by the development of innovative tools to support learning of useful skills and their generalization to help achieve real-life goals. Second, major gaps in the delivery and coordination of rehabilitation must be addressed in order to provide care to the many people with brain injury who lack access to services due to barriers imposed by distance, financial constraints, and disability. This chapter introduces and illustrates some technology-assisted innovations that may help to advance neurocognitive rehabilitation care. Examples of using technology to reach into the community via tele-rehabilitation, as well as examples of reaching students in a manner aligned with their scholastic goals, are discussed.
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