Evidence-based practice for the use of external aids as a memory compensation technique

The research to date underscores the potential of external aids to improve the daily functioning of people with memory impairments. The studies are universally supportive of the general practice of using external aids to compensate for memory impairments, but lack sufficient evaluation of critical treatment implementation parameters to support a practice standard. Thus, our committee recommends the use of external aids in the treatment of memory impairments as a rehabilitation practice guideline for adults with memory impairment following TBI. A critical research gap is the lack of information on factors that lead to long-term adoption of external aids. There is a great need for research that avoids the methodological concerns noted in the current literature pool in order to deepen our understanding of the broad spectrum of variables necessary for successful use of external aids in the memory-disordered population. Research needs to address questions related to the design and selection of aids (including both high- and low-tech devices designed for people with cognitive disabilities and aids such as palmheld devices and notebooks that are designed for the general population) and the evaluation, instruction, and ongoing monitoring of people using the devices. Research on user patterns and device acceptance in the field of augmentative and alternative communication may offer models for studying memory aid use. We conclude this report with a list of specific research questions that must be addressed before more detailed practice guidelines can be generated. 1. What are the individual and environmental factors that affect the long-term, continuous use of various types of external aids by persons with memory impairments? 2. What are the evaluation components that lead to the selection (and customization) of the most appropriate aids or devices for an individual with a memory impairment? 3. What are the training components most likely to lead to efficient, durable use of an external aid? 4. When individuals successfully use external aids, what are the best indicators to capture the aids' impact on daily functioning? 5. Which clients need explicit generalization training? 6. How can we facilitate generalization of the use of external aids across various aspects of our clients' everyday life? Copyright © 2007 Thomson Delmar Learning.