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Updated: Jul 16, 2026

Assessment and Communication for People with Disorders of Consciousness
Published on: August 1, 2017
[The 'awareness climbing': an educational board game for improving self-awareness following acquired brain injury]
M C Caballero-Coulon1, J Ferri-Campos, M C Garcia-Blazquez
1Servicio de Daño Cerebral, Hospitales NISA, Instituto Valenciano de Neurorrehabilitación, Valencia, Spain.
Aim:
To establish the effectiveness of an educational board game for improving self-awareness following acquired brain injury.
Patients And Methods:
The 'awareness climbing' is a board game format intervention for improving awareness of patients with acquired brain injury (ABI) and for facilitating the use of anticipatory and compensatory strategies. 17 patients with ABI (traumatic brain injury, 10; stroke, 5; others, 2) were included in a self-awareness rehabilitation program using the 'awareness climbing'. Self-awareness was assessed with the Self-Awareness of Deficit Interview (SADI) before and after game intervention. According to the SADI self-awareness consists of three-interdependent levels: intellectual awareness (impairments), emergent awareness (disability) and anticipatory awareness, which involve the client predicting when impairments will affect his or her performance.
Results:
Initially five patients showed impaired intellectual awareness, four patients had difficulties on emergent awareness and nine patients showed deficits on anticipatory awareness. Intellectual awareness improved in 10 patients, while six patients experienced improvements in emergent awareness over the intervention period. The most striking change was an improvement in 70% of the sample (n = 11) in anticipatory awareness after game sessions.
Conclusion:
According to SADI scores we suggest that the 'awareness climbing' may be a useful tool for improving self-awareness after acquired brain injury.
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