Providing individualized services: a traumatic brain injury case study

This applied study was designed to improve the time on task and accuracy for a woman, several years post traumatic brain injury (TBI), who previously did not reside in settings which provided individualized rehabilitation programs for persons with TBI. The program took place in a rural Adult Developmental Activity Program (ADAP) and employed a single subject design. The individual sat at a computer work station and pressed a Liberator, speech device, connected to a personal computer. The individual responded to questions concerning how she wanted to design greeting cards. Because this was a rehabilitation applied study, instructors changed her environmental setting to enhance program success. Each external change is referred to as a phase. Instructors recorded her mean baseline time on task, subsequent mean times for each phase of the study and the percentage of accurate responses to the computer-based design questions. The individual's time on task increased, steadily, from her 4.8-min mean baseline, to a mean of over 90 min (with breaks). Her accuracy also improved from 0% to very high percentages, once scoring 100%. The applied study illustrates the rehabilitation gains that may occur when programs are individually designed to accommodate ongoing adjustments. The study also reinforces the resiliency of some individuals many years post injury.