Abstract
Background:
People with severe mental illness such as schizophrenia often experience cognitive impairments and difficulty performing everyday tasks, such as money or medication management, which are critical to independence living. Thus, there is an increasing interest in developing tools to detect the earliest manifestations of cognitive and functional decline and in developing efficacious treatment approaches for those who are experiencing cognitive and functional problems. In terms of remediation strategies, a variety of cognitive remediation training (CRT) programs have emerged, many of which are computer-based. These programs train basic cognitive abilities such as working memory or reasoning and are aimed at preventing or remediating cognitive decline. Although these programs can be effective in improving cognitive abilities, there is limited evidence, which suggests that these programs result in performance gains in everyday tasks. This presentation will discuss an innovative, ecologically valid, technology-based training program that focuses on everyday tasks, which can be used to train functional skills. Data will also be presented from a small pilot study with a sample of patients with schizophrenia and healthy older adults.
Methods:
The training currently focuses on money and medication management and is designed to be consistent with adaptive training models of learning. The sample for the pilot test of the training program included nonimpaired older adults (
N
= 12) and adults with schizophrenia (
N
= 20) who ranged in age from 28 to 71 years (55% > 55 y). The sample was ethnically diverse and included males and females. Participants completed a fixed difficulty version of the tasks at baseline and then completed 4 training sessions on separate days. They then completed the fixed difficulty assessment tasks post-training.
Results:
The task performance data include real-time measures of accuracy, response time, and types of errors. Participants also completed a short interview to evaluate the training program. The data indicated that use of the task simulations, as a training tool, is feasible and acceptable to nonimpaired and impaired adult populations. Ninety-four percent of the sample thought the training was useful and felt that the training helped their ability to perform the tasks outside of the training setting. Ninety-one percent of the sample felt the training was enjoyable. In addition, participants in both groups evidenced significant improvements in the performance of both tasks. Specifically, the efficiency of task performance increased by ~50% for both groups for both tasks.
Conclusion:
Our findings indicate that use of a computer-based functional skills training program that includes veridical representations of everyday tasks is a useful tool for training functional task skills in a variety of populations.