The effects of problem-solving skills training based on metacognitive principles for children with acquired brain injury attending mainstream schools: a controlled clinical trial

Purpose. To investigate the effects of an explicit problem-solving skills training programme based on metacognitive principles for children with acquired brain injury (ABI) who attend mainstream schools. Method. Thirty-two children with moderate to severe ABI studying in mainstream schools were allocated randomly by matched pairs to either an experimental or a comparison group. The participants in the experimental group received problem-solving skills training based on metacognitive principles, while those in the comparison group were on a waiting list to receive the experimental intervention shortly after the intervention in the experimental group had been completed. All participants were measured pre- and post-intervention using measures of abstract reasoning, metacognition, problem-solving functional behaviour in the home environment or social situations and individual goal-directed behaviour. Results. Significant differences in post-test scores were found for all measurements between children in the experimental group and those in the comparison group, using the baselines of dependent variables, years of schooling and the full IQ scores as the covariates. Conclusion. The results of this study supported the use of explicit problem-solving skills training to improve daily functioning for children with ABI, and the need for a larger-scale, randomised controlled study with long-term follow-up.