Dynamic assessment of learning ability improves outcome prediction following acquired brain injury

Abstract

Primary purpose: There is a need to improve the prediction of outcome following acquired brain injury. The previous focus has been on specifying the relative contribution of such variables as pre-morbid intellectual ability, socioeconomic status, severity of injury and performance on neuropsychological assessments. To date, findings remain discrepant and often inconclusive. The present study examined whether dynamic assessment testing scores predict outcome. Research design: Both standard and dynamic assessment of 77 individuals with acquired brain injury was performed. Dynamic assessment identifies the learning potential of the individual, rather than measuring their statically assessed cognitive ability. The individual's potential to learn the Wisconsin Card Sorting Task (WCST), with guided instruction and feedback, was assessed and compared with standardized static measures. Results: Using Rasch analysis, individual learning potential was determined and, unlike the standard WCST scores, was predictive of integration into the community following brain injury. Conclusion: It is concluded that dynamic testing potentially may offer advantages over the traditional standard cognitive tests in predicting the outcome for people with brain injuries.