What are the cognitive characteristics of poor learners? Cognitive characteristics of poor learners distinguished by the dynamic WCST in a clinical sample of patients with acquired brain injury.

Abstract

In this study learning potential (LP) of patients with acquired brain injury (ABI) was assessed using the dynamic Wisconsin Card Sorting Test (dWCST). Dynamic assessment, a method to determine the ability to improve by training, has been used frequently to asses LP in patients with schizophrenia or schizoaffective disorder. However, only one study assessed LP with the dWCST in patients with ABI. Since LP seems essential for rehabilitation, this study aimed to identify different levels of LP in patients with ABI, resulting in 3 LP groups (i.e, low; moderate; high) and to relate these to cognition. Expected was that level of LP had a positive relation with cognition, especially with memory. 54 inpatients with ABI at a rehabilitation centre were included and the dWCST was administered in a pre-test-training-post-test fashion. Results showed that different levels of LP can be identified in patients with ABI resulting in a low, moderate and high LP group. These groups differed in cognition, the low LP group showed a poorer performance on verbal memory and executive functioning in comparison to the high LP group. Clinical message Dynamic assessment like the dWCST could have implications for use in rehabilitation as an addition to the standard neuropsychological assessment, reflecting not only static measures but also the ability to learn by guidance. In this manner patients with low LP can be detected easily and provided with therapy programmes tailored to their specific learning capacities.