RCT Emotion Recognition after TBI, 1
Cognitive Control (Ctrl) Intervention
Supplemental Digital Content
I. Treatment Concepts
 The Cognitive Control intervention addresses basic cognitive skills. Unlike the Faces and Stories
Interventions, it does NOT address emotion recognition skills. As a sham-control, the Cognitive
Intervention was included to control for potential effects that the Faces and Stories Interventions
might have on participants as a result of time spent interacting with a therapist. The Cognitive
Intervention is similar to the Faces and Stories Interventions in every way, except that it does not
teach direct emotional processing skills. See below section on Logistics of treatment
administration for more information on this.
II. Learning Strategies
 Repetition
 Increasing difficulty
 Feedback
III. Communicating the purpose and importance of the treatment to participants
Participants are oriented to the treatment: Even though it is not truly the goal of this treatment to
improve participants’ emotions, participants are told that the basic cognitive training they will may be an
important foundation for processing emotions. We frame the treatment in this manner because we want
to keep our participants “blinded” about the intervention they are receiving. It is important they not
know the Cognitive Intervention they are receiving is not expected to have effects. Participants are told:
“For the next several weeks we are going to work on the basic skills thought to be important for
recognizing emotions in others. Therefore this treatment looks at whether improving skills such
as speed of processing, attention, visuo-spatial organization, memory and problem solving abilities
will help you to better determine how others are feeling. We may find that you are better at some
activities than others. The ones that you are really good at, we will spend less time on. We will
focus more of our time on the activities that are more challenging for you so that we may improve
those skills. For each exercise you will get a score. In some of the activities, if you get below an 80%
you will need to repeat the exercise by the end of the 9 treatment sessions.”
III.
Description of Cognitive Control intervention and treatment administration
 This intervention is computer-based.
 The therapist and the participant could choose to start with whatever activity they felt would be
most applicable to the participants’ cognitive needs. This was important in order to keep
participants engaged and make sure they did not get bored with the “treatment”.
 All activities did not have to be completed; just those determined to be relevant. However the
participant had to come in for 9 hours of the therapy. How the activities were distributed over
the 9 hours was up to the therapist and participant. The activities the therapists had to choose
from are listed in Table 1.
 Therapists were to provide participants with advice and compensatory strategies as needed.
 The intervention addresses the following skills:
o Attention
RCT Emotion Recognition after TBI, 2
o
o
o
o
o
o
o
o
o

Speed of processing
Visuo-spatial skills
Reaction time
Memory
Planning
Problem Solving
Decision-making
Following directions
Application to Functional Skills (Table 1, Everyday Life; Math and Money)
Activities and websites used: Table 1.
Activity (all computer
exercises)
Memory for Life
Source
http://cognitivelabs.com/speedtest_mydna2.htm
http://cognitivelabs.com/sightspeedtest2.htm
http://cognitivelabs.com/cognitive_freetest3.htm
Concentration
Memory Games
Tower of Hanoi
http://faculty.washington.edu/chudler/java/brconc.html
http://www.funbrain.com/match/index.html
http://www.buzzle.com/games/MetroMatch.asp
http://www.youramazingbrain.org.uk/yourmemory/digitsp
an.htm#
http://www.easysurf.cc/menu.htm
http://cognitivelabs.com/tower_of_hanoi.htm
Diamonds of
Perception
“Acuity”
http://cognitivelabs.com/test8.htm
Battle Pong
http://cognitivelabs.com/games_Battle_Pong.htm
Block Breaker
http://cognitivelabs.com/games_blockbreaker.htm
Tetris
http://cognitivelabs.com/games_original_tetris_intro.htm
Sodoku
http://cognitivelabs.com/games_sodoku.htm
http://www.gcflearnfree.org/everydaylife
Everyday Life
 Measure food
 Mix food
 Bake
 Food labels
 Money (stamps,
change, vending
machine, ATM,
Concepts / Cognitive
skills addressed
Timed tasks on
attention, speed of
processing, reaction
time, verbal and
pictorial memory
Attention, visual
memory, spatial
memory
Attention, memory
Planning, problem
solving
Acuity, color
matching; visual
perception, speed of
processing, reaction
time.
Reaction time,
decision making and
planning, and visual
skills
Reaction time,
attention
Visual spatial
organizational skills,
reaction time
Planning, problem
solving, attention
Attention, visual
scanning, following
directions, planning
problem solving, math.
RCT Emotion Recognition after TBI, 3
Debit card,
Banking)
 Work (time
sheet,
classifieds, job
application)
 Shopping
 Maps,
schedules, and
phone numbers
Math and Money
 Addition
 Subtraction
 Multiplication
 Division
 Decimals
 Percentages
 Word problems
 Money
management
 Smart shopping
 Banking
Table 1.
IV.






http://www.gcflearnfree.org/math
http://www.gcflearnfree.org/moneybasics
Attention, problem
solving, math
Logistics of Treatment Administration
Training should be one-on-one in a quiet room.
A computer and internet are needed to access the computer exercises.
Provide breaks to the participant as needed.
Training should attempt to be administered 3 times a week for 3 weeks, with each session lasting one
hour. However, if there are transportation concerns, there is flexibility in how the 9 hours of treatment
can be administered (e.g.,…..).
Some activities require 80% accuracy to move to next exercise. If not achieved, the participant must
repeat that exercise. Participants have only 2 attempts at each exercise to reach 80%. If on the second
attempt, the participant does not reach 80%, then the therapist can move on to the next exercise.
Table 2 compares treatment differences of the Cognitive Control Intervention with Faces and Stories
Interventions.
Cognitive Control
Faces
Stories
Computer-based



9 hrs of treatment



1:1 training with RA



Use performance



accuracy to advance to
next task
Teach skills directly


related to emotion
processing
Table 2.