Therapist-Guided Verbalization During Tabletop Cognitive Tasks to Support Self-Monitoring and Daily Functioning After Stroke: A Case Report of Two Cases.

Executive dysfunction after stroke can impair self-monitoring and interfere with daily functioning. Tabletop cognitive tasks are commonly used in cognitive rehabilitation, but transferring training effects to daily life remains a challenge. This case report describes two patients with post-stroke executive dysfunction who received tabletop cognitive interventions incorporating therapist-guided verbalization and self-monitoring. Although the task content and intervention structure differed between the cases, both interventions used task performance as an opportunity to promote verbalization of the thinking process, reflection, error detection, and self-monitoring. Following the intervention period, both patients showed improvements in task performance and daily functioning. In Case 1, the patient became able to complete the Trail Making Test Japanese Version (TMT-J), and goal-directed behavior in daily life improved. In Case 2, TMT-J Part B became achievable, the Kohs Block Design Test Japanese Version improved, medication errors were no longer recorded, and improvements were also observed in other instrumental activities of daily living. These cases suggest that therapist-guided verbalization and self-monitoring during tabletop cognitive tasks may be a clinically feasible approach for supporting the transfer of cognitive rehabilitation strategies to real-life activities, although causal conclusions cannot be drawn from this report of two cases.