The effect of context on learning functional living skills for a population of people with schizophrenia
Duncombe, Linda Werkley
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This quasi-experimental study was undertaken to determine the effect of context on learning a functional living skill for individuals with cognitive deficits associated with the negative symptoms of schizophrenia. Forty-six people (ages 27-62) with non-paranoid schizophrenia or schizoaffective disorder were matched on cognitive level (Allen Cognitive Level Screen- 90, Allen, Kerberg, & Bums, 1992), cooking experience, and living situation (group home or apartment). They were then randomly assigned to one of two treatment conditions, clinic or home. All participants were evaluated and taught basic cooking skills in either the clinic or their homes. Finally, all participants were evaluated in their homes. Both groups scored significantly higher after cooking lessons (t=5.57, df = 21, p<.0001 for those in the clinic; t = 7.81. df = 21, p<.0002 for those learning at home); there was no significant difference between the two groups in where the learning took place (B = -1.8, df = 42, p<0.23). Those who learned in the clinic scored lower than the home group when tested at home (t = -2.07, df = 42, p<.0489) although this result must be accepted with caution because of a significant difference between the two groups on the first assessment of cooking skill. Additional questions yielded the following: there was a positive correlation between cognitive level and cooking skill (df = 44, r =.55, p <.001); there was a positive correlation between cognitive level and transfer of learning (df = 21, F = 52.49, p < .0000); no significant correlation was found between amount of practice and increase in cooking skill ( df = 27, r = .256, r2 = .066). People with cognitive deficits associated with schizophrenia can learn a specific functional living skill in different contexts. Qualitative aspects of those contexts are discussed. Further research is recommended to describe/understand transfer of learning from one context to another. Cognitive level is highly correlated with both ability to learn and ability to transfer learning. Additional research is recommended to adequately describe the effect of practice on learning a functional living skill. Implications for treatment and suggestions for clinical research are presented.
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