Section 245 of 440
Complete canonical tutorial. This reader section contains the same teaching body as PWR-062 · Cognitive rehabilitation. Open the Power dossier.
PWR-062 · SUPERVISED full tutorial
Pack a four-item therapy bag and restart from the last tick after interruption
This clinician-guided Goal–Plan–Do–Check exercise is a bag-packing procedure. Tariq defines four required objects, gives each object one checklist row, puts the often-missed appointment card on a labelled tray, ticks only after placement, and uses a restart marker after a planned phone sound. Final Check compares bag contents with all four rows. The exercise teaches supported task organisation; it does not test whether reminders can be removed or whether memory recovered everywhere.
1 · Permission and limits
Know exactly what you may do
2 · Get ready
Gather what you need and check the starting conditions
What you need
- A therapy bag plus water bottle, notebook, glasses case and a fictional appointment card; medication, money and real identity details are excluded.
- A Goal–Plan–Do–Check sheet with finish line ‘all four objects are in the bag’ and four rows: bottle, notebook, glasses, appointment card.
- A labelled CARD tray, thick tick box beside each row and one harmless phone sound scheduled after two placements.
- A record for omitted/repeated steps, cues, completion, time and burden.
Before you start
- The clinician screens cognition, insight, behaviour, fatigue and task hazards.
- Choose a task that can pause safely; exclude medication dosing, cooking heat and financial/legal action for first practice.
- Keep normal supports and a supervisor present when errors could matter.
- Define an immediate halt word for confusion, agitation, unsafe action or fatigue; this differs from the ordinary restart marker after the phone sound.
3 · The method
Follow these steps in order
- Write four-object finish
Write ‘bag ready = bottle + notebook + glasses + appointment card’ and place those four harmless objects on the table.
Why: A named inventory makes finish visible and countable.
Check: Tariq and clinician can point to four required objects and one empty bag.
- Make one placement row per object
Write four rows in agreed order. Each reads ‘place [object] in bag; look inside; tick once.’ Do not combine notebook and card on one row.
Why: One object per row exposes an omission or duplicate tick.
Check: Sheet has exactly four unticked placement rows matching finish inventory.
- Stage the often-missed card
Circle appointment-card row and place its object on the labelled CARD tray beside the sheet; keep other objects in their ordinary start positions.
Why: A targeted tray supports the known omission without reorganising every row.
Check: Circled row, CARD tray and appointment card visibly correspond.
- Rehearse the restart marker
Touch the words ‘last tick → next blank row’, point to a sample tick, then say the following object without moving it.
Why: Restart comes from visible completion evidence rather than guessing or starting over.
Check: Given a sample tick on row 2, Tariq points to row 3.
- Place, verify and tick
Read one row, place that object, look inside the bag to verify it, then make one tick before reading another row.
Why: Ticking after visible placement keeps checklist and bag state aligned.
Check: Every tick has one matching object inside; no unticked object is silently packed.
- Restart after the phone sound
After two verified placements, clinician plays the harmless phone sound. Tariq pauses, touches ‘last tick → next blank row’, states that row's object and resumes there.
Why: A controlled interruption tests checklist restart without using medicine, heat or money.
Check: Third placement follows first blank row; neither packed object is repeated.
- Audit sheet against bag
At Check, read all four names and touch each matching object inside. Circle an unticked, missing or duplicate row before correcting anything.
Why: Object-by-object audit catches a false sense of completion and preserves its location.
Check: Four row–object pairs match, or a specific bottle/notebook/glasses/card mismatch remains circled.
- Correct one checklist feature
Keep original circle and tick pattern. Change only one relevant feature—wider row spacing, stronger CARD label or clearer restart arrow—and schedule a matched bag with a different notebook.
Why: One visible edit can be tested against the exact omission or restart error.
Check: Correction points to recorded error while all other rows and supports stay unchanged.
4 · Worked example
See the whole method used once
Scenario
A neuropsychologist helps Tariq prepare a bag for a therapy appointment without including medication or money.
Walkthrough
- Tariq defines finished as “water bottle, notebook, glasses and appointment card are in the bag.”
- He writes four placement steps and circles the appointment card as the item often missed.
- He puts the appointment card on its labelled tray and rehearses ‘last tick → next blank row’ before starting.
- After the planned phone sound he touches the last tick, names the next blank-row object and resumes there.
- At Check, he notices the notebook is absent, keeps the error and revises the checklist spacing.
Result
Tariq completes the second matched bag task with the four-row sheet, CARD tray and restart marker. This is supported bag-packing performance, not proof of restored memory in every context.
5 · Right and wrong
Compare correct or safer execution with the common wrong version
| Moment | Right / safer | Wrong / riskier | Why it matters |
|---|---|---|---|
| Bag finish | Name bottle, notebook, glasses and appointment card. | Write only ‘pack for therapy’. | An unnamed inventory cannot expose which object was omitted. |
| Memory support | Tick one row only after its object is visibly inside. | Hide the bag sheet to test unaided recall. | The sheet is a selected rehabilitation support and aligns row state with bag state. |
| Interruption | Touch last tick and continue at first blank row. | Restart at bottle after the phone sound. | Restarting from row 1 can duplicate packed objects; guessing can skip one. |
| Error | Circle the missing notebook before widening its checklist row. | Slip the notebook into the bag and score completion. | Hidden rescue erases the omission that should determine the correction. |
| Transfer | Repeat with a different notebook but the same four-row rule. | Infer safe medication or financial planning from the therapy bag. | Transfer beyond this harmless packing routine needs separate clinical assessment. |
6 · Common mistakes
Spot the error and apply the correction
| Mistake | Fix |
|---|---|
| The finish says only ‘pack for therapy’. | Write bottle, notebook, glasses and appointment card as four visible requirements. |
| A tick is made before its object enters the bag. | Use place → look inside → tick for every object. |
| Tariq starts again at row 1 after the phone sound. | Touch last tick and say the first blank-row object before moving. |
| A helper quietly adds the missing notebook. | Circle the omission, leave it visible and change one relevant checklist feature. |
| Bag completion is called restored memory for all daily tasks. | Report four-item packing with its sheet/tray; test any related task separately with the clinician. |
7 · Practice
Turn the steps into a usable skill
First session
- Tariq and the neuropsychologist choose a bag task with no medication or money and write the finish state: water bottle, notebook, glasses and appointment card in the bag.
- Tariq writes four placement steps, circles the often-missed appointment card and puts it on a labelled tray beside the checklist.
- After placing two items, a planned phone sound interrupts the task; Tariq touches ‘last tick → next blank row’, names that object and resumes without guessing.
- At Check he compares all four finish-state objects, records any omission/repetition and leaves a missing notebook visible rather than silently adding it.
- Checklist spacing is changed once, and a matched bag with a different notebook is scheduled; the labelled tray stays if it prevented the card omission.
Repeat plan
At the clinician-set frequency, repack a matched four-object bag with one harmless object changed and the phone sound after a different completed row. Keep CARD tray and restart marker for the first comparison; fade only one sheet feature after the clinician sees correct row–object matching, and restore it if omissions or duplicate placements return.
Progress when
- Omissions/repetitions fall on new task instances.
- Tariq independently uses last-tick/next-blank restart after the phone sound.
- Four required objects match four ticks with acceptable burden.
Do not progress when
- The task includes an unmanaged safety, medicine or financial consequence.
- Fatigue, agitation or confusion grows during the sequence.
- Removing a checklist, tray or restart marker increases errors or distress.
8 · Check the result
Measure what changed
Four-object bag completion, row–object agreement and restart accuracy with supports declared
How: Record required objects present out of four; missing/duplicate/out-of-order rows; whether restart used last tick then first blank row; CARD tray, prompt and clinician help; time and burden. Preserve baseline tick pattern beside the one corrected sheet feature.
Good result: On a matched bag, row–object mismatches or restart errors fall while the declared sheet/tray support remains available and burden stays acceptable; this is supported packing performance, not a memory clearance score.
This does not prove: Separate impairment tests, strategy use, device-on function, device-off retention and everyday participation.
Self-check
- Can you demonstrate ‘Make one placement row per object’? Four unticked rows match bottle, notebook, glasses and appointment card.
- Can you demonstrate ‘Restart after the phone sound’? Last tick leads to the first blank row without a duplicate placement.
- Can you demonstrate ‘Audit sheet against bag’? Every tick has its object, or the exact mismatch remains circled.
- Can you demonstrate ‘Correct one checklist feature’? The single edit addresses the preserved omission/restart error.
9 · Stop, adapt or get help
Keep the safety boundary practical
Stop and get help
- Seek urgent assessment for sudden new confusion, memory loss, speech change, weakness or severe headache.
- Stop for escalating agitation, unsafe action, severe fatigue or loss of consent.
- Ask the rehabilitation team to redesign tasks when errors create medication, fire, financial, wandering or exploitation risk.
Accessibility and adaptations
- Use pictures, objects, audio prompts, colour coding or partner-assisted scanning instead of text.
- Use fewer harmless bag objects only when the clinician relabels the finish inventory and records assistance.
- Keep external aids in everyday use; do not withdraw them merely to create an independence test.
10 · Evidence and limits
Why these instructions are here
- primary research
A randomised trial supports combining goal management, external cues and emotional regulation after acquired brain injury.
Rehabilitation of Executive Functions in Patients with Chronic Acquired Brain Injury with Goal Management Training, External Cuing, and Emotional Regulation: A Randomized Controlled Trial - official guidance
WHO guidance supports assistive products as valid enablers of daily function.
Assistive technology
Limits
- Separate impairment tests, strategy use, device-on function, device-off retention and everyday participation.
- Unsupported claim: restore your whole brain.
- Unsupported claim: unlock executive function.
- Unsupported claim: text reminders prove unaided recovery.
- Completing one planned task does not establish global cognitive recovery, capacity or safety for consequential decisions.
Open the complete canonical research register
- Primary empirical supportLimiting / contraryRehabilitation of Executive Functions in Patients with Chronic Acquired Brain Injury with Goal Management Training, External Cuing, and Emotional Regulation: A Randomized Controlled Trial
Sveinung Tornås; Marianne Løvstad; Anne-Kristin Solbakk; Jonathan Evans; Tor Endestad; Per Kristian Hol; Anne-Kristine Schanke; Jan Stubberud · 2016 · Primary research
- Limiting / contraryOfficial boundary contextAssistive technology
World Health Organization · 2024 · Official guidance
Read the complete evidence interpretation on the Power dossier.
Tutorial delivery controls
Learn, adapt, troubleshoot and resume
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Step-by-step learner mode
Each activity includes its success check, a nearby accessible alternative and an “I’m stuck” correction path. Alternatives preserve the target where possible; when they change the task, Titan labels them as related rather than equivalent.
Write four-object finish
Write ‘bag ready = bottle + notebook + glasses + appointment card’ and place those four harmless objects on the table.
A named inventory makes finish visible and countable.
Tariq and clinician can point to four required objects and one empty bag.
I’m stuck on this step
Reset: Re-read this authored instruction — “Write ‘bag ready = bottle + notebook + glasses + appointment card’ and place those four harmless objects on the table.” — and its success check, then attempt only this step.
Possible snag: The finish says only ‘pack for therapy’.
Correction: Write bottle, notebook, glasses and appointment card as four visible requirements.
Stop / get help: Seek urgent assessment for sudden new confusion, memory loss, speech change, weakness or severe headache.
Make one placement row per object
Write four rows in agreed order. Each reads ‘place [object] in bag; look inside; tick once.’ Do not combine notebook and card on one row.
One object per row exposes an omission or duplicate tick.
Sheet has exactly four unticked placement rows matching finish inventory.
I’m stuck on this step
Reset: Re-read this authored instruction — “Write four rows in agreed order. Each reads ‘place [object] in bag; look inside; tick once.’ Do not combine notebook and card on one row.” — and its success check, then attempt only this step.
Possible snag: The result from “Write four rows in agreed order. Each reads ‘place [object] in bag; look inside; tick once.’ Do not combine notebook and card on one row.” does not yet meet this declared check: Sheet has exactly four unticked placement rows matching finish inventory.
Correction: Return to the start of “Make one placement row per object”, reduce complexity or pace, and repeat only the part needed to satisfy: “Sheet has exactly four unticked placement rows matching finish inventory.”
Stop / get help: Seek urgent assessment for sudden new confusion, memory loss, speech change, weakness or severe headache.
Stage the often-missed card
Circle appointment-card row and place its object on the labelled CARD tray beside the sheet; keep other objects in their ordinary start positions.
A targeted tray supports the known omission without reorganising every row.
Circled row, CARD tray and appointment card visibly correspond.
I’m stuck on this step
Reset: Re-read this authored instruction — “Circle appointment-card row and place its object on the labelled CARD tray beside the sheet; keep other objects in their ordinary start positions.” — and its success check, then attempt only this step.
Possible snag: Bag completion is called restored memory for all daily tasks.
Correction: Report four-item packing with its sheet/tray; test any related task separately with the clinician.
Stop / get help: Seek urgent assessment for sudden new confusion, memory loss, speech change, weakness or severe headache.
Rehearse the restart marker
Touch the words ‘last tick → next blank row’, point to a sample tick, then say the following object without moving it.
Restart comes from visible completion evidence rather than guessing or starting over.
Given a sample tick on row 2, Tariq points to row 3.
I’m stuck on this step
Reset: Re-read this authored instruction — “Touch the words ‘last tick → next blank row’, point to a sample tick, then say the following object without moving it.” — and its success check, then attempt only this step.
Possible snag: The result from “Touch the words ‘last tick → next blank row’, point to a sample tick, then say the following object without moving it.” does not yet meet this declared check: Given a sample tick on row 2, Tariq points to row 3.
Correction: Return to the start of “Rehearse the restart marker”, reduce complexity or pace, and repeat only the part needed to satisfy: “Given a sample tick on row 2, Tariq points to row 3.”
Stop / get help: Seek urgent assessment for sudden new confusion, memory loss, speech change, weakness or severe headache.
Place, verify and tick
Read one row, place that object, look inside the bag to verify it, then make one tick before reading another row.
Ticking after visible placement keeps checklist and bag state aligned.
Every tick has one matching object inside; no unticked object is silently packed.
I’m stuck on this step
Reset: Re-read this authored instruction — “Read one row, place that object, look inside the bag to verify it, then make one tick before reading another row.” — and its success check, then attempt only this step.
Possible snag: A tick is made before its object enters the bag.
Correction: Use place → look inside → tick for every object.
Stop / get help: Seek urgent assessment for sudden new confusion, memory loss, speech change, weakness or severe headache.
Restart after the phone sound
After two verified placements, clinician plays the harmless phone sound. Tariq pauses, touches ‘last tick → next blank row’, states that row's object and resumes there.
A controlled interruption tests checklist restart without using medicine, heat or money.
Third placement follows first blank row; neither packed object is repeated.
I’m stuck on this step
Reset: Re-read this authored instruction — “After two verified placements, clinician plays the harmless phone sound. Tariq pauses, touches ‘last tick → next blank row’, states that row's object and resumes there.” — and its success check, then attempt only this step.
Possible snag: Tariq starts again at row 1 after the phone sound.
Correction: Touch last tick and say the first blank-row object before moving.
Stop / get help: Seek urgent assessment for sudden new confusion, memory loss, speech change, weakness or severe headache.
Audit sheet against bag
At Check, read all four names and touch each matching object inside. Circle an unticked, missing or duplicate row before correcting anything.
Object-by-object audit catches a false sense of completion and preserves its location.
Four row–object pairs match, or a specific bottle/notebook/glasses/card mismatch remains circled.
I’m stuck on this step
Reset: Re-read this authored instruction — “At Check, read all four names and touch each matching object inside. Circle an unticked, missing or duplicate row before correcting anything.” — and its success check, then attempt only this step.
Possible snag: The result from “At Check, read all four names and touch each matching object inside. Circle an unticked, missing or duplicate row before correcting anything.” does not yet meet this declared check: Four row–object pairs match, or a specific bottle/notebook/glasses/card mismatch remains circled.
Correction: Return to the start of “Audit sheet against bag”, reduce complexity or pace, and repeat only the part needed to satisfy: “Four row–object pairs match, or a specific bottle/notebook/glasses/card mismatch remains circled.”
Stop / get help: Seek urgent assessment for sudden new confusion, memory loss, speech change, weakness or severe headache.
Correct one checklist feature
Keep original circle and tick pattern. Change only one relevant feature—wider row spacing, stronger CARD label or clearer restart arrow—and schedule a matched bag with a different notebook.
One visible edit can be tested against the exact omission or restart error.
Correction points to recorded error while all other rows and supports stay unchanged.
I’m stuck on this step
Reset: Re-read this authored instruction — “Keep original circle and tick pattern. Change only one relevant feature—wider row spacing, stronger CARD label or clearer restart arrow—and schedule a matched bag with a different notebook.” — and its success check, then attempt only this step.
Possible snag: A helper quietly adds the missing notebook.
Correction: Circle the omission, leave it visible and change one relevant checklist feature.
Stop / get help: Seek urgent assessment for sudden new confusion, memory loss, speech change, weakness or severe headache.
Correct versus incorrect execution
These accessible process diagrams are built from the tutorial’s own right/wrong teaching. They are not anatomical illustrations and do not add technique beyond the canonical tutorial.
Name bottle, notebook, glasses and appointment card.
Write only ‘pack for therapy’.
Tick one row only after its object is visibly inside.
Hide the bag sheet to test unaided recall.
Touch last tick and continue at first blank row.
Restart at bottle after the phone sound.
Circle the missing notebook before widening its checklist row.
Slip the notebook into the bag and score completion.
Repeat with a different notebook but the same four-row rule.
Infer safe medication or financial planning from the therapy bag.
Method-structure checklist
10 of 10 structural checks present
- Ordered, Power-specific instructions — present
- Every activity has a success check — present
- Materials or supplied records are declared — present
- Measurement or assessment rule is present — present
- Tutorial-specific troubleshooting is present — present
- Stopping or escalation boundary is present — present
- Every activity has an adjacent alternative — present
- Correct-versus-incorrect comparison is present — present
- Evidence context is bound to the Power record — present
- Planning metadata is present — present
The method-readiness band and presence checklist assess tutorial presentation and are separate from evidence quality for the underlying Power. They are automated editorial aids, not human approval.
Manual editorial sign-off: Pending. This tutorial must not display a human-approved state until an identified editor signs the exact content hash.