The effects of distraction on prospective remembering following traumatic brain injury assessed in a simulated naturalistic environment

The aim of this investigation was to assess deficits in prospective remembering following chronic traumatic brain injuries (TBI), under conditions of high and low distraction. We constructed a virtual shopping precinct from photographs, sounds, and video segments linked together. The street was divided into halves, a low distraction zone and a high distraction zone (with increased visual and auditory noise). Twenty persons with TBI (7 severe, 7 very severe, 6 extremely severe) and 20 matched controls completed ongoing and prospective memory tasks while "walking" along the street. In the ongoing task, participants were given ten errands to complete with a checklist accessible at any time. The prospective component required responding to three targets that appeared repeatedly. As predicted, the TBI group performed both the ongoing and the prospective components of the street task poorly compared with the controls and was more affected by distractions. The results suggest that the real-life deficits in memory skills reported by persons with TBI may become more apparent when remembering engages executive processes and that computer simulations can be used to construct sensitive measures of practical memory abilities.