Prosthetic systems for addressing problems with initiation: guidelines for selection, training, and measuring efficacy.

In this paper we address the practical considerations for rehabilitation of problems with initiation. A variety of rehabilitation strategies for clients who have problems with initiation are discussed, as are our recommendations for the use of an external cueing system with these clients. Available external cueing systems are reviewed, including those that have been shown to be effective for prospective memory deficits. We identify important factors involved in selecting a particular external cueing device, and we provide guidelines for training to both respond to and program external cues. Finally, we discuss ways to monitor the efficacy of rehabilitation of problems with initiation. Throughout we provide an illustrative case example describing implementation of an external cueing system with a client who has difficulties with initiation, other aspects of executive function, and anterograde amnesia.