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Introduction This article describes the process of establishing and measuring treatment fidelity of a complex cognitive rehabilitation intervention that uses a metacognitive strategy framework (the multicontext approach). We adapted treatment guidelines for use within an inpatient rehabilitation setting for people with acquired brain injury; explored training methods and therapist perspectives; developed and examined inter-rater reliability of a fidelity measure; and examined adherence to and proficiency of treatment methods. Method Therapist perspectives of the intervention and training were obtained from written questionnaires and reflections. Inter-rater reliability of 21 treatment components across 22 video-recorded treatment sessions was assessed by examining absolute agreement between two raters using Cohen’s kappa. The proportion of treatment components implemented in individual sessions as well as average proficiency ratings was calculated. Results The fidelity measure demonstrated good inter-rater agreement, ranging from 91–100% for treatment adherence and kappa of .77 to .94 for therapist proficiency. Adherence and proficiency varied between therapists but increased to nearly proficient levels with adjustments to training and procedures. Therapists highlighted the critical importance of video review as a training tool. Conclusion The fidelity measure provides a clinical tool for therapist self-reflection, supervision and training, as well as a tool for future research.

Introduction Adults with intellectual developmental disorders may have difficulties undertaking activities of daily living. This study aimed to identify changes in independence in activities of daily living following learning support using individualized everyday technologies. Method A double-baseline case study design explored the use of everyday technology applications and devices to support functional performance of three men aged 32, 33, and 55 years, with mild to moderate intellectual disabilities. Performance of selected tasks was video-recorded and analysed on four occasions for each participant. Baselines were recorded twice before intervention to ensure the participant’s performance of the selected task was consistent. The intervention video was recorded at the midpoint of the participant’s engagement in the study. Post-intervention video was recorded approximately 1 month after the intervention ended. Results All three participants’ functional performance of an activity of daily living task improved in accuracy and efficiency as cues from support workers were gradually faded. After the learning support ceased, technology continued to provide environmental support of participants’ ongoing independence and efficient performance of the activity. Conclusion Everyday technology applications and devices can be utilized together with a guided and structured client-centred approach and task-specific training with individuals with disability and learning difficulties.