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547 > (A) NeuroCognitive and Behavioral Impairment > Flashcards

(A) NeuroCognitive and Behavioral Impairment Flashcards

1
Q

what are the 5 parts of cognitive function

A 
alertness/orientation
attention
memory
executive function
language
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2
Q

what is alertness and orientation

A

alertness = basic arousal and response to stimuli (first goal w client bc need to be alert to do rehab)

orientation: to time, place, person (Ox3)

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3
Q

what are the 4 different types of attention?

A
  1. sustained attention (not getting distracted)
  2. selective attentnion (focus on1 when many stimuli)
  3. divided attention (focus on 2 task of equal importance at same time)
  4. alternating attention (focus on 2 things of equal importance one after the other)
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4
Q

describe the temporal classification of memory

A
  1. short term memory: mill sec - 1 sec
  2. working memory (where ot work the most ): > 1 min
  3. long term memory: days, month, year
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5
Q

what is executive functionign

A

high level cogntiive function responsible for the execution of complex task

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6
Q

give example of occupations where executive functioning is needed (adl, iadl, productivity)

A

adl: feeding, bathing, toileting, mobility, transfer, grooming, shower
iadl: medication, finance, groceries, housekeeping, laundry, making appointment, using phone
prod: school, work, volunterr

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7
Q

what are the steps(6) of executive functioning

A
  1. initiation = starting task
  2. planning: plan steps needed (abstract thoughts for decision making)
  3. organization/sequencing = execution of task in organized manner
  4. monitoring = check up while executing task
  5. adapting (problem solving and mental flexibility): devise new plan based on unexpected event
  6. evaluating performance (insight/awareness): understand strength, weaknesses
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8
Q

how do you communicate with someone with aphasia?

A

give time to answer, dont force answer, use concise sentence, give yes or no question, visual cues

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9
Q

what domain does the MOCA screen?

A

cognitive impairement and mild cogntive impairment

(orientation, short term memory, clock drawing test, exec function, language ability, animal drawing, abstraction, attention)

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10
Q

what domain does the trail making test screen

A

attention and executive dysfunction (mental flexibility)

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11
Q

what does the bells and apples test screen for?

A

screen attention

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12
Q

which assessments can be used to screen for executive functions (3)

A

moca (clock drawing part) and trail making

  • functional assessment of them doing a task
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13
Q

what could influence results of cognitive test?

A

fatigue, mood, length of eval, language, level of education, visual/auditory impairement

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14
Q

name remedial treatment approaches for orientation.

A
  1. task oriented: practice walking from room to therapy room (start with more cues then reduce)
  2. cognitive training
    - computer games involving identifying landmarks of navigation
    - practice address/full name w cueing
    - task related to time in session (at 3 pm ask therapist for medication
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15
Q

name adaptive orientation tx

A
  • use calendar, alarm, clear signs/directions, gps
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16
Q

name remedial - task oriented tx ideas for attention (sustained, divided, selective using cooking soup example)

A

task oriented approach: practice cooking a soup

  1. sustained attention:
    - focus on 1 task w cueing if they get distracted
    - start w more cues
    - grade: increase time attention must be focused (more complex meals)
  2. divided:
    - focus on>2 tasks (talking whilst cooking, sing to song)
    - grade: increase distraction or make 2 nd task more complex (calling to schedule apt whilst cooking)
  3. selective attention
    - cooking with many distractions that they need to ignore (tv, music, therapist, phone)
    - grade: change amount of distraction
17
Q

name remedial - cognitive training tx approach for attention

A
  • cueing to remain focuz during any activity (start w many cueing)
  • ask client to complete 2 tasks in session of differing or same importance (ex: ask them to sing while practicing dressing)
  • create multiple distractions w any task
18
Q

name adaptive tx for attnetion (4)

A
  • eye contact to encourage focus
  • create big point of attention (clapping, speaking loud), reduce extra distraction(quiet room when eating)
  • verbal, touching cueing
  • automatic turn off appliances
19
Q

name remedial - task oriented tx for memory

A

practice grocery shopping without a list but w a number of known items client is told to pick up
- grade: change amount of cueing and item (“do you need butter”)

20
Q

name remedial - cognitive training tx for memory

A
  • memory games (matching)
  • hide and search games where patient is shown where items are hidden
  • simon say/repeat game
  • mental math (working memory)
21
Q

name adaptive tx for memory

A
  • to do list
  • alarm/calendar
  • visual cues (post it, pictures)
  • apps (take medication)
22
Q

name remedial task oriented approach tx for executive functioning.

A
  • complete actual work w more support (visual/verbal cues) (eventually reduce suuport)
  • complete tasks (complex meal prep, plan a journey using public transportation, grocery shopping)
23
Q

name remedial cognitive training tx for exec funtion (4)

A
  • problem solving games (escape room)
  • board game that require decision making and adaptaion (monopoly, jenga)
  • verbalization of steps of task (verbalize cooking task)
  • computer games
24
Q

name adaptive tx for exec function

A
  • use of decision tree
  • take time to reflex on task before starting
  • cueing steps (verbal or visual)
25
Q

what are task oriented and cogntivie trainign tx for insight ie self evaluate how they are doing

A 
feedback
videotaping
peer group
role reversal
prediction of ones own performance
26
Q

name adaptive tx for insight

A

hide unsafe appliances/tools/car keys
unplug stove
education

27
Q

name the 8 neuro behavioral impairments

A
  1. disinhibition
  2. impulsivity
  3. flat affect
  4. emotional lability
  5. agitation/aggressivity
  6. wandering
  7. perseveration
    8 changes in mental health
28
Q

describe disinhibition

A

no filter, lack of judgement of what should or should not be said (ex: swearing)

29
Q

what is impulsivity

A

doing smthing w/o thinking of consequences

30
Q

what is flat affect

A

no emotional output

31
Q

what is emotional lability

A

uncontrolled emotional output (cant stop laughing)

32
Q

what is agitation/aggresivity

A

rxn of furstration

33
Q

what is perseveration

A

continued motor loop (keep eating when no food left)

34
Q

what steps should be taken when working w someone w behavioral impairments

A
  • understand the cause
  • show empathy
  • educate family and friends
  • disinhibition: tell client what is appropriate or not
  • impulsivity: firm and structuring
  • perservartion: cue them to next steps

547 (22 decks)

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