Assessing Cognition

Question 1

Processes Affected by Brain Injury

Answer 1

• Attention
• Memory
• Executive Function

Question 2

Attention (6)

Answer 2

• Alertness (Tonic and Phasic)
• Sustained (Vigilance)
• Selective
• Alternating
• Divided
• Attention in Daily Life

Question 3

Alertness

Answer 3

• Tonic Alertness: readiness to respond over long interval (minutes to hours). Estimated during interview or reports.
• Phasic Alertness: requires rapid response like in RT tests.

Question 4

Sustained Attention (Vigilance)

Answer 4

Tested by doing strings of computer auditory or visual stimuli. Pt must indicate when they see or hear target

Question 5

Selective Attention

Answer 5

Assessed through cancellation tasks- must scan a paper and cross out targets

Question 6

Alternating Attention

Answer 6

target to be cancelled out changes (number 6 in one line and letter B in the next line)

Question 7

Divided Attention

Answer 7

Pt must retain information while performing another task

Question 8

Attention in daily life

Answer 8

Uses every day materials, such as maps, telephone books, etc.

Question 9

Memory (Stages)

Answer 9

• Sensory Register
• Immediate Memory
• Long-Term Memory (recent & remote)

Question 10

Sensory Register or Memory

Answer 10

When incoming information is retained

Question 11

Immediate Memory (Short Term or retention span)

Answer 11

Has limited capacity & decays within a few seconds unless rehearsed. Ex: number of digits, letters or words. Usually 7 +- 2. Working memory is similar to immediate memory

Question 12

Long-term Memory (Recent Memory and Remote)

Answer 12

large capacity where information is stored. In normal people recent and remote aren’t different but those with dementia have better remote memory.

Question 13

Retrospective Memory (Declarative & Procedural)
Relates to past experience

Answer 13

• Declarative: what we know about things. Knowledge of who we are, capitols of countries, multiplication tables, etc.
• Procedural: information that’s applied automatically without having to think - how to drive, ride bike, etc.

Question 14

Prospective Memory

Answer 14

Remembering to do things in the future, i.e. keep appointments, etc.

Question 15

Examples of Assessing Memory

Answer 15

• Immediate Memory (retention span): repetition of digits, letters, etc.
• Remote Memory: ask for personal information ex: place of birth, birthdate
• Visual Memory: show picture, remove picture, ask to draw from memory

Question 16

Executive Function

Answer 16

Doing what has to be done to accomplish one’s goals or to solve a problem. Includes processes of attention, memory, planning, reasoning, abstract thinking and problem solving.

Question 17

Assessing Executive Function

Answer 17

• Response Flexibility
• Planning
• Reasoning
• Abstract Thinking

Question 18

Response Flexibility

Answer 18

TBI pts have problems inhibiting & modifying their behavior & of adapting their behavior to changing situations. They may perseverate – this shows impaired response flexibility. (Can’t shift to new stimulus.)

Question 19

Planning

Answer 19

assessed through cancellation tests, trail-making tests, or maze tests. The Five Point Test was developed to assess planning also.

Question 20

Reasoning

Answer 20

Verbal reasoning tests – “What would you do if you saw a hit and run accident?”
Verbal absurdities – See pg 155/95
Logical relationship tests – See pg 155/95
Math reasoning problems/95
Picture completion tests – pt tells what is missing in incomplete picture.
Picture arrangement/sequencing tests – pg 156 old text only
Standard Progressive Matrices – pg 157/95, Fig. 4-15.

Question 21

Abstract Thinking

Answer 21

very difficult for brain-injured person. Can be assessed through:
Proverb interpretation – Don’t put the cart before the horse. A stitch in time saves nine.
Similarities & differences
Categorization and sorting tasks – (Divergent/Convergent tasks)

Some tests are designed specifically for Executive Function assessment – pg 159/97
Six Element Test
Hayling Sentence Completion Test

Question 22

Brain Injury can result in:

Answer 22

Self-doubt
Emotional lability – exaggerated swings in emotional expression
Concreteness – loss of abstract attitude.
SLPs should watch for these traits while testing and compensate as needed.

Question 23

Cognitive Therapy

Answer 23

the type of therapy conducted with people who have TBI or other types of brain injuries to address the issues in this chapter. (new)