Awareness Flashcards
Self-Awareness FORs
- CO-OP Approach
- Dynamic Interactional Approach (DIA)
- Cognitive Rehabilitation Approach
Self-Awareness definition
- AKA insight or metacognition
- Involves self-monitoring (constantly updated as time goes on), error awareness (am I aware of the errors I’m making), and error correction
- Not only awareness of cognitive problems but can also be awareness for sensory, motor, communication problems, and impairments in daily performance
When does Self-awareness develop?
we are NOT BORN with self-awareness.
- It starts to develop slowly in toddlers.
- not completely developed until late adolescents to early adulthood
**in general, the more demanding the situation is = less insight person will have about their performance in that situation
What populations often have insight impaired?
- Developmental (autism, ADHD)
- psychological (schizophrenia, depression, bipolar, substance abuse)
- Acquired brain injury (TBI, CVA, MS, PD, seizure)
What brain area is involved with self-awareness deficits?
- Frontal Cortex - especially prefrontal cortex damage, ventral medial
- seen in TBI and CVA
Why is there a major problem for progress in rehab for clients without self-awareness?
- they typically unmotivated or uncooperative in therapy
- set unrealistic goals
- display poor judgement
- fail to see the need for compensatory strategies to help with function
Why does emotional distress develop with increased insight?
because those without self-awareness are NOT likely to be depressed about their condition.
As self-awareness improves = risk of depression increases!
What are the 3 levels of awareness?
Intellectual awareness - being aware of deficits or problems
Emergent awareness - being aware of the problem as it happens
Anticipatory awareness -
being able to plan for problems that may occur in the future
Assessments for Awareness: Questionnaires
Patient Competency Rating Scales (PCRS)
Patient Competency Rating Scale (PCRS)
-oldest and most frequently used test!
-client and caregiver complete and compare ratings
- ADLs
- Behavioral and Emotional Function
- Cognitive Abilities
- Physical Function
Assessments for Awareness: Questionnaire
Awareness Questionnaire (AQ)
compares PRE-injury and POST-injury abilities
- requires both awareness of current function and memory for previous function
- can assess client, family, or therapist
Other Assessments for Awareness
Structured Interviews
- Self-Regulation Skills Interview (SRSI)
- Awareness Interview (no scores, just discussion based)
Interventions to Improve Awareness
Intellectual Awareness (ONLY)
Compensatory and Environmental Approaches most appropriate
- Environmental mods
- education on impaired awareness and safety issues
- support groups
- errorless learning
Interventions to Improve Awareness
Emergent Awareness
GOAL: help client increase recognition of performance errors AS they occur
- Feedback - videos, guides, cues
- Self-checking/monitoring/evaluation (self-talk through activities and review performance)
- Training - occur in multiple environments with multiple tasks
- Role Reversal - have the therapist complete the activity making the types of mistakes that client tends to make
Interventions to Improve Awareness
Anticipatory Awareness
GOAL: help client anticipate future problems and develop and utilize strategies to reduce impact of those problems
- Anticipation of potential errors
- Self-prediction
- Strategy identification
How to know if Awareness is improving?
- more accurate predictions of performance
- increased strategy use
- more spontaneous use of strategies
- fewer errors in performance
