Clinical Presentation of Cognitive Disorders

Question 1

What do neuropsychologists do?

Answer 1

pinpoin pathology based on cognitive, behavioural, and emotional symptoms (eg dementia or where there is no imaging pathology); rehab to enhance outcomes post TBI or insult; management for behavioural disturbance caused by BI; assessment of competency eg for EPOA

Question 2

What diagnostic assessments of cognition are used clinically?

Answer 2

cognitive complaints (by pt or family); time frame (sudden, gradual); interviewing & observation; assessment of key domains of cognition; knowledge acquired by other professionals eg nurses, OT

Question 3

What is cognitive rehabilitation?

Answer 3

application of techniques and procedures and the implementation of supports to allow individuals with cognitive impairment to function as safely, productively and independently as possible i ntheir environment

Question 4

What is the goal of cognitive rehab?

Answer 4

to enable people to do what they would like and need to do to feel successful but find difficult because of their cognitive disability

Question 5

What are the original strategies of cognitive rehab?

Answer 5

fix it - improve cognitive domains; compensation - strategies to use intact skills

Question 6

What are the current strategies of cognitive rehab?

Answer 6

Real-world strategies in the context which the pt is likely to actually use it; worrying about what people can do and using those skills rather than focusing on the impairment

Question 7

What are the two categories of cognitive interventions?

Answer 7

environmental modifications and compensatory strategies

Question 8

What are environmental modifications?

Answer 8

changing the physical and social environment to facilitate greater independence and to reduce the impact of a person’s cognitive and behavioural difficulties; remove or manipulate precipitating environmental factors e.g. low-stimulus environments

Question 9

When are environmental modifications useful?

Answer 9

when people have: reduced insight, reduced self-monitoring and regulation, and/or significant/catastrophic attentional, memory, and executive deficits

Question 10

Examples of environmental modifications inculde

Answer 10

reduced stimulation/quiet environments; neglect (place items in intact visual field); orientation information on walls; calendars; routines; seatbelts to stop them getting out of wheelchairs

Question 11

What are compensatory cognitive interventions?

Answer 11

training/teaching clients to use behaviours or processes that circumvent difficulties caused by cognitive deficits - internal and external strategies

Question 12

What are internal compensatory cognitive strategies?

Answer 12

Improvement of skill set/learning to use other skills - mnemonic strategies

Question 13

What are external compensatory cognitive strategies?

Answer 13

Using cues and aids to assist compensation eg diaries, tablet apps