cognition Flashcards
What is the leading cause of TBI’s
Falls - 47%
What is the second leading cause of TBI’s
Being struck by or against an object. 15%
What is the third leading cause of a TBI?
Motor vehicle accidents - 15%
What are some common problems when providing treatment to clients with TBIs?
Self regulating thoughts and behaviors
Difficulty benefiting from experience and remembering information
Intention and behavior may be disconnected
Relationships suffer due to problems with perceptions, understanding and behaving according to social norms.
variance in expressive and receptive abilities
Challenges with providing SUD treatment?
lack of Experienced Staff and referral sources
labeling as noncompliant or resistant
lack of alternative forms of curriculum
What are important areas to focus on when assessing someone with a TBI?
Ask how well a person reads, writes and observes through examples, and which they prefer
ask about observation and attention span and how it is different in other environments
What are some easy things to ask in an assessment?
What helps you with: remembering new material
and names
finishing your work
staying on track
paying attention
remembering things you see or hear
making choices that keep you healthy and safe
How do you deal with alertness problems?
- Schedule Cognitive heavy groups or intense groups at optimal hours
- allow clients to move around if needed
- use peppermint oil
- practice sleep hygiene
- In residential sites, allow people to move rooms if necessary to achieve compatible environments
How do you deal with attention?
- Use space and movement to grab attention
- begin groups with active participation
- have simple cues to reduce distractions
- keep instructions simple
- use curriculum that can be converted into games
What are signs that a client is struggling with attention?
client is checked out
physical and mental restlessness
history of need for sensory stimulation
What are signs a client is struggling to process
May tire easily
Difficulty tracking conversation - watch them in groups
they may report difficulty with comprehension
How do you accommodate someone with processing struggle?
- Keep emotional tone cool. When doing more emotional work allow more time to process
- stress goes up - processing speed goes down
- break instructions/homework down into smaller parts
- keep instructions simple
- take breaks - low intensity options for groups
What should you look for if someone is struggling with memory?
inconsistent performance on a task
what works best? written? verbal?
What is a past example of learning and how did it occur
How do you accommodate someone with memory issues?
- Use visual field to support memory
- bring a note book to session - write down key points
- create repeatable routines
- Use reminders and ringtones through digital devices
What should you look for if someone is struggling with initiation?
- set a task and see if they begin
- Notice how often you need to prompt behavior
- History: either through client or collaterals?
Accommodations for initiation
Simplify: break down into small manageable pieces
- Assign only manageable piece: hold back some material
- place reminders of needed behaviors in places that can be seen
- use timers and auditory cues to begin and end behaviors
- use motivation incentives: fishbowl
What should you look for if someone is struggling with impulsivity?
- may do or say things without recognizing effects
- a lot of personal information, very early on in sessions
- may interrupt conversations regularly
Accommodations for impulsivity
Use a talking stick
- Use timers to measure clients ability to complete task
- motivational incentives to shape pro-community behaviors
- clear and direct feedback that is directed at behavior, not client
- clear and direct expectations with limits and consequences
What should you look for if someone is struggling with organizing?
lacks significant future focus
- misses deadlines
- often late or does not show up for ap
Accommodations for organizing
- Stress routines
- Use visual cues
- Use systems that match the needs of the person
- Key points of session
- Remind person of the point: expectations and goals
What should you look for if someone is struggling with flexibility?
Agitation and irritation when things change
- Perseveration
- Has difficulty with ideas about plan B - plan a will work
Accommodations for flexibility
- Increase ability to generalize (rehearse strategies)
- Think safety net first
- Allow plenty of time for session transitions
What should you look for if someone is struggling with Awareness?
- May dominate interactions with others
- low awareness of problems or lacks desire to change
- often sets unrealistic goals
Accommodations for awareness
- Identify and use appropriate self disclosure
- Motivational incentives for behaviors that support the community
- Being clear about wanted behaviors and unwanted behaviors
- Coaching clients to provide positive feedback regarding behaviors
What helps people with brain injuries benefit from treatment?
when compensatory skills are taught and practiced
What helps with group cohesion as it relates to brain injury clients?
teaching non-brain injury peers about brain injury
