Cognition and CNS Flashcards
What is cognition?
The mental process of understanding, acquiring, and knowing information
Using that information in daily life
- memory
- executive functions
- self-awareness
Neuroplasticity
The brain’s ability to change throughout the lifespan
Types of brain plasticity
Structural plasticity: experiences or memories change a brain’s physical structure
Functional plasticity: brain functions move from damaged area to undamaged area
Hierarchy of Cognition
- attention, drive, arousal
- information processing
- integration, learning, and memory
- problem-solving, anticipation, goal-setting
- self-monitoring
Basic functions of cognition
Attention and processing
- processed through the frontal lobe, filtered through the parietal lobe
- can be bottom up or top down
Memory
- hippocampus and temporal lobes as well as the frontal lobes
- all types of memory
Executive functions
- prefrontal cortex
- monitoring, planning, inhibition and monitoring of performance
- multitasking
Self-awareness
- prefrontal cortex
- both cognitive awareness and psychosocial awareness
Screening for cognitive skills
Bottom up or top down
Oriented by 4
Screen any suspected patients
- Minimental
- MOCA: Montreal Cognitive Assessment
During evaluation, what factors might affect cognition?
Emotional state
- anxiety, depression, fatigue
Level of education
- more refined skills
Familiarity with the task
Environmental factors
- noise, lights, other people, medications
Screening for orientation, attention, and processing
Focused attentions or arousal
Selective attention
Sustained attention
Alternating attention
Divided attention
Types of memory
Episodic memory
- related to time
Procedural memory
- how to do something
Semantic or declarative memory
- work based knowledge, words
Prospective memory
- remembering upcoming events
Topographical memory
- how to get somewhere, maps
Retrograde memory
Memory prior to incident
Anterograde memory
Memory status after the incident
Screening executive function
Planning
- proposal to action
Problem solving
- process with solution
Organization
- putting things in order
Judgement
- considered decision
- not impulsive
Self-regulation
- ramp up or down
Flexibility
- compromise or change ideas
Categorization
- sorting according to attributes
Abstract reasoning
Divergent thinking
- outside the box
- new ideas or methods
- creativity
Conceptualization
- invent something or formulate an idea
Screening self-awareness
Knowing one’s own capabilities, limits, skills, and level of function
- physically, cognitively, psychologically
Classes of cognitive issues
Permanent: Alzheimer’s, Parkinson’s, CVA, TBI
Temporary: CVA, TBI, Cancer
Progressive: Ms., Alzheimer’s
3 common approaches to cognitive rehab
Skill-habit training
Cognitive strategy training
Environmental modification/adaptation
Skill-habit training
Helping clients develop new routines and habits
- Requires little to no mental energy
- Doesn’t require problem solving
The goal:
- Improve a specific task
- Does not generalize to other tasks
- Improve self confidence
- Improve independence in THAT skill
Who?
- Anyone
- Those with severe impairments of memory or self awareness
- PTA-Post Traumatic Amnesia
Models:
- Occupation Oriented
- Task Oriented
For:
- Moderate to severe
- Memory loss
- Limited self awareness
- Diminished executive function
Implementing skill-habit training
- Identify Key Skills
- very specific skills - Analysis of the space, time and situation the “habit” will occur in
- Dressing doesn’t happen at 2:00 - Practice the task
- Family and therapist cue the client through the task
- Errorless Learning
- Consistency
- Chaining
* Backward and forward
Compensatory cognitive strategy training
This strategy only works if the person recognizes they have limitations
- Self awareness
Metacognition Strategy Instruction (MSI)
- You know what you know and what you don’t
We all use these strategies!
Three phases of compensatory cognitive strategy training
Acquisition
- The therapist explains the technique
- The client practices the technique
- The family supports the technique
Mastery and Generalization
- Practice opportunities to use this technique
- Generalization: if you use a paper checklist for grocery shopping, a paper checklist may be beneficial with household chores
- Therapists backs off
“did you forget something”
If they don’t know what they forgot and this occurs often, they may be a better candidate for skills-habit training.
Maintenance
- Therapist checks in to see
Cognitive Memory Strategies
Internal Memory Strategies
- Rehearsal
* Practice saying over and over
- Visual Imagery
* Take a “mental” picture
- Mnemonics
External Memory Strategies
- Checklists
- Timetables and memory books
- Day planners/Organizers
- Phones
- CAT (cognitive assistive device)
Cognitive Metacognition Strategies
CO-OP plan
- Goal
- Plan
- Do
- Check
Therapist as a coach, not telling the patient what to do
Mild to moderate cognitive loss, or temporary loss and you’re trying to restore their memory
The hope is that we get some generalization and carry over into other skills
Environmental Modification/ Adaptation
For use with:
- Major neurocognitive disorders
- This method is neither restorative or curative
- Heavily involves the caretaker
* Think 4 an under
The press (stress) of the task is not on the client
- Label items
- Declutter
- Minimalism
- Give two options
* Give no options
- Same every day
Evaluate each client for the needs of the caregiver,
- I need her to……
CNS Models and FORs
Rood
Brunnstrom
Proprioceptive Neuromuscular Facilitation
Neurodevelopmental Treatment Techniques
Margaret Rood
Key in motor learning rehab
Known for 2 things
1. Techniques of Motor Control
- Inhibition and facilitation techniques
2. Developmental Sequence
- Learn in peds
