Cognition and interventions

Question 1

Hierarchy of skills

Answer 1

bottom to top:

• alert
• attention
• memory
• executive functions

don’t have to be aware for alertness.

Question 2

cognitive rehab

Answer 2

should be systemic, should have a plan for client based off of assessments. should always be functionally oriented. Patients can generalize better with exercise that are still functional.

Question 3

Intervention principles

Answer 3

grounded in theory:

1) process training- reinforce, strengthen, or re-establish previously learned patterns of behavior.
2) Strategy training- establish new patterns of cognitive activity through compensatory cognitive mechanisms through use of environmental, internal, and external strategies.
3) Compensatory education- education on cognitive strengths and weakness. Focus on developing awareness and helping a person to adapt to their cognitive disability, even when re-establishment may not be possible
4) functional activity training- focused practice on real life skills.

Question 4

types of cues during intervention

Answer 4

• Full- overt/entire demonstration
• Specific- process cure that increases self monitoring “how will you remember…”

Opportunity- expectant pause, raised eyebrows to indicate something is left to be done

Spatial- using the environment

Temporal- timed cues.

Question 5

compensations

Answer 5

used if they cannot gain back function.

make purposeful- address a specific issue.

Question 6

interventions for attention

Answer 6

training of metacognitive strategies.

• training use of external aids.
• environmental modification/task accommodation

Question 7

interventions for memory

Answer 7

training specific tasks, habits, routines.

• compensatory strategies and external aides for specific skills.
• prospective memory training.
• attention training.
• personal history

go with errorless learning approach

Question 8

interventions for executive functions

Answer 8

• adapting or simplifying the task
• training specific functional skills or routines.
• providing cue signals within task/environment
• strategy training

large family calendar, plan, practice, and promote a therapeutic attitude.

Question 9

Interventions for awareness

Answer 9

• facilitate client discovering their own errors.
• select activities at “just right challenge”
• self prediction. ask client to anticipate difficulties on a task.
• videotape feedback
• self evaluation,
• journaling

Question 10

Vanishing cues

Answer 10

start with 12 cues and slowly whittle them away till you get no cues.

can stay with patients up to 10 year post treatment

Question 11

errorless learning

Answer 11

task broken down into simple steps,

• training starts with simple tasks with high likelihood of success.
• performance at each level is overlearned using repetitive, successful practice, and positive reinforcement

Question 12

Spaced retrieval

Answer 12

recalling information over a repetitively longer period of time intervals (30 sec, 1 min, 2 min, 4 min, 8 min)

if retrieval is successful length in increased.

can be combined with errorless learning.

Question 13

forward and backward chaining

Answer 13

method to teach a multi-step or complex skill.

Forward- start with first step and therapist completes the rest until first step is learned and progressively the client does more and more of task

Backwards- therapist completes all steps of task except last and then progressively does less working backwards.

Question 14

Prospective memory process training

Answer 14

• asks client to remember to carry out target task in specific number of minutes.
• number of minutes increased after client demonstrates repeated success at particular time interval.
• systematically lengthens amount of time client can remember and act on assigned task.

Question 15

SING

Answer 15

S-stop
I-identify main points
N-never mind details
G-get the gist

Question 16

problem solving

Answer 16

includes:

• awareness
• anticipate/plan
• execute/self-monitor
• self-evaluation