Cognitive Capacities and Abilities Flashcards
What is intellectual awareness?
- Client able to state or demonstrate knowledge of problems but not able to monitor problems
- Able to understand at some level that a cognitive function is impaired
- Unable to use strategies independently
What are therapy interventions for intellectual awareness?
- Someone other than the client initiates strategies
- Use and document through self-rating skills( self-report questionnaires and assessments/interviews
- Ask client about their perception of their strength and limitations
- Intellectual awareness has been achieved when client can demonstrate knowledge of the problems and recognize general implications
What is emergent awareness?
- Able to demonstrate knowing when a problem is happening without prompting
- Able to recognize a problem only when it is occurring
What are therapy interventions for emergent awareness?
- Strategies need to be initiated by specific situations or events
- Identify and self-correct errors during actual task performance
- Document through observation of clients actions/behaviors
What is anticipatory awareness?
- Able to predict or anticipate the situations in which problems occur
- Only at this stage will client be able to implement compensatory strategies independently
What are therapy interventions for anticipatory awareness?
- Select strategies that trigger client recognition that a problem is occurring or will occur if cognitive strategies are not used
- Predict performance on a task before commencing and select appropriate compensatory strategies
- Observe clients performance during tasks and ask timely questions during the task
- Assessments: interview: self-report, strength, perceptions
What is a self-rating assessment?
- Client uses rating scale to predict how well they will do on the task
5: I will be able to do this activity with no problems
4: I will be able to do most of this activity with no problems
3: I will be able to do some of this activity with no problems
2: I will need help to complete this activity
1: I will be unable to do this activity
- Done prior to task (client rates how they think they will perform) and upon completion of task (client rates how they think they performed)
- Rate/score the actual task performance
- Visually graph it out to show progress
- Use graph every time
How do you help someone gain awareness?
- Ask questions
- Observe client performing relevant functional tasks, then ask questions
- Intervention questions:
1) What worries you?
2) What have you tried?
3) What are your alternatives?
4) What do you anticipate?
5) Tell me what you are going to do next
Client needs to convince us that they have a problem - not the other way around
What is low level cognition?
The foundation for learning
- Awareness
- Attention
- Memory
- Perception/recognition (discussed previously)
- Visual processing
- Informational processing - follows commands
- Executive functions - initiates activities
What is higher level cognition?
- Self-awareness/insight
- Mental flexibility
- Multiple step command/direction following
- Initiate goals, plan steps towards goals, monitor and evaluate performance
- Strategic problem solving, abstract thinking
- New learning and applying new learning to situations
- Safety and judgement
What is attention?
- The backbone of cognitive rehab
- Attention skills underlie all other cognitive skills
- Inability to pay attention is one of the main reasons memory and cognitive impairments occur
- Attention activities can be very challenging
What are examples of attention systems?
- Selective attention: select the most important thing
- Alternating attention: switching from one task to another
- Divided attention - attend to two or more things at once
- Directed attention: managing attention
- Sustained attention: maintain attention for a long time
- Focused attention: discretely stay attended
How do you know if someone has problems with selective attention?
- Person may be distracted
- The person does not have the ability to select the most important thing to attend to and is unable to ignore distractions
- Person is unable to suppress conflicting stimuli, so that only one task is processed at a given time
How do you know if someone has problems with alternating attention?
- Person is confused
How do you know if someone has problems with divided attention?
- Person is having difficulty multi-tasking
- Person is unable to respond simultaneously to multiple tasks or demands
- Person is unable to think several things at once
- Person is not able to time share and process different resources
How do you know if someone has problems with directed attention?
- Person has difficulty with executive functions
- Person is unable to manage attention to stop saying one thing/doing one task (inhibit flow of thought/action) in order to do and say something else
- Does not have executive function of self-regulation
How do you know if someone has problems with sustained attention?
- Person is impulsive
- Person is unable to maintain a consistent behavioral response during continuous repetitive activity or stay with task or action over time
- Person is unable to ensure that task/goal is completed
How do you know if someone has problems with focused attention?
- Person perseverates
- Person is unable to discretely respond to specific or different kinds of visual, auditory, or tactile stimuli.
What are interventions for selective attention?
- Select book or magazine for client to read a page from and each time they see a specific word (e.g. the, for, or, out) ask them to circle the word. Let client know that changes will be occurring in the room, however they are to maintain their attention to required task for example, people coming in and out of room, lights being dimmed or brightened, noises occurring
- Gather newspapers/papers, scramble the order of each paper and have client put pages in correct order. Variations: ask client to find and circle all the l’s on the first page, or circle 2 or 3 letters at a time; use scissors to cut out words or letters to make a sentence or poem
Auditory Selective Attention Strategies
- “I’m going to read some words and each time you hear the word ‘tree’ tap your fingers on the table
What are interventions for alternating or shifting attention?
- Alternate between mental tasks of chopping vegetables while checking food so that it doesn’t boil over on the stove
- Use number or symbol code as key, decode messages, and write letter under the code
What are interventions for divided attention?
- Name of the game is SPEED and processing skills for multi-tasking
