Cognitive Presentations Flashcards
1
Q
Cognitive Linguistic Quick Test (CLQT)
A
- Enables examiner to quickly assess the relative status of five cognitive domains through ten tasks:
- Attention
- Memory
- Language
- Executive Function
- Visuospatial Skills
- Identify strengths and weaknesses in specific cognitive domains
- Provide a “snapshot” of cognitive skills
- Identify areas for direct treatment
- Identify areas needing further evaluation
- Criterion-Referenced
2
Q
CLQT demographics
A
- English adults 18-89
- TBI, CVA, Dementia, PD
- can manipulate a pen, respond verbally, can be administered bedside, can be given over 2 sessions
3
Q
5 Tasks CLQT 1
A
- Personal Facts- episodic memory, orientatiton, communication, STM and LTM
- Symbol Cancellation- visual attention, visuospatial skills, scanning, discrimination, and inhibition
- Confrontation Naming- semantica and phonology
- Clock Drawing- sustained attention, working and procedural memory, planning, comprehension, reading & writing numbers, visuospatial skills, concept of time
- Story Retelling- verbal working memory, auditory processing, expressive lang., attention
4
Q
5 Tasks of CLQT 2
A
- Symbol Trails- attention, EF, visuospatial skills/perception
- Generative Naming- word retrieval, working memory, semantics, phonological knowledge, EF
- Design Memory- working/visual memory without language, visual attention, visuspatial skills
- Mazes-EF, attention, visuospatial skills
- Design Generation- creativity, productivitiy, self-monitoring, rule following, and effective strategies
5
Q
Pediatric Test of Brain Injury (PTBI)
A
- Children are not little adults, they respond differently to TBIs
- prior to this test they adapted adult verions for kids
- Standardized, criterion referenced test
- English 6-16
6
Q
2 Purposes of PTBI
A
- Establish current ability levels
- Track changes over time
- To estimate a child’s ability to apply neurocognitive and linguistic skills that are often vulnerable after brain injury yet applicable to functioning in school
- Item response theory- items are scaled so easier questions have less pts
- Abilitiy score
7
Q
What does PTBI Measure
A
- Attention
- Memory
- Language
- Visuospatial Skills
- Executive Functions
Same measures as CLQT
*** Can be with children and adolescence 6-16 with TBI or ABI (acquired brain injury)
8
Q
- Prompt
2. Probe
A
- Prompt: neutral form of encouragement (“We have to move along”)
- Probe- cue for more specific information
9
Q
Scales of Cognitive Ability for Traumatic Brain Injury (SCATBI)
A
- To provide a systematic method for assessment of cognitive deficits associated with TBI
- adolescents and adults
- Specifically designed to measure the following cognitive processes:
1. Perception/ discrimination
2. orientation
3. organization
4. Recall of information
5. Reasoning - Primarily used with English speakers with a CHI
10
Q
SCATBI- Subtests or scales
A
- Perception and Discrimination (includes attention)- 11 testlets (sound, word, color, shape, size, picture, auditory discrimination)
- Orientation- premorbid questions and post-morbid questions
- Organization- 8 testlets (identifying picture categories, word categories, sequencing objects, words, events, (time of year, pictured tasks, recall task steps)
- Recall (Memory) 9 testlets (memory for graphic elements, word retrieval, delayed recall, cued recall of words, cued recall of words in discourse, word generation, immediate recall of oral directions, recall of oral paragraphs)
- Reasoning- 11 testlets (analogies, convergent thinking, deductive reasoning, inductive reasoning, divergent thinking, multiprocess reasoning)
- Each scale can be administered independently; the whole test does not have to be administered.
- Each scale is made up of testlets (small sets of very similar items that vary in difficulty plus a few individual items requiring more than 1 response)
11
Q
Treatment for Problem Solving
A
- Make the therapy functional and simple
- Individuals with TBI may have difficulty recognizing when there is a problem. When solving problems they may have problems deciding what the best solution is
Functional problem solving and Simple
Simple- parts=whole
Functional- more complex, real life problems
12
Q
Symptoms of deficits w/ problem solving
A
Behavioral- difficulty drawing conclusions
- inability to figure out and apply rules in problem-solving activities
- difficulty with production and fluency of thought
- inability to learn from trial and error
- poor decisions about behaviors and friends
13
Q
Assessments that look at problem solving
A
- Ross information processing assessment (RIPA-2)
- PTBI- word fluency (convergent naming)
- CLQT- confrontation naming, symbol trails, generative naming, and mazes
- assessments need to show what the patient’s strengths and weaknesses
14
Q
Treatment at Problem Solving
A
Steps that allow a clear structure to the intervention process:
- identifying problems
- Generating solutions
- Organizing
- Sequencing
- Implementing solutions
- Managing time
- Maintaining safety
15
Q
Goals for problem solving therapy
A
- Start simple and go more complex
- Teach compensatory strategies
- We want the individuals to be able to identify a problem and then take steps to solve this problem
16
Q
Problem Solving Treatment
A
- Naming categories (convergent naming and divergent naming tasks)
- Informal assessments of executive functions (require multiple steps, ask client to plan or prepare, be an observer when the client does a task, cue only when necessary)
- Work on medical situation problems (what would you do if you cannot remember when to take your medications)
- Problem solving questions (ask them what the problem is and what should be done)
- Problem solving worksheet (state the problem, potential solution, and how it worked)
- Describing specific features (how items are similar or different)
- Work with client to realize if there is a problem
- Have worksheets that require them to solve problems
ASHA states that evidence supports using metacognitive strategy instruction using step by step procedures to improve organization and problem solving.
17
Q
Reasoning- Abstract and Mathematical
A
- patients may think more concretely and only reason literally and logically
- inability to understand relations between two or more elements
- Difficulty with understanding figurative lang, sarcasm, and slang
- trouble with calculations, understanding numerical concepts, comparisons of numbers, and arthimetical symbols
- loss of calculation can be due to deficits in memory, attention, problem solving, sequencing, organization, and language
18
Q
Abstract reasoning treatment
A
- Add to category- complete a list with a similar word (helicopter, wasp, robin…)
- Wrong category- which item does not belong with the other four?
- multiple definitions- provide two definitions for the words
- analogies
- word deduction- describe what object the three clue words are describing
-proverb and expression- explain the meaning
(don’t make a mountain out of a mole-hill)
- Comprehend figurative language- explain meaning
- interpreting emotions, personal feelings
19
Q
Mathematical Reasoning Treatment
A
Math basics:
1. Counting- forewards, backwards, skip counting, roman numerals
- Reading and writing numbers- order on timeline, place value
- Comparing numbers- >, <, =
- Adding and subtracting- tasks with money
- Multiplication
Functional tasks:
- Telling time- elapsed time problems
- Money (adding/subtracting coins, bills, salary, budgeting, and shopping)- matching coins to money values
- Cooking (measurements)
20
Q
Orientation Therapy
A
Orientation- a person’s conscious awarenes of self, time, place, and situation
- Person- knowing basic information about oneself (name, age, birthdate)
- Place- knowing one’s present location (city, state, facility)
- Time- current temporal information (date, month, season, year, day of the week, time of day)
- Purpose- knowing relevant events
Alert & oriented x 4= A&Ox4
21
Q
Purpose of orientation therapy
A
- Decrease patient’s confusion
- lead patient to understand they need knowledge about themselves and their environment
22
Q
Therapy for orientation:
A
- Client questionaire (orient to self)
- Work on questions that help with orientation to immediate environment and recent happenings
- Multiple choice questions about immediate environment and recent happenings
- yes/no immediate environment and recent happening questions
- Yes/ no temporal orientation
- Answer temporal orientation skills
- Spatial orientation, ask questions based on hospital map, hotel lobby or house layout photo
23
Q
Organization therapy
A
When treating:
- Focus on sequencing the patient’s day
- sequencing automatic tasks
- categorization of items
- work/ school space and deadlines
- time management- social activities
- Money
24
Q
Organization
A
- organization deficits are some of the most common
- Sequential- Organizing through sequencing tasks
- Categorical- Organizing through common attributes
- Expressive- Organizing your thought process so you can complete a divergent naming task
25
Q
Treatment of organization
1. Sequential
A
- Process of going to the grocery store
- Organizing a picnic
- Organize your morning routine
- Driving safety
- Organizing a narrative- story grammar
- Sequencing functional tasks (setting a table, making a sandwich, making a bed)
26
Q
Treatment of organization
1. Categorical
A
- Alphabetical- ask them to organize books alphabetically
- Food categorization in a grocery store
- Laundry categorization by color
- Naming categories- convergent naming
27
Q
Treatment of organization
1. Expressive
A
- Divergent naming task, fill the category in 15 seconds (has to do with word retrieval and semantic network organization)
28
Q
Treatment of Organization
1. Functional tasks
A
- planners, folders
- create a weekly choir chart
- organize space- bedroom, desk, backpack, and kitchen
- organize medications
- use checklists/ timers
- organize money (balance a checkbook)
29
Q
Treatment Approaches for Functional Activities
Grocery shopping
A
- work with clients on going to the grocery
- create a budget
- assess what you have in the pantry
- balance checkbook (how much do you have after paying the bills)
- practice writing checks
30
Q
Treatment approaches for functional activities
Cooking
A
- Find a recipe
- see if you have all the ingredients
- Follow the directions
- set timer so food is cooked properly
- process of cleaning up and washing dishes
31
Q
Treatment approaches for functional activities
Medications
A
- pill sorting activity
- make sure client can follow instructions and is capable of handling their medications
- medication form
32
Q
Additional functional activities
A
- Reading the newspaper
- Home safety
- Dressing, self care
33
Q
Community reintegration after TBI
A
TBI can affect pyschosocial functioning
- psychological
- social
- 50% - 60% of TBI survivors struggle to gain permanent employment
- many individuals will need workplace accommodations
- Assessing readiness to work- severity of injury, duration of coma, length of hospitalization, RLAS on discharge, neuropsychological tests, history of alcohol abuse, age, and amount of education
34
Q
Instructional and environmental modifications
A
**In therapy work on strategies that will help them adjust when they go back. Teach them to be an advocate for themselves and request the modifications they need
- written materials should be clear
- presenting a model is helpful
- projects and worksheets may need to be shortened
- make sure the client is paying attention prior to speaking
- pre-teach information
- use verbal and visual cues
- see if it is possible for the patient to rest during the day
- create routines
