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Cognitive Retraining > CR: Lesson 2 > Flashcards

CR: Lesson 2 Flashcards

1
Q

What is the main goal of CR?

A

Highest possible daily function, self-efficiency

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2
Q

What must we do befor we create a treatment plan?

A

look at the type & location of the brain injury (= expected progress & prognosis)
premorbid functioning
demands of current life
support system
personality/emotional adjustment
residual strengths
ability to participate in therapy (stamina/cognitive ability)

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3
Q

Consider these things about type & location of brain injury…

A

what deficits impaired?
how severe?
how diffuse?

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4
Q

What information do physicians provide?

A

location, severity of injury, conncurrent injuries, effects of med, prognosis, what to expect

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5
Q

What information do nurses provide?

A

info about the client’s sleep habits and what time may be the patient’s best in terms of alertness & cognitive function

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6
Q

What information do physical therapists provide?

A

physical deficits, stamina
mobility options
positioning

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7
Q

What information do opccupational therapists provide?

A

the ability to participate in everyday self-help skills, ADLs, and visuospatial skills

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8
Q

What information do neuropsychologists provide?

A

cognitive functions

emotional/motiviational issues

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9
Q

What information do SLPs provide?

A

language/speech
cognition, safety
swallowing

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10
Q

What areas need to be assessed?

A 
arousal & alertness
orientation
attention/concentration
memory/learning
communication skills
presence of apraxia
reading/writing
reasoning/probelm-solving
executive functions
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11
Q

What are executive functions?

A

initiation, inhibition, planning, organizing, awareness

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12
Q

Standardized Tests

A

normed on population that represents your client
performed exactly as instructed to draw conclusions about impairment.
* altering the test may provide “qualitative data” –like what cues are helpful to this client, that you may want to use in therapy

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13
Q

What is fixed battery approach?

A

giving the same assessment or battery of assessments to all clients regardless of presenting information or deficits. Very broad in nature & time consuming–SLPs rarely do this. Not much time in rehab for this type of assessment.

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14
Q

What is the flexible, process-oriented approach?

A

targest particular areas of concern

choose assessments based on medical/other background info

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15
Q

What is tracking evaluation?

A

repeated assessments of certain skills

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16
Q

What must you bewar of in tracking evaluations?

A

practice effects

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17
Q

What kind of test can be used in tracking evaluation?

A

standardized OR informal assessments of clinical skills (ex. following directions, solving problems, reading/writing a particular passage, etc.)

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18
Q

Consider these factors when testing:

A 
physical influences
visual field deficits
perceptual deficits
paresis/paralysis
emotional factors
ecological validity
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19
Q

What are examples of physical influences

A

(fatigue, hunger, pain)

20
Q

What are visual field deficits

A

(right/left neglect)

21
Q

What are perceptual deficits

A

(visual/hearing impairement)

22
Q

What is ecological validity?

A

how the tasks relates to functions ofthe client’s everyday life

23
Q

Are rating scales standardized or non-standardized tests?

A

non-standardized

24
Q

What are rating scales?

A

several raters rate performance on practical tasks

25
Q

Name advantages of using rating scales

A
  • looks at performance accross settings
  • tracks progress on daily function
  • less time consuming and more convenient to compile
  • can be given over & over w/o practice effect
26
Q

Name two examples of rating scales

A

Neurobehavioral Rating Scale & Disability Rating Scale

27
Q

Disability Rating Scale

A

A. Eye Opening
0= spontaneous (eyes open with sleep/wake rhythms indicating active arousal mechanisms, does not assume awareness
1= to speech and/or sensory stimulation
2= to pain
3= none: no eye opening even to painful stimulation
B. Communication Ability
0= oriented (name, location, why they are there, year, season, month, day, time of day…)
1= confused (delayed or confused responses)
2= inappropriate (intelligible, but speech is used only in exclamatory or random way; no sustaied communication exchange is possible)
3= incomprehensible (moaning, groaning,…)
4= none

28
Q

There is often a period of ______ or _________ following brain injury.

A

coma

post-traumatic amnesia (PTA)

29
Q

General Cognition Assessments

A

investigate the clients’ performance on several types of cognitive domains (memory, reasoning, problem-solveing, naming, perception, etc.)

assessment ex. RIPA

30
Q

Types of Attention/ Concentration to Assess

A

sustained attention
focused attention
divided attention
information processing speed (Concentration)

31
Q

sustained attention

A

aka. vigilance

digit span recall, also continuous performance test in which person must respond when a particular stimulus is perceived

32
Q

focused attention

A

number or letter cancellation

33
Q

divided attention

A

requiring the client to do two things at once (ex. listent to a series of letters and numbers and keep a running tally of numbers)

34
Q

information processing speed

A

timing the reaction time or completion time on tasks (ex, looking up words in a dictionary…or addition tasks at varying rates)

35
Q

Memory & New Learning- Types of memory to assess:

A 
delayed recall
cued recall
recognition
verbal vs nonverbal memory
immediate memory
working memory
prospective memory
36
Q

delayed recall

A

will tell you about the ability to form new lasting memories

37
Q

cued recall

A

may give you info about what types of cues the patient will respond to best

38
Q

recognition

A

requires the least freerecall, but the most basic level of learning

39
Q

verbal vs. nonverbal

A

(CVLT vs. picture of faces)

40
Q

immediate memory

A

number or letter recall

41
Q

working memory

A

do something with the information like creation of acronyms

42
Q

prospective memory

A

remember this and I’ll ask you about it later…

43
Q

Standardized test that measure executive functions

A

RIPA, MIRBI, SCATBI, BTHI

44
Q

Use caution when using standardized tests to measure executive functions bc…

A

test lenght does NOT require a person to maintain set for long.
explicit instructions may not provide opportunity for problem solving and reasoning.
test administration does not usually occur in real-life situarions in which the cliend would have to inhibit outside distractions
the task may not have a lot of ecological validity
tests often dont assess the social executive function (ex. initiation & inhibition)

45
Q

What are some non-standardized tests for executive functions?

A

Stroop test–inference/ inhibition
Clock drawing—sequencing, visuo-spatial, organization, problem solving, LTM
semantic fluency tasks—paitent its aked to make a list of LTM–as many as I can
Rating Scales for everyday tasks. —looks at same functions, but in practical tasks

Cognitive Retraining (6 decks)

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