EXEC fx Assess Flashcards

1
Q

Assessment challenges:
multiple
paradox between ?
need to determine ?
need for assessment of

A

components of exec fx

structured vs spontaneous activity

fundamental as well as higher level cog skills

activity/participation levels

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2
Q

Current guidelines for cog com assessment after TBI:
use both
consider comm. needs of ? communicative ? and comm?

A

standardized and non standardized

indiv./ context / partner

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3
Q

Organizational Framework for Assessment:
1) tests of ?
includes tests that require creation of ? using environmental feedbakc to guide ?

2) tests of ?
-includes tests that require generation of ? and measure of lack of ?

3) tests of
-includes tests that requires ? and inhibition of ?

4) tests of ?
includes tests that requires formation of ? and conceptualization of?

A

planning, scheduling, strategy use, rule adherence
-subgoals, temporal sequencing, strategy generation/ behavior and self-monitoring

generation, fluency, initiation:
-concepts and compliance with encironmental constraints / lack of monitoring

shifting and suppression
-shifting between tasks / external or internal overlearned responses

concept formation and abstract reasoning
-concepts/ abstract relationships

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4
Q

Treatment:
the strongest research evidence favors compensatory tx that train individuals with TBI to use ?

selection of therapy approach depends on:
clinicians
time since
severity of
co-occurence of ?
clients level of
rehabilitation ?
support available in

A

strategies to circumvent exec fx impairments in daily activities

theoretical belief on nature of exec fx
-injury
-dysexecutive symptoms
-other cog. deficits
awarness
priorities of pt
environment

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5
Q

Treatment guiding principles:
1) structure: an organizational pla
-anchors: routines that are
-scaffolding: use of ?
-strategies: behaviors to help pt transition to

A

well est. in indiv. life

reminders, prompts, encouragment, reinforcement to develop systems to maintain or est. anchors

independent use of aids in natural environment

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6
Q

Tx guiding principles:
2) systematic insturction: a method that focuses on how instruction is ?

emphasizes
task?
-pre?
-..
-faded
-high amounts of
-immediate

A

designed and delivered
-error control
analysis
-pre-instruction
-modeling
-faded support
-high amounts of corrective practice
-corrective feedback

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7
Q

Tx guiding principles:
3) collaboration: partnership betweem
goal?

4) context: personal ?
train in ?

A

clinician and client
-goal setting and achievement

relevance of tx
-contextually rich, relevant environments with meaningful materials

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8
Q

Tx guiding principles:
5) metacog. instruction: self? self? and self? of cognition while performing activity
uses direct instruction to guide?
-identify
-predict
-identify
-self-monitor
-change behavior if

A

awareness/monitoring, control
-integration and internalization of self-reg. process
-goal
-performance
-possible solutions
assess performance during activity
-goal not met

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9
Q

Tx protocol:
PIE
planning stage:
who is ? what type of ? where will skill?: why is skill? and how will?

implementation: 3 phases
initial
… and…

E…

A

Plan Implement Evaluate

who is learner, wat type of info, where will skill be used, why skill being trained, how will outcome be eval.

initial acquisiton
mastery and generalization
maintenance

evalutae

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10
Q

Tx protocl:
TEACH-M

T- task
E- errorless
A- assess
C- cumulative
H- high rates of
M- Metacog.
Outcome: 5 participants learned a? in .. tx sessions

A

analysis
learning
performance
review
practice
strategy training

5 participants learned a 7 step email system in 7-15 tx sessiosn

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11
Q

Tx protocol : TATE
Training assistive technology in environment
acquisiton: modeling with ? frequent? corrective

generalization: training in a variety of

maintenance: regular

A

faded cues/ correct practice / feedback

variety of locations

review sessions

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12
Q

Other protocols:
group
problem solving
interpersonall
NICE ?

A

interactive structured treatment for social competence (GIST)

group protocol

recall

protocol

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13
Q

Problem-solving therapy:
meta-analysis of exec fx interventions indicated problem solving tx involved:
self
self
making
adjusting or modifying:

A

monitoring
recording of performance
strategy decisions based on goals
plan based on self assessment or external feedback

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14
Q

Problem solving therapy: SWAPS
STOP is there a
WHAT is the
ALTERNATIVES:
PICK and …
Satisfied with the ?

outcome: 98 indiv. made significant gains in ? handling? and dealing with ?

A

problem
problem
options to solve problem
plan chosen option
outcome of the plan

decision making/ interpersonal diff./ crises in everyday life after 3 hours of therapy each for 12 weeks

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15
Q

Goal Management training: a mindful approach to problem solving: raises awareness of ?
STOP
DEFINE
LIST
LEARN
DO IT
CHECK

A

Attentional lapses
ask what they are doing
main task
list all steps required
ask themselves whether they know all the steps
execute task
asking if they are doing what they planned to do

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16
Q

TIme Pressure mngmt:
decisions for timely completion of tasks depends on ?
three levels:
no pressure: there is enough time to ? plans can be determined ?

  1. some pressure but manageable: need to adjust decisions via ?

high pressure: requires immediate ? in order to prevent

A

amount of time pressure present

make decision/ in advance of task

anticipating and adapting behavior before time pressure builds up

decisions and actions/ failure

17
Q

Time Pressure Mngmt:
teaches strategies to prevent or manage time pressure
3 stages:
1. increase awareness that mental slowness is a ?
2. educate pts that speed of processing may not ?
3. strategy application and ?

A

problem and can significantly impact daily life

return to normal and introduced strategy “let me give myself enough time”

generalization -train under more distracting conditions

18
Q

Time pressure Mngmt:
compensatory strategies;
environmental support: auditory tone during task completion as a reminder to

outcome: performance on completion of multiple tasks improved to level of

A

think about what they were doing overall and aim of the task

control group

19
Q

Awareness Training:
pt predict performance on tasks within and outside
monitor task performance with and without use of

outcomes: increased awareness evidence by:
more accurate
differences between ?

A

skill level
compensatory strategies

predictions of performance
predicted and actual time decreased

20
Q

Cognitive Behavioral Therapy:
psychological approach usedfor tx of ?
specialized training to ? by relying on ?
teaches individuals to:
recognize
recognize and ?
use problem solving in a combination of

A

depression, ADHD, and other psych. conditions

change thinking patterns/ exec fx and may help train these functions

distortions in thinking
adjust problem behaviors
with coping skills

21
Q

Cog comm interventions:
tx often conducted in a group format though sometimes done with indiv.:
-
-
-…playing
-… feedback
-self–
social

A

discussion
modeling
role playing
verbal or visual feedback
self-monitoring
social reinforcement

22
Q

Cog-comm tx:
cognitive pragmatic treatment: designed to increase inferential abilities to ?
comprehension: matching lingquistic utterance with ?

production: modulation of comm. according to ?

outcome: higher levels of ? sensitive to ? and social ?

A

fill in gap/ what is said and what is intende d

pralinguistic info

particular context

social appropriateness/ context / social judgment

23
Q

Environmental supports:
modification of task demands:
break task into smaller
remove or minimize
provide
allow extra time to
reduce

A

smaller steps
stimuli that may elicit inappropriate behavior
break
complete tasks
environmental distractions

24
Q

Environmental supports:
2. organization of physical space
-designated areas for
centralized space for
create ?

  1. cueing and prompting:
    lists of tasks to be
    steps in
    create
A

items
calendar, schedules etc
filing system for bills and other important items

completed
specific routines
schedules

25
Q

Environmental supports:
manipulation of physiologic factors:
monitor ?
implement ?
montior level of ?

A

nutrition, sleep , acitivty level, medications

specific routines

fatigue by checking in during completion of activities