L52. Presentation of Cognitive Function

Question 1

What are some important advantages of neuropscyology?

Answer 1

• ‘Pin-point’ pathology, disease or syndromes
• Provide rehabilitation strategies to enhance outcome
• Provide management techniques for behavioural 
disturbance caused by brain injury
• Comment of competency to make decisions

Question 2

What is the major means in which neuropsychology pin-points pathology, disease or syndroms?

Answer 2

Based on the pattern of cognitive, behavioural and emotional symptoms and signs

Question 3

What are some examples of behavioural 
disturbances? Why is it important to manage them?

Answer 3

Eg. Sexual disinhibition, aggression, separation (apathy), compulsive activity

Question 4

What are some important points to consider and gain when making diagnostic assessments?

Answer 4

• Cognitive complaints – what is the person or their loved 
one concerned about? 
(Priorities)
• Time frames – is the condition sudden onset, gradual
• Good interviewing and observations
• Key domains of cognition
• Incorporate knowledge from other medical professionals 
Eg. imaging results, OT assessments, nurses observations

Question 5

What is meant by cognitive rehabilitation?

Answer 5

Application of techniques and procedures and implementation of supports to enable them to function:

• Safely
• Productively
• Independently

Question 6

What are the two major approaches used in cognitive rehabilitation?

Answer 6

1. Fix it approaches - improving separate cognitive domains: Practice model Eg. Worksheets
2. Compensation approaches – Specific strategies taught in ‘rehabilitation’ 
settings

Question 7

What is a major drawback when using the Fix it approach and the practice model?

Answer 7

There is a general difficulty with generalization of these kinds of practiced skill from the hospital and into ‘real world’

Question 8

What is the active participation model currently used in cognitive rehabilitation?

Answer 8

Cognitive rehabilitation takes place in real world contexts where the person is most likely to use/need these skills

Cognitive interventions focus on enhancing participation and reducing functional limitations

Question 9

What is a major advantage of the active participation model of cognitive rehabilitation?

Answer 9

It is GOAL DRIVEN and allows the patient to do what they want to do. The cognitive interventions must be tailored to the individual

It fosters COLLABORATION between the client, their family and the treatment team

Question 10

What is key to successful cognitive rehabilitation?

Answer 10

1. Know the person beforehand: what do they know how to do, what are they’re habits?
2. And to develop a good relationship with them

Question 11

There are high rates of depression and anxiety and changes in emotional regulation in relation to cognitive impairments. What can be inferred from this?

Answer 11

Cognitive interventions are linked with emotional and behavioural reactions

Question 12

In order for successful cognitive rehabilitation, the patient needs to be able to learn or relearn skills. What is critical in order for this to happen?

Answer 12

You must determine most effective method of learning for the individual: How do they learn

Question 13

What are the two categories of cognitive interventions?

Answer 13

1. Environmental modifications
2. Compensatory Strategies

Question 14

What is environmental modification?

Answer 14

Change the physical and social environment to facilitate greater independence and to reduce the impact of a person’s cognitive and behavioural difficulties

Remove or manipulate precipitating environmental factors. Eg. Providing low stimulus environments

Question 15

When is environmental modification useful?

Answer 15

Useful to use when people have:

• Reduced insight
• Reduced self monitoring and regulation
• Significant/catastrophic attentional, memory and executive deficits

Question 16

What is neglect? What are important interventions to aid with this?

Answer 16

Posterior injuries to RHS of brain causing inattention to the left hand side of space.

• Can teach people to scan for mild neglect (compensation)
• Need to reorganize the environment for dense neglect (don’t tend to recover)

Question 17

What are some common environmental modification intervention tools? [3]

Answer 17

1. Reduced stimulation, quiet environments
2. Declutter, orientation information on walls, calendars
3. Set routines

Question 18

What are compensation cognitive interventions?

Answer 18

Training/teaching clients to use behaviours or processes that circumvent difficulties caused by cognitive deficits

Tend to be used for discrete cognitive problems

Question 19

What is and what are some internal compensation interventions?

Answer 19

Improvement of skill set/learn to utilise other skills

Eg. Use of mnemonic strategies, metacognitive strategies (using strategies that are purposeful, requires planning out of cognitive approach to a task)

Question 20

What is and what are some external compensation interventions?

Answer 20

Use cues and aids to assist compensation of deficit

Eg. Diaries, smartphones, apps now available

Question 21

What is the basis behind the brain training exercises and apps?

Answer 21

Aimed at baby boomers who are concerned about their memory (aimed at people who don’t have cognitive impairment)

Based on neuronal plasticity. The brain that changes itself

Question 22

Brain training programs and apps are often thought of pseudoscience. Expand

Answer 22

Owen et al. (2010): People did get better at the task but there is no evidence of transference of skills of everyday life from training

There is some evidence for improvement of attentional processes using very specific training programs for them