L52. Presentation of Cognitive Function Flashcards
What are some important advantages of neuropscyology?
- ‘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
What is the major means in which neuropsychology pin-points pathology, disease or syndroms?
Based on the pattern of cognitive, behavioural and emotional symptoms and signs
What are some examples of behavioural disturbances? Why is it important to manage them?
Eg. Sexual disinhibition, aggression, separation (apathy), compulsive activity
What are some important points to consider and gain when making diagnostic assessments?
- 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
What is meant by cognitive rehabilitation?
Application of techniques and procedures and implementation of supports to enable them to function:
- Safely
- Productively
- Independently
What are the two major approaches used in cognitive rehabilitation?
- Fix it approaches - improving separate cognitive domains: Practice model Eg. Worksheets
- Compensation approaches – Specific strategies taught in ‘rehabilitation’ settings
What is a major drawback when using the Fix it approach and the practice model?
There is a general difficulty with generalization of these kinds of practiced skill from the hospital and into ‘real world’
What is the active participation model currently used in cognitive rehabilitation?
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
What is a major advantage of the active participation model of cognitive rehabilitation?
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
What is key to successful cognitive rehabilitation?
- Know the person beforehand: what do they know how to do, what are they’re habits?
- And to develop a good relationship with them
There are high rates of depression and anxiety and changes in emotional regulation in relation to cognitive impairments. What can be inferred from this?
Cognitive interventions are linked with emotional and behavioural reactions
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?
You must determine most effective method of learning for the individual: How do they learn
What are the two categories of cognitive interventions?
- Environmental modifications
- Compensatory Strategies
What is environmental modification?
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
When is environmental modification useful?
Useful to use when people have:
- Reduced insight
- Reduced self monitoring and regulation
- Significant/catastrophic attentional, memory and executive deficits
What is neglect? What are important interventions to aid with this?
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)
What are some common environmental modification intervention tools? [3]
- Reduced stimulation, quiet environments
- Declutter, orientation information on walls, calendars
- Set routines
What are compensation cognitive interventions?
Training/teaching clients to use behaviours or processes that circumvent difficulties caused by cognitive deficits
Tend to be used for discrete cognitive problems
What is and what are some internal compensation interventions?
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)
What is and what are some external compensation interventions?
Use cues and aids to assist compensation of deficit
Eg. Diaries, smartphones, apps now available
What is the basis behind the brain training exercises and apps?
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
Brain training programs and apps are often thought of pseudoscience. Expand
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
