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Cognitive Communication Disorders & Motor Speech Disorders > Normal Cognition and Assessment (COG) > Flashcards

Normal Cognition and Assessment (COG) Flashcards

1
Q

Cognition is an umbrella term for all

A

higher mental processing

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2
Q

Higher mental processes include

A

LAME = language, attention, memory, executive-functions

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3
Q

Cognition and language were historically believed to be____ but are ________

A

related but are two different things

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4
Q

Language comprehension and formulation are NOW considered

A

part of the cognitive system

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5
Q

T/F Language comprehension may not be as distinct from cognition as previously thought

A

True

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6
Q

What might the impact of medications be on a client’s cognitive functioning?

A

may variously affect the capacity for behavioral change, confusion, and memory loss in individual client

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7
Q

You should become familar with ____ ___ , their uses and ____ _____

A

common medications; side-effects

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8
Q

T/F: Cognitive change as a normal process of aging has been well documented in scientific literature

A

True

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9
Q

Some ____ abilities may improve with age (i.e. vocabulary). Other abilities decrease with time

A

Cognitive

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10
Q

________ _______ Refers to the speed with which cognitive activities are performed

A

Processing speed

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11
Q

Cognitive speed begins to decline in the ____ decade of life and continues throughout life

A

Third

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12
Q

Sustained attention shows little _____ with age

A

Decline

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13
Q

______ Control (i.e. selective and alternating attention) shows a more noticeable decline

A

Memory

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14
Q

What type of memory is explicit?

A

Declarative

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15
Q

_____ memory shows decline throughout life

A

Episodic

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16
Q

T/F: Semantic memory shows decline in later life

A

True

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17
Q

Nondeclarative (implicit memory) is what?

A

Unconscious

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18
Q

T/F: Concept formation, abstraction, inhibition and mental flexibility decline with age, especially after age 70

A

True

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19
Q

Verbal and mathematic reasoning _____ beginning around age 45

A

Declines

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20
Q

T/F: Ability to appreciate similarities and reason about familiar material remain stable throughout life

A

True

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21
Q

_____ lobe and hippocampus important for storage of new memories and retrieval of existing memories.

A

Temporal

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22
Q

Temporal lobe and _______ important for storage of new memories and retrieval of existing memories.

A

Hippocampus

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23
Q

_____ lobe and subcortical structures important for encoding information and retrieving through their role in “executive” or “supervisory” functions (e.g., attention, organization; temporal memory).

A

Frontal

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24
Q

There are multiple ___-____ memory sites, especially in integration areas of temporo-parietal lobes that are implicated in verbal and visual memory.

A

long-term

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25
Q

_______ ______ is mediated by the frontal lobe and associations with other cortical and subcortical areas that trigger the retrieval of memories.

A

Retrieval process

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26
Q

Modality specificity: verbal vs. visual memory -
Left hemisphere: ______ memory and lexical information
Right hemisphere: _____ memory, topographical memory and non-verbal information

A

verbal ; visual

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27
Q

Definition of memory: The function of the brain to _____ and ______ information

A

store and recall

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28
Q

Theoretical Models of Human Memory
____ model
____ models

A

Stages; System

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29
Q

______ Model

Intended to describe various stages of information processing: Encoding, Storage, Retrieval

A

Stages

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30
Q

Stages Model - _____ : Early processing of material to be learned.
Involves strategies such as rehearsal and organization.
Quality determines how well info is stored and later retrieved (e.g., depth of encoding, organization of material).

A

Encoding

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31
Q

Stages Model - Storage:
Holding of information in the ____ system for future use
_____-term store temporary unless transferred to long- term store
Encoding processes occur during short-term storage
_____-term store considered to be permanent unless disrupted by pathological process

A

memory; Short; Long

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32
Q

Stages Model - Retrieval:
Pulling information from _____ (long-term store) in order to use it.
Delayed recall on memory tests
May be facilitated by presentation of information in ______ formats (e.g., multiple choice, yes/no)

A

storage; recognition

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33
Q

Interaction Between Encoding, Storage, Retrieval:

T/F: Quality of encoding impacts storage and retrieval

A

True

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34
Q

Information encoded ____ and associated with pre-existing knowledge is more likely to be encoded more effectively and efficiently

A

Deeply

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35
Q

Information is better recalled under conditions ____ to when it was learned (context-dependent memory or domain specific memory)

A

Similar

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36
Q

Repeated retrieval of information can _______ probability of being retrieved at a later time

A

Increase

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37
Q

______ Models of Memory evolved from concerns that stage models were _____ and could not explain complexities of memory process

A

System; simplistic

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38
Q

Systems Models of Memory: Breakdowns occur in ___ component of system, while others are preserved
e.g., patients with severe amnesia can have preserved digit span and recall of recent items, with inability to learn new material

A

one

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39
Q

Memory is comprised of sets of _____ systems and subsystems

A

interrelated

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40
Q

Types of System Models:
____ Memory
____-term Memory
Model of _____ Memory (previously short-term; Baddeley & Hitch, 1974)
Model of Long-Term Memory (Squire, 1992; Tulving, 1985)

A

working; long; working

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41
Q

Model of Working Memory: When information arrives via the ____ organs (perceptually encoded), it goes to working memory

A

sense

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42
Q

Some information is consolidated into ____-term (pick one: long or short) memory

A

long

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43
Q

Test of Everyday Attention (TEA)

Dedicated to _______ and is Normed


A

attention

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44
Q

Attention Process Training Test (APT- Test):
Dedicated
NOT normed
Sustained, selective, alternating and divided attention
Can be followed by APT-I and APT-II _____ treatment programs

A

attention

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45
Q

Wechsler Adult Intelligence Scale (WAIS-IV):
Normed
Includes subtests:
Digit Span ______ (sustained attention)
Digit Span Backward (sustained attention, _______ memory)
Digit _____ (sustained attention, working memory)

A

Forward; working; Sequencing

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46
Q

Attention:
Remember to pay attention to ______ (e.g. auditory, visual)
Remember to consider ____ (attention normally decreases over time)

A

Modality; time

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47
Q

What types of attention might you test?

all is not an option…

A

Sustained, executive control (selective, alternating, suppression, working memory)

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48
Q

If there is an impairment in memory, what areas of the patient’s brain are most likely to be impacted?

A

Frontal lobe, temporal lobe, parietal lobe, amygdala, hippocampus, basal ganglia, prefrontal cortex, cerebrum…

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49
Q

What types of executive function might you test?

A

Initiation, problem-solving, mental flexibility, planning, judgement, inhibition, reasoning, self-regulation, meta-cognition

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50
Q

If there is an impairment in executive function, what areas of the patient’s brain are most likely to be impacted?

A

Frontal lobe ; connections

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51
Q

The MD requests a cog eval for a patient that demonstrates changes since having a UTI (urinary tract infection). Would you consider treating?

A

No correct answer insert eye roll She said no in lecture

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52
Q

What is 1 memory test??

A

Communication Activities of Daily Living
CLQT (Cognitive Linguistic Quick Test)
RIPA (Ross Information Processing Assessment)
SCCAN (Scales of Cognition of Communication for Neuro Rehabilitation
SCATBT (Scales of Cognitive Ability in Traumatic Brain Injury
MoCA (Montreal Cognitive Assessment)

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53
Q

T/F: Etiologic categories are exhaustive.

A

False, not exhaustive.

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54
Q

Name the etiologic categories (diseases)

A

Degenerative diseases, inflammatory diseases, toxic-metabolic diseases, neoplastic diseases, vascular diseases, trauma, Iatrogenic, idiopathic

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55
Q

Which etiologic category is related to declining neuronal function?

A

Degenerative diseases

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56
Q

COVID-19 and Meningitis are a type of what etiologic category?

A

Inflammatory disease

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57
Q

The inflammatory response to bacteria, immunologic reactions, and viruses is relating to what etiologic category?

A

Inflammatory diseases

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58
Q

Examples of toxic-metabolic diseases include what?

A

Vitamin deficiencies, complications of kidney and liver disease, hypoxia, hyponatremia, drug toxicity

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59
Q

T/F: Cancer is an inflammatory disease.

A

False; neoplastic disease

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60
Q

T/F: Vascular diseases are the most common cause of neurologic deficits

A

True

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61
Q

An example of a vascular disease is what?

A

Cerebrovascular disease (stroke)

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62
Q

MVA, falls, gunshot wounds, blast injury, sport related are potential precipitating events for which etiologic category?

A

Trauma

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63
Q

Which etiologic category is caused by medical examination or treatment?

A

Iatrogenic

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64
Q

T/F: Nerve damage from surgery is an Iatrogenic etiologic category.

A

True

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65
Q

T/F: Idiopathic etiologic categories are known.

A

False; unknown

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66
Q

Name the 3 parts of a Cognitive Evaluation.

A

Case History/Background
Physical Examination
Assessments

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67
Q

What does the Case History/Background include?

A

Personal Information, Medical/Social/Surgical & Treatment History, Chief Complaint, History of present illness, Current Medications, Test Results/Imaging

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68
Q

You would use the Case History/Background for what 3 reasons?

A

To determine their cognitive function pre-injury
To confirm assessment choice
To determine their current function

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69
Q

T/F: SLPs do not need to be aware of the more global elements of a patient’s condition. If it is available, it doesn’t have to be integrated into the clinical picture.

A

False

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70
Q

A physical examination includes what? (5 things)

A

General observations, vitals, oral mech, cranial nerve exam, vision/hearing

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71
Q

A case history or background is used to determine what?

A

Which assessments will be used

72
Q

T/F: We shouldn’t make a hypothesis about what we’ll see during the assessment.

73
Q

What should we look for as far as the general observations?

A

Behavior, gait/posture, alertness

74
Q

What can abnormal vital ranges tell us?

A

They can indicate a more acute problem/need

75
Q

What is the purpose of the oral mech exam?

A

Can give a general idea of motor function for the speech mechanism

76
Q

T/F: Symmetry, coordination and involuntary movements are things we need to look at for a cranial nerve exam.

A

False; oral mech exam

77
Q

What is the purpose of the cranial nerve exam?

A

Can provide information relating to the site of the lesion, neurologic conditions, etc.

78
Q

T/F: The oral mech exam can provide information relating to the site of the lesion, neurologic conditions, etc.

A

False; cranial nerve exam

79
Q

T/F: There are many imaging results if in the early disease process (acute care).

80
Q

T/F: Cranial nerves can help you consider where the issue is in the brain.

81
Q

T/F: Assessment completion & results and treatment may have an impact based on vision/hearing

82
Q

Synthesizing the results of the physical exam into the overall clinical picture of the patient can have an impact on what?

A

evaluation results or diagnosis

and treatment

83
Q

T/F: The presence or absence of an impairment should be based on the results of a single measure

A

False, should not.

84
Q

Family and friends can be helpful in providing information. List at least 3 examples of questions to ask (in regards to their Personal Info, Medical, Social, Surgical & treatment history, Chief Complaint)?

A

(all are listed)

  • What is their native language?
  • What was their pre-morbid cognitive functional skills?
  • Besides their new acquire injury, any other reasons you might see changes in their cognition?
  • What were their premorbid responsibilities to work and family?
  • What will their post-injury responsibilities be?
  • Their chief complaint: What is their awareness of what is happening?
85
Q

Define etiology.

A

Cause, set of courses, or manner of causation of a disease or condition

86
Q

Name the executive function related to Luria’s theoretical model

A

Anticipation
Planning
Execution
Self-Monitoring

87
Q

Name the executive functions related to Stuss and Benson’s theoretical model

A

Initiation
Planning
Sequencing
Organization

88
Q

Define pathophysiology and provide an example.

A

Definition: the disordered physiological processes associated with disease or injury

For example, a demyelinating disease can make neural communication slowed or stopped.

89
Q

Development of disease/injury symptoms can be:

__________ (within ______); ____________ (within _______); ___________ (within ________)

A
  • Acute: within minutes
  • Subacute: within days
  • Chronic: within months
90
Q

The course of a disease/injury can be described using 5 terms.

A

transient, improving, progressive, exacerbating-remitting, stationary (chronic)

91
Q

Name the terms for the extent of disease/injury in the brain (3 types)

A

focal, multifocal, diffuse

92
Q

Define Executive Function.

A

Set of cognitive processes important in goal-directed and purposeful behavior

93
Q

What does executive function assist with?

A

Planning, organizing, initiating, and adapting in a flexible manner, as the situation demands

94
Q

Name the theoretical models of Executive Function.

A
  1. Luria (1966)
  2. Stuss and Benson (1986)
  3. Lezak (1995)
  4. Sohlberg and Mateer (2001)
  5. Keil and Kaszniak (2002)
95
Q

Name the executive function related to Luria’s theoretical model

A

Anticipation
Planning
Execution
Self-Monitoring

APES or LAPES to include Luria in the acronym

96
Q

MEMORY assessments can be organized by:

A 
Memory Systems
Types of memory
Immediate recall
Delayed recall (retrieval)
Recognition
Forced choice
97
Q

Memory Systems assessment assesses:

A

• working vs long-term

98
Q

Types of memory assessment assesses:

A
  • Verbal (e.g. words, numbers, names) vs. nonverbal (e.g. figures, faces, spatial arrangements)
  • Declarative vs. nondeclarative
99
Q

Immediate recall MEMORY assessment assesses:

A

• Recall of stimuli immediately following presentation

100
Q

Delayed recall (retrieval) MEMORY assessment assesses:

A

• Recall of stimuli following a time interval

101
Q

Recognition MEMORY assessment assesses:

A

• Recognize target stimuli from distractor materials

102
Q

Forced choice MEMORY assessment assesses:

A

• Choose the word from a pair that was from a previous list

103
Q

Commonly administered assessments for MEMORY

A
  • Montreal Cognitive Assessment (MOCA), FYI: this is a screen, not eval
  • Dedicated: Wechsler Memory Scale – Fourth UK Edition (WMS–IVUK)

Other assessments with memory subtests:
• Arizona Battery for Communication Disorders of Dementia (ABCD)
• Brief Cognitive Status Exam
• Brief Test of Head Injury
• Burns Brief Inventory of Communication and Cognition
• Communication Activities of Daily Living
• Cognitive Linguistic Quick Test (CLQT)
• Ross Information Processing Assessment (RIPA)
• Scales of Cognition and Communication for Neuro Rehabilitation (SCCAN)
• Scales of Cognitive Ability in Traumatic Brain Injury (SCATBT)

104
Q

The regulation of one’s thoughts, emotional responses, actions, and motivation in order to behave in an expected way for a given situation is meta-cognition

A

False; it is self-regulation

105
Q

Name the executive functions related to Sohlberg and Mateer’s theoretical model

A 
Initiation and drive
Response inhibition
Task persistance
Organization
Generative thinking
Awareness
106
Q

Name the executive functions related to Keil and Kaszniak’s theoretical model

A

Planning, scheduling, strategy use, rule adherence
Generation, fluency, initiation
Shifting and suppression
Concept formation and abstract reasoning

107
Q

T/F: Components of executive function are NOT mutually exclusive

108
Q

T/F: Components of executive function do not interact or overlap

A

False: Components of executive function interact and overlap

109
Q

T/F: There is general agreement about the primary cognitive processes compromising executive function

110
Q

Define Initiation

A

The action of beginning a goal-directed task

111
Q

Define Problem-solving

A

Identifying the problem, generating potential solutions, choosing a solution, and evaluating the outcome

112
Q

What is mental flexibility

A

The ability to change a course of action or thought based on the shifting demands of a situation

113
Q

Define Planning

A

Setting objectives and determining a course of action for achieving those actions

114
Q

Define Judgement

A

Being able to discern the potentially good and harmful aspects of a situation, and act in a way that makes sense

115
Q

Define Inhibition

A

The ability to select appropriate responses and suppress unwanted actions

116
Q

T/F: The ability to select appropriate responses and suppress unwanted actions is inhibition

117
Q

Define Reasoning

A

The process of forming conclusions, judgments, or inferences from facts or premises

118
Q

Define Self-regulation

A

The regulation of one’s thoughts, emotional responses, actions, and motivation in order to behave in an expected way for a given situation

119
Q

Define Meta-cognition

A

Awareness and understanding of one’s own thoughts and skills and how you learn information

120
Q

T/F The regulation of one’s thoughts, emotional responses, actions, and motivation in order to behave in an expected way for a given situation is meta-cognition

A

False; it is self-regulation

121
Q

Every task we perform requires activation a number of cognitive processes defines ______ ______.

A

cognitive processing

122
Q

Name the two types of cognitive processing

A

Automatic processing and controlled processing

123
Q

What cognitive processing is effortless, rapid, unconscious, and uses fewer resources?

A

Automatic processing

124
Q

What cognitive processing is slow, effortful, conscious, and uses more resources?

A

Controlled processing

125
Q

What is regulation of cognitive resources?

A

Each cognitive process takes up some of the resources

126
Q

What are executive functions associated with?

A

frontal lobes and their connections

127
Q

What is divided into subsections? (neuroanatomy of executive function)

A

The prefrontal area

128
Q

List the divisions of the prefrontal area

A 
Dorsolateral
Ventrolateral
Orbitofrontal
Dorsomedial
Ventromedial
129
Q

T/F: Cognitive abilities cannot improve with age.

A

False: Some cognitive abilities may improve with age (e.g., vocabulary)

130
Q

T/F: Abilities other than vocabulary decrease with time

131
Q

T/F: Cognitive change as a normal process of aging has not been well documented in scientific literature

132
Q

What does processing speed refer to?

A

Processing speed refers to the speed with which cognitive activities are performed

133
Q

When does processing speed begin to decline?

A

In the third decade of life and continues to decline throughout life

134
Q

What is the cause of the cognitive changes reported in healthy older adults?

A

slowed processing

135
Q

Related to attention, what shows little decline with age?

A

sustained attention

136
Q

T/F: Executive control shows less noticeable decline than sustained attention.

A

False; Executive control shows a more noticeable decline

137
Q

Executing control includes _____ and ____ _____

A

selective; alternating attention

138
Q

What is the most common complaint with aging?

139
Q

Organizational Framework for EXECUTIVE FUNCTION Assessment (Keil & Kazniak, 2002)

A
  • Tests of planning, scheduling, strategy use, and rule adherence:
  • Tests of generation, fluency, initiation:
  • Tests of shifting and suppression:
  • Tests of concept formation and abstract reasoning:
140
Q

EXECUTIVE FUNCTION Tests of planning, scheduling, strategy use, and rule adherence: Includes tests that what?

A

• Includes tests that require creation of subgoals, temporal sequencing, strategy generation and application, using environmental feedback to guide behavior, and self-monitoring.

141
Q

EXECUTIVE FUNCTION Tests of generation, fluency, initiation: : Includes tests that what?

A

• Includes tests that require generation of concepts and compliance with environmental constraints, and measure lack of monitoring, i.e., through perseverative errors.

142
Q

EXECUTIVE FUNCTION Tests of shifting and suppression: : Includes tests that what?

A

• Includes tests that require shifting between tasks (i.e., set) and inhibition of external or internal/overlearned responses.

143
Q

EXECUTIVE FUNCTION Tests of concept formation and abstract reasoning: Includes tests that what?

A

• Includes tests that require formation of concepts and conceptualization of abstract relationships.

144
Q

Observation/Performance-Based Measure

A
  • Behavior Rating Inventory of Executive Functions- Adult (BRIEF-A)
  • The Dysexecutive Questionnaire (DEX) (Burgess, Alderman, Wilson, Evans, & Emslie, 1996)
  • Frontal Systems Behavior Scale (FrsBe)
  • Profile of Executive Control System (PRO-EX)
  • Executive Function Route Finding Task
  • Cognitive Estimation Task
  • American Multiple Errands Test
145
Q

Cognitive-Communication Measures

A
  • LaTrobe Communication Questionnaire (LCQ)
  • Pragmatic Profile of Impairments in Communication (PPIC)
  • The Adapted Kagan Scales
  • Discourse Analysis Measures
    * Narrative
    * Macrolinguistic
    * Micorstructural
    * Macrostructural
    * Story Grammar
  • Conversation
    * Obliges, comments, clarification
    * Exchange Structure Analysis
146
Q

Impairment-based Assessments

A 
DKEFS 
WCS 
      COWAT 
       PORTEUS 
MAZES 
CLQT
       Generate naming 
       Design generation 
       Symbol trails 
       Mazes
147
Q

Activity/Participation Assessments

A

SAVRES

BADS

148
Q

What are the functions of the dorsolateral?

A

Monitors and adjusts behavior using working memory and executive functions

149
Q

What are the functions of the ventrolateral?

A

Response inhibition Goal appropriate response selection selection attentional control vigilance

150
Q

What are the functions of the orbitofrontal?

A

Personality, emotional input, social behavior, suppression of distracting signals

151
Q

What are the functions of the dorsomedial?

A

Arousal, motivation, and initiation of activity

152
Q

What are the functions of the ventromedial?

A

Emotional control and empathy

153
Q

What are the consequences of lesions in the dorsolateral?

A

Executive function deficit
Disinterest/emotional reactivity
Decreased attention to relevant stimuli

154
Q

What are the consequences of lesions in the ventrolateral?

A

Emotional dysregulation

Poor attention and vigilance

155
Q

What are the consequences of lesions in the orbitofrontal?

A

Emotional lability
Disinhibition
Distractibility
Social inappropriateness

156
Q

What are the consequences of lesions in the dorsomedial?

A

Apathy
Decreased drive/awareness
Akinetic-abulic syndrome
Mutism

157
Q

What are the consequences of lesions in the Ventromedial?

A

Impaired judgment

Inappropriate social behavior

158
Q 
To which subsection do these connections belong to? (listed superior to inferior)
Parietal cortex 
Caudate nucleus 
Global pallidus 
Substantia nigra 
Thalamus
A

dorsolateral

159
Q 
To which subsection do these connections belong to? (listed superior to inferior)
Parietal cortex 
Caudate nucleus 
Global pallidus 
Substantia nigra 
Thalamus
A

ventrolateral

160
Q 
To which subsection do these connections belong to? (listed superior to inferior)
Temporal, parietal
Insula
Globus pallidus 
Caudate nucleus
Substantia nigra 
Amygdala
Thalamus 
Cerebrocerebellar circuit
A

orbitofrontal

161
Q 
To which subsection do these connections belong to? (listed superior to inferior)
Temporal, parietal 
Caudate nucleus
Global pallidus 
Substantia nigra 
Cingulate
Thalamus
A

dorsomedial

162
Q

To which subsection do these connections belong to? (listed superior to inferior)
Amygdala
Temporal lobe
Prelimbic cortex

A

ventromedial

163
Q

Types of Long Term Memory:

Declarative / _____ memory (conscious)

164
Q

Types of Long Term Memory:

_____: knowledge of facts (e.g. multiplication tables)

165
Q

Types of Long Term Memory:

Episodic: knowledge of _____ experience (e.g. what you had for breakfast)

166
Q

Types of Long Term Memory:

___-______ / implicit memory (unconscious)

A

Non-Declarative

167
Q

Types of Long Term Memory:

_______ memory: preserved learning even when you don’t recall learning it

A

Procedural

168
Q

Semantic and episodic are part of ____/____ memory in the model of long term memory.

A

declarative/explicit

169
Q

Procedural memory is part of _____/____ in the model of long term memory.

A

Non-declarative/implicit memory

170
Q

When symptoms resolve completely after onset, that is known as what type of course?

171
Q

Describe an improving type of course.

A

severity is reduced but symptoms are not resolved

172
Q

T/F: When symptoms continue to progress or when new symptoms appear, that is known as an exacerbating-remitting course.

A

False; progressive.

173
Q

When symptoms develop, resolve or improve, then recur and worsen, that is known as what type of course?

A

Exacerbating-remitting

174
Q

Describe a stationary (or chronic) type of course.

A

symptoms remain unchanged for an extended period of time

175
Q

The extent of a disease/injury that involves a single circumscribed area or contiguous group of structures (e.g., left frontal lobe) is what?

176
Q

T/F: Diffuse is described as involving more than one area or more than one group of contiguous structures (e.g., cerebellar and cerebral hemisphere plaques associated with MS)

A

False; multifocal

177
Q

The extent of a disease/injury that involves roughly symmetric portions of the nervous system bilaterally (e.g., generalized cerebral atrophy associated with dementia) is known as what?

Cognitive Communication Disorders & Motor Speech Disorders (6 decks)

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