TBI Interventions Flashcards
What intervention principles for TBI are associated with better outcomes for TBI patients?
- reducing cognitive load in acute stage (possibly with distributed practice) as well as altering demands on the patient by simplifying or eliminating tasks
- application of more intensive rehabilitation in later acute stage
- structured activity based protocols
- Challenging, meaningful practice addressing interfering impairments, through goal directed activities
- provide salient cues for initiation
- referral to specialized units lead to improved outcomes
- aerobic training generally improves motor function
What are communication guidelines for talking to TBI patients?
- respect individual
- respond to any and all attempts to communicate
- talk about familiar subjects and do not try to introduce new ideas
- consistency is key
- keep conversations simple and direct but at age level
How can you manage the behavior of TBI patients who may be prone to mood swings?
- Employ behavioral Interventions to reduce aggression or disruptive behaviors which impair social function
- manage the behavior before it happens with antecedent based interventions such as self monitoring and changing events before behavior issues manifest
- provide external guides for sequencing behavior using metacognitive strategies
- rely on consequence based strategies as a secondary option
What interventions help promote arousal in TBI patients?
- Coma stimulation
- Meaningful multi-sensory stimulation
- hierarchical level of cueing
- cognitive behavioral stimulation (reinforce positive response and eliminate maladaptive responses)
How can you monitor effectiveness of TBI interventions?
Select stimuli based on interview with family by introducing stimul, waiting 2-3 minutes for response, based on response continue or remove stimulation
Measure physiological and behavioral response such as HR, MAP, Modified Ashworth Scale, and Rancho Scale of Cognitive Function
What is the proper way to progress TBI interventions?
Increase the complexity of the response (amplitude or require a decision) or request a different response (motor or verbal rather than visual)
What is the role of the PT for identifying cognitive impairment?
What is the role of the neuropsychologist?
administering mini-mental test, Galvenston orientation and amnesia test, children’s orientation and amnesia test
intellectual and memory function, psychomotor and processing speed, attention, language, and executive function
What interventions can address impaired processing speed?
How should you progress these interventions?
tasks that require decoding of information to perofrm and put demand on reaction time
Increase the speed of the response or increase the complexity of the information
What interventions can address impaired executive function?
How should you progress these interventions?
Tasks that require initiation, planning, monitoring performance, anticipating consequences and responding flexibly such as ADLs
Reduce the number of external cues and increase reliance on internalized procedures
What interventions can address impaired problem solving?
How should you progress these interventions?
Tasks that require brainstorming, comparing ideas, prioritizing ideas, and drawing inferences such as a new activity which requires planning like making a new recipe
Increase the complexity of the problem
What interventions can address impaired divided attention?
Tasks that require the ability to respond to multiple stimuli simultaneously such as walking a figure 8 and carrying different size grocery bags for a motor-motor task and tandem walking while doing math for cognitive-motor tasks
How can you progress interventions that address attention for TBI patients?
- increase time for sustained attention
- increase distraction for selective attention
- increase choices to select for alternating attention
- increase number of variables for divided attention
What are the restorative strategies for TBI rehabilitation?
- Improve attention and working memory
- Improve prospective memory
- improve problem solving skills
- facilitate self awareness
What are the compensatory strategies for TBI rehabilitation?
- teach client to use memory aids
- teach self-regulatory or metacognitive strategies
- improve inhibitory control
What strategies should be used when working with children with a brain injury?
What about when working with their families?
develop unique programs, be flexible, measure success in small increments; communicate with family and develop systems for long term monitoring
- Prepare families effectively providing info on the child’s strengths and concerns
- provide multiple opportunities and methods of education
- affirm the expertise of parents
- refer family to support groups
- educate families on laws regarding individuals with disabilities
