Test 2 Flashcards
Which hemisphere damage would most likely lead to perceptual impair?
right
gnosis
knowledge or knowing
agnosia
loss of ability to recognize sensory input
visual agnosia
inability to recognize familiar people and objects
(visual system is intact)
parietal lobe
Prosopagnosia
cannot ID familiar faces or detect differences via facial Mm
L hemisphere
“all people with mole are the same”
visual spatial inattention
Client has decreased awareness of body and spatial environments on side contralateral to cerebral lesion
difficulty focusing visual attention on self-care tasks
right-left discrimination
inability to “know” R from L
L cerebral hemisphere
visual-spatial perceptual disorder
Topographical orientation – up/down, left/right
Position in space dysfunction - up/down/top/bottom
Depth perception
Compensatory intervention for visual agnosia
use other senses
increased awareness of limitation
teach location and spatial cues
tactile agnosia
astreognosis
inability to recognize familiar objects with hands
Ahyognosia
inability to discriminate between different types of materials by touch alone
Amorphagnosia
inability to discriminate between different forms by touch alone (triangle, square, circle, rectangle)
agraphesthesia
inability to recognize letters being drawn in hand
unilateral neglect syndrome
inattention to contralateral side
sensory or motor neglect
Does client fail to respond because they don’t perceive (sensory neglect) or can’t initiate the movement (motor problem)
Anosognosia-Extensive Neglect Syndrome
Extensive neglect syndrome involving failure to recognize one’s paralyzed limbs as one’s own
R hemisphere
praxis
ability to plan and execute movement
Apraxia
Inability to carry out skilled movement in the presence of intact sensation, movement and coordination
Dyspraxia
Difficulty conceptualizing, planning, organizing and sequencing sensorimotor actions to achieve a goal
Ideational Apraxia
inability to carry out a previously learned task
Ideomotor Apraxia
Involves the loss of kinesthetic memory of motor patterns – The motor plan for specific task may be lost (action)
What should cognitive rehabilitation be?
individualized, pt. goal directed, finally based, promote generalization
process training
Reinforce, strengthen or re-establish previously learned patterns of behavior
Strategy training
Establish new patterns of cognitive activity through compensatory cognitive mechanisms through use of environmental, internal, and external strategies
Compensatory education
educate on cognitive strengths and weaknesses
implemented when re-establishement is not possible
hierarchy of skills
alert > attention (awareness) > memory (awareness) > executive functions (awareness)
Should therapist expect or program for generalization?
program
what are booster shots?
plan for a possible success after fail
full salient cues
overt demonstration
specific salient cues
process cue for self-monitoring
opportunity salient cues
pause
spatial salient cues
use environment
temporal salient cues
timed cues
How to grade activity?
structure, length, environment, complexity
Why make tasks predictable?
helps pt. give meaning to task
Behavioral prosthetic
rubber band to smack wrist
cognitive prosthetic
digital recorder, checklist
cognitive robot
timed coffeemaker
cognitive corrector
pill box, spell check
cognitive assessor
scores on games
cognitive trainer
hand held brain games
cognitive archive
photo albums, online encyclopedia
cognitive art
charts, floor plan
cognitive superstition
luck pen
What does visual imagery specifically help with?
episodic memory deficits
What is semantic elaboration?
use different was to recall
spell, write down. say out loud
What is usually the return for orientation?
Person-Place-time-situation
spaced retrieval
recalling over repetitively longer periods of time
if retrieval is successful, lengthen space
can be combined with errorless learning
Prospective Memory Process Training (PROMT)
Increase delay as pt. memory lengthens
for individual’s with severe memory deficits
can encode but cannot hold onto information
PQRST
preview info to be recalled
Question about text?
Read the material
State the answers or read until able to answer
Test regularly for retention for information
SING
remember what you hear stop identify main point never mind details get the gist
What are the steps of problem solving
Be aware
anticipate
execute
eval
What is gesture to command apraxia testing? What are the two subsets?
transitive - with object
intransitive - without object
Gesture to imitation
show - reciprocate
show - tell -reciprocate
gesture in response to tool
show tool and ask how it is used
gesture comprehension
OT shows gesture
pt. tells what action is
constructional disorder
inability to copy shapes
deficit in spatial organization
R spatially disorganized
L less detail
broca’s aphasia
non-fluent
good comprehension
poor repetition
TMA aphasia transcortical motor
non-fluent - difficulty initiating and organizing response
good comprehension
good repetition
global aphasia
non-fluent inability to read or write
poor comprehension
poor repetition
isolation aphasia
non-fluent
poor comprehension
good repetition
wernicke’s aphasia
fluent - word jumble
poor comprehension
poor repetition
TSA transcortical sensory
fluent - output is meaningless or unintelligible
poor comprehension
good repetition
conduction apahasia
fluent
good comprehension
poor repetition
anomia aphasia
fluent - word retrieval and naming
good comprehension
good repetition
SLOW
short
less
observe
wait
CMS
Centers for medicaid and medicare
MDS
medical data set
way we communicate with CMS
MDS Section GG codes
01 Dependent - helper does all
02 Max A - Helper does More than 1/2, holds limbs
03 Mod A - helper does LESS than half, supports
04 supervision - touch assist, vc’s
05 Set-up or clean-up
06 Independent
07 resident refusal
09 not applicable, if not done in PLOF before exacerbation
88 not completed due to medical or safety concerns
Intellectual Awareness
state but not monitor problems
someone else has to initiate therapy
self-rating skills
achieved when: can demonstrate knowledge of problem and recognize implications
Emergent awareness
know when problem is happening as it occurs
Strategies need to be initiated by specific situations or events
Identify and self-correct errors during actual task performance
Document through observation of clients actions/behaviors (video)
anticipatory
able to predict and anticipate problems
Select strategies that trigger client recognition that a problem is occurring, or will occur if cognitive strategies are not used
Predict performance on a task before commencing and select appropriate compensatory strategies
Observe clients performance during tasks, ask timely questions during the task
Assessments – interview: self-report, strength, perceptions
Selective attention
only focusing on most important
ignores distraction
seem distracted
alternating attention
one task to another
seem confused
divided attention
attend to more than one thing at once
multi-tasking
Directed attention
manage attention
stop saying written word and only color
stroop
sustained
prolonged time
seem impulsive
buzz, buzz, 7,8,9,10,11,buzz
focused attention
discretely stay attended
perseverate
name as many things that start with F
process of memory
attend
encode
store
recall
non-declarative memory
unconscious recall - how to do things
priming
habitual
procedural
priming
stimulus produces response
habitual memory
well-rehearsed, unconscious
procedural memory
unconscious of HOW to do things
Declarative memory
consciously recalled
semantic
episodic
semantic
recall of factual knowledge
episodic
past events
compensatory/adaptive approach
do whatever it takes to get pt. to participate
for high anxiety pt
top-down
Cognitive disability model and levels
6 hierarchical levels
major cog impairment
Least restrictions while remaining I
- bed - one word commands
- some initiation with sit and stand - imitation
3 . familiar with cues - repetitive manual - cues with familiar tasks slower but able - visual
- trial and error, selfish - verbal explanation and demonstration
- plan and anticipatory - verbal and written
Neurofunctional approach
specific task with repetition in organic environment task analysis reinforcement errorless training vanishing cues chaining
cognitive rehabilitation approach
remediation for higher level
bottom up
work on memory-sequence - plan
Dynamic interactional
any level
transfer from one task to another
self-awarenss
self-monitioring
