Please enable JavaScript.
Coggle requires JavaScript to display documents.
Cognitive Rehabilitation: Evidence-Based Intervention (History (First…
Cognitive Rehabilitation: Evidence-Based Intervention
Cognitive Rehab
includes both individual/group interventions
understanding of what it is like to live with cognitive impairments - improvement specific skills to enable client to return to work, school, or community/volunteer activities
used for people with cognitive impairments caused by problems related to CNS (TBI, stroke)
exercise/techniques --> improve attention, compression, learning/memory
History
First started in WW1 for head injury patients
Luna emphasized working with the intact area in the brain, which becomes the focus of the intervention - "new circuit"
Dicer--> identifying the deficit that affects function. Then a task was chosen that matched the respected skill (deficit)
task was analyzed in terms of stimulus reaction qualities (e.g if person had memory impairment , the therapy would consist of tasks that required memory skills
increase performance by decreasing or eliminating underlying cognitive impairments
CNS= remedial/restorative , contextualized or compensatory
Approachs
remedial/restorative: bottom up-approach / similar to standardized testing. increasing with difficulty and targets specific impaired domains. When the person reaches a specified standard to related practice, the training task becomes harder
Contextualized/Compensatory Approach: using strategies to optimize remaining cognitive abilities.
Remedial Approach, Deficit-Approach: regular or routine practice may improve or at least maintain functioning in a given domain and that any effects of practice will generalize to other activities beyond the immediate training context / reducing underlying impairment or arresting it's progression/ This approach is more challenging and are not able to be transferable/generalizable to ADLS
Functional Approach: capitalizes on person's strengths to improve independence on ADLs. Emphasis on reducing activity limitations and participating restrictions rather than remediating or restoring impaired skills.
3 interventions approaches: adaptation of the activity or context, task-specific training and compensation
can be used for patients who experience mild to severe cognitive impairment
Adaptations /Training /Approach
Environmental: Beneficial for those with self-awareness and moderate to severe cognitive impairments. Errors in performance of daily tasks may be reduced by simplifying the relation between environment and response: STIMULAS-RESPONSE COMPATIBILITY / Low S-R compatibility allows for more opportunities for more mistakes. // Environmental adaptations may be implemented without extensive training to improve everyday action in this patient population (Schizophrenia)
task-specific training: practice context-specfic motor tasks and receive some form of feedback / aims to improve performance of functional tasks (functional task training uses procedural and implicit memory) through goal-directed practice and repetition/ training of functional tasks. // errorless learning: consistent therapist interventions to prevent patient from committing errors
Compensation: teaches the person to bypass or minimize the effects of the impairment by modifying the method of performing an activity (e.g checklists or goal management strategies)
Integrated approaches: A combination of elements from the remedial and functional approaches
Multi contextual approach: recognize the need for processing strategies, anticipate the need for strategy use and learn to use the strategies in needed situations, hence, transfer and generalization of learned strategies
This approach uses techniques for clients to understand, monitor, anticipate and control cognitive symptoms. This is a top-down treatment
CO-OP: client centered, performance based problem solving approach that enables skill acquisition through a process of strategy use and guided discovery
Populations requiring cognitive rehabilitation
TBI/Stroke: attention, memory, social communication skills , EF and comphrensive -holistic neuropsychological
rehab
Addiction: decision making, response inhibition, planning, working memory and attention
Dementia + other cognitive: cognitive training not as effective in mild-moderate dementia/EL is more effective in teaching adults with dementia a variety of meaningful daily tasks or skills , with gains being generally maintained at follow-up
Make most of their remaining memory ability /compensate for difficulties by using memory aids or adapting the environment to facilitate function by reducing environmental memory demands
psychatritic disorders: bipolar disorders- general stimulation (broad combination of different cognitive processes), process-specific trainings (focus on each cognitive process), functional adaptation (improve daily life functioning like routine planning)/ overall cognitive R. improves daily life functioning-computer programs are most effective
Multiple Sclerosis- attention, information processing abilities (speed), new learning and memory
ADHD- observational skills training
Cancer- memory, attention, concentration, language, multitasking, and organization skills