Cognitive Rehab
What are the five main areas of the ICF framework that are considered when looking at a client's functioning?
Health condition, body functions and structures, activities, participation, and environmental/personal factors.
What treatment approach focuses on restoring an impaired cognitive or perceptual skill?
Remedial approach.
What is visual scanning?
Voluntary eye movements and patterns of searching through the visual environment, primarily using saccades.
What does the term "agnosia" mean?
"Not knowing"; an inability to recognize an object despite intact sensory input.
What is unilateral neglect?
Reduced awareness or attention to sensory information from one side of the body or environment.
What is activity analysis, and why is it important for an OTA/PTA?
Activity analysis breaks a task down step-by-step to identify performance breakdowns and required performance components. It helps guide treatment and assess progress.
What treatment approach focuses on modifying the task or environment to help a client perform despite a persistent deficit?
Compensatory/adaptive approach.
What is visual tracking or pursuit?
Following a moving object through space using controlled eye movements.
What is astereognosis?
The inability to identify an object by touch despite adequate sensation.
Unilateral neglect most commonly occurs on which side following which type of brain injury?
Left-sided neglect following a right-brain injury.
A client has difficulty remembering appointments, planning their day, and solving problems. Which cognitive functions are likely impaired?
Memory and executive functioning, including planning and problem-solving.
An OTA has a client repeatedly practice visual-spatial exercises at a table with the goal of improving the underlying skill. Is this a bottom-up or top-down approach?
Bottom-up approach.
What is visual memory?
The ability to create and retain a mental image of an object.
What is apraxia?
The inability to plan or perform a purposeful movement despite adequate motor power, sensation, coordination, and comprehension.
What is body scheme disorder?
Impaired awareness of one's body parts, their position, or the structure of the body.
An OTA notices that a client's cognitive impairment prevents them from safely completing their morning routine. Using the ICF framework, what areas besides body functions should the OTA consider?
The client's activities, participation, environmental factors, and personal factors.
A client has difficulty remembering the steps of their morning routine. The OTA creates a visual checklist that the client follows every morning. Is this remedial or compensatory treatment, and why?A client has difficulty remembering the steps of their morning routine. The OTA creates a visual checklist that the client follows every morning. Is this remedial or compensatory treatment, and why?
Compensatory treatment because the OTA is using an external strategy to help the client function despite the memory deficit.
A client can see an object but has difficulty recognizing it when it is partially covered or viewed from a different angle. What visual-perceptual skill is impaired?
Pattern recognition.
A client understands what a toothbrush is and knows that they should brush their teeth, but they cannot correctly organize and sequence the movements needed to use it. What type of apraxia could this indicate?
Ideational apraxia, because the client has difficulty conceptualizing, planning, or sequencing the actions needed to complete the task.
A client consistently pushes toward their affected side and has decreased postural control. What condition does this describe?
Pusher syndrome.
A client has impaired attention but is still able to participate in meaningful activities when the environment is quiet and organized. What does this demonstrate about cognitive-perceptual rehabilitation?
Environmental factors can significantly influence functional performance, so treatment should consider and modify the context when appropriate.
A client practices a cognitive exercise successfully in the clinic but cannot use the skill when completing a similar activity at home. What important rehabilitation concept should the OTA consider?
Skill generalization. The client may have learned the skill in the specific clinic context but is unable to apply it to a new environment.
A client frequently bumps into objects on their left side because they fail to attend to information in that part of their visual environment. What impairment might this suggest, and what is one important distinction from hemianopia?
Unilateral neglect/visual inattention. Neglect involves reduced attention to one side, whereas hemianopia is an actual loss of part of the visual field.
A client can understand how to perform a gesture but cannot perform the gesture when asked to do so or imitate it, despite having adequate strength and sensation. What type of apraxia is this?
Ideomotor apraxia.
A client believes they can independently complete a task, predicts that they will need no assistance, but actually requires significant assistance. What rehabilitation intervention can help improve this client's awareness?
Awareness training, such as comparing predicted versus actual performance, self-monitoring, self-evaluation, and video feedback.