Define
What is a cognitive disorder? What are the components of cognition?
1. deficits in ability to think, learn, and perceive
2. attention, memory, executive functioning, awareness
Define the 2 features of attention
1. Limited capacity
2. Allocation/selection
1. you cant focus on everything at once + capacity of attention available
THINK: Central bottleneck theory, Baddeley's WM model, Automatic tasks vs Controlled processing
2. you must decide what to focus on + ability to distribute attention
THINK: resource allocation theory, multiple resource "pools",
Automatic tasks vs Controlled processing
Explain how to assess attention deficits (general brainstorm q)
Informal assessments: subtests from standardized tests, auditory attention tasks
Test of Everyday Attention (TEA)
Stroop Task
Questionnaires, interviews, observations
DIFFICULT to assess in isolation and assess ecological validity due to variations in performance and real world generalizations
What are the 3 goals of awareness assessment?
1. identify level of awareness
2. consequences of deficit
3. etiology of awareness issues: neuro vs psychological?
1. What are the 5 tx approaches for early brain injury?
2. Define Comprehensive-Holistic Rehabilitation.
EARLY brain injury
1. Pharmacological: medicine
2. Sensory stimulation
3. Physical management tx (moving body parts)
4. Deep brain stimulation
5. hyperbaric O2 tx
COMPREHENSIVE-HOLISTIC REHAB: Compensatory: reduce cognitive and functional disability to help achieve functional objectives and participate in real-world activities
What are the goals of cognitive rehab?
1. Increase independence: communicative, physical, emotional, social, vocational/academic
2. Reach highest level of functioning possible
Differentiate between Posner and Petersen's vs Sohlberg and Mateer's models of attention.
P&P: alertness, orienting/directing attention (disengaging, shifting, engaging), and executive control of detecting targets, errors in attention, and conflict resolution
S&M: Focused, sustained, selective, alternating, divided
Explain how to assess attention deficits (general brainstorm q)
Formal tests: usually neuropsychologists
TBI and dementia assessment sub-tests
Galveston Orientation and Amnesia Test (GOAT)
Verbal memory: verbal learning tasks, paragraph reading, digit span
Visual/nonverbal memory: complex figure test, picture recall
Questionnaires, observations,interview
Provide 3 examples of functional assessments.
Questionnaires typically
Quality of Communicative Life Scales
1. Name 3 treatment goals of cognition w/ dementia patients.
2. List the dx criteria for dementia. (HINT: memory +....)
1. maintain independence/qol, emphasize personal relevance, modify tx with progression, collaborative goal making, determine range of participation, activity limitation, individualized cues/strategies
2. Memory + at least one of the following
- Language impairment
- Abstract thinking deficits
- Judgement deficits
- Executive dysfunction
- Visuospatial ability
What is the difference between restorative tx vs compensatory rehab?
Restorative tx: change the person and improve brain functioning
Compensatory rehab
1. Devices and strategies: avoid problems
2. Environmental modifications: change environment for best functioning
Describe the aspects of Baddley's Model of WM
1. Central executive: decides where sensory inputs should be processed
2. Phonological Loop: auditory stimuli stored
3. Visual sketchpad: visual stimuli stored
4. Episodic memory: integrates info from PL and VS AND compares to LTM sensory information
Explain general assessment procedures for EF. (general brainstorm)
Delis-Kaplan EF Systems (nonverbal and verbal targets)
Behavior Assessment of Dysexecutive Syndrome (BADS)
Observations, rating scales, questionnaires
1. What is TEACH-M as related to EF tx?
2. What is Goal Management Training?
3. What is the purpose of metacognitive tx as related to EF?
1. Task analysis, Errorless learning, Assess performance, Cumulative review, High # of practice, Metacognition
2. establish goal, measure progress, re-evaluate goal set as necessary
3. improve self-regulation of cognition
Describe and compare motoric-imitative vs cognitive-affective tx of aprosodia.
1. Motoric-imitative (THINK MSD): facial and prosodic cues and imitation
2. Cognitive-affective: learn characteristics of emotional prosody based on feelings
What are the 4 stages of memory?
1. Encoding: analysis of materials to be remembered
2. Consolidation: process of transferring STM -> LTM
3. Storage: where info is stored for later use (LTM)
4. Retrieval: activation of LTM/previously store memories (recall, recollection, recognition, relearning)
What are the 6 components of EF according to Sohlberg &Mateer model?
1. initiation and drive
2. response inhibition
3. task persistance
4. Organization
5. generative thinking
6. awareness
(BONUS: reasoning, planning, problem solving, integration/synthesizing)
1. What is an assessment of early brain injury?
2. What is an assessment of middle-late injury
1. Glascow Coma Scale: initial level of consciousness = 1. eye opening, 2. verbal, 3. motor
2. CLQT, SCATBI
What are general tx principles for memory?
Spaced retrieval: specific goal->time intervals -> corrective feedback as necessary
Encoding strategies: chunking, mnemonics, semantic elaborations
PRO-MT: prospective memory process training: ask client to do something in future (time or at verbal prompt)
Metamemory tx: increase awareness by 1. predictions, 2. self instruction, 3. self monitoring
Errorless learning (vanishing cues)
External compensatory aids
What are the 2 general tx approaches for neglect? Provide 2 examples per type of approach.
1. Top-Down: teach strategies for functioning
- scanning tasks: anchors, visual scanning, cancellation, reading
- visuo-spatial motor tasks: limb activation, lighthouse strategy
- Feedback
2. Bottom-up: work on impairment to improve overall neglect
- prism adaptation
- mirror therapy
- sensory stimulation paired w/ visual scanning tasks
- Stimulate perception leftward w/ arrows and connectors
1. Explain the differences between explicit and implicit memory.
2. Explicit: what is episodic vs semantic memory
3. Which kind of memory is more relatively preserved in dementia and TBI?
4. What kind of memory relates to remembering to do things in the future?
1.
Implicit = unconscious knowledge of how to do something (physical, cogntive/strategic, problem solving)
Explicit = declarative knowledge of facts
2. Episodic= memory of real life events (individualized), Semantic=common knowledge unique to individual's prior learning (knowing ts lyrics)
3. Procedural/implicit
4. Prospective memory
Describe and define the levels of the Ranchos Los Amigos Scale.
What is the purpose of RLA Scale?
Purpose: level of cognitive functioning post-TBI (chronological scale of recovery progression)
Early Stage/Total Assistance
1. No response
2. Generalized response
3. Localized response
Middle Stage
Maximal Assistance: 4. confused/agitated, 5. confused, inappropriate, non-agitated
Moderate Assistance: 6. confused-appropriate
Minimal assistance for ADLs: 7. automatic -appropriate
Late Stages
Stand-by assistance: 8. purposeful appropriate
Stand by assistance on request: 9: purposeful appropriate
Modified independent: 10: purposeful appropriate
Name 4 assessments for neglect and what types of neglect they evaluate.
1. Behavioral Inattention Test (frame of reference, egocentric, allocentric)
2. Vest test (based on space: peri-personal space)
3. comb and razor test (based on space: person space)
4. wheelchair collision (based on space: extra-personal
What is the general treatment principles of attention tx?
ATP: attention processing treatment (drill)
Metacognitive Strategy Instruction: some activities are task specific, general, pacing/personal goal setting, self-monitoring, problem solving, time pressure management
Compensatory: calendars, to-do lists, alarms, key idea logsn
Environmental manipulation: task management, alter/simplify instructuons/expectations, provide environmental supports (breaks, organize, remove distractors)
1. What is RHD and how is lobe localization related?
2. What are the 4 principles of neglect?
3. What are the types of neglect and associated deficits?
1. brain damage to RH leading to inattention to left-side (NOT a visual impairment: RH -> left and right side attention, LH -> right sided attention (if LH damage = RH compensates for right sided attention / if RH damage = LH canNOT compensate for left sided attention
2.
3. Types