This type of memory has to do with time periods being attached to memories
This type of memory is the ability to recall facts and information
This type of memory has to do with how to do a task, like ride a bike. Most durable type of memory and the last type to go in degenerative neurological diseases.
Post Traumatic Amnesia
This is a temporary condition following TBI - can't lay down new memories. The longer this lasts, the worse the prognosis is.
Damage to the _____ ______ can result in: attentional deficits, visual perceptual deficits, including "left neglects," discourse and pragmatics difficulty, and affective and emotional deficits
This type of treatment method includes training to use a compensatory strategy, modifying environment, looking at activity/participation level restrictions, and looking at changes in context
This type of treatment method has drill-oriented tasks designed to change underlying function; works at level of fatigue or effort; targets body function/ impairment
Skilled Based and Process Training
What are the two types of treatment methods mentioned on the first day of class?
Six Intervention Approaches
These are the what?: Direct training of cognitive processes, specific skills training, training of metacognitive strategies, training use of external aids, environmental modifications/task accomodation, collaboration-focused programs
Direct training of cognitive processes, specific skills training, training of metacognitive strategies, training use of external aids, environmental modifications, collaboration focused program
These are the six intervention approaches in cog rehab:
candidate for cog rehab
This makes a good ___ ___ ___ ___: disability affecting activity or participation in daily life, medically stable, motivated, has seen functional impact of the disability
focal injury, diffuse axonal injury, delayed complication
What are the three mechanisms of injury?
This type of injury affects a small part of the brain; stroke, tumor, bleeding extradural and subdural hematomas
diffuse axonal inury
This type of injury might come from a GSW or a blast; extensive injury; coup/contracoup - see stretching and tearing of axons, which results in widespread patchy damage
This type of injury follows the initial insult, such as when a focal site of lesion can cause a diffuse axonal injury after awhile
Axonal membrane swells --> cells unable to remove waste --> calcium builds up in the myelin sheath --> excessive calcium causes axon to dissect --> cell body atrophies due to lost connection
These are examples of _____ _____: acute inpatient rehabilitation, home and community rehab, home with outpatient therapy, intensive day program
also known as cortical re-mapping, this refers to the ability of the human brain to change as a result of one's experience, that the brain is plastic and malleable
a loss of function that occurs in areas that are neuronally connected to a lesioned area, but geographically remote ("third cousins"). Can be temporary. Neuronal circuitry is disrupted due to swelling.
diaschisis, functional reorganization, modification of synaptic connectivity, influences on neural circuitry, impact of interhemispheric competition
What are the five mechanisms underlying neuralplasticity after brain injury, according to Solhberg & Mateer?
One of the ways in which the brain allows certain functions to return after injury; neural circuits not formerly involved in certain activities are recruited to allow those activities to take place; see a distribution of processes throughout the cortex
modification of synaptic connectivity
new dendrites are formed to allow surviving neurons to receive information from other neurons; this is a stimulation-based phenomenon based on receiving input from other neurons
influences on neural circuitry
using structure sensory input to increase connectivity of neural circuits that have been partially disconnected; this can be in the form of auditory, visual, tactile, or olfactory sensations
impact of interhemispheric competition
the undamaged hemisphere may act in such a way as to exert an inhibitory effect on partially damaged circuits; damage to one side of the brain sets up a situation where the other side takes over
This concept is relevant to cog rehab in that the CNS is not static - it is driven by change; targeted stimulation results in changes to the CNS
early symptoms post-TBI
The following are: ___ ___ _______: sleepiness, hypersensitivity, PTA, agitation, confusion, unresponsiveness
method that focuses on repetition, good at getting someone to learn one thing, but doesn't generalize
method that using increasing durations - 10am, 12pm, 2pm - person learns fact
distributed and mass
what are the two types of practice methods?
Glasgow Coma Scale
This is an assessment tool used to determine consciousness in clients. The Score of 15 reveals a fully oriented person. 3 is deep coma.
Galveston orientation and amnesia test
Looks at PTA, can be administered repeated times, looks at orientation to person, place, time, and circumstance
Executive Function route-finding task
Example of functional assessment; evaluator asks patient to find something; high scores = more independent behavior
Rigid procedures, reliability and validity, formal,
Benefits of the _____ _____ include: better for making a diagnosis or determining strengths and weaknesses, used to qualify for services, compare standard scores to show change (test-retest)
Fluid, do not have norms, making an observation in context, usually have a procedure but it hasn't been studied for psychometric principles
Benefits of the ____ ____: more representational view of the client's abilities in natural context, try out compensatory strategies for planning Tx, early on, cog rehab patients are unable to attend to a standardized test
measures performance without attempting to identify the factors that influence performance (positive or negative)
Attempts to identify the effects of factors, flexible testing, gives you an idea of strategies you might want to use in therapy
able to produce a score/number that is stable over time
same score across examiners
test tests what it is supposed to be testing
there are enough items on the test to cover the construct
base rate phenomena
refers to the premorbid condition of the patient. In testing, when a patient is demonstrating problems on psychometric tests, it is impt to take ___ ___ _____ into account, rather than attributing all deficits to the disease or trauma in question.
refers to the likelihood of detecting a deficit when that deficit is present; in cog rehab this means that most of the tests used to assess cog functioning are not designed to test the deficits seen in individuals with ABI, such as cognitive vulnerability in the presence of distraction
Cognitive Linguistic Quick Test
This is a commonly administered standardized test, which covers attention, memory, executive function, language, and visuospatial skills; clock drawing task; looks at strengths and weaknesses
focused, sustained, selective, alternating, divided
what are the five types of attention?
ability to discretely respond to specific stimuli; like a person's ability to respond to an opposing car's horn while driving
ability to maintain attention to an activity over a period of time, as well as a person's ability to hold and manipulate information in their working memory; vigilance; example: ability to look up a phone number and remember the digits as you dial the phone
ability to maintain focus on an activity while there is competing stimuli; example: ability to block out the noise from the hallway while listening to a lecture in class
ability to shift one's attention between simultaneous activities of different cognitive capacities; example: ability to listen to a professor's lecture while taking notes on a computer and following along with the powerpoint material
ability to actively respond to multiple tasks simultaneously (multi-tasking); example: ability to talk on the phone in a car
6 principles of direct training of attention
The follow are the what? : Use a treatment model grounded in attention theory, use therapy activities that are hierarchically organized, provide sufficient repetition, treatment decisions should be based on client performance, actively facilitate generalization from the start of treatment, therapy format should be flexible to individual needs
model grounded in theory, hierarchically organized activities, repetition, activities based on client performance, generalization, accommodate differences
MGT, HO, R, CP, G, AD = 6 principles of direct training of attention
Goal Attainment Scaling
This is a method for measuring the impact of a self-selected goal; shows high sensitivity to change in the areas that individuals have deemed as most important to them - more subtle assessment - measures micro-improvements
practice standard, practice guideline, practice options
3 levels of recommendation offered by Cicerone et al, in support of various interventions
highest level of recommendation, based on Class I evidence with support from lower-level evidence
Second level of recommendation, based on limited evidence from Class I studies and supported by Class II studies.
Lowest level of recommendation, based on Class II and III studies
time since injury, injury extent and severity, and recovery of different functions at different rates
3 injury-related variables linked to recovery
Test of Everyday Attention
This test can be used to assess attention; it tests skills that translate to the everyday world, including searching a map, listening for lottery numbers, and counting floors in an elevator
Wechler Memory Scale III
A test used to assess memory by providing normative data for immediate and delayed recall and recognition of short paragraphs, a word list, unfamiliar faces, and abstract designs
Stroop Color and Word Test
A test used to assess executive functions, speficially inhibitory and interference control, by showing the names of colors written in other colors - like the word "red" written in blue ink
Functional Independence Measure
This tests looks at behavior, adjustment and outcome, by using a 7-point scale to rate the level of assistance needed to perform various activities of daily living.
A practice standard mentioned in cicerone et al: ____ ____ is recommended for persons with visualspatial deficits associated with visual neglect after a R hemisphere stroke. This includes visual scanning training and computer-based restitution training.
A practice GUIDELINE from Cicerone et al - ____ ____ should be considered as a factor in the rehab of lang skills after a L hemisphere stroke.
use of external aids
___ ___ ___ ____ is a compensatory strategy mentioned in the text; includes use of day planners, written checklists, task-specific devices. Can help lessen attention problems by helping indiv track and respond to information w help of one of these.