Treat a wide range of cognitive skills including memory, problem solving, reasoning, and planning/organization with flexible, theme-based lessons.
- Gain independence in daily activities
- Improve auditory and visual memory
- Build skills in organization and planning
- Make gains in reasoning and problem solving
- Advance skills in spatial orientation and math concepts
The forty lessons are grouped by themes that represent common activities of daily living. The tasks and the items within the tasks are arranged in a hierarchy of difficulty and are highly-adaptable to individual client needs. Clients look at picture scenes, reading passages, and real-life visuals while the therapist presents the corresponding stimulus questions and directions. Each lesson is divided into two parts.
Part I consists of a full-page picture scene with corresponding memory and rehearsal tasks. Clients study the picture scene, recall details of the scene, and follow directions using the scene. Questions are provided to help the client self-reference with the depicted scene. Skills addressed include:
- short-term auditory memory
- short-term visual memory (semantic rehearsal and scene/fact rehearsal)
- spatial orientation
- following oral directions
- episodic memory
Part II expands the application of the theme to broader contexts that require problem solving and executive functions. A reading passage and a theme-based visual are used to develop skills in:
- timelines for organization and planning
- math concepts (including time concepts)
- flexibility in thinking
Each lesson concludes with two or three suggestions for generalization tasks.
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- Through conscious effort, persons with brain injury can learn to rehearse, attend, concentrate, and manipulate information in working memory. With practice, such skills can become automatic again (Parente & Herrmann, 2003).
- Meaningful items are processed more efficiently than non-meaningful items (Parente & Herrmann, 2003).
- A fixated mind-set (cognitive rigidity), jumping to conclusions, selective screening out of information, and mistaking evidence for proof are common reasoning errors among persons with brain injury (Parente & Herrmann, 2003).
- According to the Developmental Model of Recovery, rehearsal is the first stage of memory skill recovery and must precede higher-level memory strategy training (Parente & Hermann, 2003).
- Rehearsal should be trained through scene rehearsal (recall details of a scene), spaced rehearsal (recall information at timed intervals), fact rehearsal, self-referencing (associate new information with old information), semantic rehearsal (associate a word with its synonym, homophone, etc.), and loci rehearsal (recall a location) (Parente & Hermann, 2003).
- According to Laatsch et al. (as cited in Adamovich, 2005), single photon emission computed tomography (SPECT) imaging during cognitive rehabilitation revealed significant improvement following cognitive rehabilitation. SPECT data showed the most significant increase in cerebral blood flow redistribution during the treatment period compared with the no-treatment period.
- Data gathered from ASHA's National Outcomes Measurement Systems (NOMS) show that a large percentage of patients with TBI receiving speech-language pathology services made functional gains for memory (81%), attention (82%), pragmatics (83%), and problem solving (80%).
- Weakness in the executive function/self-regulatory mechanism is central to many, if not most of the cognitive problems of persons with TBI, and should be addressed relatively early in the recovery process (Ylvisaker, Szekeres, & Feeney, 2008).
Results for Adults Cognition incorporates these principles and is also based on expert professional practice.
Adamovich, B.L.B. (2005). Traumatic brain injury. In L.L. LaPointe (Ed.), Aphasia and related neurogenic language disorders (3rd ed., pp. 225-236). New York: Thieme.
American Speech-Language-Hearing Association. (n.d.). Treatment efficacy summary: Cognitive-communication disorders resulting from traumatic brain injury. Available from www.asha.org/uploadedFiles/public/TESCognitiveCommunicationDisordersFromTBI.pdf
Parente, R., & Herrmann, D. (2003). Retraining cognition techniques and applications (2nd ed.). Austin, TX: Pro-Ed.
Ylvisaker, M., Szekeres, S.F., & Feeney, T. (2008). Communication disorders associated with traumatic brain injury. In R. Chapey (Ed.), Language intervention strategies in aphasia and related neurogenic communication disorders (5th ed., pp. 879-954). Baltimore: Lippincott Williams & Wilkins.