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Results for Adults Cognition
Ages: 15-Adult   Grades: 10-Adult

Treat a wide range of cognitive skills including memory, problem solving, reasoning, and planning/organization with flexible, theme-based lessons.

Outcomes

  • 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
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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)
  • reasoning
  • perspective-taking
  • flexibility in thinking
  • predicting

Each lesson concludes with two or three suggestions for generalization tasks.

 

Copyright © 2010

Components
170 pages
  • 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.

References

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.

Author(s)

Melissa Baker, Christine Johnson

Biography

Melissa Baker, MS, CCC-SLP, received her bachelor's degree from Indiana University in 1999 and her master's degree from Rush University in Chicago in 2001.  Melissa has worked in a variety of settings, including inpatient rehab, outpatient rehab, and acute care.  She has extensive adult experience, including being a member of the brain injury team of a rehabilitation hospital and working on the medical/surgical floors of a level 1 trauma center.  She gained research and product development experience as the test coordinator for LinguiSystems and currently works for Genesis Health Systems in Davenport, Iowa.  She has a special interest in the rehabilitation of cognitive-communication disorders following traumatic brain injury.

Melissa resides in Davenport, Iowa, with her husband, Ted; their sons, Dillon (age 3) and Aaron (age 18 months); their 9-year-old vizsla; and their 2-year-old black lab.  Results for Adults Cognition is Melissa's first publication with LinguiSystems.

 

Christine Johnson, MS, CCC-SLP, received her undergraduate and graduate training at Eastern Illinois University.  She worked in a variety of healthcare settings for over 20 years, including acute care, skilled care, outpatient, and home health care.  She enjoys country living in west-central Illinois as well as playing the piano, reading, and visiting family.  She is currently marketing coordinator at LinguiSystems.  Results for Adults Cognition is Christine's second publication with LinguiSystems.  She is also the author of Results for Adults Aphasia Book 1.

Introduction

We have worked in healthcare settings for over 25 years combined.  During that time, we have had the privilege of working with clients with cognitive-communication impairments following traumatic brain injury (TBI); stroke; brain tumors; anoxic encephalopathy; and degenerative neurologic diseases, including the dementias.  Working with these clients is both challenging and intriguing.  Many of the activities we practiced during our therapy sessions with clients have come to life in Results for Adults Cognition.

Cognition includes cognitive processes and systems, such as attention, perception, memory, organization, and executive function.  Cognitive deficits affect one or all of the following areas: attention, memory, problem solving, reasoning, organization, planning, and awareness of deficits.  "Before brain injury, memory operations such as attention, rehearsal, organization, and mental transformation of new information occurred at an unconscious level.  After brain injury, a person loses his ability to execute these mental operations unconsciously.  People with brain injury must learn to consciously rehearse, attend, concentrate, and manipulate information.  Eventually, through conscious effort, the processes become unconscious again" (Parente and Herrmann, 2003).

Research shows that clients experience significant gains in cognitive-communication function after receiving speech-language therapy (Cicerone et al., 2000; ASHA Treatment Efficacy Summary).  Data gathered from ASHA NOMs shows that over 80% of patients with TBI who received speech-language therapy services made significant gains in several key cognitive areas.

Clients with brain injury, and especially those with TBI, need to efficiently manipulate novel information, develop cognitive flexibility, make accurate inferences, and use deductive and inductive reasoning.  They need to rehearse information and encode information efficiently.  Themed encoding, or the use of shared experiences combined with new information, is one technique to facilitate improved memory function.  Once the client learns new memory strategies, it is important that he practice them in a variety of novel situations.  Regular review of the strategy increases the skill level.

Results for Adults Cognition is a flexible, adaptable resource designed to improve a client's cognitive abilities.  The lessons are grouped by themes that represent common activities of daily living.  Each lesson is divided into two parts.  Part I consists of full-page picture scenes with corresponding memory and rehearsal tasks that address short-term auditory and visual memory recall, spatial orientation, following oral directions, and episodic memory.  Part II expands the application of the theme to broader contexts that require more advanced organization and reasoning.  It includes timelines for planning and organization; visuals for math concepts; and questions that address reasoning, flexibility of thinking, and predicting.  The lessons conclude with two to three generalization tasks. 

We hope you find Results for Adults Cognition a useful tool to add to your resource library.

Melissa and Christine