Module 2: Lesson 2: Intervention considerations

Question 1

What is the ACTIVE trial?

Answer 1

Advanced Cognitive Training for Independent and Vital Elderly

Question 2

What is described below:

• 10 yr randomized, controlled, intervention study
• Generated highest strength of EBP
• Training focused on 3 cognitive abilities regarded as ADL relevant and most vulnerable to early age-related cognitive decline

Answer 2

ACTIVE trial

Question 3

What is the ACTIVE trial?

Answer 3

• 10 yr randomized, controlled, intervention study
• Generated highest strength of EBP
• Training focused on 3 cognitive abilities regarded as ADL relevant and most vulnerable to early age-related cognitive decline
• General training foci (work book exercises)

Question 4

Name the treatment foci of the ACTIVE trial

Answer 4

• Memory
• Reasoning
• Attention and processing speed

Question 5

What word is described below:
Use of mnemonic strategies that rely on visual imagery, semantic knowledge, and organization techniques to remember word lists and sequences of items, text material, and the main ideas and details of stories.

Answer 5

Verbal episodic memory

Question 6

What term is described below:
Education on how to solve problems by organizing information and identifying repetitive patterns to determine what should come next

Answer 6

Inductive reasoning/working memory

Question 7

Name the 6 key overarching cognitive functions

Answer 7

• Attention
• Memory
• EF
• Unilateral neglect
• Visual object agnosia
• Apraxia

Question 8

How many types of attention are there?

Answer 8

5

Question 9

Name the type of attention below:

Detecting and allocating attention to different parts of space

Answer 9

Spatial

Question 10

Name the type of attention below:

• Maintaining a consistent behavioral set
• Activation and inhibition of responses linked to selecting target stimuli from background stimuli

Answer 10

Selective attention

Question 11

Name the type of attention below:

Maintaining a consistent response during continuous, repetitive or proglonged activity

Answer 11

Sustained attention

Question 12

Name the type of attention below:

Switching response sets according to environmental cues, allowing 2 activities with distinct response requirements to be performed in sequence

Answer 12

Alternating attention

Question 13

Name the type of attention below:

Dividing attention to respond to 2 or more tasks at the same time

Answer 13

Divided attention

Question 14

What activities/techniques are most frequently used to rehabilitate nonspatial attention?

Answer 14

• Bottom-up
• Highly structured
• Usually pencil/paper or computer based
• Designed to stress specific attentional systems
• Clients respond selectively to stimuli with variations in cueing, distraction, stimulus and complexity

Question 15

What is declarative memory?

Answer 15

• Introspection (person knows that he or she knows something)
• Divided into immediate or sensory, STM or working memory, supraspan episodic and semantic

Question 16

What type of memory is described below:

• Discrete events that retain temporal and sensory association
• Memory of autobiographical events including times, places, associated emotions, and other contextual information, and it is relevant to events of the recent and distance past

Answer 16

Episodic memory

Question 17

What is episodic memory?

Answer 17

• Discrete events that retain temporal and sensory association
• Memory of autobiographical events including times, places, associated emotions, and other contextual information, and it is relevant to events of the recent and distance past

Question 18

What type of memory starts to have deficits begin at age 50?

Answer 18

Episodic memory

Question 19

True or false?

Given sufficient attention, organization, repetition, and time, episodic skills can be proceduralized and practiced to the point of near automaticity?

Answer 19

True

Question 20

What type of memory is described below:

• Facts, dates, majority of institutionally conveyed education
• Information acquired over a lifetime of interacting with ones environment and it is not associated with a particular time or place
• Older adults typically perform as well as younger adults on tasks testing this type of memory

Answer 20

Semantic memory

Question 21

What is semantic memory?

Answer 21

• Facts, dates, majority of institutionally conveyed education

Question 22

What type of memory is described below:

• Acquisition of skills and other aspects of knowledge that are not directly accessible to consciousness.
• Can be demonstrated indirectly by actions
• Minimally affected by the passage of time

Answer 22

Procedural memory

Question 23

Describe procedural memory

Answer 23

• Acquisition of skills and other aspects of knowledge that are not directly accessible to consciousness.
• Can be demonstrated indirectly by actions
• Minimally affected by the passage of time

Question 24

What type of memory is described below:

• Store of acquired patterns of behavior not necessarily mediated by cognitive learning
• Not available to introspection
• Information accessed through performance

Answer 24

Nondeclairative memory

Question 25

Describe nondeclarative memory

Answer 25

- Store of acquired patterns of behavior not necessarily mediated by cognitive learning - Not available to introspection - Information accessed through performance

Question 26

What type of memory is described below: - Derives from a range of cognitive functions including forming an intention, remembering that a task needs to be performed, maintaining and periodically monitoring that intention, interrupting outgoing activity, initiating the action to complete the intention - Involves both memory and EF

Answer 26

Prospective memory

Question 27

Describe prospective memory

Answer 27

- Derives from a range of cognitive functions including forming an intention, remembering that a task needs to be performed, maintaining and periodically monitoring that intention, interrupting outgoing activity, initiating the action to complete the intention - Involves both memory and EF

Question 28

At what age are memory lapses frequent?

Answer 28

60

Question 29

What is the umbrella term for multiple higher order thinking processes?

Answer 29

Executive function

Question 30

What type of assessments are best used to identify EF deficits?

Answer 30

- top down assessments that require the person to establish goals and determine a course of action - novel and dynamic test conditions similar to those found in real world

Question 31

What is the CO-OP?

Answer 31

Cognitive Orientation to Daily Occupational Performance - Guided discovery, global strategy training focusing on a goal plan do check sequence - Goal of clients developing their own domain specific strategies to solve specific performance problems

Question 32

Name the percent of clients affected by unilateral neglect with acute right hemispheric stroke vs left hemispheric stroke

Answer 32

- R: 80% | - L: 15-20%

Question 33

Describe top down intervention with unilateral neglect.

Answer 33

- Encourages conscious awareness of the disability and explicitly trains patients to reorient toward the habitually neglected hemispace using compensatory strategies

Question 34

Describe the bottom up approach for unilateral neglect intervention

Answer 34

- Directed at the impairment but do not require awareness or consciously driven behavioral change - Consists of massively stimulating the patient with information originating in the habitually neglected hemispace

Question 35

Describe intervention and evidence with unilateral neglect

Answer 35

- Mixed results: Prism adaptation - Insufficient evidence: Mirror therapy for occupational performance - Conflicting/inconclusive: Right half-field eye patching - Insufficient evidence: Neck vibration and family participation

Question 36

What type of agnosia is described below: Inability to recognize and verbally identify objects despite adequate visual acuity and language skills

Answer 36

Visual object agnosia

Question 37

What type of agnosia is described below: Deficit in the final integration of various perceptual attributes

Answer 37

Apperceptive visual agnosia

Question 38

What type of agnosia is described below: Able to see an object with sufficient clarity to match or draw it, but do not know what the object is

Answer 38

Associative agnosia

Question 39

What type of agnosia is described below: Inability to remember and recognize the specific colors for common objects in the enviroment

Answer 39

Color agnosia

Question 40

Describe the term below: Disorders of skilled, purposeful movement that cannot be accounted for by weakness, akinesia, abnormal tone, sensory loss, incomprehension of or inattention to commands, or noncooperation.

Answer 40

Apraxia

Question 41

What type of apraxia is described below: - Inability to perform a purposeful motor task on command even though the client understands the idea or concept of the task

Answer 41

Ideomotor apraixa

Question 42

What type of apraxia is described below: - Inability to carry out a series of actions in the sequence required to achieve the goal - The logical sequence of single movements is not respected, objects are improperly used, or movements in the sequence are skipped or repeated - Severe difficulty using tools in real life settings

Answer 42

Ideational apraxia

Question 43

When assessing ideomotor apraxia, it is important to exlclude what?

Answer 43

- Pyramidal and extrapyramidal disorders - Basal ganglia or cerebellar disorders - Tremor - Dysmetria - Stereotypic movement disorder