name the 3 cognitive treatment approaches.
- remedial/deficit specific approach
- functional approaches
- integrated/multicontext approach
name the 3 functional cognitive treatment approaches.
- adaptation (indirect)
- task specific training
- compensation
- emphasis on improving and restoring the underlying impairment
- repetitive practice of impaired skill
- graded hierarchy
- predetermined hierarchical treatment sequence
- abstract tasks out of context
- learning principles (practice, repetitions, verbal feedback)
the remedial approach
what do assessments for the remedial approach identify?
specific cognitive deficits
what type of approach is the remedial approach?
bottom-up approach
in the remedial approach, ____ to other tasks which require the use of the skill is assumed to take place spontaneously
generalization
- emphasis on changing task performance rather than underlying skills
- minimizes or reduces use of impaired skills
- based on pessimism regarding recovery of function
the functional approach
modify the environment
adaptation approach
also could be referred to as the indirect approach
-increase or decrease the saliency of environmental stimuli or cues
adaptation approach
name 3 ways of using the adaptation approach.
- create cues in the environment to enhance function
- reorganize or rearrange the environment
- design or create new environments
name 6 examples of environmental adaptations.
- clothes pre-chosen
- items for lunch/dinner pre-organized
- programmed alarm messages
- introduce one task or task step at a time
- work task directed by another person
- adaptation of the house
name 2 examples of matching task and environmental demands to person.
- identify task components with ability range (wipe table, fold napkins)
- identify environmental factors which optimize function
- direct training of functional task
- repetition with vanishing cues
- combined with behavioral and errorless learning techniques
- capitalizes on procedural learning: “how to”
task specific training
name 3 task specific functional training methods.
- divide tasks into sub-steps
- count number of tactile, verbal, visual cues for each sub-step
- gradually fade cues
what 2 things are not required for task specific functional training?
insight and generalization
- task methods are changed
- may include use of external aids
- awareness and acceptance are prerequisites
- learning and generalization are required.
compensation approach
what 2 things are required for the compensation approach?
learning and generalization
describe the continuum of the functional approach.
adaptation - no change in person, task specific training, compensation - change in the person is expected
- directed at changing the person’s abilities while simultaneously adapting the task and environment to be at the just right challenge level.
- addressing the person, task, and environment
dynamic: multicontextual approach
what type of assessment is the AR?
functional cognitive assessment
why did OTs not assess and treat cognitive impairments historically?
thought other professions should do it
what are the current national and professional policy priorities?
AOTA has argued that an interdisciplinary performance based screening approach should be implemented for individuals categorized as unimpaired on the CAM and the BIMs
what is the most basic level in the hierarchy of cognitive skills?
attention (if we can’t attend we can’t do anything else)
what does the remedial approach assume?
assumes automatic generalization and transfer of skills
