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Neuropsychology > Lecture 4: Clinical Practice II: Chapter 5 > Flashcards

Lecture 4: Clinical Practice II: Chapter 5 Flashcards

1
Q

When is spontaneous recovery possible?

A

12-14 weeks after brain injury

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2
Q

What 3 things does spontaneous recovery depend on in brain injuries?

A
  1. Severity
  2. Location
  3. Type
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3
Q

When does the most recovery happen?

A

In the first 3-6 months after recovery

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4
Q

What is neuroplasticity?

A

The ability of the brain to modify itself functionally or structurally in response to injury (spontaneous) or under influence of stimulation and treatment (experience-dependent)

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5
Q

Does neuroplasticity occur in healthy people as well?

A

Yes, all kinds of learning experiences result in these neuronal changes throughout life

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6
Q

What are 2 reasons for spontaneous recovery?

A
  1. Diffuse and redundant connectivity
  2. Cortical reorganization
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7
Q

What is diffuse and redundant connectivity?

A

Following injury, recovery takes place by activating other areas within a network

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8
Q

What is cortical reorganization?

A

New structural and functional connections between cortical areas take over certain functions

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9
Q

What is the timetrack of behavioral recovery?

A

First you have neurological recovery in the first few months. Behavioral recovery comes next

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10
Q

What is recovery?

A

Improvement in function compared to the time of the injury

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11
Q

What is premorbid functioning?

A

The way someone functioned before the injury

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12
Q

When does neurological recovery in the form of regeneration of brain tissue cease?

A

After a year

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13
Q

What is the Kennard principle of neuroplasticity?

A

Recovery is better after an injury at a young age, because the brain is more plastic during childhood

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14
Q

What is some evidence on the Kennard principle of neuroplasticity?

A

Evidence indicates poorer recovery ofter brain injury at young age. Young individuals with TBI have the worst prognostic

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15
Q

What is meant with the double hazard in TBI in children?

A

The worst prognosis must be anticipated for the combination of severe brain injury and young age

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16
Q

What is the difference between direct and indirect symptoms?

A

Direct: loss or change in behavior or cognitive process as a direct consequence of damage (e.g. slowness of info processing)

Indirect: attempt by patient to deal with this impairment

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17
Q

What determines the patient’s ability to cope with impairments? (3)

A
  1. Premorbid functioning
  2. Coping skills
  3. Social support
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18
Q

What is the difference between adaptive and maladaptive coping?

A

Adaptive: avoid situations that involve overstimulation

Maladaptive: avoid all situations and sink into passivity

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19
Q

What are the 2 recovery levels?

A
  1. Neurological: recovery of direct symptoms
  2. Psychological: recovery of indirect symptoms
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20
Q

What is the restorative approach to rehabilitation?

A

Achieve recovery at the brain level

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21
Q

What is the compensatory approach to rehabilitation?

A

Achieve recovery at psychological level (current focus)

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22
Q

What are the 2 approaches to rehabilitation?

A
  1. Restorative
  2. Compensatory
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23
Q

What is growing into deficit?

A

Young children often don’t show lack of functions, but at a later age, when these functions should normally appear, serious deficiencies are noticed

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24
Q

With what types of injuries does treatment focused on neuroplasticity work?

A

For mild or moderate brain injuries

Severe injury that affects large networks of neurons will not result in neural reconnection

25
Q

What is bottom-up stimulation?

A

Focused stimulation for neuroplasticity. External stimuli are administered in an attempt to stimulate the formation of new neural connections

26
Q

What was Hebb’s principle underlying bottom-up stimulation?

A

Cells that fire together, wire together

27
Q

What is the difference between consistent mapping and varied mapping in learning?

A

Consistent: learning if stimulus and response repeatedly occur in the same combination

Varied: different responses are triggered by the same stimulus –> not learning

28
Q

What is state-dependent learning?

A

Learned behavior is easier to demonstrate if the application context has strong similarities with the learning context

So the behavior learning has to be strongly anchored, but in such a way it’s not dependent on the specific characteristics of learning context

29
Q

What is the variability of practice in rehabilitation?

A

Therapist introduces variations in the learning process and the learning context at an early stage, so tranfer to a different application context later on is easier

30
Q

What are 2 principles that stimulate transfer of learned behavior to other situations?

A
  1. Variability of practice
  2. Linkage to the site of application
31
Q

What is linkage to the site of application in rehabilitation?

A

A link is made between the learning behavior and the target situation as early as possible

32
Q

What is experience-dependent learning?

A

Promoting plasticity through learning

33
Q

What is function training and what type of rehabilitation approach fits best with it? What can you say about the effectiveness?

A

Recovery of cognitive functions occurs through repeated exercise

–> Restorative approach

Effectiveness: not demonstrated, almost never generalization to daily life

34
Q

What is generalization in learning? Why is it a challenge for people with brain injury?

A

Apply what is learned to everyday life

Challenge because learning depends on intact cognitive functions

35
Q

On which aspect of the ICF model does the restorative approach focus? And the compensatory approach?

A

Restorative: functions/structures
Compensatory: activities/ participation

36
Q

What is stimulus-response conditioning (S-R conditioning)? Which rehabilitation approach fits best?

A

A limited routine that is triggered by a stimulus. It’s not aimed at generalization

Compensatory approach

37
Q

What is skill training and which rehabilitation approach fits best? Give an example

A

Training skills at task level through repeated exercise, not aimed to improve underlying cognitive function. It’s very task specific and aimed at generalization

–> Compensatory approach

E.g. making tea/coffee

38
Q

What is strategy training and which rehabilitation approach fits best with it? Give an example

A

Training skills that apply in multiple tasks/situations where cognitive function is called upon. Aims for generalization and self-monitoring

–> Compensatory approach

E.g. seeing a traffic light

39
Q

What is the cognitive cycle and what approach to rehabilitation fits best with it? For which people does this work best?

A

Breaking up each task into different steps (analyze, develop strategy, implement strategy, evaluate successfulness)

–> Compensatory approach

Works best for people with problems with planning and organization and want to have more structure

40
Q

What is the difference between strategy training and cognitive cycle in rehabilitation?

A

Strategy: focus on teaching specific strategies that can be carried out in multiple contexts

Cognitive: focus on bringing structure in one’s own problem solving and it requires capacity to set one’s own goals

41
Q

What is environmental control and what approach to rehabilitation fits best with it?

A

Modifying aspects of a person’s enviornment so they can better compensate for cognitive dysfunction. It improves independence and quality of life

–> Compensatory approach

42
Q

What are the 5 methods in the compensatory approach in rehabilitation and what does each method aim to change?

A
  1. Environmental control: behavior
  2. S-R conditioning: behavior routine
  3. Skill training: skill
  4. Strategic training: strategic ability
  5. Cognitive cycle: attitude
43
Q

What is the Gross and Schutz model of neuropsychological intervention methods?

A

It proposes a hierarchy with 5 levels of learning potential. Based on this potential there are different optimal interventions

1 Environmental control
2 S-R conditioning
3 Skill training
4 Strategy training
5 Cognitive cycle

44
Q

What is neuropsychological rehabilitation?

A

It focuses on cognitive disorders and also on emotional and behavioral disorders resulting from brain injury

45
Q

What is the international classification of impairments, disabilities and handicaps (ICIDH)? What are it’s levels?

A

It creates a hierarchy in the consequences of brain injury in 3 levels

  1. Impairments
  2. Disabilities
  3. Handicaps
46
Q

What are impairments?

A

Manifestations, disorders or illnesses at the organ level

47
Q

What are disabilities?

A

Consequences of impairments at a personal level, typically seen as a restriction or lack of an ability considered part of normal functioning

48
Q

What is a handicap?

A

The adverse effects of impairments and disabilities on social functioning or the environmental/social barriers that limit a person’s functioning

49
Q

Give an example of a handicap

A

Discrimination and lack of equipment can limit a person’s functioning in society

50
Q

What is the ICF (International Classification of Functioning, Disability and Health)? What is the main difference with the ICIDH?

A

It classifies health components. It was the successor of the ICIDH

Main difference:
- ICIDH: classifies the consequences of illnesses
- ICF: focus on classification of health components. It makes it possible to chart environmental and personal/premorbid factors that can clarify classification

51
Q

What are the 2 parts of the ICF model?

A
  1. Functioning and disability
  2. Contextual factors
52
Q

What are the 3 components of functioning in the ICF model?

A
  1. Bodily functions/mental functions (properties of the person)
  2. Activities (person’s actions)
  3. Participation of a person in society (role fulfilment)
53
Q

Why has the term handicap been removed from the ICF model?

A

It’s too stigmatizing. Functioning and disability captures it all

54
Q

What are activity restrictions and participation restrictions in the ICF model?

A

Activity: reduction or loss of ability to carry out an activity

Participation: restriction that hampers or prevents normal societal role fulfilment

55
Q

What are the 2 types of contextual factors in the ICF model?

A
  1. Environmental factors: attitudes in a person’s environment and social support
  2. Personal factors: a person’s characteristics (age, SES, coping style)
56
Q

Study the ICF model!!! Summary p. 83/slide 22

A

KEEP GOING YOU’RE DOING AMAZING <3

57
Q

What are disabilities in the ICF model?

A

Functional disorders and restrictions in activities/participation.

58
Q

What are 3 types of classification in neuropsychology?

A
  1. ICIDH model
  2. ICF model
  3. Direct/indirect symptom distinguishment
59
Q

What is the difference between instrumental and operant conditioning?

A

Instrumental: linking stimulus to response

Operant: modify behavior using positive/negative reinforcement

Neuropsychology (16 decks)

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