CR: Lesson 2

Question 1

What is the main goal of CR?

Answer 1

Highest possible daily function, self-efficiency

Question 2

What must we do befor we create a treatment plan?

Answer 2

look at the type & location of the brain injury (= expected progress & prognosis)
premorbid functioning
demands of current life
support system
personality/emotional adjustment
residual strengths
ability to participate in therapy (stamina/cognitive ability)

Question 3

Consider these things about type & location of brain injury…

Answer 3

what deficits impaired?
how severe?
how diffuse?

Question 4

What information do physicians provide?

Answer 4

location, severity of injury, conncurrent injuries, effects of med, prognosis, what to expect

Question 5

What information do nurses provide?

Answer 5

info about the client’s sleep habits and what time may be the patient’s best in terms of alertness & cognitive function

Question 6

What information do physical therapists provide?

Answer 6

physical deficits, stamina
mobility options
positioning

Question 7

What information do opccupational therapists provide?

Answer 7

the ability to participate in everyday self-help skills, ADLs, and visuospatial skills

Question 8

What information do neuropsychologists provide?

Answer 8

cognitive functions

emotional/motiviational issues

Question 9

What information do SLPs provide?

Answer 9

language/speech
cognition, safety
swallowing

Question 10

What areas need to be assessed?

Answer 10

arousal & alertness
orientation
attention/concentration
memory/learning
communication skills
presence of apraxia
reading/writing
reasoning/probelm-solving
executive functions

Question 11

What are executive functions?

Answer 11

initiation, inhibition, planning, organizing, awareness

Question 12

Standardized Tests

Answer 12

normed on population that represents your client
performed exactly as instructed to draw conclusions about impairment.
* altering the test may provide “qualitative data” –like what cues are helpful to this client, that you may want to use in therapy

Question 13

What is fixed battery approach?

Answer 13

giving the same assessment or battery of assessments to all clients regardless of presenting information or deficits. Very broad in nature & time consuming–SLPs rarely do this. Not much time in rehab for this type of assessment.

Question 14

What is the flexible, process-oriented approach?

Answer 14

targest particular areas of concern

choose assessments based on medical/other background info

Question 15

What is tracking evaluation?

Answer 15

repeated assessments of certain skills

Question 16

What must you bewar of in tracking evaluations?

Answer 16

practice effects

Question 17

What kind of test can be used in tracking evaluation?

Answer 17

standardized OR informal assessments of clinical skills (ex. following directions, solving problems, reading/writing a particular passage, etc.)

Question 18

Consider these factors when testing:

Answer 18

physical influences
visual field deficits
perceptual deficits
paresis/paralysis
emotional factors
ecological validity

Question 19

What are examples of physical influences

Answer 19

(fatigue, hunger, pain)

Question 20

What are visual field deficits

Answer 20

(right/left neglect)

Question 21

What are perceptual deficits

Answer 21

(visual/hearing impairement)

Question 22

What is ecological validity?

Answer 22

how the tasks relates to functions ofthe client’s everyday life

Question 23

Are rating scales standardized or non-standardized tests?

Answer 23

non-standardized

Question 24

What are rating scales?

Answer 24

several raters rate performance on practical tasks

Question 25

Name advantages of using rating scales

Answer 25

* looks at performance accross settings * tracks progress on daily function * less time consuming and more convenient to compile * can be given over & over w/o practice effect

Question 26

Name two examples of rating scales

Answer 26

Neurobehavioral Rating Scale & Disability Rating Scale

Question 27

Disability Rating Scale

Answer 27

A. Eye Opening 0= spontaneous (eyes open with sleep/wake rhythms indicating active arousal mechanisms, does not assume awareness 1= to speech and/or sensory stimulation 2= to pain 3= none: no eye opening even to painful stimulation B. Communication Ability 0= oriented (name, location, why they are there, year, season, month, day, time of day...) 1= confused (delayed or confused responses) 2= inappropriate (intelligible, but speech is used only in exclamatory or random way; no sustaied communication exchange is possible) 3= incomprehensible (moaning, groaning,...) 4= none

Question 28

There is often a period of ______ or _________ following brain injury.

Answer 28

coma | post-traumatic amnesia (PTA)

Question 29

General Cognition Assessments

Answer 29

investigate the clients' performance on several types of cognitive domains (memory, reasoning, problem-solveing, naming, perception, etc.) assessment ex. RIPA

Question 30

Types of Attention/ Concentration to Assess

Answer 30

sustained attention focused attention divided attention information processing speed (Concentration)

Question 31

sustained attention

Answer 31

aka. vigilance | digit span recall, also continuous performance test in which person must respond when a particular stimulus is perceived

Question 32

focused attention

Answer 32

number or letter cancellation

Question 33

divided attention

Answer 33

requiring the client to do two things at once (ex. listent to a series of letters and numbers and keep a running tally of numbers)

Question 34

information processing speed

Answer 34

timing the reaction time or completion time on tasks (ex, looking up words in a dictionary...or addition tasks at varying rates)

Question 35

Memory & New Learning- Types of memory to assess:

Answer 35

``` delayed recall cued recall recognition verbal vs nonverbal memory immediate memory working memory prospective memory ```

Question 36

delayed recall

Answer 36

will tell you about the ability to form new lasting memories

Question 37

cued recall

Answer 37

may give you info about what types of cues the patient will respond to best

Question 38

recognition

Answer 38

requires the least freerecall, but the most basic level of learning

Question 39

verbal vs. nonverbal

Answer 39

(CVLT vs. picture of faces)

Question 40

immediate memory

Answer 40

number or letter recall

Question 41

working memory

Answer 41

do something with the information like creation of acronyms

Question 42

prospective memory

Answer 42

remember this and I'll ask you about it later...

Question 43

Standardized test that measure executive functions

Answer 43

RIPA, MIRBI, SCATBI, BTHI

Question 44

Use caution when using standardized tests to measure executive functions bc...

Answer 44

test lenght does NOT require a person to maintain set for long. explicit instructions may not provide opportunity for problem solving and reasoning. test administration does not usually occur in real-life situarions in which the cliend would have to inhibit outside distractions the task may not have a lot of ecological validity tests often dont assess the social executive function (ex. initiation & inhibition)

Question 45

What are some non-standardized tests for executive functions?

Answer 45

Stroop test--inference/ inhibition Clock drawing---sequencing, visuo-spatial, organization, problem solving, LTM semantic fluency tasks---paitent its aked to make a list of LTM--as many as I can Rating Scales for everyday tasks. ---looks at same functions, but in practical tasks