Executive Function Module 4 Flashcards

Question

Formal Assessments in DIA

Answer 1

Any test that allows you to observe the explicit effects of cueing on performance - Contextual Memory Test - Toglia Category Assessment (EF) - Deductive Reasoning Test (EF) - Dynamic Object Search Task (VP) - Executive Function Performance Test (EFPT) - Route Finding Test * *- Prospective/Retrospective Memory Questionnaire (because you can examine the effect of self vs environmental cueing)

Answer 2

Client Selected Goals - they identify problem areas - they identify activity based goals - goals designed to maximize engagement

Answer 3

Dynamic Performance Analysis (DPA) - therapist observes client performance of selected activities - therapist identifies "breakdowns" in task performance, where cues or assistance are needed - Therapist observation often leads to changes in client goals

Answer 4

"Goal-Plan-Do-Check" metacognitive strategy is taught to the client - helps client develop a plan to improve performance in daily activities - develop a method for evaluating the activity (Knowledge of results and knowledge of performance )

Answer 5

Therapist assists with self-monitoring, error awareness, and self-instruction of performance -client is helped to learn about their performance, use the metacognitive strategy, and problem solving ability **NOTE: This model is very client involved --> Therapist role is in selecting and modifying activities

Answer 6

- Client has some AWARENESS of their deficits - Client has EF deficits and primary focus of therapy (problem solving, planning, and organization) - Client has the ability to engage in mutual goal setting (requires basic skills in memory, learning, attention, and motivation) GOAL: Teach client a strategy they can use independently to solve future problems

Answer 7

``` Strategy Training Techniques GOAL: increase self-awareness and control of cognitive processes -self-instruction training -problem solving training -goal management training -time pressure management ``` Specific for dealing slowed processing speeds = one of the most common complaints in CVA, TBI, MS, PD, and other neurological disorders

Answer 8

Step 1: Teach client about executive functions that are impaired Step 2: Teach the client strategies to improve functions (practice with strategies) Step 3: Teach the individual methods to promote transfer of skills across context (practice with the strategies)

Answer 9

Extensive training in EF likely in OUTPATIENT settings - outpatient cognitive rehabilitation setting - home health care - vocational training and rehabilitation - outpatient day programs OTHERS: - Introduce strategies in inpatient, subacute settings (limited opportunity to practice with step 2, and a little opportunity to practice with step 3 due to time and facility constraints) - -Self-instruction is easier to introduce, focus on BADL and simple IADLs - GOAL-PLAN-CHECK-DO with simple IADL tasks

Answer 10

- Client verbalizes the action plan before and during the execution of the task - GOAL: gradually fade verbalization **over verbalization --> whispering --> internal talk

Answer 11

Levels of Support -Self-verbalization - talk through a script of the entire activity (high support) - Self-guidance - talk through key reminders of plan (medium support) - Self-questioning - pose a series of questions to double check performance (least support)

Answer 12

Teach clients to break down problems into smaller steps and use a step-wise approach to problem solving 5 steps: 1. Problem Orientation - recognize situations where a problem exists that needs to be solved 2. Problem Definition - identify the main relevant information versus irrelevant information 3. Generating Alternatives - generate as many possible solutions to problem as possible 4. Decision Making - weight pros and cons of potential solutions 5. Solution Verification - recognize bad solutions, self-correct errors, try other solutions

Answer 13

- Use across multiple tasks - provide cues and prompts to begin with --> gradually fade over time - Journaling - client keeps track of perceived deficits in task performance before and after training (looks at self-awareness changes)

Answer 14

Problem Solving Training (PST) - Focus on the problem (I forget things when going grocery shopping) - Focus is on developing multiple ways of addressing this problem - More appropriate if the client has awareness about when problems occur but does not know how to prevent or solve the problems * *More appropriate if the client doesn't have awareness of has limited awareness about all the situations * *where a problem occurs (works on increasing awareness) Goal Management Training (GMT) - Focus is on the occupation (getting dressed, going to the store) - Focus is on predicting potential problems that could occur

Answer 15

-A structure problem solving strategy designed to deal with decreased processing speed (address the problem of slow processing in multiple occupational areas) 3 Levels of decision making: - strategic (long-term plans) - Tactical (short-term, moment to moment adjustments in plans) - Operational (if tactical fail, rapid decisions under time pressure, during task performance) GOAL: To use task analysis and modification to reduce daily time demands so that client can complete tasks despite slow processing speed

Answer 16

1. Reduce # of distractors in environment More structure/less distraction --> less structure/more distraction GOAL: achieve mastery in less demanding environment before moving to more demanding 2. Cognitive scheduling/fatigue management to balance load of fatiguing decision making

Answer 17

1. Checklists - self-instructional strategy 2. Pagers 3. Organizers/notebooks