Memory Intervention Techniques Quiz

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Questions and Answers

Which factor is NOT considered when choosing a compensatory technique for memory intervention?

Severity of injury

Presence of comorbid conditions

Social supports

Client’s preferred methods of learning (correct)

What is the primary goal of memory notebooks and technology in memory interventions?

To provide a change in laboratory-based measures

To utilize learning theory to improve memory function (correct)

To enhance procedural memory skills only

To promote trial and error learning

Which stage is NOT part of the three stages of using memory notebooks?

Application

Acquisition

Adaptations

Evaluation (correct)

What does the WSTC strategy primarily aim to address?

Self-regulation and self-awareness Signup and view all the answers

What is a key characteristic of errorless learning as a strategy?

It emphasizes learning without making errors. Signup and view all the answers

What is the first stage in the memory process?

Attention Signup and view all the answers

Which brain structure is primarily involved in the retrieval of memories?

Frontal lobe Signup and view all the answers

What type of memory allows a person to manipulate information actively within short term storage?

Working memory Signup and view all the answers

Which of the following describes implicit memory?

Unconscious form of memory concerning skills and tasks Signup and view all the answers

Which part of memory is involved in retaining information for extended periods?

Long term memory Signup and view all the answers

Episodic memory is best defined as:

Memories of personal experiences Signup and view all the answers

Which structure is NOT primarily associated with the storage of memories?

Visual system Signup and view all the answers

Compensatory techniques are most associated with improving function in which type of memory deficits?

Both short term and long term memory Signup and view all the answers

What is the primary function of the prefrontal area related to attention?

To support selective attention Signup and view all the answers

What does sustained attention refer to?

Maintaining attention over a long period of time Signup and view all the answers

Which area of the brain is primarily involved in attentional switching?

Prefrontal cortex Signup and view all the answers

What does divided attention allow an individual to do?

Attend to multiple tasks at once Signup and view all the answers

Field dependent behavior is characterized by which of the following?

Being distracted by external stimuli Signup and view all the answers

Which intervention strategy helps improve attention by increasing task demands?

Introducing progressive task challenges Signup and view all the answers

What role do psychostimulants play in addressing attentional impairments?

They aid in improving attentional focus Signup and view all the answers

Which of the following does NOT support maintaining attention?

Setting multiple simultaneous tasks Signup and view all the answers

What is the primary focus of metacognitive skills in the Dynamic Interactional Model?

Enhancing self-awareness of strengths and deficits Signup and view all the answers

What must occur for the transfer of learning to take place according to the Dynamic Interactional Model?

It must be explicitly taught through varied tasks Signup and view all the answers

Which of the following is a component of the Dynamic Interactional Model?

Awareness training Signup and view all the answers

How does the Dynamic Interactional Model suggest practicing strategies?

Across different activities, situations, and environments Signup and view all the answers

What role do awareness questions play in the Dynamic Interactional Model?

They help clients detect errors and estimate task difficulty Signup and view all the answers

What is a critical aspect of training within the Dynamic Interactional Model?

Teaching scanning strategies in varied tasks Signup and view all the answers

Who developed the Dynamic Interactional Model and the Multicontext Treatment Approach?

Joan Toglia Signup and view all the answers

According to the Dynamic Interactional Model, which of the following statements is true about cognitive performance?

It results from the interaction of person, activity, and environment. Signup and view all the answers

What is the primary focus of metacognitive training?

To teach clients to recognize their own cognitive deficits Signup and view all the answers

Which of the following strategies is emphasized in the practice component of metacognitive training?

Using a pacing strategy to manage task demands Signup and view all the answers

What is the goal of goal management training?

To improve the ability to maintain intentions in goal-directed behavior Signup and view all the answers

Which of the following is a technique used in goal management training?

Gradual fading of cues Signup and view all the answers

Which intervention specifically focuses on enhancing memory?

Self-instruction training Signup and view all the answers

Which component is essential for effective problem solving training?

Asking clear questions and evaluating alternatives Signup and view all the answers

Which step is NOT part of the goal management training process?

Randomly selecting tasks without planning Signup and view all the answers

How does environmental manipulation aid in interventions?

By adjusting the level of distraction in the environment Signup and view all the answers

What is a primary objective of occupational therapy for individuals with dementia?

To improve their physical and mental activity as long as possible Signup and view all the answers

Which feature is NOT mentioned as part of interventions for cognitive issues?

Psychological evaluation Signup and view all the answers

What factor can enhance a client's chances of receiving proper care in a healthcare setting?

A documented cognitive impairment that impacts function and safety Signup and view all the answers

Which aspect should practitioners prioritize while choosing interventions for clients?

Current research and the client's valued occupations Signup and view all the answers

During acute care, what is a key role concerning discharge?

Evaluating the discharge environment and next level of care Signup and view all the answers

When addressing wandering behavior in clients with dementia, what should be avoided?

Reasoning with the client Signup and view all the answers

Which of the following is emphasized for maintaining a client with dementia in the least restrictive setting?

Emphasizing remaining strengths Signup and view all the answers

What type of strategy instructions are included in cognitive intervention approaches?

Domain-specific strategy instructions Signup and view all the answers

Study Notes

Neurocognition: Assessment and Intervention

The presentation is about neurocognition, specifically assessment and intervention.
The presenter is Megan Mueller, OTD, OTR/L, BCPR.
The year of the presentation is 2024.

Class Objectives

Explain the unique view and role of occupational therapy (OT) in assessing and addressing functional cognition.
Compare and contrast different models for cognitive intervention (e.g., DIM, NFA, CDM).
Describe common top-down and bottom-up cognitive assessments.
Examine common interventions for awareness, attention, memory, and executive functioning.
Analyze strategies to incorporate functional cognition into acute care settings.
Evaluate interventions to support clients with dementia and their caregivers.

Cognition

Cognition is the brain's ability to process, store, retrieve, and manipulate information.
It includes skills of understanding, knowing, judging, decision-making, and environmental awareness.
Functional impairments can include impaired alertness/arousal, decreased response to environmental stimuli, anosognosia (unawareness of a deficit), impaired attention, disorientation, memory loss (short and long term), and impaired organization/sequencing, perseveration, impaired problem-solving.

Unique Perspective on Cognition

Functional cognition is defined as the ability to use and integrate thinking and performance skills for everyday complex activities, including instrumental activities of daily living (IADLs).
It relates to available resources utilized by the client to meet daily living requirements for ADLs and IADLs.
Functional cognition evaluates a client's capacity to manage everyday challenges.
It emphasizes the dynamic interplay between client, activity, environment, and context.

Unique Perspective on Cognition (Continued)

OTs are focused on improving participation and quality of life for clients with cognitive impairments.
Examples of this approach include working on a math equation worksheet to address organization, or paying credit card bills to improve organizational skills that stem from executive functioning or memory impairments.
Cognitive interventions should address the client's specific needs, and are tailored to various tasks and contexts while acknowledging the importance of generalizability.

Evaluation and Assessments

Evaluations focus on client performance in relevant occupations.
The MOCA score and corresponding impact on occupations are evaluated.
Goals should relate to improving occupational performance.
Examples of goals include increasing sustained attention to 10 minutes in a shopping task, or increasing functional and/or cognitive skills in various domains for which the client demonstrates deficits.

Interventions

Cognitive interventions typically focus on graded relevant occupations in natural settings and on the use of cognitive models and strategies.
Interventions should appropriately address attention skills, including manipulating size, shape, and color of materials while also gradually increasing task demands for client engagement.

Outcomes

Clients may experience improved performance in occupational areas, as evidenced by improved MMSE scores.
Improvements may also occur in the ability to organize novel medications using cognitive strategies in low-stim environments.

Out of Date Perspective

It was once assumed that remediation from identified impairment(s) would automatically resolve into improvements in functional daily activities, based on repetition or practice in isolation from contextual activities.
This assumption has been found not to be supported by empirical research, and therefore interventions are better focused on independent living, purpose, and quality of life despite cognitive impairments.

Models Guiding Cognitive Intervention

Dynamic Interaction Model (DIM)

Cognition is the result of the interaction between the person, activity, and environment.
A targeted treatment strategy is practiced across varied tasks and diverse situations.
This approach emphasizes metacognitive awareness-to aid in client awareness of strengths and deficits, estimate task difficulty and foresee outcomes.
The goal is to transfer learned skills in one context to other contexts (generalization).

Neurofunctional Approach (NFA)

An approach to compensate for cognitive impairments.
Focuses on retraining real-world skills related to cognitive impairments rather than focusing on cognitive perceptual processes.
The goal is to improve and restore the specific deficits in a functional context.
Intervention focuses on the functional limitation without targeting the underlying causes.
Repetition and context are key.
Use of routines, cues, and errorless learning.

Cognitive Disabilities Model(CDM)

Cognitive functioning is viewed on a continuum (level 1-level 6).
Adaptive intervention adjusts the activity itself to accommodate cognitive levels.
Cognitive restoration isn't the goal
Strengthening residual abilities is the goal.
The approach emphasizes establishing the current cognitive level and maintaining or restoring the highest levels of function through adaptive techniques and caregiver involvement.

Assessments

Occupational therapy embraces performance-based assessments and acknowledges the necessity of tools which may involve cognitive assessments based on facility reporting.
A range of cognitive assessment tools is available depending on the setting and client needs (e.g., BCAT, BCRS, BIMS, MOCA, MMSE, The Mini-Cog, etc.)
The Confusion Assessment Method for the ICU

Non-Standardized Structured Observation

Observation skills are utilized to discover underlying cognitive deficits which impair performance.
Errors in performance are acceptable if safe and not severe.
Observation looks for impairments in several key areas, such as attention, memory, insight, organizational skills, initiation, termination, decision-making, problem-solving, planning, self-correction, sequencing complex actions, and judgment.

Cognitive Assessment Summary

Most cognitive assessments are pen and paper/tabletop assessments; however, there is a growing demand for assessments that align with the demands of daily activities and participation.
Ecological validity of assessments emphasizes the degree to which the demands of the assessment resemble real-world functional and meaningful tasks. High ecological validity will identify difficulty performing real-world functional and meaningful tasks.
Various assessments are highlighted, such as the Modified Barthel Index, the SLUMS, the Mini-Mental State Examination (MMSE), and the Multiple Errands Test (MET).

Attention

Attention is essential for other higher-level cognitive functions, like memory and executive functions.
Common attention deficits after brain injury include problems with arousal, selective attention, sustained attention, attentional switching, and divided attention.
Attention deficits are often observed in tandem with other cognitive deficits.

Attention Intervention

Interventions can include systematic training with progressively increasing demands to improve attentional skills.
Reducing environmental distractions and educating clients regarding self-pacing can be helpful.
In some cases, a physician-prescribed medication may be necessary.
Specific skill training may help client relearn functional tasks.

Memory

Memory involves encoding, storage, and retrieval of information.
Important terminology includes short-term memory (STM), long-term memory (LTM), encoding, storage, retrieval, and types of memory (declarative, implicit, episodic, semantic).
Memory impairments can utilize mnemonic devices, rehearsal strategies, and temporal tags to improve.