Module 10

cognition

the ability to use mental processing skills to interact with, and meet the demands of, one’s environment

sustained attention

Supports tasks that require vigilance and the capacity to maintain attention over time; often measured by the time spent on a task

divided attention

attending between two or more tasks simultaneously; dual tasking or multitasking; the capacity to attend to two competing stimuli simultaneously.

alternating attention

The ability to switch attention flexibility from one concept to another; related to cognitive flexibility.

selective/focused attention

The type of attention involved in the processing and filtering of relevant information in the presence of irrelevant stimuli; the efficiency with which people can search and focus on specific information while ignoring distracters

short-term memory

conscious awareness of information from less than an hour ago

working memory

Related to short-term memory; refers to actively manipulating information in short-term storage through rehearsals

long term memory

Relatively permanent storage of information with unlimited capacity

declarative memory

Knowing that something was learned; verbally retrieving a knowledge base (e.g., facts) and remembering everyday events; includes episodic and semantic information; a form of LTM

non-declarative memory

Knowing how to perform a skill, retain previously learned skills, and learn new skills; a form of LTM; also called procedural memory

episodic memory

Autobiographic memory for contextually specific events and personally experienced events; a form of declarative LTM

semantic memory

Knowledge of the general world and facts, linguistic skill, and vocabulary; may be spared after injury; a form of declarative LTM

dynamic interactional model

views cognition as a product of the interaction among the person, activity, and environment

quadraphonic approach

was developed by Abreu and Peloquin1 for use with individuals who were cognitively impaired after brain injury. This approach is described as including both a “micro” perspective (a focus on the remediation of subskills, such as attention and memory) and a “macro” perspective (a focus on functional skills, such as activities of daily living [ADLs] and leisure activities)

cognitive rehabilitation/retraining model

Based on neuropsychological, cognitive, and neurobiological rationales, this model focuses on cognitive training by enhancing clients’ remaining skills and teaching cognitive strategies, learning strategies, or procedural strategies.

neurofunctional approach

applied to those with severe cognitive impairments secondary to brain injuries. This approach focuses on training clients in highly specific compensatory strategies (not expecting generalization) and specific task training

explicit memory

Memories of events that have occurred in the external world; information about a specific event at a specific time and place

implicit memory

Memories necessary to perform events and tasks or to produce a specific type of response; does not require conscious retrieval of the past; knowledge is expressed in performance, without the person being aware of having it

attention

Processes that allow a person to gain access to and use incoming information; includes alertness, arousal, and various attention processes (e.g., selective attention)

dementia

alteration in mental processes due to organic disease, no change in level of arousal, progressive and typically insidious in onset

delirium

disorientation accompanied by irritability, agitation, suspicion, and fear; misperception of stimuli; loud, talkative behaviors; acute onset; arousal level is affected

Glasgow Coma Scale

is the standard quick-screening for level of arousal and is typically documented before formal cognitive testing begins

ranchos los amigos cognitive

describes recovery patterns after TBI. 10 levels to better capture higher functioning stages of recovery

Ranchos Level I

No Response: No observable reaction to visual, auditory, tactile, or painful stimuli

Ranchos Level II

Generalized Response: Inconsistent, non-purposeful reactions (e.g., gross movement) to any stimulus

Ranchos Level III

Localized Response: Responds specifically but inconsistently to a stimulus; may follow simple commands

Ranchos Level IV

Confused – Agitated: Heightened alertness, agitation, and confusion; behavior is bizarre and non-purposeful; poor safety awareness

Ranchos Level V

Confused – Inappropriate, Non-Agitated: Responds to simple commands; easily distracted; needs max cueing; inconsistent memory

Ranchos Level VI

Confused – Appropriate: Goal-directed behavior with cueing; recall of overlearned tasks improves; still relies heavily on external structure

Ranchos Level VII

Automatic – Appropriate: Appropriate in familiar settings but robotic/automatic; poor insight into deficits; needs stand-by assistance for safety

Ranchos Level VIII

Purposeful – Appropriate (Standby): Oriented, carries over new learning; needs standby assist for unfamiliar or higher-level tasks

Ranchos Level IX

Purposeful – Appropriate (On Request): Independent with familiar tasks; needs assistance only on request for unfamiliar demands

Ranchos Level X

Purposeful – Appropriate (Modified Independent): Independent with intermittent difficulty under stress, multitasking, or novel situations; may use compensatory strategies