Week 11 | Day 1 | PSYA02

Neuropsychology In Context

• WWI & WWII left a lot of brain-injured soldiers and people had to find more specialized ways to help them
• Educational testing: already wide use of standardized tests (Binet’s test)
• Basic research: experimental studies made the theories behind neuropsychology assessment stronger
• Neuroimaging: impressive advances in the ability to image a brain meant less need for tests to identify injured areas (eg. they don’t need to do a test, we can just do a scan of your brain)
• Historically: World War Soldiers have brain injuries, how does this affect their thinking skills and where is the injury?
• Present: Impact on thinking skills, what is the consequence and how can we help?

Cognitive Training

Basic approach: ‘Trainee’ completes structures cognitive tasks, typically adaptive or performance over a period of time/sessions

• • Grounded in a cognitive theory
  • Adaptive design is key to neuroplasticity

Neuroplasticity: the ability of the nervous system to respond to intrinsic or extrinsic stimuli by reorganizing its structure, function, and connections

• • Commonly invoked mechanism for the efficacy of cognitive training
• Training is typically specific to cognitive ability, which may be a barrier to generalized rehabilitation programs
• Cognitive training can be thought of as a restorative approach

Near vs Far Transfer:

• Near Transfer: training on one task generalizes to performance on another, highly similar task (eg. training on one working memory tasks improves your performance on another working memory task)
• Far Transfer: training on one task generalizes to performance on another, dissimilar or loosely similar tasks (eg. working memory task training improves academic functioning or other real-world skills)

Cognitive Training Example

• “What happens if we train cognitive training paradigm while patients are in for substance abuse?”
  • Training did not have any impact on reduced substance abuse relapse
  • Basically, this means that even if you train using games (like Lumosity), it may help better performance in similar games but not transferable to real-life skills

Cognitive Rehabilitation

• The main function is to support the patient’s ability to function in their day-to-day life
• Treatment target: Depends on the patient's goals that depend on the patient's willing to participate in treatment
• Several approaches to cognitive rehabilitation:
  • Not trying to restore cognitive deficit, but instead emphasizing their strong points
  • Restoration of cognitive deficit
  • Modification of environment
  • Implementation of supports
  • Systems-type interventions (eg. family support)
• Examples of compensatory approaches
  • Internal: raising awareness of potential cognitive errors
    • Eg. mega-cognitive monitoring in Goal Management Training
  • External: lists and record keeping to support memory
    • Eg. memory organizer in Learning the Ropes for Living with MCI

Cognitive Rehabilitation Example:

• Go slow but try to make no mistake in doing that task
• Gradually go faster

Rehabilitation vs Training

Holistic Approaches

• Emphasizing multiple domains of functioning

Complementary, Not Incompatible

• Cognitive training and rehabilitation both offer approaches to provide treatment or intervention to individuals with varying levels of cognitive difficulties
• The primary differences are in their target outcomes and approaches, but can often be completed in combination (not mutually exclusive approaches
• Newer models emphasize holistic, integrative approaches
• As a newer area of clinical practice, continuous improvement, adaptations, and research will continue to shape current approaches
  • Ngl I have no idea what I wrote for this it’s just from the lecture pls review