Cognitive Psychology and Assessment

Overview of Sohlberg and Mateer’s Clinical Taxonomy of Attention

  • Sohlberg and Mateer (2010) developed a comprehensive Clinical Taxonomy of Attention that categorizes different types of attention and related assessment tasks.

Components of Executive Functions

  • Executive functions encompass a variety of cognitive processes essential for controlling behavior and coordinating complex tasks. The main components include:

    • Inhibition: Ability to suppress responses or actions that are inappropriate.

    • Working Memory: Capacity to hold and manipulate information in mind.

    • Cognitive Flexibility: Ability to switch between different tasks or mental frameworks.

    • Planning: The process of setting goals and determining the necessary steps to achieve them.

    • Problem Solving: Ability to find solutions to complex and novel situations.

Types of Interventions and Assessment Tasks for Cognitive Domains

  • Various cognitive domains each have specific intervention and assessment tasks:

    • Attention:

    • Stroop Test: Measures selective attention and cognitive control by requiring individuals to name the color of the ink a word is printed in, rather than the word itself.

    • Digit Span Task: Assesses working memory by requiring participants to repeat back sequences of numbers.

    • Language:

    • Verbal Fluency Tests: Evaluate expressive language abilities by asking individuals to generate as many words as possible within a specific category in a given timeframe.

    • Memory:

    • Recall and recognition tasks that assess different types of memory systems including long-term and short-term memory.

Identifying Cognitive Domains in Situations

  • Practitioners need to be able to identify the type of memory, attention, or component of executive function at play in different scenarios presented.

  • Example scenario: If a client has difficulty following complex instructions, this may indicate deficits in working memory or cognitive flexibility.

Brain Areas Associated with Cognitive Domains

  • Understanding the neurology behind cognition is essential:

    • Frontal Lobe: Involved in executive functions such as decision making, problem solving, and inhibition.

    • Parietal Lobe: Plays a role in attention and spatial awareness.

    • Temporal Lobe: Associated with memory and language processing.

    • Occipital Lobe: Primarily responsible for visual processing but can influence attention related to visual stimuli.

Influences on Social Communication Development

  • Social communication is shaped by various factors including:

    • Cognitive Skills: Such as language development and executive functioning.

    • Social Context: Including family, peers, and cultural influences.

    • Neurological Factors: Brain structure and functioning that influence communication abilities.

Components of Long-Term Memory and Consolidation

  • Long-term memory consists of several components:

    • Declarative Memory: Knowledge of facts and events that can be consciously recalled.

    • Procedural Memory: Memory of how to perform tasks that is often automatic and not consciously recollected.

    • Consolidation: The process of transferring memories from short-term to long-term storage, often facilitated by sleep and repetition.

Interventions Based on Symptoms

  • Clinicians must be able to select the most effective intervention based on the client's specific symptoms:

    • Example: For a client with impaired inhibition, behavioral approaches or cognitive retraining might be most beneficial.

Therapy Targets in Case Studies

  • Identifying appropriate therapy targets involves understanding the nature of deficits present in the case, allowing for tailored treatment plans.

Identifying Brain Areas Affected by Symptoms

  • Clinicians should be able to connect specific symptoms with vulnerable brain areas to better understand the underlying issues.

    • Example: Difficulties with attention may relate to dysfunction in the frontal or parietal lobes.

Recognizing Symptoms and Deficits by Cognitive Domain

  • Each cognitive domain is associated with particular symptoms:

    • Attention Deficits: May lead to problems with sustaining focus, distractibility, or trouble following conversations.

    • Memory Impairments: Can manifest as forgetfulness, difficulty learning new information, or trouble recalling past events.

Selecting Assessment Tasks for Symptoms

  • When evaluating a case, the choice of assessment task should align with the symptoms and areas of deficits presented.

    • For example, a client exhibiting issues with verbal recall should undergo memory assessments such as free recall tasks or recognition tests.

Overview of Sohlberg and Mateer’s Clinical Taxonomy of Attention

  • Sohlberg and Mateer (2010) developed a comprehensive Clinical Taxonomy of Attention that categorizes attention into a hierarchy of 5 levels, ranging from basic to complex:

    • Focused Attention: The fundamental ability to respond discretely to specific visual, auditory, or tactile stimuli.

    • Sustained Attention: The ability to maintain a consistent behavioral response during continuous and repetitive activity. This includes both vigilance and mental flexibility.

    • Selective Attention: The capacity to maintain a behavioral or cognitive set in the face of distracting or competing stimuli.

    • Alternating Attention: The mental flexibility that allows individuals to shift their focus of attention and move between tasks having different cognitive requirements.

    • Divided Attention: The highest level of attention, involving the ability to respond simultaneously to multiple tasks or multiple task demands (e.g., multitasking).

Components of Executive Functions

  • Executive functions encompass a variety of high-level cognitive processes essential for controlling behavior and coordinating complex tasks. Key components include:

    • Inhibition: The ability to suppress responses or actions that are inappropriate, including interference control and stop-signal control.

    • Working Memory: The capacity to hold and actively manipulate information in the mind, often conceptualized as a central executive managing a phonological loop and visuospatial sketchpad.

    • Cognitive Flexibility: Also known as set-shifting, this is the ability to switch between different tasks, mental frameworks, or rule sets.

    • Planning and Organization: The process of setting goals, determining necessary steps, and sequencing actions to achieve a long-term objective.

    • Problem Solving: The ability to analyze novel situations and find effective solutions by applying logic and reasoning.

Types of Interventions and Assessment Tasks for Cognitive Domains

  • Specific tasks are used to isolate and measure various cognitive domains:

    • Attention:

      • Stroop Test: Measures selective attention and cognitive control by requiring individuals to name the color of the ink a word is printed in, rather than reading the word itself (suppressing the automatic response).

      • Digit Span Task: Assesses working memory and short-term capacity by requiring participants to repeat sequences of numbers in forward, backward, or ascending order.

      • Paced Auditory Serial Addition Test (PASAT): Evaluates speed of information processing and sustained/divided attention.

    • Language:

      • Verbal Fluency Tests: Evaluate expressive language and executive control. This includes Phonemic Fluency (generating words starting with a specific letter like F, A, or S) and Category Fluency (naming animals).

    • Memory:

      • California Verbal Learning Test (CVLT): Assesses verbal learning and memory through list learning over multiple trials.

      • Recall vs. Recognition: Differentiating between the ability to independently retrieve information (recall) and the ability to identify information when presented with it (recognition).

Identifying Cognitive Domains in Situations

  • Practitioners analyze functional breakdowns to identify underlying deficits:

    • Working Memory Deficit: A client might forget the first part of a multi-step instruction (e.g., "Go to the kitchen and grab the blue folder") before they arrive at the location.

    • Cognitive Flexibility Deficit: A client may become "stuck" on a task (perseveration) when the rules change, unable to adapt to the new requirement.

Brain Areas Associated with Cognitive Domains

  • Frontal Lobe:

    • Dorsolateral Prefrontal Cortex (DLPFC): Primary region for working memory, planning, and shifting focus.

    • Orbitofrontal Cortex (OFC): Involved in inhibition and emotional regulation.

  • Parietal Lobe: Critical for spatial attention, sensory integration, and orienting in space.

  • Temporal Lobe:

    • Hippocampus: Crucial for the encoding and consolidation of new declarative memories.

    • Wernicke’s Area: Located in the posterior temporal lobe; essential for language comprehension.

  • Occipital Lobe: Responsible for visual processing; damage can lead to visual attention deficits like hemispatial neglect.

Influences on Social Communication Development

  • Social communication involves the integration of several skills:

    • Cognitive Skills: Language development allows for complex expression, while executive functioning allows one to suppress inappropriate remarks (inhibition).

    • Social Context: Cultural norms and peer interactions shape the usage of pragmatics (the social rules of language).

    • Neurological Factors: Theory of Mind (ToM) abilities are supported by specific networks in the prefrontal cortex and temporal-parietal junction.

Components of Long-Term Memory and Consolidation

  • Declarative (Explicit) Memory: Knowledge that can be consciously recalled. It is subdivided into:

    • Episodic Memory: Autobiographical events (e.g., what you ate for breakfast).

    • Semantic Memory: General world knowledge and facts (e.g., knowing that Paris is the capital of France).

  • Procedural (Implicit) Memory: Memory for how to perform motor tasks or skills (e.g., typing or riding a bike) which is often preserved in cases of amnesia.

  • Consolidation: The process of stabilizing a memory trace. Systems consolidation involves the gradual transfer of dependence from the hippocampus to the neocortex over time.

Interventions and Clinical Application

  • Restorative Training: Aimed at improving the underlying cognitive function (e.g) Attention Process Training).

  • Compensatory Strategies: Using external aids (planners, alarms) or internal strategies (chunking information) to bypass the deficit rather than fixing it.

  • Symptom Mapping: If a client presents with poor focus and high distractibility, a clinician may investigate dysfunction in the frontal or parietal systems and utilize a Stroop test for objective confirmation.