Full Course Description


Module 1 - Cognitive Rehabilitation: Therapeutic Strategies for Effective Intervention

Program Information

Objectives

  1. Articulate the six types of attention and their connection to cognitive-linguistic impairments.
  2. Connect behavioral manifestations with specific cognitive and/or linguistic disorders.
  3. Analyze appropriate tools for the assessment of attention, memory function and visuospatial function.
  4. Characterize the attributes of executive functions and explain their connection to other cognitive processes.
  5. Formulate functional short-term and long-term patient goals for the remediation of cognitive-linguistic impairments.
  6. Distinguish impairments to the arousal, attention, and awareness continuum across etiologies (right hemisphere damage vs. dementias and traumatic brain injury).
  7. Integrate the appropriate therapy tasks, exercises and games in patient treatment programs.

Outline

Cognitive-Linguistic Assessments

  • Screening tools
  • Cognitive evaluations (standardized and non-standardized)
  • Language assessments (standardized and non-standardized as they apply to cognitive assessments)
  • Rating scales (provider and consumer)

Cognitive Rehabilitation Techniques

  • Remediation / Compensation / Adaptation
  • Therapy decision-making (dynamic/ongoing assessment; patient centered; goal directed)

Documentation of Skilled Services

  • Justification for skilled, necessary and reasonable therapy
  • ICD-9 / ICD-10 codes pertinent to SLP intervention
  • SMART goals
  • Outcome measures
    • FIMS
    • NOMS
      • Relevancy to G-Codes
      • A guide for developing LTG’s
  • Key elements required for:
    • Daily notes
    • Progress notes

Attention

  • Posner’s Theory of Attention
  • Anatomic substrates of the attention system
  • Attention subtypes
  • Functional manifestations of inattention
  • Interventions strategies for promoting improved attention across recovery continuum
    • Remediation
      • Wakefulness (stimulation management programs)
      • Reduced agitation (validation therapy, environmental modification, positive psychology)
      • Increased function (direct attention training with reflection)
    • Compensatory strategies (partner-based supports, environmental interventions)
    • Adaptation techniques (assisted prompting)
  • Goal writing for attention deficits

Memory

  • Anatomy of the memory systems
  • Memory types
  • Encoding / Consolidation / Retrieval
  • Interventions for facilitating recall
    • Remediation
      • Utilization of preserved systems (spaced retrieval, routines, implicit learning)
      • Adaptation techniques
    • External aids
    • Task-specific learning
    • Goal writing for attention deficits

Executive Functions (EF)

  • Anatomic substrates of the EF system
  • McCloskey’s Executive Functions
  • Executive functioning hierarchy
    • Self-activation
    • Self-regulation
    • Self-realization
    • Self-determination
  • Functional manifestations of EF impairments
  • Specific focus areas for EF’s
    • Functional problem solving
    • Awareness / Insight
  • Strategies for reducing the effects of executive dysfunction
    • Remediation (Reflection, video self-modeling, Ylvisaker’s Goal-Plan-Do-Review)
    • Compensation (routines, environmental interventions, partner-based interventions)
    • Adaptation (cognitive prosthetics)
  • Goal writing for EF and problem solving

Visual Perceptual Function

  • Anatomy of the visual system
  • Warren’s Visual Perceptual Hierarchy
  • Functional manifestation of visual perception deficits
  • Therapeutic strategies specific to:
    • Low vision
    • Hemispatial neglect
    • Remediation (known quantities, metacognitive/self-regulatory interventions)
    • Compensation (environmental interventions, partner-based interventions, edgeness and bookness)
    • Adaptation (visual/attentional prosthetics)
  • Goal writing for visual perceptual impairments

Special Considerations

  • Delirium
    • DSM-5® criteria for delirium
    • The neuroscience of delirium
    • Diagnosing delirium
    • Protective, predisposing and precipitating factors for delirium
    • Reversible causes for delirium
    • Treatment techniques for delirium
  • Depression
    • Clinical manifestations of geriatric depression
    • Medications which can cause depression
    • SLP role in the management of depression
  • Right Hemisphere Dysfunction (RHD)
    • Assessment tools specific to RHD
    • Clinical manifestations of RHD
      • Left hemispatial neglect
      • Pragmatic impairment
      • Reduced awareness / insight
      • Cognitive impairment

Specific Therapy Activities

Case Studies

Copyright : 02/19/2016

Module 2 - Cognitive Therapy for Dementia: Effective Evaluation & Therapeutic Interventions

Program Information

Objectives

  1. Communicate the differences between cortical and sub-cortical dementias.
  2. Evaluate and accurately stage the patient with cognitive impairment to inform clinical treatment interventions.
  3. Discriminate the forms of memory and the dementia diagnosis associated with each form.
  4. Utilize an appropriate iPad® application for cognitive therapy.
  5. Articulate one functional long-term goal and two functional short-term goals for cognitive therapy.
  6. Implement the appropriate therapeutic intervention strategies for different cognitive impairments.

Outline

Differentiation of Dementias
  • Cortical & Sub-cortical
  • Static or Dynamic/Reversible
Etiology of Various Dementias
  • Alzheimer’s
  • Parkinson’s
  • Vascular Dementia
  • Huntington’s
  • Lewy Body
  • Frontotemporal Dementia
  • Wilson’s
  • PSP
  • Cerebral Degeneration
  • Basil Ganglia Degeneration
 
Stages of Dementia/Clinical Staging
Identification of Models of Memory & Their Relationship to Dementia
  • Etiology & Symptoms
    • Sensory Memory
    • Working Memory
    • Declarative Memory
  • Non-declarative Memory
Medicare Compliance, Medical Necessity, Goal Writing
  • Jimmo v. Sebelius – Impact on treatment
Evaluation Tests
  • Brief Cognitive Rating Scale
  • Global Deterioration Scale
  • St. Louis University Mental Status Test (SLUMS)
  • Stroop Test
  • Trails A & B
  • Cognitive Linguistic Quick Test
  • Scales of Cognitive and Communication Ability for Neurorehab (SCCAN)
  • Environmental and Communication Assessment Toolkit for Dementia (ECAT )
  • MCI Screen
  • Allen Crosswalk & Cognitive Levels
Direct Therapeutic Interventions for Dementia
  • Spaced Retrieval
  • Priming
  • Reminiscence Therapy
  • Medications
  • Montessori Principles
  • Allen’s Techniques
  • Chaining Techniques
  • Attention Training Techniques
  • Sensory Stimulation Techniques
  • Errorless Learning Techniques
  • Meta-memory Exercises
  • Cognitive Rehab Dining
  • Appropriate iPad® Apps for Cognitive Therapy
Indirect Therapeutic Interventions for Dementia
  • Environmental Adaptations
  • Assistive Techniques for Cognition
  • Simulated Presence Therapy
  • Linguistic Manipulations
  • External Aids
  • Caregiver Education

Copyright : 01/22/2016

Module 3 - Rehabilitation to Support Memory and Cognitive Decline: Effective Interventions for Managing the Aging Brain

Program Information

Objectives

  1. Assess the advantages/disadvantages of the three most commonly used cognitive assessments.
  2. Implement effective evaluation/treatment interventions in the management of memory/cognition decline.
  3. Implement assessment tools that quickly determine a patient’s ability to retain new information.
  4. Characterize at least six conditions/comorbidities that impact cognitive/memory function.
  5. Categorize normal vs. abnormal cognitive/ memory deficits through the aging process and implement appropriate interventions for each stage.
  6. Implement the evaluation tools related to cognitive/memory deficits that are best for determining driving ability and driving skills assessment.
  7. Communicate the most up to-date evidence based resource information for patient/family education.

Outline

Spectrum of Cognitive/Memory Decline: Latest Research

  • Neuroplasticity
  • Reversible causes
  • Effect on Executive Function (EF)
  • Cannabis use

Memory Loss and Cognitive Impact: Clinical Examples

  • Normal memory/cognitive decline
  • Mild Cognitive Impairment (MCI)
  • Mild Alzheimer’s Disease (AD)
  • Moderate AD
  • Severe AD
  • Relationship to EF

Cognitive Assessments: Hands on Activities

  • MoCA
  • SLUMS
  • Trail Making
  • MMSE
  • ACLS
  • Stroop Color

Interventions for Contributing Factors

  • Depression and suicide: Assessments, referral needs, non-medication therapy
  • Sleep issues: Sleep log, sleep hygiene program, environmental strategies
  • Mental and physical inactivity: Brain stimulation activities, exercise programs/guidelines
  • Vision and hearing loss: Sharpen your observational skills, referral needs, lighting strategies

Interventions for Independence and Safety Issues

  • Falls: Computer-based training, decrease risk, increase reaction time, home safety checklist
  • Driving: Assessment tools, strategies for cessation of driving, state requirements
  • Medication: Self-medication management assessment tool, self-strategies for adherence, caregiver training
  • Home Management: Adaptive equipment, strategies for home safety, appropriate discharge environment
  • Communication: Strategies for working with caregivers and physicians

Interventions for Managing Memory/Cognitive Decline

  • Physical Exercise: Best type, program implementation, shoes
  • Communication: Creating stage appropriate handouts
  • Computer-based Cognitive Training: Use and evidence-based outcomes
  • Spaced Retrieval: Incorporating into treatment, baseline for patient education
  • Compensatory Strategies: Lists, calendars, skill set money management

Education and Resources

  • Caregiver: Burnout, support systems, community services
  • Medicare Guidelines: Documentation requirements, assessment facts
  • Web resources: Support groups

Copyright : 10/13/2017