1. Shayla Haynes
2. Signs/Characteristics
   1. • Inability to do simple tasks
   2. • difficulty in initiating/completing a task
   3. • difficulty in switching from one task to the next
   4. • diminished capacity to locate visually or to identify objects necessary for task completion
   5. • inability to follow simple one step instructions, despite apparently good comprehension
   6. • may make the same mistakes over and over
   7. • activities may take an extremely long time to complete or they may be done impulsively
   8. • may hesitate many times, appeared distracted & frustrated, & exhibit poor planning
   9. • frequently inattentive to one side of the body & extrapersonal space, & may deny the presence or existence of their disability
3. Cognitive Deficits
   1. Attention Disorders
      1. 4 Types of Attention
         1. Sustained
         2. Focused/Selective
         3. Alternating
         4. Divided
   2. Memory Disorders
      1. Levels of Memory
         1. Immediate Recall
         2. STM
         3. LTM
4. Higher-Order Cognition Deficits
   1. Executive functions
      1. Volition
      2. Planning
      3. Purposive Action
      4. Effective Performance
5. Perception Deficits
   1. Body Scheme/body image disorders
      1. Unilateral neglect
      2. Somatoagnosia
         1. Inability to ID/orient one's body parts or others'
      3. Right-Left Discrimination
      4. Finger Agnosia
      5. Anosognosia
   2. Spatial Relation Disorders
      1. Difficulty perceiving relationship between self & 2+ objects
      2. Figure-Ground Discrimination
      3. Form Discrimination
      4. Spatial Relations
      5. Position in Space
      6. Topographic Disorientation
      7. Depth and Distance Perception
      8. Vertical Disorientation
   3. Agnosias
      1. Can't recognize object w/1 sensory but can with other sensory
   4. Apraxia
      1. Impairment of voluntary skilled learned movement
      2. Ideomotor Apraxia
         1. Disconnect between idea of movement & its motor execution
            1. can't move on command but can move automatically
         2. Buccofacial Apraxia
      3. Ideational Apraxia
         1. Failure in the conceptualization of the task
            1. can't move on command or automatically; doesn't know how to do it
6. Standardized Tests
   1. MOS
   2. SF-36
   3. TOM
   4. COPM
   5. RNL
   6. FIM
7. Intervention/Treatment
   1. Retraining/Transfer-of-Training Approach
      1. skills learned from one task can generalize to others; the transfer of training approach
      2. Remediation of underlying skills the pt. lost &it can generalize to other skills
      3. approach is based on: a disruption in one brain region can have a neg impact on brain functioning as a whole
      4. practice in one task w/particular cognitive or perceptual reqs will enhance performance in other tasks w/similar perceptual demands
      5. retraining cognitive and perceptual processes for generalizability/transfer of learning to occur
   2. Sensory Integrative Approach
      1. adaptive responses influence the way the brain organizes & processes sensation-->enhanced learning ability
      2. By offering opportunities for controlled sensory input, the PT can affect normal CNS processing oof sensory info & thus elicit specific desired motor responses
      3. The performance of these adaptive responses, in turn, influences the way in which the brain organizes & processes sensation, thus enhancing the ability to learn
      4. ie: rubbing or icing to provide sensory input, resistance & WB to impart proprioceptive input
   3. Neurofunctional Approach
      1. Retraining Real World Skills
      2.  Have to Do the task exactly how the pt would do b/c generalizability isn’t possible/believed  If pt used to walk down stairs carrying a bag while talking on the phone, u have to rehab doing exactly that
      3. says transfer of learning doesn't occur and thus must practice every activity in its true context in order to recover fnx
   4. Rehabilitative/Compensatory (Functional) Approach
      1. most widely used in treating perceptual deficits
      2. says that pts w/brain trauma will have difficulty generalizing & learning from dissimilar tasks. Direct repetitive practice of specific functional skills that are impaired is an efficient means of enhancing pt's independence in those specific activities
      3. ie: Pt w/difficulty in depth & distance perception who is unable to navigate a flight of stairs would be made aware of deficit, provided with external cues to compensate & would repetitively practice adapted techniques for safe stairclimbing. The more closely the therapeutic practice situation resembles home situation, the less generalizing is required & the more success the patient is likely to have when returning home
      4. in this a functional approach, therapy is viewed as learning process that takes into consideration the unique strengths & limitations of the individual patient. Is composed of 2 complementary components:
         1. Compensation
            1. ie Pt w/ visual field cut, PT should explain and make patient aware of deficiency/visual problem; patient should then be shown how to turn the head to compensate for the deficit of only seeing half of the environment. Can incorp scanning as well
         2. Adaptation
            1. alteration of the environment
   5. Cognitive Approach
      1. Training to structure & organize info & carryover to functional activities
         1. ie: using multi environments in which to carry out training activity to enhance transfer of learning; analyzing characteristics of task to establish criteria to determine a transfer of learning and that took place; providing training to make the patient aware of abilities, the level of difficulty of task, & promote self-examination of performance; relating new information or skills to previously learned ones
      2. Quadraphonic Approach
         1. is an interactive rehab approach that provides a holistic perspective for the management of stroke, TBI, brain tumors, CP, & other neurological disorders
         2. Uses both a micro & macro perspective for evaluation & treatment
            1. Macro: mgmt guidelines of fnxal performance & real life occupations
            2. Micro: mgmt guidelines of performance components/subskills that incld attn, visual perception, memory, motor planning, postural control & prob solving
            3. Eval & tx incorps 4 theories: Information Processing; Teaching/Learning; Neurodevelopment; Biomechanical
8. KR vs KP
   1. KR-Correct outcome Attained?
   2. KP-How task accomplished?
9. Memory Retraining
   1. Remedial Approach
   2. Compensatory Approach