1.  Neuroscience

2.  Neuropsych

3:  Psych (learning theory, cognitive info processing concepts)

4. Dynamical Systems Theory

1. Processes by which sensory input is transformed, reduced, elaborated, stored, recorded, and used

2.  The ability to process, store, retrieve, and manipulate information

3.  The capacity to take in, organize, assimilate, and integrate new information with previous experience and to adapt to the environmental demands by using info previous acquired to plan and structure behavior for goal attainment.

It is part of the mind body system in which cognitive functions cannot be understood fully w/o reference to the motor system. 

Information coming into the cognitive process is gathered by the body through the senses as well as being generated through bodily actions

Cognitive Disabilities:  identify the extent of client's cognitive limitation and adapt tasks and the environment accordingly.  Assumes that task involvement does not change functional capacity

Neurofunctional training:  training in a very specific compensatory strategy or training in a specific functional task.  Requires learning to perform relatively simple procedures under controlled conditions with sufficient repetition tso that behavior becomes highly habituated and automatic

Preservation, transformation, and transfer of info through 3 distinct stages.

1.  Sensory perceptual memry

2.  working memory

3.  LT memory

Cognition is a dynamic self organizing phenomenon.  Its not just a function of underlying neurological integrity and personal cognitive capacities

Cognitive processes emerge from the interaction of multiple factors, both inside and outside the person interacting together

It views cogniton as a dynamic, simulationeous interaction of:

1.  Structural Capacity

2.  Personal Capacity

3.  Self Awareness

4.  Processing Strategries

5.  Environmental Factors

"Self awareness, personal and structrual capcities, processing strategies, environmental factors"

Selecting, Organizing, Using, Processing

Performance Anticipation, and Monitoring

1.  Remedial/Restorative Logic-  To remediate or restore logic

2.  Adaptive or compensatory logic

3.  Cognitive Disabilties (when learning is restricted)

4.  Neurodisabilities (when learning is restricted)

5.  Process Oriented

Therapy that capitalizes on their existing potentials.  Use strategies to substitute or compensate for limitations.

Accordingly, individuals should be made aware of their cognitive limitations and learn to compensate for their problems using their remaining abilities

Learning and transfer of learning

Higher-level cognitive processes (awareness and executive conrol)

It examines how and under what conditions a client shows a problem, the strategies a client uses to process information, and how such strategies succeded and fail under different task and environmental conditions.

The therapist identifies task and environmental dimensions that created difficulty for the client

Client information-processing difficulties that create problems

Treatment is then individualized, taking this information into consideration

1.  Occupational/functoinal consequences of impaired cognition

2.  Assessment of cognitive components

3.  Dynamical Assessment

4.  Determination of level of cognitive impairment/function

1.  Observe them during task performance and take note of their processing strategies, functional impairment, overall cognitive level

2.  Interview to gather information on the clients awareness of cognitive impairments, lifestyle

3.  Standardized tests (verbal, paper and pencil, tabletop) for screening cognitive proglems, deermining extent of impairment, assessing specific cognitive abilities

It looks at how cognitive impairments affect function, satisfaction, lifestyle.  Then place the impairment in the occupational context

We need to determine:

1.  The extent to which cognitive limitations restrict independence and affect safety

2.  The impact of the impairment in the larger occupational life of the person

Used to identify the extent and nature of underlying cognitive deficits to understand why performance is breaking down

Can focus on higher cognitive functions (executive functions and awareness) and lower and specific cognitive functions

Probs w awareness are inferred by:

1.  comparing a clients verbal report or rating of impairment with a more objective measure

2.  comparing a clients verbal report or rating impairment with a more objective measure

3.  comparing a clients predicted with actual task performance

4.  Examining a persons ability to choose tasks within abilities and to detect and correct errors

Can include a wide range of strategies

Should include tabletop, functional, and observational measures

Assessments that involve functional tasks are most preferable and most ecologically valid means to uassess executive function

Problem discovery (identifying where and how performance breaks down) and problem-solving (identifying and testing strategies for solving probs)

Toglia says that dynamical assessment includes:

1.  Determing a clients self-perceptions of performance

2.  During task performance, the therapist observes and seeks to facilitate changes in performance by using cues, strategy teaching, and changes in task

3.  After task performance, asking clients for perceptions of their own performance

Quadraphonic approach:  has 7 levels focused on the degree of dependence/independence.  Functional level is determined by a variety of sources and the functional level is used as a basis for identifying goals and intervention strategies

The cognitive disabilities approach:  proposes a continuum of cognitive impairment/functioning.  it is divided into 6 kevels

1.  Interview/background info on occupational history

2.  Cognitive screening and baseline tests

3.  Observing cognition in occupational task performance to determine the influence of the persons cognitive problems on performance

4.  If warranted, cognitve tests to identify the nature and extent of problems in specif cognitive domains (spatial neglect, attention, memory, and executive function)

5.  Observation/measure of the influence of specific cognitive deficits on daily functions

6.  Determine the resources and barriers in the clients environment

1.  Remedial- is suitable for those with mild to moderate unawareness and capacity to learn.  It may be educationing the client about their impairment or helping the client experience the impairment in activity.  Remedial treatment of executive functions:  includes providing persons with opportunities to choose, select, plan and self correct

2.  Compensatory approach;  stresses environmental adaptations and using behavior approaches to extinguish maladaptive behaviors stemming from unawareness.  Compensatory provides external support or strategies to allow adequate performance

It is based on the principle that performance can be modified by changing any or all of the following:APE

1.  Activity Demands

2.  Person's use of strategies and self-awareness

3.  Environment

it emphasizes training in awareness and info processing strategies that imporve performance.  Use activity analysis to id opportunities for task modification and make sure to have them practice in multiple contexts

it is designed for persons with stroke and TBI.  Aims to broaden the persons capacity to process information, transfer and genrealize it to functional areas, improve awareness avoid entering situations beyond capacities, and use alternative more effective cognitve strategies

Cognitive Retraining focuses on:

1.  Enhancing remaining abilities and using supports to maximize success and minimize frustration

2.  Individual or group training in suitable cognitive strategies

3.  Uses specific structured teaching-learning strategies

4.  Training in procedural strategies (how to do specific routine tasks in a structured environment)

For clients with severe cognitive impairments...NFT uses two main strategies

1.  Training clients in highly specific (task or context) compensatory strategies

2.  Specific task training to assist clients to perform a given functional behavior

It emphasizes cognitive overlearning.  repeated short practice sessions in a controlled environment until it becomes habituated.  NFT uses the behavior techniques of cueing, chaining, and reinforcement.  NFT emphasizes avoiding errors bc the clients targeted by this approach do not learn form their mistakes and therefore repeat them

Potentially relevant to all populations.  Mediated learning to affect the cognitve structures (behavior patterns and learning sets)  that set the course of cognitive development and shape the learning capacity of the person.

The therapist is the mediator, and the therapist should:

1.  Increase intentionality of the client and raise his/her awareness of the way he/she acts

2.  Help the client look beyond immediate needs and concerns to make generalizations

3.  Raise the individuals awareness and understanding, making explicit the reasons and motivations for doing things

4.  Help the individual feel a sense of competence and ability in task performance

Cognitive intervention for improving motor performance in children with developmental coordination disorder.

COOP is a strategic sequence of identifying a goal, planning, doing, and checking.

COOP is a process of guided discovery that seeks to scaffold learning; the child is supported to find out how to do the task at hand.  The therapist asks guiding questions and coaches the child toward finding strategies to improve performance