What is Cognitive Rehabilitation?
People who experience brain injuries often experience cognitive impairment and emotional difficulties that can interfere with their daily functioning and interpersonal relationships. Cognitive difficulties typically can include impairment in executive functions (planning, sequencing, initiation, inhibition, flexibility in thinking), complex attention, problems producing or understanding language, different aspects of memory, motor control and difficulty controlling behavior. Emotional symptoms typically include anxiety and depression, but may also include personality changes. Cognitive rehabilitation refers to therapeutic techniques that help improve such cognitive difficulties and help individuals develop skills to compensate for cognitive limitations resulting from brain injury of stroke. The techniques used are carried out by a professional certified and trained to administer cognitive rehabilitation interventions, such as a neuropsychologist. The goals of Cognitive Rehabilitation differ depending on the, age, injury, symptoms, and time since injury, abilities of each individual, type of injury, extent of the injury, and educational achievement, but techniques used generally focus on increasing behaviors that promote overall brain health, promoting optimal cognitive functioning, and learning skills to compensate for areas of difficulty. Research suggests that patients of all ages can benefit from cognitive rehabilitations, but that it is important to begin cognitive rehabilitation as early as possible to receive the most benefit. Ideally, patients should begin treatment less than a year after injury as those patients tend to experience the most improvement.
Cognitive Retraining
Cognitive retraining may involve practicing one area of cognition (attention, memory, visuospatial
processing)in an attempt to restore the ability through practice and mastery. For example, visuospatial
training can help with difficulties orienting to or responding to objects, or pictures shown on the side opposite to the site of the injury, attention training is a technique used to help people with brain injury to improve attention, and language training can help with problems producing and/or comprehending language that are often experienced after a stroke. Such retraining techniques often include specific drills and exercises, using paper and pencil tasks, computerized programs, and these activities are done both at home and in a clinical setting.
Compensatory Strategies
An alternative strategy involves compensatory strategies, which can be developed to help a patient use things in their environment to make up for difficulties in cognition. For example, a memory book can be useful for someone who has difficulties remembering things like appointments or even what they do on a day-to-day basis. Other compensatory tools include pagers, alarms or PDAs, and computerized software programs that can be used to help an individual experiencing memory, organizational and everyday planning difficulties.