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These systems are more likely to be impaired
higher complex systems- due to the amount of connections
How many categories of Attention are there
Four
Categories of Attention include:
Arousal/Alertness-focused attention
Vigilance-sustained attention
Selective Attention-filter
Capacity-divided attention
autonomic system with behavioral response
arousal/alertness
maintain alertness overtime
vigilance
filter and select specific information for a task
selective attention
ability to change focus
capacity
example of attention where you hear a loud noise and look toward that direction
alertness/arousal
example of attention where you sit in a lecture and pay attention
vigilance
example of attention where you talk on the phone while driving
capacity
regulates and maintains arousal/alertness ad supports in constant attentive state (sustained attention)
Reticular Activating System (RAS)
shift attention to incoming stimuli AKA fight or flight
colliculi
visual attention is located where
superior colliculi
auditory attention is located where
inferior colliculi
sensory info, relay info, and filtering located
thalamus
where does filtering occur in the thalamus
pulvinar nucleus
-fine tuned filter of visual and spatial aspects of attention;
-allocation of resources (alternating and divided attetion)
parietal lobe
select a response & inhibit overlearned responses (such as driving if in another country)
anterior cingulate
selection of response (initiate and inhibit)
&
selection of info to be held online occur here
frontal lobes
of parietal lobe, anterior cingulate, and frontal lobes, which have executive functioning
anterior cingulate and frontal lobes
three systems in the Posner and Peterson Model (1990)
Alerting, Orienting, and Executive
system in the Posner and Peterson Model (1990) that is contained in brain stem and parietal lobe (vigilance & sustained attention)
alerting
system in the Posner and Peterson Model (1990) that is contained in pulvinar nucleus & colliculi ; prioritizing sensory info
orienting
system in the Posner and Peterson Model (1990) that is contained in frontal and anterior cingulate
executive functioning
how we bring in sensory information
attention
three key memory components
encoding, storage, retrieval
how we process/analyze sensory info for storage
encoding
how information is stored
storage
how information is realled
retrieval
problem with encoding and storage (not able to make new memories)
anterograde amnesia (Dory)
problem with recall (can form new ones but don't remember past)
could be protective response to not remember what caused the TBI
rehearse and restore memories in order to consolidate
short term into long term memories
brain will fill in the gaps, which is called __________ with memory- might not recall it all exactly right
confabulations
memory you can declare or verbalize
explicit
memory of facts, figures, and anatomy that is overrehearsed and automaic recalling
semantic
you cannot have _________ memory loss
semantic
memories based off of episodes you have had (riding a bike, christmas events, first day of OT school)
episodic
remembering things you have to do in the future
prospective memory
two types of prospective memory
time based and event based
most difficult type of prospective memory
time based
prospective memory that is more difficult; no cues, more of a frontal process,
time based prospective memory (have to do everyday at 3 pm)
easier prospective memory that is in the cortical; more autonomic; things in the environment cue you
event based prospective memory
where encoding, storage and retrieval occurs
formation of new memories
hippocampus
encoding and retrieval of LTM
-circuits with hippo to support and encode new memories
-aids in retrieval (those with damage here tend to confabulate)
frontal regions
retrieval and item recognition
left parietal cortex
procedural and motor learning
striatum
links memory and emotion; classical conditioning
-mediates learning and expression of emotional responses to stimuli
amydgala
components of Baddeley Working Memory Model
central executive
visuospatial sketch pad
phonological loop
episodic buffer
prospective actions, retrieval of LTM, integrating new info, and attn control system
central executive
holds visual and spatial information
visuospatial sketch pad
holds verbal and auditory information
phonological loop
integrates information and chunks them together to store and retrieve later
episodic buffer
an umbrealla term for a host of cuntions that allow people to plan and organize
executive function
increased of activation in these areas during early/mid phases of skill acquisition
prefrontal
as skill develops ______activation decreases ad we are able to accomplish with less cognitive processing
prefrontal
integration center for executive functioning
frontal lobes
used to describe and explain behavoior; as an assessment for planning
theoretical frameworks
theoretical framework that explains exec. fun. as one single system
-damage to one system causes dysfunction
-not widely accepted
single system theories
framework for exec.fun. that says one costruct (working memory/intelligence) is the key to exec. fun.
-working memory is most common (Baddeley)
construct-ed theories
most prominent theories that use mult. systems together to compormise exec. fx
-automatic / routine vs controlled/ novel
multiple process theories
Shallice's Four levels of behavior
action units
schema
contention scheduling
supervisory attentional system
includes basic abilities (reaching for object)
(Shallice's level of behavior)
action units
actions closely associated with eachother through repetition and practice
(Shallice's level of behavior)
schema
action selection based off incoming stimuli (thoughts) and schema (what is known)
-quick selection of routine behavior in well known behaviors
(Shallice's level of behavior)
contention scheduling
conscious controlled planning
(Shallice's level of behavior)
supervisory attentional system
automatic levels of behavior
(Shallice's level of behavior)
action units
schema
contention scheduling
conscious alteration and control level of behavior
(Shallice's level of behavior)
supervisory attentinoal system
knowledge about ones own cognitive abilities and functional limitations
awareness
three levels of awareness
intellectual, emergent, anticipatory
self-awareness; knowledge of limitations
(levels of awareness)
intellectual awareness
on-line moitoring; ability to recognize they are having a problem while it is occuring
(levels of awareness)
emergent awareness
on-line moitoring; ability to anticipate problem before it occurs
(levels of awareness)
anticipatory awareness
first stage in CFE
occupational history
second stage in CFE
cognitive sceening/ baseline
examples of cognitive screening/baselines for CFE
short blessed
MoCA
examples of higher level cognition
EFPT, Kettle, AMPS, MET
cognitive test for specific domains (attention, memory, apraxia, agnosia, aphasia) include
TEA, FAST, BIT
cognitive tests in occupations
A-ONE, EMQ
stages in the process of the CFE
1. occupational history
2. screening and baseline test
3. general measures of cognition and EF in occupations (OT specific)
4. cognitive test for specific domains (may be other domains)
5. measures of specific domains in occupations
6. environmental measu
which states are mandatory in the CFE
1,2,3 you always do, 4 or 5 & 6
purpose is a brief screening to assess cognitive impairment and record changes ocertime -dementia in geriatric population
11 questions, 7 domains
Mini Mental State Exam (MMSE)
purpose: short screening of cognitive impairment used in screening for dementia
6 questions (0-4 = no impair; 10+ = impairment)
Short Blessed Test (SBT)
correlated closer to _____ is best
1.0
purpose is to rapidly screen for mild cognitive dysfunction
16 items in 11 categories
Montreal Cognitive Assessment (MoCA)
performance based assessment of Executive functioning that is addressed to gaps in performance based assessments (work oriented and clinically feasibile)
work simulated library
-inventory control (primary task)
-phone messages (secondary task)
-tell time
Complex Task Performace Assessment (CTPA)
A number of discrete and different tasks have to be completed.
many tasks
performance needs to be dovetailed in order to be time-effective
interleaving required
due to cognitive or physical constrains; only one task at a time
one task at a time
things won't always go as planned
interruptions and unexpected outcomes
time for a return to task already running task is not signaled by situation
delayed intentions (prospective memory)
task differs in proprity, difficulty, and length
differing task characterstics
people decide for themselves what constitutes adequate performance
self determined targets
no minute by min performance feedback
no immediate feedback
developed to localize brain lesions and help with diagnoses, shift focus to examine behavioral manifestations
traditional assessment
prediction of everyday life function, self identified limitations with current assessments
neuropsychological assessment
can have _____________deficits in absence of identified impairment on neuropsychological assessments
performance-based executive function deficits
examples of neuropsychological assessments
D-kefs and BADS
validity relatable to the real world
ecological validity
test results can predict real world performance
verdicality
has to look like the real activity
versimilitude (similarity of the assessment and the real world)
this assessment has four performances of ADL tasks (cooking telephone use, medication management and bill paying) & level of independence is recorded and categorized into initiation, organizatoin, sequencing, judgement and safety, and completion
EFPT
IADLS assessment in clinic or home to measure basic and higher level cognition graded 0-4 (0= intact performance, 4= assistance)
kettle test
consists of 26 core tasks, categorized in 4 functional domains
5 functional mobility
3 personal self care
14 IADLS with cognitive emphasis (CIADL
4 IADL with physical emphasis (PIADL)
Performance Assessment of self care skills (PASS)
performance based assessment of EF
-client is asked to enter appointments into a calendar
-there are rules to remember
Weekly Calendar Planning Activity (WCPA)
list of ADL and IADLs and client and OT chooses 2-3
Assessment of Motor and Process Scale (AMPS)
based off of six ADL tasks (dressing shopping making toast phone, wash and travel)
cognitive performance test (CPT)
pediatric version of EFPT that mimics cooking tasks of EFPT with playdough
Children Kitchen Task Assessment (CKTA)
designed to simulate how a person would performn an activity in everyday life that requires executive functioning
-shoppig task in a hospital district
-6 simple tasks (buy a loaf of bread)
1 prospective memory task
1 demanding tasks
MET