In the world of neuroscience, the word “cognitive” means how you think, reason and perceive the world around you. When the brain is damaged – from a traumatic injury, illness or stroke, many times the cognitive functions are interrupted. In order for the person to be able to return to some sort of normalcy they will need rehabilitation to retrain their brain. This rehabilitation is called “cognitive retraining” or “cognitive rehabilitation.”
The purpose of cognitive retraining is to reduce the problems associated with brain injury, mental disabilities or the onset of mental problems due to aging. Overall, the purpose of the therapy is to allow the patient to be able to function in everyday life, and learning to live with their disabilities and improve their quality of life.
There are two parts to cognitive rehabilitation:
- Restoring the lost skills
- Compensating for lost or impaired areas
Restoring skills is similar to rebuilding muscle tone, it involves exercise that will rebuild lost or impaired skills such as attention, memory, concentration, perception, organization, problem solving and judgment. This could include computer programs designed specifically to interpret what we see (visual-perception); our reflexes; concentration and memory games; blackboards to practice mathematical skills; workbooks and puzzles to help with math, memory, reasoning and visual perception; and strategy games. Material should not be too difficult, or too easy, but challenging enough to build new neurons and strengthen the ones that already exist.
Therapists will help the patients to practice “thinking on their feet,” and simulate real-life situations like going to the grocery store or preparing a meal. They will tailor the plan to meet the needs of the patient, and increase the activity level as they go along.
Compensating techniques in rehabilitation involve learning to use strategies or memory tools to strengthen weaker areas of the brain. Strategies are planned to help each patient utilizes their strengths to compensate for the damaged areas. Learning these tools will not only make up and reroute weakened areas in the brain, it could actually rebuild the skill itself. For example, using a checklist may actually improve attention skills.
Any therapy has to be tailored to the individual’s needs and abilities. Some cognitive retraining techniques may require higher skill levels, and may be applied only after the patient has made significant progress in their recovery.
The mental state of the patient also must be taken into consideration. The majority of people who have been injured, and realize they need to relearn a skill they had mastered as a child, or may never be able to do something that was routine to them before, go through mental stages similar to grief. One of the most common mental areas that need to be addressed before any therapy can begin is depression. They may need help from a mental health professional, and medication, before they begin work on their cognitive or physical skills.
Repetition is essential in cognitive retraining. In order for someone to master a task they have to repeat if over and over again until it becomes automatic. Feedback is another important element of cognitive retraining, and the use of rewards as an incentive.
Retraining usually begins with simpler skills and proceeds to more complicated ones. The therapist may address cognitive skills while the person is practicing real-life tasks to enhance their performance. In fact, practicing skills in the ways and settings they will be used in real life is critical to the success of retraining efforts.
It is possible that someone may be able to master a difficult task in one setting, like the hospital, but not be able to adapt once they get home. Before a patient is released they have to be able to show they can transfer their abilities to everyday settings just as easily as they did in the hospital – and maintain that progress over time.
The length of time for cognitive training can vary, depending on the type and extent of the injury or damage, and they type of skills that need to be mastered. It can go from just a few days or weeks, to months or years to retrain someone to organize his or her home or workplace for them to function. The use of computers for cognitive retraining has become an increasingly common practice.
About the author:
Ron White is a two-time U.S.A. Memory Champion and memory training expert. As a memory keynote speaker he travels the world to speak before large groups or small company seminars, demonstrating his memory skills and teaching others how to improve their memory, and how important a good memory is in all phases of your life. His CDs and memory products are also available online at BrainAthlete.com.
Sources:
Everyday Ways to Stay Sharp
Want to keep your brain in shape? Work it: http://www.aarp.org/health/brain-health/info-08-2008/noodle_boosters.html
