This text-based course is a transcript of the live event, “Cognitive Rehabilitation of Children and Adolescents: Practical Strategies for the Home, Community, and School Environments,” presented by Stephanie Mayer Volker, M.S. CCC-SLP.
>> Amy Hansen: Welcome to our ESS seminar, “Cognitive Rehabilitation of Children and Adolescents: Practical Strategies for the Home, Community, and School Environments,” presented by Stephanie Volker. Stephanie is a speech-language pathologist II at Cincinnati Children’s Hospital Medical Center and is the team leader of Cincinnati Children’s outpatient neurorehabilitation team. She has specialized in rehabilitation for children, adolescents, and adults her entire career, and is an AACBIS certified brain injury specialist. She has lectured on a variety of topics related to brain injury rehabilitation and compensatory strategy training. Welcome Stephanie and thank you for sharing your expertise with us.
>> Stephanie Volker: Thank you for joining today. Just a note that I have two other courses available on SpeechPathology.com which I may be referencing throughout today’s session. They are about developing compensatory strategies for a more functional treatment approach of traditional speech-language therapy issues as well as cognitive issues in both the home and the school environments. Today’s session will focus more specifically on the framework for cognitive rehabilitation for the pediatric population. I will highlight some practical strategies for you to implement in your practice. We will cover the basics of cognitive rehab, some factors to consider when you apply cognitive rehabilitation theory and practice in the pediatric population, the components of a cognitive rehabilitation approach - a step-by-step process which I follow when I am providing therapy. There are 10 steps, but we will cover the first 5 today. We will also discuss case studies and practical strategies.
Efficacy of Cognitive Rehabilitation
There is a big push for evidence-based practice now to make sure we know what we are doing, why we are doing it, and whether or not it works. There have been substantial literature reviews and studies which generated substantial evidence to support intervention for attention and memory, social communication skills, and executive functions after a traumatic brain injury (TBI). An article by Cicerone et al. (2011) gives a lot of great information about the efficacy of cognitive rehabilitation. Some of this information is given below.
- There is substantial evidence to support interventions for attention, memory, social communication skills, executive function, and for comprehensive-holistic neuropsychologic rehabilitation after TBI (Cicerone et al., 2011).
- There is substantial evidence to support cognitive rehabilitation for people with TBI, including strategy training for mild memory impairment, strategy training for post-acute attention deficits, and interventions for functional communication deficits (Cicerone et al., 2005).
- There is Level 2 evidence that behavioral and cognitive skills post ABI can be improved by participating in neurorehabilitation or neurobehavioral programs (Braunling-Mcmorrow et al., 2010).
- There is substantial evidence to support the use of direct attention training and metacognitive training after TBI to promote the development of self-directed strategies during post-acute rehabilitation and foster generalization to real-world tasks (Cicerone et al., 2011).
- Self-directed strategy training is recommended for the remediation of mild memory deficits after TBI (Cicerone et al., 2011).
- For impairments of higher cognitive functioning after TBI, interventions that promote self-monitoring and self-regulation for deficits in executive functioning (including impaired self-awareness) and social communication skills interventions for interpersonal and pragmatic conversational problems are recommended after TBI (Cicerone et al., 2011).