Jerry Hoepner – Cognitive Rehabilitation

Rehabilitation of cognitive impairments is becoming increasingly complex. Your patients present with multifaceted, complex cognitive impairments.-Cognitive deficits that are multifaceted. You only have 48 minutes per day, five days per semaine, to learn and improve their cognition.

Jerry Hoepner – Cognitive Rehabilitation

Cognitive-Linguistic Assessments

• Screening tools
• Cognitive Evaluations (standardized and not)-standardized)
• Language assessments, both standardized and unstandardized-Standardized as they are applicable to cognitive assessments
• Rating scales (provider/consumer)

Cognitive Rehabilitation Techniques

• Remediation/Compensation/Adaptation
• Therapy decision-Making (dynamic/ongoing assessment; patient-centered; goal-directed)

Documentation of Skilled Services

• Justification for skilled, reasonable and necessary therapy
• ICD-9 / ICD-10 codes relevant to SLP intervention
• SMART goals
• Outcome measures
  • FIMS
  • NOMS
    • Relevance to G-Codes
    • A guide for developing LTG’s
• The following are key elements:
  • Daily notes
  • Notes on progress

Attention

• Posner’s Theory of Attention
• The attention system’s anatomic substrates
• Attention subtypes
• Functional manifestations inattention
• Strategies for improving attention across the recovery continuum
  • Remediation
    • The management of stimulation programs through wakefulness
    • Reduction in agitation (validation Therapy, Environmental Modification, Positive Psychology)
    • Increased function through direct attention training with reflection
  • Partner – Compensatory strategies-Environmental interventions, based support
  • Adaptation techniques (assisted prompting)
• Goal writing for attention deficits

Memory

• Anatomy and function of the memory systems
• Memory types
• Encoding/Consolidation/Retrieval
• Interventions to facilitate recall
  • Remediation
    • Utilization of preserved system (spaced retrieval routines implicit learning, routines, and routines)
    • Adaptation techniques
  • External aids
  • Task-Particular learning
  • Goal writing for attention deficits

Executive Functions (EF).

• Anatomic substrates of EF System
• McCloskey’s Executive Functions
• Hierarchy for executive function
  • Self-activation
  • Self-Regulation
  • Self-realization
  • Self-Determine
• Functional manifestations of EF impairments
• Specific focus areas for EF’s
  • Problem solving in functional areas
  • Awareness/Insight
• Strategies to reduce the impact of executive dysfunction
  • Remediation (Reflection, video self-modeling, Ylvisaker’s Goal-Plan-Do-Review)
  • Partner, compensation (routines, interventions in the environment, partners-(Based interventions)
  • Adaptation (cognitive prothetics)
• Problem solving and goal writing

Visual Perceptual Function

• Anatomy and function of the visual system
• Warren’s Visual Perceptual Hierarchy
• Visual perception deficits are a functional manifestation
• Special therapeutic strategies to:
  • Low vision
  • Hemispatial neglect
  • Remediation (known amounts, metacognitive/self).-Regulative interventions
  • Compensation (environmental interventions) for the partner-Bookness, edgeness, and based interventions
  • Adaptation (visual/attentional prothetics)
• Writing goals for visual perceptual impairments

Be aware of the following special considerations

• Delirium
  • DSM-5® criteria for delirium
  • The neuroscience behind delirium
  • Diagnosing delirium
  • Preventive, protective and precipitating factors to delirium
  • Reversible causes for delirium
  • Treatment techniques for delirium
• Depression
  • Geriatric depression: Clinical signs
  • Depression can be caused by certain medications
  • SLPs role in the treatment of depression
• Right Hemisphere Dysfunction
  • RHD Assessment Tools
  • RHD clinical manifestations
    • Left hemispatial neglect
    • Pragmatic impairment
    • Sensitivity/Intelligence: Reduced
    • Cognitive impairment

Particular Therapy Activities

Case Studies

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Description:

Rehabilitation of cognitive impairments is becoming increasingly complex. Your patients present with multifaceted, complex cognitive impairments.-You only have 48 minutes five days a week to help them understand their cognitive impairments. Keep up with the ever-changing information-Changes in evidence concerning assessment and treatment for acquired cognitive disabilities can seem daunting. You may have forgotten what you learned in graduate training programs. You are also better prepared to apply your knowledge in the clinical setting. We will discuss how anatomy and physiology can be applied in daily practice, and the importance of current knowledge.-Effective clinical practices and the ability to adapt to new evidence-based practices. Join Jerry HoepnerCCC, PhD-SLP to gain a better understanding of cognitive impairments and organize cognition in a manageable framework. Functional goals will guide your therapy.

• Cognitive-Linguistic Assessment Tools
• Documentation required for reimbursement
• Attention
• Memory
• Executive Function Skills
• Visual Perceptual Function
• Dementia, Depression and Right Hemisphere Dysfunction

Dr. Hoepner You will learn how to properly create a plan for care and help patients function better. Take this information.-Attend a packed seminar to systematically learn the anatomy of each cognitive component-Communication system and quickly move into specific management techniques. You will leave with practical, useful and immediately applicable techniques that you can implement in your practice. Dr. Hoepner You will be able to go beyond lecturing and encourage learning through a collaborative exchange relating therapy techniques.

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