Cognitive Impairments: Memory, Screening, and Intervention

presented by Karen L. McCulloch

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The purpose of this course is to provide an overview of the different ways that memory may be described and highlight common memory impairments that occur as a result of neurologic disease or injury. Particular emphasis will be placed on the procedural/non-procedural memory distinction as it relates to improving motor function in patients seen in rehabilitation.

Meet Your Instructor

  • Karen L. McCulloch, PT, PhD, MS, NCS

    Karen L. McCulloch, PhD, PT, MS, NCS, is a Professor in Physical Therapy in the Division of Physical Therapy, Department of Allied Health Sciences, School of Medicine at University of North Carolina – Chapel Hill, where she has taught entry-level and advanced-level students in neurorehabilitation since 1993. She has served in multiple roles within the Academy of Neurologic Physical Therapy, including the inaugural Director of Education, and has been honored with the Service to the Section Award and the APTA Lucy Blair Service Award. Karen has cared about individuals with traumatic brain injury since beginning as a PT in clinical practice, extending from moderate to severe brain injury to a recent focus on concussion. Her research has focused on developing outcome measures and interventions to improve active movement, balance, and functional mobility, with the aim to improve quality of life. She developed the Arm Motor Ability Test (for upper limb recovery following stroke) and the Walking and Remembering Test (for dual-task performance in older adults and individuals with acquired brain injury). She served as an ORISE Fellow with the Army Office of the Surgeon General, addressing TBI issues that affect individuals in military service. Her current research efforts are focused on wounded warriors with mild traumatic brain injury as part of a team that developed the Assessment of Military Multitask Performance, a test battery of challenging dual- and multi-task activities. She is currently leading a group writing a clinical practice guideline for physical therapy management of concussion, and is involved in intervention studies that address treatment for sports and military concussion. Funding support for her research has come from the Foundation for Physical Therapy, Centers for Disease Control and Prevention, National Institutes of Health, National Football League, and Department of Defense.

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Chapters & Learning Objectives

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  1. Memory Definition and Types

    1. Memory Definition and Types

    This chapter answers the question, "What is memory?" The taxonomy of memory (Squire) is covered. The instructor discusses ways to describe memory, including: time-based (working, short-term, long-term; retro and anterograde amnesia), content based (episodic, visuospatial, phonological), and systems (declarative/non-declarative).

  2. Screening for Memory Impairments

    2. Screening for Memory Impairments

    This chapter covers simple screening tools that identify memory impairments. Relative lack of clear procedural memory tests is discussed, as well as collaboration with OT, neuropsychology/psych, or speech-pathologist to understand memory strengths/deficits.

  3. Intervention in the Presence of Memory Impairment

    3. Intervention in the Presence of Memory Impairment

    This chapter covers structuring therapy – when memory is expected to improve and when memory is not expected to improve or may worsen. A case example is discussed that describes the training approach to capitalize on procedural memory as a relative strength.