presented by Rob Winningham
Many times cognitively impaired patients are unable to learn basic ideas and compensatory strategies, which impedes progress in learning new motor behaviors and reduces the ultimate efficacy of therapy. In this course, we will discuss many strategies and interventions designed to enhance some patients’ abilities to encode new declarative memories. We will discuss short-term strategies that can be used without cognitive rehabilitation, and then we will discuss longer-term interventions. We will also work to overcome the possible challenge of creating interventions that yield improvements that generalize beyond the specific task or exercise done in the clinic. This course is the third of a five-part series.
Dr. Rob Winningham has 25 years of experience researching human memory and has largely focused on older adults and ways to enhance their mental functioning and quality of life. He creates brain stimulation activities for over 10,000 retirement communities and rehabilitation facilities as a part of Dr. Rob’s Cranium Crunches on activityconnection.com and helps create cognitive stimulation video games for linkedsenior.com and other companies. Dr. Winningham has served as Dean of the College of Liberal Arts and Sciences and Chair of the Behavioral Sciences Divisions at Western Oregon University where he is also professor in both the Psychological Sciences and Gerontology Departments. Dr. Winningham received his Ph.D. in Neuroscience from Baylor University. He has trained thousands of professionals to offer high quality cognitive rehabilitation and therapy programs. In addition to publishing many peer-reviewed articles in the area of human memory, Dr. Winningham has been invited to given well over 1000 invited presentations about memory and aging at various conferences and workshops. His book, Train Your Brain: How to Maximize Memory Ability in Older Adulthood was published by Baywood Publishing and his latest book was published in 2016 and is entitled Cranium Crunches. For more information go to: www.robwinningham.com
The idea that encoding new memories is based on rehearsal is not complete. In order to maximize cognitive ability, executive functioning in general and attention in particular must be maximized. The importance of these principles is demonstrated, and strategies are introduced that therapists and other professionals can use to maximize attention, in the moment, even without long-term cognitive rehabilitation. Common challenges experienced when people lose inhibitory abilities are also discussed.
Testing clients has a number of positive benefits, including focusing clients on the to-be-remembered information and giving them rehearsal trials. We will discuss how to take advantage of retention testing, in an effort to help people make new declarative memories and learn new compensatory strategies.
Another empirically supported strategy to enhance executive functioning and attention is the Generation Effect. The Generation Effect refers to an enhanced ability to remember ideas, information, or compensatory strategies that one actively figured out versus having the information passively presented. Visualization and the use of signs are also explained in this chapter.
Caregivers can either impede therapeutic progress by doing things for their clients that the clients are able to do, or caregivers might impede learning by supporting behaviors in a different sequence than the therapist was trying to do. Clients can get additional rehearsal trials by explaining to their caregivers how they need to perform a certain task. We will discuss how a quick conversation with a caregiver can improve therapeutic outcomes.