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“Cognitive Simulation Therapy: Functional, Friendly and Free”!Presented By:Gina England MA, CCC-SLPSpeech and Language Pathologistgeseminars@Introduction to Cognitive Simulation Therapy:Professional literature for the field of speech pathology contains occasional references to “simulation therapy” or “simulated/virtual activities” within the context of therapeutic modalities relative to cognitive rehabilitation. The literature substantiates the need for a more functional approach to neuro-rehabilitation if we are to realize optimal functional outcomes in our current healthcare climate. This is especially relevant today as clinicians deal with reduced lengths of stay and limited outpatient benefits in their daily clinical practice. The incorporation of readily available and free websites into the cognitive therapy session is one way to achieve our mutual goal of optimal functional outcomes. Historical Foundations:* Treating patients in non-clinical areas of our facilities* Group therapy* Community re-integration* Main Streets within an existing facilityMore Current Foundations:* Simulation training is routinely being used to train allied health professionals. Why not our patients? * SIMU CASE Software* The Simulation Lab at Concord Hospital* Simulated classrooms at UNH for the nursing curriculum* Patient Simulation Training for Dysphagia – August 2016 ASHA PerspectivesClinical Rationale for Simulation Therapy:* Increased patient engagement secondary to the increased relevancy of the therapy activities* Personalization/individualization of treatment plans* Earlier development of a more functional home program component to support and reinforce the treatment plan* Therapy goal achievement – functional activities increase functional outcomes and are MeasurableOur Goal: To not necessarily train a particular skill set (e.g. medication management); but to target a specific executive function that will impact multiple skill sets. Internet Based Simulation Therapy – Live Demonstrations:Esl-* Originally designed as an English as a second language website – Randall’s Listening Lab* Auditory comprehension* Working and short term memory* Organization* Logic and :* Based on the popular tv show* Contains jeopardy style game boards for hundreds of topics* Personalization of therapy materials relevant to a patient’s occupation and/or areas of interest* Long term memory/recall* Fund of knowledge* Deductive :* Personalization of therapy materials relevant to a patient’s former or current occupation* Contains sample tests and exams for occupations that require a professional license* Also includes sample SATs for our younger patients* Long term memory* Deductive Reasoning Health.utah.edu/ot/colleagues/index.html * Simulates online shopping and online bill paying as a cognitive retraining activity* Also provides a comprehensive list/review of assessments that are available to the OTR Faculty.bucks.edu/specpop/topics.htm * Useful resource for cognitive retraining in younger and higher level clients seeking a return to school or work* Simulating classroom and homework activities* Organization, note taking, planning and new learning * Pre-recorded mini lectures typically 6-18 minutes in length including a vast variety of topics* Note taking skills* Short term memory recall and the practicing of STM strategies* Making inferences* Sustained Attention* Identifying Pros and Cons of a topic* Simulated A collection of short videos that provide the aphasic patient the opportunity to practice speech and language for community based encounters by answering questions posed by a real person in a community setting.Multiple settings and scenarios are included; all with a focus on community re-entry/participation.The aphasia patient can pause the video after the question has been asked in order to get more time to respond, or try to answer the question in real time.Some of the video participants have foreign accents which increases the challenge level.This resource performs best on a laptop or PC versus a tablet unless the tablet has good memory storage as there are a number of videos. This also affords the aphasic patient a larger screen in which to view the context of the scenario (location details).Web Based Resources: Websites (free,free,free)Website NameContent selection of community based background noise audio tapes designed to add additional challenges to your aphasia therapy Originally designed as ESL resource, but transcends nicely to language rehabilitation efforts. Extensive language based activities that can be worked directly on the computer screen or printed for Listening, reading, spelling and naming activities. Functions just like an app.Csuspeechandhearingclinic.Your very own aphasia workbook online! Use it directly on your computer.Suggested Therapy Activities: Obtain Job Description Use related licensing exams from Role Playing / Video Analysis Use Background Noise Videos on You-Tube to Increase Complexity of Cognitive Tasks Job Simulation Activities in the Clinic if Possible Constant Therapy App for Daily Home Program Functional Activities Teaching Self-Advocacy ScriptsReferences:Altschuler, Eric, Multari, Alicia et.al. “Situational Therapy for Wernicke’s Aphasia”. Medical Hypotheses; (2006) 67, 713-716.Cicerone, Keith, Levin, Harvey et.al. “Cognitive Rehabilitation Interventions for Executive Function: Moving From Bench to Bedside in Patients With Traumatic Brain Injury”. Journal of Cognitive Neuroscience; (2006) 18:7, 1212-1222.Klinger, E.,Kadri, A. et.al. “AGATHE: A Tool for Personalized Rehabilitation of Cognitive Functions Based on Simulated Activities of Daily Living”. IRBM; Volume 34, Issue 2, 113-118.Satish, U., Streufert, S., Eslinger, PJ. “Simulation-based Executive Cognitive Assessment and Rehabilitation After Traumatic Frontal Lobe Injury: A Case Report”. Disability and Rehabilitation; (2008); 30(6), 486-478.Zhang, Ling et.al. “A Virtual Reality Environment for Evaluation of a Daily Living Skill in Brain Injury Rehabilitation: Reliability and Validity”. Archives of Physical Medicine Rehabilitation; (2003); 84: 1118-1124. ................
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