The Intensive Cogni.ve-Communica.on Rehabilita.on (ICCR) Program for ...

The Intensive Cogni.ve-Communica.on Rehabilita.on (ICCR) Program for Young

Adults with Acquired Brain Injury

Presented at the 46th Annual Clinical Aphasiology Conference

June 3, 2017

Katrina Ross, M.S. CF-SLP, Natalie Ross, M.S., Natalie Gilmore, M.S. CCC-SLP, Carrie Des Roches, B.A., and Swathi Kiran, Ph.D. CCC-SLP

Cogni.ve Rehabilita.on and ABI

? Acquired Brain Injury (ABI), due to stroke or TBI, typically results in impairments of:

? Language - e.g., speaking, listening, reading, wriSng ? Cogni*on - e.g., aTenSon, memory, execuSve funcSoning

(Chapey, 2008; Cicerone et al., 2011; Kennedy et al., 2008; Sohlberg & Mateer, 1989)

? Deficits are o]en chronic (i.e., >6 months post onset; Cicerone et al., 2011; Kennedy & Coehlo, 2005)

? TBI called a "chronic condiSon" and a "disease process" (Corrigan & Hammond, 2013; Masel & DeWiT, 2010)

? Young adults are a frequently affected and growing populaSon within ABI ("TBI: Get the Facts," 2017; "Young Stroke Survivors," 2016) ? This age-group would typically be involved in higher educaSon, but that is o]en precluded by injury

? CogniSve RehabilitaSon (CR) is a therapeuSc program designed to target cogniSvelinguisSc deficits (Cicerone et al., 2000) that may be impairment-based, funcSonal, or a combinaSon of the two

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Impairment-Based and Restora.ve CR

? Impairment-based approaches seek to strengthen cogniSve-linguisSc skills at

the precise level of breakdown to maximize neurological gains (Kleim & Jones, 2008;

Laatsch & Krisky, 2008; Lesniak, Polanowska, Seniow, & Czlonkowska, 2014)

COGNITION

? ATenSon Process Training (APT; Sohlberg, McLaughlin, Pavese,

Heidrich, & Posner, 2000)

? Visual scanning training to remediate hemispaSal neglect (Cicerone et al., 2011)

? CategorizaSon Program (CP; ConstanSnidou, Thomas, & Robinson, 2008) for problem solving

? MulS-step sequence training for problem solving and execuSve funcSon (Ehlhardt, et al., 2008)

LANGUAGE

? SemanSc Feature Analysis (SFA; Boyle, 2004; Wambaugh, Mauszycki,

Cameron, Wright, & Nessler, 2013)

? Phonological Components Analysis (PCA; Leonard, Rochon, &

Laird, 2007)

? Verb Network Strengthening Treatment (VNeST; Edmonds,

Mammino, & Ojeda, 2014)

? Melodic IntonaSon Therapy (MIT; van der Meulen, et al., 2012)

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Func.onal and Compensatory CR

? FuncSonal approaches support cogniSve-linguisSc improvements in everyday, personally meaningful contexts (Elman & Bernstein-Ellis, 1999; Johnson, Hough, King, Vos, & Jeffs, 2008;

Kagan, 2011)

? Compensatory approaches help individuals adapt to their ABI

COGNITION

? Memory books, automaSc electronic reminders, and other external aids (Cicerone et al., 2011; SIGN, 2013)

? MetacogniSve strategy training, e.g., Time Pressure Management (Fasom, Kovacs, Eling, & Brouwer, 2000), Brain BudgeSng (Mayer, Mitchinson, & Murray, 2016), and TEACH-M

(Ehlhardt, Sohlberg, Glang, & Albin, 2004)

? Errorless learning techniques (Bertens, Fasom, Boelen, & Kessels,

2015)

? Caregiver training and environmental adaptaSons

(Cicerone et al., 2011; SIGN, 2013)

LANGUAGE

? AcSvity-level training, e.g. pracSce reading a menu

(Simmons-Mackie & Kagan, 2007)

? PromoSng Aphasics' CommunicaSve EffecSveness (PACE; Davis, 2005) and Oral Reading for Language in Aphasia (ORLA;

Cherney, 2010)

? Script Training (Cherney, Kaye, & van Vuuren, 2014) ? Constraint Induced Language Therapy (CILT; Allen et al., 2012) ? ConversaSon Partner Training (Simmons-Mackie et al., 2010) and

environmental adaptaSons

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Comprehensive CR

? The gold-standard CR combines these approaches in order to provide comprehensive, holisSc, integrated treatment (Cicerone et al., 2011)

Impairment

FuncSonal

? To maximize outcomes, CR should also account for principles of neural plasScity

: (Kleim & Jones, 2008)

Intensity RepeSSon

Specificity Salience

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