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Cognitive Case Study: Pat

By: Sarah Dobbs, Amanda Jones, Marisa Sevick. Cognitive Case Study: Pat. Background:Pat. 57 y/o woman who sustained a TBI after a MVA at the age of 16. Lives in a single story home with two roommates A ssistants come in frequently to help with tasks. No family living

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Cognitive Case Study: Pat

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  1. By: Sarah Dobbs, Amanda Jones, Marisa Sevick Cognitive Case Study: Pat

  2. Background:Pat • 57 y/o woman who sustained a TBI after a MVA at the age of 16. • Lives in a single story home with two roommates • Assistants come in frequentlyto help with tasks. • No family living • Does have close friends and support through church family

  3. Initial Eval Assessments • Short Blessed Screening Test • Score of 14 (further assessment needed) • Deficits observed: • Short-term memory: Ex. address to remember-Ct. repeated it out loud 4 x’s and could not recall any of it when asked. • Attention: Ex. Listing months of the year reversed-Ct. initially didn’t listen to directions and said months in correct order.

  4. Initial Eval Assessments • Cognitive Linguistic Quick Test • Ct. scored moderate-severe in all domains except language (mild severity) and clock drawing (WNL*) • Summary Scores by deficit area/severity: • Attention: 59 = moderately impaired • Memory: 129 = moderately impaired • Executive Functioning: 15 = severely impaired

  5. Tx Task Chosen/Rationale • Task: • Focus on memory to work on identification information • Rationale: • Client centered • Moderate impairment per eval • Safety • Transferable to other areas

  6. FOR forTx Session • Levels of Awareness • Establishing anticipatory awareness • Not easiest to determine • Still at emergent level • Facilitate recognition compensations

  7. LTG and STG for Ct. • LTG: Client will increase short-term memory abilities marked by use of compensatory strategies (ie. reference informational card) 85% of occurrences with no cuing, during therapy tasks, by 11/11/11. • STG: Client will increase awareness and demonstrate understanding by verbalizing at least 2 scenarios, with minimal cues, which she could use her compensatory strategy, by the end of the first session. • STG: Client will demonstrate use of compensatory strategies (ie. reference informational card), for memory and attention deficits, 70% of occurrences with min. cuing, during scenario task, by the 10/20/11.

  8. Initial TxSession • Some anticipatory awareness was observed • Cueing necessary • Lack of information for tx task • THINK ON OUR TOES!!! • Focus on phone number with memory strategy and 5 min. of distraction • Able to recall after 4 attempts

  9. Further TX Sessions • Review tx session prior • Discuss safety concerns • ID card and its use • Changes in routine • Other memory compensations • Daily routine • Calendar • Checklist • Focus on Independence

  10. Group Reflection • Ct.’s deficits were easy to identify but hard to implement in tx. • Some anticipatory awareness was foundafter cueing • Did well with thinking on our toes with what we had to work with • More backup tasks were needed • Great learning experience!

  11. Questions?

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