Cognitive Rehabilitation

What is Cognitive Rehabilitation Therapy?

Cognitive rehabilitation is a program of guided therapy to learn (or relearn) ways to concentrate, remember and solve problems after an illness or injury affecting the brain. It is a structured set of therapeutic activities designed to retrain an individual’s ability to think, use judgment and make decisions.

The focus is on improving deficits in memory, attention, perception, learning, planning and judgment. There are many intervention strategies and techniques used to help children reduce, manage or cope with cognitive deficits. The desired outcome of cognitive rehabilitation is an improved quality of life or an improved ability to function in home and community life.

Cognitive rehabilitation techniques are restorative – training or re-training the brain in normal function – or compensatory, which teaches the child to use tools to help make up for the deficit.

Both of these therapies are considered to be short term. 

What are the Benefits of Cognitive Rehabilitation Therapy?

The overall goal of cognitive rehabilitation is to improve cognitive abilities in order to obtain as much independent functioning as possible. Some of the specific benefits of cognitive rehabilitation include improvements in the following deficits:

  • Attention
  • Problem-solving
  • Memory
  • Visual-spatial relations
  • Learning functional tasks such as feeding and dressing

Cognitive rehabilitation may be performed in conjunction with or as part of other therapies, such as occupational, speech or behavior therapy.

Who Performs the Cognitive Rehabilitation Treatment?

Cognitive rehabilitation may be performed by a variety of professionals, such as neuropsychologists, psychologists or occupational therapists. The nature of the condition and the specific cognitive deficits determines what kind of specialist would be needed.

There are two treatment approaches to cognitive rehabilitation. The restorative approach is based on the theory that repetitive exercise can restore lost or under developed functions. Some methods and techniques include:

  • Auditory, visual and verbal stimulation and practice
  • Number manipulation
  • Computer-assisted stimulation and practice
  • Behavior modification

The second cognitive rehabilitation model, the compensatory approach, strives to develop external assistance for cognitive deficits. Compensatory cognitive rehabilitation may use the following techniques:

  • Employing visual cues, written instructions, memory notebooks, watches, beepers, computers and other electronic devices to trigger functional behaviors.
  • Simplifying complex tasks, capturing the patient’s attention, minimizing distractions and teaching self-monitoring procedures.

The compensatory approach to cognitive rehabilitation has been more widely accepted than the restorative approach, but these approaches are not mutually exclusive. Many therapeutic programs employ elements of both.

Finding a Qualified Therapist or Program

Parents may receive a referral from their doctor to a qualified professional, or one may be provided as part of the services received through school. Cognitive rehabilitation may be performed by one or more of the qualified professionals already on your child’s team – for instance, the occupational therapist may also be able to provide cognitive rehabilitation for some functions.

What are the Drawbacks of Cognitive Rehabilitation?

Some of the drawbacks of cognitive rehabilitation stem from the nature of the disability itself. Sometimes a degree of progress is achieved, only to plateau because the skill cannot be gained due to physical function limitations. There is also a high degree of patient frustration with this type of therapy. The compensatory approach may place a greater burden on parents who may have to input the initial information into the tools used by the child.

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