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		Cognitive Performance
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 Cognitive Performance Cognitive performance is a measure of how well our brain functions. After a traumatic brain injury, it's common for patients to report cognitive performance difficulties. These deficits can present as problems in everyday brain functions such as: Attention.
    Concentration.
    Speech.
    Language.
    Memory.
    Reasoning.
    Planning.
    Problem-solving. Although it's stressful to endure cognitive performance issues in important tasks and roles, neuropsychological assessments and may not demonstrate significant impairments in any specific neuropsychological domain. Cognitive performance dysfunction may be relatively subtle and only occur in demanding situations. TBICoE provides resources for medical providers to support military and civilian health care providers in assessing and treating service members and veterans who have sustained a TBI. Possible Indicators of Cognitive Dysfunction After a TBI **Cognitive Functions**
            **Common Difficulties**Attention and Information Processing
            Following conversations and maintaining one’s train of thought
                Recalling information that is read and the contents of conversationsMemory
            Remembering to take medications and show up for appointments
                Remembering instructions, especially multi-componentLanguage
            Easily accessing words when verbally expressing oneself
                Comprehending complex written and spoken informationExecutive
            Managing time
                Organizing oneself to initiate and engage in productive use of time Cognitive Rehabilitation Restoring cognitive performance after a TBI requires cognitive rehabilitation. Some treatments provided by certain programs have not been fully proven as effective stand-alone therapy for TBI, so cognitive rehabilitation is administered in a comprehensive package of physical therapy, occupational therapy, and speech-language pathology. TRICARE covers medical treatments that are proven safe and effective. **Type of Therapy**
            **Area of Cognitive Impairment**
            **Specific Examples**Attention Process Training
            Attention
            Letter cancellation tasks with distracting noise in backgroundError Management Training
            Attention
                Memory
                Executive functioning
                Social pragmatics
            Individual and group self-awareness trainingEmotional Regulation Training
            Attention
                Memory
                Executive functioning
                Social pragmatics
            Anger Management TrainingExternal Cuing
            Attention
                Memory
                Executive functioning
            Supervised living
                Smart Phone
                PDAIntegrated Use
            Attention
                Memory
                Executive functioning
                Social pragmaticsMemory Notebook
            Attention
                Memory
                Executive functioning
            Prosthetics
                PDAProblem-Solving Training
            Attention
                Memory
                Executive functioning
                Social pragmatics
            Internal problem-solving
                Internal dialogueSocial Communications Skills Training Groups
            Executive functioning
                Social pragmatics
            Group cognitive therapyVarious Mneumonic Techniques
            Memory
            Story method
                Acronyms
                Sentence/acrostics
                Method of loci
                Chunking
                RepetitionVisual Imagery Mneumonics
            Memory
            Imagery-based trainingWorking Memory Training
            Attention
            Completing two cognitive tasks simultaneously
 Frequently Asked Questions Cognitive Rehabilitation The complexity of the brain and brain injuries has led to questions about the nature of cognitive rehabilitation and its availability to service members who have sustained TBIs. View questions and answers about cognitive rehabilitation. Does DOD/TRICARE cover cognitive rehabilitation? On April 14, 2010, the Assistant Secretary of Defense (Health Affairs) directed the implementation of a broad-based DOD pilot program intended to conform to the proceedings, and resulting guidance document, of the Consensus Conference on Cognitive Rehabilitation for Mild Traumatic Brain Injury held in April 2009. This guidance document outlined a standardized and measurable process for the provision of cognitive rehabilitation services. This policy mandated the implementation of the guidance at 13 military treatment hospitals and clinics. In 2010, DOD provided over 45,000 hours of care involving cognitive rehabilitation to service members and over 32,000 hours to family members of active duty members and retirees. These treatments were delivered by a wide array of health professionals, including psychologists; occupational, speech and physical therapists; and physicians.
 Who may benefit most from cognitive rehabilitation? Patients who have experienced moderate to severe TBI and who suffer from recurring symptoms such as attention and memory deficits, problems with executive functioning and social pragmatics deficits are most likely to benefit from cognitive rehabilitation. In cases of mild TBI, nearly 90 percent recover with no residual problems and only those with persistent symptoms need to be evaluated and treated.
 What is CBT? Cognitive behavioral therapy is a common type of mental health counseling consisting of a range of therapies designed to treat conditions like anxiety or depression. CBT is meant to help patients become aware of inaccurate or negative thinking and to view challenging situations more clearly and respond to them in a more effective way. CBT can be an effective tool to help anyone learn how to better manage stressful situation.
 What is the difference between cognitive rehabilitation and CBT? Cognitive rehabilitation is a collection of treatment strategies designed to address problems with memory, attention, perception, learning, planning and judgment brought about by brain injury, neurological disorders and other illnesses. Cognitive Behavioral Therapy is a common type of mental health counseling to help a patient become aware of inaccurate or negative thinking.
 Why is it difficult to determine how effective cognitive rehabilitation can be; there seems to be great disparity of opinion on the subject? Limited data on the effectiveness of cognitive rehabilitation programs are available, and this is in part due to the heterogeneity of the subjects, interventions and outcomes studied. Lack of rigorous methodology (i.e., randomized controlled trials) in efficacy studies has also contributed to the disparity in opinion on the effectiveness of cognitive rehabilitation.
 Is cognitive rehabilitation effective or ever used for injuries that did not involve head injuries? For example, is cognitive rehabilitation effective for psychological disorders? The benefit of cognitive rehabilitation is not limited to patients with head injuries. Patients with psychological disorders that have impairments in attention, memory, socialization, and reasoning and processing skills can also benefit from cognitive rehabilitation.
 Are there "specialists" in cognitive rehabilitation, or do most doctors understand their uses? Neuropsychologists specialize in neuropsychological cognitive testing that is used to determine if a patient will benefit from cognitive rehabilitation. They are also the primary providers who develop the individualized cognitive rehabilitation plan for patients. However, cognitive rehabilitation may be performed by an occupational therapist, physical therapist, speech/language pathologist, neuropsychologist, or a physician.
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                FAQs (1) FAQ
    Feb 27, 2024
    Cognitive Rehabilitation            
    The complexity of the brain and brain injuries has led to questions about the nature of cognitive rehabilitation and its availability to service members who have sustained TBIs.
    
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