Cognitive Intervention with Individuals with Dementia: Linking Strategies to Targets

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By Nikki Kneale

It is estimated that by 2050 up to 16 million Americans will be living with dementia. This does not mean that this is solely a problem for the future. In a 2013 survey by ASHA, cognitive communication ranked second in percentage of caseload make-up; specifically, cognitive communication for dementia ranked 3rd (ASHA, 2013). There are a number of strategies SLPs working with residents who have dementia can use, each with their own small but growing body of evidence. So, which treatment strategy is a therapist to use? How do we know which one is best?  Is one more beneficial than the other for a particular individual? The answers to these questions become more and more important as the number of residents admitted to skilled nursing facilities with cognitive impairment rises.

That is what Hooper et al. sought to find out in their article An Evidenced-Based Systematic Review on Cognitive Interventions for Individuals with Dementia.

What did they do?

They conducted a systematic review of research studies published between 2002 and 2011 that assessed the effects of different types of strategies that SLPs can utilize with residents with dementia. Hooper et al. sought to understand the effect of cognitive interventions on tests or specific tasks targeting cognitive communication and “the effect of cognitive interventions on measures of cognitive communication activity limitations/participation restrictions”. The following interventions were examined: errorless learning, spaced retrieval training, vanishing cues, and a specific verbal instruction strategy.

What did they find?

Different approaches worked better with different kinds of information.

Errorless learning:

  • Studies showed positive outcomes for teaching factual information

Spaced retrieval:

  • Studies showed positive outcomes for teaching factual information
  • Improved completion of ADLs and tasks when combined with other techniques (verbal rehearsal, errorless learning and vanishing cues)

Vanishing cues:

  • There were fewer studies on this approach than spaced retrieval or errorless learning. The small effect size of these studies lad the authors to report “individual study results were positive but overall results were inconclusive”

Verbal instruction strategy delivered by an electronic device:

  • Improved completion of ADLs

To read the full article for yourself, you can visit:

http://ajslp.pubs.asha.org/article.aspx?articleid=1782723

References

ASHA, American Speech-Language-Hearing Association. (2013). SLP Health Care Survey report: Caseload characteristics trends, 2005–2013. Available from http://www.asha.org.

Hopper, T., Bourgeois, M., Pimentel, J., Qualls, C. D., Hickey, E., Frymark, T., … & Wright, H. (2013). An evidence-based systematic review on cognitive interventions for individuals with dementia. American Journal of Speech-Language Pathology, 22(1), 126-145.

For more information on Research Tuesday, please visit Gray Matter Therapy. Happy researching!

Research Tuesday

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