Download Interventions for Cognitive-Linguistic Disorders Associated with

Interventions for CognitiveLinguistic Disorders Associated
with Alzheimer’s disease
Purpose of Presentation
 The purpose of this presentation is to take a look
at four different type of interventions used to
treat cognitive-linguistic disorders associated
with Alzheimer’s disease and give future and/or
present speech-language pathologist some
ideas on how to implement these approaches.
Basic Goals for Intervention
 “Designing interventions for persons with
dementia should take into account the
communication environment. Factors in this
environment would include opportunities for
interaction and typical communication partners.
Caregivers maintain that eroding communication
is the single most distressing problem they face
in managing the disease. Therefore, prolonging
communication for as long as possible, and at as
high a level as possible, is a critical goal of
intervention” (Ripich, D., & Horner, J., 2004 p.3).
Interventions
Graphic and Written
Cues
Reminiscence
Therapy
Spaced-Retrieval
Training
MontessoriBased
Interventions
Graphic and Written Cues
 Uses familiar photographs and/or factual information to
promote communication.
 Recognition memory and the ability to read aloud are
skills that clients with Alzheimer’s dementia are likely to
be able to use.
 Photographs and factual information can be incorporated
into most therapy sessions whether group or individual
(Hopper, T. 2005).
How to Implement Graphic and Written Cues
 The speech-language pathologist can implement the
client’s pictures into memory books which are photo
albums with captions. The SLP can use these to help the
client retrieve the names of family members/caregivers,
for example.
 When discussing daily activities such as eating or
bathing, the speech-language pathologist can
incorporate pictures of food or clothing to help the client
with topic maintenance.
Reminiscence Therapy
 Reminiscence therapy is a way for clients with
Alzheimer’s disease to practice communication skills
using a variety of materials such as pictures or music, or
activities such cooking, or painting, that the client once
or currently enjoys.
 This type of therapy can be used with verbal and nonverbal clients
 “Maintains cognitive stimulation, improves memory
recall, and improves/maintains communication skills”
(Ripich, D 2005 p 6).
How to Implement Reminiscence Therapy
 The speech-language pathologist could use the client’s
pictures as a way of facilitating conversation about
events or times that were enjoyable to the client. Photos
usually represent enjoyable experiences and help to
summon memory.
 A client who may not want to interact with the speechlanguage pathologist may be more inclined to talk while
painting or even cooking.
 Reminiscence therapy can be used in individual or group
settings
 The use of family and friends can further enhance
reminiscence therapy and even help the client to be
more engaged (Kennard, C. 2005).
Montessori-Based Interventions
 “Basic technique is to create structured,
stimulating activities that are appropriate to an
individual’s cognitive abilities, allowing
engagement in tasks and the opportunity for
social interaction.
 Can be used in individual and group settings”
(Hopper, T. 2005 p.3).
How to implement Montessori-based Interventions
 The speech-language pathologist could use an
activity such as gardening, in a group setting, to
maintain basic sequencing skills by giving each
client a turn to explain what step comes next.
 Use very obvious external cues such as the
written word “rake” on that item, and make sure
all of the items for the activity are easily
accessible.
Montessori-based Interventions cont….
 “ Dr. Camp has developed a number of general
categories that compartmentalize Montessoribased activities and these include……….”(Elliot,
G.,2005 p.28)
Compartmentalized Montessori-based Activities
Group or Social
Activities
(question asking,
reading, memory
bingo, and group sorting)
Sensory Discrimination
(sound, color, smell,
touch and weight)
Cognitive Activities
(category sorting,
matching and arranging
Items in a series)
General
Categories
Motor Activities
Care of the Person
(activities of daily living;
self care)
(range of motion tasks,
fine and gross motor
skill practice, balance)
Care of the Environment
(making flower arrangements,
using place settings,
watering plants)
Spaced-Retrieval Training
 Memory training technique
 “Gives clients with Alzheimer’s disease practice at
successfully recalling information over longer intervals of
time” (Brush & Camp, 1998).
 “The goal is to teach a functional piece of information or
behavior that can be used in everyday situations (i.e
room number, caregiver name)” (Hopper, T. 2005 p.3).
 “Spaced-retrieval techniques recognize that explicit
memory is impaired but capitalize on implicit memory
and spared capacity” (Elliot, G.,2005 p.27).
How to Implement Spaced-Retrieval Training
 Let’s say one of the client’s goals is to remember one of
their caregiver’s names. The SLP would ask the client,
for example, “What is your doctor’s name?” Then provide
the answer “Dr. Smith.” That particular question could
then be asked at the beginning of every session for 6
sessions.
 The main goal would be to then generalize that particular
question.
Additional Articles
 Effect of Presentation Modality on Immediate
and Delayed Recall in Individuals With
Alzheimer's Disease
 Effects of Cognitive-Communication Stimulation
for Alzheimer's Disease Patients Treated
With Donepezil
 Effectiveness of Communication Strategies
Used by Caregivers of Persons With
Alzheimer's Disease During Activities of
Daily Living
References
 Brush, J.A. & Camp, C.J. (1998). A Therapy Technique for Improving Memory:
Spaced-Retrieval, Beachwood, Ohio, Menorah Park Center for Senior Living.
 Carnahan, N., Lingle, A., &McCullough, K. (2005) Using Spaced Retrieval Training in
the Treatment of Alzheimer’s Dementia. Retrieved on November 28, 2005 from
http://convention.asha.org/handouts/293_Carnahan_Natalie_072927_111405094554.
pdf
 Elliot, G (2005) Spaced Retrieval and Montessori for Dementia: Interventions Know to
Enhance Function in Dementia.
 Hopper, T. (2005, Nov. 8). Assessment and Treatment of Cognitive-Communication
Disorders in Individuals with Dementia. The ASHA Leader, pp10-11
 Kennard, C. (2004, Mar.31). Reminiscence Therapy. Retrieved on November 28 from
Yahoo’s About website: http://alzheimers.about.com/b/a/076219.htm
 Ripich, D. & Horner, J. (2004, April27). The Neurodegenerative Dementias: Diagnosis
and Interventions. The ASHA Leader, pp.4-5, 14
 Ripich, D. (2005, Feb.3). Alzheimer’s Disease, Assessment and Intervention. p6