Cognitive retraining
Definition
Cognitive retraining is a therapeutic strategy that seeks to improve or restore a person's skills in the areas of paying attention, remembering, organizing, reasoning and understanding, problem-solving, decision making, and higher level cognitive abilities. These skills are all interrelated. Cognitive retraining is one aspect of cognitive rehabilitation, a comprehensive approach to restoring such skills after braininjury or other disability.
Purpose
The purpose of cognitive retraining is the reduction of cognitive problems associated with brain injury, other disabilities or disorders, and/or aging. The overall purpose of the therapy is to decrease the everyday problems faced by individuals with cognitive difficulties, thereby improving the quality of their lives.
Precautions
The extent to which a person with a brain injury can recover from or compensate for cognitive problems related to the injury requires more information about the person and about their injury. Therapy must be tailored to each individual's needs and abilities. Some cognitive retraining techniques require higher levels of skill, and therefore would be more suitable for persons who have made some progress in their recovery. Moreover, a person's moods and emotions have an effect on their cognitive skills. Someone who is depressed, for example, may need psychotherapyand/or medication before he or she can engage in and benefit from cognitive retraining. Some persons with brain injuries may find it difficult to transfer a skill learned in one setting, such as a clinic, to another setting, such as their home. Although a specific individual may show some improvement on training tasks, his or her cognitive skills may not be considered improved or restored unless there is some evidence that the skills have been transferred to everyday settings and can be maintained over time.
Description
Professionals from a variety of fields, such as psychology, psychiatry, occupational therapy, and speech-language pathology, may be involved in cognitive retraining. The techniques of cognitive retraining are best known for their use with persons who have suffered a brain injury. Cognitive retraining has also been used to treat dementia, schizophrenia, attention-deficit disorder, learning disabilities, and cognitive changes associated with aging.
Cognitive retraining includes a considerable amount of repetitive practice that targets the skills of interest. In fact, repetition is essential for the newly retrained skills to become automatic. Regular feedback is another important element of cognitive retraining, as is the use of such rewards as money. Retraining usually begins with simpler skills and proceeds to more complicated skills. The therapist may address cognitive skills while the person is practicing real-life tasks, in an effort to improve their performance of these tasks. In fact, practicing skills in the ways and settings they will be used in real life is critical to the success of retraining efforts. The length of time for cognitive training varies according to the type and extent of the injury and the type of retraining skills used. For example, retraining memory may take months or years. In comparison, it may take only a few days or weeks to retrain someone to organize his or her home or workplace. The use of computers for cognitive retraining has become an increasingly common practice.
