COGNITIVE REHABILITATION is an area of specialization that focuses on restoring the functions of the brain that have been identified in the neuropsychological assessment as being impaired or inefficient. The aim of the rehabilitation program is to “retrain” or help the brain develop the ability to execute mental functions that have been disrupted or undeveloped due to injury or abnormal developmental processes.
A mixture of various hands-on, mental, and computer-based activities are implemented at different times during the training program in order to achieve the desired level of competence and efficiency. Through this individualized program, children and adults who have suffered a traumatic brain injury from an auto accident, falls, blast injury in war zones, neurodegenerative or neurodevelopmental disorders, and an array of medical conditions such as (brain tumor, seizures, liver failure, encephalopathy, metabolic disorders, neurotoxin exposure, etc.) can experience notable improvements in functioning which may bring meaningful changes in quality of life.
Often times, more basic skills have to be developed or strengthened before integrating more complex or higher-order skills into the system. Otherwise the weak “infra-structure” is unable to withstand the demands that are placed upon it and will quickly collapse. Therefore, a careful study of each patient’s specific pattern of cognitive strengths and weaknesses is a fundamental component for the development of the most effective individualized brain retraining program. Because a Neuropsychological Assessment is the most comprehensive tool to achieve such understanding of brain functioning, I see this evaluation as an integral part of the Cognitive Rehabilitation Program.
Neurocognitive retraining is based on the premise of brain plasticity or the ability of this vital organ to change in response to renewed stimulation and it is viewed by many as a lifelong characteristic of the human brain, with the possibility of reorganization existing for years after an injury or a developmental mishap. Brain plasticity has become a more intriguing topic of research since advanced imaging studies have afforded us with first hand images of the changes that occur in the brain when exposed to new stimuli or alternative ways of responding.
Anecdotal stories as well as studies have shown that after an injury, other parts of the brain can learn to take over the function of the injured areas and renewed brain activity can be regained in the affected sites. A child’s developing brain is particularly capable of this plasticity and may benefit more readily from the cognitive rehabilitation efforts. Hence, it becomes particularly relevant to gain a thorough understanding of a child’s cognitive issues as soon as difficulties reaching normal developmental milestones are noted.
How an injury or disruption in the normal developmental process affects brain functioning varies from person to person according, for instance, to the individual’s premorbid (before the injury) abilities, personality characteristics, temperament, severity of the injury, gestational stage when the brain insult occurred etc.
In addition to assisting in the restoration and development of new skill sets Cognitive Rehabilitation also incorporates adaptive and compensatory strategies which involves helping the individual 1) learn how to do things differently and 2) implement helpful modifications in his/her environment so as to reduce the detrimental effects of the identified deficits.
With this comprehensive approach that includes remediation, retraining and implementation of compensatory strategies the Cognitive Rehabilitation Program can make a vital contribution in helping the individual return to his/her pre-injury capacity or attain a level of optimal adaptive functioning that has never been achieved before. Hence, Cognitive Rehabilitation brings not only substantial savings in medical case management cost (Cherek and Taylor, 1995) and the restoration of cognitive abilities impacted by a variety of medical conditions but it also has a therapeutic value with the resulting increase in the individual’s sense of confidence, competence and self-esteem.