IMPORTANT! To complete Quiz 3, you'll need module 3 too!
All the information needed of module 4 to complete quiz 3 of the course 'Neuropsychological Rehabilitation' at Tilburg University.
This summary contains all the articles and book chapters, and also the most important information mentio...
MODULE 4: INTERVENTIONS FOR DEFICITS IN
ATTENTION, PROCESSING SPEED AND WORKING
MEMORY
WILSON (2017); CHAPTER 13: PROCESSING SPEED
o Slowness of information processing or reduced processing speed is one of the
foremost symptoms after acquired brain damage.
Not only does slow information processing hamper several cognitive processes
like attention, memory and executive function, it also has a major impact on
the life of patients.
o The treatment of slow information processing after acquired brain damage primarily
involved three approaches:
Pharmacological
In pharmacological approaches, methylphenidate has been used to
improve speed of information processing.
Remedial
The most common approach to rehabilitation of slow information
processing is computer-mediated remedial training.
Compensatory
Assessment of processing speed
o Speed of information processing refers to how quickly a person can react to incoming
information.
This process consists of several operations such as encoding, understanding
and manipulating information, formulating a reaction and executing a
selected response.
o In neuropsychological tests, cognitive operations and speed of motor reaction are not
distinguished and hence are computed as one variable.
It is only in reaction time tasks that decision times and motor response times
have been regularly registered and described separately.
o Stroke patients responding with the hand ipsilateral to their lesion have only slower
movement times in cognitively demanding tasks, but not in simple and choice
reaction tasks.
It is found that slowness after TBI is generalised and does not pertain to any
particular stage in cognitive processing.
o Speed of information processing can also be measured through behavioral
observation.
The Rating Scale of Attentional Behavior (RSAB) contains several items
related to slow information processing on a 5-point scale ranging from ‘not at
all’ to ‘always’.
The Mental Slowness Observation Test (MSOT) contains four tasks that are
commonplace for most people, amenable to accurate timing and easily
standardized.
, Module 3 A.E.M. van Wordragen 2100382
The Mental Slowness Questionnaire (MSQ) comprises 21 daily activities
related to slow information processing which are scored on a 5-point
frequency scale and a 3-point severity scale.
Processing speed after TBI
o Some authors have demonstrated that when slowness in basic speed of information
processing is controlled for, deficits in divided attention, focused attention and task
switching are no longer apparent.
This suggests that most attentional processes are dependent on adequate
speed of information processing.
However, other studies have shown that deficits in the strategic control
of attention are still present after slowness of information processing
has been accounted for.
o Slow processing speed was pervasive across al neuropsychological tasks in TBI
patients, and the authors found that only residual problems in response inhibition
remained after controlling for basic slowness.
These finding support the pervasive and independent influence of reduced
processing speed on attentional performance after TBI.
o Although slowness of processing speed shows a significant amount of recovery after
ABI, especially in patients with TBI after the fist 6-8 months post-injury, this
slowness remains a chronic impairment for many patients.
o Salthouse (1996) postulated two mechanisms responsible for impaired
performance in cognitive tasks:
The limited time mechanism: during the achievement of a cognitive task,
especially tasks with external time limits, the time to perform later operations
is greatly restricted when a large amount of the available time is occupied by
the execution of early operations.
This mechanism is at work in tasks with external time limits, wherein
relevant cognitive operations are achieved too slowly within the
available time (having an conversation and having trouble keeping up).
The simultaneity mechanism: products of early processing may be lost by the
time they are needed for later processing.
When information is processes slowly, relevant information may not
be available or be impoverished or degraded by the time it is needed.
Treatment of slowed processing speed
Pharmacological interventions
o Methylphenidate has been widely used for the treatment of ADHD, and to improve
attentional behavior and processing speed after TBI.
Some studies did indicate significant results but further research is needed.
Remedial approaches
o ACTIVE study
Speed of processing training, presented via computer, focused on visual search
and the ability to process increasingly more complex information presented in
successively shorter presentation times.
The effects were followed up until ten years after training with three
sets of assessment:
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