Cognitive Syndromes
Cognitive Remediation
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Cognitive remediation is a form of rehabilitation therapy used to treat children, adolescents, and adults with neurological deficits. This covers a variety of diagnoses, but is often used for people who are recovering from a traumatic brain injury.
Cognitive remediation provides a unique, personalized program that brings change by helping caregivers gain a better understanding of their loved one’s abilities. This approach centers on the person with brain injury’s strengths to make up for his or her acquired weaknesses. It also focuses on rehabilitating known weaknesses through retraining and using a variety of techniques for learning.
The skills required for impulse control and memory improvement can be significantly improved through cognitive remediation. The program involves a careful analysis of what strategies are currently not working to determine better approaches for the person with brain injury. Often the rehabilitation professional is able to evaluate and control environmental factors that may be making problems worse.
The typical cognitive remediation program typically targets:
• Attention deficits
• Poor memory
• Learning difficulty
• Poor social skills
• Anxiety / Depression
• Adjustment-Related concerns
The goal in remediating cognitive deficits is to help brain injured persons develop new skills they can then apply in a variety of academic and social situations. Often specific suggestions for making modifications at school and home are made. This type of treatment also emphasizes the skills necessary to build positive peer relationships and to make better decisions about independence and responsible behavior.
An experienced team of neuropsychologists, school / vocational planners, clinical psychologists, and/or therapists work together to give the most appropriate care for the patient. A neuropsychologist often assesses the candidate to determine if he/she would benefit from this program and identifies the specific areas for work. A common focus is transitioning a patient from the acute hospitalization (or outpatient program) back to school or work. Often an Assistive Technology assessment is completed to determine if computerized adaptive devices would be useful.
There are several ways a person with brain injury can enter a cognitive rehabilitation program.
1. Medical doctor referral such as the primary care physician, physiatrist or neuropsychologist.
2. Hospitals with brain injury programs.
3. Private programs through healthcare professionals (usually neuropsychologists).
A family member may initiate a referral by requesting one from the doctor. If the physician is not familiar with cognitive remediation, the family should ask to consult with a neuropsychologist who is.
In all cases, a referral from a M.D. is required if insurance coverage is being requested. For insurance purposes, cognitive remediation is covered under the medical diagnostic code 97533, not mental health. Families need to consult their own medical insurance plan or insurance case manager to see if they have coverage.
Cognitive rehabilitation has proven effective in helping persons with brain injury resume their social, educational and vocational lives by recovering function and learning strategies to compensate for weaknesses. It is also a tool that helps the family support their loved one’s efforts to reach their cognitive potential.
Dr. Thomas Burns received his Masters and Doctoral degrees in Clinical Psychology. After obtaining specialty training in Neuropsychology and completing a postdoctoral residency at Atlanta’s Scottish Rite Children’s Medical Center, Dr. Burns was licensed as a Psychologist in Georgia. He is board certified by the American Board of Professional Neuropsychology and is currently the Director of Neuropsychology at Children’s Healthcare of Atlanta. Dr. Burns also practices in private practice in Atlanta, treating both adults and children.