Psychological techniques

The management of memory impairment is discussed elsewhere (see Chap.t§L.2.5.2). Elderly people

Reality orientation attempts to improve the cognitive performance of people with dementia through repeated presentation of orientation information. This can be done using patient groups to discuss the day's events, and/or reality orientation boards displaying information about the day, for example the date, the weather, and the name of the next meal. A systematic review(!9 suggests that the method is effective in improving measures of cognition and orientation, but has little impact on behaviour. But the gains are not large and may be lost once the treatment is discontinued, and some have argued that it may adversely affect mood.

Other psychological strategies used in the elderly with dementia include reminiscence therapy (1!> and validation therapy.(!2) In both these therapies discussions of autobiographical memories are used to improve mood, and foster a sense of well being and worth. There is little good evidence that these therapies produce anything more than short-lived and modest gains in mood, cognition, and behaviour.^„i3

Younger people with dementia

Other cognitive techniques have been tried in younger patients with dementia following an acquired single-incident brain injury. These include attention training, for example repeated practice to detect a moving target/!4,!5,) and computer-mediated cognitive rehabilitation.(!6) The evidence that any of them work is inconsistent. Return-to-work programmes should be offered to younger patients with mild and relatively static dementia. Though they have not been evaluated using randomized, controlled trial methodology, a comparison of the employment status of patients before entering such a programme with their status after completing the programme, suggests that return-to-work programmes are effective.(!7,)

Funny Wiring Autism

Funny Wiring Autism

Autism is a developmental disorder that manifests itself in early childhood and affects the functioning of the brain, primarily in the areas of social interaction and communication. Children with autism look like other children but do not play or behave like other children. They must struggle daily to cope and connect with the world around them.

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