Cognitive Enhancement Therapy for Adults With Autism Spectrum Disorder: Results of an 18-Month Feasibility Study.

Cognitive Enhancement Therapy for Adults with Autism Spectrum Disorder: Results of an 18-month Feasibility Study.

J Autism Dev Disord. 2013 Apr 26;
Eack SM, Greenwald DP, Hogarty SS, Bahorik AL, Litschge MY, Mazefsky CA, Minshew NJ

Adults with autism experience significant impairments in social and non-social information processing for which few treatments have been developed. This study conducted an 18-month uncontrolled trial of Cognitive Enhancement Therapy (CET), a comprehensive cognitive rehabilitation intervention, in 14 verbal adults with autism spectrum disorder to investigate its feasibility, acceptability, and initial efficacy in treating these impairments. Results indicated that CET was satisfying to participants, with high treatment attendance and retention. Effects on cognitive deficits and social behavior were also large (d = 1.40-2.29) and statistically significant (all p < .001). These findings suggest that CET is a feasible, acceptable, and potentially effective intervention for remediating the social and non-social cognitive impairments in verbal adults with autism. HubMed – rehab

Depression in Older Adults: Screening and Referral.

J Geriatr Phys Ther. 2013 Apr 24;
Vieira ER, Brown E, Raue P

Depression is related to disability and affects rehabilitation participation, outcomes, and compliance with treatment. Improving older adult depression detection and referral requires knowledge, skills, supportive organizational policies, and access to mental health experts. This review provides a selected overview of evidence-based approaches for screening of suspected cases of depression in older adults by physical therapists and other non-mental health professionals and discusses procedures to refer suspected cases to primary care providers and/or mental health specialists for evaluation, including resources and a tool to assist in communicating depression-related information to the primary care provider or mental health specialist. We hope that this review will promote the incorporation of evidence-based screening and referral of suspected cases of depression in older adults into routine practice. HubMed – rehab

A Low-Vision Rehabilitation Program for Patients With Mild Cognitive Deficits.

JAMA Ophthalmol. 2013 Apr 25; 1-8
Whitson HE, Whitaker D, Potter G, McConnell E, Tripp F, Sanders LL, Muir KW, Cohen HJ, Cousins SW

IMPORTANCE We are unaware of any standardized protocols within low-vision rehabilitation (LVR) to address cognitive impairment. OBJECTIVE To design and pilot-test an LVR program for patients with macular disease and cognitive deficits. DESIGN The Memory or Reasoning Enhanced Low Vision Rehabilitation (MORE-LVR) program was created by a team representing optometry, occupational therapy, ophthalmology, neuropsychology, and geriatrics. This pilot study compares outcomes before and after participation in the MORE-LVR program. SETTING Eligible patients were recruited from an LVR clinic from October 1, 2010, through March 31, 2011. PARTICIPANTS Twelve patients completed the intervention, and 11 companions attended at least 1 training session. INTERVENTION Key components of the MORE-LVR intervention are as follows: (1) repetitive training with a therapist twice weekly during a 6-week period, (2) simplified training experience addressing no more than 3 individualized goals in a minimally distracting environment, and (3) involvement of an informal companion (friend or family member). MAIN OUTCOME MEASURES Version 2000 National Eye Institute Vision Function Questionnaire-25; timed performance measures, Telephone Interview for Cognitive Status-modified(TICS-m), Logical Memory tests, satisfaction with activities of daily living, and goal attainment scales. RESULTS Twelve patients without dementia (mean age, 84.5 years; 75% female) who screened positive for cognitive deficits completed the MORE-LVR program. Participants demonstrated improved mean (SD) scores on the National Eye Institute’s Visual Function Questionnaire-25 composite score (47.2 [16.3] to 54.8 [13.8], P = .01) and near-activities score (21.5 [14.0] to 41.0 [23.1], P = .02), timed performance measures (writing a grocery list [P = .03], filling in a crossword puzzle answer [P = .003]), a score indicating satisfaction with independence (P = .05), and logical memory (P = .02). All patients and companions reported progress toward at least 1 individualized goal; more than 70% reported progress toward all 3 goals. CONCLUSIONS AND RELEVANCE This pilot study demonstrates feasibility of an LVR program for patients with macular disease and mild cognitive deficits. Participants demonstrated improvements in vision-related function and cognitive measures and expressed high satisfaction. Future work is needed to determine whether MORE-LVR is superior to usual outpatient LVR for persons with coexisting visual and cognitive impairments. HubMed – rehab

[Comparison of the performance-oriented mobility assessment and the Berg balance scale : Assessment tools in geriatrics and geriatric rehabilitation.]

Z Gerontol Geriatr. 2013 Apr 27;
Schülein S

BACKGROUND: In order to develop and coordinate an integrated plan for treatment of hospitalized elderly patients in danger of future falls it is of utmost importance to ensure using the assessment that best targets people who are at risk for falling. For this purpose the performance-oriented mobility assessment (POMA) and the Berg balance scale (BBS) can be used. The purpose of this study was to collate the results of articles published on these assessment tools in order to appraise whether one of them could be favored under the viewpoint of practicability and expressiveness. METHOD: A literature search was conducted for studies examining the two assessment tools published since 1986 through December 2011 in English and German language. Reference sections were also inspected for additional citations. RESULT: Overall 19 studies were retrieved in order to answer the posed question. Of the total number of 1,455 patients in the identified articles, 712 with an average age of 74.1 years were included in the BBS trials and the POMA was assessed using 743 patients with an average age of 75.7 years. The BBS was good at identifying elderly people who are at risk for falling (sensitivity 84-95.5?%) and those who are not at-risk for falling (specificity 76.5-95.5?%. The demonstrated results for the POMA ranged from relatively poor to good (sensitivity 64-95.5?%) and from poor to very high (specificity 60-100?%). The BBS demonstrated its strengths in the more precise survey for monitoring balance and predicting risk for falling. Weaknesses of the BBS were the higher average time of processing and the inability to detect changes in gait. The advantages of the POMA was the short processing time, the possibility for separate identification of balance and gait and the high accuracy in recognition of gait changes. CONCLUSION: The results suggest that the POMA can be used as a fast screening tool to evaluate risk for falling or changes in gait ability. Geriatric patients who screen positive for risks of falls using the POMA should be selected for further assessment using the BBS. The BBS is a concise assessment tool for monitoring balance and to predict a person’s current risk for falling. HubMed – rehab