Sandra Laujin

What is neuropsychological rehabilitation or cognitive remediation?

Neuropsychological rehabilitation, otherwise known as cognitive remediation, is the therapeutic treatment of children with learning difficulties due to a cognitive problem or problems.

In psychological terms, cognitive processes refer to all the mental processes that lead to the acquisition, treatment, storage and use of information or knowledge. They encompass a range of functions controlled by the brain: attention, memory, reasoning, language, planning, organisation etc.

There are many kinds of cognitive disorders/difficulties and these correspond to the brain function affected. For example, attention, learning, memory and reasoning difficulties are all types of cognitive difficulties.

The origin of these brain disorders may be developmental or due to environmental factors. Changes in cerebral functioning may be triggered by brain trauma or conditions such as autism, Down’s syndrome or Alzheimer’s disease. People who suffer from autistic spectrum disorders for example generally have difficulties with attentional and executive functions. Certain difficulties may also have their roots in emotional issues – for example, hyperactivity is often a symptom of anxiety.

Who is cognitive rehabilitation aimed at?

Neuropsychological rehabilitation offered at the practice may be of help to your child if they suffer from:

• A learning difficulty: your child has problems learning and studying
• An attention difficulty: your child is unable to concentrate
• A reasoning difficulty: your child struggles to understand what is being taught at school and the concepts behind the information.
• A memory difficulty: your child struggles to learn and retain

Why seek cognitive rehabilitation for your child?

Cognitive difficulties/disorders have a major impact on learning and future careers. Addressing these difficulties as soon as possible promotes improved learning and helps to avoid academic failings.

Neuropsychological rehabilitation aims to re-educate deficient cognitive functions. Working on these capacities can enhance your child’s global cognitive functioning and thus improve the processes through which information is acquired and minimise learning difficulties.

The objectives of this type of psychological treatment are the following:

• Specific training of deficient cognitive functions
• Development of limited capacities
• Reorganisation of inefficient learning strategies
• Use of preventative and compensatory strategies
• Acquisition of more effective learning strategies
• Maximised use of existing capacities and strengths
• Transfer of skills to other types of activities and contexts

When is neuropsychological rehabilitation appropriate?

Assessment of the disorders or difficulties

Any neuropsychological rehabilitation must be preceded by a comprehensive psychological and neuropsychological assessment that will identify and diagnose the cognitive functions that are causing difficulties. The difficulties and learning disorders will be evaluated.

Difficulties rarely have one cause only. The complex nature and mechanisms of the brain mean that it is essential to explore all factors that may have an influence on learning (for example psychological, medical, instrumental and developmental factors).

Full assessment in the case of a learning disorder being related to a cognitive disorder enables detection of the type, severity and origin of the difficulty. Once a diagnostic has been made, the neuropsychologist can recommend the most appropriate therapeutic treatment(s). The neuropsychologist can also work collaboratively with the school and assist the teacher in putting psychoeducational programs into place that are adapted to your child’s needs.

Why assess the severity of a child’s difficulties?

Firstly it is important to ascertain whether your child is suffering from a learning difficulty (cognitive difficulty) or from a learning disorder (cognitive disorder). The prior may be surpassed through psychoeducational interventions, whilst the latter will require neuropsychological rehabilitation.

Why identify the origin(s) of your child’s difficulties?

Emotional difficulties may be behind a whole range of more or less severe learning difficulties without any actual disorder being present. For example, until the emotional factor has been resolved, an anxious child will often be distractible, hyperactive and struggle with tasks involving reasoning or memorisation. In this case, psychotherapy would treat the emotional difficulty as opposed to neuropsychological rehabilitation addressing cognitive difficulties.

In general it is the diversity and duration of symptoms that should alert teachers and parents. A full assessment enables a psychologist and neuropsychologist to confirm or disregard any hypotheses about cognitive or emotional difficulties.