Powered by Care: Defining the cognitive aspect of rehabilitation

Powered by Care Therapy

By Kristy Wolfe, MA, CCC-SLP, Director of Therapy Operations at Encompass Health Rehabilitation Hospital of Huntington

Speech language pathologists evaluate and treat disorders of communication and swallowing (dysphagia). Many complex processes within each of these domains.

The complex system of cognition intertwines with language skills and is crucial in order for us to communicate effectively. If the cognitive system does not work correctly for whatever reason, then a person cannot communicate effectively. Strokes, traumatic brain injuries, dementia or other neurological diseases can affect cognition.

The American Speech Language and Hearing Association (ASHA) describes cognitive-communication disorders as, “difficulty with any aspect of communication that is affected by disruption of cognition. Communication may be verbal or nonverbal and include listening, speaking, gesturing, reading and writing in all domains of language”.  

Areas of Cognitive Communication Disorders (CCDs) could include:

  1. Memory: Short-term memory and recalling of new information, or long-term memory challenges
  2. Attention: Ability to determine what information is most relevant and block out the rest
  3. Organization and Planning: What steps need to come first, prioritizing tasks
  4. Problem Solving and Reasoning
  5. Social Skills (pragmatics): Following rules of communication with turn taking, filtering of inappropriate thoughts and not saying those thoughts out loud, etc.
  6. Insights into safety awareness

Although it takes a team of professionals to assist with these areas, speech language pathologists are equipped with the ability to provide a plan of care based on the patient’s overall communication needs.

Examples of cognitive communication treatment may include:

  1. Functional problem solving in a simulated grocery store setting, such as taking a grocery list with a certain amount of money and prioritizing which items are needed in order to cook a meal.
  2. Improving short term memory with compensatory strategies such as memory books, calendars, to-do lists.
  3. Improving social skills and attention in a group setting, by giving a patient guidance and feedback about the appropriateness of turn taking and allowing another person to speak without interruption.
  4. Improving organization and planning by sorting simulated medications in a pillbox and determining how to take the medication according to directions at the appropriate times.

As the geriatric population increases, our rehabilitation hospitals will continue to see more patients affected by forms of dementia We do not shy away from treating these cognitively impaired patients. We are able to provide patients and families with strategies, tools and education to build upon a patient’s strengths and compensate for their deficits as they progress through this illness.

Communication is the one of the most fundamental needs for our patients.  Speech language pathologists are honored to play a part in improving communication for our patients.

Wolfe has been with Encompass Health Rehabilitation Hospital of Huntington in West Virginia since 2008. She has more than 20 years of experience as an American Speech-Language-Hearing Association certified speech language pathologist and 14 years as a therapy director, serving across the levels of post-acute care and in public schools Wolfe holds a master’s degree in communication disorders from Marshall University.

Encompass Health’s Powered by Care series profiles how Company leaders and clinicians are delivering on our promise of connected care and superior outcomes.