PLANen

Plan A Day

RehaComcomputer-assisted cognitive rehabilitation - brain performance training

www.rehacom.com

RehaCom

computer-assisted cognitive rehabilitation

by HASOMED GmbH

This manual contains information about using the RehaComtherapy system.

Our therapy system RehaCom delivers tested methodologiesand procedures to train brain performance .RehaCom helps patients after stroke or brain trauma with theimprovement on such important abilities like memory,attention, concentration, planning, etc.

Since 1986 we develop the therapy system progressive. It is our aim to give you a tool which supports your work bytechnical competence and simple handling, to support you atclinic and practice.

Idea and conceptionProf. Dr. Joachim FunkeRuprecht-Karls-University Heidelberg, Germanychair in general and theoretical psychology

®

HASOMED GmbHPaul-Ecke-Str. 1D-39114 MagdeburgGermany

Tel. +49-391-6230112

IContent

© 2008 HASOMED GmbH / Prof. J. Funke

Table of contents

Part I Description of the training 1

................................................................................................................................... 11 Training tasks

................................................................................................................................... 62 Performance feedback

................................................................................................................................... 63 Structure of the level of difficulty

................................................................................................................................... 94 Training parameters

................................................................................................................................... 115 Evaluation

Part II Theoretical concept 12

................................................................................................................................... 121 Basic foundations

................................................................................................................................... 152 Aim of the training

................................................................................................................................... 153 Target groups

................................................................................................................................... 174 Bibliography

Index 20

1 Plan A Day


1 Description of the training

1.1 Training tasks

The procedure Plan a day is used to train the patient's ability to organize andplan a day. This is carried out in a very realistic manner, in that particular taskshave to be dealt with at specific places and must be completed within a givenpoint in time. The basic idea of the procedure was conceived by Prof. Dr.Joachim Funke, Chairman of General and Theoretical Psychology at theUniversity of Heidleberg. The adaptive RehaCom version was then developed inco-operation with his colleagues at the University.

Every planning task consists of two stages which can be dealt with in continuousalternation - the task and the city map.

In the task stage: the patient is shown a list of appointments on the screen,which he has to deal with (figure 1). The patient must make sense of eachindividual task and develop their of solution strategies.

Figure 1: Task stage at level 10.

In the city map stage the computer takes over the previously trained strategy. A

2Description of the training


small city map appears with nine buildings which are connected by severalstreets (figure 2). In order to enter the solution into the computer, the patient canuse the keys of the RehaCom panel, the mouse or the touch screen. Anexplanation of the use of the mouse will follow shortly. The position of the mouseon the screen is highlighted by a grey arrow(cursor).

Figure 2: City map stage at level 10. The buildings to be attended are marked incontrast to the others by light red writing.

On the left, either the appointments (task stage) or the city map can be seen. Onthe right, the appointment calander with appointments as well as the list of the still to be completed appointments can be seen. The brown function keys aresituated below these dates. If the cursor is placed on one of these function keys,the text becomes red. The patient can switch, as desired, between the task stageand city map stage, by clicking(with the mouse) on the function keys with thesame name. How does the patient operate the procedure?

At first, the patient must establish which buildings have to be visited and inwhich order. By clicking on the function keys, the patient can then change

3 Plan A Day


their position on the city map. The current position is indicated by a waving,red flag. All buildings which have to be visited are highlighted with light redwriting - all others are designated with yellow writing.

The first destination is chosen by a mouse click on the red point below abuilding or onto a building itself.The red flag then moves to this building. Inorder to confirm the choice the patient must press on the building again -the building is then entered - symbolically. The mouse pointer then changesinto a green door. Alternatively, the function keys can be activated with themouse. The appointment then appears in the appointment book on theupper right and is removed from the list of appointments still to becompleted. Buildings, which should not be visited (yellow writing), can notbe entered. After completion of the task at hand the patient can then clickon to the nearest building or activate the next task with the function keys, forexample, in order to consider the next move. All further tasks are finished inthis manner. The therapists should provide the patients with suitablesolution strategies.

The function key RETURN appears on the upper right with the entry of thefirst appointment into the appointment book . If this press button is pressed(clicking with the mouse), the red flag is moved back a step (the currentsite). Similarly the previous appointment is removed from the appointmentbook and entered again into the list of the still to be completedappointments. In this way, a decision can be corrected.

If the function key time plan is activated, then a heading appears (figure 3)in which the dates, duration and the roadways of the appointments, in theappointment book, are set in relation to a time axis. In this way theoverlapping of appointments becomes obvious. This function also helps thepatient to develop strategies (to visualize the appointments and of thetimes). The importance of the colors is explained in the instruction stagebefore each task.



Figure 3: Time planning - graphic representation of the appointments with anexplanation in the instruction stage of level 36.

From Level 26 on, a taxi can be used to shorten journey times. If the patientwishes to use the taxi, he should activate the function key taxi "before starting thejourney". A green car then appears, which is also the symbol used in the relevantappointment in the calendar and in the time graphic (figure 4). The currentjourney time appears at each individual location. This is to help the patientimprove and reduce journey time time (figure 4). This changes from location tolocation. The use of the taxi halves the journey time. The patient instructionsgives clearer explanation before such a task.attention

5 Plan A Day


Figure 4: Taxi symbol and journey time at level 30.

The patient should press the finished function key on completing the task. Adetailed error report is then shown if the solution is incorrect. The patient is giventhe option of correcting their errors. When the patient selects the "yes" key theprevious task reappears (by activating the function key return. Otherwise, thetask is evaluated, as it stands, in relation to the closest level of difficulty. When using the RehaCom panel, some special features should be takeninto consideration. The patient can switch between screens, right and left,by pressing the '+' key. The active screen has a light green frame. If theright screen is active, the function keys on the screen can be manipulatedwith the arrow keys and the patient confirms his choice by pressing the OKkey. If the left screen is active, the red flag can be manipulated with the arrow keys is moved in order to move to the next building and/or up to thenext crossroads in the city map. When the patient presses the OK key thepatient can enter the virtual building and the appointment is placed in theappointment book.

Operation with the mouse is a lot easier and is highly recommended.Experience tells us that it is easier for patients to familiarize themselves with thetask when using the mouse. If patients suffer from movement disabilities in their



fingers, the mouse can be moved with the one hand and the patients can confirmtheir choice (with the other) by pressing the OK key on the RehaCom panel. Theeasiest method of operation is, of course, the touch screen.

Before every new task, the patient is given lengthy instructions on the practicemethod (learning by doing).

1.2 Performance feedback

No feedback occurs while during each task. The solution and the errors made areanalyzed only after the patient presses the finished key and differentiated asfollows:

· The number of the completed appointments does not match those required for

the solution.

· The order of completion was incorrect.

· The taxi was not used in the case of specific tasks.

1.3 Structure of the level of difficulty

The procedure operates in an adaptive manner. The structure of the level ofdifficulty incorporates 3 types of heuristics:

· Consideration of priorities,

· Minimizing the journey times and

· Maximizing the completion of tasks.

Within the given heuristics, the levels of difficulty are varied according to furthercriteria. These parameters were determined within the framework of a pre-study.The difficulty does not increase in a linear manner. Consolidation phases changewith levels which require additional levels of decision. In total 55 levels areavailable.

In the case of the first heuristic, considering priorities, the dates arecharacterized explicitly or implicitly as very important or important. It is thesepriorities which have to be considered.valid to consider it. It is referred in the taskas to how many tasks have to be completed. The following parameters are used:

· Clarity of statement: IMPORTANT or VERY IMPORTANT (salient=clear, not

salient= statement packed in the text e.g., "It is very important for you toparticipate in this event.").

· Information about times: kind of time described, whether there is no time

7 Plan A Day


shown, a point in time or a period of time - in relation to the appropriate taskwhich has to carried out.

· Number of the appointments: Groups from appointments (pairs and threes)

which have no bearing on the time.

The column "No. solution" shows the number appointments which can be chosen.

Level salient time No. Pairs No. threes No. solutions

1 yes without 1 0 1

2 yes without 0 1 1

3 no without 1 0 1

4 no without 0 1 1

5 yes point in time 2 0 2





10 no point in time 2 0 2





15 yes period of time 2 0 2





In the case of heuristic - minimization of journey time - the task is to chose theappointment constellation with the least amount of journey time. This is why ataxi should be used for the longest way in some tasks. The parameters vary

· Number of tasks.

· Journey time display: In the planning of time stage- By selecting "yes" the

journey times are specified in relation to the respective places. By selecting"no", the journey times must be estimated.

· Information about the final destination: By selecting "no" no final destination is

indicated, the task is then less complex. By selecting "yes" a final destination isselected. On the way to the destination, the patient has to consider differentcombinations.

· Use of the taxi: A taxi must be used for long journeys. The number of possible



combinations then increases.

Level No. tasks journey time destination Taxi

20 2 yes no no

21 2 no no no

22 2 yes yes no

23 2 no yes no

24 3 yes no no

25 3 no no no

26 3 yes no yes

27 3 no no yes

In the case of the heuristic - maximizing the completion of tasks, thepatient has to complete as many appointments as possible, being carefulnot to overlap appointments. There appointments which have to be finishedat specific points in time and there are ones which have to be dealt withover a period of time. As levels increase the number of appointments andthe variety of appointments also increases (those which perfectly or partlyoverlap). The taxi may also be used. The patient's task is to find the optimalselection of appointments. It should be pointed that the tasks at the higherlevels of difficulty would be demanding for non-suffers and so it is probablethat the patients may not be able to solve them.

The following parameters featured in this heuristic are:

· Number of the fixed tasks: Tasks with a fixed time (e.g. "She must be at the

doctor at 2 o'clock.").

· Number of the variable tasks: Tasks which have to be completed over a period

of time. There is a variety of ways to complete the appointments and therefore itis more difficult to classify them into the time schedule.

· Number of the unsolvable appointments: These appointments can not be put

into the appointment book (leads to incompletion of tasks)

Level No. Tasks fixed variable unsolvable

28 3 3 0 0

29 3 2 1 0

30 3 1 2 0

31 3 0 3 0

32 4 3 1 0

33 4 2 2 0

34 4 1 3 0

9 Plan A Day


35 4 0 4 0

36 4 3 1 1

37 4 2 2 1

38 4 1 3 1

39 4 0 4 1

40 5 3 2 0

41 5 2 3 0

42 5 1 4 0

43 5 0 5 0

44 5 3 2 1

45 5 2 3 1

46 5 1 4 1

47 5 0 5 1

48 6 3 3 1

49 6 2 4 1

50 6 1 5 1

51 6 0 6 1

52 6 3 3 2

53 6 2 4 2

54 6 1 5 2

55 6 0 6 2

1.4 Training parameters

In the manual RehaCom basic foundations, general notes and referenceson the training parameters and their effect are given. These referencesshould be taken into further consideration.

Picture 5 shows the parameter menu:



Picture 5: Parameter menuü

Current level of difficulty:The level of difficulty can be set up from level 1 to 55. Duration of training/Cons. in mins:A training period of 30 minutes is recommended.

Heuristics:The Heuristics were described in the section on the structure of the level ofdifficulty. These have been further broken down into sections. The sectionsof the heuristics can be used separately or in combination with oneanother.

Number of corrections:If the patient has input an incorrect solution (ending the task by pressing thefunction key - finished), the patient can once again attempt to process thetask correctly. The maximum number of these attempts is determined bythe parameter "number of corrections" (0..9). In this way, the patient has thechance to learn from their mistakes.

Number of repetitions:The patient moves on to a higher level when the correct number of taskshave been solved, in relation to the amount of repetitions used and vice

11 Plan A Day


versa. In this way, the difficulty is only modified if a positive or negativeperformance consolidation occurred. If the parameter is set at 0, the levelcan be increased and/or reduced after each correctly and/or incorrectlysolved task. Corrections of erroneous solutions (see parameter "number ofcorrections") are not considered here.

Appointment display:A display of the appointments still to be completed are shown on right edgeof the screen below the appointment book. This is to help those patientswho have difficulty with their memory. It also places the focus of the trainingstrictly on the planning of a day. This display should be switched off if onewishes to asses the patient's memory.

Input modus:The procedure can be operated by using the RehaCom panel, the mouse orthe touch screen.

With each individual set up of the procedure the following default values areset up:

Current level of difficulty 1Duration of training 30 MinutesHeuristics allNumber of corrections 2Number of reputations 2Appointments shown yesInput modus Mouse

1.5 Evaluation

The diverse possibilities of the data analysis for the determination of the furthertraining strategies are described in the RehaCom basic foundations.

In the graphics as well as in the tables, and along with the set up in the Trainingsparameters, the following information is also available:

Level current level of difficultyTraining time (effective) training timePause Number of pausesSolution Quality of the solution (OK, Number, incorrect (Number

of wrong appointments), incorrect appointment (wrongappointment fill in), incorrect order (appointments in thewrong order), Taxi incorrect)

Tasks Amount of work in the task stage



Planning Amount of work in the planning stage (Window citymap)

Time Amount of work in the time windowCorrections continuous number of corrections, beginning at 0 Appointments Nu umber of appointments in the taskSolutions Number of completed appointments/ Number still to doTotal duration Duration of planning in min:s the current task including

previous corrections

In the result menu there is an additional key - show the way - which showspossible ways available. A picture appears along with the solution for the currenttask. The key 'starting point' returns the flag to the start position. The key 'run'moves the flag along the way chosen by the patient. The therapist can determinewhether the task was solved precisely or through trial and error.

2 Theoretical concept

2.1 Basic foundations

Everyday tasks usually require both a motoric and cognitive capability profile,which consists of a combination of several independent skills.

The underlying ability to develop plans and then implement them is one of themost complex of all cognitive human abilities.

A reasonable and independent course of action is only then possible, if behaviouris planned and organized over a long period of time.....and considered inconjunction with priority tasks.

It requires the capability, behaviour to initiate, supervise, reflect and if necessaryto be flexible and adaptive (Alderman & Ward, 1991; Burgess & Alderman, 1990;cf. Wilson et al., 1998). The term planning means - a type of provisionalpresentation of a course of action - in which all the shared conditional variablesare explored and coordinated in order to reach a specific target. Simultaneouslymental planning sequences are conceptual courses of action with flexible andreversible process components, in which, individual actions are examined andchecked for their consequences and connections to different possible courses ofaction and for their part once again checked for theses additional possibleconsequence.(Dörner, 1990; cp. von Cramon & von Cramon, 1993). Extensiveproblem analyses demands the generation of hypotheses as well as therecollection of various heuristics: an wealth of information, which must besimultaneously held (memory functions) and processed.

13 Plan A Day


The ability to plan and carry out actions is assigned to the so-called executivefunctions. Lezak(1983; cf.von Cramon & von Cramon, 1993) defines these asevery capability which enables a person to pursue work and to partake in a sociallife and to a certain degree be able to look after themselves.

For this purpose, the following are necessary:

· the ability to formulate goals alone,

· to execute plans with a particular goal in mind and

· to have control over one's motor skills, so that a particular goal can be

achieved.

Stuss & Benson (1984) have limited the executive functions of basal cognitivesystems like attention, visual-spatial performance, memory, natural language,movement e.t.c and they have subdivided them into the components anticipation,goal selection, planning and checking. In their hierarchically organizedFeedback-Feed forward-Model of brain functions (Stuss, 1992) three functionallevels exist:

· sensory-perceptual level (perception, automatic processes),

· level for the frontal controlled executive control,

level for self reflection and ones relationship with one's environment.

The model of the working memory from Baddeley & Hitch suggests a centralexecutive, just like Shallice's supervisory system (1982; cf., 1991) and theanalogy of the functions of the executive control and should be considered asStuss considered them. Karnath (1992) considered the common characteristics of different theoriesabout the participation of frontal structures in the mental planning process (Pribram, 1987; Berstein 1975; Shallice,1988 and Luria 1966; cf.Karnath, in1992) as follows:

1. Information analysis, exploration2. The planning process a) Drafting models for courses of action/ structuring a sets of tasks b) Anticipation (if there is no hint as to the solution after the situation analysis) 3. Automatic re-call of currently available plans in routine situations 4. Executing actions 5. Checking the course of actions by means of feedback task, cf., planning ofactions.

To this day, we still cannot present a conclusive theoretical model of the

14Theoretical concept


fundamental basics and functions of the frontal neural networks. However, as aresult of empirical clinical experiences, we are able to presume that the humanfrontal part of the brain is involved in mental tasks, which generate (or areresponsible for) the above mentioned skills (cf.Stuss & Benson, 1984).

Based on the fact that these abilities are absolutely necessary for individuals tohave some form of everyday independence; it then follows that patients withdisturbances or impairments to their executive functions often suffer fromconsiderable hindrances in both their private and public lives. To clinically defineor locate such an impairment is often problematic and can affect, in a selectivemanner, certain cognitive, emotional and behavioural areas.

Such symptom complex impairments to the planning of action, memory, problemsolving thinking and the lack of obvious of signs of illness, can complicate thetherapeutic process, as there is often an inadequate use of the therapeuticstrategies available.

Patients with impairments to their executive functions can achieve inconclusiveresults under standard diagnostics techniques. Usually patient first becomeaware of these problems in everyday life situations. Recently, a lot moreprocedures have been developed which represent standard everyday situationsof planning and orientation. Therefore these procedures clearly have a higherecological validity. Das Behavioural Assessment of the Dysexecutive Syndrome(BADS - Wilson et al., 1998) contains tasks, which - in combination withbehavioral observation during the examination - registers the above mentionedsymptoms in a highly differentiated manner. In particular the tasks "Zoo visit" and"Six-element tests" provides the therapist with important information, with regardto the patients impairments to planning.

Therapeutic extensions to the treatment of impairments to the executive functionsshould also take the following into consideration:

· Re-establishing lost functions

· Learning internal strategies (e.g. Self instruction )

· The use of external aids (e.g. Notes, Quix, Psyx Memophon)

· Behaviour examined in relation to the patients environment (e.g. therapeutic

behavioural extensions)

In a therapy program developed by Cramon & Cramon both cognitive as well asbehavioural aspects of this type of impairment have been taken intoconsideration.

The sections on aim of the training and target groups contain additional

15 Plan A Day


information.

2.2 Aim of the training

The aim of the training is to improve the executive functions, in particular -planning of actions and competence in everyday life The procedure puts demandon memorizing specific sequences as well as a continuing observation ofindividual steps.

The procedure offers the therapists the possibility to interact with the patients, tohelp them develop strategies to improve the cognitive functions and theirself-control. In the case of disorders to self control and the planning of onesactions (Monitoring) therapeutic behavioural techniques can be established andpracticed in parallel with the procedure (for example self expression). In this waycomplex planning processes can be developed - like the possibility ofnon-structured everyday life situations, the aim of which is to locate differentavailable components and to select the correct or most efficient one.

Plan A Day is an everyday life oriented practice procedure which makes bothdemands on basic and more complex cognitive abilities. It can be set up to beeither memory intensive or not (strictly planning of actions). An essentialadvantage is that consists individual sequences of action are followed andtherefore the patient controls the process at all times.

Before the patient begins training with this procedure the basic executivefunctions and abilities can also be trained with the following Attention &Concentration (AUFM), Verbal Memory (VERB), Word- and pictorial memory(WORT and BILD) or Shopping (EINK).

In general, an extensive neuropsychological diagnostic is a better method toestablish which therapeutic procedures are appropriate.

2.3 Target groups

The training procedure Plan A Day was developed for patients with imparimentsto their executive functions, in particular for patients who have problemsplanning actions and solving logical problems.

Disturbances to the planning of actions in patients who suffer from a form a braindamage may have many different sources. In particular, after uni or bilateral frontal injuries, the brain suffers cognitive, emotional and behaviouraldisturbances, which based on their functions is know as Dysexecutives



Syndrome (Baddeley & Wilson, 1988), (Stuss & Benson, 1984; Duncan, 1986;Baddeley & Wilson, 1988; Shallice & Burgess, 1991; von Cramon & von Cramon,1992; Stuss, 1992). These may include:

· Attention disorders (selection, focusing),

· Vigilance disorders,

· Increased distraction/ interference vulnerability,

· Disturbances of memory,

· Decreased learning ability,

· Disorders in aim-oriented action,

· Disturbances to the logical problem solving ability,

· Decreased abstraction,

· Inability to distinguish important from unimportant (information selection),

· decreased ability for the initiating and the sequencing of actions,

· Rigidity

· Incorrect notion of temporal sequences,

· Impulsiveness or loss of initiative,

· Difficulties in using responses,

· Inability to locate error or correct,

· Dissociation between knowledge and action,

· Incorrect anticipation of consequences of action (foresighted thinking),

· Incorrect self regulation and self perception,

· inadequate social behaviour,

· lack of insight into the illness, Anosognosia.

Luria ( 1966, cf.von Cramon & von Cramon,, 1993) paraphrased this type ofthinking and motoric impairments as a kind of disconnections syndrome :"... Thepatients have difficulties analyzing the conditions of a problem and recognizingimportant connections and relations. The sequence of precise operationsappears to be dissolved into its parts and haphazard; they ignore the phase ofthe preliminary examination of the conditions and limitations of a problem andreplace purely intellectual operations by unrelated, impulsive actions..."

Along with frontal injuries of different genesis (vascular cerebral injuries andinfarcts and hemorrhages, brain traumas, tumors) the above-mentioneddisturbances can also be observed after numerous diffuse injuries to the brain(primary- and secondary-degenerative brain infections like Hypoxia, etc).

Patients often have problems organizing their everyday life as a result deficientaspects to their abilities or as a result of the dysexecutive syndrome. As thesyndrome is itself is a combination of impairments to attention, memory,behavioral and motor skills, it therefore constitutes a particular challenge to

17 Plan A Day


therapists in the field of neuropsychology. This is complicated by the fact thatpatients' basic cognitive functions(attention, visual spatial performance, memory,speech and motor skills) are often more or less severely impaired and thesedeficits lead to more complex types of impairments.

The procedure can also quite easily be used with patients who suffer frommemory problems, particularly those who suffer from short term memory andworking memory disturbances.The training of relevant single components is worthwhile only when if specificabilities are no longer or only partly available (memory, ordering, adding andsubtracting). In addition to neuropsychological rehabilitation, the procedure canalso be applied for cognitive treatments at an educational level as well as in thefield of geriatric study. The patient must have a standard unimpaired linguistic ability in order for thetraining to be worthwhile and must be in a position to deal with such tasks - i.e.the required level of attentive skills.

Patients with serious deficits to their short term memory and working memoryshould seek a different type of therapeutic treatment or try working with lessdemanding procedures.

2.4 Bibliography

Aktinson R.C., Shiffrin R.M. (1968): Human memory: a proposed system and itscontrol process. Ub: Spence K, Spence J (Ed.): The psychology of learning andmotivation, Vol. 2. New York: Academic Press.

Baddeley, A.D. & Hitch, G. (1974): Working Memory. In: Bower, G.A. (Ed.):Recent Advances in learning and motivation, Vol. 8. New York: Academic Press.

Baddeley, A. & Wilson, B.A. (1988): Frontal Amnesia and the DysexecutiveSyndrome. Brain and Cognition, 7, S. 212-230.

Cramon, D.Y. von & Matthes- von Cramon, G. (1991): Problem-solving Deficits inBrain-injured Patients: A Therapeutic Approach. NeuropsychologicalRehabilitation, 1 (1), S. 45-64.

Cramon, D.Y. von & Matthes- von Cramon, G. (1992): Reflections on theTreatment of Brain-Injured Patients Suffering from Problem-solving Disorders.Neuropsychological Rehabilitation, 2 (3), S. 207-229.

Cramon, D.Y. von & Matthes- von Cramon, G. (1993): Problemlösendes Denken.In: Cramon, D.Y. von; Mai, N. & Ziegler, W. (Hrsg.): Neuropsychologische



Diagnostik. Weinheim: VCH. S. 123-152.

Duncan, J. (1986): Disorganisation of Behaviour After Frontal Lobe Damage.Cognitive Neuropsychology, 3 (3), S. 271-290.

Gauggel, S. & Konrad, K (1997): Amnesie und Anosognosie. In: Gauggel, S. &Kerkhoff, G. (Hrsg.): Fallbuch der Klinischen Neuropsychologie. Praxis derNeurorehabilitation. Göttingen: Hogrefe. S. 108-119.

Hömberg, V. (1995): Gedächtnissysteme - Gedächtnisstörungen. NeurologischeRehabilitation 1, S.1-5.

Karnath, H.-O. (1991): Zur Funktion des präfrontalen Cortex bei mentalenPlanungsprozessen. Zeitschrift für Neuropsychologie, 2 (1), S. 14-28.

Keller, I. & Kerkhoff, G. (1997): Alltagsorientiertes Gedächtnistraining. In:Gauggel, S. & Kerkhoff, G. (Hrsg.): Fallbuch der Klinischen Neuropsychologie.Praxis der Neurorehabilitation. Göttingen: Hogrefe. S. 90-98.

Kerkhoff, G., Münßinger, U. & Schneider, U. (1997): Seh- undGedächtnisstörungen. In: Gauggel, S. & Kerkhoff, G. (Hrsg.): Fallbuch derKlinischen Neuropsychologie. Praxis der Neurorehabilitation. Göttingen: Hogrefe.S. 98-108.

Kohler, J. (1997): Das "Plan-A-Day"- Programm. In: Gauggel, S. & Kerkhoff, G.(Hrsg.): Fallbuch der Klinischen Neuropsychologie. Praxis derNeurorehabilitation. Göttingen: Hogrefe. S. 348-357.

Kolb, B. & Whisaw, I. Q. (1985): Fundamentals of Human Neuropsychology. W.H. Freeman and Company.

Reimers, K. (1997): Gedächtnis- und Orientierungsstörungen. In: Gauggel, S. &Kerkhoff, G. (Hrsg.): Fallbuch der Klinischen Neuropsychologie. Praxis derNeurorehabilitation. Göttingen: Hogrefe. S. 81-90.

Schuri, U. (1988). Lernen und Gedächtnis. In Cramon, D. v. & Zihl, J.(Hrsg.).Neuropsychologische Rehabilitation. Berlin, Heidelberg, New York:Springer-Verlag.

Schuri, U. (1993): Gedächtnis. In: Cramon, D.Y. von; Mai, N. & Ziegler, W.(Hrsg.): Neuropsychologische Diagnostik. Weinheim: VCH. S. 91-122.

Shallice, T. & Burgess, P.W. (1991): Deficits in Strategy Application FollowingFrontal Lobe Damage in Man. Brain, 114, S. 727-41.

19 Plan A Day


Stuss, D.T. (1992): Biological and Psychological Development of ExecutiveFunctions. Brain and Cognition, 20, S. 8-23.

Stuss, D.T. & Benson, D.F. (1984): Neuropsychological Studies of the FrontalLobes. Psychological Bulletin, 95 (1), S. 3-28.

Tulving, E. (1972): Episodic and semantic memory. In: Tulving E. & Donaldson,W. (eds.): Organisation of memory. New York: Academic Press,

Wilson, B.A.; Alderman, N.; Burgess; P.W.; Emslie, H. & Evans, J.J. (1998):Behavioural Assessment of the Dysexecutive Syndrome. Suffolk:TVTC ThamesValley Test Company.

Index 20


Index

- A -Aim of the training 15

Aims 12

Anosognosia 15

Anticipation 12, 15

Appointment display 9

Appointment summary 1

assosiative connections 15

atttention disorders 15

- B -Behavioural Assessment of the DysexecutiveSyndrom 12

Behaviourial checks 12

Behaviourial disturbances 15

Bibliography 17

- C -clarity of the statement 6

cognitive functions 15

competence in actions 15

connections as per content 15

consequence of actions 15

Consideration of priorities 1, 9

consultation of training 11

continuous data analysis 11

control over ones actions 12

Correction 1, 6, 9

current level of difficulties 9

- D -defined term 12

destination 6

Diagnostic 12

difficulty levels 11

Disconnections syndrom 15

distraction 15

Duration of trainingr/Cons. in min 9

Dysexecutive Syndrom 15

- E -error 1

everyday situation 15

executive checks and controls 12

executive functions 12, 15

external Strategies 12

- F -Feedback 12

Feedback-Feedforward-Model 12

filling in of appointments 1

fixed appointments 6

frontal damage to the brain 15

- H -Heuristic 1, 6, 9

- I -Impulsive nature 15

Independence 12

Information analysis 12

Input mode 9

Instructions 1

internal Strategies 12

- J -Journey plan 1

journey time 6

- L -lack of perception into the illness 12

Level 6

logical thought 15

loss of iniative 15

Plan A Day21


- M -Maximizing the completion of tasks 1, 9

Memory 12

memory disorders 15

mental process of planning 12

minumal learning ability 15

Motoric model 12

- N -neuropsychologiscal Rehabilitation 15

not-salient 6

not-the-optimal solution 6

number of appointments 11

number of corrections 11

- O -Overlapping 1

- P -Pauses 11

Perception 12

performance feedback 6

period of time 6

Perseverence 15

Planning 11

planning /drafting of actions 12

Planning ability 1

planning actions 12

planning competence 15

planning of action disorders 15

Planning of actions 15

planning process 15

Plannning 1

Plans 12

point of time 6

practice 1

Priority 6

Problem solving thought 15

problem solving thought process 12

Process components 12

- R -reduction of journey time 1

Reduction of journey times 9

Rehabilitation 12

RehaCom-Procedure 15

Repetition 9

- S -salient 6

self control 15

Self perception 15

self reflection 12

self regulation 15

sequence of actions 15

Social behaviour 15

solutions 11

still to be completed appointments 1

Strategies 15

strategies for memory 15

Structure of the level of difficulty 6

Supervisory System 12

Symptom complex 12

- T -taking back of appointments 1

Target groups 15

Task 1

Tasks 6

Taxi 1, 6

theoretical basic foundations 12

Therapy 12, 15

time 11

Time graphic 1

total duration 11

Training mode 1

Training parameters 9

Training screen 1

Training summary 1

training time 11

Type od errors 6

Index 22


- V -variable appointments 6

- W -Working memory 12, 15

Date post:	23-Mar-2016
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