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Memory is the storage of things learned and retained from activity
or experience. Cognition refers to thinking skills. Cognition includes
an awareness of one's surroundings, sustained attention to tasks,
memory, reasoning, problem solving, and executive functioning (e.g.
goal setting, planning, initiating, self-awareness, self-inhibiting,
self-monitoring and evaluation, flexibility of thinking). Cognitive
difficulties are highly common in persons who have suffered tramatic
brain injury. Deficits in cognition vary depending on the location
and severity of the injury to the brain.
What Causes Problems with Memory & Cognition?
Many illnesses, traumas, and disorders can cause difficulties with
memory and cognition including Alzheimer's disease, multiple small
strokes (multi-infarct dementia), Parkinson's disease, Huntington's
disease, drug use or interactions, depression, brain tumors, other
cerebrovascular disease, head trauma, and alcoholism.
What Are the Symptoms Associated with Poor Memory or Cognition?
Cognitive-communication problems that can occur include difficulty
with attention, memory, organization, reasoning, problem-solving,
orientation, social judgment / pragmatics.
Attention problems include difficulty concentrating on a task amid
distractions and paying attention for more than a few minutes at
a time. Also, performing more than one task at once may be difficult
or impossible. When a person’s memory is affected, they may
have difficulty recalling already learned information, such as street
names or important dates, and may not be able to learn new information
easily. Organization problems include being able to correctly sequence
events when telling a story or giving directions or maintaining a
topic while conversing with others.
Reasoning may also be impaired and the person may not be able to
interpret abstract language, such as metaphors, or respond to humor
appropriately. The individual may not react appropriately when presented
with a common occurrence, such as a car breakdown or overflowing
sink. This is due to impaired problem-solving abilities. Leaving
the individual unsupervised may be dangerous in such cases, as they
could cause injury to themselves or others.
A person who has difficulty recalling the date, time, or place is
said to have orientation problems. The individual may also be disoriented
to self, meaning that they cannot correctly recall personal information,
such as birthdate, age, or family names. When human beings converse,
they rely not only on words to convey messages, but also on body
language, facial expressions, and intonation (how the voice rises
and falls while speaking).
Cognitive impairments can cause problems with pragmatics, leading
the individual to ignore or misinterpret such nonverbal cues and
lose the meaning of the message. They may also lack facial expression
when speaking ("flat affect") or speak in monotone or too
rapidly. Social judgment may also be impaired and the person may
laugh at inappropriate times or say inappropriate things without
realizing that they have done so.
Who Can Help with Memory & Cognition Problems?
Speech-language pathologists certified by the American Speech, Language & Hearing
Association (ASHA) with training in the area of memory and cognitive-communication
skills can plan and implement treatment to improve and supplement
a client’s compromised skills in memory and cognition.
What Can Communication Partners or Spouses Do?
- Provide a consistent routine every day.
- Use calendars, clocks, and notepads to remind the person of important
information.
- Decrease distractions when communicating.
- Break down instructions to small steps and repeat directions as needed.
- Ask questions and use reminders to keep the individual on topic.
- Avoid sarcasm, metaphors, etc. when speaking to the individual.
- Provide appropriate supervision to ensure the person's safety.
Questions?
People who are interested in more information about memory and cognition
issues should contact HSDC’s Speech department at 206.323.5770
V/TTY or Email: speech@hsdc.org.
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