A Child and Family Psychiatry

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The Thinking and Learning Program (TALP)

The Thinking and Learning Program (TALP) includes elements of the Feuerstein Instrumental Enrichment (FIE) program and Cognitive Remediation Therapy (CRT).

The Feuerstein Method and Cognitive Remediation Therapy teach the skills of learning and thinking.

Feuerstein Instrumental Enrichment (FIE) program consists of activities which develop such important thinking skills as finding patterns, comparing, categorizing, analyzing, understanding emotions, and much more; this focus then improves an individual’s learning potential. The program has resulted in improvements in individuals with Brain Injury, Autism, ADHD, Down’s Syndrome, Dyslexia, and Learning Disabilities.

Cognitive Remediation therapy, also referred to as Cognitive Enhancement Therapy, is a therapeutic approach focused on treating specific neurocognitive areas. CRT is unique because it has a goal to develop the underlying cognitive skills that are critical for everyday life.

What is Cognitive Remediation Therapy (CRT) ?

Cognitive Remediation Therapy, also referred to as Cognitive Enhancement Therapy, is a therapeutic approach focused on treating specific neurocognitive areas. Here are some examples of identified areas:

Attention

Working Memory

Verbal, Visual & Auditory Learning Memory

Speed of Informational
Processing
Problem Solving & Reasoning

WHAT IS WORKING MEMORY?
Working memory is the ability to hold information in immediate awareness while performing a mental operation. For example, being forgetful about where you JUST put your keys while chatting on the phone or finding it difficult to listen and take notes at the same time. To gauge your working memory right now (if it’s safe to do so) try to pat your head, rub your tummy, moonwalk, and sing your ABCs simultaneously.

WHAT IS THE PRIMARY GOAL OF CRT?
The principal goal of CRT is to reduce cognitive deficits and strengthen an individual’s capacity to accept, process and manipulate information while improving their overall quality of everyday life.

IN WHAT CONDITIONS IS CRT MOST EFFECTIVE?
Cognitive Remediation is a valuable tool in the treatment of people who deal with a vast array of impaired cognitive functions. That being said, where CRT could arguably be considered most effective would be in these common conditions:

Traumatic Brain Injury (TBI); post-stroke conditions; Attention Deficit Hyperactivity Disorder (ADHD).

Youth with higher-functioning autism spectrum disorders and serious learning disabilities.

Bipolar; Depression; PTSD patients who suffer with cognitive disabilities; Schizophrenia; Alzheimer Disease.

YOU OR YOUR CHILD MIGHT NEED CRT IF YOU’RE:

Having difficulty paying attention for short and/or long periods of time.
Easily distracted by surrounding ‘background’ sounds and activity.
Frequently asking for instructions and explanations to be repeated.
Finding it tough to know or understand things right after they’re presented.

Often forgetful about what you were ‘just was thinking about.’
Having difficulty following guided or written 2 and 3-step instructions.

Having difficulty retelling information from materials you just heard, read or saw.

Challenged when asked to repeat simple verbal directions.

Often taking a long time to answer questions.

Often taking longer time to complete tasks or homework or tests than ‘normal’.

Please browse the example list below demonstrating different situations where people find CRT beneficial:

The 1st grader getting increasingly frustrated due to difficulties learning to read and pay attention for short or a long periods of time.

The 5th grader having difficulty recalling class content for tests and for this reason spending enormous time on homework.

College students struggling to remember what he/she read in class or study groups and unable to comprehend or process audibly-delivered information.

A 45-year-old male with TBI who finds it difficult to retell information from materials they read or saw. Or, who finds it challenging to distinguishing between letters of the alphabet.

A 52-year-old female with Post-Stroke Condition who has trouble following 2 or 3-step instructions, and who seems not to know things directly after they’re presented.

I HAVE TBI OR DEAL WITH POST STROKE CONDITIONS. WHY DO I NEED CRT?
Many patients recovering from a stroke or TBI display different degrees of cognitive changes and emotional difficulties. Cognitive deficits might include problems with attention, memory, verbal and visual learning memory, information processing or executive functioning problems. Cognitive remediation therapy is very useful when helping patients overcome these cognitive difficulties. By improving cognitive areas: attention, different types of memories, and processing speed patients restore everyday functioning.

DO YOU PROVIDE CRT FOR KIDS OR ADULTS?
Yes, CRT is provided for kids and adults.

HOW IS CRT DELIVERED?
CRT is delivered as a set of structured exercises via a computer program, by an individual, or through group activities. Presently it’s provided as a face-to-face restorative approach. Together, I guide the patient through a set of repetitive exercises directed towards specific cognitive processes in an effort to see real-world results and improvements. Exercises designed to isolate specific components of impaired cognition like selective attention, visual perception, prospective memory, etc.

WHAT IS UNIQUE ABOUT CRT AND DIFFERENT FROM STANDARD EDUCATION?
CRT has a goal to develop the underlying cognitive skills mentioned above. By improving cognitive skills, a person improves their ability to read and calculate information.

IS CRT THE SAME AS COGNITIVE BEHAVIORAL THERAPY – CBT?
These are two different types of therapies. CRT shouldn’t be confused with CBT, which is a form of psychotherapy that emphasizes the role of thought patterns in moods and behaviors.

HOW LONG IS THE CRT COURSE OF TREATMENT?
The length of a unique individual’s course depends on different things. For example, the extent and severity of their cognitive deficit, medical comorbidities, social support, the nature of neurocognitive deficits, and of course the person’s effort and willingness to participate. The average length of courses is around 10-12 weeks, 3 or 4 times per week. It’s crucial for individuals to do exercises at least 20 min a day, 4-5 days a week for 8-12 weeks.

SHOULD I VISIT YOUR OFFICE 3-4 TIMES PER WEEK?
No. The visits to the office are twice per month or every 2 weeks. Between those times we’ll meet and collaborate through email and telecommunication.

WHAT IF MY CHILD OR I DON’T LIKE THE COURSE OF CRT?
No problem, we can simply stop the course at any time with no ill impacts. We can then re-assess and move forward with the best care.

I NEED THE CRT COURSE, WHAT’S MY FIRST STEP?
The first step is to meet and obtain a complex assessment that includes psychological testing and a clinical assessment. It helps confirm that you or your child have neurocognitive deficits and could benefit from CRT. Also, it helps to make a decision, if you or your child need only CRT or psychotherapy or pharmacotherapy or all together. It might be beneficial to provide CRT together with psychotherapy in order to support the person as he/she experiences different emotions related to cognitive dysfunction.

HOW DO I SCHEDULE AN APPOINTMENT?
You can schedule your first appointment by sending your request to ysherk@hotmail.com or you can call 614-407-6513 and leave a detailed message about your needs.


MY CHILD HAS BEEN DIAGNOSED WITH AUTISM SPECTRUM DISORDER & ADHD. HOW COULD MY CHILD BENEFIT FROM THE CRT COURSE?
Your child might have been given the diagnosis of Autism spectrum disorder, ADHD or he/she might have developmental delays, the list might be longer. The first question is whether your child has IEP, a 504 plan, or any neurological or psychological evaluations have been performed. The psychological evaluation(s) show what type of cognitive deficits your child has. The CRT course might be provided based on the results of psychological deficits.