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Dr. J. Stone

March is Brain Injury Awareness Month

March is Brain Injury awareness month, so it seems appropriate to discuss some memory strategies. Memory is defined as “the ability to recall events on command.” We all would love to have better memories, however, sometimes life events occur that alter this ability, but there are strategies that can help.

 

Adapt your environment: Hang a dry erase board in your kitchen or office to write down reminders or needed grocery items. You can also keep a dry erase calendar in a central area of your house or office to keep track of your daily/weekly activities. Some of you may be saying that you already do this on your Smart Phone, which is great, but for some folks after a brain injury, they need to “see” reminders to help improve memory skills – a visual reminder. If you want to use your Smart Phone for reminders, make sure to alarm your reminders. You could even set a daily alarm to remind yourself to look at your schedule! If Smart Phones are confusing, you can carry a datebook and get in the habit of reviewing the datebook every morning to review your day’s activities. Make sure you put things back in the same spot (e.g. keys on the hook by the door, coat in the closet, briefcase on the desk in the home office, bills in a basket, etc.) this will help build a routine of where items are to be found and it will significantly decrease your frustration when searching for the items (especially if you are in a hurry!). Routines are very important for memory because they help build long term memories, which is where information we want to retrieve exists.

 

Improve your wellbeing: Anxiety, stress and depression can significantly decrease memory skills. You need to have a balance between work and relaxation, so seek out/plan enjoyable activities outside of your work day. Maintain friendships and talk about your difficulties and frustrations, you never know who will give you some good strategy suggestions! Stay physically active, even simple exercises like taking the stairs instead of the elevator can help. Be assertive; learn to say “no” to excessive demands. This one is really important, manage you time and take breaks. Sometimes after sustaining a brain injury people want to “push” themselves to get better, but this is actually counterproductive. Your body and brain need time to heal and taking breaks is the best way to make progress. Do one thing at a time; establish a goal and break the steps down into smaller, more manageable parts.

 

Other helpful cognitive strategies: Attention is the key to a better memory, so try to focus on information you want to remember and reduce the background distractions. When trying to remember new information, make associations with existing information in your memory. Mentally retrace your steps to trigger your memory for where you may have left an item. Hang reminder signs or use sticky notes to trigger memories of activities you want/need to do. When trying to recall a list of items, chunk the like items together to be able to recall them more easily.

 

As a neurorehabilitation specialist I have taught many of these strategies to my clients over the years and the majority had a lot of success. Recovering from a brain injury can take time, but using strategies consistently can definitely help.

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Carol Bardsley, M.A., CPCRT, CBIS – At The Center I facilitate the Therapeutic Activities Group, which is an educational group for people who have sustained a traumatic brain injury.  I also provide one-on-one Cognitive Rehabilitation Therapy to clients either in their homes or in our office. In addition, I assist Dr. J. Stone with the neuropsychological evaluations.

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My Kid Has ADHD… Now What?

Last week, I spoke about the core features of ADHD – mostly, a decreased ability to stop from doing something. This not only explains the impulsive behavior we see, like calling out, interrupting, quick to laugh, etc. but also inattentive and distracted behaviors, when every little thing needs to be attended to, looked at, thought about.

The main take home point of the talk was to develop appropriate expectations. Medication, therapy and parenting techniques can help our children function better, but none of them take away the ADHD. Instead of saying things such as, “You’re 12 now, you should be able to do this.” or, “You have to try harder to pay attention!”, we need to expect that that they will need help getting started, staying on task and shifting from one thing to another. We should expect that they will struggle remembering things from time to time and will forget to turn in homework. The more you know about ADHD – and specifically, your child’s ADHD, the more accurate your expectations will be. Don’t be afraid that helping too much will enable these children and “spoil” them; that they will never learn to do things for themselves. It is simply not true.

If you’re wondering how much support is enough or too much – don’t worry; it’s constantly changing! Instead, my rule of thumb is to provide as little support as is necessary for them to be successful. Note the two important parts: 1) Your support must lead to success. For example, homework will be completed; trash will be taken out (all of it – all the way to the curb). If it’s not done right, you might have helped enough, and 2) Provide only what they need. Think in terms of the executive functioning demands of the task. Are they having trouble getting started, organizing their thought for a paper, turning off the video game? Although setting a timer is good idea (and nearly cliché in ADHD), don’t be afraid to actually turn the game off yourself. Just give them a warning ahead of time so they know it’s coming. Don’t make it punitive – make it helpful.

I gave the example of a boy who was having difficulty taking out the trash completely (he’d always miss something!). Instead of doing it for him (too much) or telling him what he did wrong after he was done (too little – and too late), his mother simply walked with him throughout the process, prompting only when needed. Her presence was all he needed to remind him to stay on task, think about what he needed to do and to know that he had a safety net (mom) in case he forgot. The task was successful and he felt much better about that than always forgetting some aspect of the job. Eventually, his mother faded her help, the routine he established stuck and he did great (or as great as any other teenager does when taking out the trash!).

Lastly, when supporting children with ADHD, it is important to keep in mind what is actually getting in their way? Is it some aspect of the ADHD? It might not be. While a child might have ADHD, it doesn’t define them and there is a lot going on in childhood; normal stress and worries, normal inattention, normal mood fluctuations, etc. Be careful not to define everything through the ADHD. They are not limited by their ADHD, it’s simply something that needs to be managed, much like diabetes. If treated properly and appropriate behavioral changes are made, it can be virtually invisible. However, if left untreated it can cause serious complications. The better educated parents and children with ADHD are, the more they will know what to expect, the more likely they will develop preventive behaviors and they more likely they will be successful.

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To schedule an appointment with Dr. Stone, please request an appointment.

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What is a Therapist?

Many people who I see for treatment refer to me as their “therapist” and I’m fine with that. They also use the word interchangeably with “counselor” and “psychologist”, which I’m also fine with, especially since I am a psychologist. But, really, is there a difference? And if so, what is it?

Certain professions are regulated by the state in order to protect the public. That way, you know that if someone says they are a doctor, accountant or psychologist, for examples, you can trust that they have met the requirements set by the state to practice that profession.

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Teenagers and Sleep

We can all agree that there are few things as satisfying as a good night of sleep. It is essential to our well-being. During sleep we heal, we learn and regain our energy. It helps us pay attention, think faster and it improves our mood. A lack of it and we become grumpy, fatigued and have difficulty concentrating. When you don’t get enough sleep, you are more likely to get injured, sick or have an accident. Drowsiness and falling asleep while driving accounts for more than 100,000 car crashes each year. According to a study by the AAA Foundation for Traffic Safety, people who sleep six to seven hours a night are twice as likely to be involved in such a crash as those sleeping 8 hours or more, while people sleeping less than 5 hours increased their risk four to five times.

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Parent’s Guide to the Pediatric Neuropsychological Assessment

What is a Pediatric Neuropsychologist?

Neuropsychology is a specialty within the field of Psychology that focuses on brain-behavior relationships. A Pediatric Neuropsychologist uses standardized tests and observes behavior to define a child’s pattern of brain functioning and overall development. The child’s performance is compared to what is expected at the child’s age-level or compared to a specific group of children.  The child’s individual pattern of strengths and weaknesses is defined based on these comparisons. The pediatric neuropsychologist uses his/her knowledge of brain development, organization and functioning and their effects on development to guide the assessment, interpret the results and guide the recommendations. (more…)

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