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Biomedical subjects

C A Mateer

Publications and source records attributed to C A Mateer.

At least 19 recordsLinked to original sources
PubMed2006

Attention rehabilitation following stroke and traumatic brain injury. A review.

UNLABELLED: Attentional capacities, which are frequently impaired following brain injury, have also been found to be amenable to rehabilitation. This review discusses various approaches to attention rehabilitation in adult clients following stroke and traumatic brain injury. Attention process training has been accepted by many as a practice standard in postacute clients, however, its ability to generalize to new situations and to functional capacities is unclear. There is evidence for the use of psychostimulant medication, which may be most helpful when prescribed in combination with attention training. Biofeedback is a new avenue for intervention and is beginning to show some promising RESULTS: Rather than train underlying processes, another approach which shows promising results in a few small studies is training clients on specific functional skills, such as driving or vocational duties. Finally, modifications to the environment, implementation of strategies, provision of emotional support, and introduction of external supports/aids are important parts of a rehabilitation program, especially as the client returns to their home environment.

Attention↗
PubMed2004

Measuring awareness of financial skills: reliability and validity of a new measure.

This paper examines the psychometric properties of a three-part (participant, informant, and performance) Measure for assessing Awareness of Financial Skills (MAFS). The MAFS was administered to 10 seniors with dementia and 25 well-functioning seniors, and their informants. Measures of cognitive functioning, social desirability, neuroticism, and perceived control were administered to each participant to allow for an assessment of validity. Internal consistency estimates for the participant and informant questionnaires were found to be 0.92 and 0.97, respectively. Convergent validity analysis indicated that performance on this measure was related to level of cognitive functioning, with higher level of unawareness associated with decreased cognitive ability. Discriminant validity analysis showed that performance on this measure was not related to social desirability or neuroticism. This study provides evidence that the MAFS is a reliable and valid tool for assessing awareness of financial skills in older adults.

Aged↗
PubMed2004

Awareness of financial skills in dementia.

The present study examined the relations among levels of cognitive functioning, executive dysfunction, and awareness of financial management capabilities among a sample of 42 community-dwelling persons with dementia. Financial tasks on the Measure of Awareness of Financial Skills (MAFS) were dichotomized as simple or complex based on Piaget's operational levels of childhood cognitive development. Severity of global cognitive impairment and executive dysfunction were significantly related to awareness of financial abilities as measured by informant-participant discrepancy scores on the MAFS. For persons with mild and moderate/severe dementia, and persons with and without executive dysfunction, proportions of awareness within simple and complex financial task categories were tabulated. Significantly less awareness of financial abilities occurred on complex compared with simple tasks. Individuals with mild dementia were significantly less aware of abilities on complex items, whereas persons with moderate/severe dementia were less aware of abilities, regardless of task complexity. Similar patterns of awareness were observed for individuals with and without executive dysfunction. These findings support literature suggesting that deficits associated with dementia first occur for complex cognitive tasks involving inductive reasoning or decision-making in novel situations, and identify where loss of function in the financial domain may first be expected.

Aged↗
PubMed2003

Variables related to job satisfaction among professional care providers working in brain injury rehabilitation.

PURPOSE: To examine variables that contribute to work satisfaction among rehabilitation professionals involved in brain injury rehabilitation. METHOD: One hundred and thirty-three respondents completed a job satisfaction questionnaire and qualitative questions regarding sources of stress and satisfaction in working with individuals with acquired brain injury (ABI). RESULTS: Factor analysis yielded four factors relating to intrinsic satisfaction, perceived importance to the organization, organizational support and training support. Although intrinsic satisfaction was significantly related to the three other factors, it was best predicted by training support, particularly training that addressed the management of intrusive and/or aggressive behaviours. Qualitative correlates of both work stress and satisfaction were also identified with respect to personal issues, client-related issues, and organizationally-related issues. CONCLUSIONS: Satisfaction with work in ABI rehabilitation is derived from multiple sources, but it appears to be largely dependent on feeling important to, and valued by, the organization and on the level of support and training provided in the workplace.

Adult↗
PubMed2001

Utilization behavior: clinical manifestations and neurological mechanisms.

This paper describes a variety of motor release phenomena, including manual grasping and groping, imitation behavior, utilization behavior, and alien hand sign, their clinical manifestations. and proposed neural mechanisms. One of these specific neurobehavioral disorders, initially described by Lhermitte (Brain [1983] 106: 237-255), and termed utilization behavior, is addressed in more detail. Patients with this disorder are described as reaching out and using objects in the environment in an automatic manner. The current paper provides a comprehensive review of studies that have documented utilization behavior in individuals with a variety of pathologies, all having a specific predilection for the frontal lobes and frontal-striatal systems. Goldberg's (Behavioral and Brain Sciences [1985] 8: 567-616) theoretical framework for understanding motor release phenomena, which conceptualizes these behaviors as resulting from an imbalance between proposed medial (voluntary, goal directed, and future directed) and lateral (automatic, stimulus bound, and visually based) motor systems, is also discussed. Utilization behavior may prove to be a common underlying cause of high levels of excessive and intrusive motor behaviors within various clinical populations. A more comprehensive understanding of the neural systems underlying utilization behavior may prove highly useful for the differential diagnosis of conditions involving the mesial frontal cortex and fronto-striatal connections. Recent studies have started to investigate utilization behavior in clinical populations with known or suspected frontal system dysfunction, including adult patients with a variety of psychiatric conditions and children with ADHD.

Brain Diseases↗
PubMed2001

Improving attention and managing attentional problems. Adapting rehabilitation techniques to adults with ADD.

Research and clinical experience in the field of brain injury rehabilitation have focused quite extensively on the need and potential to retrain attentional skills that are commonly affected by acquired brain injury. Four approaches to managing attention impairments that have emerged from this literature include attention process training, training use of strategies and environmental support, training use of external aids, and the provision of psychosocial support. Most often, several of these will be used in combination. For example, a therapy regimen might include attention process training emphasizing specific components of attention (e.g., sustained attention), in conjunction with training in pacing techniques, and psychosocial support, where the client keeps behavioral logs and discusses insights gained from tracking attention successes and attention lapses. Although there are as yet little data with regard to the effectiveness of these approaches in adults with developmental disorders of attention, there is a growing literature suggesting they may be effective in children and adolescents with ADHD. Further investigation of the application of such techniques in adults with a wide variety of attention disorders, including developmental disorders, would be valuable.

Adaptation, Psychological↗
PubMed1999

Executive function disorders: rehabilitation challenges and strategies.

Individuals with frontal lobe impairments often demonstrate a variety of disorders of executive function that pose significant challenges to rehabilitation. Impairments in initiation, sequencing, impulse control, attention, prospective memory, and self-awareness frequently manifest in disorganized and maladaptive behaviors that severely impact many aspects of adaptive functioning. A greater awareness of the nature of these deficits, improved tools for evaluation, and an increased interest in rehabilitation have led to the development of both specific strategies and general schemas for treating and managing executive function deficits. Studies supporting the use of environmental manipulations, compensatory strategy training, and techniques to improve underlying skills, including attention and prospective memory, are described. An overarching strategy for working with individuals with impaired executive functions is proposed, based on the individual's level of awareness and context dependency. Rehabilitation is conceptualized as a set of activities, which assist the individual in moving from a more dependent, externally supported state to a more independent, internally supported and self-regulated state through the systematic shift in external to internal regulation of behavior. Successful movement along this continuum is variable across cases, but the literature suggests that significant gains in function and behavior are possible.

Behavior↗
PubMed1998

Awareness intervention: who needs it?

It is widely accepted that awareness deficits present challenges to recovery and should be addressed as part of rehabilitation programming. Response to awareness intervention is commonly inferred from measurements that rely on reports by subjects and significant others. This article describes the findings from a pilot study that examined the relationship among a variety of awareness indicators in three individuals with brain damage over a 9-month period. Results suggest a dissociation between behavioral and perceptual indices of awareness. Changes in behavioral indicators of awareness selected by caregivers were not related to changes in self- or caregiver ratings. The clinical and research implications of the findings are discussed.

Activities of Daily Living↗
PubMed1996

Management of attention and memory disorders following traumatic brain injury.

Disorders of attention, memory, and executive function are common sequelae in children who have sustained traumatic brain injuries. Given the persistent nature of these deficits, there is a need for efficacious remedial approaches. Typically, remediation is approached, through one of three general intervention strategies: externally focused interventions aimed at changing the environment so that the effect of the dysfunction is minimized, internally focused interventions aimed at improving the underlying cognitive ability, and compensatory interventions aimed at teaching children to use alternate strategies that lessen the impact of the dysfunction. This article describes current research involving these approaches for the treatment of attention and memory disorders in children.

Adolescent↗
PubMed1992

Developmental impact of frontal lobe injury in middle childhood.

Executive function of frontal lobe systems, like intelligent behavior, appears to demonstrate two major features: it is adaptive and goal-directed. Disruption of executive function following injury to the frontal lobes in childhood might be predicted to impact the trajectory of normal cognitive, behavioral, and social development. Case studies of two children injured at different ages showed the primary developmental impact to involve the behavioral and social realms. While cognitive development may be suspected to also be considerably influenced, assessment of changes in cognitive abilities by traditional psychometric means was found to be problematic. Psychometric changes were found to occur over a prolonged period of time, emphasizing the importance of documenting observations and chronicling postinjury events.

Brain Injuries↗
PubMed1989

Training use of compensatory memory books: a three stage behavioral approach.

A systematic, structured training sequence for teaching individuals with severe memory impairments to independently utilize a compensatory memory book is reviewed. The training sequence is theoretically motivated, incorporating both principles of learning theory as well as aspects of memory known to be preserved in many patients with even severe amnestic disorders. This paper describes the components of a functional memory book system as well as the three-stage behavioral training procedure. An illustrative case study reviewing the training and resultant effective use of a memory book system for daily living and employment in a severely memory-impaired patient is provided.

Adult↗
PubMed1987

Effectiveness of an attention-training program.

Attention Process Training (APT), a hierarchical, multilevel treatment program, was designed to remediate attention deficits in brain-injured persons. The program incorporates current theories in the experimental attention literature. Four brain-injured subjects, varying widely in both etiology of injury and time post onset, underwent intensive cognitive remediation including 5 to 10 weeks of specific attention training. Results are displayed using a single subject multiple baseline across behaviors design. All four subjects demonstrated significant gains in attention following the initiation of attention training. Remediation of another cognitive function (visual processing) was not associated with alterations in attention behavior. The merits of a process-specific approach to cognitive rehabilitation are discussed.

Adult↗
PubMed1985

Right hemisphere appreciation of prosodic and linguistic indications of implicit attitude.

Appreciation of attitudes conveyed through prosodic cues and lexical content was examined in subjects with temporal lobe seizure foci. One task involved auditory judgments of the consistency of verbal and intonational meaning of sentences. Errors on judgments of consistent verbal and prosodic stimuli were not only more frequent in the right temporal group than in left temporals or controls but were strongly related to neuropsychological indices associated with extent of right temporal involvement. Answering questions based on written narratives in which multiple attitude markers were either redundant or conflicting comprised the second task. Right temporal patients as a group had difficulty in answering inferential questions about paragraphs with inconsistent indicators of attitude. Even low-scoring right temporals were able, however, to answer inferential and factual questions when the verbal context markers consistently reinforced a particular attitude.

Adolescent↗
PubMed1984

Alterations in visually related eye movements following left pulvinar damage in man.

This case study presents evidence for two subtle types of eye movement abnormalities following surgical resection of the left posterior pulvinar in man. First, visual fixations during vertical pattern matching are on average both increased in number and prolonged in duration compared to controls, although normal fixation durations also occur. Second, unilateral deficiencies during search and scanning performance are associated with eye movements directed into the hemifield contralateral to the lesion. Although direct damage to parietal cortex and indirect damage to other visually related structures cannot be ruled out as other explanations for these deficits, these findings are consistent with recent electrophysiological and behavioral studies of the pulvinar in both human and non-human primates, and suggests a fruitful area for further investigation of pulvinar function.

Adult↗
PubMed1984

Cerebral organization of oral and signed language responses: case study evidence from amytal and cortical stimulation studies.

A normally hearing left-handed patient familiar with American Sign Language (ASL) was assessed under sodium amytal conditions and with left cortical stimulation in both oral speech and signed English. Lateralization was mixed but complementary in each language mode: the right hemisphere perfusion severely disrupted motoric aspects of both types of language expression, the left hemisphere perfusion specifically disrupted features of grammatical and semantic usage in each mode of expression. Both semantic and syntactic aspects of oral and signed responses were altered during left posterior temporal-parietal stimulation. Findings are discussed in terms of the neurological organization of ASL and linguistic organization in cases of early left hemisphere damage.

Adult↗
PubMed1983

Neuropsychological and linguistic correlates of atypical language lateralization: evidence from sodium amytal studies.

The intracarotid injection of sodium amytal is a technique that has been used to determine on which hemisphere language functions depend. Based on use of this technique in a series of patients (n = 99), three groups of patients - one with left hemisphere language lateralization, one right hemisphere language lateralization, and one bilateral language representation - were identified. These three groups were compared in relation to demographic variables, variables related to seizure disorder and neuropsychological variables. Comparisons were also made between the groups on incidence of speech blockage, naming errors and reading errors and on patterns of linguistic breakdown during reading under conditions of left and right amytal perfusion. The nature, potential etiology and effects of atypical (right hemisphere or bilateral) as opposed to the more common left hemisphere language organization are discussed.

Adult↗