Use Of Compensatory Strategies Research Articles

Psychometric Properties of the Spanish Version of the Cognitive Problems and Strategies Assessment in Patients with Bipolar Disorder.

Cognitive deficits play an important role in Bipolar Disorder (BPD). The Cognitive Problems and Strategies Assessment (CPSA) is a measure that evaluates the patient's perception of cognitive difficulties, and the spontaneous use of compensatory strategies and could thus have potential utility for clinical practice in patients with BPD. Our aim was to determine the validity and reliability of the Cognitive Problems and Strategies Assessment (CPSA) in Bipolar Disorder (BPD). Ninety-three BPD outpatients and 90 controls completed the Assessment of Problems with Thinking and Memory (APTM) questionnaire and the Assessment of Memory and Thinking Strategies (AMTS) questionnaire which constitute the CPSA, the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA), as a measure of convergent validity, and general sociodemographic data. Cronbach's alpha coefficient, Spearman's correlation coefficient and independent sample t tests were used for Internal consistency, Convergent validity and Discriminant validity. The APTM had a Cronbach's alpha coefficient of 0.93 and the AMTS 0.90. The COBRA score and the APTM were significantly correlated. BPD patients exhibited higher scores on the APTM and lower scores on the AMTS than controls. The present instrument enriches the clinician's repertoire for rapid and inexpensive cognitive evaluation in BPD.

Relationships Between Anxiety, Attention, and Reading Performance in Children.

Many studies link anxiety in children with reading difficulties, but some facets of anxiety have been found to be positively associated with reading achievement. Attentional Control Theory offers a potential explanation for these seemingly contradictory findings, positing that anxiety can both interfere in attentional processes and enhance effort and use of compensatory processing strategies. The current study examines the relationships between anxiety, attentional control, and reading performance (word reading/decoding and passage comprehension) in a racially-diverse sample of 251s-grade students, 152 of whom had not met reading benchmarks using screening measures. Results showed that harm avoidance was positively associated with reading performance and physical symptoms of anxiety were negatively associated with reading performance. These links were attenuated when including attentional control in the model, suggesting mediation and lending support to Attentional Control Theory. Further research is needed to confirm causal mediation effects between anxiety, attentional control, and reading performance.

Cultural Adaptation of the Functional External Memory Aid Tool for Use in the United Kingdom and Australia

Purpose: The Functional External Memory Aid Tool (FEMAT) is a performance-based measure of applied cognitive-linguistic abilities and attempted use of compensatory aids and strategies (e.g., using a calendar to recall an appointment) through completion of simulated everyday living tasks. The FEMAT was originally developed in the United States (US), and a need arose from clinicians to adapt the FEMAT for use in other countries. The aim of this study is to describe the cultural adaptation process that resulted in the United Kingdom (UK) and Australian (AU) versions of the FEMAT via international clinical research partnerships. Method: The FEMAT was adapted into UK and AU cultures using established guidelines for cultural and linguistic adaptation. The adaptation was completed by researchers and clinicians from the US, UK, and AU, and we followed a six-step process: (a) preparation, (b) forward translation, (c) back translation, (d) committee review, (e) field testing, and (f) finalization. Results: The FEMAT items and materials were successfully adapted from the source culture (i.e., English-US) to the target cultures (i.e., English-UK, English-AU). Through the adaptation process, the FEMAT items were determined to be conceptually appropriate for each culture and minimal modifications were made to the FEMAT materials (e.g., voicemail recordings recorded in target dialect). The finalized FEMAT-English-UK and the FEMAT-English-AU versions are available for free on the FEMAT website. Conclusions: Through successful international clinical research collaborations, the FEMAT was successfully adapted for use in other English-speaking cultures. This work provides guidance to streamline future FEMAT cultural adaptations. Supplemental Material: https://doi.org/10.23641/asha.25564461

Compensatory Strategy Intervention: What Older Patients Want and Why.

Compensatory strategies can improve performance of instrumental activities of daily living in people with cognitive impairment. This study investigated patient interest in compensatory strategy interventions and preference for various intervention formats. Semi-structured qualitative interviews with 38 older adults with cognitive impairment queried motivation to improve strategy use and interest in intervention formats/delivery methods. Two coders used thematic analysis to determine rates of interest in each intervention type and explore patient-reported barriers and facilitators to motivation and intervention models. Most of the samples reported motivation to enhance compensatory strategy use. Degree of motivation was driven by current experiences with strategy use, perceived benefit of potential changes, intrinsic desire to improve life and self, and current perceived need. The vast majority were interested in hour-long, multi-session, instructor-led interventions. Just over half of the sample was interested in a self-directed virtual program, and just under half was interested in involving family/friends. Facilitators and barriers to interest in intervention formats and delivery methods varied based on participants' previous experiences, preferred learning style, content, and time commitment of the intervention, and perceived current need for intervention. One-fifth of the sample expressed no interest in any intervention type, though they expressed openness to assistance in the future as needed. Older adults with cognitive impairment are generally motivated to enhance their compensatory strategy use. Clinicians/researchers designing compensatory strategy interventions should consider instructor-led formats, present individualized benefits of interventions, and demonstrate the benefits of both preventative and remedial intervention to optimize patient engagement.

Metacognitive beliefs of efficacy about daily life situations and use of cognitive strategies in amnestic mild cognitive impairment: a cross-sectional study.

Metacognition, the ability to monitor and regulate cognitive processes, is essential for individuals with Mild Cognitive Impairment (MCI) to accurately identify their deficits and effectively manage them. However, previous studies primarily focused on memory awareness in MCI, neglecting other domains affected in daily life. This study aimed to investigate how individuals with MCI perceive their abilities to handle various cognitively challenging situations representing real-life scenarios and their use of compensatory strategies. Thus 100 participants were recruited, including 50 with amnestic MCI with multiple deficits (aMCI) and 50 cognitively healthy controls (HC) matched in age and education. Participants completed three metacognitive scales assessing self-perceived efficacy in everyday life scenarios and one scale evaluating use of cognitive strategies. Results indicated that aMCI participants reported significantly lower self-efficacy in memory and divided-shifted attention scenarios compared to HC. Surprisingly, no significant group differences were found in the self-reports about the use of cognitive strategies. This suggests a potential gap in understanding or applying effective strategies for compensating cognitive deficits. These findings emphasize the importance of cognitive training programs targeting metacognitive knowledge enhancement and practical use of cognitive strategies that could enhance the quality of life for individuals with MCI.

“My Goal Is to Talk Like a Native”: Emergent Bilingual Students’ Use of Language Learning Strategies

This paper investigates emergent bilingual students’ (Finnish and Swedish) use of language learning strategies (LLS). The focus is on the frequency of LLS use, the difference between Swedish and Finnish speaking students’ use of LLS and the effect on use of LLS to improve the students’ weaker language. The data consisted of students’ self-reports concerning the use of LLS and their proficiency in their L2 on a seven-point Likert scale online survey. The survey also included an opportunity to comment on the answers. The data were gathered in 2019/2020. The instrument was influenced by the SILL (Strategy Inventory for Language Learning) (Oxford 1990) but adapted to the current research context on the basis of the researchers’ expertise and previous interviews with students. The measured and analysed LLS were metacognitive, social, cognitive and compensation strategies. The response rate was approximately 30% (N=184). The results indicated clear differences between Swedish-speaking and Finnish-speaking students regarding the use of different types of LLS. Finnish speaking students made significantly more use of metacognitive strategies while Swedish-speaking students made significantly more use of compensation strategies. Regarding the students’ use of social strategies, it was obvious that some Finnish-speaking students associate the use of Swedish in real-life communication situations with stress and anxiety. Moreover, the students’ use of LLS significantly predicts their progress in the weaker language. We suggest that the students should be offered language strategy instruction for them to understand and more effectively apply language learning strategies, to improve their weaker language at all levels.

Error monitoring in amnestic mild cognitive impairment: Cognitive correlates and relationship to measures of everyday function.

Accurate error monitoring is important for successful completion of everyday tasks and compensatory strategy use. This study examined how error awareness is impacted in amnestic mild cognitive impairment (aMCI) compared to cognitively healthy older adults (HOA). Cognitive correlates of error monitoring and relation to objective and self-reported measurement of everyday function were also evaluated. Twenty-four individuals with aMCI and 24 cognitively HOAs completed standardized cognitive measures (domains: attention, working memory, executive functioning, memory, language, visuospatial abilities); a computerized go-no-go paradigm task that evaluated error monitoring; a naturalistic, performance-based measure of everyday functioning (day-out-task; DOT); and self- and informant-report measures of everyday dysexecutive difficulties (DEX). Participants with aMCI demonstrated significantly poorer error monitoring as compared to the HOA group (Cohen's d = 1.02). Working memory and executive functioning were significantly related to error monitoring for both groups. After accounting for age and global cognitive status, hierarchical regressions revealed error monitoring significantly predicted DOT total time (but not accuracy) as well as both self- and informant-report DEX scores. Compared to HOAs, individuals with aMCI exhibited poorer conscious error awareness. Better error monitoring was associated with higher working memory and executive functioning abilities and predicted better everyday functioning. If individuals with aMCI experience difficulties recognizing performance inaccuracies, they will be unable to correct their errors, leading to mistakes in everyday task completion and difficulty implementing appropriate compensatory strategies. Findings suggest that error monitoring may be a potential target for intervention with individuals with aMCI. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

80 Ecological Momentary Assessment of the Fluctuations in Cognitive Performance and Contextual States of Community-Dwelling Older Adults

Objective:Ecological momentary assessment (EMA) allows for tracking participant responses across multiple timepoints within the context of typical daily experiences. This study used EMA delivered via smartwatches to investigate dynamic associations between older adults’ fluctuations in cognitive performance as measured by an n-back test and self-reports of current internal (i.e., mental sharpness, fatigue, stress) and external (i.e., environmental distractions, time of day) contextual states over seven days. We hypothesized that 1) cognitive test fluctuations throughout the week would be meaningful beyond average cognitive test scores and 2) cognitive test scores would fluctuate in response to internal and external contexts.Participants and Methods:Participants were 28 community-dwelling older adults recruited for a larger clinical trial assessing the influence of lifestyle factors and compensatory strategy use on cognitive health. During week one of the trial, participants received a smartwatch which sent prompts four times a day for seven consecutive days. The prompts included a 45-second one-back shape test, along with Likert-style questions about their current experience. Questions assessing participants’ internal contexts asked about participants’ experience “right now” of mental sharpness, physical fatigue, and stress. External context was assessed via the EMA prompt, “Right now my environment is distracting,” and time of day of the response.Results:Data was screened such that all data points outside the 7-day prompt window were removed, one participant who did not respond to any prompts was removed, and participants who responded to less than 60% of the shape test prompts were removed (n = 10). The sample used for this preliminary analysis included 17 participants (Age, M = 71.94 years; Education, M = 14 years; 88% Female; 88% White) with an average compliance of 75% (Range = 17 - 26 shape test responses) and an average shape test accuracy of > 92%. Hypothesis 1 was supported by the large fluctuations of the average cognitive test scores across timepoints (M = 24.35, Min = 16, Max = 27, SD = 2.54) and by repeated-measures ANOVA of average cognitive test scores by day (F(1,7) = 5.24, p < 0.01). Hypothesis 2: Cross-correlation lags 0 to 4 were assessed. For internal contexts, cross-correlation showed a medium correlation between mental sharpness and cognition for lags 0 (r = 0.46) and 1 (r = 0.4); a small to medium correlation between physical fatigue and cognition for lags 0 (r = -0.51) and 1 (r = -0.31); and no correlation between stress and cognition (r < 0.2). For external contexts, cross-correlation revealed no correlation between environmental distraction and cognition (r < 0.3), and repeated measures ANOVA revealed no effect of time of day on cognition scores (p > 0.05).Conclusions:Older adults’ cognitive performance on an n-back shape test varied over time with internal contextual states. Cognitive performance was positively associated with feelings of mental sharpness and negatively associated with physical fatigue. Current external environmental distractions and time of day were less influential on cognitive performance. As more data is collected, influences of individual fluctuations in cognitive performance will be investigated.

A - 15 Elucidating Patterns of Naturalistic Behavior in those with Self-Reported Functional Cognitive Decline.

There is relatively little known about the effect of subjective cognitive decline on everyday behaviors in community-dwelling older adults. We investigated use of compensatory strategies, busyness, and engagement in productive activities in older adults with subjective decline versus those without subjective decline. 353 adults (65+ years old) completed an online survey including demographic information, self-reported decline in functional cognition (Everyday Cognition Questionnaire; ECog), subjective busyness (Martin and Park Environmental Demands Questionnaire), engagement in productive activities (Temple Activities Engagement Questionnaire), and use of compensatory strategies (Memory Compensation Questionnaire). Two-tailed t-tests compared these variables amongst two groups: "decliners," (ECog Score > 1.49) and "non-decliners," (ND; ECog Score < 1.50). There were no significant differences in demographics between the decliners (mean age = 76.68, sd = 8.22, p = 3.00; mean edu = 15.55, sd = 3.97, p = 0.91) and ND (mean age = 75.71, sd = 6.93; mean edu = 15.50, sd = 3.19). Decliners reported greater use of compensatory strategies (mean = 95.58, sd = 20.21, p < 0.001) compared to ND (mean = 80.43, sd = 19.56). Decliners also reported greater daily busyness (mean = 14.47, sd = 5.7, p = 0.002) compared to ND (mean = 12.66, sd = 4.19), but no difference in the engagement in productive activities. Decliners utilize more compensatory strategies in their daily lives (e.g., using external aids, concentrating harder, etc.), and report feeling busier despite no difference in engagement of productive daily tasks. Future work should clarify how compensatory strategies in decliners are used and whether increased busyness reflects increased task demands or the use of compensatory strategies. Psychoeducation should promote compensatory strategies that are effective and alleviate subjective busyness.

Cognitive and Emotional Disorders during Multiple Sclerosis – Exogenous and Endogenous Conditions, Contemporary Methods of Treatment and Prevention

Multiple sclerosis (SM) is an autoimmune, demyelinating disease of the central nervous system. The disease affects patients of all ages, with a higher incidence in women. The etiopathogenesis of SM is not fully understood — it is believed that autoreactive lymphocytes play a key role in the development of the disease, although genetic predisposition and environmental factors also play a role. Diagnosis is based on the McDonald criteria, and the disease has different clinical presentations. Treatment is based on immunomodulation, aims to control the disease, and prevent recurrence. Frequent symptoms of the disease are motor, sensory, and cognitive disorders. Cognitive impairment, which is common in multiple sclerosis patients, has numerous consequences in everyday life (mental, social, economic) that significantly reduce the quality of life. Psycho-cognitive dysfunction, which can occur at any stage of the disease, is associated with changes in the central nervous system. Prevention of these disorders includes the early application of treatment methods that modify the natural course of the disease and the implication of pro-health behaviors, such as quitting smoking, proper diet and physical exercise. Pharmacological treatment shows limited effectiveness. Rehabilitation involving the use of compensatory strategies, remedial methods aimed at brain neuroplasticity and cognitive training shaping new functional networks of the brain is important. The aim of this work is to present the problem of cognitive and emotional disorders in the course of multiple sclerosis, with particular emphasis on endo- and exogenous conditions, together with modern methods of their treatment and prevention. (JNNN 2023;12(3):140–146)

Game-supported cognitive strategy training for slowed information processing speed after acquired brain injury: study protocol for a randomised controlled trial

IntroductionMany individuals with acquired brain injury tend to experience problems with slowed information processing speed (IPS). A potentially beneficial and cost-effective supplement for cognitive rehabilitation of impaired IPS may be...

Evaluation of the Effectiveness of Assistive Technology for Executive Function Support for People With Acquired Brain Injury: Protocol for Single-Case Experimental Designs.

Executive function, including prospective memory, initiating, planning, and sequencing everyday activities, is frequently affected by acquired brain injury (ABI). Executive dysfunction necessitates the use of compensatory cognitive strategies and, in more severe cases, human support over time. To compensate for the executive dysfunction experienced, growing options for electronic mainstream and assistive technologies may be used by people with ABI and their supporters. We outline the study protocol for a series of single-case experimental designs (SCEDs) to evaluate the effectiveness of smart home, mobile, and/or wearable technologies in reducing executive function difficulties following ABI. Up to 10 adults with ABI who experience executive dysfunction and have sufficient cognitive capacity to provide informed consent will be recruited across Victoria and New South Wales, Australia. Other key inclusion criteria are that they have substantial support needs for everyday living and reside in community dwellings. On the basis of the participant's identified goal(s) and target behavior(s), a specific electronic assistive technology will be selected for application. Both identification of the target behavior(s) and selection of the assistive technology will be determined via consultation with each participant (and their key support person, if applicable). The choice of SCED will be individualized for each participant based on the type of technology used in the intervention, the difficulty level of the behavior targeted for change, and the anticipated rate of change. For each SCED, repeated measurements of the target behavior(s) during the baseline condition will provide performance data for comparison with the performance data collected during the intervention condition (with technology introduced). Secondary outcome measures will evaluate the impact of the intervention. The protocol includes 2 customizable Microsoft Excel spreadsheets for electronic record keeping. Recruitment period is June 2022 through March 2024. Trial results for the individual participants will be graphed and analyzed separately using structured visual analysis supplemented with statistical analysis. Analysis will focus on important features of the data, including both within- and between-phase comparisons for response level, trend, variability, immediacy, consistency, and overlap. An exploratory economic evaluation will determine the impact on formal and informal support usage, together with quality of life, following the implementation of the new technological intervention. The study has been designed to test the cause-effect functional relationships between the intervention-in this case, electronic assistive technology-and its effect in changing the target behavior(s). The evaluation evidence gained will offer new insights into the application of various electronic assistive technologies for people who experience executive dysfunction following ABI. Furthermore, the results will help increase the capacity of key stakeholders to harness the potential of technology to build independence and reduce the cost of care for this population. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622000835741, https://www.anzctr.org.au/ACTRN12622000835741.aspx. DERR1-10.2196/48503.

Real-world compensatory strategy use in community-dwelling mid-life and older adults: An evaluation of quality

Objective: Older adults often spontaneously engage in compensatory strategies (CS) to support everyday task completion, but factors that influence success of chosen CS remain unclear. This study examines whether real-world prospective memory (PM) task completion is better predicted by CS count or a CS quality rating. Method: Seventy mid-life and older adult participants were presented four novel, real-world PM tasks via remote assessment and encouraged to use their typical CS. The examiner captured detailed information about planned CS at task presentation (T1) and utilized CS at follow-up testing (T2). From this information, count (CS Count; quantity of CS) and quality (CS Quality; rating of CS thoroughness and utility) scores were coded separately for the planned and utilized CS. PM task performance accuracy was also coded (PM Accuracy). Results: Hierarchical regressions revealed planned CS Count and Quality did not predict PM Accuracy. In contrast, the utilized CS Quality predicted a significant amount of PM Accuracy variance over and above CS Count, global cognition, and age (R2 = .47, ΔR2 = .24, ΔF = 29.36, p < .001, f2 = .45). Furthermore, utilized CS Quality accounted for a similar amount of variance in PM Accuracy when utilized CS Count was removed from the model. Conclusions: This study’s CS coding system can capture and quantify the quality of strategies, which uniquely predicts real-world PM performance. This coding system may provide researchers with a nuanced CS measure and lead to improved CS interventions designed to support everyday PM performance, such as targeted CS trainings.

Compensation Strategies Use in EFL Students’ Translation from Arabic into English

Several techniques and strategies are used in translating a source language (SL) into the target language (TL). The purpose of these techniques is to produce a successful translation. Compensation is one type of these strategies. This study aimed at investigating the use of compensation strategies by Saudi EFL students in translating Arabic texts into the English language. Specifically, it attempted to reveal the types of compensation strategies used in the students’ target texts (TTs) and the most common types of compensation. Adopting content analysis, the study analysed six TTs produced by six students enrolled in a translation course in the summer term for the academic year 2021 in a Saudi public university. Results showed that the TTs contained all types of compensation. Results also revealed that compensation by splitting was the most common type. In second place appeared compensation in kind, compensation by merging, and compensation in place. The study recommended that translation instructors need to train their students extensively on compensation strategies to assist them in producing successful TTs.

The cognitive and behavioral correlates of functional status in patients with frontotemporal dementia: A pilot study.

Objective: Frontotemporal dementia (FTD) impinges significantly on cognition, behavior, and everyday functioning. Goal of the present study is the detailed description of behavioral disturbances and functional limitations, as well as the investigation of associations between cognition, behavior, and functional impairment among FTD patients. Given the importance of maintaining a satisfying functional status as long as possible, this study also aims to identify the cognitive correlates of compensatory strategy use in this clinical group. Methods: A total of 13 patients diagnosed with FTD (behavioral variant FTD = 9, non-fluent variant primary progressive aphasia = 3, semantic dementia = 1) were administrated a broad range of neuropsychological tests for the assessment of different cognitive abilities. Behavioral symptomatology and performance on everyday activities were rated with informant-based measures. Descriptive statistics were used for the delineation of behavioral and functional patterns, whereas stepwise multiple regression analyses were performed to identify associations between cognition, behavior, and functional status. Results: Negative symptoms, especially apathy, were found to predominate in the behavior of FTD patients. Instrumental tasks, such as housework and leisure activities, appeared to be the most impaired functional domains. Working memory was the strongest cognitive correlate of performance across various domains of everyday functioning, whereas working memory along with short-term verbal memory accounted for a great proportion of variance in compensatory strategy use. Behavioral disturbances and especially negative symptoms were also found to contribute significantly to functional impairment in FTD. Conclusions: Executive dysfunction, as well as behavioral disturbances contribute significantly to functional disability in FTD. Early interventions tailored at these domains may have the potential to improve functional outcomes and delay the rate of functional decline among FTD patients.

Cognitive Strategies: Moderating the Relationship between Executive Functions and Daily Functioning

Whereas prior studies have addressed relationships between cognitive strategies and learning and achievement, very few dealt with their connection to daily functioning. This study examines the moderation effect of the frequency of compensatory cognitive strategy use within that relationship among university students. A sample of 336 students (18-36 years; 180 women, 156 men) answered the Dysexecutive Questionnaire (DEX; executive function components), Time Organization and Participation Scale (TOPS; daily functioning), and Compensatory Cognitive Strategies Scale (CCSS; strategy use). The results showed significant correlations between the DEX and TOPS for three CCSS levels (-1.0, -1.0 to 1.0, and 1.0 SD from average); the higher the frequency of cognitive strategy use, the stronger the association between the DEX and TOPS. The findings suggest that more frequently use of cognitive strategies can strengthen efficient daily functioning.

The role of Cognitive Reserve and depression on executive functions in older adults: a 10‐year longitudinal study

AbstractBackgroundCognitive reserve (CR) refers to the use of compensatory strategies related to executive functions (EFs) to reduce the negative effects of age‐related brain changes. Depression represents a risk factor for dementia, but little is known about its role in the association between CR and EFs.In the present study, we tested whether depression moderated the association between CR and EFs, and which variables among CR, depression and APOE‐e4 status (e4/non‐e4) predicted conversion to Cognitively Unimpaired‐Declining (CUD; Johnson et al., 2018) and Mild Cognitive Impairment (MCI) from a Cognitively Unimpaired‐Stable (CUS) baseline.Method416 participants were selected from the Wisconsin Registry for Alzheimer’s Prevention. These were native English speakers, aged ≥50, CUS at baseline, and with no history of neurological or psychiatric disorders. Of these, 290 were still CUS, 97 were CUD and 29 had MCI at the 10‐year follow‐up visit. Depression was assessed with the 20‐item Center for Epidemiologic Studies Depression Scale (CES‐D). A standardized composite score from three tests (CFL, Digit Span, Letter‐Number sequencing) estimated EFs. Another composite score, based on the WRAT‐3 Reading subtest (a measure of literacy or premorbid abilities) and years of education estimated CR. A hierarchical linear regression was performed to evaluate the effect of CR and depression on EFs at follow‐up. Baseline demographic variables (age, gender, APOE‐e4) and diagnosis at follow‐up (CUS, CUD, MCI) were entered in Model 1, CR and depression in Model 2, and the CR*Depression interaction in Model 3. Moreover, a multinomial logistic regression was used to predict conversion to CUD and MCI from baseline.ResultModel 3 added significantly onto Model 2 (p = .024), indicating a moderation between CR and depression on EFs. Particularly, the beneficial effects of CR on EFs seem to be mitigated by increasing levels of depression. In the multinomial regression, depression predicted conversion to CUD from CUS while CR, depression and APOE‐e4 predicted conversion to MCI from CUS.ConclusionThese findings support the hypothesis that CR, associated with EFs, may protect against cognitive aging, but also highlight the disruptive effect that depression has on long‐term cognitive health. Further studies may replicate these findings in clinical populations.

Analysis of limb kinetic asymmetry during a drop vertical jump in adolescents post anterior cruciate ligament reconstruction.

Limb asymmetry after ACL reconstruction is often cited as a risk factor for ACL reinjury. We assessed ground reaction forces on each limb during a drop vertical jump, and compared kinetic symmetry between limbs in adolescents post-ACL reconstruction versus healthy controls. Forty-four participants who underwent an ACL reconstruction (16 male/28 female, mean age 16.1±1.5, mean 7.3±0.9months post-ACL reconstruction) and 34 controls (20 male/14 female, mean age 14.9±1.1) completed a drop vertical jump captured on a Vicon system and Bertec force plates. Kinetic variables were calculated individually for each limb. Inter-limb asymmetry was calculated as an index between each limb (involved versus uninvolved for the ACL reconstruction group, and left versus right for controls), and was compared between groups using independent t-tests. Asymmetry was significantly more pronounced in the ACL reconstruction group versus the controls for peak contact ground reaction force (11.6% vs 4.4%, p=0.009), eccentric impulse (8.8% vs 3.8%, p=0.009), eccentric mean force (8.0% vs 3.4%, p=0.006), concentric peak ground reaction force (4.1% vs 0.8%, p=0.003), concentric impulse (5.1% vs 1.1%, p=0.001), and peak landing ground reaction force (12.7% vs 1.7%, p<0.001). Limb kinetic asymmetry during a drop vertical jump was more pronounced in adolescents post-ACL reconstruction versus controls for both eccentric- and concentric-phase variables, which may indicate the use of compensatory strategies to offload the post-operative limb. Targeted interventions to produce more symmetric loading and unloading during jumping tasks should be developed, tested, and monitored to determine the impact on rehabilitation programs, return-to-sport evaluations, and injury prevention outcomes.

Preliminary Efficacy of Combining Internal and External Cognitive Strategy Training in a Case of Anoxia

<h3>Research Objectives</h3> To determine the effect of combining internal and external cognitive strategy training techniques on functional outcomes in a case of anoxic brain injury. The purpose of cognitive rehabilitation is to train skills necessary for completion of daily cognitive tasks and to train compensatory strategies as a means for restoring lost functioning. According to our knowledge, to date, clinical treatment, and outcomes for cases of anoxic injuries due to near drowning are inconsistent for both treatment and prognostic outcomes. We seek to contribute to current research in this preliminary study, by examining use of combined supportive clinical techniques. <h3>Design</h3> This was a retrospective case study design. Data was collected onsite from the electronic clinical records for speech sessions conducted from April 2021 until July 2021. <h3>Setting</h3> Private institution. College campus speech clinic. <h3>Participants</h3> Case study for a 21-year-old male with a diagnosis of anoxic brain injury due to drowning. <h3>Interventions</h3> This study examined the use of compensatory strategies, internal (mental self-talk, association and organizational) techniques and external (alarms, notes, oral self talk) technqiues, for improved functioning, carryover of skills to daily life. <h3>Main Outcome Measures</h3> Client accuracy of trained techniques and self-report of follow through and carryover. <h3>Results</h3> The client benefitted from effective combining of internal and external techniques due to residual initiation, attention, and planning and forethought difficulties. In addition, the client responded positively to questions relating to self-perception of satisfaction of carryover and level of functioning. <h3>Conclusions</h3> Case study findings revealed overall improvement in both internal and external compensatory strategy use for each identified cognitive deficit. This included skills of attention, memory recall, speed of processing, and executive skill functioning. Most important for this case was that although all diagnosed deficits were within a mild range of severity level, the need for external systems persists. Residual initiation problems, external alarms, reminders, and task guided systems seemed to trigger internal strategy use for improved functioning. <h3>Author(s) Disclosures</h3> No conflicts.

Results from the ‘‘Healthy Mind’’ Intervention Program

<h3>Research Objectives</h3> To present the theoritical framework that supports the use of the Healthy Mind intervention as part of a systematic psychosocial and cognitive treatment program for older adults. To present the effectiveness of the intervention program in a group of older adults in Cyprus. <h3>Design</h3> Semi-experimental design with random assignment into the two groups. Pre post assessment and follow up testing was conducted at study completion, 4 weeks and 12 weeks with the training specific dependent measures (Memory Compensation Strategies (MCS), Problem Solving (PS), Emotion Regulation (ER) and Locus of Control (LOC). All participants underwent a comprehensive neuropsychological assessment to determine the level of cognitive functionality. <h3>Setting</h3> General community. <h3>Participants</h3> The experiment group included 30 healthy participants (Age, M=69.03, SD=3.4; Education, M=11.73, SD=2.1) and 30 healthy control participants, (Age, M=70.12, SD=3.51; Education M=11.7, SD=2.0). <h3>Interventions</h3> Healthy Mind intervention it's a systematic psychosocial and cognitive treatment program for older adults. This intervention has a strong educational focus that promote a more realistic understanding of cognitive aging and relevant contextual factors (e.g., health, lifestyle, beliefs). Furthermore use active components of skills development like emotion regulation, memory compensation strategies, problem solving skills and increase internal locus of control. <h3>Main Outcome Measures</h3> Memory Compensation Strategies (MCS), Problem Solving (PS), Emotion Regulation (ER) and Locus of Control (LOC). <h3>Results</h3> Mixed MANOVA (a = .05) comparing the two groups revealed significant improvement for the treated group after 10 weeks of training on MCS, PS, ER and LOC. Repeated measure ANOVAS showed significant training effects for intervention group p < .000. This improvement was maintained at the follow-ups. (p<.000). <h3>Conclusions</h3> The preliminary results from this group intervention implementing a multi-dimensional intervention program suggest that the intervention is both feasible and effective. Treated participants demonstrated improvement in the use of memory compensatory strategies, problem solving, emotion regulation and increased internal locus of control. Implications for rehabilitation will be presented. <h3>Author(s) Disclosures</h3> None.