CogniPlus: Training cognitive functions
Contents
1. visual NBACK fo Markus Sommer Rudolf Debelak Christine Heidinger o SCHUHFRIED GmbH a CODING Working memory Spatial coding Dieter Schellig Uwe Schuri Walter Sturm SCHUHFRIED GmbH Theory Both monitoring and coding are base mechanisms of working memory They are used for metacognitive control and coordination of cognitive processes and form the basis for more complex cognitive activities Monitoring in working memory involves the controlled supervision of storage processes and stored represen tations Storage in spatial working memory requires the coding of incoming information according to its spatial features the location at which the stimuli were per ceived and or their spatial arrangement is stored Spa tial coding links the individual items to representations binding and gives them a structure There is no pure representation of a visually perceived stimulus each stimulus also has a spatial code For example the information that a driver obtains by looking in his rear view mirror is incorporated into the stored image of the driving environment More complex examples include following assembly instructions or wiring diagrams creating mind maps or working with multiple open windows on a computer Setting and task The client observes vehicles driving onto a bridge mem orizing phase While driving over the bridge the vehi cles disappear from the client s view rehearsal phase When they re2. assessment treatment of attention disorders functional reorganisation after attention therapy and functional imaging of attention functions with the know how of the best of the best makes CogniPlus one of the most advanced cognitive training programs on the market today Firm foundations In 1993 Prof Sturm and his colleagues de veloped the AIXTENT training program for the treatment of attention disorders Efficiency studies showed that training must be deficit specific if it is to be effective Building on this insight SCHUHFRIED worked with Prof Sturm to produce a second genera tion version of AIXTENT AIXTENT II which later be came known as CogniPlus 2 Based on a function oriented intervention approach Each CogniPlus training program is tailored to a spe cific deficit because studies have shown that use of over complex training programs may actually cause performance to deteriorate Training programs are only offered for cognitive functions that are scientifi cally proven to be trainable 3 Embedded in a context of scientific theory CogniPlus training programs are always developed in the light of the relevant up to date scientific literature Theory led design is a top priority All our partners are noted for their theoretical expertise as well as their practical clinical experience 4 Realistic and motivating design Clients want to apply their improved skills as quickly as possible in ever
3. crossmodal suddenly emerge from the darkness The client s task is to respond only to relevant stimuli If he responds late to a relevant stimulus or fails to respond at all negative feedback is given in the form of a crash of thunder and a flash of lightning If the client responds in error to an irrelevant stimulus the figure or the sound source is illuminated in red Training forms The SELECT training program consists of three training forms gt The S1 training form trains selective attention in the visual modality figures appear in the tunnel gt S2 is the acoustic training form in which the client s task is to respond to relevant sounds gt In the S3 training form the client is instructed to re spond to specific stimulus combinations figures that make particular noises The CogniPlus training programs Attention Selective SE LECT Ll Walter Sturm SCHUHFRIED GmbH Difficulty structure There are 15 difficulty levels for each training form SELECT adapts to the client s ability level in two ways Firstly the number of relevant or irrelevant stimuli in creases or decreases Secondly at each difficulty level the maximum permitted reac tion time adapts to the speed Worth knowing of the clients reactions Thus SELECT can also be used with patients for a skilled client the wagon with impaired field of vision gets faster after the first few responses This ensures that from the outset t
4. for the elderly in Feusisberg Switzerland as part of a study being carried out for a Master s dissertation The purpose of the study was to identify whether the provision of cognitive training in addition to strength and balance training has a positive impact on mobility There is growing recognition of the fact that for eld erly people in particular maintaining physical stability while walking requires cognitive resources and that it is more difficult for these people to master dual tasks e g talking while walking without deterioration of per formance We decided at the outset to use CogniPlus because this software can be used to train both divided and selective attention Other advantages are that the au tomatic adaptation to the user s ability the clear sce narios and the user friendly keyboard make the system particularly suitable for older people On account of the positive results in the final tests in our study and the popularity of the training program with the users more and more homes were prepared to take part in a further study conducted by ETH Zu rich This means that we have so far been able to equip six other centers for the elderly with CogniPlus Next year we plan to run the study in seven additional cent ers for the elderly The computer training is carried out as part of the study and involves each participant training for ten minutes three times a week At the end of the study the program is inco
5. CODING DATEUP DIVID FOCUS HIBIT R NAMES NBACK PLAND ROTATE SELECT SPACE VIG VISMO VISP n EREEP SZ RE es a ee E E ee oe O ee oe a See a ee a ee a Rs vivivivivivivivivivivivis vVivivivivivivivivivivivivivis CV lt Ss lt z Chinese simplified K viivii ivi ivii iiv v M v ZMMMMMMMMMMM Me v v v K lt lt lt Ea Arabic AMMMMMMMMMMMM MY AMMMMMMMMMMMM Me rr o w i cS YW E v v v v v viviviviviviviviviviviviviviv BEBMMMMMEBMMMBMM MMMMMMMMMMMM MY v v v v v v v Vv AMMMMMMMMMMMMe Vv Vv Vv Vv VEV Vv v viivi i ivi ivi iiiv AMMMMMMMMMMMM ee AMMMMMMMMMMMM ee AMMMMMMMMMMMM ee AMMMMMMMMMMMM Me ZMMMMMMMMMMM Me Vv The Vienna Test System NEURO Neuropsychological Assessment using the Vienna Test System NEURO The Vienna Test System VTS is the world wide standard for computer based psycho logical assessment A special version has been developed for the assessment of neu ropsychological and clinical issues known as the Vienna Test System NEURO Advantages of the Vienna Test System NEURO Precise assessment gt Computer based neuropsychological tests guaran tee the reliability of the assessment process through standardized instructions practice phases and error free scoring gt Administration of the tests on a computer enables pa tients time critical responses to be measured with a high level of precisi
6. The CogniPlus training programs Working memory Rehearsal visuospatial VISP a Dieter Schellig Uwe Schuri Walter Sturm SCHUHFRIED GmbH Difficulty structure The VISP training program has 18 difficulty levels The demands on visuospatial working memory are varied in a number of ways At some levels the ships move while at others they remain motionless at anchor Across the levels there is an increase in the number of ships that the client must actively rehearse and reproduce The number of ships on the screen and the length of time for which they are highlighted also vary Through various forms of guidance the client is trained to improve his remembering of the ships positions by prac ticing sequential rehearsal during the rehearsal phase The rehearsal aids are gradually reduced as the client progresses through the levels At the outset the ships are highlighted again during the rehearsal phase in the same order as during the memorizing phase Later the ships are shown in the rehearsal phase without high lighting so that the client must now shift his attention between the positions unaided At the higher difficulty levels the ships eventually disappear and the client must click with the mouse to indicate where the highlighted ships were previously seen Corresponding test in the VIENNA TEST SYSTEM CORSI COGNIPLUS 13 The CogniPlus training programs The CogniPlus training programs Working memory Updating
7. are heightened mainly by increasing the number of stimuli butterflies that the client must retain and update The three types of task n back running keep track occur one after the oth er across the different levels at the highest levels they are combined to form new task variants As the level in creases both the number of butterflies on the screen and their speed also increase In addition the timing of the questions becomes increasingly unpredictable as the client progresses through the levels Long term memory Learning of face name associations The NAMES training program enables the cli ent to practice effective strategies for learn ing people s names and associating them with faces Theory According to current psychological models of cognition people s names have fewer structural bindings than other identity specific semantic details such as occupation or nationality and names of objects Because of their limited binding the learning and later recall of people s names is a particularly demanding cognitive task However per formance in learning face name pairs can be improved by applying particular processing strategies such as conscious linking with information already in memory and use of mental imagery Setting and task In NAMES the client is instructed to remember the names of individuals The names must then be recalled when pictures of the individuals are displayed In the course of training the clien
8. at www schuhfried com Over 120 tests are available In addition there are two test sets compiled by experts which are tailored to a specific disorder and cover the most important dimen sions relevant to the disorder The Test Sets EN i ra 4 2 COGBAT Cognitive Basic Assessment The COGBAT test set is used to clarify the cognitive status of patients suffering from neurological and or mental disorders Cognitive status needs to be assessed as comprehensively broadly as possible but also as quickly as possible Carefully selected methods are used to assess subdimensions from the fields of attention memory executive functions and information processing speed COGBAT has been normed across all tests and thus as an overall package and validated on different patient groups Straightforward scoring provides a rapid overview of impaired and unimpaired dimensions 24 COGNIPLUS DRIVESC DRIVESC Fitness to Drive Screening The test set DRIVESC assesses the three key de terminants of driving ability stress tolerance re action time and skill in obtaining an overview It is an efficient tool for screening the fitness to drive of individuals affected by neurological and or men tal disorders The validity of the DRIVESC test set has been demonstrated repeatedly in multi center studies involving healthy drivers and patients with brain damage 3 The Vienna Test System NEURO CogniPlus and the Vienna Test Syst
9. in the viewfinder may point to the upper right while the viewfinder jumps to the lower left Note The instructions for the SPACE training program are displayed on only one side of the screen and are there fore easily read by patients with neglect or visual field impairment VISP is a training program for improving active rehearsal in spatial working memory Theory Rehearsal processes can improve short term and long term memory However rehearsal is not a form of simple storage but a controlled and attention based series of retrievals and re encodings of material the aim being to maintain this material from perceptual processing or long term memory in the focus of attention Spatial attention is the central process in spatial re hearsal just as subvocal articulation is the key function for verbal rehearsal For example we let our gaze travel repeatedly from one location to another thereby allow ing our attention to shift sequentially between various spatial positions and protecting this spatial information against forgetting Setting and task In VISP the client has a bird s eye view of a number of ships on the ocean Some of the ships are indicated in turn e g they are illuminated or disappear This is the memorizing phase In the rehearsal phase that follows the client is encouraged in various ways to practice re hearsal He must subsequently reproduce the sequence in which the ships were indicated recall phase
10. of distracting stimuli which may be acoustic visual or a combina tion of the two gt In the S2 training form the task is to detect acoustic stimuli in the face of other stimuli which may likewise be acoustic visual or a combination of both Difficulty structure The difficulty structure of the FOCUS training program is designed to adapt as far as possible to the amount that the client can take in Thus a client of weak abil ity will be presented with a low stimulus environment while a client of strong ability will be confronted with a large number of distractor stimuli The number of dis tractor stimuli presented is carefully graded and the time allowed for identification of a stimulus is adapted to the client s skill The DIVID training program trains divided attention the ability to perform different tasks simultaneously Theory The ability to divide one s attention depends on the pro cessing resources available and on the nature of the combined tasks The more similar the tasks the grea ter the interference that arises between them Wickens 1984 In everyday life the ability to split one s attention is relevant to many skills for example driving a car which normally requires the simultaneous monitoring of a number of different information streams Setting and task In this training program the client takes on the role of a security official at an airport He has to simultaneous ly observe both a ra
11. programs are specifically tai lored to the deficits tested by the Vi enna Test System Careful assessment is a prerequisite when treating attention disorders since it has been shown in several therapy Studies that therapy must be tailored to a specific deficit Particularly in the case of disorders of elementary atten tion functions alertness vigilance the use of over complex training pro grams may result in a deterioration in performance Computerized therapy programs that train specific attention functions in realistic everyday situa tions have proved useful Guidelines of the German Society for Neuropsy chological Assessment and Therapy COGNIPLUS 25 Training at the computer USER FRIENDLY SOFTWARE The CogniPlus menu is clear user friendly and simple and intuitive to use You don t need to be Bill Gates to find your way around That s a promise INPUT DEVICES The CogniPlus training programs can be worked with a normal computer keyboard or with SCHUHFRIED s Basic response panel The mouse is needed for some training programs while VISMO requires the Universal response panel The response panels are particularly suitable for in dividuals with restricted hand movement We shall be happy to advise you Worth knowing The response panels can also be used as input devices for the Vienna Test System 1 Set up the training program Starting CogniPlus takes you directly to the convenient and detaile
12. reactions is an important component of the ability to act flexibly and appropriately If environmental conditions change practised reaction patterns are often dysfunctional and must be suppressed so that new behaviour appropriate to the situation is possible Deficits of response inhibition are reported gt in diseases characterised by impairment of impulse control e g ADHD borderline personality disorder dependency disorders gt in diseases characterised by rigid and inflexible be haviour schizophrenia compulsive disorders gt in various neurological diseases Parkinson s disease dementia of the Alzheimer s type The HIBIT R training program trains response inhibition the ability to suppress unwanted reactions Setting and task In the HIBIT R training program the client assumes the role of a post office employee who must sort letters and packages as quickly and accurately as possible by pressing a button He must look out for specific features e g the presence of a stamp that indicate when he must react and when he must not react Four different scenarios Go Nogo Stop Signal Task Cued Go Nogo Behavioral Shift make different demands on the client s ability to suppress a reaction In HIBIT R the client is free to choose between different tasks and is therefore instrumental in making the program motivating Difficulty structure The difficulty levels of HIBIT R vary systematically in the demands the
13. specialist in computer based psychology COGNIPLUS amp a Ssh oe l is a training system for training cognitive functions Efficient Multi media Motivating phate is scientifically based and incorporates up to date psychological findings The content of CogniPlus is closely linked to the Vienna Test System internationally the most widely used test system for professional psychological assessment This means that diagnosis treatment and evaluation can be efficiently linked COGNIPLUS E is available in a wide range of languages at no extra cost So that each client can train in his own language You too can profit from a state of the art program that covers all areas of cognitive training COGNIPLUS DEMO VERSION SCHUHFRIED Read more about the interlinking of COGNIPLUS and the VIENNA TEST SYSTEM gt page 23 Read more about the language versions gt page 22 t ii 1 Developed by You get more 7 reasons to choose CogniPlus prominent scientists Many prominent scientists including Prof Walter Sturm Prof Joachim Funke and Prof Matthias Weis brod have worked with experts at SCHUHFRIED to develop CogniPlus Extensive experience combined Worth knowing Prof Dr Walter Sturm has been head of the clinical neuropsychology de partment at the neurological clinic of the medical faculty of RWTH Aachen University since 1995 His main areas of research are neuropsychological
14. taken by other cars increasingly rarely the surroundings become more monotonous as darkness falls and the number of sudden braking manoeuvres from overtaking vehicles decreases In addition the intensity of the feed back on delayed and omitted reactions becomes weaker as the difficulty level increases The challenge therefore changes gradually from a sustained attention task to one requiring real vigilance At each difficulty level the maximum permitted reaction time adapts to the speed of the client s reactions Tak ing the client s first valid reactions as a starting point an individual reaction time limit is determined and used as a basis for measuring all further reactions made in the course of the training program This ensures that from the outset the training program is optimally adapted to the client s skill and is never either too easy or too dif ficult for him The SELECT training program trains selective attention the ability to respond quickly to relevant stimuli and to suppress inappropriate responses Theory An attention selectivity training program should help the client to distinguish rapidly between relevant and irrel evant aspects of a task Most selective attention tasks require a quick decision within a set of stimuli in which the relevant and irrelevant items are clearly defined Setting and task The client travels through a tunnel in a mine car Relevant and irrelevant stimuli optical acoustic or
15. that patients like to work with CogniPlus The graphic is snappy modern and quite realistic the instructions of the different trainings are clear and easy to understand and at the end of each exercitation it is possible to immediately visualize the results and the possible outcome of the perform ances in the different training sessions that have been performed thanks to the presentation of numeral ta bles and graphs This usually is a very good feedback for patients because it allows a better comprehension of their results Grounding on the problems that the patient has which have been ascertained previously through a deep specialized test we evaluate the exer cise that should be done the time 15 30 45 minutes and the number of weekly sessions We furthermore appreciate the theoretical and sci entific aspects on which the different contents of the CogniPlus trainings have been planned which are broadly described in the user s manual It is possible to measures the results of the rehabilitations trough the WAF Test Perception and Attention Function of the Vienna Test System These are dosed separately for each sub component of attention before and after the rehabilitation ETH Swiss Federal Institute of Technology Zurich Application Cognitive training in centers for older people Dr Eling D de Bruin In 2008 we were able to start using the CogniPlus training system at the Alterszentrum am Etzel center
16. themselves the programs are attrac tively designed and when used appropriately there is very little need for additional motivating intervention Even the Divided Attention DIVID program the graphics of which have been designed with adults in mind is well received by children not least because it is set in an airport and rouses their interest By combining CogniPlus training with supporting measures designed to ensure the transfer of training effects to everyday life optimum treatment success can be achieved as many case studies show COGNI Service PLUS 33 SS Service System requirements SYSTEM REQUIREMENTS As at November 2012 Computer gt PC with pentium or compatible CPU min 2 5 GHz gt at least 512 MB RAM gt DirectX 9 0 compatible 3D graphics card with at least 128 MB RAM and a Nvidia GeForce FX5200 or better or ATI Radeon 9500 or better graphics chip The display driver must support Open GL ver sion 1 4 or higher gt USB headset or USB speakers Please ask your dealer or SCHUHFRIED GmbH about suitable de vices gt DVD drive hard drive mouse keyboard gt USB ports for the license dongle and any addition al hardware if all the computer s USB ports are in use a USB hub with external power supply will be required gt serial port if a Test System Interface is used gt network card for connecting the computer to a net work e g for setting up a test system net
17. 27 29 30 30 34 35 nalh a a a a YOU GET MORE CogniPlus CogniPlus 7 reasons to choose CogniPlus THE COGNIPLUS TRAINING PROGRAMS ATTENTION ALERT Attention Alertness VIG Attention Vigilance SELECT Attention Selective FOCUS Attention Focused DIVID Attention Divided NEGLECT FIELD OF VIEW TRAINING SPACE Neglect visual field training Visuospatial attention WORKING MEMORY VISP Working memory Rehearsal visuospatial CODING Working memory Spatial coding NBACK Working memory Updating visual DATEUP Working memory Updating spatial LONG TERM MEMORY NAMES Long term memory Learning of face name associations EXECUTIVE FUNCTIONS HIBIT R Executive functions Response inhibition revised version PLAND Executive functions Planning and action skills SPATIAL PROCESSING ROTATE Spatial processing Mental rotation VISUOMOTOR SKILLS VISMO Visuomotor coordination LANGUAGES THE VIENNA TEST SYSTEM NEURO THE VIENNA TEST SYSTEM AND COGNIPLUS A GREAT TEAM TRAINING AT THE COMPUTER User friendly software Input devices A typical training session Direct training SERVICE Best Practice CogniPlus in use System requirements Also from SCHUHFRIED THE VIENNA TEST SYSTEM amp BIOFEEDBACK 2000 t 4 amp COGNIPLUS Request the demo version now without obligation CogniPlus CogniPlus OEE is a product of the SCHUHFRIED company your
18. 9 and the German Soci ety for Neurology Deutsche Gesellschaft fur Neurolo gie DGN 2008 iatan a i STRENGTH COGNIPLUS 5 DIMENSION SUBDIMENSION Intensity Attention Selectivity Neglect visual field training Working memory Memory Long term memory Executive functions Spatial processing Visuomotor skills SPECIFIC COGNIPLUS FUNCTION TRAINING Alertness Vigilance Selective attention Focused attention Divided attention Visuospatial attention Rehearsal visuospatial Spatial coding Updating visual Updating spatial Learning of face name associations Response inhibition Planning and action skills Mental rotation Visuomotor coordination The ALERT training program trains the alert ness dimension of attention the ability to temporarily increase and sustain the intensity of attention Theory When the intensity of attention is temporarily aroused exogenously by a warning signal phasic alertness is in volved If the arousal occurs without a cue the situation involves intrinsic alertness The aim of alertness train ing must be to increase intrinsic alertness since only in this case is arousal entirely cognitively controlled However where there are deficits related to alertness it is necessary to first improve phasic alertness and only then to proceed to working on intrinsic alertness Setting and task A motorcycle is d
19. COGNIPLUS www schuhfried com Training cognitive functions For attention memory executive functions spatial processing visuomotor skills and neglect SCHUHFRIED parum PPA Get in touch For queries and catalog orders Mon Thurs 8 a m 5 p m Fi sam 2 pm E mail info schuhfried at Telephone 43 2236 42315 Fax 43 2236 46597 Website schuhfried com HEC K Address SCHUHFRIED GmbH Hyrtlstrasse 45 2340 Moedling Austria Help Desk Queries on installation and operation for our customers Mon Thurs 8 30 a m 4 30 p m Frisa 30am 130pm pe E mail support schuhfried at Telephone 43 2236 42315 60 SCHUHFRIED About this document SCHUHFRIED GmbH E mail info schuhfried at Hyrtlstrasse 45 Internet www schuhfried com 2340 Moedling Tel 43 2236 42315 Austria Fax 43 2236 46597 Your own personal online demonstration Fast efficient personal Upon request a member of the SCHUHFRIED team will in the same way as in a webinar take you through CogniPlus online and answer your questions You don t need anything for this personal online tour except a telephone a computer with internet access and a little time EA E mail info schuhfried at Telephone 43 2236 42315 Media owner and editor SCHUHFRIED GmbH Place of publication Moedling Austria Release date 09 2014 Publisher druck at Leobersdorf Editors in chief Doreen Kallweit Johanna Egle G
20. ake demands on attention over a long period of time often a number of hours and the nowing relevant stimuli typically occur VIG can also be used with patients with at very irregular intervals and impaired field of vision Correspo at a very low frequency among a large number of irrelevant stimuli Vigilance training can not be effective unless a training session lasts for more than 30 minutes at the minimum Setting and task The client is driving along a straight highway At irregular intervals other vehicles come towards him on the opposite carriageway or overtake him The client s task is to react by pressing a button when an overtaking vehicle suddenly brakes in front of him Once he has reacted the vehicle s brake lights go out and it accelerates away from him If the client fails to react within the permitted time the brake lights start to flash Eventually there is a loud squealing noise which is designed to draw the client s attention to what is happening nding test in the VIENNA TEST SYSTEM WAFV 8 COGNIPLUS The VIG training program trains the attention dimension of vigilance the ability to sustain attention over a lengthy period of time under monotonous stimulus conditions Difficulty structure The VIG training program has 30 difficulty levels A de creasing stimulus frequency makes it more and more difficult for the client to sustain his attention he is over
21. any patients find it entertaining and motivating The connection between reaction speed and traffic situation is logical The instructions in all three program modules are eas ily understood without additional explanations and the programs adapt well to the user s ability The Re sponse Panel is very user friendly and also suitable for patients with motor disabilities The theory led devel opment of the training software which has been spe cifically designed to improve particular facets of atten tion and the electronically included and scientifically sound manuals contribute to the very satisfactory use of the system in our everyday work Given regular training three to five units week signifi cant improvements in attention are observed in some patients Children amp Young People s Psychiatric Service Baselland Application Children with ADS Angelika Berger Dipl Psych neuropsychologist FSP GNP senior psy chologist Since 2003 the Baselland Children amp Young Peo ple s Psychiatric Service in Switzerland has been running therapy groups for children with ADS in the age range 9 12 focusing on attention A core tool of this group therapy is computerised attention train ing originally using the AIXTENT program and now with the new version CogniPlus The group therapy which is conducted by a team of psychologists is intensive it consists of 20 ses sions with the children and accompanying pa
22. appear at the end of the bridge one of the vehicles may have changed its position in the spatial ar Corresponding test in the VIENNA TEST SYSTEM CORSI 14 COGNIPLUS CODING is a program for training monitoring processes and Spatial coding in visuospatial working memory rangement This vehicle must be identified recall phase this involves comparing the new arrangement of the vehicles as they leave the bridge with the stored layout of their previous arrangement and scanning the new ar rangement for differences Difficulty structure CODING has 21 difficulty levels At the different dif ficulty levels different storage and retrieval strategies are required ranging from the identification of errors to reconstruction of the original sequence and the correc tion of errors The demands on monitoring processes increase throughout the program The lower difficulty levels train the monitoring skills re quired to identify errors the client must decide whether or not the arrangement of the vehicles shows changes errors yes no answers Later the client must click on the vehicle that has changed its position within the spa tial arrangement Finally at the highest level the diffi culty is increased by the disappearance at the recall stage of the spatial structures between the vehicles the scene must be reconstructed from memory At this level the client must dissolve his binding of the entire spatial structure The prog
23. arance of an obstacle and the emergency braking At the first session the speed of the client s initial re actions is assessed and he is assigned to a difficulty level appropriate to his ability This ensures that from the outset the training program is optimally adapted to the client s skill and is never either too easy or too dif ficult for him Worth knowing ALERT can also be used with patients with disorders of the field of vision The instruction pages are then dis played on one side of the screen and the obstacles only appear on one side e g trees only fall onto the carriage way from the right Worth knowing ___ The range of CogniPlus training programs keeps growing When you buy the CogniPlus adminis Visit www schuhfried com for the latest information tration software or an update you will l l receive 20 hours of free training to use Corresponding test in the with any of the CogniPlus programs VIENNA TEST SYSTEM WAFA 6 COGNIPLUS COGNIPLUS 7 The CogniPlus training programs VIG Attention Vigilance Walter Sturm SCHUHFRIED GmbH Worth k Theory Long term alertness tasks require the client s attention to be focused continuously for long periods of time on One or more sources of information in order to detect and respond to small changes in the information pre sented Davies et al 1984 Vigilance represents a spe cial variant of long term attention Vigilance tasks m
24. ask of deciding on the best order in which to carry out the day s activities The starting point is a list of things that need to be done and a virtual street The CogniPlus training programs PLAND EE Daniel V Holt Joachim Funke o SCHUHFRIED GmbH plan on which various buildings and the client s current position are marked In accordance with the planning task the client must devise a strategy for deciding the order in which the different components of the task will be tackled and hence the order in which the buildings will be visited Training forms The PLAND training program consists of three train ing forms S1 S2 and S3 in which the task varies in accordance with three types of requirement observing priorities minimising journey time and maximising the number of tasks completed Difficulty structure The S1 training form has 19 difficulty levels the S2 form has 16 and the S3 form 28 In all training forms the number of things that need to be done increases as the difficulty level rises Depending on the training form other difficulty parame ters may be added as the difficulty level increases e g increase in overlapping appointments Corresponding test in the Corresponding test in the VIENNA TEST SYSTEM VIENNA TEST SYSTEM yA inimplementation INHIB 18 COGNIPLUS COGNIPLUS 19 The CogniPlus training programs NEW ROTATE Spatial processing Mental rotation Markus Sommer Christine Heidinger
25. asy to use software Order now free of charge Catalog Biofeedback 2000 E mail info schuhfried at Psychometric assessment Vienna Test System Cognitive training CogniPlus Biofeedback Biofeedback 2000 t SCHUHFRIED SCHUHFRIED GmbH Hyrtistrasse 45 2340 Moedling Austria Telephone 43 2236 42315 Fax 43 2236 46597 E mail info schuhfried at www schuhfried com
26. ately 1 In the change of perspective tasks the client sees the object on the right hand side of the screen surrounded by cameras He must work out which camera was used to take the picture shown on the left of the screen 2 The rotation tasks are similar In this case the screen shows symbolic axes of rotation rotation rods which can be used to rotate the object in space The client must work out which axis needs to be used to rotate the object in order to create the reference picture Difficulty structure Difficulty is varied across the various levels mainly by changing the following task characteristics gt the figural complexity of the objects gt the direction and angle of rotation gt the object s positional complexity gt the complexity of the coordinate system implied by the cameras or rotation rods The training program uses objects of various different types e g cartoons buildings The aim of using a wide range of practice material is to improve the client s mo tivation to train and to ensure that the cognitive skill that is developed can be generalized effectively Worth Knowing Requires the Universal response means of tracking tasks panel These involve using a The VISMO training program trains visuomo tor coordination the ability to coordinate hand and arm movements in response to vis ual stimuli Theory Visuomotor coordination skills play an important part in many everyday sit
27. d menu As soon as you have registered a client CogniPlus opens a client file with the four index cards Client data Training Results and Logbook On the Client data index card you can enter the client s details The Training index card lists all the available train ing programs You can select the desired program and specify its duration A session can consist of several training programs presented one after the other in the Training at the computer A typical training session order specified by you in the training sequence list The Results and Logbook index cards provide training results and session data In the Logbook the system automatically records the details of each session You can also add comments here You thus have a compact but complete digital client file If your client is able to work alone after selecting the training programs you can specify whether he is to move on directly from one program to the next thus working his way independently through the session or whether you will start the next program for him The Standard and Universal Vienna Test System re This means that your pres sponse panels can also be used with the CogniPlus ence during the session is training programs Worth knowing ________ not essential unless the Save even more time with the Direct client needs special care Training function e g children or severely Standard res
28. em 1 TEST VIENNA TEST SYSTEM Psychological assessment T TEST THE SUCCESS OF TRAINING A great team 2 TRAIN COGNIPLUS Cognitive training SPECIFIC VIENNA COGNI FUNCTION TEST SYSTEM PLUS Attention Neglect visual field training Memory Executive functions Spatial processing Visuomotor skills Alertness Vigilance Selective Focused Divided Visuospatial attention Rehearsal visuospatial Spatial coding Updating visual Updating spatial Learning of face name associations Response inhibition Planning and action skills Mental rotation Visuomotor coordination co Is co rc co Is cp Te DDr mD cp oe n Sa cp I aD Ics ep Iz ED IIc a Ind Em Ine in implementation The tests of the Vienna Test System and the training procedures of Cogni Plus are coordinated The training programs are based on the same the oretical models as the tests to which they correspond this provides an ef ficient and theoretically sound link be tween assessment training and the subsequent analysis of effectiveness The corresponding tests and training programs are based on the same the oretically clearly defined constructs but do not involve the same tasks This enables a reliable distinction to be made between the material spe cific learning effect and the desired training effect The summary shows which CogniPlus training
29. epre sentation of a digital picture frame on his screen A suc cession of photographs appears in the frame the pho tos have different subject matter animals landscapes colors etc The client s task is to decide whether the current photograph matches the one that was shown The following task will help you to improve your memory You will be shown a series of photos If the current picture it back matches the picture that was shown press the green button PEE EIEN conte SE cts lf the current picture does not match the one that was shown two pictures back press the red button Press the green button to practise the task first one two or three places back the number of places varies with the level If it matches he should press the green button If it does not match the red button must be pressed The client receives feedback on his performance at regular intervals approx every 5 minutes The aim of this feedback is to maintain the client s motivation at an optimal level Difficulty structure NBACK has 15 difficulty levels and adapts to the client s ability in four ways 1 The difficulty is varied by changing the number of stimuli that the client must remember At the lower levels the current stimulus needs only to be compared with the immediately preceding one At the highest levels the cur rent stimulus must be compared with the one that was displayed three places back 2 The semantic simi
30. he training program is optimally adapted to the client s skill and is never either too easy or too dif ficult for him Corresponding test in the VIENNA TEST SYSTEM WAFS COGNIPLUS 9 The CogniPlus training programs ME FOCUS DIVID ME Walter Sturm o SCHUHFRIED GmbH Walter Sturm o SCHUHFRIED GmbH Theory Focused attention describes the ability to isolate a seg ment of reality in order to be able to analyse it more closely It is particularly important to be able to main tain this focus in the face of distractions and to sup press the interference caused by the simultaneous and automatic processing of information Setting and task A boat travels through a lush African landscape The client is confronted with a wide range of different stim uli screeching birds flying dragonflies a ruin on the banks of a river a waterfall etc His task is to respond to pre defined relevant stimuli without letting himself be distracted by the large number of other stimuli Corresponding test in the VIENNA TEST SYSTEM WAFF 10 COGNIPLUS The FOCUS training program trains focused attention the ability to respond only to relevant stimuli among a high density of distracting stimuli Training forms The FOCUS training program consists of two training forms each of which has ten difficulty levels gt The S1 training form requires the client to recognise visual stimuli against a background
31. hip within the telescope s finder a green circle on the screen Since the object is moving across the sky as it is being watched the client must actively track it with the finder The aim is not to lose the object from the finder The longer the finder remains on the object the more points the client accumulates Difficulty structure The VISMO training program has 22 difficulty levels Training adapts to the client s performance level in four ways As the difficulty level increases the path along which the target object travels becomes invisible and increasingly difficult to follow the speed of the target ob ject increases and the number of distracting objects in the scene also increases Corresponding test in the VIENNA TEST SYSTEM 2HAND COGNIPLUS 21 gt LE gt Be FEE Ea FY V K E i a a a 7 E F 3 _ F A Soe 8 P wes Z_ Gs DU L yp yi i a a d f Q k n a a a p a a We Balk Vi g 4 Be Ge uE eh a gt f i g N E o wu _ d ad i A i gt A g L i mA A x gt 7 A DO y Ko A P o S ar sat Sa ese To enable clients to train in their own language CogniPlus is cur rently available in 16 languages op The CogniPlus training programs are continually being translated into additional languages Visit www schuhfried com for up to date information Basic software ALERT
32. larity of the pictures represents an additional difficulty parameter At higher levels the pic tures become more similar 3 The picture content becomes more abstract and hence more difficult to verbalise 4 The picture presentation time becomes shorter as the difficulty increases Corresponding test in the VIENNA TEST SYSTEM NBN COGNIPLUS 15 The CogniPlus training programs ae DATEUP Working memory Dieter Schellig Uwe Schuri Walter Sturm SCHUHFRIED GmbH by Which butterfly was the next to last to land Theory Updating information is a fundamental cognitive proc ess New stimuli and information from perception or long term memory bombard us constantly and replace older versions continuous updating is required For ex ample driving in a city involves a rapid and continuous process in which observed situations are briefly stored compared with newly perceived ones and immediately replaced for instance if a number of vehicles are ap proaching an unsigned junction and it is necessary to decide who has priority At the same time information from long term memory is activated in order to identi fy what has been perceived and process it in a goal directed manner for example on European roads this will involve recalling the rule which states that drivers must give way to traffic from the right In the scientific literature updating is regarded as one of the basal ex ecutive control mechanisms of worki
33. made possible through a generous grant by the Icelandic Li ons Club Nj r ur Grensas neuropsychological rehabilitation is an in out and daypatient treatment facility for adult pa tients mainly post acute traumatic brain injury TBI and stroke Most of these patients suffer from some sort of attentional dysfunction CogniPlus is therefore an exciting new venue for us in the rehabilitation of these patients especially given its theoretical basis and emphasis on various subcomponents of attention We value the scientific background of CogniPlus and the in depth explanations and descriptions in the user manuals Several of our patients are now undergoing daily Cogni Plus sessions at Grensas about 30 45 minutes each session 5 days a week Our experience so far is that patients greatly enjoy these sessions as the material is user friendly and interesting training instructions easy to understand and the immediate presentation of results immensely motivating In addition the tasks within the various CogniPlus subcomponents are of in trinsic value to day to day functioning and as such an important element to promote generalization of effects to everyday life The outcome of rehabilitation is measured by the cor responding WAF Perception and Attention Function subtests of the Vienna Test System which are admin istered separately for each attention subcomponent This enables us to gather precise pre and post data on the improve
34. ment of attentional function due to the actual CogniPlus rehabilitation process 32 COGNIPLUS Treatment and Rehabilitation Center for Neurology and Orthopaedics Bad Pirawarth Application Neuropsychological rehabilitation Kerstin Heger Clinical and health psychologist The psychology department at the neurological Treat ment and Rehabilitation Center at Bad Pirawarth has been using the neuropsychological training software CogniPlus for more than three years For patients with impairments of cognitive functions as a result of stroke craniocerebral trauma tumour surgery Parkinson s disease MS incipient or early stage dementia and other neurological diseases CogniPlus provides some effective training modules for improving the functioning of attentional performance This enables treatment to be targeted at the patient s specific limitation At the Pirawarth clinic we have successfully used the programs DIVID divided attention SELECT selective attention and ALERT alertness SELECT includes not only visual and acoustic variants but also a crossmodal version which makes compara tively challenging demands on patients abilities DIVID is particularly appealing in its design airport operations and the various tasks are presented very comprehensibly and realistically ALERT is designed in a varied and interesting way and has a reality link to the attention function the ride on a motorcycle to train alertness m
35. nd scoring correct delayed etc It is also possible to compare performance in the most recent session with that in the preceding sessions 28 COGNIPLUS Training at the computer Direct training Mimma Direct training The new Direct Training function enables training to be administered fully automatically without a supervi sor It is used mainly in CogniPlus networks that have access to a central database However Direct Train ing can also be used on local CogniPlus systems This is how it works You first assign each client a per sonal ID and set up a training session You start Direct Training by selecting Direct Training in the System menu Alternatively Direct Training can be started from an icon on the desktop or from the Start menu Via his own screen the client will now be instructed to enter his personal ID and then to confirm that his personal details are accurate He then accesses the training session and training proceeds in the same way as training started manually by the supervisor Worth knowing You can also use a barcode reader to input the client ID COGNIPLUS 29 Service Best practice CogniPlus in use Kolpinghaus Gemeinsam Leben Vienna Application Geriatrics Thomas Pletschko Clinical and health psychologist sociologist Kolping haus fur betreutes Wohnen GmbH In the housing complex run by Kolpinghaus fur be treutes Wohnen GmbH in Vie
36. ng memory These mechanisms are used to control and coordinate cog nitive processes and form the basis for more complex cognitive processing The executive functions of work ing memory can be improved through repetitive training Olesen et al 2004 Erickson et al 2007 Jaeggi et al 2008 Dahlin et al 2008 The DATEUP program trains the updating function by means of tasks of three types that are widely used and well confirmed in the literature running tasks keep track tasks and n back tasks The aim of training is to achieve more flexible and more au tomated updating of material in spatial working memory and to improve complex cognitive functions Updating spatial The DATEUP training program trains the ex ecutive updating function of spatial work ing memory Updating is the ability to renew memory contents in a controlled and goal directed manner Setting and task The client watches butterflies in a natural setting as they fly over flower meadows and sandy ground From time to time one butterfly lands and another starts its flight etc until eventually at irregular intervals the client is asked a question Depending on the type of task the client must now highlight one or more butterflies for example the last but one butterfly the last three butterflies or the last of each of three different butterfly types Difficulty structure The DATEUP training program has 25 difficulty levels The demands on working memory
37. nge of scenes on several control monitors sliding doors at the entrance ticket counter luggage conveyor and announcements made over the loudspeaker system His task is to deal with problems that occur by pressing the response key If the client fails to react promptly to a problem or a relevant an nouncement the picture is frozen on all channels and the channel on which the problem occurred is highligh ted The events displayed do not continue until the re action button is pressed The CogniPlus training programs Difficulty structure DIVID has 15 difficulty levels The difficulty levels vary in terms of the number of channels that the client has to monitor the frequency of breakdowns the minimum in terval between two breakdowns and the maximum time allowed for noticing a breakdown Corresponding test in the VIENNA TEST SYSTEM WAFG COGNIPLUS 11 The CogniPlus training programs 5 SPACE Neglect visual field training Visuospatial attention Walter Sturm o SCHUHFRIED GmbH your attention on specific objects 4 Imagine that you are a photographer b Through the viewfinder of your camera you see a busy riverside walk The viewfinder of your camera moves to z various objects on the river bank that are not at first visible Press the green button to continue with the instructions Theory In everyday life our attention may be focused on a dif ferent source from our perceptive organs Periphe
38. nna different generations live side by side the majority of residents are older people in need of care CogniPlus has been used since autumn 2006 The aim of cognitive training with Cogni Plus is to train functions affected by dementia related deterioration and to stimulate mental activity in indi viduals affected by symptoms of depression in old age Before training commences a detailed assessment is carried out using appropriate psychological assess ment tests such as the WAF tests from the Vienna Test System The training sessions themselves are conducted once a week and last for approximately 45 minutes After twelve training sessions the progress made is evaluated once again by using psychological assessment tests The value of CogniPlus in our residential home can be seen in two areas Firstly it is very useful for the type of dementia related deterioration for which cognitive training has been shown to be effective that is in cases of mild cognitive impairment which is often a precursor of dementia and mild dementia Secondly it also has a positive effect in individuals with depressive symptoms with the result that these residents then re port more mental activity in their everyday lives 30 COGNIPLUS Clinica Hildebrand Centro di riabilitazione Brissago Switzerland Application rehabilitation of cognitive functions of adults and older people Marco Di Gangi Psychologist neuropsychologist FSP The h
39. nstruction phase is always followed by a prac tice phase If the client s responses indicate that he has not yet understood the task the system will auto matically repeat the instructions The training phase does not start until the client has successfully com pleted the practice phase 4 Training phase You can use the CogniPlus programs to carry out training at any level of difficulty across the ability range If a new client commences training Cogni Plus quickly and automatically identifies his ability level and classifies him accordingly If the client has already completed one or more training sessions the new session begins where the last one finished So that clients are neither under nor over chal lenged all the training programs have been designed to be adaptive that is they adapt themselves con tinuously to the client s ability level 5 Evaluation of results CogniPlus provides two types of evaluation of results 1 For the client Each training session concludes with an easily read chart of performance in recent sessions 2 For the test supervisor At the end of the session detailed results of the individual programs used dur ing that session are available These results include mean reaction times and the number of correct de layed incorrect and omitted responses at each level of difficulty In addition a chart records each response made during the session in terms of difficulty level reaction time a
40. o SCHUHFRIED GmbH The CogniPlus training programs Visuomotor coordination VISMO ooo Rudolf Debelak Christine Heidinger o SCHUHFRIED GmbH Welche Kamera liefert dieselbe Ansicht wie auf dem linken Bild Klicken Sie auf diese Kamera Theory Current theoretical models of this ability area assume that the process of solving mental rotation problems involves four stages see Just amp Carpenter 1985 Aren dasy amp Sommer 2010 gt Search stage the search for corresponding object parts gt Encoding stage constructing a mental image of the object to be rotated gt Transformation stage transformation by means of rotation or change of per spective gt Confirmation stage comparison of actual results with intended outcome Studies show that this ability can be improved through training and practice In general the best results are achieved by using training methods in which different spatial strategies are permitted and practised for a sum mary Handet al 2007 Corresponding test in the VIENNA TEST SYSTEM 3D 20 COGNIPLUS ROTATE trains the ability to form a three di mensional mental image of an object depicted in two dimensions and to manipulate the im age by means of a change of perspective or rotation mental rotation Setting and task In the ROTATE training program the client is shown 3D objects that he must compare with reference pictures Two types of task are presented altern
41. on gt Determining the type and location of a brain injury by means of imaging techniques and apparative tests provides initial indications of possible function impair ments Neuropsychological tests enable these func tion impairments to be assessed both qualitatively and quantitatively the test results provide information about the extent and nature of a deficit Fast assessment gt Standardized computerized instructions and practice phases save time as does error free computerized scoring gt The Word reports with boilerplate texts included in the Vienna Test System NEURO make writing re ports easy gt The user friendly administration software makes data management efficient and straightforward Parallel versions The Vienna Test System NEURO contains many parallel versions of tests that help to avoid practice memory and learning effects when tests are adminis tered for follow up purposes Extensive norms Extensive norm samples are available in the Vienna Test System NEURO It is possible to select compara tive samples based on gender education or age as well as the total sample For many tests the compara tive group includes people aged over 85 The norms of all tests are revised at least every eight years COGNIPLUS 23 The Vienna Test System NEURO Wide range The Vienna Test Sysetm NEURO can be used to as sess all relevant neuropsychological functions and par tial functions find a summary
42. ospital Hildebrand from December 2007 has the software CogniPlus with the aim to use it in the field of rehabilitation of cognitive functions of adults and older people who have had cerebral lesions e g craniocer ebral trauma ictus brain cancer anorexia The differ ent programs of CogniPlus allow to train the capacities of phasic and intrinsic alertness a reaction to simple visual or auditory stimuli with or without cue ALERT of Selective Attention the ability to quickly and in an appropriate way react to relevant stimuli and the conse quent ability to inhibit the reactions to irrelevant stimuli SELECT of Visual Spatial Attention the ability to ori entate attention in space to detect stimuli which are in the visual field SPACE of Divided Attention ability to keep ones attention to different stimuli at the same time DIVID of Vigilance ability to maintain an adequate concentration for long periods of time in condition of routine VIG There are furthermore other programs which we still do not have for the stimulation of the Work Memory NBACK of the Focal Attention FOCUS and of the Visual Motor Coordination VISMO The usefulness of such software in the clinical practice of rehabilitation is that due to cerebral lesions due to different causes the cognitive problems which have been more frequently corroborated are in the sphere of memory of attention and of operational functions Our experience demonstrates
43. ponse panel gt page2S disabled patients gt 7 colour keys gt 10 number keys gt 1 sensor key gt Connection for foot operated keys gt USB connection 2 Instruction phase Each training program starts with an instruction phase Simply formulated instructions inform the cli ent of what he has to do He can spend as much time reading them as he wishes this prevents stress To make things easier for the client all CogniPlus programs are designed along the same lines In ad dition they make use of everyday knowledge for ex Universal response panel ample based on traffic light usage the start button is always green Guided by gt 2 analogue joysticks Worth knowing _________ the careful use of size and gt 2 twist knobs Because they can be presented on color on the screen the gt 7 colour keys one side of the screen only the Cogni client absorbs information gt 10 number keys Plus training programs ALERT VIG selectively in accordance and SELECT are also suitable for with the importance of the patients with hemineglect or hemi various elements gt 1 sensor key gt Connection for foot operated keys anopsia The text then appears on gt USB connection either the left or the right half of the screen depending on the region of the neglect 26 COGNIPLUS COGNIPLUS 27 Training at the computer A typical training session 3 Practice phase The i
44. ral stimuli lying outside our central field of vision can attract the focus of attention to themselves They then bring about a change in the direction of gaze or a turning of the head towards an object or event visuospatial atten tion Peripheral cues tend to bring about an automatic exogenous spatial shift of attention while central cues e g an arrow in the fixation point pointing to the left or right are more likely to produce a cognitively control led endogenous shift of attention since a particular ex pectation is generated Both peripheral and central cues cause a covert shift of attention to the right or left and thus make it easier to detect stimuli in the half of the visual field in which the cues occur or to which they point valid condition However if the cue is in the wrong half or points in the wrong direction invalid condition the speed of reaction to the target stimulus is slowed since attention must first be shifted from the wrong focus to the correct spatial position Setting and task The client assumes the role of a photographer His task is to observe various scenes such as a market place air port office children s playground etc The camera view finder moves towards a particular point in the area under Corresponding test in the VIENNA TEST SYSTEM WAFR 12 COGNIPLUS The SPACE training program was created for patients with hemineglect but it can also be used successfully with pa
45. ram is adaptive because the client is con stantly working at the limit of his individual ability there is little scope for automated processing controlled monitoring must therefore be continuously applied The NBACK training program trains the monitor ing function of working memory the ability to retain information and continuously update it Theory Working memory is of key importance in dealing with the demands of everyday life especially when informa tion that has been briefly presented must be retained and cognitively processed or when a task needs to be performed or a goal achieved Many diseases such as Alzheimer s disease Huntington s chorea Parkinson s disease or attention deficit hyperactivity disorder are as sociated with impairments of working memory and con sequent difficulties in coping with everyday tasks Recent scientific findings indicate that the capacity of working memory can be improved through regular train ing As the work of various researchers has shown the effect of such training is enhanced if the training tasks adapt to the client s ability level This is the case in NBACK The training material consists of n back tasks which require the client to react to stimuli that recur at a particular interval These tasks place demands on the client s ability to retain task related information and con tinuously update it in his mind Setting and task In the NBACK training program the client sees a r
46. raphics Johanna Kurz www kurzundkallweit at Photos SCHUHFRIED GmbH fotolia Cover Robert Kneschke shutterstock Cover Denis Babenko p 24 Yuri Arcurs Konstantin Sutyagin Alexander Raths Lisa F Young Polina Nefidova p 23 Yuri Arcurs rangizzz p 29 Ilike p 30 Yuri Arcurs p 31 Yuri Arcurs p 34 Daboost istock p 4 LdF p 33 avdeev007 Copyright SCHUHFRIED GmbH Moedling All rights reserved For the sake of readability the masculine form has been used throughout to designate both genders ee Contents im Find it fast COGNIPLUS FROM A Z 7 gt ALERT 14 CODING 16 gt DATEUP 11 gt DIVID 10 gt FOCUS 18 gt HIBIT R 17 gt NAMES 15 gt NBACK 19 gt PLAND 20 gt ROTATE 9 gt SELECT 12 gt SPACE 8 gt VIG 21 gt VISMO 13 gt VISP Attention Alertness Working memory Spatial coding Working memory Updating spatial Attention Divided Attention Focused Executive functions Response inhibition revised version Long term memory Learning of face name associations Working memory Updating visual Executive functions Planning and action skills Spatial processing Mental rotation Attention Selective Neglect visual field training Visuospatial attention Attention Vigilance Visuomotor coordination Working memory Rehearsal visuospatial ul A O O NNA 10 11 12 12 13 13 14 15 16 17 17 18 19 20 20 21 21 22 23 25 26 26 26
47. rents evenings In the therapy sessions each child uses the computer to work on two areas of attention The children very much enjoy working with Cogni Plus The tasks are designed to arouse their interest and the graphics are appealing The use of the pro gram is also easy for the children to master Clinical catamnesis indicates very satisfactory improvement for a large proportion of the children as revealed both in the re testing of attentional performance and in the assessments of parents and teachers Neuro oncology unit of the University Clinic for Children s and Young People s Medicine Vienna Application children and young people Thomas Pletschko Clinical and health psychologist sociologist University Clinic for Children s and Young People s Medicine AKH Vienna Dr Ulrike Leiss Clinical and health psychologist University Clinic for Children s and Young People s Medicine AKH Vienna CogniPlus has been in successful use for more than a year in the neuro oncology unit at the University Clinic for Children s and Young People s Medicine The program has been found to represent a suitable treatment option for a variety of indications On the one hand we use it for training neuropsychological functions where there are function deficits on the other it also proves very beneficial for children and young people with a poor experience of self efficacy or low frustration tolerance For the children
48. riven along a winding road The cli ent s task is to carefully observe the stretch of road in front of him and to press the reaction key as quickly as possible when obstacles appear If the client reacts in time the motorcycle slows down and the obstacle disap pears so that the rider can continue on his way If the reaction is delayed there is an emergency stop there is a loud braking noise the motorcycle comes to a halt and a yellow exclamation mark appears on the screen Training forms The ALERT training program consists of two training forms The S1 training form trains phasic alertness while the S2 training form trains intrinsic alertness In the S1 training form the obstacles designed to external ly arouse the client s attention are preceded by acous tic and visual warning signals In the S2 training form The CogniPlus training programs ME The CogniPlus training programs ALERT E Walter Sturm SCHUHFRIED GmbH the acoustic and visual warning signals are omitted The motorcycle then travels through a foggy night time landscape in which the obstacles suddenly appear out of the mist Difficulty structure Each of the two training forms contains 18 difficulty lev els The degree of challenge is increased by shortening the maximum permitted reaction time At the first level the client has 1 8 seconds in which to react to an ob stacle but at the highest level only 0 3 seconds elapse between the sudden appe
49. rporated into everyday activities at the center People are constantly coming forward to use the computer and they also express interest in try ing out the training program Feedback from residents is consistently positive they enjoy the program and that includes those who never thought that they would ever use the computer It provides a welcome diversion and an ideal supplement to the strength and balance training We use the WAFG program in the Vienna Test System to assess performance in divided attention tasks The automatic scoring of parameters including reac tion time and number of omitted stimuli helps us to work more efficiently since we do not have to take painstaking measurements ourselves Another advantage is that the training results can be viewed after each session this greatly increases us ers motivation The difficulty level is adjusted auto matically which makes the training progressive and efficient COGNI Service PLUS 31 Service Best practice CogniPlus in use Rehabilitation department Grensas National Hospital of Iceland Application adult patients treatment of post acute traumatic brain injury TBI and stroke Dr Claudia H Georgsdottir Clinical Neuropsychologist In late spring of 2010 the rehabilitation department Grensas at the National Hospital of Iceland Land sp tali h sk lasj krah s finally was able to purchase CogniPlus with its subcomponents This was
50. ser or inkjet printer black and white or color Other quality products from SCHUHFRIED Vienna Test System Psychometric assessment The Vienna Test System VTS is known world wide as the leading computerised psychological assessment tool The system consists of powerful administration software the tests themselve and additional optional input devices You can choose from more than 120 tests gt intelligence tests gt ability tests gt personality tests gt attitude tests gt clinical tests These tests include not only computerised versions of familiar paper and pencil tests but also auditory multi media and adaptive tests They can be combined as required in order to provide the best set of tests for your particular purpose We shall be happy to advise you Order now free of charge Catalog Vienna Test System E mail info schuhfried at Biofeedback 2000 Multimedia system Biofeedback 2000 is the innovative wire less biofeedback system from SCHUHFRIED It can be used for relaxation rehabilitation and as sessment Buy just the modules that you need The key features of Biofeedback 2000 gt transmission of readings via radio technology Bluetooth gt compact lightweight radio modules that are worn directly on the body gt complete freedom of measurement during measurement gt highly sensitive sensors with high stability against artefacts gt user friendly e
51. t is taught strategies to assist learning and recall The difficulty of the tasks is varied systemati cally in the course of the program At the most advanced difficulty levels the individuals are introduced to the client by a speaker as at a party This is intended to simulate a real life situation in which a number of names must be remembered in a short period of time and thus facilitate transfer to everyday life The CogniPlus training programs NAMES EE Uwe Schuri Dieter Schellig Walter Sturm o SCHUHFRIED GmbH Difficulty structure In the NAMES training program difficulty is varied by changing the number of people in a set to be learned the extent to which the names conjure up meanings or images the appearance of the individuals and the way in which the task is presented In addition at the lower levels there is an option to view hints on memorizing strategies and to enter tips that the individual has devised Corresponding tests in the Corresponding test in the VIENNA TEST SYSTEM VIENNA TEST SYSTEM NBN CORSI FNA 16 COGNIPLUS COGNIPLUS 17 a HIBIT R Executive functions Response inhibition revised version Ms Fiona Jones The CogniPlus training programs Matthias Weisbrod Stefan Kaiser Ute Pfuller Daniela Roesch Ely Steffen Aschenbrenner SCHUHFRIED GmbH Ms Fiona Jones Hampton Road 3 Hampton Road 3 Oxford OX1 4BJ UK UK Theory In everyday life the ability to suppress unwanted
52. tients who have an impairment of the visual field It improves the visuospatial directing of attention and is in tended to train the specific ability to direct at tention to stimuli on the contralesional side of the field of vision observation The task is to take a photo by pressing the reaction key as soon the viewfinder stops and has captured an object In each scene there is a fixation point in the center towards which the client should direct the position of his head and the direction of his gaze and where he can find the viewfinder if he has lost sight of it Difficulty structure There are ten different difficulty levels each of which displays a different scene of interest on the screen The level of difficulty is increased by varying the way in which the viewfinder moves con tinuous movement jumping Worth knowing movement with and without We recommend the use of monitors a return to the center and with a screen diagonal of at least 19 the complexity of the scene so that the area of the visual field In addition at the lower lev _ being trained is as large as possible els of difficulty the task is made easier by an acoustic and visual cue sound and arrow in the middle of the viewfinder which indicates the direction of the next movement At the higher levels of difficulty only irregular cues are given and the cues may give no indication of direction or even be completely wrong for example the arrow
53. uations such as driving a car using household equipment or picking up objects Coordinating motor movements with visual stimuli re quires anumber of different abilities First it is necessary to identify what movements are necessary to achieve a particular goal This involves creating internal models of the movement After this the relevant movement must be planned and prepared and finally the movement is ex ecuted While the movement is being performed the in dividual must use visual feedback to monitor whether the desired goal is being achieved If necessary the move ment must be changed or a new movement may need to be initiated At the same time all external influences on the movement such as gravity must be taken into account VISMO trains clients vis uomotor coordination by gt Feadimorelonipage26 joystick to keep a circle positioned over a target object on the screen The target object moves across the screen along a path that varies in its degree of complex ity A number of studies have shown that regular training with tasks of this type improves visuomotor performance in patients with motor disabilities There is also evidence that these tasks can improve visuomotor ability even in people without motor disabilities Setting and task In the VISMO training program the client is instructed to observe the sky through a telescope His task is to keep a particular object a satellite planet or space s
54. work gt operating system Windows XP Vista 7 x32 or x64 It is important that no programs are installed on the computer that could interfere with the presentation of training e g through high CPU usage or unwant ed output on the screen 34 COGNIPLUS Monitor gt CRT or TFT colour monitor with at least 15 visible screen diagonal 19 for the SPACE training program gt For CRT monitors the refresh rate must be at least 75 Hz gt Itis recommended that only synchronous TFT mon itors are used asynchronous screens may flicker in a way that interferes with training The test pro gram PixPerAn can be used to check whether a screen is synchronous or asynchronous Safety devices If CogniPlus is used with in the healthcare service use of the following devic es is required medical grade isolation transformer in accord ance with EN 6061 gt galvanic medical net work isolator in accord ance with EN 60601 if the computer is con nected to a data network Please ask your in house health and safety officer Printer optional Worth knowing Products of SCHUHFRIED GmbH are developed and produced in ac cordance with EU Directive 93 42 EEG The CE mark confirms that our products comply with technical safety regulations electro magnetic com patibility guidelines EN60601 bio compatibility guidelines EN30993 product specific requirements and quality management standards La
55. y make on response inhibition The inhibition of responses is made more difficult across the difficulty levels by a reduction in the number of no go stimuli shorter presentation time of the letters and packages and an increasing number of discriminators several stamps additional inscriptions on a package Executive functions Planning and action skills In the PLAND training program action and planning skills are trained through the presen tation of realistic planning tasks Theory Meaningful and independent action in everyday life be comes possible only when behaviour is planned and organised over a relatively long period and competition between tasks is dealt with by setting priorities Plan ning ability can be impaired by brain damage of any etiology and origin especially where there is damage to frontal structures or diffuse cerebral damage Execu tive functions can also be affected by a range of psy chiatric illnesses including schizophrenia and depres sion PLAND is a training system based on everyday activities which enables clients to practise creating and implementing schedules of varying complexity It gives the therapist the opportunity to work interactively with the patient to devise various strategies for improving cognitive functions and self control The aim is to im prove planning and action skills in everyday situations Setting and task In the PLAND Plan a Day training program the client is given the t
56. yday life In CogniPlus the ability dimensions being trained are almost always embedded in lifelike scenarios This has been achieved through collaboration with computer game programmers who have produced impressive three dimensional scenes It is this appealing modern and motivating appearance that makes CogniPlus popular with clients Adapts automatically to 5 the client s ability CogniPlus is an intelligent interactive system which is neither too easy nor too difficult for the client It reliably identifies the client s ability level and adapts automati cally to it One of the conditions for successful training is thus met the users of the program are motivated 6 Training at all ability levels The CogniPlus training programs can be used across the entire ability range This opens up completely new opportunities for use alongside the traditional areas of application such as the rehabilitation of patients with brain damage For example CogniPlus can be used to improve the driving related skills of people convicted of traffic offences to improve the attention of children with ADHD or to improve the mental activation of patients with MCI 7 Recommended by respected institutions The Aixtent training programs which led to the develop ment of the CogniPlus attention training modules are listed with recommendation strength A in the guidelines of the Society for Neuropsychology Gesellschaft fur Neuropsychologie GNP 200
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