It’s All About Remediation

Hello and welcome back! I hope you all have been enjoying my weekly musings, because I’ve certainly been enjoying writing them. Now, as you know, the primary purpose of my project is to determine if the utilization of fine motor skills can improve executive functioning (EF) in individuals with autism. Today, we’ll be delving back into the research, more specifically, a different, tried and true approach towards improving cognitive (including EF) functioning: cognitive remediation.  

Let’s define it 

In a broader sense, cognitive remediation (CR) is a systematic approach to teaching individuals to overcome cognitive deficits arising from brain dysfunction. Accordingly, typical targets of CR include memory, attention, motivation, language, and, of course, executive functions. Defined more specifically, CR is behavioral interventions that help improve cognitive functioning through the use of repetitive exercises and positive reinforcers, such as praise and/or tokens for participation and increased attention span.

CR is essentially an umbrella term for psychological interventions that use cognitive training exercises to remedy difficulties in social cognition and neuropsychological functioning; as such, the term includes cognitive training, cognitive enhancement therapy, and cognitive rehabilitation. 

One example of CR is shown below. The intervention is divided into modules, each meant to target different skills/deficits, through a variety of exercises, for improvement.

Some history and relevant applications 

The use of cognitive training and subsequent CR interventions were originally developed for use in brain lesions, then broadened to be used for patients with schizophrenia, and later further adapted for patients with anorexia nervosa. 

However, in more recent years, an increasing number of studies have been conducted on the use of CR interventions with regard to autistic individuals, who, as I’ve previously mentioned, are known to face struggles with cognitive functioning, which includes executive dysfunction. Findings from these studies have indicated that CR can be effective in improving cognitive functioning, not limited to but including executive functioning, in autistic individuals.

So what’s the catch?

While shown to be effective, there exist a variety of barriers for the translation of CR interventions from purely empirical study to the clinical setting. Notably, given the numerous forms of CR, it is difficult to discern which particular CR intervention would be ideal and most effective for a particular autistic individual. Additionally, researchers have reported potential issues with accessibility and cost in relation to CR treatments/therapies. 

Consequently, it is essential that we continue to explore other methods to help remediate these cognitive deficits; this is precisely my goal with this project, which, hopefully, may encourage modes of therapy for autistic individuals that hone in on their fine motor skills as a means to improve their otherwise impaired executive functions. But hey, that still remains to be seen. One of the most wonderful aspects of the field of science is that it is truly dynamic; there is always room for improvement, innovation, and discovery. All we have to do is keep an open mind and be willing to learn. 

“The measure of intelligence is the ability to change.” – Albert Einstein