Implementing Neuroscience Principles to Support Habilitation and ...

TABLE 8-18
Ways to Design Therapeutic Interventions for a High School Boy Who Wants to Work But Has Poorly
Modulated Internal Motivation System
Performance Possible
Need and Problems
Neurological (data from Restorative Adaptive Alter Preventative
Correlate Table 8-17) Interventions Interventions Interventions Interventions
Ryan wants to Ryan displays a Work with Ryan
work: disruption in high need to assert
and manager to
connections of the himself
identify stocking
hypothalamus are
plans for sections
leading to poorly
of the store
modulated internal Ryan displays a Schedule work
motivation (see
high need to inter- during peak traffic
Table 8- 17)
act with others times to improve
number of chances
for Ryan to have
contact with others
Ryan displays a
low to moderate
need to feel competent
and successful
Ryan displays a
low need to obtain
reinforcement
Assign a prescribed
pattern for
the stocking task
Locate a large grocery
store for
Ryan's employment
to help persons whose CNS is disrupted to use activity in
context. This is the essence of occupation.
This chapter only addressed a few of the key features of
CNS operations that support or create barriers for performance;
there are many neuroscience texts that provide information
on these topics in more depth (e.g., Kandel. Schwartz
& Jessel, 1991). As a closing exercise, let us look at one constellation
of neurological problems and the intervention possibilities
that emerge with that neurological status. Table 8-
19 provides a summary of the CNS structures that are affected
when the middle cerebral artery is infarcted (we are using
the right middle cerebral artery in this example). The Table
summarizes the possible clinical problems that would
emerge from this insult, and then offers functional life interventions
using the restorative (i.e., remedial) and adaptive
(i.e., compensatory) approaches. Using this process, the
provider can make links between the neurological correlates
and behavioral implications, and expand thinking about
intervention options for persons who have performance
needs to help them achieve their objectives by tapping the
exquisite potential of the CNS as they live fruitful lives.
STUDY QUESTIONS
1. Explain why the arousal/alerting and discrimination/mapping
are necessary for normal performance.
2. Why is centrifugal control a critical feature of sensory
processing
3. Describe differences in performance difficulties with
disruptions in the motor systems.
4. Design one of each intervention for a cognitive difficulty
using the EHP framework.
5. Identify three intervention strategies for someone who
is a "sensation seeker."