Modifying Cognitive Tests for Patients with Visual Impairments

Treatment Tip

I am a recent "non-traditional" graduate of Ohio State University where I had the privilege of being mentored and instructed by Michelle Bourgeois. I completed the University's Interdisciplinary Specialization in Aging and am now working in my clinical fellowship position at a skilled nursing facility. I am so grateful to Dr. B, as we lovingly call her, for her generous spirit and passion for those with dementia. She never let an opportunity slip by to remind us of the individual and practical needs of our clients and to consider the environment in which they have to safely live.

The December 2011 Special Interest Group 15's Perspectives reminds me yet again of all the factors I need to consider as I evaluate and treat my clients. I have discovered, however, that one of the greatest hurdles many of my clients face is the loss of their visual acuity. Where I was prepared to orient them by using signs, reminder notes, journals, or memory books I have been faced with the fact that many of them will not benefit from those cues due to their poor vision. Starting with the evaluation, I was stymied by the ability to use many of the commonly used assessments because of their reliance on vision. I discovered that the Montreal Cognitive Assessment (MoCA) had been evaluated for a modified version which allowed me to eliminate the first four items and still be a valid tool. The article Sensitivity and Specificity of the Montreal Cognitive Assessment Modified for Individuals who are Visually Impaired supports this modification.

I think we all need to be aware of the tools that are available to us but then to also take the time to look further when our clients' sensory skills eliminate traditional avenues of treatment or assessment. Thank you for these articles in this month's Perspectives. I always find information I can use every day to make a positive difference in my patients' treatment.

Submitted by Mary Anne Kane, MA, CF-SLP, Heartland of Marion, Marion, Ohio

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