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A SMART Approach for Enhancing Higher-Order Cognitive Functioning Following Sports and Recreation-Related Mild TBI in Youth Using Telepractice

A side-view of a young Black girl working on her homework at home; she is typing information on a laptop as the sun glares brightly through the window. Used in Limitless brochure.

Perspectives of the ASHA Special Interest Groups

Lori G. Cook, Nellie N. Caulkins and Sandra B. Chapman

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Childhood through adolescence is a critical period for brain development, particularly in the frontal lobe, where higher-order cognitive skills like reasoning, strategic learning, attention, and other executive functions, evolve. Sports or recreational activities can lead to injuries such as a concussion, or mTBI, which can sometimes result in long-lasting impacts on everyday academic and life skills due to disruptions in this typical brain development. To specifically address the cognitive function of youth who have sustained an mTBI, 12 teens, at least 3 months from their initial injury, completed 10 computer sessions of Strategic Memory Advanced Reasoning Tactics (SMART™) delivered over Skype. Following training, participants improved in their ability to abstract meanings and recall facts from complex information. Additionally, improvements in working memory and cognitive flexibility occurred following SMART even though the tactics did not specifically target those skills. Given this ability to remediate higher-order cognitive processes, ongoing support for youth following their injury can assist in their rehabilitation and return to pre-injury functioning. Remote computer delivery of cognitive remediation can increase access to treatment for families lacking resources due to finances or location, thus potentially reducing socioeconomic disparities in cognitive rehabilitation. 

Table 2 outlines the timeline of the topics and focus of each telepractice SMART™ session completed by participants.

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Lori Cook, PhD, CCC-SLP

Director of Clinical Research Head of Research, The BrainHealth Project Adjunct Assistant Professor, School of Behavioral and Brain Sciences

Sandra Bond Chapman, PhD

Chief Director Dee Wyly Distinguished Professor, School of Behavioral and Brain Sciences Co-Leader, The BrainHealth Project

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