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Neuropsychology NHS Lothian | Our Services

Managing cognitive changes

Cognition involves a range of different thinking abilities, including those mentioned above, and many more. Sometimes a neurological condition can affect the way these thinking abilities work, causing difficulties in aspects of our lives. In the links to the left of the page/underneath you can find information about some of the different brain areas, thinking abilities and useful strategies for dealing with these difficulties. 

The Brain

Different areas of the brain are associated with different abilities which is why people have different experiences depending on what area has been affected, such as different symptoms in different stroke patients. We do not yet know everything about the brain, and research is ongoing. However, below is some information about what each of the areas of the brain are generally associated with. 

Graphic showing brain lobes in different colours
Function of the lobeConsequences of Neurological Changes
Frontal lobe:
Executive functions, thinking, planning, problem solving, multitasking emotions personality and behavioural control
Frontal lobe:
Lack of focus, difficulty concentrating, irritability, language difficulty, impulsiveness, emotional lability
Temporal lobe
Memory, hearing and understanding speech
Temporal lobe:
Ditioulty with short and long-term memory, learning new information
Parietallobe:
Perception, integrating sensory information, Making sense of the world, arithmetic, spelling
Parietal lobe:
Difficulty with reading, spatial misperception
Occipital lobe:
spelling vision, recognising objects
Occipital lobe:
Blind spots, blurred or double vision
Cerebellum:
Coordination, fine motor movement balance, walking and speech articulation
Cerebellum:
Difficulty walking, slurred speech, reduced dexterity, impaired coordination
Brainstem:
Autonomic activities such as  alertness breathing and swallowing
Brainstem:
Difficulty maintaining own autonomic responses such as breathing and swallowing

Attention

Strategies to help if you are struggling with attention problems are listed below:

  • Try doing and concentrating on one thing at a time so that you don’t overload your attentional resources
  • Remove distractions – try to work in a quiet environment with no background distractions.
  • Take breaks – it will be especially helpful if you have attention problems when you are tired
  • Find the best time of day for you to work as this differs between people
  • Talk out loud – This can help to keep the brain focused on the task at hand. Try reading instructions out load or simply try saying “stay focused”
  • Break bigger tasks down into small manageable chunks and give yourself breaks in between and pace yourself
  • Set goals – Having something definite to work towards can help you stay motivated
  • Reward yourself when you achieve a target or a goal
  • Be assertive – we can’t control our environment all the time, and sometimes it can be important to ask for help. Other people can’t always see cognitive problems and so it’s sometimes necessary to tell them what is difficult for us. If you feel you are being overloaded by a conversation and you cannot attend to all of the information, request that the other person slows down their delivery or repeats the key points

Memory 

Strategies to help if you are struggling with memory problems are listed below. Not every strategy will work for everyone, so it can be trial and error to find the right one for you.

Internal Strategies

These are things that you can do inside your head to try to remember things:

  • Attention – we are more likely to remember something if we have been able to give it our full attention. Focus on what is being said to you and try to reduce background distractions.
  • Break down large pieces of information into “bite-sized” chunks. Organise them under headings and have no more than five or six bits of information in each chunk.
  • Repeat information over and over. You can do this silently in your mind or out loud.
  • Expanded rehearsal – Practice recalling information over longer and longer delays. Repeat the information immediately after you have taken it in, then again after a slight delay, then again after a longer delay and so on.
  • Make it meaningful – people tend to remember information that is more meaningful or important to them. When trying to remember something, think about how important it is to you.
  • Make links – Link the information you want to remember to things you already know and remember. For example, if you want to remember that Charles’ birthday is the 27th of December, imagine that it is two days after Christmas. As a child he must have got lots of joint presents. The more links you create the stronger the memory becomes.
  • Use a context – Some people find it easier to remember information in a context, they are more likely to remember a story than a list of words or numbers. For example, when trying to remember a shopping list, make a story around the ingredients, or think of them in the context of the recipes you plan to make with them.
  • Effortless learning – With some memory difficulties, people learn most efficiently when they get the information right first time. If you get something wrong, you are more likely to remember the wrong answer than the right answer. Therefore, when you are unsure of something, instead of guessing, ask the correct answer first.
  • Mnemonics – These are saying rhymes or drawings that help us remember things better. You probably use a few already, for example “Thirty days has September, April, June and November”.
  • Use cues – Retrieval cues involve retracing a sequence of events or action in your mind in order to remember something. This can be helpful if you have misplaced something, start from where you last had it and retrace your steps. First letter cues are good for recalling a word or someone’s name. Go through the letters of the alphabet until you find the letter you are looking for. This can be enough to trigger the rest of the word.
  • Leading questions – Ask yourself the 5 W’s: Who, What, When, Where, Why?

External Strategies

These are environmental changes we can make to help us remember things.

  • Write it down – Keep a notepad and pen handy. Try to have a structure to your notes so that they are easy to remember when you go to read them again.
  • Use a to-do list – you could have a morning routine check list to make sure you have done everything, for example.
  • Have a routine – For example, taking medication at the same time each day, or doing tasks in the same order.
  • Use a calendar to help you remember important dates, plans and appointments. Scoring off each day can also help you to remember what day it is.
  • Set alarms on your phone or tablet to remind you of things you need to do.
  • Keeping things in the same place will help you remember where to find things.

Executive Function

Strategies to help if you are struggling with executive function problems are listed below.

Initiation

  • Having a structure or routine can be helpful, aiming to make some tasks more automatic. A set bedtime, for example.
  • Motivational Cue – Some people find it helpful to use a motivational phase or song to help them start actions. For example, when they are getting up in the morning saying “Right, let’s go!” or playing “wake me up before you go-go”. Try to think of a phrase or song that makes you feel good and is meaningful to you.
  • External prompts – Use external prompts, reminders or alarms to remind you to start doing things.

Inhibition, Planning and Problem-Solving

These are all different abilities but there are several strategies that help with all three:

  • Stop, think, act – Before acting on a situation or responding in a conversation, take a mental step back and give yourself time to process what is being said to you. This can be difficult but gets easier with practice.
  • Write down your plan – this gives you time to think through the different steps and check that it will work. You can write it down as a check list to help you keep track of your performance.
  • Talking yourself through a plan – helps  keep you focused on what you are doing and makes you more mindful of any mistakes.
  • Check in with yourself – In between stages of a task it helps to take a step back and think through what you have done and what you still need to do.
  • Don’t rush – Taking your time is the key to success. Make sure you have plenty of time to do what you need. Try not to put too much pressure on yourself to achieve things quickly.
  • One thing at a time – Try to avoid multi-tasking. Finish one task before moving on to the next.
  • Ask for feedback – Sometimes we can think we are doing better or worse than we actually are. It can be helpful to get a different perspective. Ask someone you trust, a friend or family member, for their feedback or opinions.

Flexibility

  • Give yourself time – If you have had changes to your flexibility this may mean you will find a bit of extra time in between tasks or topics of conversation helpful. When moving from one task to another, try to take a breath and ground yourself before moving onto the next thing.