Are there variations between face-to-face and on-line neurorehabilitation? Case Examine

The Bolivian company Consultora-Strategia explains the differences between neurorehabilitation in person and online using the example of a girl with a low attention span.
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Consultora-Strategia is a company made up of professionals with more than twenty years of experience in various fields of psychology. We offer services in two main areas: in human resources through our online psychometrics system (Strategia-Solutions) and in education, the activities of which are related to our expert process of career guidance and cognitive neurorehabilitation.

How did we work before the delivery of Covid?

The neurorehabilitation processes created by the counselor allow us to develop and potentiate the cognitive processes in a significant way, so that in most cases of our patients it has been possible to completely overcome the learning difficulties.

The usage of manipulative didactic material and exercises Our pre-delivery program was based on transparencies, looking at different levels of difficulty that children and adolescents had to overcome depending on their age of maturity and cognitive developmental characteristics.

Using statistically reliable tests along with a pre-test and post-test method allows us to make an objective and scientific analysis of the results obtained.

What did we do during the delivery?

Due to the restriction from COVID-19, our cognitive neurorehabilitation area had to be suspended for three months. Fortunately, we met NeuronUP, whose platform offers us a range of didactic games as well as digital interactive maps and sheets that can be customized according to our needs and the specific needs of each of our patients. Through this platform we had the opportunity to rebuild most of our programs, which made it possible for us to open the online maintenance system on a national and international levelMaintaining the quality of the work done.

Our sessions are conducted via video conference, the children and teenagers share their screen and the professional can monitor 100% of the session as if she were in the office The sessions are carried out with the interaction, motivation and guidance of the therapistAspects that are fundamental within the process. Likewise, we conduct a thorough review of each patient’s performance through our monitoring tables to adjust each session, increasing or decreasing the difficulty and / or time of each exercise according to their performance, so they stay motivated with each new challenge.

Next we describe the specific case of a 10 year old girl. For reasons of confidentiality and professional ethics, we will not reveal her real name, so we will call her Carla from now on.

Carla’s case

In September 2019, Carla’s mother presented herself to Consultora-Strategy to evaluate her daughter, stating that the girl was having difficulty maintaining her concentration and having difficulty doing math. For example, a series of tests on cognitive thinking, learning styles, global awareness, body schema, visceral perception and neuropsychological development were carried out.

diagnosis

The following diagnosis was achieved:

  1. Difficulty processing auditory information.
  2. Dyscalculia
  3. Low attention capacity.

It was concluded that the main areas to be stimulated were: attention capacity, auditory processing, auditory memory, numerical reasoning, visual reasoning, and body schema.

Neurorehabilitation: Differences Between Current and Online Neurorehabilitation

Work started in September 2019 and had to stop at the end of October due to political circumstances in Bolivia that forced us to stop for almost a month. Work resumed from the end of November to the beginning of March 2020. At that point, Covid-19 arrived in Bolivia and was locked up. Because of this, we had to pause for three months, so NeuronUP allowed us to resume Carla’s sessions from June 2020.

From September 2019 to February 2020, we started working on attention span, auditory processing, auditory memory, and numerical reasoning. In February we found that Carla’s cognitive abilities had increased significantly in all areas that had been stimulated up to that point. From June 2020 we continued the stimulation by NeuronUP with 100% online sessions, kept our programs and adapted the digital material provided by NeuronUP to the work in the office. We also began to stimulate body schema and visual thinking (areas that had not been stimulated until that moment).

evaluation

An evaluation was carried out at the end of August to scientifically analyze the progress. The results obtained were very satisfactory.

Global attention capacity

Differences between in-person and online neurorehabilitation

Differences between in-person and online neurorehabilitation

September 2019

February 2020

Months of stimulation in this area: None Months of stimulation in this area: Four (4)
Selective attention

Percentile: 60 (10% above average)

Capacity:medium

Selective attention

Percentile: 99 (49% above average)

Capacity: Very high

Divided attention

Percentage of errors related to correct answers: 11.1%

Capacity: Medium Low Low

Divided attention

Percentage of errors related to correct answers: 4%

Capacity: High

Sustained attention

Capacity:deficit

Sustained attention

Capacity:Very high

Processing of auditory information

Differences between in-person and online neurorehabilitation

September 2019

February 2020

Months of stimulation of this area: None Months of stimulation of this area: Four (4)
AUDIO-VERBAL UNDERSTANDING

Dekatype: 5

Capacity: medium

PHONOLOGICAL LIQUID

Dekatype: 4 (1 standard deviation below average)

Capacity:Medium low

VERBAL STORAGE

Dekatype: 3 (2 standard deviation below average)

Capacity: Low

RHYTHM

Dekatype: 5

Capacity:medium

AUDIO-VERBAL UNDERSTANDING

Dekatype: 8th

Capacity: High

PHONOLOGICAL LIQUID

Dekatype: 5

Capacity:medium

VERBAL STORAGE

Dekatype: 7 (2 standard deviation below average)

Capacity:Medium high

RHYTHM

Dekatype: 5

Capacity:medium

Differences between in-person and online neurorehabilitation

September 2019

August 2020

Months of stimulation of this area: None Months of stimulation of this area: Six and a half (6 ½)
ONEUDITORY MEMORY

Quotient: 81

Percentile: 10 (40% below average))

capacity : Very low

AUDITORY WORKING MEMORY

Quotient: 113

Percentile: 81 (31% below average))

Capacity: High

Numerical thinking


September 2019

August 2020

Months of stimulation of this area: None Months of stimulation of this area: Six and a half (6 ½)
NUMERICAL REASONS

Quotient: 91

Percentile: 27 (23% below average)

Capacity: Medium low

NUMERICAL REASONS

Quotient: 105

Percentile: 66 (16% below average)

Capacity: Medium high

Visospatial reasoning


September 2019 August 2020
Months of stimulation of this area: None Months of stimulation of this area: Two and a half (2 ½)
Quotient: 92 Quotient: 105
Percentile: 30 (20% below average) Percentile: 63 (13% below average)
Capacity: Medium low Capacity: Medium high

Body schema

BODY SCHEME (100% online stimulation)
September 2019 July 2020
Months of stimulation of this area: None Months of stimulation of this area: Two (2)
Result: 19th Result: 36
Chronological age: 10 Chronological age: 10 years 10 months
Mature Age: 8th Mature Age: 12
Difference: 2 years below chronological age. Difference: 1 year and 2 months above the chronological age.

If one compares the results of the stimulation, one can see that the visual reflections, which had no stimulation in the first stage, showed no change. However, once cognitive stimulation was started, positive and significant changes were detected.

Conclusion of the differences between presential and online neurorehabilitation

Likewise, in Carla’s case, it can be demonstrated that our cognitive rehabilitation programs either through presentation stimulation (with manipulative didactic material) or through online stimulation (with digital didactic material from NeuronUP) were of great benefit to the girl and not there were significant differences between the current one and online neurorehabilitation.

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Summary

Differences between in-person and online neurorehabilitation

item name

Differences between in-person and online neurorehabilitation

description

Consultora-Strategia explains the differences between personal and online neurorehabilitation using the example of a girl.

author

Strategia consultant

Editor’s name

NeuronUP

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NeuronUP

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