RH22
Use of the Multiple Sclerosis Cognitive- Linguistic Checklist and the Brief International Cognitive Assessment for Multiple Sclerosis: Generating Patient Centered Goals
Speech Language Pathologists (SLPs) are responsible for identifying and providing care for persons with Multiple Sclerosis (pwMS) with deficits in cognitive- linguistic function. The patient - centered model of care includes the patient's concerns in the development of the plan of care and input into treatment goals. The Multiple Sclerosis Cognitive-Linguistic Checklist (MSCLC) is a patient-centered reporting tool which identifies specific examples of functional challenges at home, work and the community. Patient report alone is subjective, and difficult to quantify.
The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) consists of three published standardized tests chosen by a consensus panel, which provides reliable and objective measure of deficit in processing speed and visual/auditory encoding. Alone, the BICAMS does not identify specific examples of the functional ramification of these objective deficits.
Utilizing the MSCLC as a complement to the BICAMS is a method developed by the PI to gain repeatable objective evidence of deficit and patient -centered data to generate meaningful, measureable goals.
Objectives:
1. To show prevalence of deficit in attention, memory and word retrieval complaints in the caseload of the SLP
2. To show use of the BICAMS and MSCLC evaluation tools together to generate measureable and meaningful cognitive - linguistic goals
Methods:
1. At eval the patient reports deficit in attention, memory and/or word retrieval
2. The BICAMS is administered. Patients who are identified as appropriate for treatment based on level of deficit are offered treatment of specific duration and frequency
3. Patients appropriate for treatment complete the MSCLC
4. SLP writes goals based on deficit established by BICAMS, relfecting the patient concerns identified in the MSCLC
Results:
Sample Case Study
Patient - A teacher experiencing difficulty completing work requirements.
BICAMS
SDMT: 1.0 SD below mean
CVLT2: 1.5 SD below mean
BVMTR: 1.0 SD below mean
Response on MSCLC: Increased difficulty returning to task once distracted by non- routine things at work such as colleagues walking into the room, fire alarms, misplaced material. At home, phone calls, dogs barking, children squabbling draw the patient off-task.
Sample Goal: The patient will repeat 7 units of information, in the correct order after 2-3 distractions to restore ability to return to task after distraction.
Conclusions:
1. PwMS presenting for evaluation by SLPs are identifying complaints of cognitive-linguistic deficit.
2. Use of the MSCLC as a companion to the BICAMS is an effective method to objectively identify level of cognitive deficits and subjectively identify the effect those deficits may be having on the daily routines of pwMS.
3. Using these data, meaningful and measureable patient-centered goals can be written by the SLP to restore specific function to the patient.