Welcome to BCAT® Brain Rehabilitation!
Brain rehabilitation exercises can often improve cognition and, in some circumstances, may protect against memory loss caused by brain diseases like Alzheimer’s disease. The BCAT Brain Rehabilitation approach emphasizes three cognitive domains: attention, memory, and executive functions. We call these three domains the Cognitive Task Manager because they are central to everyday functioning. Our cognitive exercises target these three areas. Please note the table below. It indicates the preferred rehabilitation exercise with the domains it is designed to address.
We also provide a series of other more general cognitive exercises. These include Mazes, Word Searches, and Word Scrambles. Each have different levels of difficulty and each has been empirically tested for effectiveness. For these exercises, trial-and-error is necessary to find the right “fit” between difficulty level and the participant’s ability to do the tasks.
We are often asked if people who have dementia can benefit from the BCAT Brain Rehabilitation exercises. We have found that individuals who have Mild Cognitive Impairment (MCI), and who have mild to moderate cognitive impairment show the most improvement. We also provide a series of “brain fitness” paper-and-pencil exercises on our website.
There is evidence that frequent participation in mentally stimulating activities is associated with decreased rates of cognitive decline and risk for dementia. In fact, in the BCAT ENRICH® program, we suggest that participants routinely engage in cognitively stimulating exercises as one of six "brain healthy" behaviors. This does not mean that brain rehabilitation exercises will prevent dementia, but that they may delay onset and improve functional ability. Mental stimulation throughout the life span, not just in the older adult years, is thought to be vital for healthy cognitive functioning in the older years. Frequent mental exercises that "work" attention and memory skills are particularly important. For mental stimulation to be effective, it should:
- Be moderately challenging. That is, not so easy that the exercises can be completed without really working, nor so difficult that one feels frustrated.
- Be novel. That is, exercises should be varied with the introduction of new activities. This requires mental creativity.
- Be frequent. Like with physical exercise, brain rehabilitation is best achieved with frequent exercise. This could be daily, or at least five times a week.
- Be fun. It is in our human nature to participate more actively in activities that we enjoy. Frequency is often associated with pleasure.
- Be social. While it is not vital that mental stimulation be done in a social context, for some individuals who do not get much social stimulation, cognitive exercising with others may be beneficial.
How to Use Our Program
In our program, we stress using the online interactive exercises. We have designed each exercise with the best neuroscience evidence available. At the same time, we strive to make the exercises practical and accessible. Please follow these guidelines:
- The duration of sessions should vary depending on the attentional capacity and tolerance of the participant. Typically, five minutes of “warm-up” and ten minutes of treatment-intensive exercises are recommended.
- We suggest that the participant engage in only one module per session.
- We suggest that the session begin with a warm-up exercise, which can be a lower difficulty level (an example would be Level I on Memory Match for someone for which Level II is the treatment level), or a very basic and easy to accomplish task. Here are some examples:
- “Count backwards from 10 to 1.”
- “How many letters are in the word (e.g., CAN, BLUE, APPLE)?”
- “Tell me each time you hear my say the letter M (L-M-M-D-C-E-A-M-B-M).”
- “Repeat these numbers after I say them (5-2-3; 6-9-8-5; 2-4-1-6-8).”
- “Tell me the months of the year starting with January.”
- “Tell me the days of the week starting with Monday.” (You can do this backward too)
The Interactive Modules
Memory Match – This online, interactive module focuses on attention and visual memory. How is this helpful? It recruits those parts of the brain that are responsible for concentration and attention, as well as visual memory. The objective is to require the brain to focus and create unique visual memories.
This likely involves the hippocampus, temporal lobes, and frontal lobes. There are three levels of difficulty in the module, beginning with level 1 and progressing through level 3. People tend to find level 1 easiest to do. Level 2 is more challenging. Level 3 is the most difficult. For those individuals who want to try an even more challenging exercise, there is a separate expert level. We recommend starting with Level I to establish a baseline. Each exercise is randomly recreated each time the participant plays, creating hundreds of possible combinations. So generally speaking, each time the game is played, your participant has a different exercise. One also can choose to "score" your performance. Performance is measured in terms of time and number of errors made. This allows you to track improvement in these skills.
Sort the Set – This online, interactive module focuses on attention and cognitive set-shifting. Set shifting is an important executive function (The “executive functions” serve as the command and control center of the brain. Some people refer to them collectively as the “brain’s CEO.”). Set-shifting is a frontal lobe function that requires the brain to juggle multiple tasks and keep things in order.
There are three levels of difficulty in the module. We recommend starting with Level one to establish a baseline. Performance can be tracked from session to session. To do this, simply choose to “score” performance by clicking on the appropriate icon.
Color Illusion – These color illusion exercises are modeled after John Stroop's 1935 research. Stroop described a process of "selective attention." Basically, the color illusion exercises require one to selectively pay attention to one task while not paying attention to a competing task. These exercises can increase cognitive control, strengthen one’s ability to attend and focus, and improve executive functions. We used the basic Stroop theme, but then expanded upon it to create dynamic exercises. The administration of this module does not requiring the participant to “click through” the exercises. It does require the participant to say words out loud. There are two levels of difficulty. The Color Illusion module is not scored automatically.