The BCAT® Approach
The BCAT® Approach is a unique applied concept for assessing and working with people who have memory and other cognitive impairments. It is designed for any clinical and residential setting in which cognitive functioning and cognitive impairment is a central issue. The BCAT® Approach integrates distinct systems: The BCAT Test System, the BCAT Brain Rehabilitation Program, the BCAT Working Memory Exercise Book and the MemPics® Book Series. All are person-centered programs that are used by healthcare professionals, facilities, patients, caregivers, and other stakeholders. The Test System rapidly, yet comprehensively, assesses current cognitive functioning. Test scores can be used to determine specific Brain Rehabilitation interventions and treatment modules. The BCAT® Approach is interactive and online.
The BCAT Test System
The BCAT® Test System is comprised of five unique assessment instruments. The primary test is the Brief Cognitive Assessment Tool (BCAT) which can be administered in 10-15 minutes by professionals and techs, is sensitive to the full spectrum of cognitive functioning (normal, MCI, dementia), produces separate Memory Factor and Executive Functions Factor scores, and can predict basic and instrumental activities of daily living (ADL, IADL). The BCAT has also been shown to help predict discharge dispositions, facilitate Advance Directives determinations, aid in fall prevention programs, and help with non-pharmacological behavior management. View a sample BCAT report »
The BCAT-SF is designed as a shorter version of the full BCAT. The Short Form can be administered in five minutes or less. While it is not as robust or comprehensive as the full BCAT, the short version has strong reliability, construct validity, and predictive validity. When time is particularly limited (e.g., primary care settings), the six-item, 21-point short form is a dependable cognitive screening tool. The Short Form can differentiate between persons with and without dementia. It can be downloaded or used as an online tool.
The Brief Anxiety and Depression Scale (BADS) is a brief screening tool for mood impairment developed for older adults. It can be administered by a clinician, by proxy (knowledgeable informant), or self-administered for those who are cognitively capable. The BADS can be administered in less than five minutes. It can provide an indication of probable clinical depression and/or anxiety, but a diagnosis should not be based on the BADS alone.
The Kitchen Picture Test of Judgment (KPT) was designed as a visually presented test of practical judgment. The KPT is a unique illustration of a kitchen scene in which three potentially dangerous situations are unfolding. Patients are asked to describe the scene as fully as they can, to identify the three problem situations, to rank the order of importance of each situation in terms of dangerousness, and to offer solutions that would resolve the three problems. The KPT has been found to have construct validity (it measures the construct "judgment"), and can be used to differentiate between those who have dementia and those who do not.
The BCIS was designed to assess the cognitive functioning of patients with severe dementia. The BCIS is an 11-item, 14-point scale. It was developed to not only track cognitive changes in severely demented patients specifically, but to provide information to better manage behavior problems. We recommend using the BCIS when severe cognitive impairment has already been established, or when the patient scores under 25 on the BCAT. It is most effective in confirming severe impairment and tracking cognitive changes over time in advanced dementia.
The BCAT Brain Rehabilitation Program
This program is used either as cognitive rehabilitation (return the patient to baseline) or to promote positive cognitive functioning (and buffer against cognitive decline). The main modules are interactive and online; and they target attention, memory, and executive functions. We refer to this triad as the "cognitive task manager" used for everyday functioning. Our program is not a home brain fitness program, though one could do the exercises at home. Rather, it works best as an intervention tool for professionals who are working with patients who demonstrate cognitive decline. The program is ideal for rehabilitation therapists, and can promote positive rehab outcomes in physical therapy, occupational therapy and speech therapy.
The BCAT Working Memory Exercise Book
Working memory is the ability to mentally hold and manipulate information over a short period of time. You might think of it as a cognitive “workspace” in which we temporarily store information we hear, see, or feel (tactile) in order to do something with it. From a working memory perspective, the two dominant domains are phonological and visuo-spatial. There is often a good deal of overlap and synergy between the two. There are direct consequences to impaired working memory. Reduced or impaired working memory means that one cannot efficiently make new memories and may be limited in performing life tasks.
Here are some examples of everyday working memory:
- Remembering a new phone number or an address
- Following directions—“Make a left turn at the traffic light, and the gas station is on your right.”
- Remembering a person’s name just after meeting her
- Making a mental math calculation—You want to buy an item at the grocery store, and you quickly calculate whether you have enough money.
The 15 exercises provided in the Exercise Book are based on neuroscience research. Each has been tested with clients who have cognitive capacities that range from normal cognition to severe cognitive impairment. Each exercise type is further divided into “basic” and “complex” levels of difficulty. These are relative terms. Practitioners and clients should use this Exercise Book if any of the following goals apply:
- To improve “working memory”
- To increase a client’s ability to attend and focus
- To teach/learn memory strategies
- To improve cognitive-communication skills
- To increase the client’s success and safety with functional tasks (Instrumental Activities of Daily Living)
- To provide a buffer against future cognitive decline
The MemPics® Book Series
The MemPics® series is based on research conducted in the BCAT Research Center. It is a component of the larger BCAT Approach, which integrates cognitive assessment, cognitive rehabilitation, and working memory exercises. MemPics® books are designed to engage participants who have memory loss in fun and cognitively enhancing activities. The books activate old memories through pictures and conversations about familiar people, places, objects, and events. Activating old memories provides a foundation for engaging participants in directed conversation to improve cognitive performance. The MemPics® books have six separate activities. Each activity has four components: a picture, fun facts, prompting questions, and a brief story.
MemPics® can be used individually or in small groups. Participants can use the books by themselves, with family members and friends, and as part of a group event. For each activity, one can utilize all four features, or focus on just the picture, fun facts, prompting questions, or the story. You can choose any exercise, and proceed through the book in any way you choose. Research shows that MemPics® is more effective when each participant has her own book.
To read about MemPics® in scientific peer reviewed journals, click here.