Cognitive Abilities and Intervention Strategies (CAIS) - Beyond Behavior

The cais, Online Course, Three-Volume Manual (in the “Additional Resources” section)

• cais questions and intervention strategies are all presented here under “Additional Resources”.  There are four parts to the cais: Cognitive Abilities, Environment, Communication, and Task.  All four parts are available in both an interactive format and as pdfs that are downloadable and printable.
• Online course of five modules that explore concepts behind the cais, give examples from the cais, describe how to use it, and offer additional tips.
• Three-volume manual includes downloadable and printable pdfs of:
  • All the cais Questions and Intervention Strategies
  • 5 background chapters that explore in-depth the cais concepts and additional intervention strategies
  • 43 handouts that go into more depth regarding specific topics
  • Curriculum you can use to teach, use, or explain the cais concepts 

The entire manual is provided as downloadable and printable pdfs under “Additional Resources”.

For more information, see “Making The Cais For Looking Beyond Behavior:  More About the cais, Beyond Behavior Online Course, and Additional Resources”.

In the 1970s I was relating to a variety of people who were living with psychiatric and/or brain diagnoses in my work. I often saw frustration, stress, and anger, as well as pleasure and great empathy in the people living with a diagnosis, and in those who were relating to them. I noticed that the way a person acted and felt often depended to a great extent on how someone interacted with them.

I remember asking myself, “What is it that allows a person to feel better or to communicate or perform tasks more easily some times than other times?” “What role does the brain play in how a person acts, thinks, and feels?” “What can I do to help a person when each person seems to be so unique?” “How can I reduce the distress and frustration, and increase the satisfaction and contentment?”

So, I began graduate school (before a degree in neuropsychology existed) and spent the next forty-three years trying to find the answers to these questions. Here is some of what I’ve come up with. I am very excited!

You’ll find here some ideas of practical everyday intervention or support strategies you can try that address a person’s cognitive abilities and other effects of changes in the brain. They can help you reduce and prevent distress and distressing situations or behavior and help you and a person you relate to feel comfortable, and enjoy your time together!  I hope you too find these strategies helpful and exciting!

Shelly Weaverdyck

Author of the Cognitive Abilities and Intervention Strategies (cais) - Beyond Behavior resources and online course, the cais, and the cais three volume manual

Shelly Weaverdyck, PhD has specialized in cognition and the brain for nearly 40 years, advising and teaching staff, families, health professionals, and academic and professional organizations. She focuses on the brain and cognition and how to support a person living with cognitive and/or mental health challenges in a way that improves quality of life and reduces distress and distressing situations.

As a private consultant, Dr. Weaverdyck for many years presented seminars and trainings in mental health (e.g., on the brain and schizophrenia, on dementia, and on cognitive interventions) for the State of Michigan Department of Health and Human Services (mdhhs). She has also been presenter and long-term consultant to academic, mental health, outpatient, and long-term care residential settings internationally and nationally. In addition to the two innovative residential units noted in the section here ‘How the cais was Created”, she consulted in the creation and operation of a variety of other day and residential programs. Video productions, including those presented on national television, and other publications featured some of the intervention methods developed and practiced in these settings.

At the University of Michigan, Dr. Weaverdyck was the dementia specialist for 13 years at the Turner Geriatric Outpatient Clinic, taught in the Psychology Department, was on the research faculty, served as a member on doctoral dissertation committees, and consulted for the (then) Michigan Alzheimer’s Disease Research Center. At Eastern Michigan University, she was director of the Alzheimer’s Education and Research Program for 14 years and was the founder and director of its Alzheimer’s Research program for 12 years before that.

In addition to academic and professional articles and chapters in various books and journals, Dr. Weaverdyck coauthored the Bloomer Block Assessment Protocol, a neuropsychological instrument published in 1999 by Western Psychological Services, and in 2005 in collaboration with Nancy Mace and Dorothy Coons, a book called “Teaching Dementia Care” published by Johns Hopkins University Press. She wrote a chapter on assessment in the 1997 book “Key Elements of Dementia Care” edited and published by the US national Alzheimer's Association, and in 1999 two training curricula for Michigan’s long term care facilities for the Michigan Public Health Institute. She was editor and frequent author of the Caring Sheets in the Michigan Dementia Care Series produced at Eastern Michigan University and supported by MDHHS. The caring sheets are posted here on this Improving MI Practices (imp) website.

As a result of the work and experiences described above, but in particular her early experience as a paid direct care partner/caregiver/nursing assistant, staff development trainer, activities director in long-term care, and personally as a family member, Dr. Weaverdyck created the Cognitive Abilities and Intervention Strategies (cais) with support from MDHHS. The cais is a guide for supporting a person and their cognitive abilities. A three-volume manual includes the CAIS Questions to Ask, CAIS Intervention Strategies, a curriculum to teach concepts underlying the CAIS, five chapters, and 43 cais handouts to elaborate on topics in more depth and the concepts underlying the cais. An online course of five modules shows how to use the cais with additional tips and concepts to consider. The cais, three-volume manual, and online course are all posted on this imp website.

For more about the author’s work see the section “How the cais was Created”.

How the cais was Created

Acknowledgements and a dedication are at the end of this section.

For more information about the work of this author, see “About the Author: A Summary”.

The Cognitive Abilities and Intervention Strategies (cais) by Shelly Weaverdyck has evolved from various early versions by the author.  There were a variety of publications by the author throughout the years that addressed concepts related to the cais, but the actual conceptual outline was first presented in the author’s 1987 University of Michigan PhD dissertation (A Cognitive Intervention Protocol Applied to a Neuropsychological Case Study), then further elaborated by the author in chapters on assessment and intervention in dementia in the 1990 book edited by Nancy Mace, the 1991 book edited by Dorothy Coons, and the 1997 book edited by the US national Alzheimer’s Association (all cited in the accompanying resources).  Specific questions to be asked that were drawn from the conceptual outline were first presented in 1999 in Caring Sheets #21-#24 that were part of the Michigan Dementia Care Series (through Eastern Michigan University) currently posted here on the imp website.  In 2002-2003 they were refined with the creation of what is now called the “cais Educational Series” curriculum (through the University of Michigan).  The questions were then more formally structured into the 2005 Cognitive Impairment Assessment Protocol (ciap) and the Cognitive Impairment Intervention Protocol (ciip).  The Caring Sheets, cais Educational Series curriculum, ciap and ciip were all written and distributed by the author with support from the Michigan Department of Health and Human Services (mdhhs) at many seminars and trainings in academic, mental health, residential, and long-term care settings at the state level and beyond.  This final refinement of the ciap and ciip into the Cognitive Abilities and Intervention Strategies (cais) by the author occurred in 2019-2020 again with support from mdhhs. 

Other publications by the author further explored and elaborated on the concepts underlying the cais and its application to a variety of persons in a variety of settings.  The author collaborated in the creation of two innovative residential units in southeast Michigan called Wesley Hall (in the 1980s) and Huron Woods (in the 1990s), that focused on cognitive (neuropsychological) intervention for clinical, demonstration, and research purposes, through the University of Michigan and Eastern Michigan University respectively. This was partially supported by the then Michigan Department of Community Health, now mdhhs.  Wesley Hall was internationally recognized and used by the United States congress as a model representing state of the art care.

Acknowledgements:

The creation of the CAIS could not have occurred without the work, commitment, and creativity of many people through the years who have helped to shape and encourage the development of the CAIS and its concepts.  I cannot possibly name all of them.

I received specialized training in neuropsychology at the University of Michigan in the late 1970s and early 1980s from Aaron Smith PhD, one of the very early neuropsychologists.

Others who believed in the CAIS and provided the context that nurtured it and allowed it to grow include Irene Kazieczko, Alyson Rush, and Brenda Stoneburner from MDHHS; John Addis, Sommer Young, Lindsey Wood and the wonderful conscientious Improving MI Practices (IMP) team from Addis Enterprises; Dorothy Coons, Bill McKeachie, Sara Holmes, Julie Wheaton, and Sid Gilman from the University of Michigan; Amy Wittle La Fleur and Anne Robinson (primary collaborator on the Wesley Hall and Huron Woods innovative residential units) from Eastern Michigan University; and colleagues Marci Cameron (primary editor of the CAIS manual), Chris Curtin (who led the manual editing team of Marci Cameron, Gail Brusseau, and Jackie Dobson, along with the wide ranging consultant group that helped with feedback and practice), Todd Tarrant (who edited the online course), and Mary Kay Wirth (Director of Nursing in a long-term care setting who created an exemplary culture of compassion, rigor, and staff education).  Some of these and others have been acknowledged for their generous assistance in various parts of the CAIS manual.  I want to especially highlight Marci Cameron for her faithful commitment and honed editorial support, Sommer Young for producing the online course with patience, kindness, and skill during the trials of the pandemic, Dorothy Coons who provided many opportunities for showcasing the CAIS and its concepts from graduate school days on, Anne Robinson for her passion, stimulating ideas, and commitment to excellence, and especially Alyson Rush who remained committed to the CAIS from the beginning and made it happen.

I am indebted to the many colleagues in community mental health, home health, group homes, day programs, and long-term care settings, as well as family members, who piloted or used the CAIS, Curriculum, and concepts in their interactions, work, and intervention planning as they provided direct assistance, supervision, or consultation through the years.   MDEN participants with coordination from Sara Homes, Julie Wheaton, and Chris Curtin played a major role in this for the past 23 years. Their feedback, questions, ideas, and documentation were invaluable. 

I am also grateful to my family, including my siblings who together, with love and nuance supported our parents in their final years, and my parents who loved with compassion and were enormously influential in their children’s ability to think independently and outside the box.  My own children (Anna, Eli, Noah, and Miriam) grew up with brain and cognition talk and taught me much about both, with fun and humor. They and their partners continue to give loving emotional support and to stimulate new ways of thinking.  Miriam and Anna also gave much needed logistical and technology advice and support, and Miriam and Anne generously contributed their marvelous acting skills to the online course during the pandemic.  Most of all, Curtis Weaverdyck, my husband and life partner of 43 years has been an unwavering source of love and support (including acting in the online course!). He truly is a best friend who has walked with me through this journey and made it wonderful.

The greatest impact on my thinking, inspiration, and passion has come from each person with whom I have worked and assisted throughout these many years.  As noted in the “About the Author: A Summary” section, the creation of the CAIS was initially inspired by my early experiences assisting with activities of daily living and later fed by experiences in the variety of roles I have had since then, including that of family member.  Most of what I know I learned from each person, and those who cared about them, who participated in my personal, clinical, consulting, teaching, and research efforts.  It is from these encounters that this CAIS has truly evolved.  You are the reason the CAIS was created and the vision of what it is meant to be. Thank you for your genuine expressions of emotions and your ways of thinking.  Your willingness to share who you are and what you have experienced has made a significant difference in the lives of others and in our understanding of the brain and cognition.  Again, thank you.

Dedication:

The CAIS is dedicated to my mother, Margaret Weaver who lived until the age of 97.  She lived graciously with cognitive changes (and increasingly challenging cognitive needs) for 20 years at the end of her life.  And to my father, Richard Weaver who not only loved her, but was there for her.