Cole Ch. 7: Allen’s Cognitive Disabilities Group

Limitation in sensorimotor actions originating in the physical or chemical structures of the brain and producing observable and assessable limitations in routine task behavior

Cognitive disability

Method of determining the functional complexity of an activity by separating the activity into steps and determining the physical and cognitive functional abilities required to do each step

Task analysis

Allen's more dynamic approach to task analysis includes factors like . . .

Culture, motivation, situational context, information processing

Allen's 3 categories of task performance

Attention, motor actions, conscious awareness

Allen's 6 stages of Cognitive Levels

Automatic, postural, manual, goal-directed, exploratory/independent learning, planned

Allen's Cognitive Level: conscious, but bedridden and respond mainly to internal/subliminal cues

Automatic

Allen's Cognitive Level: can be stimulated to perform postural actions (motion and position cues, can imitate gross motor actions)

Postural

Allen's Cognitive Level: manual actions in response to tactile cues

Manual

Allen's Cognitive Level: emergence of purposeful activity, response to visual cues

Goal-directed

Allen's Cognitive Level: trial and error, inductive reasoning, capable of new learning

Exploratory/independent learning

Allen's Cognitive Level: absence of disability, deductive reasoning and planning ahead, anticipation of future events, organized behavior

Planned

Focuses on compensating for cognitive impairments and optimizing use of available functional abilities

Cognitive Disabilities Model

OTs at this level are most helpful in providing appropriate sensory stimulation and attempting to elicit motor responses of any kind.

Automatic

Engaging the client in any self-care tasks is an appropriate intervention at this level; activities consist of imitation of gross body movement, such as clapping

Postural

Actions based on interest in objects found within arm's reach may be repeated many times; guiding principles in activity selection are repetition and manipulation

Manual

Craft projects and activities in response to visual cues are ideal interventions in this level

Goal-directed

Groups at this level introduce more complex tasks like clay mosaics and cooking; difficulties requiring intervention usually involve impulsivity and lack of planning or anticipation

Exploratory/independent learning

What settings is Allen's model most applicable to?

Chronic and acute care

Allen's cognitive level assessment: following simple directions

Running stitch

Allen's cognitive level assessment: problem solving abilities

Whip stitch

Allen's cognitive level assessment: information processing

Cordovan stitch

Give sensory cues to appropriate level

Facilitate

Ask focused questions to encourage problem solving

Probe

Allow client time to process cues and questions and try out new behaviors

Observe

When frustration arises, correct error or do a step for the client

Rescue

Allen's cognitive principle: fluctuation in levels based on cognitive demands; conservation of brain energy when possible

Brain conservation

Allen's cognitive principles: cognitive level increases with awareness of environment; use what is being observed in environment to help inform cognitive level

Usable task environment

Allen's cognitive principles: cognitive processing can be equivalent to everyday tasks; more difficult tasks associated with more cognitive processing

Task equivalence

Allen says that for more functional behavior, the _______________ must change.

Cognitive thinking process