Foundations in Functional Cognition

What is functional cognition?

Functional cognition refers to how cognitive processes support participation in daily activities within a person’s real-world environment, emphasizing the interaction of cognition, occupation, and context

How does the OT approach to cognition differ from other fields?

OT considers not just cognitive factors but their interaction with the whole person in daily life, focusing on how cognition supports or hinders occupational performance

What is the primary goal of performance-based function cognition tests?

To assess and characterize functional cognition and occupational performance, not to diagnoses specific brain diseases

What are performance-based tests designed to evaluate?

How individuals apply metacognitive, cognitive, and performance-based skills in real, meaningful occupations

Why might performance-based testing predict community functioning better than neuropsychological tests?

Because it reveals the types of errors made, awareness of awareness, and their effects on daily life, capturing real-world performance

What are the 5 domains of the Cognitive-Functional Evaluation Framework?

1) Cognitive Occupational Narrative

2) Cognitive Factors

3) Occupational Performance

4) Self-awareness and Beliefs

5) Environmental factors

What is the cognitive occupational narrative?

It captures the client’s view of their functional cognition through interviews, occupational profiles, and standardized questionnaires

What do cognitive factors refer to in the C-FE?

Interactions of cognitive processes with occupational and contextual factors affecting performance, including identifying cognitive strengths and deficits.

What does occupational performance observation target?

How clients select and use materials, carry out steps, and adjust when facing problems during daily tasks

What are the key steps of process skill errors?

Omission, addition, repetition, and accuracy errors

What are two types of self-awareness assessed in functional cognition?

Metacognitive knowledge (before a task) and online awareness (during/after a task)

How are environmental factors assessed in functional cognition evaluation?

By evaluating supports/barriers in the client’s surroundings and how effectively clients use environmental supports

What criteria should be considered when selecting a performance-based cognitive test?

Reliability, validity, internal consistency, ceiling/floor effects, sensitivity, specificity, and ecological validity.

How do screening tools differ from diagnostic tools?

Screenings give baseline profiles and flag deficits/strengths for further assessment, while diagnostics confirm or rule out specific conditions

Name three commonly used cognitive screening tools in OT.

BIMS, MMSE, MoCA

What is the menu task and why is it used?

A paper-and-pencil screen that identifies clients at risk for functional cognitive impairment, quick and easy to administer and score

How does the C-FE guide interventions

By describing cognitive strengths/weaknesses and guiding recommendations, support levels, and intervention plans

Errors of omission

Made when actions necessary to complete the task are not performed or are incompletely performed

Errors of addition

actions that are not necessary to complete the defined task

errors of repetition

unnecessary repetitions of an action or sequence of actions required to complete the task

Errors of accuracy

made when actions are performed incorrectly, out of sequence, too slowly, or too quickly

Levels of assistance for cognition

1) Indirect verbal guidance

2) Direct verbal guidance

3) Gestural guidance

4) Physical assistance

5) Performance of the task step for the client