to assess cognition as an OT, we must look beyond a specific cognitive skill and look at how these skills impact what?
a person’s everyday functioning
name the 2 frameworks that can be used for assessing cognition.
- ICF
- cognitive functioning evaluation
systematic framework for understanding and classifying the course and complications of human functioning
ICF
systematic method of evaluating the impact of cognitive deficits on daily living developed by OT
cognitive functional evaluation (C-FE)
- the way clients understand their cognitive profile and the way they interpret its impact on their occupational experiences.
- captures the individual’s experience as it is shaped by subjective personal factors, values, priorities, and choices.
- evaluation of the it is a dynamic process that addresses how the client perceives the effects of cognitive factors in various occupations and contexts.
cognitive occupational narrative
- used to help clients describe their social, instrumental, and leisure activities.
- composed of 89 photos depicting the performance of various activities
activity card sort (ACS)
evidence-based outcome measure designed to capture a client’s self-perception of performance in everyday living over time
COPM
an individualized outcome measure involving goal selection and goal scaling that is standardized in order to calculate the extent to which a patient’s goals are met.
goal attainment scale (GAS)
generic patient-reported outcome measure that quantifies health status and measures health-related quality of life
SF-36
self-report questionnaire that evaluates disability and health-related quality of life after stroke
stroke impact scale (SIS)
a subjective quality of life measure designed to measure global life satisfaction, a subjective cognitive assessment, in contrast to an objective quality of life survey
satisfaction with life scale
what type of approach do the surveys and questionnaires provide?
top-down approach
- baseline cognitive functioning, which include both cognitive deficits and strengths
- gathered via cognitive screens and comprehensive assessments
- assessments can be either static or dynamic in nature
cognitive factors
given to capture a baseline, question asked and answer given
static assessments
given with the use of cues and gestures to physical assist to see how the pt. may best complete the task given the examiner info on what is required for optimal performance
dynamic assessments
name an example of a dynamic assessment.
EFPT
- observable behaviors related to cognitive function during tasks, activities, and occupations.
- includes process skills, errors, response to errors and behaviors, level of assistance required for tasks, activities and occupations
occupational performance
describe the hierarchy of cues/physical assistance in order (6 components).
- general verbal cue
- specific verbal cue
- gesture
- physical assistance
- hand over hand assist
- total assistance
name the 2 types of self-awareness and beliefs evaluated.
- metacognitive knowledge or intellectual awareness
- online awareness
- physical setting, social network, cultural context
- can impact positively or negatively to overall performance
- necessary to understand what the pt. is already using, how you can add to these factors or utilize what is in place to improve participation
environmental factors
name 4 methods of gathering information regarding environmental factors.
- interview
- design form for pt. and family to complete regarding home set up
- ask for a video or photos of the living environment
- questionnaires
name 3 evaluation methods.
- self reports and informant reports regarding everyday functioning
- performance-based assessments
- interviews
- recognizing the scores - total score vs. subtest scores
- what do the scores directly mean
- do the scores have a value or category of deficits
scores/interpretation
- identifying scores (baseline, look back over time to see changes)
- correlation to specific ADL or IADL that may be impacted
- not a diagnosis
- what are areas of strengths
documentation
