Interventions for Functional Cognition

A treatment guide for the OT profession helping clinicians in the area of functional cognition. Valuable for students, new graduates or clinicians in rehab hospitals, SNF, Home Health, and outpatient settings. Divided into low level, moderate level, and high level cognitively performing clients. The treatment guide is a 32 page electronic PDF and will be sent to your personal email. Typically this will be sent to you in one day, but please allow 2-3 days. When you purchase this PDF you acknowledge that this is copyrighted material and agree not to distribute or share without expressed written permission. All sales are final.

Sample Page--Moderate to Severe Cognitive Impairment Intervention

When dealing with a traumatic brain injury, a stroke, or other neurological conditions, a cognitive impairment can be a significant barrier preventing safety and independence with personal occupations. When treating clients with moderate to severe cognitive impairments it can become frustrating because of the lack of carryover from one session to the next. This is because moderate to severe functioning clients often lack the awareness and the short-term memory to benefit from traditional trial and error learning methods. A different form of training must be utilized.

The Neurofunctional Approach utilizes many different therapeutic techniques that can help improve an individual’s independence with their desired occupations. Several of these techniques include errorless learning, therapeutic practice, a verbal cue hierarchy, and chaining.

Learning is an important part of any occupational therapy practice. What happens when we can’t teach clients in the traditional fashion in which we instruct verbally and the client listens and then performs, to eventually learn the new skill? What happens if a client has a cognitive impairment or even dementia? Does this mean we just discharge OT?

Often when a client has a moderate to severe cognitive impairment traditional trial and error learning creates more confusion and leads to clients making more errors repeatedly. Errorless learning uses a systematic procedural approach that minimizes errors when clients practice a task. Take the example of donning a pair of pants, in which the client doesn’t organize the pants ahead of time and therefore often puts the pants on backwards. When errors are allowed each practice session to allow the client to learn from their mistakes, it often appears as though the client makes the exact same mistakes the next time. This makes sense because the client lacks working memory, so explicit cues are forgotten quickly after each trial. So, with errorless learning we tap into a client’s procedural learning by offering the “just right cues” required for success. So, in the case of the dressing example a direct cue is given to the client to organize their pants prior to donning to ensure a successful trial. Overtime and with much practice this will become an automatic behavior.