Cognitive Disabilities Frame of Reference

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Questions and Answers

Which cognitive level is characterized by the person primarily responding to internal or subliminal cues and being mostly bedridden?

  • Level 3 – Manual Actions
  • Level 2 – Postural Actions
  • Level 4 – Goal-directed Actions
  • Level 1 – Automatic Actions (correct)

At which cognitive level does a client typically respond best to proprioceptive cues, such as moving their hands to reach for objects?

  • Level 3 – Manual Actions
  • Level 4 – Goal-directed Actions
  • Level 1 – Automatic Actions
  • Level 2 – Postural Actions (correct)

What is a primary focus when assisting a client at Level 3 – Manual Actions?

  • Performing manual actions in response to tactile cues (correct)
  • Promoting independent living skills
  • Maintaining attention for up to 60 minutes
  • Encouraging new learning through demonstration

Which of the following best describes an action that individuals at Level 4 – Goal-directed Actions can manage?

<p>They can start to demonstrate minor independence. (C)</p> Signup and view all the answers

What is an appropriate task that could be used for someone assessed at Level 2?

<p>Imitating clapping hands with cuing (D)</p> Signup and view all the answers

Which cognitive level includes the ability to perform familiar repetitive actions with appropriate supervision?

<p>Level 3 – Manual Actions (D)</p> Signup and view all the answers

Which cognitive level is primarily focused on the client being able to follow others and perform basic self-care tasks?

<p>Level 2 – Postural Actions (B)</p> Signup and view all the answers

At which cognitive level is supervision necessary to ensure safety with potentially dangerous items like tools and knives?

<p>Level 3 – Manual Actions (C)</p> Signup and view all the answers

What is the primary premise of Claudia Allen's frame of reference regarding functional behavior?

<p>Functional behavior is based on cognition and the thinking process. (D)</p> Signup and view all the answers

What term describes a limitation in sensory motor actions due to brain structure defects?

<p>Cognitive disability (A)</p> Signup and view all the answers

What does the concept of 'brain conservation' explain?

<p>Familiar tasks require less cognitive energy, saving energy for new challenges. (A)</p> Signup and view all the answers

What is the purpose of task analysis in occupational therapy according to Allen's model?

<p>To identify daily life skills with similar physical and cognitive demands. (C)</p> Signup and view all the answers

How does the environment influence task completion in Allen's frame of reference?

<p>A familiar and safe environment can enhance task performance. (B)</p> Signup and view all the answers

What types of tasks can clients at Level 5 perform in response to cues?

<p>Goal directed tasks with verbal and visual cues (D)</p> Signup and view all the answers

What aspect does the management of a client incorporate in Allen's cognitive disabilities model?

<p>Assistance from caregivers and adaptation of the environment. (A)</p> Signup and view all the answers

Which ability distinguishes clients at Level 6 from those at lower levels?

<p>Ability to plan ahead and anticipate future events (B)</p> Signup and view all the answers

Which tool was used by Allen in her research for assessment of cognitive levels?

<p>Leather lacing (B)</p> Signup and view all the answers

What would be a primary focus of therapy according to the cognitive disabilities frame of reference?

<p>Concurrent assessment and management of the client. (D)</p> Signup and view all the answers

What is a characteristic of clients at Level 5 regarding their cognitive processing?

<p>They can follow complex multi-step instructions. (D)</p> Signup and view all the answers

Which cognitive abilities are intact at Level 5 but limited at Level 6?

<p>Concrete thinking and planning (D)</p> Signup and view all the answers

When assessing a client's cognitive level, what should be taken into account during a task analysis?

<p>Cues, attention, action/activity, and speed (C)</p> Signup and view all the answers

What is one of the roles of the therapist as it pertains to evaluating cognitive levels?

<p>To assess the client's cognitive level and observe behavioral changes (A)</p> Signup and view all the answers

What major deficit do clients at Level 5 demonstrate compared to those at Level 6?

<p>Capability of planning future actions (D)</p> Signup and view all the answers

Which method is used to assess a client’s cognitive level through structured activities?

<p>Routine Task Inventory (RTI-2) (D)</p> Signup and view all the answers

Flashcards

Cognitive Disability

A limitation in sensory-motor actions caused by brain structure issues, leading to observable difficulties in routine tasks.

Normal Cognitive Ability

The ability to process information efficiently, observed in planned motor actions.

Brain Conservation

The idea that familiar tasks use less brain energy, allowing for more demanding tasks later.

Task Equivalence

This concept proposes that similar physical and cognitive demands are shared by different daily tasks.

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Cognitive Disabilities Frame of Reference

Focuses on assessing and managing cognitive disabilities through interventions like caregiver support and environmental adaptations.

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Environment

The physical and social surroundings that impact task performance.

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Group Activities

A group therapy approach combining assessment and treatment.

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Cognitive Disabilities Reconsidered Model

A tool for understanding and assessing cognitive disabilities, designed by Claudia Allen.

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Goal-Directed Activity

The individual is able to respond to activities that have a purpose, remember them, and understand the steps involved.

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Basic Living Skills

The individual can take care of themselves by performing basic everyday tasks like showering, getting dressed, and eating.

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Responding to Cues

The person can follow instructions and complete tasks based on verbal or visual cues.

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Exploratory Actions

The individual can learn new procedures and remember multiple steps at a time, but struggles with understanding long-term consequences of their actions.

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Planned Actions

The client can think logically, plan for the future, and understand the impacts of their choices. This represents the highest level of cognitive function.

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ADM (Allen Diagnostic Module)

A tool used to assess a client's cognitive ability by evaluating their performance on standardized craft projects.

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RTI-2 (Routine Task Inventory)

An assessment tool that evaluates a client's ability to perform daily living activities.

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ACL (Allen Cognitive Level Test)

An assessment tool that assesses a client's cognitive function to identify their current level of functioning and any cognitive disabilities.

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Level 1: Automatic Actions

The stage where a person responds primarily to internal or subliminal cues, often involving reflexive actions. They are usually bedridden and require significant care.

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Level 2: Postural Actions

The stage where a person responds best to proprioceptive cues (touch and movement). They may imitate gross motor actions with much guidance and need assistance with basic tasks like bathing and dressing.

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Level 3: Manual Actions

The stage where a person responds to tactile cues (touch) and demonstrations. They can perform manual actions with one-step instructions and often repeat actions based on interest in objects.

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Level 4: Goal-directed Actions

The stage where a person can perform goal-directed actions and are less dependent on others. They can initiate and complete tasks with minimal supervision.

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Level 4.6: Independent Living

The lowest level within Level 4, where a person can live independently.

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Facilitating Cognitive Assistance

A way to provide cognitive assistance that involves guiding, prompting, and observing a person's actions.

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Probing Cognitive Assistance

A way to provide cognitive assistance that involves asking questions and prompting reasoning.

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Observing Cognitive Assistance

A way to provide cognitive assistance that involves watching a person's actions and providing feedback.

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Study Notes

Cognitive Disabilities Frame of Reference

  • Developed by Claudia Allen in the 1960s
  • Focuses on the link between cognition and functional behavior
  • Updated in 2005 by Levy and Burns, renamed the cognitive disabilities reconsidered model
  • Emphasizes that changing thought processes leads to improved functional behavior
  • Includes the concept of normal cognitive ability (information processing capacity for planned actions), involving physical and mental abilities

Normal Cognitive Ability

  • Viewed as the capacity for planned motor actions
  • Observable and inferable through observed actions

Cognitive Disability

  • A limitation in sensory-motor actions rooted in brain structure or function
  • Leads to observable limitations in everyday tasks
  • Can result from anatomical or physiological brain defects

Brain Conservation

  • Explains why people with normal cognition may perform lower due to energy limitations in tasks
  • Familiar tasks use less brain energy, leaving resources for new or challenging ones

Task Equivalence

  • Identifies similar skills in daily tasks
  • Uses leather lacing to demonstrate similar steps
  • Occupational therapists use task analysis to find similar steps to help clients succeed
  • Emphasizes environmental factors, as a comfortable environment improves performance

Cognitive Levels

  • The Occupational Therapist assess, and positions the client within one of six cognitive functioning levels. The levels are
    • Automatic Actions (Comatose): client responds only to internal cues, often bedridden, and needs total care
    • Postural Actions: client responds to proprioceptive cues, can imitate gross motor actions, and may assist in simple tasks.
    • Manual Actions: client responds to tactile cues, can perform manual tasks with repetition, and maintain attention for short periods.
    • Goal Directed Actions: client displays more independence, performs basic life skills, and responds to verbal and visual cues.
    • Exploratory Actions: client uses trial and error, learns new information, and can anticipate future events
    • Planned Actions: client shows high-level reasoning, planning, and independent functioning

Client Management

  • Involves assistance from caregivers and environmental adaptations
  • Removes dangerous items to improve functioning in the home

Assessment & Management

  • Cognitive function is assessed concurrently with management strategies to support the client
  • Observations are made to identify appropriate support and interventions

Further Considerations

  • Clients can follow multi-step demonstrations, and focus attention on visible elements, ask for assistance, and work in safe environments
  • Clients can maintain focus for one hour, manage routines, and perform exploratory actions
  • Higher levels demonstrate social awareness, physical awareness, and long-term planning, and are able to plan ahead.

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