Assessing Abilities and Capacities: Cognition PDF

Assessing Abilities and Capacities: Cognition Part 1 OT 211 Dr. Qussai Obiedat  INTRODUCTION Cognition: integrated functions of the brain that result in thought and goal-directed action, allowing humans to...

Assessing Abilities and Capacities: Cognition Part 1 OT 211 Dr. Qussai Obiedat  INTRODUCTION Cognition: integrated functions of the brain that result in thought and goal-directed action, allowing humans to be aware, think, learn, judge, plan, and execute behavior Processes of cognition include: Orientation Perception Attention Memory and learning Judgment Reasoning Language Executive functions 2  PRIMARY COGNITIVE OPERATIONS Prerequisites for higher-level thinking: Orientation: awareness of self in relation to person, place, time, and circumstance Attention: the ability to consciously process a limited number of inputs simultaneously Components of attention: focused, sustained, selective, alternating, and divided Learning dependent on attention Memory: information storage and retrieval Types: sensory registers, short-term/working, long-term (declarative, non-declarative) 3 ATTENTION & PERFORMANCE 4  MEMORY DEFINITIONS Sensory registers: information from environment is briefly held in stores specific to the human senses Millisecond storage Influenced by acuity of senses, affective set, and perception Short-term/working memory: limited information storage that is very accessible temporarily Role in information processing, concentration, and problem-solving Focused attention required for ~30 sec to be stored in long-term memory Restricted holding capacity (~7 sec) Long-term memory: storage of information for minutes to a lifetime through relatively permanent changes in the brain cell structure Explicit (declarative) memory: pertains to factual information (includes: episodic, semantic, prospective) Implicit (non-declarative) memory: does not involve conscious awareness of learning (includes: procedural) 5 MEMORY PROCESSING 6  EXECUTIVE ABILITIES Executive abilities: a group of higher order thinking processes that enable individuals to achieve self-determined goals and engage independently and purposefully in complex everyday tasks Initiation, inhibition, task persistence, organization, generative thinking, awareness Deficits in executive abilities results in difficulty with novel and complex tasks that were previously performed via procedural memory Experience mental fatigue, decreased mood, deterioration in ADLs/IADLs, difficulty RTW Impairments are major factors with the loss of everyday competence and social autonomy 7  SELF-AWARENESS Self-awareness: executive ability that pertains to the ability to process information about the self and compare it with a long-standing self-evaluation Highest of all integrated activities of the brain TBI vs. degenerative disorders vs. caregiver burden Primary Dimensions: 1. Appreciation of personal attributes (strengths & weaknesses) 2. Initiation of compensatory strategies in response to known personal attributes 8  HIERARCHY OF SELF-AWARENESS Understanding Deficit in Intellectual awareness: ability to understand impairment (impeded by deficits in memory) Awareness Emergent awareness: recognition of problem when it is occurring Anticipatory awareness: ability to anticipate a challenge resulting from impairment (depends on existence of intellectual and emergent awareness) 9  METACOGNITION Metacognition: requires knowledge of one’s cognitive abilities and regulation to coordinate cognitive processes through monitoring and control Patients can have a deficit in their executive functions but be aware of their impairments and are able to initiate strategies to circumvent potential problems Informs selection of attainable goals and strategies to best facilitate performance Ongoing monitoring of process with adjustment of strategies and incorporating feedback affects self-awareness which alters perceptions of personal attributes 10  INTERSECTION OF ATTENTION, MEMORY, AND EXECUTIVE FUNCTION Dual-task performance: the incorporation of a secondary (cognitive) task while a patient performs a simple primary task Requires divided attention Requires flexible allocation of attention Challenges the resource-limited working memory Demonstrates the complexities of real-world occupational performance 11  WHY DO OTS ASSESS COGNITION? To measure baseline, progress, and/or outcome status To understand the patient’s cognitive strengths, weaknesses, and capacity for strategy use in order to plan intervention To estimate the patient’s ability to safely perform everyday activities 12 COMPONENTS OF THE ASSESSMENT Prepare Select Administer Interpret Report Review medical Decide Observe and Consider extent Document record approach note behaviors to which other results and Perceptions of and/or during variables discuss with current status measure, assessment influenced those involved and priorities + purpose of following score observation assessment, standardized Perform vision and methods screen if not psychometric available properties Coordinate with team 13 Thank You! 14