Do you or a loved one have a new cognitive injury? Our occupational therapist Sonia discusses what to expect…

By November 3, 2020January 21st, 2021No Comments

When understanding an individual’s functional performance, one’s physical, mental, and cognitive health, are all key components to consider. By understanding the relationship between one’s functioning, environmental context, and daily occupations, Occupational Therapists can help to develop tailored treatment plans that can help individuals achieve their goals and improve their engagement in their meaningful activities.   Cognition refers to our ability to obtain, store, manipulate, and retrieve information through our experiences, senses, and thoughts. It is known as our everyday information-processing functions such as memory, attention, and executive functioning, which guides our behaviour. How we use these skills to perform our self-care routine, household chores, leisurely and productive tasks, as well as access our community, is known as functional cognition. Every daily task involves a series of cognitive functions which often go unacknowledged. For example, cooking requires many skills such as strong executive functioning (e.g.  planning out a multi-step recipe with the right ingredients and cookware), strong sustained and divided attention (e.g. focusing on a cooking step and monitoring many processes at once), and strong memory (e.g.  being able to remember where items are placed in your kitchen). Developmental disorders, neurological diseases such as stroke and traumatic brain injuries, mental illness, and life stresses/changes such as a traumatic event, can all take a toll on our cognitive functioning and overall well-being.  Before implementing a treatment plan, it is important to assess a client’s cognitive functioning through formal  and informal assessments (e.g. client subjective report, observations, receiving collateral information from  family and friends, and through cognitive tests such as the MoCA and BrainFX). These assessments help to provide insight into which functional areas a client may be having challenges with.   Interventions may be compensatory in nature and focus on education about internal and external cognitive strategies. External cognitive strategies incorporate the environment and may include: training an individual  to use daily planners, calendars, smartphones, lists, medication blister packs, and/or using the environment  to help maintain a routine and keep items in a specific place. Internal mental strategies may include practicing to visualize information, learning how to categorize pieces of information together, and/or repeating information, to help with learning and recall. In addition to these strategies, it is essential to maintain a healthy lifestyle (e.g. practice good sleep hygiene, exercise, and maintain a good diet). Functional skills training is also an intervention which helps to improve a client’s ability to perform his/her daily occupations independently. Through behavioral modification and repetitive practice, individuals may be able to learn new tasks despite cognitive limitations. Through techniques of “shaping” or “backward chaining”, clients can learn new behaviors through successive learning goals or step-by-step training. Working through functional activities such as, organizing medications in a dosette to improve medication management, can help to compensate for challenges such as memory decline. Additional activities such as, scanning worksheets, can help improve attentional skills, or doing word math problems, to help improve visual processing.  In summary, maintaining our cognitive abilities or finding ways to compensate for our cognitive limitations is critical for our ability to perform our daily tasks independently, as these functions oversee our thoughts, actions, and behaviour. Functional cognition allows us to understand the world around us and interact in our environments safely, efficiently, and appropriately. Interventions can help strengthen cognitive functions, allow one to use their environment to compensate for their impairments, and help to re-train their behaviour through modification strategies. OT treatment can lead to successful outcomes and improved performance in occupational tasks.