Occupational therapist practice patterns in relation to clients with cognitive impairment following acquired brain injury

Abstract

Swedish occupational therapy practice for clients with cognitive impairments following acquired brain injury focuses highly on occupational performance. Therapies targeting executive functioning seem particularly important in practice and a collaborative approach involving clients, relatives and other staff is a prominent feature in practice.

Assessment of clients with cognitive impairments: A survey of Norwegian occupational therapists in municipal practice

“…With top-down assessments, OTs use a broad approach and can assess clients by focusing on their roles and whether the person is able to perform occupations, through observation and informal interviews [12]. Several research studies have investigated OTs' pattern of practice in relation to the assessment of clients with cognitive impairments [7,[15][16][17][18][19][20][21][22][23][24]. The results of these studies indicate that OTs use both top-down and bottom-up assessments when assessing clients with cognitive impairments.…”

“…The results of these studies indicate that OTs use both top-down and bottom-up assessments when assessing clients with cognitive impairments. Related to assessment of cognitive function, most standardized assessments used are bottom-up assessments [7,[15][16][17][18][19][21][22][23], although top-down assessments are valued as more important for OTs [8,20,21,23]. The top-down assessments preferred are often non-standardized, such as informal interviews and observation [8,[16][17][18][19][21][22][23]25].…”

“…Related to assessment of cognitive function, most standardized assessments used are bottom-up assessments [7,[15][16][17][18][19][21][22][23], although top-down assessments are valued as more important for OTs [8,20,21,23]. The top-down assessments preferred are often non-standardized, such as informal interviews and observation [8,[16][17][18][19][21][22][23]25]. The Assessment of Motor and Process Skills (AMPS) [26] is the most commonly mentioned standardized top-down assessment tool used in order to measure the consequences of cognitive impairments on the activities of daily living (ADL) [15,16,[18][19][20]24,27].…”

“…The top-down assessments preferred are often non-standardized, such as informal interviews and observation [8,[16][17][18][19][21][22][23]25]. The Assessment of Motor and Process Skills (AMPS) [26] is the most commonly mentioned standardized top-down assessment tool used in order to measure the consequences of cognitive impairments on the activities of daily living (ADL) [15,16,[18][19][20]24,27]. The majority of the bottom-up assessments frequently mentioned in international studies are standardized assessments such as the Mini Mental State Examination (MMSE) [16][17][18]22,23,25,28], Neurobehavioral Cognitive Status Examination (Cognistat) [15,17,18,29], Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) [17,20,24,25,30] and Rivermead Behavioural Memory Test [16,19,22,24,31].…”

“…In Oceania, the Australia Therapy Outcome Measure (AusTOM) [19,35] and the Assessment of Living Skills and Resources [17,36] are frequently used tools. In Scandinavia, the Cognitive Test 50 (CT-50) [24,37] and the ADL taxonomy [16,38] are tools that are frequently used by Danish and Swedish OTs.…”