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Advanced Neurology

REVIEW ARTICLE
Cognitive assessment in acute care following

traumatic brain injury: A scoping review of
performance-based tests

1,2
Katherine Goodchild * , Jennifer Fleming 2 , and Jodie Copley 2
1 Department of Occupational Therapy, STARS Surgical Treatment and Rehabilitation Service,
Brisbane, Queensland, Australia
2 School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland,
Australia

Abstract

It is recommended that the assessment of cognitive function by occupational
therapists is best conducted by observing the performance of everyday tasks in
real-life environments. Given the constraints of acute care settings, selecting the
appropriate cognition assessment for patients with traumatic brain injury (TBI) can
be challenging. A scoping review was used to explore the evidence for occupation-
based assessments of cognition for use with patients with TBI and explore their
clinical applicability for the acute setting. Assessments were included if they focused
on performance-based tests using real-life or simulated activities of daily living
*Corresponding author: (ADL) or instrumental ADL tasks. From 29 identified articles, 18 occupation-based
Katherine Goodchild
(katherine.goodchild@health.qld. assessments of cognition were reported for use in patients with TBI. They varied
gov.au) in terms of time and resources required to administer, complexity, and variety of
Citation: Goodchild K, Fleming J, assessments. This review highlights a range of assessments of cognitive function
Copley J. Cognitive assessment available to patients with TBI in acute care, which support occupational therapists
in acute care following traumatic to use an occupation-centered approach. Issues faced by occupational therapists
brain injury: A scoping review of assessing cognitive function in the acute care setting include time and environmental
performance-based tests. Adv
Neurol. 2025;4(1):53-71. constraints. A small number of portable, contemporary, and performance-based
doi: 10.36922/an.4508 assessments relevant to younger adults warrant further investigation to determine
Received: August 12, 2024 their feasibility for use in acute care.
Revised: October 23, 2024
Accepted: November 25, 2024 Keywords: Traumatic brain injury; Functional cognition; Occupational therapy;
Cognition; Assessment; Acute care
Published Online: December 16,
2024
Copyright: © 2024 Author(s).
This is an Open-Access article 1. Introduction
distributed under the terms of the
Creative Commons Attribution A traumatic brain injury (TBI) can be a life-changing event, affecting performance in
License, permitting distribution,
and reproduction in any medium, multiple domains, including cognitive function with impairments commonly seen in
provided the original work is attention, memory, and executive functions. For patients who have had a severe TBI,
1
properly cited. difficulties in instrumental activities of daily living (IADLs), such as preparing a meal,
Publisher’s Note: AccScience using transport, house cleaning, and completing laundry, were reported to persist at
Publishing remains neutral with 2 years post-injury for 90% of people. IADLs learned in early adulthood require the
2
regard to jurisdictional claims in 3
published maps and institutional integration of complex cognitive functions and are more likely to be affected by TBI.
affiliations. Impaired IADL performance as a result of TBI negatively impacts a person’s ability

Volume 4 Issue 1 (2025) 53 doi: 10.36922/an.4508