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Advanced Neurology Cognitive assessment using performance-based tests

is an important role of occupational therapists working in Brisbane and Women’s Hospital Foundation.
acute care with patients following TBI. Using performance-
based approaches for assessment, occupational therapists Conflict of interest
can integrate everything they know about a patient’s The authors declare no conflicts of interest.
occupational role, environment, and task performance and
make recommendations for rehabilitation following TBI. Author contributions
The challenge faced by occupational therapists in acute Conceptualization: All authors
care is choosing which standardized assessment is the best
fit for each patient, within acute care constraints. Clarity Investigation: All authors
of assessment findings enables prediction of real-world Methodology: All authors
functioning and appropriate and timely rehabilitation to Writing-original draft: All authors
commence. Having increased awareness of assessments to Writing-review & editing: All authors
choose from may improve evidence-based occupational Ethics approval and consent to participate
therapy assessment practices and facilitate critical
reflection on how occupational therapists currently assess Not applicable.
cognition. Consent for publication
Assessment choice ultimately depends on the
experience of the occupational therapist in applying Not applicable.
clinical reasoning to determine the best assessment or
combination of assessments for each patient who has Availability of data
had a TBI. This review provides a list of assessments Data are available on request.
that have potential for use in acute care within defined
parameters of inclusion and exclusion criteria and should References
be viewed in conjunction with existing psychometric 1. Hendry K, Ownsworth T, Beadle E, et al. Cognitive deficits
evidence. It remains unclear how occupational therapists underlying error behavior on a naturalistic task after severe
currently choose assessments, and it is suspected that traumatic brain injury. Front Behav Neurosci. 2016;10:190.
assessment choice has a high variability between clinicians, doi: 10.3389/fnbeh.2016.00190
organizations, and internationally. Further research on
issues influencing the decision-making of occupational 2. Bottari C, Dassa C, Rainville C, Dutil E. The IADL profile:
therapists working in acute TBI settings is required. When Development, content validity, intra- and interrater
choosing a cognitive assessment with patients following agreement. Can J Occup Ther. 2010;77(2):90-100.
TBI, it is recommended that occupational therapists use doi: 10.2182/cjot.2010.77.2.5
an occupation-based approach to ensure that they are 3. Goverover Y, Johnston MV, Toglia J, DeLuca J. Treatment
providing evidence-based assessment.
to improve self-awareness in persons with acquired brain
There are several performance-based assessments of injury. Brain Inj. 2007;21(9):913-923.
cognition available for occupational therapists to use with doi: 10.1080/02699050701553205
patients with TBI. PBT has potential clinical applicability
in the acute care setting. This scoping review may provide 4. Ownsworth T, McKenna K. Investigation of factors related
a reference for occupational therapists seeking to conduct to employment outcome following traumatic brain injury:
A critical review and conceptual model. Disabil Rehabil.
performance-based tests of cognitive function in acute care 2004;26(13):765-783.
settings by outlining the clinical applicability of published
assessments. doi: 10.1080/09638280410001696700
5. Edwards DF, Wolf TJ, Marks T, et al. Reliability and
Acknowledgments validity of a functional cognition screening tool to identify
None. the need for occupational therapy. Am J Occup Ther.
2019;73(2):7302205050p1-7302205050p10.
Funding doi: 10.5014/ajot.2019.028753

This review was conducted with the financial support of 6. Holmqvist K, Kamwendo K, Ivarsson A. Occupational
the Royal Brisbane and Women’s Hospital Occupational therapists’ descriptions of their work with persons suffering
Therapy Department Cramond Fellow and the Post- from cognitive impairment following acquired brain injury.
graduate Research Scholarship grant from the Royal Scand J Occup Ther. 2009;16(1):13-24.

Volume 4 Issue 1 (2025) 67 doi: 10.36922/an.4508