Core Concepts

Functional cognition encompasses the underlying global cognitive processing capacities that work together as a whole to enable an individual to “function,” that is, to use relevant and realistic occupational performance skills to engage in daily activities and occupations (Allen, et al., 2007; McCraith, Earhart, & Austin, 2011). It is hypothesized that these global cognitive processing capacities can be inferred from observations of functional performance.

Intervention and outcomes in the CDM

All intervention approaches in the CDM are designed to promote a “fit” between the activity demands of valued activities and what is cognitively realistic (Can Do), psychologically relevant (Will Do), and socially and environmentally possible (May Do) (McCraith, Austin, & Earhart, 2011, p. 385). This process of creating a “fit” assumes the involvement of clients and caregivers to identify “Will Do” and “May Do.” It also requires practitioners to analyze the activity and environmental demands of valued activities to insure that the cognitive demands “fit” individuals’ available cognitive capacities or to identify other realistic activity options that are most apt to be performed safely and successfully.
Modifying Activities and Environments: Within the CDM the primary intervention approach focuses on compensating for functional cognitive disabilities or limitations and enhancing functional cognitive abilities by modifying the environments and activities rather than by changing an individual’s available cognitive capacities through remediation.
Establish and/or Restore: In the context of the CDM, performance skills and activity patterns such as routines may be learned or resumed if they are within the individual’s functional cognitive capacities as described by the Allen scale of cognitive levels and modes. . Practitioners may also use serial assessments to monitor improvement or stabilization in functional cognitive abilities associated with changing conditions
Maintenance and Prevention: Maintenance and prevention are closely aligned in the CDM approach to intervention, particularly in long term care and care of persons with stable conditions. Maintaining a person’s best ability to function may create optimal conditions for preventing or slowing decline in functional cognition

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