21 terms

Allen's Cognitive Model

STUDY
PLAY
Who developed the model?
Claudia Allen
What is the Cognitives Disabilites Model about?
How cognition enables adult occupation
Model is stressed for adults

Requires advance cognition

Ideas come from neuroscience
Focus on literature that deals with limits of brain function
Cognitive Disabilites Model
Motor abilities and cognition are closely related
Strong psychomotor emphasis

Can be used in conjunction with biomechanical model

Focus on safety
What is healthy cognition?
Motor acts premeditated by seeing possibilities & selecting best course of action
Possible negative effects are anticipated in advance
Symbols, past experiences, & prior knowledge used
Healthy Cognition
Generalization & distinctions made
Sensations & perceptions are selective
Social good & responsibility are recognized
Top-level cognition = responsible conduct, ethical concept of prudence
Prudence: avoidance of injury to self or others
Threats to healthy cognition
Disease Process
Schizophrenia, dementia, depression, TBI, CVA, MS
Brain Impairment
Permanent or temporary
Cognitive Disability
Permanent or temporary
Occupational Deficits
Psychosocial Problems
Disruptive behaviors, interpersonal issues, emotional problems
Function & Dysfunction
Function: ability and capacity to use mental energy to guide motor and speech performance

Dysfunction
Impairment in sensorimotor information processing
Six levels of function/dysfunction continuum
Change can occur within a level
Rehabilitative view of change
Cognitive Levels
Six Levels: Coma (0.8) to Normal (6.0)
3 Components:
Attn
Motor control
Verbal performanceFunctional Levels:
What functional people do

What a person can do
What a person will do
What a person may do
Cognitive Level 1
Automatic Actions:
Moans/non-verbal, eye-tracking, swallows
Responds to pain/discomfort, slow information processing
Physically: usually unable to sit/walk, able to roll, raise extremity
Unable to toilet, attention span: seconds
Cognitive Level 2
Postural Actions:
Name, gestures, short-phrases, some awareness of env't
Physically: sitting, stands (may not be stable), challenged gait
Eats with supervision, awareness of toilet, limited grasp, attention span: minutes
Cognitive Level 3
Manual Actions:
Grasps & move objects, naming, shapes, sense of completion
Attention span: ½ hr, needs assist for task completion, repetitive actions
Sup/A for self-care, I with eating, walking problemati
Cognitive Level 4
Goal Directed:
Sequencing through steps (6), problem identifying, contrast & compare, verification, out of sight = out of mind (visual cues)
Can be I with self-care, limited work/social skills
Structured schedule/routine, learning is limited, attn span: hrs
Cognitive Level 5
Exploratory Actions:
Forgets, pros/cons, secondary effects, varies own pace, trial & error, motor actions can be effected
I with self-care, improved housekeeping, safety risk
Impulsive, fails to anticipate, flexibility in changing steps
Cognitive Level 6
Planned Actions:
Healthy occupation, anticipates future, advantages & disadvantages, abstract thought
Mistakes are predicted & avoided, social awareness, executive functioning
Functional Milestones
6.0 Premeditated activities
5.6 Social Bonding Anticipates safety Driving Child care
5.0 Intonation in speech
4.6 Live alone
4.2 Discharge to street
4.0 Independent Self Care
3.6 Cause & Effect
2.8 Grab bars
2.2 Walking
1.8 Pivot Transfer
1.4 Swallow
1.0 Conscious
Evaluation
ACL: Allen Cognitive Level Test
Leather- lacing
Place mat
Diagnostic Module
Use of crafts: woodworking, weaving
Routine Task Inventory (RTI)
Checklist of self-care and IADLs
OT fills out on patient performance
Allen Cognitive Level Screen
ACL: Allen Cognitive Level Test
Leather- lacing
Place mat
Additional Assessments
Routine Task Inventory: (RTI)
Checklist of self-care and IADLs
OT fills out on patient performance
Diagnostic Module:
Use of crafts: woodworking, weaving
Goal Setting
Match cognitive level to occupational form
Goals must be functional
Functional and socio-cultural success
Therapist sets goals with patient input
Emphasis on safety
Use just-right match to person and cognitive level
Humanitarian vs humanistic
Intervention
Occupation will not increase cognitive level
Increased only through medical intervention, healing, maturation
Can learn within cognitive level
Involves a lot of compensation
Focus on care-giver education
SAFETY
Advantages
Maximizes potential
Allows for independence
Match environmental demands
Adapts environment
Present new information appropriately
Provides structure for safety
Additional support in times of stress or change
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