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Occupational Therapy Cognitive Tests: How to Choose the Right Assessment  Beyond Occupation Companion Audio Read the Full Companion Article Occupational Therapy Cognitive Tests: Cognitive Tests Useful in Functional Cognition There are dozens of cognitive assessments available to occupational therapy practitioners, but knowing the name of a test is very different from knowing when to use it and what clinical question it can help answer. In this companion audio, Michelle Eliason discusses how to think through cognitive assessment selection using a functional cognition approach. Rather than reviewing cognitive tests one by one, the episode walks through common clinical presentations and considers how an occupational therapy practitioner might decide whether to investigate memory and learning, attention, executive functioning, language retrieval, visuospatial processing, visual perception, motor performance, or functional cognition more closely. The discussion also emphasizes an important principle: a cognitive score does not interpret itself. Standardized findings become more meaningful when they are considered alongside the occupational profile, functional activity analysis, clinical observation, environmental demands, patient and caregiver report, and the person's response to cueing or support.   Topics Discussed How to choose a cognitive assessment based on the clinical question General cognitive screening versus more targeted cognitive assessment Montreal Cognitive Assessment Mini-Mental State Examination Addenbrooke's Cognitive Examination Repeatable Battery for the Assessment of Neuropsychological Status Distinguishing memory impairment from problems with attention or encoding Hopkins Verbal Learning Test Rey Auditory Verbal Learning Test California Verbal Learning Test Digit Span Word retrieval and verbal fluency Controlled Oral Word Association Test Boston Naming Test Semantic Fluency Test Executive functioning and attention Stroop Color and Word Test Trail Making Test, Parts A and B Wisconsin Card Sorting Test Delis-Kaplan Executive Function System Tower of London Test Behavioural Assessment of Dysexecutive Syndrome Visuospatial and visual-perceptual assessment Clock Drawing Test Rey-Osterrieth Complex Figure Test Judgment of Line Orientation Block Design subtest of the Wechsler Adult Intelligence Scale Motor-Free Visual Perception Test Distinguishing cognitive limitations from motor limitations Purdue Pegboard Test Functional cognitive assessment Executive Function Performance Test Performance Assessment of Self-Care Skills Dynamic Lowenstein Occupational Therapy Cognitive Assessment Test of Everyday Attention Canadian Occupational Performance Measure Assessment of Motor and Process Skills Connecting standardized cognitive findings to occupational performance Key Clinical Takeaway Do not start with the assessment. Start with the clinical question. A broad cognitive screen may identify that additional evaluation is needed, but it does not necessarily explain why a patient is having difficulty managing medications, preparing meals, navigating the community, returning to work, or completing another complex daily activity. General cognitive screening is only one piece of a larger functional cognition evaluation.   If a patient appears to have a memory problem, determine whether the difficulty involves initial attention and encoding, learning across repetition, storage, delayed retrieval, recognition, interference, or working memory. If performance deteriorates as a task becomes more complex, consider whether inhibition, cognitive flexibility, planning, strategy shifting, processing speed, or error monitoring may be contributing.     Most importantly, bring the findings back to function. Functional assessments can help answer the question that a brief cognitive screen often cannot: What happens when this person has to use these cognitive abilities to complete an actual or simulated everyday task?   The strongest functional cognition evaluation combines the occupational profile, standardized assessment, skilled observation, functional activity analysis, information from the client and care partners, and clinical reasoning to determine how cognition is influencing participation, safety, and independence.   Helpful Functional Cognition Resources Explore the Functional Cognition Resource Page for additional education related to cognitive evaluation and intervention. Looking for treatment ideas? Visit the Interventions for Cognition Dashboard. Not sure how functional cognitive impairment may present clinically? Explore the Most Common Functional Cognition Patient Presentations. You can also review the Occupational Therapy Evaluation and Diagnoses Process for additional resources related to evaluation and clinical reasoning.   Continue Learning With Us Did you find this information helpful? Please share this episode with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it. Would you like access to the clinical resources discussed throughout this article? Explore our membership options to learn more about the Functional Cognition Lab, resource library, and clinical support available to members. Looking for more individualized support with assessment selection, functional cognition, treatment planning, or clinical reasoning? Learn more about the Functional Cognition Lab Mentorship Program. You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools for rehabilitation practice. Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter.   Hosted by Michelle Eliason, MS, OTR/L Beyond Occupation Companion Audio connects rehabilitation science, occupational therapy, and real-world clinical practice. Learn more about Michelle C. Eliason, MS, OTR/L

5 Must-Dos to Personalize Occupational Therapy Treatment: The First Step Toward Precision Rehabilitation  Beyond Occupation Companion Audio Read the Full Companion Article 5 Must-Dos to Personalize Occupational Therapy Treatment: The First Step Toward Precision Rehabilitation Precision rehabilitation is moving rehabilitation beyond diagnosis-driven treatment toward intervention that is increasingly matched to the individual patient, including their impairments, preserved abilities, environment, response to treatment, and functional goals.   In this companion audio, Michelle Eliason discusses five practical ways occupational therapy practitioners can begin personalizing treatment now. The episode focuses on developing a more detailed patient profile, identifying the cognitive and motor systems contributing to occupational dysfunction, connecting interventions to the actual functional problem, considering contextual factors, and using the patient's treatment response to guide future clinical decisions. Rather than asking only, “What intervention works for this diagnosis?” the discussion encourages practitioners to consider which intervention makes sense for this particular person and why. Topics Discussed Individual patient profiles in occupational therapy Impaired versus preserved abilities Moving beyond diagnosis-based treatment planning Cognitive systems affecting occupational performance Motor, sensory, and visual-perceptual contributors to dysfunction Functional cognition and activity analysis Matching intervention to the actual performance breakdown Knowing when to use whole-task versus component-level treatment Psychological and social influences on occupational performance Environmental barriers and supports Measuring response to intervention Using errors, cueing, accuracy, assistance, and carryover as treatment data Re-evaluating and modifying intervention Precision rehabilitation and occupational therapy clinical reasoning Key Clinical Takeaway Personalized occupational therapy treatment requires more than selecting meaningful activities. Practitioners need to determine what is different about the individual patient, which systems are contributing to the performance problem, and which intervention is most appropriate for that specific mechanism and functional outcome. Treatment should also remain flexible. The patient's response provides clinical information that can help determine whether an intervention should be continued, progressed, modified, compensated for, or replaced.   Precision rehabilitation begins when we become more specific about which intervention, for which patient, targeting which mechanism, at which point in recovery, for which functional outcome.   Continue Learning With Us Did you find this information helpful? Please share this article with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it. Would you like access to the clinical resources discussed throughout this article? Explore our membership options to learn more about the Functional Cognition Lab and the clinical resources available to members. Looking for direct clinical reasoning and mentorship support? Learn more about the Functional Cognition Lab Mentorship Program. You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools for rehabilitation practice. Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter. Hosted by Michelle Eliason, MS, OTR/L Beyond Occupation Companion Audio connects rehabilitation science, occupational therapy, and real-world clinical practice. Learn more about Michelle C. Eliason, MS, OTR/L

12 Executive Functioning Activities for Occupational Therapy  Beyond Occupation Companion Audio Read the Full Companion Article 12 Executive Functioning Activities for Occupational Therapy Executive functioning is what helps a person determine what needs to be done, organize information, begin a task, maintain a plan, adapt when something changes, recognize errors, and ultimately complete meaningful everyday activities. In this companion audio, Michelle Eliason discusses practical executive functioning activities occupational therapy practitioners can use to examine and address initiation, planning, organization, sequencing, working memory, inhibition, cognitive flexibility, self-monitoring, problem solving, time management, and error recognition. The episode takes a closer look at the first six intervention themes, including generative naming, information prioritization, multistep planning, calendar planning, medication-management simulation, and mental manipulation. Activities seven through twelve are introduced with additional examples available in the full companion article. The discussion then moves beyond the activities themselves to address how executive functioning interventions should be graded, what practitioners should document, why neuroscience should not be overstated, and how preparatory cognitive activities must ultimately connect back to occupational performance. Topics Discussed What executive dysfunction can look like during everyday activities Why executive functioning is not a single cognitive skill Moving beyond isolated “brain games” in occupational therapy The A to Z Challenge and generative naming Main-idea identification and information prioritization Planning multistep functional activities Calendar planning and scheduling Medication-management simulations Serial subtraction and mental manipulation Trail-making activities Stroop-inspired inhibition activities Rule switching and cognitive flexibility Error-detection activities Time estimation and task completion Functional problem-solving scenarios Grading executive functioning activities Documenting observable cognitive performance and cueing Executive functioning intervention should not end when a patient successfully completes a worksheet, card sort, trail-making task, or planning exercise. The clinical question is whether the cognitive skill and strategy transfer into the person’s actual life. Can they organize medications, manage appointments, prepare for an activity, recognize an error, adjust when a plan changes, estimate how much time they need, or independently use a strategy when the therapist is no longer present? Executive functioning intervention becomes occupational therapy when the cognitive demand, therapeutic method, and meaningful participation goal are deliberately connected. Continue Learning With Us Did you find this information helpful? Please share this article with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it. Would you like access to the clinical resources discussed throughout this article? Explore our membership options to find the level of support that works best for you. Looking for a more formal learning and mentorship experience? Learn more about the Functional Cognition Lab Mentorship Program. You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools you can use in rehabilitation practice. Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter. Hosted by Michelle Eliason, MS, OTR/L Beyond Occupation Companion Audio connects rehabilitation science, occupational therapy, and real-world clinical practice.

Occupational Therapy for Arthritis: Evaluation, Joint Protection, and Everyday Activities Beyond Occupation Companion Audio Read the Full Companion Article Occupational Therapy for Arthritis: Evaluation, Joint Protection, and Everyday Activities Arthritis is not a single diagnosis. It is an umbrella term that includes degenerative, autoimmune, inflammatory, infectious, and metabolic conditions affecting the joints and surrounding tissues. In this companion audio, Michelle Eliason discusses how arthritis can affect occupational performance and how occupational therapy practitioners can evaluate and address pain, stiffness, swelling, weakness, fatigue, reduced range of motion, joint instability, and difficulty completing everyday activities. The episode also explains why osteoarthritis and rheumatoid arthritis require different clinical considerations and how treatment planning should reflect the person’s diagnosis, disease activity, symptoms, joint integrity, medications, and response to activity. Topics Discussed Differences between osteoarthritis and rheumatoid arthritis How arthritis affects ADLs, IADLs, work, leisure, and community participation Components of an occupational therapy arthritis evaluation Pain, stiffness, swelling, fatigue, weakness, and joint instability Grip, pinch, fine motor coordination, and hand function Joint-protection strategies Activity grading and energy conservation Adaptive equipment and environmental modification Therapeutic activity and exercise Connecting interventions to meaningful occupational outcomes Psychosocial factors, including confidence, coping, resilience, and self-efficacy Occupational Therapy Resources Mentioned The full article includes links to occupational therapy education, clinical tools, and patient resources related to arthritis evaluation and treatment. Clinical Interview for Arthritis A structured clinical interview covering symptom history, pain location, disease onset, medication use, morning stiffness, joint patterns, visible changes, muscle weakness, and difficulty completing everyday activities. Rheumatoid Arthritis Versus Osteoarthritis A visual comparison of the autoimmune and inflammatory characteristics of rheumatoid arthritis and the degenerative joint changes associated with osteoarthritis. Living With Degenerative Osteoarthritis A patient-friendly resource explaining degenerative joint changes and foundational joint-protection principles. Interventions for Arthritis During Everyday Life Practical examples of reducing joint strain while carrying objects, opening doors, handling kitchen items, reading, typing, and completing ADLs and IADLs. Rheumatoid Arthritis Information Information addressing inflammation, systemic symptoms, bone health, physical activity, and ongoing health management for people living with rheumatoid arthritis. Pain and Trigger Point Tracker A tool that helps patients document where symptoms occur, recognize patterns, and monitor whether pain locations change over time. Salutogenesis: Assets for Health and Wellbeing A resource for identifying and documenting personal strengths such as coping, resilience, empowerment, connectedness, self-efficacy, and quality of life. Arthritis Resource Bundle The Arthritis Resource Bundle brings together practical evaluation, education, and treatment resources for occupational therapy practitioners working with people who have arthritis. Visit the full article to access the resources discussed throughout this episode: Explore Occupational Therapy for Arthritis Key Clinical Takeaway Arthritis treatment should not become a generic list of exercises. Occupational therapy intervention should address the specific mechanism interfering with function and connect every strategy to an occupational problem that matters to the patient. The most important question is not simply whether pain decreased or strength improved during a treatment session. It is whether the person can now prepare a meal, manage medications, dress, bathe, move through the home, participate in work, or return to a valued activity with greater comfort, independence, and control. Continue Learning With Us Did you find this information helpful? Please share this article with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it. Would you like access to the clinical resources discussed throughout this article? Explore our membership options to find the level of support that works best for you. Looking for a more formal learning and mentorship experience? Learn more about the Functional Cognition Lab Mentorship Program. You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools you can use in rehabilitation practice. Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter. Hosted by Michelle Eliason, MS, OTR/L Beyond Occupation Companion Audio connects rehabilitation science, occupational therapy, and real-world clinical practice.

Interdisciplinary and Transdisciplinary Teams in Rehabilitation  Beyond Occupation Companion Audio Read the full companion article: Interdisciplinary and Transdisciplinary Teams in Rehabilitation Rehabilitation depends on collaboration, but having several professionals involved does not automatically mean care is coordinated. In this companion audio, Michelle Eliason breaks down the differences among multidisciplinary, interdisciplinary, and transdisciplinary care and explains how each model influences communication, shared goals, professional roles, and the patient experience. The episode discusses: What makes a rehabilitation team truly interdisciplinary How interdisciplinary care differs from multidisciplinary care How physicians, nurses, physical therapists, occupational therapy practitioners, speech-language pathologists, social workers, and case managers may contribute to the same functional goal Why professional overlap does not automatically mean duplication How transdisciplinary teams integrate expertise and reinforce selected strategies across disciplines Why legal scope, competence, and professional responsibility must still be respected Where occupational therapy fits within rehabilitation teamwork Why occupation-centered reasoning and activity analysis remain central to occupational therapy How occupational therapy practitioners can communicate and protect the full scope of the profession A stroke rehabilitation example illustrates how different team members may address medical stability, mobility, communication, cognition, swallowing, medication management, environmental barriers, discharge planning, and everyday routines while working toward shared outcomes. The episode also addresses the reality that healthcare systems are often hierarchical. Although transdisciplinary care may offer the most integrated experience for patients and families, collaboration can become difficult when certain professions receive greater authority, visibility, or reimbursement while others must repeatedly justify their role. Michelle also discusses why occupational therapy should not be reduced to dressing, bathing, or upper-extremity exercise. Occupational therapy practitioners may address movement, gait, balance, cognition, vision, sensation, emotional regulation, environmental demands, and other factors affecting occupational performance. The distinction lies in how occupational therapy analyzes the relationship among the person, task, environment, habits, roles, routines, and meaningful occupations. The central message is that collaboration does not require occupational therapy to become smaller. Strong teamwork occurs when every profession clearly understands its contribution, respects the expertise of others, communicates effectively, and confidently brings its full value to the table. Member Resources Tips to Navigate Professional Bullying Protecting Professional Autonomy Interprofessional Value Handout Continue Learning With Us Did you find this information helpful? Please share this article with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it. Would you like access to the clinical resources discussed throughout this article? Explore our membership options to find the level of support that works best for you. Looking for a more formal learning and mentorship experience? Learn more about the Functional Cognition Lab Mentorship Program. You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools you can use in rehabilitation practice. Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter.

Cognitive Strategy Training in Occupational Therapy  Beyond Occupation Companion Audio Read the full companion article: Cognitive Strategy Training in Occupational Therapy: How to Use the Cognitive Strategies Worksheets Giving a patient a list of memory tips is not the same as providing cognitive strategy training. In this companion audio, Michelle Eliason discusses how occupational therapy practitioners can move beyond generic recommendations and help patients select, personalize, practice, and carry cognitive strategies into real daily routines. The episode explores nine major cognitive strategy themes: Memory and recall Visual scanning and spatial awareness Planning and sequencing Attention and focus Executive function and problem-solving Expressive language and word-finding Social communication Environmental strategies Metacognitive and awareness tools A case example involving an older adult with a recent Alzheimer’s disease diagnosis illustrates how strategy training can support meal preparation, morning routines, organization, memory, and continued participation in meaningful roles. The discussion also explains why the worksheet itself is not the intervention. Skilled occupational therapy occurs through clinical discussion, patient choice, task analysis, environmental setup, functional practice, caregiver involvement, follow-through, and modification based on what the patient actually uses. You will also hear practical guidance for: Selecting only the strategy categories most relevant to the patient Connecting recommendations to specific occupational problems Turning broad suggestions into concrete routines Observing awareness, problem-solving, flexibility, and strategy use Tracking adherence without overwhelming the patient Adjusting strategies that are forgotten, rejected, or difficult to use Supporting autonomy and internal locus of control The goal is not for the patient to memorize a long list of cognitive strategies. The goal is to establish a few reliable supports that improve occupational performance in the moments that matter. Member Resources Cognitive Strategy Patient Education Sheets Cognitive Strategy Master List Continue Learning With Us Did you find this information helpful? Please share this article with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it. Would you like access to the clinical resources discussed throughout this article? Explore our membership options to find the level of support that works best for you. Looking for a more formal learning and mentorship experience? Learn more about the Functional Cognition Lab Mentorship Program. You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools you can use in rehabilitation practice. Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter.

8 Functional Object Retrieval Activities for Occupational Therapy  Beyond Occupation Companion Audio Read the full companion article: 8 Functional Object Retrieval Activities for Occupational Therapy Object retrieval may look simple, but it requires the person to combine attention, working memory, visual scanning, mobility, sequencing, object recognition, and environmental navigation within one functional task. In this companion audio, Michelle Eliason discusses how occupational therapy practitioners can use object-retrieval activities to examine the interaction between cognition, movement, vision, and everyday occupational performance. The episode reviews eight ways to grade object retrieval, including: Retrieving one visible object Retrieving multiple objects in a specific order Gathering items for a familiar routine Following verbal location descriptions Carrying objects to designated destinations Completing retrieval during mobility and obstacle negotiation Remembering instructions after a delay or interference task Adjusting when the original plan changes You will also hear practical guidance for changing the number of objects, instruction length, environmental complexity, sequence demands, delay, visual similarity, destination requirements, and amount of support. The discussion emphasizes that an incorrect response should not automatically be labeled as a memory failure. Performance may also be affected by auditory comprehension, visual scanning, spatial language, mobility, initiation, cognitive flexibility, environmental distraction, or difficulty retaining the destination. The episode also explores internal and external cognitive strategies, including verbal rehearsal, chunking, visualization, written instructions, environmental labels, consistent object placement, one-step directions, and point-of-performance cueing. Most importantly, object retrieval should eventually resemble the participant’s real routines, environments, and responsibilities. The goal is not simply to make directions longer or harder. The goal is to help the person listen, remember, move, locate, transport, and use objects more successfully during everyday occupations. Continue Learning With Us Did you find this information helpful? Please share this article with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it. Would you like access to the clinical resources discussed throughout this article? Explore our membership options to find the level of support that works best for you. Looking for a more formal learning and mentorship experience? Learn more about the Functional Cognition Lab Mentorship Program. You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools you can use in rehabilitation practice. Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter.

I Almost Failed Neuro. Here’s What Happened Over the Next 10 Years. Beyond Occupation Companion Audio Read the Full Companion Article https://www.botportalceus.com/blog/I-almost-failed-neuro-in-OT-school Neuroscience does not come naturally to every occupational therapy practitioner—and it did not come naturally to Michelle Eliason. In this personal companion episode, Michelle reflects on nearly failing neuroscience in occupational therapy school and the slow, often uncomfortable process of developing a deeper understanding of the brain over the next decade. She discusses what it looked like to repeatedly revisit difficult concepts, connect neuroscience with patient performance, and gradually move from memorizing terminology to understanding the relationship between brain structure, function, behavior, and everyday activity. The episode also reflects on a 2024 paper exploring white matter integrity, information-processing speed, aging, and traumatic brain injury. Rather than viewing the paper as a finished representation of her current thinking, Michelle describes it as evidence of the point at which the pieces were beginning to come together. This episode is for practitioners, students, and rehabilitation professionals who have ever believed they were “not a neuro person.” Understanding develops over time—one patient, one question, and one clinical connection at a time. Continue Learning With Us Explore clinical resources and support options:https://www.botportalceus.com/membership-options Learn more about the Functional Cognition Lab Mentorship Program:https://www.botportalceus.com/functional-cognition-lab-mentorship Explore AOTA-approved courses and clinical resource packages:https://www.botportalceus.com/store Subscribe to the Functional Cognition Lab Newsletter:https://www.botportalceus.com/newsletters/functional-cognition-lab Did you find this episode helpful? Share it with another occupational therapy practitioner, student, educator, or rehabilitation professional who may need the reminder that where they are today is not where they will remain.

Managing and Inhibiting Spasticity Companion Audio  Beyond Occupation Companion Audio Companion article: Managing and Inhibiting Spasticity Spasticity can affect movement, comfort, positioning, self-care, mobility, sleep, caregiver assistance, and participation in everyday activities. In this companion episode, Michelle Eliason discusses occupational therapy strategies that may help manage spasticity while keeping treatment connected to meaningful function. The episode explores approaches such as positioning, stretching, weight-bearing, sensory input, movement preparation, relaxation, visual feedback, and selected neurodevelopmental treatment principles. The focus is not simply on decreasing muscle tone. It is on helping the patient move more comfortably, participate more fully, maintain range of motion, reduce secondary complications, and complete daily activities with greater safety and independence. Continue Learning With Us Explore our clinical resources and support options:Membership Options Learn more about formal mentorship in functional cognition:Functional Cognition Lab Mentorship Program Explore additional education and practical treatment resources:AOTA-Approved Courses and Clinical Resource Packages Receive free functional cognition education each week:Functional Cognition Lab Newsletter Did you find this episode helpful? Share it with another occupational therapy practitioner, student, educator, or rehabilitation professional.

Occupational Therapy Goals for Cognition Companion Audio Blog: Beyond Occupation by Michelle C. Eliason, MS, OTR/L Writing measurable cognition goals can be difficult, especially when broad terms such as memory, attention, executive functioning, judgment, and functional cognition must be translated into observable occupational performance. In this companion episode, Michelle Eliason discusses how occupational therapy practitioners can write cognition goals that reflect meaningful daily activities, identify the support a participant requires, and demonstrate functional change over time. The full article includes goal examples for attention, memory, executive functioning, functional cognition, cognitive-motor dual tasking, strategy use, and everyday activities such as medication management, meal preparation, appointment planning, and household routines. Continue Learning With Us Read the full article:Occupational Therapy Goals for Cognition Explore our clinical resources and support options:Membership Options Learn more about formal mentorship in functional cognition:Functional Cognition Lab Mentorship Program Explore additional education and practical treatment resources:AOTA-Approved Courses and Clinical Resource Packages Receive free functional cognition education each week:Functional Cognition Lab Newsletter Did you find this episode helpful? Share it with another occupational therapy practitioner, student, educator, or rehabilitation professional.

Simple Ways to Add Dual Tasking to Occupational Therapy Treatment Beyond Occupation Companion Audio Read the full companion article: Simple Ways to Add Dual Tasking to Occupational Therapy Treatment Visit the full article for the complete intervention examples, clinical reasoning, references, member resources, and embedded links. Dual-task training does not need to be complicated. In this episode of Beyond Occupation, Michelle C. Eliason, MS, OTR/L, explores simple ways occupational therapy practitioners can add cognitive and motor demands to activities they are already using in treatment. The episode explains why a patient may perform well when tasks are completed separately but begin to lose balance, make errors, forget instructions, or slow down when those demands are combined. It also emphasizes that dual tasking should not mean adding a random question to every exercise. The added task should reflect the patient’s actual goals, reveal meaningful performance breakdown, or reproduce the demands of everyday occupations. In This Episode You will hear practical examples involving: Laminated number and alphabet targets Carrying household items while responding to conversation Digit-span reversals during movement Balance activities paired with categorization Memory recall during functional tasks Medication-management simulation while standing Dual tasking during ADLs and IADLs Signs that the combined demand may be too high Ways to adjust treatment based on fatigue, safety, and current capacity The central takeaway is simple: begin with tasks the patient can perform safely, add one demand at a time, and observe what changes. The best dual-task activity is not necessarily the hardest one. It is the activity that helps the practitioner understand where performance breaks down and supports the patient in returning to meaningful daily life. Keywords Occupational therapy, dual tasking, dual-task training, functional cognition, cognitive-motor training, working memory, divided attention, medication management, ADL training, IADL training, balance, executive function, activity analysis, neurological rehabilitation, treatment ideas, and occupation-based intervention. Continue Learning With Us Did you find this information helpful? Please share this article with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it. Would you like access to the clinical resources discussed throughout this article? Explore our membership options to find the level of support that works best for you. Looking for a more formal learning and mentorship experience? Learn more about the Functional Cognition Lab Mentorship Program. You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools you can use in rehabilitation practice. Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter.

Occupational Therapy Goals for Balance and Stability in Neuromuscular Re-Education Beyond Occupation Companion Audio Companion article: Occupational Therapy Goals for Balance and Stability in Neuromuscular Re-Education Visit the full article for goal-writing examples, related clinical resources, member links, and additional occupational therapy intervention ideas. Writing occupational therapy goals for balance and stability can feel more complicated than it should. Practitioners often understand the underlying problem. A patient may need improved sitting balance, safer transfers, stronger postural reactions, better coordination, greater stability during mobility, or more confidence during daily activities. The challenge is translating that clinical reasoning into a goal that is measurable, functional, and clearly connected to occupational performance. In this episode of Beyond Occupation, Michelle C. Eliason, MS, OTR/L, reads the companion article exploring how to write occupational therapy balance and stability goals within neuromuscular re-education. The episode emphasizes that balance goals should describe more than an exercise. Standing on foam, reaching outside the base of support, or maintaining an unsupported position may be useful interventions, but the goal should explain why the skill matters. Can the patient maintain balance while getting dressed? Can they stand safely at the sink? Can they reach into a cabinet, carry laundry, complete a shower transfer, respond to a loss of balance, or navigate a busy environment? That is where the goal should begin. Major Points Discussed The essential components of a measurable balance or stability goal How to connect neuromuscular skills to meaningful occupational performance A practical formula for writing functional balance goals Static and dynamic sitting balance goals Static and dynamic standing balance goals Functional mobility and transfer goals Reactive balance and fall-prevention goals Dual-task balance goals Balance-confidence and fear-of-falling goals How to progress goals beyond simply using unstable surfaces Common mistakes in occupational therapy goal writing How assistance, cueing, accuracy, safety, and time criteria strengthen a goal Why the occupation should guide both the intervention and the measurable outcome What a Strong Balance Goal Should Include A functional occupational therapy balance goal should identify: The specific balance, stability, coordination, or motor-control skill The meaningful activity affected by the impairment The measurable performance outcome The expected assistance, cueing, safety, accuracy, or time criteria The expected time frame For example, rather than writing: The patient will improve balance. A stronger goal may describe the patient retrieving kitchen items from outside the base of support without losing balance and with a clearly defined level of cueing or assistance. This gives the practitioner, patient, payer, and interdisciplinary team a clearer understanding of what is changing and why that change matters. Types of Balance Goals Explored Sitting Balance Static sitting balance supports occupations such as grooming, eating, dressing, computer use, schoolwork, and leisure. Dynamic sitting balance becomes important when the person must reach, turn, lean, shift weight, manage clothing, retrieve objects, or return to midline during an activity. Standing Balance Static standing balance may support brushing teeth, washing hands, preparing food, managing clothing, showering, and waiting in community environments. Dynamic standing balance is required when a person reaches, turns, steps, carries objects, changes direction, or moves outside the base of support. Functional Mobility and Transfers Mobility goals become more meaningful when they identify the occupation being supported. Rather than measuring walking distance alone, a goal may address walking while carrying laundry, navigating the kitchen, entering a vehicle, completing bathroom transfers, moving through a grocery store, or transporting work materials. Reactive Balance and Fall Prevention Real-life balance challenges are not always predictable. Reactive balance goals examine whether the person can respond to an unexpected obstacle, trip, slip, surface change, or displacement using an effective stepping, grasping, or postural response. Dual-Task Balance Many people appear safe in a quiet treatment space but become unstable when they must think, talk, remember, scan, carry, or make decisions while moving. Dual-task balance goals may combine mobility with: Remembering a shopping list Following directions Scanning for signs or products Navigating obstacles Carrying household items Responding to questions Planning the next step of an activity These goals help connect balance, mobility, and functional cognition. Balance Confidence A person may have enough physical ability to complete an activity but avoid it because of fear of falling. Balance-confidence goals can combine a standardized measure with return to meaningful activities such as shopping, showering, attending church, gardening, exercising, or walking outdoors. Progressing Balance and Stability Goals Progression does not always require foam pads, wobble boards, or more unstable equipment. A goal or intervention may be progressed by changing: Hand support Base of support Reaching distance Movement speed Visual input Cognitive demand Environmental distractions Assistance level Task complexity The number of occupational demands occurring at once A patient may progress from standing quietly at a counter to preparing a meal while reaching, turning, carrying objects, scanning the environment, and responding to conversation. That progression often reflects everyday occupational performance more accurately than simply moving to a more unstable surface. Key Clinical Takeaway Balance and stability goals should not become a collection of increasingly difficult exercises. The practitioner must identify the postural, sensory, motor, cognitive, coordination, or confidence-related problem that is limiting occupational performance and connect that impairment to something the patient needs or wants to do. The goal is not merely to improve standing, reaching, or walking. The goal is to help the person dress, bathe, prepare meals, manage the home, return to work, shop, participate in the community, care for others, and safely resume the occupations that give daily life meaning. Occupational Therapy and SEO Keywords Occupational therapy, occupational therapy goals, balance goals, stability goals, neuromuscular re-education, functional balance, static sitting balance, dynamic sitting balance, static standing balance, dynamic standing balance, postural control, postural reactions, reactive balance, fall prevention, balance confidence, fear of falling, functional mobility, transfer training, gait and occupational performance, dual-task balance, cognitive-motor training, coordination, motor control, sensory integration, ADLs, IADLs, functional cognition, occupational performance, goal writing, SMART goals, rehabilitation documentation, OTR, OTA, neurorehabilitation, and occupation-based intervention. Continue Learning With Us Did you find this information helpful? Please share this article with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it. Would you like access to the clinical resources discussed throughout this article? Explore our membership options to find the level of support that works best for you. Looking for a more formal learning and mentorship experience? Learn more about the Functional Cognition Lab Mentorship Program. You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools you can use in rehabilitation practice. Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter.

What Is Dual Tasking in Occupational Therapy? Beyond Occupation Companion Audio Companion article: What Is Dual Tasking in Occupational Therapy? Visit the full article for references, educational resources, intervention ideas, member resources, and embedded links. Dual tasking is frequently described as doing two things at once—but clinically, the concept is more specific. A true dual task occurs when a person performs two separate tasks simultaneously, with each task having its own goal and measurable outcome. For example, a person may walk across a room while naming animals. Walking and word generation can each be evaluated independently. In this episode of Beyond Occupation, Michelle C. Eliason, MS, OTR/L, reads the companion article exploring what dual tasking means, why combined cognitive and motor demands may cause performance to deteriorate, and how occupational therapy practitioners can apply dual-task principles within meaningful occupations. The episode distinguishes true dual tasks from complex functional activities. Carrying a glass of water while walking, for example, may be better understood as one complex task with a shared goal rather than two independent tasks. Both types of activities can be valuable in occupational therapy, but practitioners should understand what they are actually assessing and treating. This companion audio also explains dual-task interference, which occurs when one or both tasks decline because they are competing for limited attention, processing capacity, sensory resources, or response-selection systems. A person may walk safely and answer questions accurately when each task is completed separately. When the tasks are combined, however, the person may slow down, stop moving, lose balance, forget instructions, respond less accurately, or abandon one part of the activity. These breakdowns may reveal difficulties that are not visible during quiet, single-task testing. Major Points Discussed What qualifies as a true dual task The difference between dual tasks and complex functional activities What dual-task interference looks like during movement and cognition Cognitive-motor and motor-motor dual tasking Why no single type of dual task is always more difficult Capacity-sharing theory and limited attentional resources Multiple Resource Theory and competition between processing channels Central bottleneck theory and delayed response selection The strategies people use to alternate, group, or prioritize tasks Why neurological conditions may reduce the automaticity of movement The relationship between dual tasking and functional cognition How dual-task demands appear during real-world occupations Why dual-task intervention should extend beyond walking while counting How to select secondary tasks based on the person’s goals and occupations How to grade motor, cognitive, sensory, and environmental demands The influence of coordination, sensory integration, praxis, and postural control The roles of occupational therapy, physical therapy, and speech-language pathology How interdisciplinary collaboration can support cognitive-motor rehabilitation Dual tasking is especially relevant after stroke, traumatic brain injury, Parkinson’s disease, multiple sclerosis, dementia, vestibular dysfunction, cerebellar disorders, and other neurological conditions. After neurological injury or disease, an activity that was once automatic may begin to require conscious attention. Walking may now require active monitoring of balance, step length, posture, foot clearance, turning, and obstacle avoidance. When an additional cognitive demand is introduced, the person may no longer have enough available capacity to complete both tasks successfully. Dual Tasking in Occupational Therapy Occupational therapy practitioners can use dual-task intervention to examine how cognition, movement, sensation, emotion, habits, roles, and environmental demands interact during everyday performance. The clinical question is not simply: Can the person walk while counting? The occupational therapy practitioner may instead ask: Can the person prepare breakfast while monitoring a timer? Can they navigate a store while remembering and comparing products? Can they complete a morning routine while managing interruptions? Can they carry laundry while remembering where each item belongs? Can they move safely while listening for a child? Can they return to work while responding to changing demands? The secondary task should be selected because it reflects the cognitive demands of the person’s goals, not simply because it is easy to administer. A teacher may need to move through a classroom while processing verbal information and monitoring the environment. A parent may need to prepare food while listening for a child. A person returning to grocery shopping may need to combine walking, visual scanning, decision-making, and working memory. Walking while counting backward may be clinically useful, but it does not automatically represent the occupation the person needs to resume. Grading Dual-Task Intervention Dual-task intervention should begin by examining each task separately. The practitioner determines whether the person can safely and accurately perform the motor task alone, complete the cognitive task alone, and then manage the two tasks when combined. Task demands can then be graded by changing one variable at a time. Motor demands may be changed through speed, distance, surface, obstacles, direction changes, object weight, base of support, or assistance level. Cognitive demands may be changed through instruction length, response speed, distraction, memory load, familiarity, inhibition, switching, sequencing, or problem-solving. The practitioner may also manipulate task priority by asking the person to prioritize movement, prioritize the cognitive task, maintain equal performance, or switch priorities when cued. These changes help reveal how the person allocates attention and where performance begins to break down. Key Clinical Takeaway Dual-task training is not about making activities difficult for the sake of difficulty. It is the intentional combination and grading of meaningful demands so that practitioners can identify interference, understand the systems contributing to performance breakdown, and develop interventions that support participation in real life. The goal is not simply to improve performance during a therapy exercise. The goal is to help the person think, move, adapt, and remain safe while completing the occupations that everyday life actually requires. Occupational Therapy Keywords Occupational therapy, dual tasking, dual-task training, dual-task interference, cognitive-motor dual tasking, motor-motor dual tasking, functional cognition, cognitive rehabilitation, neurological rehabilitation, neurorehabilitation, executive function, attention, working memory, processing speed, inhibition, cognitive flexibility, task switching, divided attention, motor planning, praxis, balance training, gait training, sensory integration, postural control, Parkinson’s disease, stroke rehabilitation, traumatic brain injury, multiple sclerosis, dementia rehabilitation, vestibular rehabilitation, cognitive load, occupational performance, activity analysis, IADLs, interdisciplinary rehabilitation, OTR, OTA, physical therapy, and speech-language pathology. Continue Learning With Us Did you find this information helpful? Please share this article with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it. Would you like access to the clinical resources discussed throughout this article? Explore our membership options to find the level of support that works best for you. Looking for a more formal learning and mentorship experience? Learn more about the Functional Cognition Lab Mentorship Program. You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools you can use in rehabilitation practice. Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter.

When the Scores Don’t Match the Person Beyond Occupation Companion Audio Companion article: When the Scores Don’t Match the Person: Using Activity Analysis to Bridge Cognitive Capacity and Functional Performance Visit the full article for the complete discussion, clinical examples, references, resources, and embedded links. What should an occupational therapy practitioner do when a person’s cognitive assessment scores do not seem to match how they function in daily life? In this episode of Beyond Occupation, Michelle C. Eliason, MS, OTR/L, reads the companion article exploring the important difference between cognitive capacity and functional performance. Standardized cognitive assessments provide valuable information about attention, memory, processing speed, executive function, visuospatial skills, and other areas of cognition. However, testing completed in a controlled environment cannot fully capture how a person performs within familiar routines, meaningful occupations, and real-world environments. A person may score poorly on a cognitive screening measure while continuing to manage medications, prepare meals, navigate the community, or complete familiar household routines. In other cases, a person may achieve a relatively strong score but still experience significant difficulty managing complex daily activities. These differences are not necessarily contradictions. They reflect the influence of task familiarity, environmental supports, compensation strategies, established routines, procedural learning, fatigue, distraction, stress, and the specific cognitive demands of the activity. This companion audio explains how occupational therapy practitioners can use activity analysis to identify where performance breaks down, why it breaks down, and how intervention can be designed around the actual demands of meaningful occupations. Rather than allowing a cognitive score to become the final clinical conclusion, occupational therapy can use the score as the starting point for more precise, occupation-centered clinical reasoning. Major Points Discussed The difference between cognitive capacity and functional performance Why standardized cognitive scores may not predict daily function How familiar routines and procedural learning can support performance The role of environmental organization, visual cues, written supports, and compensation Why a person’s independence may be real but dependent on very specific conditions How fatigue, stress, illness, distraction, interruptions, or unfamiliar environments may reveal hidden performance difficulties How activity analysis helps identify the specific cognitive demand causing a task to break down Why medication management involves more than memory The role of attention, sequencing, working memory, prospective memory, inhibition, orientation, visuospatial processing, and error recognition during IADLs How occupational therapy practitioners can reduce cognitive load to support successful performance How cognitive load can be intentionally graded to build capacity, generalization, and strategy use The distinct contribution of occupational therapy within cognitive rehabilitation The collaborative roles of the OTR and OTA in assessment, intervention, observation, documentation, and treatment progression The central message of this episode is that a low cognitive score should not automatically be treated as proof that a person cannot function independently. At the same time, successful performance within one familiar routine should not automatically be interpreted as evidence that cognitive impairment is no longer affecting daily life. Occupational therapy practitioners must examine the conditions surrounding performance. What strategies is the person using? How much support is being provided by the environment? What happens when the routine changes? Can the person return to the task after an interruption? Does performance remain accurate and safe when distractions are introduced? Can the same strategies be used in a different environment? Activity analysis allows occupational therapy practitioners to move beyond asking only what a person scored. It helps identify where performance breaks down, which cognitive processes are contributing, what supports are sustaining success, and how intervention can strengthen meaningful participation in daily life. Occupational Therapy Keywords Occupational therapy, functional cognition, cognitive rehabilitation, cognitive remedial therapy, activity analysis, cognitive assessment, cognitive screening, cognitive capacity, functional performance, occupational performance, executive function, working memory, attention, processing speed, prospective memory, cognitive load, cognitive load grading, cognitive load reduction, mild cognitive impairment, MCI, traumatic brain injury, TBI rehabilitation, stroke rehabilitation, dementia rehabilitation, neurorehabilitation, medication management, instrumental activities of daily living, IADLs, environmental modification, compensatory strategies, cognitive strategy training, occupation-based intervention, outpatient occupational therapy, OTR and OTA collaboration, functional cognitive assessment, and clinical reasoning. Continue Learning With Us Did you find this information helpful? Please share this article with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it. Would you like access to the clinical resources discussed throughout this article? Explore our membership options to find the level of support that works best for you. Looking for a more formal learning and mentorship experience? Learn more about the Functional Cognition Lab Mentorship Program. You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools you can use in rehabilitation practice. Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter.

Join the OT conversation in the clinical realm immediately. Read the ACOTE standards listed at the front of your course syllabi and know the difference between what the school “interprets” as meeting this requirement and what ACOTE actually “requires” Read your textbooks to actually understand the information and how it applies to the occupational therapy process Create Systems, Structure, and Organization from Day 1 Developing effective study habits https://www.buffalooccupationaltherapy.com/blog/advice-for-occupational-therapy-students/