Occupational therapy: current practice and training issues in the treatment of cognitive dysfunction

A significant relationship exists between cognitive abilities and functional performance in activities of daily living. Occupational therapists are involved in providing cognitive rehabilitation to individuals with brain damage by assisting them in fulfilling self-care, work and leisure roles. Since occupational therapists specialize in functioning in the real world, they should have a primary role on the interdisciplinary team in assessing and treating cognition as it relates to function. Particular areas of expertise include assessment and intervention in daily living tasks, safety issues and cognitive/perceptual dysfunction. Treatment strategies in occupational therapy are classified into two approaches: remedial and compensatory. A combination of the two approaches has been found to be the most beneficial method of intervention. Though current training guidelines for occupational therapists in cognitive rehabilitation are vague, the major focus has been on evaluating functional status and intervening when cognitive/perceptual deficits are present. Future training for practitioners in this area will require more specialized experiences and education. Additional research will need to be conducted by therapists to document treatment efficacy. Despite current health care constraints, occupational therapists must not lose sight of delivering quality care in an individualized and holistic manner.