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Rehabilitation professionals still do not communicate effectively about cognition
Erik S Lande1, Richard L Wanlass2
1Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, Santa Barbara, CA.
Objective:
To examine current use of descriptive labels for levels of cognitive impairment and types of memory to explore whether rehabilitation disciplines are now communicating more effectively.
Design:
Survey of rehabilitation professionals.
Setting:
Hospital rehabilitation programs.
Participants:
Respondents (N=130) representing 8 facilities in 5 states completed surveys.
Interventions:
Not applicable.
Main Outcome Measures:
Responses to survey questions about severity and types of memory impairment were examined with the Kruskal-Wallis test to determine the impact of profession on ratings. Post hoc Mann-Whitney U test comparisons of the 2 professions with the most cognitive assessment experience, psychologists/neuropsychologists and speech-language pathologists, were conducted.
Results:
Ratings of various deficit levels differed significantly by profession (mild: H=39.780, P<.000; moderate: H=43.309, P<.000; severe: H=38.354, P<.000), but not by program location. In comparing psychologists/neuropsychologists and speech-language pathologists specifically, we found a significant discrepancy in ratings for percentile ranges associated with the terms mild (U=103.000, P<.001), moderate (U=78.000, P<.000), and severe (U=109.000, P<.001). Disagreement on the meaning of descriptive memory terms was noted among rehabilitation professionals in general, with large percentages of respondents not agreeing on the meanings of terms.
Conclusions:
A significant lack of consensus persists regarding the understanding of common cognitive terminology. This miscommunication affects cognitive impairment descriptors (eg, mild, moderate, severe) and categorization of types of memory. Only half of rehabilitation professionals appear aware of this discrepancy, suggesting that education is necessary to bring greater awareness of the potential for miscommunication.
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