How does occupational therapy literature conceptualise executive functions and how this influences occupational...

Occupational therapists (OT) are commonly tasked with assessing the functional impact of an executive dysfunctional following a brain injury. Research has highlighted uncertainty in the literature regarding how this phenomenon is understood in occupational therapy.

To explore the conceptual understanding of executive function in OT literature and how this influences the professions approach to assessment.

An integrative review of 13 studies was completed using thematic analysis to generate themes in the literature.

Four themes were generated: (1) There is inconsistency in our working definition of executive functions (EF) and what constitutes a component (2) EF is conceptualised in singular complex tasks in the OT literature, (3) There is uncertainty on the accuracy of assessing EF performance in one-off tasks (4) There is uncertainty about what constitutes normal EF performance in an occupation.

This integrative review identifies challenges in the conceptualisation and assessment of executive functions within OT. Inconsistent definitions, reliance on neuropsychological frameworks and standardised assessments, such as the multiple-errands test and executive function performance test, fail to capture the complex and individualised nature of occupational performance. The limited integration of occupational science further hampers the development of OT-specific approaches. Clearer definitions and qualitative research would enable advancements in practice and enhance client-centred interventions.