Functional Cognition: Cognitive Rehabilitation Assessment and Intervention

Functional Cognition: Cognitive Rehabilitation Assessment and Intervention Methods

Instructor:  Joan Toglia PhD, OTR/L, FAOTA        Dates:    Thursday, June 2 –  Friday, June 3, 2022 

Location:    Hotel Clique Calgary Airport

Cost:           $650. + GST (5%) Early Bird Rate, $700. + GST (5%) after May 1, 2022

Price includes handouts, breakfast, breaks and lunches. A block of rooms will be held at the Hotel Clique Calgary Airport until May 2, 2022. Please call and book your accommodation: (403) 460 9588 (front desk). Code to quote: 0604MW or under group name MindWorks. 

Who Should Attend

• Occupational Therapists (OT)
• Speech Language Pathologists (SLP)
• Occupational Therapist Assistants (OTA)
• Communicative Disorders Assistant (CDA)
• Rehabilitation Support Workers (RSW)

Course Description and Agenda

Functional Cognition: Cognitive Rehabilitation Assessment and Intervention Methods

Day 1: Cognitive Deficits: Assessment Tools and Performance Based Measures

This workshop will provide therapists with the ability to analyze and interpret task errors observed during IADL performance and select or choose the most appropriate assessment tools and outcome measures for adults with acquired brain injury and executive function deficits. An in depth review of executive function (EF) components and the interdependence of EF with other cognitive perceptual domains will provide a foundation for interpretation of performance errors.   Different assessment methods will be reviewed with a focus on executive function and recently developed performance based measures. Evaluations that include standardized rating scales of awareness, everyday behaviors, cognitive screenings, IADL, and specific cognitive perceptual tests will be discussed along with general implications for treatment.

 DAY 1

8:00 am

Registration and Breakfast

9:00

Overview of Cognition and Occupational Performance

• Executive Function Performance & Functional Cognition
• Interpreting clinical scenarios
• Recognizing the components of EF within performance
• Video Clips:   Analysis of client perspectives and functional cognitive errors

10:45-11:00

Break

11:00-12:00

Cognitive Assessment: Standardized Tests

• Screening: Micro Screens, Mental Status Screens (MoCA), Higher Level Screens
• Interpretation of results and relationship to ADL/ IADL
• Assessment resources
• Specific Areas of Assessment – Online CMT-2
• Deciding When and Where to Start: Building a Decision Tree

12:00- 1:00

Lunch

1:00- 1:30

Cognitive Questionnaires and Rating Scales

• Assessing Awareness
• Assessing perceptions of cognitive everyday symptoms

1:30-2:45

Performance Based Assessment

• Performance Based measures - different methods of Assessment
• Small group activity and role play
• (Continued) Discussion of Performance Based Assessments
• Documentation of results

2:45- 3:00

Break

3:00-4:15

• WCPA- Overview, Interpretation and case analysis:   Using assessment as a foundation for treatment planning Case Analysis Continued
• Complex task performance and subtle cognitive deficits

4:15-4:30

Summary and questions

Day 2: An Overview of Cognitive Intervention Methods for Optimizing Function

A broad overview of different methods that can be used to promote and enhance cognitive function and participation in everyday activities will be presented. Interventions such as errorless learning,  task and environmental adaptations, use of everyday technology, remediation and emerging technologies will be discussed in the context of Occupational Therapy and evidence based practice. The afternoon will focus on use of a metacognitive strategy approach. Case examples and videos will show how repeated experiences with a range of activities that present common cognitive challenges, provide clients with the opportunity to self-discover patterns of performance errors, anticipate activity conditions that present difficulties, and practice similar strategies across different tasks. Clinical examples and applications will focus on adults with stroke and acquired brain injury, however implications for a wide range of populations will be discussed.

 DAY 2

7:30 - 8:30

Breakfast

8:30– 10:15am

An Overview of Cognitive Rehabilitation Approaches

• Errorless learning, spaced retrieval and task specific training
• Cognitive adaptations – Matching adaptions to symptoms
• Use of Everyday Technology to support cognitive performance in learning and daily life.

10:15- 10:30

Break

10:30 – 12:00pm

• Use of Everyday Technology to support or enhance cognitive function (continued)

Neuroplasticity and remediation

• Computer based cognitive remedial programs

12:00- 1:00

Lunch

1:00-   2:30

Promoting Strategy Use to Optimize Function

Metacognitive Strategy Approaches  

Overview of the key components of the Multicontext approach

Expanding use of functional cognitive activities to place demands on executive functions.

Video Case examples and discussion

2:30-   2:45

Break

2:45-    3:45

• Metacognitive Strategy Training Techniques: Mediation Guidelines for facilitating self-regulation & executive thinking
• Integrating use of strategies across a wide range functional cognitive activities

3:45-    4:00

• Summary and discussion

COURSE OBJECTIVES Upon completion of this course, participants will be able to:

1. identify and analyze different cognitive perceptual symptoms from written case descriptions and video clips (e.g. working memory, flexibility, inhibition, prospective memory).
2. determine the impact of executive function disorders on everyday activities.
3. select standardized assessments and rating scales that can be used to differentiate symptoms, prioritize goals and establish a baseline for intervention.
4. identify and differentiate between different types of Performance Based Assessments.
5. interpret evaluation data and link results to treatment planning.
6. identify and implement a wide range of evidence based intervention strategies to enhance everyday functioning for persons with cognitive perceptual impairments.
7. compare and contrast different treatment techniques and identify clinical indications for use.
8. describe different ways that everyday technology can be used in treatment to support and enhance cognitive function.
9. demonstrate the ability to analyze and manipulate EF components of activities to provide the optimal level of challenge.
10. identify a wide range of cognitive functional treatment activities that can be used within metacognitive based strategy intervention for individuals with moderate and mild cognitive difficulties.
11. integrate a metacognitive framework across a variety of activities.

Joan Toglia, Ph.D, OTR/L, FAOTA is Professor of Occupational Therapy and Dean of the School of Health & Natural Sciences at Mercy College, Dobbs Ferry, New York and Professional Associate in the Rehabilitation Medicine Department at New York Presbyterian- Cornell Weill Medical Center.. Dr. Toglia has over 30 years of experience in Occupational Therapy and is internationally recognized as a leader in the rehabilitation of persons with cognitive deficits. In addition to her degree in Occupational Therapy, Dr. Toglia completed advanced graduate and doctoral work in Educational Psychology with specializations in cognition & learning as well as measurement & evaluation.  

Dr. Toglia has contributed extensively to the field of cognitive perceptual rehabilitation as a clinician, author, educator and researcher. She has presented over 300 workshops and lectures around the world on cognitive rehabilitation, focusing on theory, assessment methods and intervention strategies to support and optimize cognitive function across different ages and diagnostic groups. Her publications and research include a focus on metacognitive strategy intervention, assessment tools and the relationship between cognitive impairments and occupational performance.

Selected Publications

Chen, P., & Toglia, J. (2019). Online and offline awareness deficits: Anosognosia for spatial neglect. Rehabilitation psychology, 64(1), 50.

Katz, N. & Toglia, J. (2018). Co-Editors. Cognition and Occupation Across the Life Span: Models for Intervention in Occupational Therapy 4th Edition. Baltimore: MD: American Occupational Therapy Association.

Toglia, J. (2017). Schedule activity module: Functional cognitive rehabilitation activities and strategy based intervention. NY: MC CogRehab Resources, LLC.

Toglia, J., Lahav, O., Ben Ari, E., & Kizony, R. (2017). Adult Age and Cultural differences in the   Weekly Calendar Planning Activity (WCPA). American Journal of Occupational Therapy. 71(5),

Toglia, J., Askin, G., Gerber, L.M., Taub, M.C., Mastrogiovanni, A.R., O’Dell, M.W. (2017) Association between two measures of cognitive instrumental activities of daily living and their relationship to the Montreal Cognitive Assessment in persons with stroke. Archives of Physical Medicine and Rehabilitation.

Toglia, J., Askin, G., Gerber, L. M., Jaywant, A., & O'Dell, M. W. (2019). Participation in Younger and Older Adults Post-stroke: Frequency, Importance and Desirability of Engagement in Activities. Frontiers in neurology, 10, 1108.

Jaywant, A., Toglia, J., Gunning, F.M., O’Dell, M.W. (2019). Subgroups Defined by the Montreal Cognitive Assessment Differ in Functional Gain During Acute Inpatient Stroke Rehabilitation. Archives of Physical Medicine and Rehabilitation. doi: 10.1016/j.apmr.2019.08.474.

Foster, E.R, Spence, D., Toglia, J. (2017) Feasibility of a cognitive strategy training intervention for people with Parkinson disease. Disability and Rehabilitation,

Toglia, J., Golisz, K. (2017). Traumatic brain injury (TBI) and the impact on daily life.  In N.D. Chiaravalloti & Y. Goverover (Ed.), Changes in the Brain: Impact on Daily Life. (pg 117 – 143). Springer Publications.

Toglia, J. (2015). The Weekly Calendar Planning Activity (WCPA): A Performance Test of Executive Function. AOTA Press: Bethesda, MD.

Toglia, J., Rodger, S., & Polatajko, H. (2012). Anatomy of cognitive strategies: A therapist’s primer for enabling occupational performance. Canadian Journal of Occupational Therapy. 79(4), 225-236.

Toglia, J.P., Johnston, M.V., Goverover Y., Dain, B. (2010). A Multicontext Approach to Promoting Transfer of Strategy Use and Self regulation After Brain Injury: An Exploratory Study. Brain Injury. 24, 664-677.

Rosenblum, S., Josman, N. & Toglia, J. (2017). Development of the Daily Living Questionnaire (DLQ): A factor analysis study. Open Journal of Occupational Therapy, 5 (4), Article 4.      

Umanath, S., Toglia, J., McDaniel, M. (2016). Training Prospective Memory for Transfer. In T. Strobach and J. Karbach (Eds). Pg 81-91. Cognitive Training: An Overview of Features and Applications. Springer Publications.