The cognitive disability model, Lecture notes of Occupational therapy

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Module: Occupational

Therapy in Mental Health

Topic: Cognitive Disability

Model

Number of credits: 20

Content I. Principals of Cognitive Disability Model II. Assumptions of Cognitive Disability Model III. stages of cognitive development according to Jean Piaget IV. Six Allen cognitive levels V. Indication of this Model VI. Cognitive functional activities

Principals of Cognitive Disability Model  (^) It Based on the stages of cognitive development as described by Jean Piaget  (^) Cognitive ability is determined by biological factors( Genetic factors and neurophysiology) and the potential for improvement is dictated by those factors.  (^) Functional behavior is based on cognition.

Principals of Cognitive Disability

cont’d

 (^) If the person’s cognitive level cannot change, adapting activity or modify the environment will provides opportunities for the individual to succeed.  (^) Once the maximum level has been achieved, compensation must be made biologically, psychologically, or environmentally  (^) Cognitive performance is placed on a continuum divided into six (6) levels.

Stages of cognitive development According to Jean Piaget  (^) Refers to the child’s capacity to understand certain concepts which is based on the child’s developmental stage.  (^) Jean Piaget Believed that all children develop according to four stages based on how they see the world.

**1. Sensori-motor (birth –2 years)

1. Preoperational (~2-7)
2. Concrete operational (~7-11)
3. Formal operations (~12-15)**

1.Sensorimotor Stage  (^) Birth to about 2 years, rapid change is seen throughout  (^) The child will explore their environment through their senses, including sight, hearing, touch, taste, and smell i. Explore the world through senses & motor activity Ex: Puzzles, sound toys Early on, baby can’t tell difference between themselves & the environment Ex: Do not know who is feeding them or who help them when they cry ii. If they can’t see something then it doesn’t exist iii. Begin to understand cause & effect Ex: To press a button and make sound iv. Can later follow something with their eyes

…more preoperational

 (^) Lack Conservation of matter – understanding that something doesn’t change even though it looks different, shape is not related to quantity Ex.1: Are ten coins set in a long line more than ten coins in a pile? Ex.2: Is there less water if it is poured into a bigger container?

3.Concrete Operational Stage  From about 7 to about 11 i. Abstract reasoning ability & ability to generalize from the concrete increases ii. Understands conservation of matter This stage allows children to engage in more advanced problem-solving and reasoning within their immediate, real-world context

Formal Operations

 (^) From about 12 to about 15 i. Be able to think about hypothetical situations ii. Organize information iii. Reason scientifically

Indications

 TBI

 CVA

 Dementia

 Alzheimer’s disease

…… Levels

 Level III , Manual Actions

are characterized by beginning to use hands to manipulate objects. The individual may be able to perform a limited number of tasks with long-term repetitive training.  (^) Level IV, Goal Directed Actions are characterized by the ability to carry simple tasks through to completion. The individual relies heavily on visual cues. He/she may be able to perform established routines

…… Levels

 (^) Level V, Exploratory Actions are characterized by overt trial and error problem solving. New learning occurs. This may be the usual level of functioning of 20% of the population. 

Level VI, Planned Actions,

characterized by the absence of disability. The person can think of hypothetical situations and do mental trial and error problem solving.

Activity ideas for levels

cont’d

Level 2  (^) Parachute games  (^) Simple ball activities  (^) Using grab bars  (^) Food exploration (textures, tastes)  (^) Rhythmic type of activities (wheelchair dancing)  (^) Partial physical and verbal prompting – simple one- or two-word commands  (^) Directed walking  (^) Big movement – floor games

Activity ideas for levels

cont’d

Level 3  Sorting  (^) Beading  Pegboard  Tearing or cutting – contributing towards larger end product) To include different abilities to contribute.  Making fruit salad with easy to cut fruit  (^) Stirring and mixing (baking groups to accommodate different levels)Verbal prompting and modeling  (^) Sheltered employment