Occupational Therapy Cognitive Tests for Functional Cognition
Occupational Therapy Cognitive Tests: How to Choose the Right Assessment
Beyond Occupation Companion Audio
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Occupational Therapy Cognitive Tests: Cognitive Tests Useful in Functional Cognition
There are dozens of cognitive assessments available to occupational therapy practitioners, but knowing the name of a test is very different from knowing when to use it and what clinical question it can help answer.
In this companion audio, Michelle Eliason discusses how to think through cognitive assessment selection using a functional cognition approach. Rather than reviewing cognitive tests one by one, the episode walks through common clinical presentations and considers how an occupational therapy practitioner might decide whether to investigate memory and learning, attention, executive functioning, language retrieval, visuospatial processing, visual perception, motor performance, or functional cognition more closely.
The discussion also emphasizes an important principle: a cognitive score does not interpret itself. Standardized findings become more meaningful when they are considered alongside the occupational profile, functional activity analysis, clinical observation, environmental demands, patient and caregiver report, and the person's response to cueing or support.
Topics Discussed
- How to choose a cognitive assessment based on the clinical question
- General cognitive screening versus more targeted cognitive assessment
- Montreal Cognitive Assessment
- Mini-Mental State Examination
- Addenbrooke's Cognitive Examination
- Repeatable Battery for the Assessment of Neuropsychological Status
- Distinguishing memory impairment from problems with attention or encoding
- Hopkins Verbal Learning Test
- Rey Auditory Verbal Learning Test
- California Verbal Learning Test
- Digit Span
- Word retrieval and verbal fluency
- Controlled Oral Word Association Test
- Boston Naming Test
- Semantic Fluency Test
- Executive functioning and attention
- Stroop Color and Word Test
- Trail Making Test, Parts A and B
- Wisconsin Card Sorting Test
- Delis-Kaplan Executive Function System
- Tower of London Test
- Behavioural Assessment of Dysexecutive Syndrome
- Visuospatial and visual-perceptual assessment
- Clock Drawing Test
- Rey-Osterrieth Complex Figure Test
- Judgment of Line Orientation
- Block Design subtest of the Wechsler Adult Intelligence Scale
- Motor-Free Visual Perception Test
- Distinguishing cognitive limitations from motor limitations
- Purdue Pegboard Test
- Functional cognitive assessment
- Executive Function Performance Test
- Performance Assessment of Self-Care Skills
- Dynamic Lowenstein Occupational Therapy Cognitive Assessment
- Test of Everyday Attention
- Canadian Occupational Performance Measure
- Assessment of Motor and Process Skills
- Connecting standardized cognitive findings to occupational performance
Key Clinical Takeaway
Do not start with the assessment. Start with the clinical question.
A broad cognitive screen may identify that additional evaluation is needed, but it does not necessarily explain why a patient is having difficulty managing medications, preparing meals, navigating the community, returning to work, or completing another complex daily activity. General cognitive screening is only one piece of a larger functional cognition evaluation.
If a patient appears to have a memory problem, determine whether the difficulty involves initial attention and encoding, learning across repetition, storage, delayed retrieval, recognition, interference, or working memory. If performance deteriorates as a task becomes more complex, consider whether inhibition, cognitive flexibility, planning, strategy shifting, processing speed, or error monitoring may be contributing.
Most importantly, bring the findings back to function. Functional assessments can help answer the question that a brief cognitive screen often cannot:
What happens when this person has to use these cognitive abilities to complete an actual or simulated everyday task?
The strongest functional cognition evaluation combines the occupational profile, standardized assessment, skilled observation, functional activity analysis, information from the client and care partners, and clinical reasoning to determine how cognition is influencing participation, safety, and independence.
Helpful Functional Cognition Resources
Explore the Functional Cognition Resource Page for additional education related to cognitive evaluation and intervention.
Looking for treatment ideas? Visit the Interventions for Cognition Dashboard.
Not sure how functional cognitive impairment may present clinically? Explore the Most Common Functional Cognition Patient Presentations.
You can also review the Occupational Therapy Evaluation and Diagnoses Process for additional resources related to evaluation and clinical reasoning.
Continue Learning With Us
Did you find this information helpful? Please share this episode with another occupational therapy practitioner, student, educator, or rehabilitation professional who may benefit from it.
Would you like access to the clinical resources discussed throughout this article? Explore our membership options to learn more about the Functional Cognition Lab, resource library, and clinical support available to members.
Looking for more individualized support with assessment selection, functional cognition, treatment planning, or clinical reasoning? Learn more about the Functional Cognition Lab Mentorship Program.
You can also explore our AOTA-approved courses and clinical resource packages for additional education, treatment resources, and practical tools for rehabilitation practice.
Interested in receiving free functional cognition education each week? Subscribe to the Functional Cognition Lab Newsletter.
Hosted by Michelle Eliason, MS, OTR/L
Beyond Occupation Companion Audio connects rehabilitation science, occupational therapy, and real-world clinical practice.