A National Survey of Occupational Therapy Practitioners' Evaluation of Cognition in Adults.

Abstract

Importance: Cognitive skills play a central role in a person's independent community functioning. As a profession, occupational therapy practitioners need to understand how cognitive evaluation is incorporated into the overall provision of occupational therapy services.

Objective: To describe occupational therapy practitioners' current practice for evaluating cognitive function in adults across treatment settings.

Design: A cross-sectional survey conducted from September 2022 to September 2023.

Setting: Web-based survey distributed through online platforms, direct e-mail invitations, and in person through flyer distribution.

Participants: Four hundred forty-six licensed occupational therapy practitioners with at least 6 mo of experience in adult treatment settings.

Results: Most occupational therapy practitioners evaluate cognition using clinical judgment rather than neurocognitive screening measures, χ2(9) = 52.39, p < .001; or functional cognitive measures, χ2(9) = 77.49, p < .001. More occupational therapy practitioners evaluate cognition using neurocognitive screening measures rather than functional cognitive measures, χ2(9) = 68.63, p < .001. The Montreal Cognitive Assessment (25.6%) was the most used standardized neurocognitive measure, and the Allen Cognitive Level Screen (15.2%) was the most widely used standardized functional cognitive measure. Various factors (e.g., time required for use, cost, ongoing peer or administrative support) were perceived to affect the selection and use of measures.

Conclusions and relevance: Occupational therapy practitioners primarily use unstandardized methods to evaluate cognition. When standardized measures are used, neurocognitive measures were used more frequently than functional cognitive measures. Occupational therapy practitioners report that comprehensive evaluation of cognition includes information derived from a variety of sources. Plain-Language Summary: In this study, we describe the current practices of occupational therapy practitioners for evaluating cognitive function in adults. We found that occupational therapy practitioners most often evaluate cognition using unstandardized methods. Standardized paper-and-pencil neurocognitive measures are used more often than functional cognitive measures that observe a person's ability to perform practical real-world tasks.