Treatment of Functional Cognition Part 1: Clients With Limited Awareness
Presented by Meghan Doherty
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Clients with moderate to severe functional cognitive impairments often demonstrate limited awareness of their deficits, which presents unique challenges for intervention. This course focuses on evidence-based treatment approaches for individuals who lack insight into their functional cognition challenges. Participants will learn how to determine a client’s level of awareness using theoretical models and performance-based assessments and how that awareness guides treatment planning. Specific attention is given to errorless learning through the neurofunctional approach and the use of environmental modifications and care partner training when remediation is not feasible. Designed for occupational therapy practitioners across adult settings, this course provides practical strategies to improve real-world performance and promote meaningful occupational engagement for clients with limited cognitive awareness.
Learning Outcomes
- Determine a client’s level of awareness and how it influences intervention planning to support occupational performance
- Distinguish between task-specific and compensatory environmental modification treatment strategies for functional cognition
- Apply evidence-based strategies to support awareness in clients with functional cognitive limitations
- Implement the neurofunctional approach through treatment planning in a case study
Meet your instructor
Meghan Doherty
Dr. Meghan Doherty has been learning, working, and researching with individuals across the lifespan with neurological and functional cognitive conditions since 2008. She holds a Bachelor of Science from Truman State University, and a Master (2008), and Doctorate (2016) degrees in occupational therapy from Washington…
Chapters & learning objectives
1. Addressing Awareness Deficits in Occupational Therapy
This chapter introduces the theoretical foundations of awareness, including the pyramid model and the dynamic comprehensive model, and explains their application in occupational therapy practice. Learners will explore how awareness levels impact treatment planning and understand when to target awareness remediation versus when to shift to compensatory strategies. Case examples help illustrate clinical decision-making for clients with limited insight into their cognitive deficits.
2. Errorless Learning for Functional Cognitive Deficits
Focusing on the neurofunctional approach, this chapter teaches clinicians how to implement errorless learning strategies for clients with moderate to severe cognitive impairment. Through repetition, environmental support, and habit training, therapists can foster behavioral automaticity in meaningful daily tasks. The chapter outlines cueing techniques, chaining methods, and goal development to support implicit learning when explicit strategy use is not possible.
3. Compensatory Interventions for Functional Cognition
This chapter covers practical compensatory strategies for clients with limited awareness and memory impairments, particularly when intensive training approaches are not feasible. Learners will review interventions such as environmental modifications, activity simplification, and care partner education to enhance safety and participation. The importance of collaboration with care partners and adapting tasks to the client’s cognitive capacity is emphasized to support continued engagement in daily routines.
