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Occupational Therapy vs Neuropsychology

Occupational Therapists (OT’s) are experts in “functional cognition”, or in other words, how a person’s thinking skills affects their performance in daily tasks.

Cognitive changes can affect a person’s performance in daily life. 

OT’s understand terms used by neuropsychologists and doctors to describe cognitive changes, such as ‘selective attention’ or ‘working memory’ but ultimately emphasis is placed on how those changes affect a person’s ability to perform their usual tasks. This can include activities such as managing medication, paying bills, driving or controlling spending on the poker machine. So, while a neuropsychologist can give a detailed description of what deficits might exist and what part of the brain is damaged, an occupational therapist looks at how this can affect the person’s actions in the real world.

How does an OT assess cognition?

OT’s use usual daily activities to assess cognitive skills in a practical way, considering the environment they’re performed in. Daily activities are often more engaging for a person than pen and paper tasks and show how people use contextual cues or strategies to overcome issues. OT’s take into account of how medications, tiredness, mood or sudden changes, such as delirium, can have on a person’s cognitive presentation.

Why is assessment important?

The purpose of doing an assessment is to find out what functional impact the deficits may have, and to intervene to maximise participation and quality of life. OT’s can provide education and compensatory strategies and can utilise modern technology to maximise participation in day to day tasks. Through diagnosis and support, improved participation in daily activities can follow. An occupational therapist can often play an important role in influencing a person’s living place, advocating for remaining at home with supports or modifications of activities, rather than resorting to residential support unnecessarily. It can also provide valuable insights for family on how best to support the person. Knowing the real-world deficits allows an OT to devise a plan of action and choose a frame of reference appropriate to the issue. So, for example a client with a stroke may start retraining in skills whereas for someone with dementia a compensatory approach might be taken.

Of course, there are some people with cognitive changes who lack insight as part of their condition. Here, OT’s can help by identifying cognitive changes which can lead to early diagnosis. OT’s can educate family members to follow up in the longer term or advise a medical specialist who can monitor progression, or link with relevant community or Government support agencies.