The Allen’s Cognitive Disabilities Model (CDM) emphases on the integration of the cognitive functional ability and the level of activities that clients are able and willing to perform. Interventions using this model can take place individually or in group. When implementing the intervention, therapists consider each client’s needs and implement changes in task accordingly. In group sessions, each client’s cognitive mode of performance is considered individually and adapted to the modified task with appropriate level of required cognitive functional ability. To describe the degree of cognitive disability, this model uses six functional cognitive levels:
(1) automatic actions,
(2) postural actions,
(3) manual actions,
(4) goal-directed actions,
(5) exploratory actions, and
(6) planned actions.
Each cognitive level consists of modes of performance, and the overall performance ranges from 0 (generalized reflexive actions) to 6 (normal functioning). Assessments on functional history aim to evaluate functional levels in the domains of ADL, IADL, etc., in order to suggest the level of cognitive abilities and task performance of specific client. Interventions using this model consist of three stages such as post-acute, rehabilitation, and long-term care. Task analysis and activity analysis are mainly used for analyzing each task to match the demands to the cognitive level to each client during intervention. Short-term goals aim to match to the current mode of performance, whereas long-term goals are based on prediction of change in performance modes. The ultimate goal of this model is to maintain the client’s existing skills, and to develop new coping strategies.
Domain of occupation
Activity analysis and task analysis are utilized to match each client’s cognitive level with appropriate task demands
Allen, C. K. (1992). Cognitive disabilities. In N. Katz (Ed.), Cognitive rehabilitation: Models for intervention in occupational therapy (pp. 1-21). Stoneham: Butterworth-Heinemann.
The dynamic interactional model of cognitive rehabilitation emphasizes that cognition is a continuous product of the dynamic interaction between the individual, task, and environment. Individual factor includes structural capacity (including physical limitation), strategies (including organized approach/routine/tactics), metacognitive processes (knowledge and regulation of own cognitive processes and capacities) and learner characteristics such as motivation and knowledge. These individual factors interact with other factors during information processing and learning.
This model is based on the concepts of metacognition and awareness to view the relationship between the metacognition and awareness as a dynamic process. This model differentiates between one’s self knowledge and awareness that are pre-existing or stored within long-term memory (or called metacognitive knowledge) and the knowledge and awareness that is activated during a task (or called on-line awareness).
This model is symbolized as an infinity symbol, which emphasizes that independence is a continuum without a start or an end. An individual’s independence can exist at any point within this continuum. Inside the symbol, there are two sides representing two themes, they are personal factors and environmental factors. The lighter (left) side of the model represents personal factors, which consists of personal attributes.
Acquiring motor skill is a process that requires practices, feedback, and involvement of the learner. This frame of reference employs several principles from learning theory. It focuses on the child’s ability, characteristics of the task, skills required, environment, and regulatory conditions. Regulatory conditions are aspects of the environment that determine movement specifics, which are described in a continuum between closed and open tasks.
This model aims to facilitate occupational therapists in accessing clients’ mind as an instrumental tool for occupational functioning and adaptation to the environment. It consists of three phases across 10 steps.