This framework aims to guide clinical reasoning with respect to describing, analyzing, and selecting a potential strategy for a client’s unique performance problem. It identifies seven general attributes that can be used to describe and organize cognitive strategies. They are:
strategy outcomes, including acquisition/reacquisition of skills, coping with challenge, and optimal performance.
strategy purpose, e.g., optimizing skill performance, learning a specific daily routine.
range of application, including general or special.
visibility, including overt or covert.
permanence, including temporary or permanent.
performance phase, including before or during task.
strategy target, including person, task, and environment.
Each includes a range of behaviors. These behaviors are illustrated to help clinicians for attribute selection in interventions, and to clarify the differences. It proposes that the first consideration in reasoning strategy selection is to clearly identify desired outcome and purpose of the strategy in supporting the outcome. For example, performance strategies support the accuracy and quality of performance, and learning strategies optimize attention during learning. This framework summarizes various aspects of strategy use to guide therapist’s reasoning on client readiness. Strategy use can be subdivided into those aspects that are relevant prior to a task (e.g., prerequisites to strategy use) and those that may be observed during or immediately after a task (e.g., strategy execution, quality, monitoring and evaluation, and effect on learning or performance). Prerequisites for effective cognitive strategy use include the person’s general knowledge, repertoire, and beliefs about the value of strategies.
Domain of occupation
This framework identifies performance problems and suggests how the seven general attributes can be used clinically to address different clinical problems and desired outcomes across age groups.
Toglia, J., Rodger, S., & Polatajko, H. (2012). Anatomy of cognitive strategies: A therapist’s primer for enabling occupational performance. Canadian Journal of Occupational Therapy, 79(4), 225-236.
This framework describes different aspects of cognitive strategy use to support practitioners’ clinical reasoning about clients’ reasoning and successful strategy use. It divides strategy use into four aspects, relevant to the task, each rated by therapists’ observation. The first aspect, prerequisites for effective cognitive strategy use, relevant prior to a task, includes the person’s strategy knowledge, strategy repertoire, strategy beliefs, anticipation and recognition of needs, and strategy generation and selection.
The clinical reasoning framework aims to guide practitioners in selecting strategies in approaching sensory challenges in order to optimize participation of children with autism spectrum disorder. Several clinical reasoning considerations are based on this framework, and these include research evidence, client- and family-centeredness, practice contexts, occupation-centeredness, and risks. This framework emphasizes on the use of mutual information-sharing and coaching to empower families or teachers and develop their own solutions to supporting children’s participation.
This integrative framework mainly consists of two elements: (1) the factors influencing clinical reasoning (CR), and (2) the evolving CR process underlying the choice of teaching strategies. First, both internal factors (relate to occupational therapists, such as knowledge and experience, personal habits) and external factors (relate to client, environment, task, and interaction of them, such as emotional/cognitive/physical availability, previous knowledge) influence CR of therapists.
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.