Dynamic interactional model of cognitive rehabilitation
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. Information processing is broadly divided into three stages: input, elaboration, and output. Each stage requires specific sets of cognitive skills, and the control functions (executive function, metacognition) influence all stages. Type of environment (social, physical, cultural) influences an individual’s ability to process information and adapts to demands. It can mediate processing between task and the individual. The task mainly involves surface characteristics (e.g., number of items, type of stimuli, active postural requirement) and conceptual characteristics (e.g., underlying skills and strategies used to perform the task, underlying meaning of task). Within this dynamic interactional model of cognitive rehabilitation, assessments are divided into two types. Static assessments are used to identify and quantify cognitive deficits. Dynamic assessments are used to identify and specify the conditions that have the greatest influence on performance. They are also used to identify learning potential (awareness, responsiveness, etc.). For intervention, this model suggests that a functional approach is more appropriate for client with poor learning potential, and a multiple-context approach is more appropriate for patients with potential for learning.
Domain of occupation
This model is developed specifically for adults with brain injure, and so clients with developmental and mental disabilities may not be applicable.
Toglia, J. P. (1992). A dynamic interactional approach to cognitive rehabilitation. In N. Katz (Ed.), Cognitive rehabilitation: Models for intervention in occupational therapy (pp. 104-140). Boston: Andover Medical Publishers.
The Functional Model of Cognitive Rehabilitation (FMCR) applies general concepts from the Canadian Model of Occupational Performance (CMOP). It aims to complement to the CMOP for choosing, organizing, and performing useful and perceived meaningful occupations in order to addresses the cognitive performance component. In the CMOP, the cognitive performance components include perception, concentration, memory, comprehension, and judgement. The FMCR recognizes the dynamic interaction between clients and their environments (physical, cultural, and social).
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).
Rehabilitative frame of reference (FOR) considers rehabilitation as the process of facilitating patients in fulfilling daily activities and social roles with competence. This FOR is used with clients whose underlying impairments are unlikely to remediate and be considerable permanent, or the clients who lack motivation to participate in remediation. The theoretical basis of this FOR is that the client must focus on the remaining abilities, despite of any disabilities, to attain his/her highest level of functioning in the desired occupational performance.
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.
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.