Key Takeaways:
Returning to work after a neurological injury or mental health challenge is a pivotal milestone in a individual’s rehabilitation journey. Occupational therapists (OTs) play a crucial role in this transition by evaluating and enhancing the cognitive skills essential for workplace success. While physical recovery is often emphasized, cognitive readiness is equally vital for sustainable reintegration into employment.
Maysn's story: A case study
At just 24 years old, Maysyn was victim of 2 life altering strokes. Together, Neurofit, Maysyn and her clinical team worked together to adapt to her new life, seeing growth in memory, attention and processing, alongside building hope for her future. Using Neurofit, the team evaluated these 5 following cognitive domains, adapting to Maysyn's needs to build confidence and independence. Check out the full case study here: Maysyn's story
I. Executive Functioning
Executive functions encompass higher-order cognitive processes such as planning, organizing, initiating tasks, and regulating emotions [1]. These skills are fundamental for managing complex work tasks and adapting to dynamic workplace environments.
Clinical insight: Deficits in executive functioning can lead to difficulties in task management, problem solving, and maintaining productivity. Research indicates that occupational therapy interventions targeting executive functioning can significantly improve work performance and facilitate RTW outcomes [2].
Tools: The Executive Function Performance Test (EFPT) is a top-down performance assessment designed to examine cognitive integration and functioning. Check out a free version of the tool here: Executive Function Performance Test
II. Attention and Concentration
Sustained attention and the ability to concentrate are critical for performing job tasks efficiently and safely. These skills enable individuals to focus on tasks, process information accurately, and respond to workplace demands.
Clinical insight: Impairments in attention can result in errors, decreased productivity and increased risk of workplace accidents. Studies have shown that cognitive rehabilitation focusing on attention enhancement leads to improved occupational performance and supports successful RTW [3].
Tools: The Test of Every Day Attention (TEA) is a comprehensive attention test that measures different aspects of attention including selective attention, sustained attention, and attentional switching — using everyday materials. View the tool here: Test of Every Day Attention (TEA)
III. Working Memory
Working memory involves the temporary storage and manipulation of information necessary for complex cognitive tasks. It is essential for following instructions, problem-solving, and decision-making in the workplace.
Clinical Insight: Deficits in working memory can hinder an individual’s ability to perform multi-step tasks and adapt to new information or procedures. Occupational therapy interventions that include working memory have been effective in enhancing and maintaining working memory years after injury.
Tools: The Wide Range Assessment of Memory and learning (WRAML) measures short- and long-term memory function in children and adults. Check out the tool here: Wide Range Assessment of Memory and learning (WRAML)
IV. Processing Speed
Processing speed refers to the pace at which individuals perceive, interpret and respond to information. In fast-paced work environments, efficient processing speed is vital for meeting deadlines and managing workloads. It is also closely related to verbal and visual working memory [4].
Clinical insights: Reduced processing speed can lead to slower task completion, increased errors and heightened stress levels, which can be counteractive to a successful RTW program. In fact, processing speed has been described as one of the key cognitive domain for successful employment following neurological injury [5].
Tools: The Pattern Comprehension Processing Speed Test (PCPST) is a short and easy to implement tool developed by the NIH to assess processing speed. Check out the tool here: The Pattern Comprehension Processing Speed Test (PCPST)
V. Emotional Regulation and Stress Tolerance
The ability to manage emotions and cope with stress is crucial for maintaining workplace relationships and handling job related pressures. Emotional regulation impacts decision-making, conflict resolution, and coverall job satisfaction
Clinical insight: Challenges in emotional regulation can result in interpersonal conflicts, decreased motivation and absenteeism. OT interventions focusing on emotional regulation techniques, such as mindfulness and cognitive-behavioural strategies are effective in enhancing resilience and supporting RTW [6].
Tools: The Difficulty in Emotional Regulation Scales (DERS) is designed to provide insights into an individual’s ability to understand, accept and mange emotions effectively. Check out the tool here: The Difficulty in Emotional Regulation Scales (DERS)
Integrating Cognitive assessments into OT practice and RTW management
To effectively support their clients in their RTW journey, OTs should incorporate comprehensive cognitive assessments in their practice. Utilizing standardized measurements and individualized evaluations allows for the identification of specific cognitive deficits and development of targeted intervention plans. Each individual’s rehabilitation journey will be different.
One major problem facing clinicians is the variety, time, and cost of assessment tools. Success for clinicians and client can be facilitated by unified, easy to implement systems that assess multiple cognitive domains and track progress over time.
Neurofit provides a gamified approach to improving cognitive outcomes and facilitate RTW rehabilitation. The carefully designed virtual tasks are designed to target key cognitive outcomes including executive functioning, memory and processing, while monitoring engagement and mood. It also provides easy-to-use dashboards for clinicians to monitor client progress and adjust challenge levels according to client feedback. Neurofit is one example of technological development that will help redefine the standard of care, facilitating the best outcomes for both clients and clinicians.
Check out Neurofit’s platform and sign up for a free demo on our website to see how Neurofit can facilitate your practice and client outcomes: https://www.neurofit.ca/
Conclusions:
Cognitive readiness is a critical component of successful RTW outcomes. By systematically assessing and addressing executive functioning, attention, working memory, processing speed, and emotional regulation, OTs can empower clients to navigate the complexities of the workplace effectively. Integrating evidence-based cognitive assessments and interventions into occupational therapy practice not only enhances individual client outcomes but also contributes to broader workforce productivity and well-being.
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