problem solving occupational therapy

Problem Solving: A Teaching and Therapeutic Tool for Older Adults and Their Families

• First Online: 26 November 2014

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• Laura N. Gitlin 2  

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Problem solving is integral to clinical reasoning and everyday occupational therapy practices. It can also be a systematic therapeutic modality for identifying client or family caregiver concerns and teaching new approaches to self-management. This chapter presents a systematic approach to help occupational therapists (OTs) identify target problem areas and potential modifiable contributing factors when working with older adults and families. The approach is applicable to a broad range of clinical problems associated with the consequences and management of chronic illness and provides therapists with an important tool for actively engaging clients in self-management.

The OT needs to have effective communication skills, respecting a family’s values and understanding where they’re coming from.… That’s critical, even more than knowing her intervention strategies.Family caregiver

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Department of Community-Public Health, Center for Innovative Care in Aging, Johns Hopkins University, 525 N. Wolfe Street, Suite 316, Baltimore, MD, 21205, USA

Laura N. Gitlin

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Karolinska Institute Associate Professor, Stockholm Sweden, Nacka, Sweden

Ingrid Söderback

The Case Study of Using Problem Solving for Marie, Living with Alzheimer’s Disease and her daughter Donna

Keywords: Behavioral symptoms, Caregiver burden, Caregiving, Problem solving

Introduction

The theme of this case study concerns family challenges associated with caring for a person with moderate stage dementia and the use of problem solving to identify discrete problem areas and potential solutions.

The students’ tasks include:

To determine strategies to help Donna manage her mother’s behavioral symptoms and to also be able to take better care of herself.

To work with Donna to identify underlying patterns and mutable factors that may be contributing to her mother’s behaviors.

To apply problem solving to come up with a set of strategies Donna agrees to try.

As a starting point, students should use the following references to gather background information.

Important references are:

Gitlin LN, Hodgson N (in press) Caregivers as therapeutic agents in dementia care: The evidence-base for interventions supporting their role. In: Gauglher J and Kane R (eds) Family Caregiving in the New Normal, Elsevier

Gitlin LN (2011) Problem solving in health and illness. In: Craft-Rosenberg M, Pehier S (eds) Encyclopedia of family health, Sage

Gitlin LN (in press) Problem solving: a teaching and therapeutic tool for older adults and family members. In: Söderback I (ed) International handbook of occupational therapy interventions, 2nd edn. Springer, New York, pp 205–216

Overview of the Content

Major goal of the actual interventions are to

Enable the caregiver to prevent, minimize, or reduce behavioral symptoms of her mother

Enhance the mother and the caregiver’s quality of life

Enable the caregiver to find time for herself

Learning Objectives

By the end of studying this chapter the learner will:

Understand how to apply problem solving with families caring for persons with dementia

Identify potential strategies (behavioral, environmental) that can minimize behavioral symptoms

Examine the interactions of persons with dementia, their care environment, and impact on families

The Background History of Mary and Her family

Personal information.

Marie is an 80-year-old female diagnosed with Alzheimer’s disease 4 years ago. She lives with her daughter, Donna, and her daughter’s husband and two teenage sons in a ranch house in a suburban area. Marie has her own bedroom, sitting room, bathroom, and kitchenette in an “in law” suite attached to the family home. Marie was a full-time wife and homemaker who never worked outside the home. Her husband passed away in 2000, and she came to live with Donna a year later as she was having difficulty keeping up with her finances, shopping, and other basic tasks of daily living.

Marie prided herself on her homemaking skills. She was a great cook and loved to bake. She enjoyed knitting and was an active community volunteer first with the children’s school and later (as they grew older) with her local church. She stopped driving her car right after her diagnosis, as she was afraid to drive.

Marie’s daughter reports that she appears to be easily agitated, highly anxious, and keeps repeating the same questions over and over with her (e.g., where are you going? When are we eating?). She has been resisting going out of the house for family dinners at the local restaurant or to attend church. She tends to become anxious and fearful when it is time to leave the house for anything (appointments, outings, etc.).

Donna is finding it increasingly difficult caring for her mother and attending to her other responsibilities including a part time job in her local school system, being there for her two sons and husband, attending to her household responsibilities, and taking care of herself. She is feeling very stretched and indicated she is having difficulty sleeping, feels very tired and alone, and feels very sad everyday to see her mom the way she is now. Donna wants help but is reluctant to ask anyone else to help her with her mom. She also can be a perfectionist and wants things done a certain way in her home.

Medical Diagnoses and Prognoses

Marie has dementia , most likely of the Alzheimer’s type. She is in the moderate stage of the disease, which is a progressively degenerative disease process. Her short-term memory is poor and she is having increasing difficulty initiating, planning, and organizing activities she used to do (e.g., cook a meal) demonstrating executive functional challenges. She continues to have some insight, although limited, of her cognitive changes. She is becoming increasingly agitated and confused as she loses her cognitive abilities. She is in relatively good physical condition with no other chronic conditions. Her vision is good with glasses but she is experiencing some hearing loss although she does not wear a hearing aid. While her ambulation in general is good, she did fall 6 months ago—she tripped over the carpet and fell to the ground. She was bruised but no bones were broken.

Reason for Seeking Occupational Therapy

Marie is experiencing behavioral symptoms, which prompted her physician to be concerned about her home safety and daily function. She suggested occupational therapy to assess Marie’s safety at home and to work with the caregiver to teach her behavioral management skills.

Occupational Performance Issues

Marie used to cook but is having difficulty knowing what to do in the kitchen. This frustrates her. She is also having increasing difficulty dressing and bathing herself, but she does not want any help from her daughter. She is starting to look a little raggedy which is not like her previous self.

The Student’s Report

The following guiding questions have been identified in developing possible solutions for Marie and Donna. These questions are generated from the available literature references and our clinical experiences:

What specific questions would you ask the caregiver to learn about her mother’s presenting behaviors?

What would you like to learn about Marie’s day?

What would you like to learn about the relationship of Donna and her mother?

What aspects of the physical and social environment would you want to learn about and/or for which you may have potential concerns?

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Gitlin, L. (2015). Problem Solving: A Teaching and Therapeutic Tool for Older Adults and Their Families. In: Söderback, I. (eds) International Handbook of Occupational Therapy Interventions. Springer, Cham. https://doi.org/10.1007/978-3-319-08141-0_27

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Occupational Therapy Go

Clinical Reasoning in Occupational Therapy: A Comprehensive Guide

Clinical reasoning is the backbone of effective decision-making and problem-solving in occupational therapy (OT). It enables therapists to analyze complex situations, gather information, and develop tailored treatment plans for their clients. In this blog post, we will delve into the intricacies of clinical reasoning in occupational therapy, exploring its importance, key components, and practical strategies. Whether you’re a seasoned occupational therapist or a student just starting your journey, this guide will empower you to enhance your clinical reasoning skills and deliver optimal outcomes for your patients.

Important of Clinical Reasoning in OT

The Significance of Clinical Reasoning in Occupational Therapy At the core of occupational therapy lies the process of clinical reasoning. This cognitive process allows therapists to integrate knowledge, clinical expertise, and patient values to make informed decisions. Here’s why clinical reasoning is paramount in occupational therapy:

• Promotes Personalized Treatment: Clinical reasoning enables occupational therapists to individualize treatment plans based on the unique needs and goals of each client. By analyzing client factors, activity demands, and environmental considerations, therapists can tailor interventions to maximize functional outcomes.
• Enhances Problem-Solving Abilities: Occupational therapists face diverse challenges and must navigate complex client situations. Clinical reasoning equips them with the skills to identify problems, explore potential solutions, and make sound judgments that optimize intervention effectiveness.
• Facilitates Evidence-Based Practice: Clinical reasoning guides therapists in critically evaluating research evidence and integrating it with their clinical expertise. This ensures that therapeutic interventions are grounded in the latest scientific knowledge and align with best practices.

Components of Clinical Reasoning in OT

Components of Clinical Reasoning in Occupational Therapy To fully grasp clinical reasoning in occupational therapy, it’s essential to understand its core components. Here are the key elements involved:

Strategy of Clinical Reasoning for OT

Strategies for Enhancing Clinical Reasoning in Occupational Therapy

• Continual Professional Development: Engage in ongoing learning and attend relevant workshops, conferences, and seminars to stay updated with the latest evidence-based practices and research.
• Reflective Practice: Regularly reflect on clinical experiences, seeking to understand the reasoning behind your decisions and analyzing the outcomes. This introspection helps refine your clinical reasoning skills over time.
• Collaborative Approach: Foster open communication and collaboration with colleagues, clients, and other healthcare professionals to gain diverse perspectives and enhance your problem-solving abilities.
• Utilize Clinical Tools: Make use of standardized assessment tools, clinical guidelines, and evidence-based resources to support your clinical reasoning process.

FAQ: Frequently Asked Questions about Clinical Reasoning in Occupational Therapy

Q1: What role does clinical reasoning play in the occupational therapy process?

A1: Clinical reasoning serves as the foundation for decision-making in occupational therapy. It guides therapists in analyzing client information, identifying problems, setting goals, planning interventions, and evaluating outcomes.

Q2: How can I improve my clinical reasoning skills?

A2: Enhancing clinical reasoning skills requires a combination of ongoing learning, reflective practice, collaboration, and utilization of clinical tools. Engaging in professional development activities and

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Can strengthening older adults' problem-solving skills through occupational therapy improve their occupational performance? A protocol for a systematic review and meta-analysis

Affiliations.

• 1 Department of Occupational Therapy, VIA University College, Aarhus, Denmark.
• 2 Programme for rehabilitation, VIA University College Research Centre for Health and Welfare Technology, Aarhus, Denmark.
• PMID: 32544358
• DOI: 10.1080/11038128.2020.1775886

Background: Older adults' occupational performance is challenged due to chronic health conditions, aging processes, and deteriorating functioning. Thus, their occupational performance cannot be expected to remain stable in the long term after an occupational therapy intervention. Older adults may therefore need to strengthen their problem-solving skills during occupational therapy not only to solve current occupational performance issues but also to maintain their improvements and deal with new such issues a later point in time.

Aims: This systematic review and meta-analysis aims to identify, analyse and present current scientific knowledge about the effectiveness and contents of occupational therapy interventions aimed at improving older adults' occupational performance by strengthening their problem-solving skills.

Methods: MEDLINE, EMBASE, CINAHL and PsycINFO will be searched systematically to identify trials of occupational therapy interventions aimed at improving older adults' occupational performance by strengthening their problem-solving skills. We will include randomized controlled trials and quasi-experimental trials in populations aged 65+. Three reviewers will independently screen and select references, extract data and assess the quality of included studies using the Cochrane Collaboration's risk of bias tool.

Significance: The findings can inform and inspire clinical practice and will help to identify the need for further research.

Keywords: Activities of Daily Living (ADL); elderly; functioning; occupational performance; occupational therapy; older adults; problem-solving; systematic review.

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• Strengthening problem-solving skills through occupational therapy to improve older adults' occupational performance - A systematic review. Nielsen TL, Holst-Stensborg HW, Nielsen LM. Nielsen TL, et al. Scand J Occup Ther. 2023 Jan;30(1):1-13. doi: 10.1080/11038128.2022.2112281. Epub 2022 Aug 22. Scand J Occup Ther. 2023. PMID: 35995214 Review.
• What are the short-term and long-term effects of occupation-focused and occupation-based occupational therapy in the home on older adults' occupational performance? A systematic review. Nielsen TL, Petersen KS, Nielsen CV, Strøm J, Ehlers MM, Bjerrum M. Nielsen TL, et al. Scand J Occup Ther. 2017 Jul;24(4):235-248. doi: 10.1080/11038128.2016.1245357. Epub 2016 Oct 21. Scand J Occup Ther. 2017. PMID: 27769123 Review.
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Executive Functioning Occupational Therapy: Enhancing Daily Life Skills

In this post, you will learn: Explore Executive Functioning Occupational Therapy: a comprehensive guide to enhancing daily life skills. Learn targeted strategies and interventions for improved cognitive control and adaptability.

Occupational therapy plays a crucial role in enhancing the quality of life for individuals with executive functioning challenges. Executive functions are a set of cognitive processes that allow us to plan, organize, initiate, and complete tasks. These processes are essential for successful daily living and can significantly impact one's ability to perform various occupations, including school, work, and social activities.

In recent years, the focus on executive functioning within the field of occupational therapy has grown, with practitioners developing targeted interventions and strategies to help individuals struggling with these cognitive processes. Occupational therapists work closely with clients to identify strengths, areas of improvement, and potential barriers to success while tailoring a customized approach to address cognitive needs effectively.

Key Takeaways

• Executive functioning is crucial for daily living, impacting performance in various occupations and activities.
• Occupational therapists play a vital role in helping individuals with executive functioning challenges.
• Personalized strategies and interventions in occupational therapy address cognitive needs effectively and enhance quality of life.

Understanding Executive Functioning

Defining executive function.

Executive function refers to a set of cognitive processes that enable individuals to manage and regulate their thoughts, emotions, and actions. These mental skills encompass problem-solving, self-reflection, and metacognition. In other words, executive functions help us make decisions, plan, organize, and monitor our performance in daily activities. We use these skills constantly, whether we’re at home, work, or school.

Importance of Executive Functioning

Developing strong executive function skills significantly impacts our daily lives and overall well-being. These cognitive abilities help us maintain a positive mindset, increase self-awareness, and adapt to changing situations. In children and youth, strong executive functions are crucial for academic success, social-emotional growth, and self-regulation. Similarly, for adults, these cognitive processes play a vital role in occupational performance, personal relationships, and mental health.

Assessing Executive Function Skills

Evaluating executive function skills can provide valuable insights into an individual's cognitive abilities and help tailor interventions to address specific deficits. In occupational therapy, tests such as the Executive Function Performance Test can help therapists determine the level of support individuals need following a stroke. By assessing and understanding the cognitive deficits of individuals, we can help families and support systems provide the appropriate assistance in daily life.

In summary, understanding executive functioning is essential for ensuring success and well-being in various aspects of life. As occupational therapists, it's our responsibility to develop and apply interventions that enhance executive function skills and promote optimal performance in daily activities.

Related Executive Function Posts You Will Love!

Improving Executive Function: Top Tips for Boosting Brain Power

Executive Function Skills List: A Quick Guide for Success

Occupational Therapy and Executive Functioning

Role of occupational therapy.

In occupational therapy, we aim to assist individuals in developing and maintaining their functional abilities. One aspect we focus on is executive functioning, which involves initiation, self-monitoring, and regulation of behaviors. These are all critical components in a person's daily life, allowing them to successfully navigate various tasks and situations.

We recognize the importance of addressing executive functioning skills in children and youth, as it can significantly impact their overall development and occupational performance. By implementing therapeutic interventions targeting executive functions, we can support our clients in reaching their full potential and increase their participation in meaningful activities.

Importance of Intervention

Intervening early in cases where individuals show difficulty with executive functions is crucial. Providing proper support and guidance can make a huge difference in their ability to navigate daily tasks, succeed in school, and interact with others. By incorporating executive functioning strategies and activities into our occupational therapy sessions, we can foster better self-awareness, problem-solving, and decision-making skills in our clients.

Furthermore, as occupational therapists, we recognize the need for adaptation and flexibility in our approach. We understand that each person comes with a unique set of strengths and areas for improvement. Keeping this in mind, we tailor our interventions to best meet the needs of each individual, continually reevaluating our methods to ensure optimal outcomes.

Measuring Occupational Performance

In order to assess the impact of our interventions on executive functions, we use various tools to measure occupational performance. One such method is the Executive Function Performance Test (EFPT) , which allows us to evaluate higher-level cognitive functions through the use of a structured cueing and scoring system.

In addition to standardized assessments, we also utilize goal setting, informal observations, and feedback from clients, families, and other professionals to gauge progress and guide our interventions. This comprehensive approach enables us to monitor our clients' development and continually adapt our therapy sessions to support their growth in executive functioning skills best.

Practical Approaches in Occupational Therapy

In occupational therapy sessions, we focus on several approaches to support the development of executive functioning skills. These approaches include task management strategies, attention improvement techniques, and fostering organization skills.

Strategies for Task Management

When it comes to task management, we believe in breaking tasks into smaller, achievable steps to facilitate task initiation and completion. Here are a few methods we use in our sessions:

• Chunking : We break down larger tasks into smaller, more manageable parts.
• Visual supports : We utilize visual aids such as checklists and schedules to help clients manage their tasks effectively.
• Timers : We encourage the use of timers to support time management and keep clients on track with their tasks.
• Positive reinforcement : We provide feedback and praise for task initiation and completion to boost motivation and self-confidence.

Techniques for Attention Improvement

To help improve attention, we employ various techniques to keep our clients engaged and focused during occupational therapy sessions. Some of the methods we utilize include:

• Fidget tools : We provide tools like stress balls, fidget spinners, or alternate seating options to help clients channel their excess energy and maintain focus.
• Mindfulness practices : We incorporate mindfulness exercises, such as deep breathing and guided meditation, to help clients center their thoughts and improve their attention.
• Individualized attention strategies : We work with clients to identify personal techniques that help them maintain focus, such as taking short breaks or using white noise.

Approaches for Fostering Organization Skills

Developing organization skills is essential for managing daily tasks effectively. We focus on the following methods to help clients improve their organizing abilities:

• Visual organization aids : We use visual tools like color-coding systems and labels to help clients categorize and arrange items logically.
• Routines and schedules : We assist clients in establishing daily routines and schedules to promote predictability and organization in their lives.
• Goal setting : We work with clients to set realistic and attainable goals related to organization, such as decluttering a specific area or maintaining an organized workspace.

By incorporating these practical approaches in our occupational therapy sessions, we strive to foster the development of essential executive functioning skills, including task management, attention improvement, and organization.

Working with Different Groups

In our occupational therapy practice, we work with various groups of individuals, focusing on their unique needs and challenges. This allows us to tailor our interventions and support to help them achieve their goals and improve their executive functioning skills. In this section, we will discuss three specific groups that we cater to: children, individuals with autism, and people with mental health needs.

Occupational Therapy for Children

We believe that it's essential to address executive functioning challenges early in life, as these skills are crucial for success in school and daily activities. Our approach with children involves using play-based and engaging activities that help them develop and improve their planning, organization, time management, and self-regulation skills. By incorporating fun and enjoyable tasks, we can create a positive environment that fosters growth and development, ultimately supporting their overall well-being.

Supporting Autistic Individuals

A significant portion of our work involves helping autistic individuals, who often face unique challenges related to executive functioning. Autism spectrum disorder has been linked to deficits in motor skills and executive function, impacting their ability to succeed in school, work, and other aspects of life. Our approach in this area is tailored to the specific needs of each individual, using a combination of therapies that address both fine and gross motor skills development, as well as targeted interventions to improve executive functions.

Catering to Mental Health Needs

Lastly, we are dedicated to supporting individuals with mental health needs, as executive function deficits have been associated with various mental health disorders. In fact, improving executive function can be essential for these individuals to succeed in their work, education, and daily living pursuits. We establish a safe and supportive environment for our clients to work on practical problem-solving, emotional regulation, and self-monitoring strategies. By focusing on these elements, we aim to help them overcome the barriers they face due to executive function challenges and enhance their overall quality of life.

Executive Function Coaching

Coaching model.

In our executive function coaching, we focus on helping individuals improve their cognitive abilities related to planning, organizing , and problem-solving. We utilize a personalized coaching model that aims to enhance clients' self-regulation skills, adaptability, and overall executive functioning.

Our coaching model is a blend of one-on-one sessions and group activities. Through individualized coaching sessions, we assess each client's unique strengths and weaknesses and create a specialized plan tailored to their needs. Collaborative group activities allow clients to practice newly acquired executive functioning skills in real-life situations and offer an opportunity for peer feedback and support.

Professional Development

Continuous professional development is vital for the success of our executive function coaching program. Engaging in ongoing training and education ensures that we stay updated on the latest research and methods in occupational therapy. One way we do this is through the use of online training modules. I really enjoyed taking executive function continuing education courses from Sensational Brain. You can check it out here!

Conferences, seminars, and workshops are also an essential part of our professional development. These events provide a venue for our team to learn from leading experts in the field, share their own experiences, and network with other professionals.

Resources for Executive Functioning

Free resources.

As occupational therapists, we understand that finding free resources for executive functioning can be crucial for some families and practitioners. One excellent source for information and support is the American Occupational Therapy Association , which offers various resources, including research articles focused on executive functioning lens for occupational therapy with children and youth .

In addition to professional organizations, various websites and online platforms provide free resources. These may include printable worksheets, activities, and guides to help improve executive functioning skills in children and adolescents.

You can get this free executive function checklist by subscribing to my email list below!

Useful Products

Occupational therapists often recommend specific products to help clients develop and enhance their executive functioning skills. These products may vary from board games that promote planning and problem-solving skills to books that teach time management and organization strategies. Some popular choices include:

• Timer apps for smartphones, which can help clients stay on task and manage their time more effectively
• Color-coded organization systems, such as folders, calendars, and planners, to help clients visually structure their day-to-day activities
• Board games and puzzles that stimulate cognitive skills like planning, attention, and decision-making

Blogs and Popular Topics

As we explore the world of executive functioning and occupational therapy, we often come across informative blogs and websites that discuss popular topics in the field. Some notable blogs might cover innovative therapy techniques, case studies, or trending issues related to executive functioning. For example, the SAGE Journals offers a paper about putting executive performance in a theoretical context, useful for occupational therapists.

Special Topics in Executive Functioning

Inhibition and self-control.

In our practice as occupational therapists, we often encounter individuals with challenges in inhibition and self-control. These aspects of executive functioning play a vital role in regulating behavior and emotions. Inhibition involves the ability to resist impulses and distractions, while self-control focuses on managing emotions and maintaining appropriate behavior.

Working memory is essential for inhibition and self-control as it helps individuals hold and process information to make well-informed decisions. By addressing these executive functioning skills, we can help our clients improve emotional control and behavioral inhibition, leading to better overall functioning in daily life.

Effects on Processing Speed

Processing speed is another crucial aspect of executive functioning that may impact an individual's performance in various tasks. It refers to the rate at which individuals can process and understand information. Executive functioning challenges, such as deficits in working memory or inhibition, can directly affect processing speed.

As occupational therapists, we strive to address these issues by implementing interventions designed to enhance processing speed and overall executive functioning. By doing so, we can help our clients function more effectively in their daily tasks and routines.

Impact of Sensory Factors

Lastly, sensory factors play a significant role in executive functioning as well. Sensory processing refers to the way our brains receive and interpret sensory information from the environment. When sensory processing is compromised, it can impact executive functioning skills, such as working memory, emotional control, and self-regulation.

In our practice, we consider the unique sensory needs of our clients and work on developing sensory executive functioning skills. By addressing sensory factors, we can help our clients better cope with their environment and improve overall executive functioning. This approach enables us to provide comprehensive interventions that cater to the individual needs of each client.ÎÅ

Executive Function and Occupational Therapy

We've explored the importance of executive functioning in occupational therapy and discussed various aspects such as impulse control, flexible thinking, foresight, and hindsight. Executive functioning plays a significant role in our daily lives, and its impact on children and adolescents has been highlighted in occupational therapy literature .

As we've seen, occupational therapy can provide support and interventions for individuals with executive functioning challenges, enabling them to improve their performance in daily tasks and activities. Evidence from studies like this preliminary study demonstrates the value of occupational therapy in addressing executive function-related issues and providing screening and treatment to help individuals achieve better outcomes.

Introducing tools like the impulse control journal and incorporating strategies to develop flexible thinking can be beneficial for both clinicians and clients. By promoting foresight and hindsight, we can help people adapt to situations, learn from past experiences, and plan for the future.

We hope we've highlighted the relevance of executive functioning and occupational therapy. Continued research and awareness of this topic will undoubtedly contribute to developing more effective interventions and improved outcomes for individuals facing executive functioning challenges.

Frequently Asked Questions

What are common activities for enhancing executive function in adults.

There are several activities that can help adults enhance their executive function. Some popular ones include:

• Task management: Encouraging the use of to-do lists, setting priorities, and breaking down tasks into smaller, manageable steps.
• Planning and organization: Providing support in setting goals, identifying resources, and creating timelines to accomplish tasks more efficiently.
• Memory training: Encouraging the use of mnemonic devices and practicing recall strategies.
• Cognitive exercises: Engaging in activities such as crossword puzzles or Sudoku can help improve problem-solving, memory, and attention skills. For more activities, you may refer to the Dream Home Assessment study.

How can an occupational therapist help improve problem-solving?

Occupational therapists can help improve problem-solving skills by:

• Assessing a person's strengths and weaknesses related to problem-solving.
• Developing an individualized intervention plan with specific goals and strategies.
• Collaborating on the creation of practical scenarios to practice problem-solving skills.
• Monitoring progress, adjusting the intervention plan as needed, and providing regular feedback.

What are the key components of a skills checklist for executive functioning?

A skills checklist for executive functioning often includes:

• Response inhibition: The ability to think before acting.
• Working memory: The capacity to hold and manipulate information for short periods.
• Emotional control: The ability to manage and regulate emotions.
• Task initiation and completion: The ability to begin and complete tasks in a timely manner.
• Planning: The skill of organizing information and tasks, then executing a plan.
• Organization of materials: The ability to organize personal belongings and workspace.

At what age do executive function skills typically develop?

Executive function skills develop gradually throughout childhood and adolescence. Some essential executive functioning milestones include:

• Between 2-3 years: Developing basic attention, beginning to control emotions, and early problem-solving skills.
• Between 5-7 years: Increasing working memory capacity, more advanced problem-solving, and the ability to plan and complete simple tasks.
• Between 12-18 years: A substantial development of executive functioning skills, including abstract thinking, reasoning, multitasking, and self-monitoring.

What are some effective games for improving executive functioning?

Fun and engaging games can help improve executive functioning skills. Some examples are:

• Memory games: Classic card-matching games or apps that challenge working memory.
• Board games: Strategy games like chess, checkers, or Settlers of Catan can improve planning and problem-solving skills.
• Puzzles: Jigsaw, Sudoku, and crossword puzzles can help with visual-spatial processing and attention to detail.
• Brain teasers: Riddles, logic puzzles, and lateral thinking challenges can improve critical thinking and cognitive flexibility.

What is the role of occupational therapy in promoting executive function?

Occupational therapists play a crucial role in promoting executive function by:

• Assessing an individual's strengths and weaknesses in executive functioning.
• Developing targeted interventions to address specific skills deficits.
• Collaborating with the client on goal setting and intervention strategies.
• Monitoring and adjusting the intervention plan based on the client's progress.

For more information on occupational therapy and executive functioning, you can refer to this scoping review of the literature .

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Functional Cognition and OT: Our Time to Shine

One of things I love most about being an occupational therapist is the huge diversity in our scope of practice . Bridging the gap between physical therapy and speech pathology, occupational therapy practitioners truly get the best of both worlds. We are able to dip our hands into orthopedic conditions as well as cognitive impairments (via neuro rehab).

While we typically consider speech therapists the cognitive and language experts, occupational therapists do play a big part in cognitive therapy. Functional cognition relates to the cognitive skills required to complete those meaningful daily activities that we all know so well.

So What Do These Self-Care Tasks Include?

For OTs, these instrumental ADLs (or IADLs) include tasks such as online shopping or planning a weekly menu and grocery list. Treatment for functional cognition is truly a place for OTs to let our creativity shine. You probably have endless books with cognitive worksheets for patients to complete. But I would suggest ditching those for a bit, and bring it all back to our roots (aka: function ).

Think outside the box – I bet you can create some awesome activities or “worksheets” that are much more realistic and applicable to everyday life.

Everyday tasks don’t require just one cognitive component. We use memory, attention, problem solving, etc., cohesively to complete necessary tasks. So let’s think about the wide assortment of tasks we complete every day as adults.

Of course, some of these tasks will vary depending on the age range of your patients. Patients who are still working or have children will have different responsibilities, and thus a different set of IADLs, than those who are retired or are living in independent living/assisted living communities.

OTs are typically most attuned to two cognitively-related IADLs: paying bills and medication management. But adults obviously have so many more responsibilities, so why does our toolbox stop there?

As a parent, I can think about what I am responsible for and use that as a basis for forming challenging tasks for my patients.

• Make a weekly meal plan and coordinated grocery list
• Schedule my son’s before and after school sessions
• Make doctor’s appointments and write them on our family calendar
• Write checks to daycare
• Pay lunch money online
• Plan out a gift list for Christmas
• Manage the spending for each of my kids and nieces or nephews
• Figure out how long it will take me to get to various stores or offices using my phone map
• Plan vacations and date nights

The list goes on! We are all responsible for so many daily tasks.. And so are our patients. So get out there and find out what they personally need to do to help them live life to their fullest potential.

Functional Cognition and Mealtime

Planning a weekly meal schedule is such a common and necessary task, and one that can change each week since we typically don’t eat the same things over and over!

Have your patient write out a week’s worth of basic dinners, and under each item include the required ingredients. They can use that list as their shopping list, or combine ingredients if the meals match up well.

Prior to shopping for ingredients, have them look through a local grocery store’s ads to find items on sale that might correspond to their list. Did they choose ordering pizza one night? Locate the pizza restaurant of their choice on their phone and identify what they want to order.

If you are working with someone experiencing aphasia or even processing difficulties, consider simulating a call to the restaurant with you providing the prompts for ordering delivery, which includes asking for their phone number, what they would like to order, how they will pay, and their address.

Scheduling and Timing Appointments

We probably all have used calendar tasks with patients, having them organize a series of events onto specific calendar dates. But simply writing appointments down on a calendar does not cover the entire task requirement. We can work on functional math when determining when to leave home for appointments depending on how early we need to be there.

For example, if you made a doctor appointment for 1:15 pm and the office is 15 minutes away from your house, how early should you leave to arrive 10 minutes early? Rather than simply work on writing a patient’s name, address, and phone number correctly on a blank piece of paper, simulate this requirement in a real-life situation – have them fill out a doctor office new patient form.

Money Management 

Managing money does not have to end at paying bills and balancing your checking accounts. As shopping online is so prevalent these days, it is a necessary addition to your intervention activities. Start with a designated task, such as planning a birthday party.

Involve all aspects of organizing the party, writing down whom to invite, food/snacks to be served, supplies needed, etc. Use the list to shop for supplies online and find a bakery that is close to their house (using their phone’s Map app) so that they can order a cake. Search for supplies on Amazon and write down the cost of each item.

Downgrade the task by providing a pre-fabricated list of supplies (rather than having them independently create one), and direct them to choose items that are most appropriate and required for a birthday party. Simulate a call to the bakery and take their cake order.

Have them calculate the total cost of the birthday party supplies and food (or separate these depending on how you grade the task).

You can use the same method for any entertainment activity and create varying challenges: going to the movies, planning a day out with a child or grandchild, or creating an estimated budget for a Christmas gift list.

Creating Your Own Scenarios

I seem to be making a case for task-specific simulation in intervention. We do this constantly with ADL practice, so why not up the ante on how we address functional cognition and use the same practice? With some spare time you can create your own scenarios, and you may enjoy doing it!

The University of Utah’s College of Health has a great resource for OT therapeutic activities that includes online bill paying (including utilities and credit cards) as well as a new online shopping activity – check this out to get you started.

Otherwise, have fun! Enjoy flexing your creative muscles and coming up with a product you can be proud of.

How do you like to incorporate functional cognition in your OT interventions? Please share your favorite functional cognition intervention tips and ideas in the comments below. 

And for even more about working in neuro occupational therapy in general, you can also check out Renee’s Day in the Life as an Outpatient Neuro Occupational Therapist here .

This post was originally published on April 6, 2020 and last updated on February 26, 2024.

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Executive Function Games

Colleen beck otr/l.

• by Colleen Beck OTR/L
• November 27, 2023

These executive function games are specifically selected to improve attention, organization, focus, working memory, and other executive functioning skills. Executive function is a set of cognitive skills that allows us to perform tasks.

Use this list of games and toys to help kids build and establish executive functioning skills in the home, school, or community. These are great games to use in therapy to boost executive function for improved independence, safety, and task completion.

Kids, teens, and young adults are developing executie functioning skills up through the early twenties and even early thirties in order to accomplish daily life tasks. The key to building skills in attention, focus, prioritization, etc. is practice!

Actually trying and trying again when unsuccessful is a huge strategy when it comes to practicing executive functioning skills, but games and toys are a fun way to develop these skill.

Amazon affiliate links are included in this blog post. As an Amazon Influencer, I earn from qualifying purchases.

Executive function games

There are some really fun and engaging games and toys for executive functioning skill development out there! We’ve broken down some of our top picks for building skills in distraction, planning, prioritization, self-control, and other areas of executive function.

Other tools you might like include our self-awareness games . These support executive functioning skills and overall awareness of tools that an individual might need to use.

You might want to check out our blog post on handwriting games for more ideas. Using pencil and paper games can target handwriting and executive functioning skills, which has a connection.

Head Rush (affiliate link) is a game that targets the development of mindfulness, empathy, and open communication. This is a great therapy game for helping kids develop communication tools with family and friends, especially when voicing their personal challenges and emotions.

This game would be perfect for family game night!  

Visual Brainstorms Game  (affiliate link) can help kids address executive functioning abilities by addressing problem solving, prioritizing, reasoning, logic, and abstract thinking.  

Learning Self-Control in School  (affiliate link) is a game that addresses planning, attention, and consequences to behaviors.     

The game Actions and Consequences  (affiliate link) can help kids learn that their actions have consequences! It’s a good game for younger kids.  

  The  Original Memory Game  (affiliate link) is the one that has spurred a TON of varieties of matching, memory, and concentration.   

Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to [email protected].

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Occupational Therapist, OT - Visits

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• Area: Occupational Therapy
• Employment Type: Per Diem
• Published: Aug 28 2024
• Location: Middletown / Delaware

Description

$7,500 sign on bonus for full time.

BAYADA Home Health Care is currently seeking an Occupational Therapist, OT, for a Part Time or Full Time opportunity performing home health visits. This office services adult and geriatric patients on a per visit basis in homes throughout Cecil County .

As a home care Occupational Therapist, you will be an integral member of a multi-disciplinary health care team that provides rehabilitative care and skilled nursing to clients, affording them the opportunity to receive the medical care required to remain at home.

Occupational Therapist, OT Responsibilities:

• Make home visits to clients in designated geographic territories.
• Perform thorough evaluations of patients’ functional status, including muscle function, endurance, visual coordination, written and verbal communication skills, and ADL and IADL performance.
• Assess cognitive, psychological and motor aspects of performance and develop individualized intervention plans to achieve favorable outcomes.
• Evaluate home environment for hazards or barriers to more independent living.
• Identify equipment needs and environmental adaptations resulting in enhanced outcomes for clients.
• Continually assess and revise the occupational therapy care plan, and participate with nursing in the multidisciplinary care plan, as appropriate.
• Educate and instruct patients, family members, or other patient representatives, in rehabilitative care and activities necessary to promote the client's health, safety and independent living.
• Accurately document observations, interventions, and evaluations pertaining to patient care management and services provided, utilizing a state-of-the-art touch pad tablet.

Occupational Therapist, OT Qualifications:

• A current MD Occupational Therapist license.
• Prior home care experience preferred, but not required
• A minimum of one year of recent work experience as an Occupational Therapist.
• Graduation from an occupational therapy program accredited jointly by the Committee on Allied Health Education and Accreditation of the AMA and the AOTA, as indicated by school transcript or diploma.
• Ability to work independently and manage time effectively.
• Strong interpersonal skills, organizational skills, and problem solving skills.
• Solid computer skills; prior experience with electronic medical records (EMR) preferred.

BAYADA believes that our employees are our greatest asset:

• Enjoy being part of a team that cares and a company that believes in leading with our values.
• Feel confident, safe, and supported with PPE supplies, comprehensive infection prevention protocol, daily pre-screens, and close monitoring of the COVID-19 outbreak.
• Develop your skills with training and scholarship opportunities.
• Advance your career with specially designed career tracks.
• Be recognized and rewarded for your compassion, excellence, and reliability.
• Benefits may include mileage reimbursement; weekly pay and direct deposit; scholarship opportunities; one-on-one training; recognition programs; referral bonuses; 401(k) with company match; and opportunities for career advancement.

BAYADA believes that our clients and their families deserve home health care delivered with compassion, excellence, and reliability. Be part of a caring, professional team that is instrumental in providing the highest quality care while developing your career with an industry leader. Apply now for immediate consideration.

As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates.

BAYADA Home Health Care, Inc., and its associated entities and joint venture partners, are Equal Opportunity Employers. All employment decisions are made on a non-discriminatory basis without regard to sex, race, color, age, disability, pregnancy or maternity, sexual orientation, gender identity, citizenship status, military status, or any other similarly protected status in accordance with federal, state and local laws. Hence, we strongly encourage applications from people with these identities or who are members of other marginalized communities.

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