What is Functional Cognition?
Ever had an initial with a client who seems to understand everything you're saying in session, yet you get the feeling they're still struggling to put things into practice day-to-day? That's often where functional cognition comes into play.
Okay, let's think about function - Take a physical disability for an example - someone with an incomplete spinal cord injury may be able to present in an assessment to complete sit to stand and 6 min walking test. They can technically "walk" according to standarised assessment. However over lay that with real life demands - ie. you're not walking on a flat surface for 6 min intervals - they cannot ambulate without their wheelchair in their daily life - their functional mobility is that they require a wheelchair.
Functional cognition is no different. We talk a lot about cognitive abilities – attention, memory, info processing, executive function - but functional cognition is about how your clients actually use those skills in the real world to manage their everyday tasks. It's the difference between knowing how to bake a cake in theory and actually being able to gather the ingredients, follow the recipe, manage the oven temperature, and get it onto a plate!
Think of it like this: someone might have a good memory (a cognitive skill), but their functional cognition is how well they use that memory to remember appointments, medication times, or instructions you've given them. Another client might be able to understand complex ideas (another cognitive skill), but their functional cognition is how effectively they can organise their finances, plan their week, or solve unexpected problems that pop up.
Functional cognition is the bridge between someone's underlying cognitive abilities and their capacity to live independently and participate meaningfully in their daily life. It encompasses a whole range of skills, including:
Organising and planning: Structuring tasks, setting priorities, and managing time.
Initiating and completing tasks: Starting activities and seeing them through to the end.
Managing time and resources: Allocating time and using available resources effectively.
Problem-solving: Identifying and resolving issues that arise in daily life.
Self-awareness: Understanding one's own strengths and weaknesses and how they impact task performance.
When a client faces challenges in their functional cognition, even seemingly simple tasks can become significant hurdles. They might struggle to keep their house tidy, manage their bills, follow a recipe, or even get out the door on time.
Understanding what functional cognition is and how it manifests in daily life is the crucial first step in recognising when your clients might be struggling. In our next episode, we'll start looking at the key things you might observe in your clients that can hint at underlying functional cognition challenges.
– Imogen
