Professional Documents
Culture Documents
Presenters
Joan Toglia OTR/L, PhD, FAOTA
Dean & Professor, Occupational Therapy
School of Health & Natural Sciences
Mercy College, Dobbs Ferry, NY
Professional Associate, NYP Weill Cornell
Jtoglia@mercy.edu
Research
Chronic Illness
Developmental Disorders
www.Multicontext.net
Inhibition Organization
Integration
and
Working Self
Memory Coordination Monitoriing
of EF
Processes
Monitor time
Distracting Questions
Prior to administering….
Review full manual carefully
Strategy Checklist
Strategy Use
Case 1- Stroke
63 yo female, post stroke several years
Entered Appointments 9
Efficiency 556
Summarize
Performance
Strategies Observed
Strategy type
Used her finger (partial)
Crossed off appointments (cued - partial)
Pauses and re-reads
Self- Checks (inefficient)
Went down the list in order (not strategy)
Strategy Generation
Check off appointments once entered from the start
Go slowly; pace myself
Check appointment days for conflicts prior to entering them
Interpretation
Avoid over-interpretation of accuracy
score !
Case 2
WCPA-17
Outpatient
Functional Concerns
.
MoCA = 24/30
Efficiency Score:
speed–accuracy trade-off
Awareness/Client Perception
of Task Difficulty
Performance
- Omission errors, misses details/info
- Difficulty keeping track (rules)
Information Sheet
Case 3
Outpatient Rehabilitation Setting
• Avid passion for cooking, involved in meal planning and grocery shopping
• Followed daily routine, read the newspaper every morning upon waking
schedule
12
Self-ratings 12 9 3 Overestimation
Accuracy
estimation 5 8 3 Overestimation
WCPA 10 Results
WCPA Variables
Planning time 13 secs
Total time 7 mins, 40 secs
Entered Appointments 10/10
Accuracy 5
Errors 5
Rules Followed 5
Self Recognition of Errors 4
After Task:
Noticed there were flexible and fixed appointments that conflicted
Aware that he followed all rules
Aware that he made errors (did he fully understand he misinterpreted
instructions?)
Strategy Use
Unaware of used strategies during WCPA, some being inefficient
No true strategy generation pre or post task
Vague conceptualization of pre-planning in post task interview
Aware of errors however cannot figure out how to prevent errors next time
using strategy
Unable to generalize similarities of task to other daily iADLs, such as
managing his own errands/appointments
Treatment Implications?
Based on current level of insight,
performance limitations and specific
cognitive perceptual impairments…
What type of treatment approach would be
best to use?
What kinds of activities would you choose?
Activity Demands
Organization and Planning – multiple choices and options to take or make
Multiple steps or criteria to follow
Keeping track of additional information during task (following rules, attention
to a time, ignoring distractors)
www.multicontext.net
Background
• 65 YO Caucasian Male
assistance
• MoCA=26
Interdisciplinary Observations:
Impulsive tendency, able to recognize errors after the fact, requires cueing for pacing
and intervention for impact of tendency to minimize errors.
Location
Location and SR
Location and SR
Location and SR
• Consistently used finger, verbal rehearsal, and checking off appts entered
• Occasionally entered fixed appointments first, then flexible and
underline/circled key words
Tell me how you went I’ve done scheduling for academics. I looked
about doing this? for flexible vs. inflexible appointments.
Self-ratings 12 6 6 Overestimation
Accuracy 6 10 4 Overestimation
estimation
Performance Profile
Treatment Implications
Types of Activities
Class/Activity Schedule A (Search locate Level A) 29/30
Accuracy
Treatment
Kitchen Task
WCPA Research
Similarities
375 Americans and 433 Israeli healthy adults across 3 age
groups (20-39; 40-64; 65-87),
Accuracy scores were similar in both countries
Significant differences between adults below and above
age 65, in both countries, on the majority of WCPA
variables
Older persons > 65 in both countries were less accurate,
efficient and strategic than younger adults (p< .05).
Total time was not significantly different between the
youngest and oldest groups
Interpretation
1) Accuracy & Efficiency-
Normative Comparison - WCPA-17
Percentile tables in manual
Lahav, O., & Katz, N. (2015). Weekly calendar planning activity for university students: Comparison of
individuals with and without ADHD by gender. Journal of Attention Disorders, 19, 1-11.
Stephens, J. A., & Berryhill, M. E. (2016). Older adults improve on everyday tasks after working
memory training and neurostimulation. Brain stimulation, 9(4), 553-559
Toglia, J., & Berg, C. (2013). Performance-based measure of executive function: Comparison of
community and at-risk youth. American Journal of Occupational Therapy, 67, 515–523.
Toglia, J. (2015). Weekly calendar planning activity. AOTA Press: Bethesda, MD.
Toglia, J., Lahav, O., Ben Ari, E., & Kizony, R. (in press). Adult Age and Cultural differences in the
Weekly Calendar Planning Activity (WCPA). American Journal of Occupational Therapy.
Toglia, J. & White, S. (in press). The Weekly Calendar Planning Activity. . In B. J. Hemphill-Pearson
and C. K. Urish (Eds.) Assessments in Occupational Therapy Mental Health: An Integrative Approach
(3rd Ed.). Slack Inc: Thorofare, NJ.
Weiner, N. W., Toglia, J., & Berg, C. (2012). Weekly calendar planning activity (WCPA): A
performance-based assessment of executive function piloted with at-risk adolescents. American
Journal of Occupational Therapy, 66, 699–708.
Zlotnik, S., & Toglia, J. (2018). Measuring Adolescent Self-Awareness and Accuracy Using a
Performance Based Assessment and Parental report. Frontiers in Public Health, 6(15), 1-9.