Cognitive Functional Evaluation (CFE) Process for Individuals with Suspected Cognitive Disabilities

The purpose of this paper is to conceptualize the evaluation process for individuals with suspected cognitive disabilities. The Cognitive Functional Evaluation (CFE) process yields a comprehensive profile of the clients' cognitive strengths and weaknesses in occupational performance. The components of the CFE are outlined in six stages as a decision tree with examples of standardized instruments from which to choose the assessments for each client evaluated: (1) interview and background information; (2) cognitive screening and baseline status tests; (3) general measures of cognition and executive functions in occupation; (4) cognitive tests for specific domains; (5) measures of specific cognitive domains in occupations; and (6) environmental assessment. The first three stages are required to ascertain basic cognitive abilities underlying occupational performance. Tests for each stage can be chosen from the ones listed according to the client characteristics and the theory utilized, there is no need to use all of them. Once this data is available a further decision is made whether a more in-depth assessment is needed (stages (4) and (5)). The environmental component is evaluated in all instances with at least one of the assessments. The CFE process for individuals with suspected cognitive disabilities is recommended to be used by occupational therapists as a common ground for evaluation, documentation, and communicating information.