Persistent Failure among Rehabilitation Professionals to Communicate Effectively about Cognition

Objective: In 1992, Wanlass and colleagues reported on the striking lack of consensus in the use of cognitive terminology within and across rehabilitation disciplines. This follow-up examined use of descriptive labels for level of cognitive impairment and types of memory to explore whether disciplines are now communicating more effectively. Method: One hundred and thirty respondents representing eight facilities in five states were surveyed. One-way ANOVAs examined the impact of profession on the dependent variables. Post hoc comparisons of two professions with the most cognitive assessment experience, psychologists/neuropsychologists and speech therapists, were conducted. Results: Ratings of various deficit levels differed significantly by profession, mild: F(8, 87) = 7.536, p < .000; moderate: F(8, 83) = 10.088,p < .000; severe: F(8,84) = 6.046, p < .000, but not by program location. Examining psychologists/neuropsychologists and speech therapists specifically, there also was a significant discrepancy in ratings for percentile ranges associated with "mild" (p < .002), "moderate" (p < .000), and "severe" (p < .004). Conclusion: Consistent with the original 1992 study, a significant lack of consensus regarding the understanding of common cognitive terminology persists. This miscommunication affects cognitive impairment descriptors (e.g., mild, moderate, severe), as well as categorization of types of memory. Only half of rehabilitation professionals appear aware of this discrepancy, suggesting that education is necessary to bring greater awareness of the potential for miscommunication.