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Optimizing Functional Cognition and Executive Function: Assessment and Intervention Strategies

Instructor:  Joan Toglia PhD, OTR/L, FAOTA
Dates:         Thursday, October 25 – Saturday, October 27, 2018
Location:    Holiday Inn Peterborough Waterfront (150 George St. N., Peterborough)
Cost:           $599+HST Early Bird Rate, $675+HST after September 30, 2018

Prices include handouts, continental breakfast and lunches. A block of rooms will be held at the Holiday Inn Peterborough Waterfront until September 24, 2018. Contact reservations at 1-866-258-5181 and mention affiliation with MindWorks to receive the discounted rate.


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Who Should Attend

  • Occupational Therapists (OT)
  • Speech Language Pathologists (SLP)
  • Occupational Therapist Assistants (OTA)
  • Communicative Disorders Assistant (CDA)
  • Rehabilitation Support Workers (RSW)


Course Description

Dr. Joan Toglia giving a workshop at the University of Haifa in Israel in 2016.

Dr. Joan Toglia giving a workshop at the University of Haifa in Israel in 2016.

This workshop provides a comprehensive overview of assessment and treatment for people with mild to moderate acquired brain injuries. Clinical examples, cases and video clips will be used throughout all 3 days of the workshop.

The first half of the workshop will review the cognitive functional evaluation process. It will provide therapists with the ability to analyze and interpret task errors observed during IADL performance and select or choose the most appropriate assessment tools and outcome measures.

A variety of assessment tools will be discussed including clinician and patient reported rating scales or questionnaires, awareness measures, cognitive screenings, cognitive-IADL assessments and participation measures.

Different performance-based assessment methods will be reviewed with a focus on analysis of and interpretation of performance errors. The integration of findings, measurement of outcomes and use in treatment planning will be described and illustrated.

The second half of the workshop provides in-depth information on clinical treatment of adults with executive dysfunction and other cognitive perceptual deficits. Interventions such as use of everyday technology, Apps, metacognitive strategy training and working memory training will be discussed along with applications, updated evidence and indications for use.

A metacognitive strategy based approach (Multicontext treatment (MC)) that focuses on guiding self-monitoring skills and promoting strategy use and generalization across everyday activities will be emphasized. Treatment activities will be analyzed, and examples of functional cognitive activity modules and guidelines will be illustrated. Participants will practice specific cueing methods and use of a structured metacognitive framework designed to help people understand, anticipate, monitor and control cognitive symptoms.

Specific cognitive performance difficulties in executive function and memory (such as working memory, prospective memory, flexibility, impulsivity, initiation, planning etc.) will be discussed within the context of case scenarios. Participants will practice analyzing and applying treatment guidelines to cases

Clinical examples and applications will focus on adults with acquired brain injury, however implications for a wide range of populations will be discussed.

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Course Objectives

Upon completion of this course, participants will be able to:

  1. Understand and identify different cognitive perceptual symptoms from written case descriptions and video clips (eg. working memory, flexibility, inhibition, prospective memory).
  2. Select appropriate assessment tools that match client’s level and needs.
  3. Compare and contrast different performance-based assessment methods .
  4. Use, analyze, interpret and document results of performance based testing (eg. WCPA).
  5. Identify assessment tools for measurement of treatment outcome.
  6. Identify ways that technology can promote cognitive functioning and be used within intervention. .
  7. Identify and describe how to utilize a metacognitive framework as part of a comprehensive and inter-professional cognitive rehabilitation program.
  8. Describe how to manipulate and structure a wide range of functional cognitive treatment activities to promote strategy use, awareness and generalization.
  9. Analyze and expand the range of treatment activities used with clients who have problems in self awareness, executive function and memory initiation, impulsivity.
  10. Describe external and internal strategies that are effective in managing executive function symptoms such as problem in initiation, impulsivity, loosing track, difficulty shifting set and managing multiple step activities) .
  11. Analyze and differentiate between types of cues and mediation methods that can be utilized in treatment.
  12. Demonstrate how to structure treatment activities and sessions to promote strategy use and carryover.
  13. Demonstrate the use of guided questioning techniques.

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Past workshop with Dr. Joan Toglia

Day 1 – Thursday, October 25, 2018

7:30am Registration and Continental Breakfast
8:30am Welcome
8:30 – 10:00am Overview of Executive Function (EF)

  • Executive Function Performance & Functional Cognition
  • Managing cognitive challenges
  • Interpreting clinical scenarios
  • Recognizing EF components within performance
  • Video Clips: Analysis of client perspectives and functional cognitive errors
10:00 – 10:15am Break
10:15 – 12:00pm Cognitive Functional Evaluation Process

  • ICF Framework
  • Deciding when and where to start: A decision tree
  • Understanding the clients perspective: Interviews and rating scales
  • Assessment resources and Apps
  • Cognitive Screening completed. Now what?
  • Interpreting and using results from Screenings: Relationship to IADL
12:00 – 1:00pm Lunch
1:00 – 2:30pm Cognitive IADL and Performance Based Assessment

  • Performance Based Measures
  • Different Methods of Performance Based Assessment
  • Small group activity
  • Interpreting and Documenting results
2:30 – 2:45pm Break
2:45 – 4:15pm Performance Analysis: Examining Error Patterns

  • WCPA – Overview
  • Case Examples
  • Documentation of Results
4:15 – 4:30pm Summary and questions

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Day 2 – Friday, October 26, 2018

7:30am Continental Breakfast
8:30 – 10:00am Functional Cognition and Performance Analysis

  • Other Tools
  • erformance Analysis Framework

Next Steps in Assessment and Putting in All Together

  • Integration of assessment findings
  • Treatment Planning and Approaches
  • Linking Assessment to Treatment Planning
  • Case analysis and treatment planning
10:00 – 10:15am Break
10:15 – 11:00am Subtle Cognitive Deficits: Outcome Measurement tools & Participation

  • Identifying Tx targets and outcome measures
  • Case example: Assessment and Treatment
11:00 – 12:00pm Cognitive Interventions

  • Use of Everyday Technology to support or enhance cognitive function
12:00 – 1:00pm Lunch
1:00 – 1:45pm Neuroplasticity and remediation

  • Computer based cognitive remedial programs
  • New and Emerging Technologies: Virtual Reality and simulations to enhance cognitive performance
1:45 – 2:30pm Promoting Strategy Use to optimize function

  • Metacognitive Strategy Approaches
  • Key components of the MC approach
  • Video Illustration
2:30 – 2:45pm Break
2:45 – 4:15pm Expanding Treatment Activities across functional contexts

  • Manipulating and analyzing EF demands of activities
  • Placing demands on specific cognitive performance abilities
  • Functional cognitive treatment activities and strategy training
  • Sample MC treatment protocols and Activity Modules

Structuring Treatment to enhance carryover across activities

4:15 – 4:30pm Summmary and dicsussion

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Day 3 – Saturday, October 27, 2018

7:30am Continental Breakfast
8:30 – 10:00am Metacognitive Strategy Training Techniques

  • Facilitating strategy use, error recognition, and self-monitoring
  • Small group activity
  • Methods for promoting strategy use and managing errors
  • Structuring treatment sessions: Metacognitive framework
  • Other awareness training techniques
10:00 – 10:15am Break
10:15 – 12:00pm Mediation within Treatment Activities

  • Facilitating executive thinking skills and self-monitoring
  • Critique and Analysis of mediation and cues
  • Analyzing videos
  • Rating awareness and strategy use within treatment
  • Generalization & Transfer: Methods for bridging and connecting activity experiences
12:00 – 1:00pm Lunch
1:00 – 3:30pm Putting it all together: Application of Intervention Framework to clinical cases

  • Sample Case illustrations
  • Video Analysis of Cases and Problem Solving
  • Management of Multiple Step Activities
  • Promoting awareness and strategy use across activities

Team approach to promoting metacognitive skills and strategy use

3:30 – 4:00pm Summary, Discussion, and Questions

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About Joan Toglia

Joan Toglia PhD, OTR/L, FAOTA

Joan Toglia PhD, OTR/L, FAOTA

Joan Toglia, Ph.D, OTR/L, FAOTA is Professor of Occupational Therapy and Dean of the School of Health & Natural Sciences at Mercy College, Dobbs Ferry, New York and Professional Associate in the Rehabilitation Medicine Department at New York Presbyterian- Cornell Weill Medical Center.

Dr. Toglia has over 30 years of experience that includes acute, rehabilitation and outpatient settings with persons with stroke, acquired brain injury and other neurological disorders. In addition to her degree in Occupational Therapy, Dr. Toglia completed advanced graduate and doctoral work in Educational Psychology with specializations in cognition & learning as well as measurement & evaluation.

Dr. Toglia is internationally recognized as a leader in the rehabilitation of persons with cognitive deficits and has contributed extensively to the field as a clinician, author, educator and researcher. She has presented over 300 workshops and lectures around the world on cognitive rehabilitation, focusing on theory, assessment methods and intervention strategies to support and optimize cognitive function across different ages and diagnostic groups.

Her publications and research include metacognitive strategy intervention, assessment tools and the relationship between cognitive impairments and occupational performance.

Selected Publications

Katz, N. & Toglia, J. (2018). Co-Editors. Cognition and Occupation Across the Life Span: Models for Intervention in Occupational Therapy 4th Edition. Baltimore: MD: American Occupational Therapy Association.
Chen, P. & Toglia, J. (in press). Online and offline awareness deficits: Anosognosia for spatial neglect. Rehabilitation Psychology.
Toglia, J. (2017). Schedule activity module: Functional cognitive rehabilitation activities and strategy based intervention. NY: MC CogRehab Resources, LLC.
Toglia, J., Lahav, O., Ben Ari, E., & Kizony, R. (2017). Adult Age and Cultural differences in the Weekly Calendar Planning Activity (WCPA). American Journal of Occupational Therapy. 71(5).
Toglia, J., Askin, G., Gerber, L.M., Taub, M.C., Mastrogiovanni, A.R., O’Dell, M.W. (2017) Association between two measures of cognitive instrumental activities of daily living and their relationship to the Montreal Cognitive Assessment in persons with stroke. Archives of Physical Medicine and Rehabilitation. DOI: 10.1016/j.apmr.2017.04.007
Foster, E.R, Spence, D., Toglia, J. (2017) Feasibility of a cognitive strategy training intervention for people with Parkinson disease. Disability and Rehabilitation.
Toglia, J., Golisz, K. (2017). Traumatic brain injury (TBI) and the impact on daily life. In N.D. Chiaravalloti & Y. Goverover (Ed.), Changes in the Brain: Impact on Daily Life. (pg 117 – 143). Springer Publications.
Toglia, J. (2015). The Weekly Calendar Planning Activity (WCPA): A Performance Test of Executive Function. AOTA Press: Bethesda, MD.
Toglia, J., Rodger, S., & Polatajko, H. (2012). Anatomy of cognitive strategies: A therapist’s primer for enabling occupational performance. Canadian Journal of Occupational Therapy. 79(4), 225-236.
Toglia, J.P., Johnston, M.V., Goverover Y., Dain, B. (2010). A Multicontext Approach to Promoting Transfer of Strategy Use and Self regulation After Brain Injury: An Exploratory Study. Brain Injury. 24, 664-677.
Rosenblum, S., Josman, N. & Toglia, J. (2017). Development of the Daily Living Questionnaire (DLQ): A factor analysis study. Open Journal of Occupational Therapy, 5 (4), Article 4.
Umanath, S., Toglia, J., McDaniel, M. (2016). Training Prospective Memory for Transfer. In T. Strobach and J. Karbach (Eds). Pg 81-91. Cognitive Training: An Overview of Features and Applications. Springer Publications.

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