A wide array of cognitive impairments can underlie different types
of organizational difficulties. For example, disorganization in time,
materials and space, communication, or task steps may be related to
an impulsive, unsystematic approach, lack of attention to details,
inability to keep track of items or materials simultaneously, inability to
recognize patterns, difficulty making connections or associations
between similar thoughts, ideas or objects, inability to think ahead,
(Suchy, 2016). The observation that individual EF or task components
can be intact yet performance can disintegrate when individual tasks
need to be interleaved or performed concurrently has led to the
emerging view of multitasking as a separate ability (Burgess, 2015;
Just &Buchweitz, 2016).
Functional Cognitive Example of Multitasking
Clinical Example 2.14 presents a high-functioning person who scores
within normal limits on standardized neuropsychological tests but
demonstrates functional cognitive difficulties.
Clinical Example 2.14 Multitasking During Cooking
Susan performed well on tests of neuropsychological tests including working memory,
flexibility, initiation, and inhibition. Susan was asked to make breakfast for three people
including a cheese omelet, coffee, tea, and toast so that everything would be ready at the
same time. Susan put the toast in the toaster, started the coffee, and then began the
Manipulating Activity Characteristics to Influence Cognitive Performance
Knowledge and skill in adjusting activities to vary cognitive demands
and thus impact performance provide a foundation for both
assessment and intervention. It allows the therapist to identify the
types of activities that a person might need supports for, as well as
guides the selection, sequence, and grading of treatment activities.
Table 4.2 illustrates how specific functional tasks such as packing a
lunch or making coffee can be modified to place different demands on
different EF skills by changing key activity characteristics. As in the
preparing lunch examples above, the “same” activity can present
different cognitive demands and produce different performance