Books and Training: The Allen Cognitive Theory, Functional Cognition and the Cognitive Levels 

The need to write books for healthcare clinicians as well as for general distribution was to inform formal and informal caregivers as to ‘why’ people with deficits in functional cognition behave the way they do. The starting point for my first book, “Midlife’s Challenge: Understanding and Coping with Decline in Thinking and Behaviour” came about from having to walk a careful path in helping my immediate family members as well as assisting many friends to manage their own relatives or elderly friends.  The 2008 book, “Caregiver’s: Drowning in a Sea of Cognitive Challenges” is a greatly expanded version of the first book. This 432 page book weaves together scientific knowledge, humanistic stories and practical information into a powerful resource book.

The way in which people with deficits in functional cognition are able to make sense of what is going on around them, and how they are able to cope on a day-to-day basis, are described and further developed throughout each book. The different cognitive levels are illustrated in the two books for general distribution and further emphases is placed by the telling of heart wrenching true-to-life stories. These stories are told to guide and assist caregivers to understand the intricacies of the problems which will confront them while caring for people with deficits in functional cognition. There are six cognitive levels, five of which are further divided into modes, each having very distinct observable patterns of performance. A difference in the performance level of one mode can make a huge difference as to how a person is able to make sense of what is happening around them. This includes how they can satisfactorily manage their own needs with social assistance from their caregiver. 

The functional cognition approach is significantly different from the traditional neuropsychological approach. As early as 1965, Claudia Kay Allen recognized there were underlying cognitive processes, including the ability to recognize an object and begin a task with a goal in mind. In the model she developed, Allen describes the concept of functional cognition as a measure of “global cognitive function” based on “global cognitive abilities.” This is a very different approach from the focal neurological deficit model.

The theory behind functional cognition is concerned with how people learn and what happens to learning when disease processes and injury to the brain cause global cognitive restrictions. When global cognitive restrictions occur, the ability of a person to pay attention to environmental cues is reduced. In 2006, Earhart stated, “an individual’s functional behaviors are guided by the degree to which they are able to use cues in their environment.” Therefore, if people are not able to use cues their ability to learn is reduced; or what can be learnt may become distorted information. This means people are not able to make judgments which involve being able to use complex visual cues, e.g. undulations in the surface of a road or the depth of water in a saucepan. If people cannot recognise and react to cues, they are not able to interpret what they are seeing and putting them at risk of injury. If a person wants and needs to remember something new, but cannot functionally focus on sensory information in their environment then new learning cannot occur.

Note: The heading "Caregivers" in the Main Menu on this website provides information on training for healthcare professionals and clinicians as well as for formal and informal caregivers.