Brief report| Volume 96, ISSUE 1, P158-162, January 2015

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Rehabilitation Professionals Still Do Not Communicate Effectively About Cognition

Published:September 15, 2014DOI:


      • Rehabilitation team members continue to exhibit poor consensus on the meanings of common cognitive terms for severity ratings and memory functions.
      • Only half of rehabilitation professionals believe there is a common understanding of cognitive terminology.
      • Even the 2 types of professionals most likely to use cognitive assessment measures (speech-language pathologists and psychologists/neuropsychologists) have significant discrepancies in how they interpret the severity of cognitive deficits.



      To examine current use of descriptive labels for levels of cognitive impairment and types of memory to explore whether rehabilitation disciplines are now communicating more effectively.


      Survey of rehabilitation professionals.


      Hospital rehabilitation programs.


      Respondents (N=130) representing 8 facilities in 5 states completed surveys.


      Not applicable.

      Main Outcome Measures

      Responses to survey questions about severity and types of memory impairment were examined with the Kruskal-Wallis test to determine the impact of profession on ratings. Post hoc Mann-Whitney U test comparisons of the 2 professions with the most cognitive assessment experience, psychologists/neuropsychologists and speech-language pathologists, were conducted.


      Ratings of various deficit levels differed significantly by profession (mild: H=39.780, P<.000; moderate: H=43.309, P<.000; severe: H=38.354, P<.000), but not by program location. In comparing psychologists/neuropsychologists and speech-language pathologists specifically, we found a significant discrepancy in ratings for percentile ranges associated with the terms mild (U=103.000, P<.001), moderate (U=78.000, P<.000), and severe (U=109.000, P<.001). Disagreement on the meaning of descriptive memory terms was noted among rehabilitation professionals in general, with large percentages of respondents not agreeing on the meanings of terms.


      A significant lack of consensus persists regarding the understanding of common cognitive terminology. This miscommunication affects cognitive impairment descriptors (eg, mild, moderate, severe) and 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.


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