Cognitive Functional Capacity Evaluation (CFCE)

Cognitive Functional Capacity Evaluation testing measures take into consideration factors that result following an acquired brain injury and or post-concussive syndrome.  The Cognitive Functional Capacity Evaluation evaluates an individual’s functional and cognitive capacity in relation to their ability to perform essential critical job demands with a focus on the intersection of physical, physiological, cognitive, and behavioral implications of an injury or medical condition.

The Cognitive Functional Capacity Evaluation includes formal standard / traditional Functional Capacity Evaluation testing measures of strength, mobility, limb coordination, positional tolerances, material and non-material handling abilities, in addition to the standardized assessment of cognitive functioning.  The cognitive assessment incorporates both component and performance-based tests, non-standardized assessment, and structured observations of physical, cognitive, behavioral, and psychosocial functioning.

This evaluation is tailored to address the comprehensive and complex issues related to an individuals’ functioning in real-world environments, promoting the ecological validity of the evaluation.  The evaluator can determine the individual’s overall functional capacity; specifically, their abilities or limitations in the physical, cognitive, behavioral, and psychosocial realms, and make observations of a range of critical factors such as physiological complaints, pain, fatigue, task persistence, etc that influence functioning over time. This information assists in assessment of occupational performance with determination of workplace tolerance and the capacity to return to work whether that be to their pre-injury occupation or an alternate occupation or position.  It also helps to assist in determination of the evaluee’s ability to perform activities of daily living and leisure interests as well.

A Cognitive Functional Capacity Evaluation follows a standardized methodology with analysis of cognitive job demands and incorporation of work-specific testing. It is a useful and relevant quantified assessment to determine cognitive functional capacity for employment.  This approach highlights ecologically valid measures of work-specific tolerance, particularly in the areas of attention, activity tolerance, mental stamina, and executive functioning.

This evaluation is an assessment method used to determine whether a job match exists for a specifically identified occupation or occupations with consideration for physical, functional cognitive and psycho-emotional factors, environmental factors, whether there is a need for accommodations to enable return to employment, and to identify specific targets for rehabilitation intervention to support this outcome, if applicable.

The term “functional cognition” which can be defined as the cognitive ability to perform daily life tasks, is conceptualized as incorporating metacognition, executive function, other domains of cognitive functioning, performance skills (e.g., motor skills that support action), and performance patterns

Rather than assess specific cognitive skills (e.g., attention, memory, executive function) in isolation from one another, the goal of the Cognitive Functional Capacity Evaluation is to identify clients’ capacity to perform essential tasks given the totality of their abilities, including their use of strategies, habits and routings, and contextual and environmental resources.

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