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Run: Functional Cognition Performance Assessment

Functional Cognition Performance Assessment template for observing how a person starts, plans, sequences, and safely completes real-world kitchen and executi...

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Assessment Setup and Safety

Assessment environment is safe, uncluttered, and appropriate for task observation critical (required)

Workspace should allow safe observation of the task without immediate hazards.

Yes No N/A

Required task materials are available and within reach

Examples may include kettle, cup, water source, utensils, ingredients, or written instructions.

Yes No N/A

Participant understands the task instructions

Rate the participant's initial comprehension of the task goal and steps.

Immediate safety risks identified before task start critical (required)

Select any observed risks present before task initiation.

Note (optional)

Task Initiation and Planning

Initiates task without excessive delay

Assess whether the participant begins the task in a timely manner.

Identifies task goal and required sequence

Observe whether the participant can state or demonstrate the correct order of steps.

Organizes materials before starting

Evaluate whether materials are gathered and arranged efficiently.

Requires verbal cueing to proceed to next step

Record the highest level of cueing required during task initiation and planning.

Sequencing, Problem-Solving, and Safety

Completes task steps in correct sequence critical (required)

Assess whether the participant follows the expected order of operations.

Recognizes and corrects errors independently

Examples include overfilling, forgetting a step, using the wrong item, or unsafe handling.

Maintains safety awareness during task critical (required)

Observe attention to heat, water, sharp objects, spills, and appliance use.

Uses judgment appropriately when unexpected issue occurs

Examples include missing item, changed instructions, or minor spill.

Task Completion and Assistance Level

Level of assistance required to complete task critical (required)

Select the highest level of assistance required during the assessment.

Task completed successfully critical (required)

Indicate whether the participant completed the observed task to an acceptable standard.

Yes No N/A

Final task outcome is safe and usable

Assess the end result of the task, such as prepared beverage, meal component, or organized materials.

Observations, Recommendations, and Follow-Up

Observed cognitive strengths

Document strengths such as attention, memory, problem-solving, or self-correction.

Observed cognitive deficits or performance barriers

Document barriers such as poor sequencing, distractibility, impulsivity, or reduced insight.

Recommended supports or compensatory strategies

Select supports that may improve task performance or safety.

Note (optional)

Follow-up required

Indicate whether reassessment, referral, or additional intervention is recommended.

Yes No N/A

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