5 minute read
A Model Life: How a Queensland OT Left her Mark on Functional Cognition
Felicity Fay, Founder at OT Do and Cathy Hill, Founder at OT Do
Delaune Pollard In care settings around the country, a simple task of lacing a thread has become the preferred method of screening a person’s functional cognitive ability. The Allen’s Cognitive Levels screening tool (ACL) is a standardised, evidence-based assessment approach. It determines what a person can do (rather than what they can’t), or what is meaningful and realistic when considering occupational performance.
Occupational therapist Delaune Pollard has played a key role in the ACL’s uptake, dedicating her adult life to the application of the Cognitive Disabilities Model (CDM), which informs all aspects of the ACL tool.
Who is Delaune Pollard?
As a young graduate from the University of Queensland in 1961, Delaune Pollard had little idea that her career path would take her on such a diverse journey. It was also a path that would indelibly shape the care of people living with disabilities and alter the perception of disability to a model of ability.
Moving through the spectrum of human care, Delaune’s remarkable story encompasses academia, politics, and community and peak organisations. Her journey took her to Pennsylvania, the epicentre of functional cognition study. She became a lobbyist and advocate for those who did not have a voice, and mentored and taught the many who followed her example. A Model Takes Shape
A knowledge of the impacts of a cognitive disability on occupational performance needs to be understood and applied to ensure the best outcomes and the selection of the ‘best fit’ strategies for individuals.
The CDM helps us to recognise the cognitive complexity of tasks that people are able to engage in (Can Do) by assessing their functional cognitive capabilities to perform. This is then considered alongside the activities they want to do (Will Do), and how social and environmental barriers and enablers may impact (May Do).
What we now understand as ‘functional cognition’ is a term that Delaune introduced in a 2005 publication, Allen’s Cognitive Levels: Meeting the Challenges of Client Focused Services (Pollard, D. V. and Olin, D., 2005). This core construct recognises the link between brain function and task behaviour.
For therapists, the connection between function and cognition removes the stigma of disability or impairment, and shifts the focus towards interventions that build on abilities.
The guided use of the ACL enables caregivers to plot abilities on a series of rubrics, much like a teacher fills in learning outcomes for students. When the level of functional capacity is known, strategies can be implemented to help the client succeed in the activities they can and wish to do.
Practice Made Perfect
Delaune applied her expertise in multiple settings. In Brisbane in the 1970s she assisted children with learning problems, sparking her interest in the study of cognition. Later, she became Occupational Therapist-in-Charge at Queensland’s largest psychiatric hospital, where she gained skills in psychogeriatrics and forensics.
In the 1990s she studied under the guidance of Professor Claudia Allen at the Eastern Pennsylvania Psychiatric Institute and formed key relationships with cognitive disability advisors throughout the US. She became an Allen Cognitive Advisor and Master Clinician in cognitive disabilities.
Delaune’s clinical experience extends across multiple areas of practice. From “The Park” Wolston Park Memorial Hospital and John Oxley Forensic Facility, to paediatrics, employment consultancy, policy management, and political advocacy.
A prolific writer, Delaune has authored five clinical texts to support occupational therapy practice. These were informed by the CDM and established research, along with her own research and clinical observations. In her ever-practical support to caregivers, she has written several textbooks on sustainable care for people with a cognitive disability.
She also formed her own company, specialising in the assessment and management of people with cognitive disabilities and providing an advisory service to the aged-care and insurance industries.
Tireless in her advocacy, Delaune used her extensive experience in many different roles, such as consultancy, policy, and education. She was able to make a submission to the House of Representatives Standing Committee on Ageing to support best practice in Aged Care. As Vice-President of the Local Ambulance Committee on Tamborine Mountain, Delaune keenly supported the inclusion of people with disabilities on the committee in active and meaningful roles. This drive towards inclusiveness and appreciation of people, informed by pragmatic expectations of ability, and support through ‘May Do’ factors, has been an ongoing standard throughout Delaune’s career.
Towards a Sustainable Future
Now more than ever, occupational therapists must be able to assess and then establish effective, timely strategies for clients. We need to have the tools to follow through with best practice.
Within an Australian context, Delaune’s pioneering work has ensured the CDM remains accessible, dynamic, occupationcentric, and evidence-informed in its application. She continues to exemplify her passion to educate occupational therapists and other allied-health professionals, to support caregivers, and to advocate for the CDM and the people it supports.
The founders at OT Do (Occupational Therapists Do) are inspired by Delaune’s example. Cathy Hill worked with Delaune for many years and says Delaune’s motivation for continuing professional engagement is two-fold: “Firstly, it derives from an irresistible urge to discover and describe the physiological basis for developmental and ageing behavioural changes, leading to increasing or declining individual ability to function. Secondly, there is her need to use this information to support human best ability to function at all ages and in all areas of the human condition.”
OT Do practitioners continue Delaune’s passion—advancing innovative practice for caregivers and contributing to further development of the model. Above all, we remain firmly focused on occupational outcomes for the people supported by occupational therapists.
Many people who don’t function at an optimal cognitive developmental level for human behaviour can still be valued and appreciated for functioning to their best ability, which reflects their maximum effort—Delaune Pollard.
About the Author OT Do was established two years ago and services areas in south-east Queensland. The combined clinical experience of the proprietors, Felicity Fay and Cathy Hill, extends to more than forty years. Together, they have assembled a team of occupational therapists whose practice is firmly informed by the CDM as one of the primary organising models.
OT Do services the areas of Brisbane, the Gold Coast, and Toowoomba. Its practitioners train workers in all aspects of the CDM. More widely, OT Do facilitates workshops in functional cognition around Australia.
