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Introduction to the Special Issue on Cognition and Executive Function

This issue of the journal is dedicated to the occupational therapists who serve those with executive function impairments. Over the past decade, a number of occupational therapists have been building their science to answer important questions to guide the identification of occupational performance problems stemming from brain injury, developmental disorders, and chronic neurological conditions. Others have focused their efforts to develop interventions to help patients/clients recover and gain the skills to live meaningful family, work, and community lives. This special issue on executive function reports on research in the field that can be used by occupational therapists as they are called on to determine a person’s capacity to live alone safely, to function in the community, to work, or to participate in any task that is important and meaningful for them. The assessments presented in this issue can be used to determine strengths, limitations, and challenges in performance. This issue also includes reports on interventions that can be used to enable clients to learn skills and environmental strategies to support them in daily life. The occupational therapist approaches the measurement and treatment of cognitive deficits, not only to know what a person can do, but to know what to do to foster the individual’s engagement in daily life because occupation is a basic human need, a determinant of health, and a source of meaning. Some professionals have the sense that they have the primary role in the assessment and treatment of cognitive impairments; we have even heard of occupational therapists relegating the role of cognition to others. This journal issue and the work of its authors suggest that occupational therapists have taken a leadership role in assessment of and intervention for executive function. We hope that readers find this issue of the journal interesting and useful. The authors have made major contributions to our understanding of the critical role occupational therapists play in managing cognition, particularly executive function. You will also see that cognition is central to the performance of complex tasks, including any activity that must be performed in a sequence of steps. Executive function supports occupational engagement, particularly in novel, complex, and unstructured activities, and is essential to our understanding of occupational performance. When we were asked to be guest editors for this issue, we received more excellent articles than could be put in one issue. We are pleased that the American Occupational Therapy Foundation made it possible to publish this expanded special issue that includes articles to ground cognition theoretically in occupation, issues associated with the identification of executive dysfunction in performance-based assessments, the impact of cognition on participation, and both occupation-based and virtual interventions to help clients gain the skills to support their recovery and engage in activities central to their daily lives. We are grateful for the contributions of the authors and we hope that this issue will begin a dialogue about occupational therapy’s unique role in the management of cognitive impairments.