FCA Overview

Overview of FCA

Functional Cognitive Activities (FCA) is a comprehensive system for addressing functional cognition in persons with cognitive deficits due to acquired brain injury: stroke, traumatic brain injury, tumors, etc.. OT, PT, ST and activities therapists can use the structured system to plan treatment sessions that incorporate the skilled use of therapeutic tasks and activities to foster independence.

More extensive information about the FCA approach is available thru 2 continuing education opportunities:

Facilitating Functional Cognitive Rehab (6 hr. Summit Education live course)

Occupation Based Cognitive Rehab (1 hr. occupationaltherapy.com webinar)

FCA Website

The therapist uses the FCA website to choose tasks and activities arranged in a hierarchy of 8 levels of functional cognition. The levels begin by having the person practice initiating the next step in a sequence of basic ADL tasks; gradually progressing to the highest level of planning and multitasking to carry out complex ADL. The system also includes an evaluation scale, functional goals and a progress guide to help with treatment planning and documentation.

** Many of the tasks and activities on the website pertain to materials and locations specific to the setting where the FCA approach was developed. Therefore therapists will need to adapt tasks and activities to match their current setting.

“Task” vs. “Activity” vs. “Project”

Definition for the terms used in the FCA approach:

“Step” – a fundamental process required to carry out an action
(examples: squeezing toothpaste out of tube, slicing a tomato)

“Task” – a set of related steps to achieve a goal
(examples: brushing teeth, making a sandwich)

“Activity” or “Session” or “Lesson” – a collection of tasks (or exercises) to use in a session
(examples: carrying out morning ADL routine, making lunch to take to work)

“Project” – ideating and carrying out all of the activities necessary to complete a complex assignment
(examples: going shopping for food, completing a school assignment )