The 3 Global Elements

The 3 Global Elements of Cognitive Functioning

A core concept of this approach is that the person’s cognitive performance level is based on 3 global elements of cognitive functioning rather than scores on cognitive sub-skills. It is the awareness and management of these 3 global elements that indicate how independent a person will be.

Interpersonal relationships: self awareness, social skills, comprehension, self regulation
Environment:
physical space, personal awareness, body scheme, safety awareness, community, buildings
Time parameters:
orientation, time limits, schedules, estimating time, multi-tasking, project deadlines

The 3 Global Elements in Detail

Interpersonal Relationships and Self Awareness
 
This is arguably the most important of the 3 global elements. If the person is going to be independent to any degree – he must be aware that he has cognitive deficits. Otherwise he will have to be supervised to get by in daily life. The highest level of self awareness is developing insight into the reason for the deficits which indicates total understanding of his situation. Before the person develops self awareness he must be able to communication effectively with others, follow instructions, control his emotions and monitor his behavior.
 
Subcomponents of interpersonal relationships and self awareness include:
initiating communication, orientation to others, phone use, expressing emotion, following commands, reading comprehension, self regulation, error detection and correction, engaging others, setting goals.

Time Awareness and Management
 
Being able to monitor time during daily activities is very important to living independently. At the beginning stages of time management the person must simply be able to initiate switching from task to task. After that he progresses to showing that he can interrupt what he is doing at a particular time of day to change tasks. This leads to using a time schedule to complete a series of tasks. Next the person moves on to creating his own time schedule for completing multiple tasks by considering time limits, following rules, prioritizing tasks and estimating the time needed to complete them. The highest levels of time management include formulating, then implementing a plan to complete complex projects by a deadline while demonstrating effective multi-tasking to increase efficiency in daily life.

Environmental Awareness and Management
 
Awareness of the environment begins with the person being aware of his own body image. It progresses to attending to objects within reach such as wheelchair brakes and walkers. Shortly after the person begins to scan the room around him for objects in his immediate field of view. As he starts to move around the room he is able to recall items that are stored in cabinets or closets. Next he attempts to organize items he needs for tasks as he works at a table or countertop so he can be more efficient. Soon he begins to find his way around the first floor of a building. He shows he can carry and keep track of where he keeps his phone, schedule or notetaking device. Once he demonstrates he can find his way in a multi-level building he ventures out into the community to carry out assignments. He can use maps or GPS when he is in unfamiliar areas.