Mental Status Examination
Order of testing
- Global functions
- Standard functions
- Limbic/global functions
- Dominant hemisphere functions
- Non dominant hemisphere function
- Less localizing tests
Clues
Inability to do simple tasks independently, participate fully/safely in self care or in PT
- The patient is unable to perform a task when asked
- But all of a sudden is able to do it?
- indicates: Not a motor problem, either an association issue or attention issue
Difficulty w/ initiation or completion of tasks
Difficulty switching from one task to the next
Unable to locate visually, identify objects necessary for task completion
Losing place on page when reading/writing
Unable to follow simple one step commands despite good comprehension
Difficulty w/ spatial concepts (prepositions): “in, out, on, under, next to, up, down, in front of”
Makes same mistakes repeatedly
Excessive time to complete activities or done impulsively
Hesitation, frustration, inattention to space/one side of body
Poor planning
Inaccuracy that cant be confirmed by coordination, strength, comprehension impairments
Trouble/inability w/ remembering L and R
Why
Why should you distinguish between Sensory, cognitive and perceptual deficits?
- R/o pure sensory impairments BEFORE testing perceptual/cognitive deficits
- Impacts design of treatment for each impairments
- Potential to refer to other provider: ot, slp, neuropsychologist
How to recognize deficits
How do I know I should test for perceptual or cognitive deficits?
- Look/listen
- Task analysis
- Visual screen
- Hearing screen
- Check sensation
- Not psychosocial/emotional status
- Formal testing indicated when motor, sensory, comprehension all functional