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Background: Making a decision is a cognitive task that requires the use of cognitive functions such as attention, memory, language, and executive function. Researchers have found people with cognitive deficits perform worse than healthy controls on experimental measures of decision-making. Researchers have also shown that persons with aphasia (PWA) may have deficits in the cognitive functions implicated in rational decision-making. Aims: In this paper, we will discuss the cognitive processes associated with decision-making by examining decision-making abilities in populations with cognitive deficits. Then we will discuss cognitive functions within the dual-process theory of decision-making, and describe the way(s) in which these processes may be impaired in PWA. We will also present a theoretical model of cognitive processes involved in decision-making and discuss the potential clinical implications of cognitive impairments on decision-making in PWA. Main contribution: This paper provides a theoretical foundation to support future discussions and investigations of decision-making in PWA. Conclusions: Making a rational decision may be more challenging for PWA, given the possibility of concomitant cognitive impairments. Future research is needed to validate or refute the theoretical synthesis presented in this paper. This could be accomplished through a variety of qualitative, quantitative, and mixed-methods research studies.

Purpose Decision making involves multiple cognitive and linguistic processes. The extent to which these processes are involved depends, in part, on the conditions under which decision making is assessed. Because people with aphasia (PWA) have impaired language abilities and may also present with cognitive deficits, they may have difficulty during decision-making tasks. Yet little research exists on the decision-making abilities of PWA. Thus, the purposes of this study were to investigate the performance of PWA on linguistic and nonlinguistic decision-making measures and to explore the relationship between decision making and cognitive test performance. Method A quasi-experimental design was used to compare the performance of PWA ( n = 16) and age- and education-matched control participants ( n = 16) on three decision-making tasks: Making a Decision subtest from the Functional Assessment of Verbal Reasoning and Executive Strategies (linguistic decision-making task), Iowa Gambling Task (nonlinguistic decision-making task with ambiguity), and Game of Dice Task (nonlinguistic decision-making task without ambiguity). Participants also completed assessments of language, working memory, and executive functions. Scores on the three decision-making tasks were compared between groups, and cognitive influences on decision-making performance were examined using correlation analyses. Results PWA differed significantly from control participants on linguistic decision making, particularly when required to verbalize their rationale for making their decision. PWA and control participants did not differ significantly on measures of nonlinguistic decision making. Performance on multiple cognitive measures was correlated with performance on the linguistic reasoning task, as well as one of the nonlinguistic tasks (Game of Dice Task). Conclusions Decision-making tasks that are heavily dependent on language, such as those used in capacity assessments, may disadvantage PWA. Assessments of decision-making capacity should include communication supports for people with acquired communication disorders; further investigation in the areas of decision making and aphasia is needed.

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Background/aims The skills and attributes that facilitate the transition from student to professional (also known as work readiness) have not been fully explored in rehabilitation medicine. The aim of this study was to develop a model of work readiness for new rehabilitation medicine professionals that allows for a successful transition to the workplace. Methods A qualitative approach was used to explore the perspectives of 26 clinicians, regulators and employers about work readiness in rehabilitation disciplines. Transcripts were coded and analysed using content analysis methods. Results At the core of work readiness for rehabilitation medicine professionals were three complex endeavours that were framed as professional challenges. Each endeavour integrated one or more foundational skills and could improve context-bound applied skills. Conclusions Work readiness in rehabilitation requires active and ongoing commitment from students, post-secondary programmes and employers.