Stephen Wey's doctoral study
The dynamic assessment of zones of proximal development in the
context of dementia rehabilitation and enablement
Stephen Wey, Senior Lecturer and
doctoral student in the Faculty of Health and Life Sciences at York
St John University.
Stephen’s doctoral studies are being supervised by Dr. Alison
Laver-Fawcett, Dr. Kathy Ring and Professor Patrick Doherty.
The aim of this doctoral research project is to explore the role
of dynamic assessment in identifying potential interventions for
rehabilitative and enabling practice with people with dementia.
Dementia comprises a set of conditions that are becoming more
prevalent in our increasingly ageing population and that have a
major impact on competence in daily living, occupational
performance, social interaction and well-being and yet there are
currently few tools available to occupational therapists and other
practitioners that go beyond assessment of what the person can or
cannot to do to identifying areas of potential for rehabilitative
and enabling interventions. Dynamic assessment is an interactive or
transactional approach to conducting assessment that aims to assess
areas of potential; particularly in terms of learning potential or
potential to make use of rehabilitative interventions. The
theoretical basis for dynamic assessment is found in the work of
the psychologist Lev Vygotsky and his concept of “The Zone of
Proximal Development” (or ZPD). The ZPD refers to the gap between
what a person has already mastered (their actual level of
development) and what he or she can achieve when provided with a
supportive learning environment (potential development). The ZPD
encapsulates the person’s cognition as an emergent, transactional
and dynamic process rather than a fixed state as standardised
What we are interested is points of transition between
internalised or mastered skills in people with dementia, and skills
that are starting to become detached and de-generalised from the
whole. We are also interested in how to identify areas of emergent
skill or adaptation; we do not consider skill loss to be one way
but see people with dementia as constantly striving to make sense
of and reconstruct their lived world and experiences, in the face
of internal and external (social and cultural) processes of
disintegration, disablement and exclusion. We would argue
that many of the actions described one-sidedly as “challenging
behaviours” can also be understood more fully in the light of such
strivings to make sense of the world through actions and meaning
making. So for people with dementia we are also taking into account
the situated and distributed cognitive environment but not just
seeing it as one constructed by the person’s caregivers but also,
primarily, by themselves in the course of their life histories and
strategies for living.
The study will discuss the utility of the ZPD concept as guiding
principal in rehabilitation with people who have dementia and
include a critical analysis and review of dynamic assessment tools
and procedures that may be used with people who have dementia in
the context of rehabilitative and enabling practice. The overall
outcome will be the development of a dynamic assessment toolkit for
use with people who have dementia to identify areas of potential
and skills that are hard to identify using current assessment
approaches. Such a tool aims to assist practitioner’s in the
assessment of a person’s potential for rehabilitation and ways to
tap into latent skills and capacities to maximise
occupational engagement and well-being.
For more information or to contact Stephen
Wey, S. (2001). Redefining the Possible: Occupational Therapy in
the Treatment of the Person Experiencing Dementia. In Proceedings
of OCTEP Dementia Clinical Forum – Conference 2000 - Papers and
Wey, S. (2001). Looking after Well-Being: a Community
Perspective. Journal of Dementia Care, 9(1), 18-20.
Bruce, E., & Wey, S. (2001). Looking after Well-Being: How
it Works in Practice. Journal of Dementia Care, 9(4), 27-30.
Wey, S. (2002). Occupation is Our First Language. In Proceedings
of OCTEP Dementia Clinical Forum second national conference.
Wey, S. (2002). Occupational Therapy, Transitional Phenomena and
Dementia. In Proceedings of OCTEP Dementia Clinical Forum second
Wey, S. (2002). Intensive Home Based Dementia Rehabilitation.
Journal of Dementia Care, 10(3), 28-33.
Wey, S. (2004). One size does not fit all. In M. Marshall,
Perspectives on Rehabilitation and Dementia. London: Jessica
Wey, S. (2006). Working in The Zone - A social ecological
framework for dementia rehab. In J. Woolham, Assistive Technology
in Dementia Care. Hawker publications.