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Stephen Wey's doctoral study

The dynamic assessment of zones of proximal development in the context of dementia rehabilitation and enablement

Stephen WeyStephen 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 testing assumes. 

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

E: S.Wey@yorksj.ac.uk
T: +44(0)1904-876790
W: w.mendeley.com/profiles/stephen-wey/ 

 

Publications

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 Workshops.

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 national conference.

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 Kingsley.

Wey, S. (2006). Working in The Zone - A social ecological framework for dementia rehab. In J. Woolham, Assistive Technology in Dementia Care. Hawker publications.