What is Dual Tasking?

Dual tasking—the act of performing a motor task while simultaneously engaging in a cognitive task—has become a cornerstone of effective rehabilitation. This method mirrors the multitasking demands of daily life, training the brain to handle multiple streams of information and action at once. Often, clients are surprised by how previously effortless tasks suddenly feel challenging after injury, illness, or neurological conditions.

Examples of dual tasking in everyday life:

• Carrying a full glass of water from the kitchen to the recliner without spilling.
• Walking while having a conversation.
• Cooking while listening for children in another room.
• Navigating stairs while holding groceries.
• Listening to directions while maneuvering through a crowded space.

These everyday scenarios demand a seamless blend of motor and cognitive processes, and disruptions in one domain can lead to falls, errors, or fatigue. By integrating dual-tasking exercises into therapy, we train clients to build resilience across both cognitive and physical domains.

Examples of Dual Tasking in Occupational Therapy (OT):

Motor-Motor Dual Tasking:

• Carrying Items While Navigating Obstacles – Improves coordination, spatial awareness, and endurance.
• Reaching Overhead While Shifting Weight – Enhances postural control and balance.
• Simultaneous Upper and Lower Limb Exercises – Strengthens bilateral coordination and gross motor function.

Cognitive-Motor Dual Tasking:

• Walking While Naming Items in a Category – Strengthens executive function, memory recall, and gait stability.
• Reciting a Recipe While Preparing Ingredients – Improves working memory and motor planning.
• Counting Backward During Transfer Training – Reinforces attention, problem-solving, and reduces fall risks.
• Sorting Objects While Maintaining Balance on a Foam Pad – Trains visual scanning, attention, and core stability.

With a neuroscience-based understanding of dual tasking, occupational therapy practitioners can address the functional deficits associated with a variety of pathologies—from stroke and brain injury to Parkinson’s Disease and other movement-related conditions

Dual Tasking and Interdisciplinary Care

Dual tasking isn’t reserved for a single profession—it’s an interdisciplinary tool that fosters collaboration between occupational therapy (OT) and physical therapy (PT). While cognition is often associated with speech therapy, motor-cognitive integration belongs across all rehabilitation disciplines.

The misconception that cognition falls solely within the speech therapy domain limits the potential for growth and cross-discipline collaboration. As healthcare providers, we have a collective responsibility to recognize that functional cognition, motor control, and sensory integration intersect across OT, PT, and speech therapy.

Why is this important?

• Healthcare infrastructure is stretched thin. Many clients have limited access to providers or face restrictions due to insurance barriers.
• Inequities in rehabilitation staffing mean some professions are underrepresented in healthcare teams. This leaves clients at risk of missing vital components of their care.
• Aging populations increasingly require cognitive and physical rehabilitation to maintain independence and age in place.

By embedding cognitive-motor approaches like dual tasking into PT and OT sessions, therapists can fill gaps in client care, ensuring holistic treatment even in the absence of speech therapy or neuropsychological services.

A Call for Collaboration, Not Competition

As rehabilitation professionals, defending our scope of practice should not come at the expense of client outcomes. The interdisciplinary approach to cognition and movement creates new opportunities—expanding job roles, enhancing professional respect, and ultimately empowering clients to thrive.

Rather than viewing cognition as “scope territory,” we must embrace its shared potential. In a healthcare system where client needs often outpace provider availability, it’s our responsibility to advance cognitive integration across all rehabilitation disciplines.

Coordination and Sensory Integration – Key Components

Beyond dual tasking, coordination drills and sensory integration exercises offer another avenue to connect cognition with movement. These interventions enhance:

• Motor Planning (Praxis): Requiring clients to plan and execute multi-step motor sequences.
• Body Awareness: Building spatial orientation and proprioception.
• Executive Function: Facilitating decision-making and problem-solving during movement.

Examples:

• Obstacle Navigation with Visual or Auditory Cues: Encourages sensory processing and postural adjustments.
• Hand-Eye Coordination Games: Strengthens fine motor skills while reinforcing focus and attention.
• Sequential Movement Patterns: Involves activities like following light patterns or copying motor sequences, fostering memory and praxis.

Real-Life Application: The OT’s Role

Occupational Therapy Practitioners are uniquely positioned to design interventions that reflect real-life challenges by embedding functional cognition and psychosocial support into motor-based interventions. This comprehensive approach ensures that clients can apply rehabilitative gains to occupations that are meaningful and essential to daily living.

Case Example:

Client Profile:
A 58-year-old client with early Parkinson’s Disease presents with balance issues and reports difficulties managing household tasks. While strength training improves lower extremity function, the client forgets to turn off appliances or loses focus mid-task. 

Intervention Plan:

• Dual-Tasking Approach:
  Have the client practice standing balance while recalling the steps for meal preparation or answering logic questions related to real life scenarios while performing upper and lower body exercises together to replicate functional reaching and bending during household chores reinforcing executive function and motor control simultaneously.
• Memory and Safety Recall Tasks:
  Engage the client in sequencing exercises to reinforce routine safety checks and improve recall of household tasks (e.g., turning off appliances). Consider teaching
• Mental Practice and Reflection:
  Introduce problem-solving scenarios involving potential errors or complications (e.g., forgetting to turn off the stove). The client can reflect on the situation, identifying solutions and reinforcing cognitive flexibility and self-awareness.