PERFORMANCE AREAS
ACTIVITIES OF DAILY LIVING
Activities of daily living refer to activities involved in taking care of one's own body and
include such things as dressing, bathing, grooming, eating, feeding, personal advice care.
INSTRUMENTAL ACTIVITIES OF DAILY LIVING
Instrumental activities of daily living refer to activities that may be considered optional and
involve the environment. IADLs include care of others, care of pets, child rearing,
communication device use.
EDUCATION
Education is an area of occupation that includes formal (e.g., university, coursework) and
informal (e.g., obtaining topic-related information or skills, instruction/training in areas of
interest) learning.
WORK
Work refers to paid or volunteer activities and includes the entire range of employment
activities such as interests, pursuits, job seeking, and job performance, to retirement preparation
and adjustment, as well as volunteer exploration and participation.
Play
Play refers to "any spontaneous or organized activity that provides enjoyment, entertainment,
amusement, or diversion.
LEISURE
Leisure refers to nonobligatory activity. This area of occupation includes planning as well as
participating in the activity.
SOCIAL PARTICIPATION
Social participation refers to activities involving interactions with others, including family,
community, and peers/friends.
ANALYSIS OF OCCUPATIONAL PERFORMANCE
Performance skills-including motor, process, skills are small units of performance.
ENGAGEMENT IN OCCUPATION TO SUPPORT PARTICIPATION IN CONTEXT OR CONTEXTS
Performance in Areas of Occupation
Activities of daily living (ADL)*
Instrumental activities of daily living (ADL)
Education
Work
Play
Leisure
Social participation
Performance Skills
Performance Patterns
Motor skills
Process skills
Communication/interaction skills
Habits
Routines
Roles
Context
Activity Demands
Client Factors
Cultural
Objects used and their properties
Body functions
Physical
Space demands
Body structure
Social
Social demands
Personal
Sequencing and timing
Spiritual
Required actions
Temporal
Required body functions
Virtual
Required body structures
Context
Definition
Cultural
Customs,
beliefs,
activity
patterns,
behavior
standards,
and
expectations accepted by the society of which the individual is a
member.
Physical
Nonhuman aspects of contexts. Includes the accessibility to and
performance within environments having natural terrain, plants,
animals, buildings, furniture, objects, tools, or devices
Social
Availability and expectation of significant individuals, such as spouse,
friends, and caregivers.
Personal
personal context includes age, gender, socioeconomic status, and
educational status.
Spiritual
The fundamental orientation of a person's life; that which inspires and
motivates that individual.
Temporal
"Location of occupation performance in time".
Virtual
Environment in which communication occurs by means of airways or
computers and an absence of physical contact.
OCCUPATIONAL THERAPY PROCESS
The evaluation includes an occupational profile and analysis of occupational
performance.
The evaluation process involves a client-centered approach; the OT practitioner is
interested in the client's viewpoint, narrative, and desires.
During the evaluation, the OT analyzes the client's performance skills and client
factors to determine strengths and limitations for the client.
INTERVENTION PLAN
Once the goals and objectives have been established, the intervention approach is
developed. The OTPF identifies five general approaches to intervention: create,
establish, maintain, modify, and prevent. The following paragraphs describe each
approach and provide a clinical example.
CREATE/PROMOTE (HEALTH PROMOTION)
This approach provides opportunities for people with and without disabilities. The
OT practitioner sets up a program or activity in the hope that all those who
participate will benefit by enhanced performance.
ESTABLISH/RESTORE (REMEDIATE)
The OT practitioner uses strategies and techniques to chance client factors to
establish skills that have not yet developed or to restore those that have been lost.
MAINTAIN
This intervention approach provides support to allow the client to continue to
perform in the manner in which he or she is accustomed.
MODIFY (COMPENSATION, ADAPTATION)
Sometimes activities are changed so that clients may continue to perform them
despite poor skill level. Compensation refers to changing the demands of the activity
or the way the client performs the activity. This is useful when client factors are not
changeable in a practical amount of time and the client wishes to engage in the
activity.
PREVENT
OT practitioners are interested in keeping clients well, and as such they may help
clients engage in activities to prevent or slow down disease, trauma, or poor health.
TYPES OF OCCUPATIONAL THERAPY INTERVENTIONS
Upon determining the client's goal for therapy, the OT practitioner decides the best
strategy for meeting the goals.
Therapeutic use of occupations and activities refers to selecting activities and
occupations that will meet the therapeutic goals. Preparatory methods.
Preparatory activities should be conducted as one part of the intervention session
rather than making up the entire session.
Purposeful activity leads to occupation and may be a part of the occupation.
Occupation-based activity refers to participation in the actual occupation, which
has been found to be motivating and which results in better motor responses and
improved generalization.
Consultation involves a type of intervention in which practitioners use their
knowledge and expertise to collaborate with the client.
Education involves imparting knowledge to the client. This intervention type
involves providing clients information about the occupation, but it may not result in
actual performance of the occupation.
OUTCOMES
The OT practitioner can measure improvement or enhancement of the client's ability
to carry out activities of daily living, or what is called occupational performance.
As clients improve skills and perform occupations, they show improved role
competence, that is, the ability to meet the demand of roles. Furthermore, clients
become more able to adapt or change to varying situations. Another outcome that
can be measured following occupational therapy intervention is client satisfaction.
Engagement in occupations and activities impacts a client's health and wellness.
Quality of life may improve and thus is considered a desired outcome of
intervention.