ACTIVITY ANALYSIS FORM √- the goals and activity don’t match…need to fix one or other; your analysis
and grading are good – just fix the goals
Name: Eve Eighmey, MOTS
CLIENT: Linda
Name of activity: Washing her dog this activity doesn’t seem to match the goal this is an IADL – pet care
Performance area of occupation: Leisure leading to ADL this activity is an IADL
Long Term Goal (COAST)/Short Term Goal: these goals don’t match the activity
 Long Term Goal: Client will shower independently without adaptive equipment within pre-injury time
within two weeks.
 Short Term Goal: client will shower with adaptations as needed within 10 minutes of pre-injury time
within one week.
Activity Demands
Objects and their properties (Materials, Tools, and Equipment . . .)
 Dog
 Shampoo
 Shower or sink
 Brush
 Towel
 Water
 Washing Mit/Glove
Space Demands (physical environment requirements):
 Room with a sink or tub (Bathroom or Kitchen)
 Area with non-carpet floor to dry and brush dog
Social Demands (rules or expectations related to social skills):
 Therapist
 Dog
Sequence and Timing (steps and amount of time to complete):
1.
Linda will prepare water to appropriate temperature ( 2 minutes)
2.
Linda will take leash/collar off of dog and place in tub/sink (1 minute)
3.
Linda will put dog into tub/sink and wet the dog completely (5 minutes)
4.
Linda will open shampoo, place on dog, and close shampoo (2 minutes)
5.
Linda will lather dog completely (4 minutes)
6.
Linda will rinse dog completely (4 minutes)
7.
Linda will remove dog from tub/sink and dry dog completely (4 minutes)
8.
Linda will brush dog (4 minutes)
9.
Linda will clean up area (4 minutes)
Safety Precautions and Contraindications:
 Area where activity should occur should be a nonstick floor or have a bath mat
 Dog should be calm to avoid further injury
Activity Analysis 8/3/05 ahh
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 Linda should not attempt this on her own without successfully completing it with a therapist
Client Factors
For each Client Factor, indicate if the activity you have selected to analyze would NORMALLY be affected by
alterations in this factor. If not, check n/a. If an alternation in this client factor would affect performance, indicate if
the activity would be significantly (sig) affected or only minimally (Min) affected. Space is provided for comment, if
you feel necessary
N/A Sig Min
Mental Functions
Global Mental Functions (affective, cognitive, perceptual)
Consciousness functions
Level of arousal
X
Level of consciousness
To person
Comments
X
Orientation functions
X
To place
X
Linda should be aware of her surroundings to
remain safe.
To time
X
Linda should complete this activity when the dog is
in a calmer state.
To self
X
Linda should be aware of her mood and be patient
during activity.
To others
X
Linda should be aware of what the animal is doing
at all times to remain in control of the activity.
Conscientiousness
Temperament and personality functions
X
Emotional stability
X
Openness to experience
X
Energy and drive functions
Motivation
X
Impulse control
X
Interests
X
Values
Specific Mental Functions
Attention functions
Sustained attention
Activity Analysis 8/3/05 ahh
Linda must be motivated to try and complete this
activity because it requires high effort and control.
Linda must be ready to overcome challenges and
not give up and change the plan quickly.
Linda loves her animal and must be interested in
taking care of it which will help her take of herself.
X
X
Divided attention
Memory functions
Retrospective memory
Linda must start and remain calm during the
activity to handle the dog.
Linda must be ready to try the activity even if she
cannot complete it.
X
X
Majority of Linda’s attention should be focused on
the dog through the entire activity.
Linda should be aware of her surroundings, but
should be mainly focused on the activity and what
the dog is doing during the bath.
Linda should remember how she used to wash her
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dog because it was a task she completed before
injury.
Prospective memory
X
Linda should be aware of parts of the activity she
may have to change due to her injury and put them
in her memory bank for use in washing herself and
her dog.
Perceptual functions
Visuospatial perception
X
Linda needs to be aware of items around her to
complete the task.
This activity will require remaining aware and alert
to the temperature of the water, presence of the dog
and items to wash him, and of pain to her injury.
Interpretation of sensory stimuli
(tactile, visual, auditory, olfactory,
gustatory)
Thought functions
Recognition/Concept formation
X
X
Categorization
X
Generalization
X
Awareness of reality
X
Logical/coherent thought
X
Appropriate thought content
Linda will need to be able to generalize this
activity to other activities in her daily life such as
washing herself with her injury and making
necessary adjustments.
Linda will need to logically put together steps to
complete the task.
X
Higher-level cognitive functions
Judgment
X
Concept formation
Linda will need to have appropriate judgment of
water temperature, the cleanliness of the dog, and
the completion of the task to correctly finish the
task.
X
Time management
X
Problem solving
X
Decision-making
X
Mental functions of language
Receive/express self
(spoken/written/sign)
Calculation functions
Add/subtract
Linda will need to recognize when one part of the
activity is complete and move on to the next task.
Linda will need to use her time effectively to
decrease her time washing herself to increase her
ADL productivity in the morning and decrease
extra time to get ready due to her injury.
Linda will need to be ready to change her plan if
something unexpected occurs while completing the
activity. An example would be the dog escaping
the tub/sink.
Linda needs to be able to decide when each step is
complete and be ready to move on to the next one.
She also should be able to decide the best way to
complete the task with the limitations of her injury.
X
X
Experience of self and time functions
Activity Analysis 8/3/05 ahh
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Linda may need to speak to the animal to calm him.
Body image
Self-concept
X
X
Self-esteem
X
Sensory functions and pain
Seeing and related functions
Visual acuity
X
Hearing and vestibular functions
Hearing function
X
Vestibular function
Additional sensory functions
Taste function
Linda needs to believe she can complete this task
and that she has the ability to wash her dog alone.
Linda will need to believe she can complete this
task.
X
Linda will need balance herself while holding the
dog and completing the washing, rinsing, drying
and brushing of the animal.
X
Smell function
X
Proprioceptive function
X
Touch function
X
Sensation of pain
X
Linda will need to aware of what is around her and
her strength and abilities needed to complete this
task.
Pain
Linda will need to be aware of if she is causing
further injury to her hand or if she is injuring the
dog through alterations made to the activity due to
her injury.
Neuromusculoskeletal and movement related functions
Function of joints and bones
Mobility of Joint Functions X
PROM
Stability of Joint Functions
X
Mobility of Bone Functions
Muscle Functions
Muscle power functions
Muscle tone functions
Muscle endurance functions
Movement functions
Motor reflex functions
X
X
Activity Analysis 8/3/05 ahh
Linda will need muscle power to hold the dog
down, facilitate the necessary items to complete the
bath, and groom the dog.
X
X
Linda will need endurance because this task may
take 30 minutes or more during which she will be
actively working the entire time.
X
Linda will need motor reflexes in case of injury to
her hand or if the water temperature becomes too
hot.
Linda will need to be in control of her body to
complete the task in order to be in control of the
dog during the bathing.
Linda will need to be in control of her body to
complete the task in order to be in control of the
Involuntary movement reaction
functions
Control of voluntary movement
functions
Linda will need AROM of joints to complete the
task, especially of her non injured upper extremity.
Linda will need stability to hold herself and the dog
in position during the bathing.
X
X
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Involuntary movement functions
X
dog during the bathing.
Linda will need to be in control of her body to
complete the task in order to be in control of the
dog during the bathing.
Gait pattern functions
X
Cardiovascular, hematological, immunological, and respiratory system function
Cardiovascular system function
Blood pressure function
X
Respiratory system function
Respiratory functions
X
Additional functions and sensations of the cardiovascular and respiratory systems
Exercise Tolerance functions
X
Linda will need to be able to tolerate activity of the
dog and herself to complete the dog washing.
Skin and related structure functions
Skin functions
Protective functions of skin
X
Linda will need to be protective and aware of her
scar from her surgery to repair her broken wrist.
Repair functions of skin
X
PERFORMANCE SKILLS
For each skill, indicate the NORMAL level of performance required (min, mod, max) to perform the activity you are
analyzing. Minimum (Min) entails some required skill but very brief, non sustained and easily compensated if not
present. Moderate (mod) entails frequent need, sustained usage and significant problems if not present. Maximum
(Max) entails continuous need and near impossible performance if not present.
Min
Mod Max
Motor Skills
Posture
Stabilizes
Comments
X
Linda needs to be able to stabilize herself to
control the dog and the activity.
X
Linda needs to be able to change positions
smoothly and often to wash the dog.
Reaches
X
Bends
X
Linda needs to have full reaching capacity as the
dog changes positions and to grasp items such as
shampoo and brush.
Linda needs to bend down to tub level and remain
there for more than 10 minutes to get down to the
level to complete the task.
Coordination
Coordinates
X
Manipulates
X
Aligns
X
Positions
Mobility
Walks
Flows
Strength & Effort
Moves
X
X
X
Transports
Activity Analysis 8/3/05 ahh
Linda needs the coordination to complete multiple
items at once such as controlling the dog and
opening the shampoo.
Linda need to manipulate the items needed for the
task such as shampoo and brush.
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Linda needs to be able to move herself and the
dog.
Linda
X needs to be able to transport the dog to and
Lifts
X
Calibrates
X
Grips
Energy
Endures
Paces
X
Linda needs to be able to grip the shampoo, brush,
and, dog.
X
Linda will need energy to complete the task and to
maintain control of her dog.
Linda will need to pace herself to complete the
task in its entirety.
X
Visual-Motor Integration
Oral-Motor Control
X
X
Process skills
Energy
Paces
X
Attends
X
Knowledge
Chooses
X
Uses
X
Handles
Heeds
Inquires
Temporal Organization
Initiates
Linda will need to pace herself of each task and
not get ahead of herself missing a step trying to
finish the bath quickly.
Linda will be aware of the task at all times and
have her full attention to what is happening at each
step.
Linda will need to make well thought choices to
complete the task and maintain control.
Linda will need to use her previous knowledge of
how to complete this task to complete it under
different circumstances and with limitations.
X
X
X
Linda will need to inquire if she has questions
about completing the task without aggravating her
current injury.
X
Continues
X
Sequences
X
Terminates
X
Activity Analysis 8/3/05 ahh
from the tub and out of the bathroom.
Linda needs to be able to lift herself, the dog, and
items needed to wash the dog. All of these items
are different sizes and weights.
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Since this task is based on getting back to
completing ADL’s, Linda will need to be aware of
all aspects of time during this task, including
starting, moving to the next step, and ending the
task.
Since this task is based on getting back to
completing ADL’s, Linda will need to be aware of
all aspects of time during this task, including
starting, moving to the next step, and ending the
task.
In order to complete this task, Linda will need to
be aware of the next step.
Since this task is based on getting back to
completing ADL’s, Linda will need to be aware of
all aspects of time during this task, including
starting, moving to the next step, and ending the
task.
Organizing Space and Objects
Searches/locates
X
Gathers
X
Organizes
X
Restores
Linda needs to be organized and know where
objects needed to complete the task are at all times
to fulfill the activity requirements.
Linda needs to gather everything before the task
for ease of completion and the end of the task to
ensure safety and cleanliness of area.
X
Navigates
X
Linda needs to be able to navigate the area to
complete the task safely without injury to the right
hand.
X
With the dog as part of the task, Linda needs to
adapt as needed due to the dog’s spontaneity.
Linda needs to accommodate herself and the dog.
X
Linda needs to adjust if the dog is unwilling to
participate or if she feels discomfort to her injured
wrist.
X
Linda should remain in contact with the dog at all
times to have control of the situation and compete
it in a timely manner.
Linda should look only at the dog to keep him
calm.
Maneuvers
X
Orients
X
Postures
X
Linda should be able to maneuver to complete the
task and avoid injury and make accommodations to
her left wrist.
Linda should be orientated to place and time to
complete hers task, make improvements, and avoid
injury.
Linda should have correct posture to avoid injury
to her back while lifting and washing the dog.
Adaptation
Notices/responds
Accommodates
X
Adjusts
Benefits
X
Communication/Interaction skills
Physicality
Contacts
Gazes
X
Gestures
X
Information/Exchange
Articulates
X
Asserts
Asks
X
X
Engages
Expresses
Activity Analysis 8/3/05 ahh
Linda should only articulate with the dog in a
positive manner or with the therapist if necessary,
focus should be on the task.
Linda needs to be assertive when handling the dog.
X
X
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Linda needs to be fully engaged with the task and
the animal to remain in control of the activity and
its completion.
Modulates
X
Linda may need to adjust her tone when handling
the dog to calm him down or reassure him that all
is going to be okay.
Linda share concerns with the therapist as needed
or following the end of the task.
Linda should only speak to the therapist as needed.
Focuses
X
Relates
X
Linda should be focused on the dog and herself
and what is happening between the two to avoid
injury to her hand.
Linda should respect the dog and complete the task
as timely and efficiently as possible since they are
not enjoying the activity.
Shares
X
Speaks
X
Sustains
Relations
Collaborates
X
Conforms
Respects
X
X
X
GRADING THE ACTIVITY
Next, identify the performance skill you are grading (e.g. coordination) and describe how you could make the
activity more difficult (grading up) or easier (grading down) for your specific client.
Performance Skills
Grading down (easier)
Grading Up (harder)
Motor Skills:
Posture-Stabilizes
Therapist will helps stabilize the dog
in the bathtub.
Linda will use a handheld shower head
to wash the dog while stabilizing the
dog in the tub.
Strength & Effort:
Grips
A small shampoo bottle will be used
for ease of holding.
A larger and heavier shampoo bottle
will be used during the bath.
Motor Skills:
Manipulation
Linda can use a bath glove to wash
the dog.
Linda will use only her dominant right
hand to wash the dog.
Strength & Effort:
Lifts
Therapist will lift the dog into and
out of the tub for Linda.
Linda will lift dog out of tub using her
non-dominant left hand only.
Mobility:
Bends
Linda will complete activity in sink
and avoid bending down to tub.
Linda will remain bending in all
directions during bath, to hold dog,
reach for items and, control water.
Based on:
American Occupational Therapy Association. (2002). Occupational therapy practice framework: Domain and process. Bethesda, MD: Author.
Watson, D. E. (1997). Task analysis: An occupational performance approach (pp. 378 – 383). Bethesda, MD: AOTA
Activity Analysis 8/3/05 ahh
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