OCCT 506: Clinical Reasoning about Occupation
Form #4
Student: Michelle Ashley & Rachel Zimmerman
Activity: Challah Baking
Date: 9/19/12
Activity Analysis for Therapeutic Intervention
Directions: This form is to be completed as a group. It requires detailed analysis of the therapeutic activity you present and teach to
the class. Complete all sections in complete sentences with thorough descriptions and thought.
Provide a brief description of the
activity.
Identify the major steps, including
the time required for each.
Section I
Activity Description
Baking challah, a traditional type of Jewish bread, involves using
ingredients to make dough, and forming the dough into various
shapes.
1. Retrieve the dry ingredients needed for the challah recipe
from the pantry and place on the working surface. The dry
ingredients include yeast, all-purpose flour, salt, honey, oil,
and cinnamon-sugar mixture. (30 seconds)
2. Retrieve perishable items needed for the challah recipe from
the refrigerator and place on the working surface. This
recipe requires one egg per batch, plus another egg that will
be used to brush the top of the challah. (10 seconds)
3. Retrieve a large mixing bowl, liquid measuring cup, dry
measuring cups, and dry measuring spoons and place near
the ingredients. (30 seconds)
4. Measure 1 cup plus 2 teaspoons of flour and 1 teaspoon of
salt and dump into the large mixing bowl. (30 seconds)
5. Add an 8 gram package of rapid rise yeast to the mixture and
stir to combine with the flour and salt. (20 seconds)
6. Turn on the kitchen faucet and adjust the water temperature
so that the water is very warm. When very warm, place the
liquid measuring cup under the faucet to fill it to 1 cup.
Warm water should be used to ensure activation of the yeast.
(15 seconds)
7. Measure ½ cup of honey and ¼ cup of oil and add to the dry
(Modified from Hersch, Lamport, & Coffey, 2005)
OCCT 506: Clinical Reasoning about Occupation
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Energy Patterns: Describe the
required energy level in terms of
light, moderate, or heavy work
patterns and provide an explanation
for the level specified (refer to
description of MET levels in W&S).
Section II
Therapeutic Qualities
Activity Patterns: Indicate the
patterns of activity expected for
successful completion of the
activity.
mixture, along with the 1 cup of warm water. (1 minute)
8. Crack the eggshell on the side of the bowl and let the egg fall
into the bowl while holding the eggshell to ensure it does not
fall in. Add a measured 3 cups of flour to the bowl and knead
all the ingredients together with hands. (3 minutes)
9. Continue to knead the dough, adding more flour if the dough
is too sticky, until all ingredients are well incorporated into a
mass of dough. Cover the mixture with a towel and set aside
for ten minutes. (15 minutes)
10. After ten minutes, separate the dough into 4 even parts and
form each part into the desired shape. Let the shaped
challahs rise for two hours before baking. (2 hours and 15
minutes)
11. After the two hours, brush the tops of the challahs with a
beaten egg and sprinkle cinnamon-sugar mix on the top.
Place in a preheated 350F oven for 25 minutes, or until the
challah appears golden brown. (30 minutes)
Depending on the recipe used for the challah, required energy levels
could range from light work to moderate work. In general,
measuring the ingredients and shaping the dough would be
considered light work. Additionally, in a smaller recipe, less force is
used when kneading the dough, whereas a larger batch of dough
would require a greater amount of force for a longer duration of
time. When the activity is light work the MET value would be 2-3
and oxygen would be consumed at7-11 mL/kg per minute. If
working with a larger batch of dough, a MET level of 3-4 would be
accurate. Moderate oxygen levels consumed would be 11-14 mL/kg
per minute.
Structural, methodical, and orderly activity patterns are used in
baking challah. A recipe must be chosen in order to achieve the
correct taste and consistency in the final baked product. The recipe
would serve as the structure within the activity. Orderly activity
(Modified from Hersch, Lamport, & Coffey, 2005)
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


Structural/Methodical/Orderly
Repetitive
Expressive/Creative/Projective
patterns involve performing tasks in a certain sequence, such as
retrieving the mixing bowl before measuring the ingredients.
Methodical activity patterns become most relevant when one bakes
challah on a regular basis and has formed certain methods that they
have found to be successful or useful in the past.
Repetitive activity patterns would include the motion of kneading
the dough. Kneading entails mixing the dough with one’s hand to
form a cohesive mass of dough and to eliminate possible air bubbles.
This can take several minutes and involves the same hand actions
being repeated throughout the process.
Describe required body structures
Expressive, creative, and projective activity patterns are involved in
choosing a challah recipe, forming various shapes of challah, as well
as deciding what toppings to use for the challah. In choosing a
recipe, one can decide if they prefer sweet or savory tasting bread.
Variations of challah can include adding raisins or chocolate chips to
the dough. Furthermore, different flours can be used to substitute
for all-purpose flour for those with food allergies or health concerns.
Whole wheat, rice, tapioca, spelt, and rye flours are some examples
of the different substitutions. There are endless possibilities for
shaping the challah, such as braided, round, or pull-apart style rolls.
One can also decide to top the challah with a variety of toppings,
such as cinnamon-sugar, poppy seeds, sesame seeds, Italian
seasoning, or a crumbly streusel.
The eyes are required to read the recipe, obtain accurate
measurements of ingredients, and to visually determine the
appropriate consistency of the dough. The eyes are also required to
create the different shapes of challahs.
The ears are involved in hearing the oven timer ring when the oven
has reached its preheated temperature, as well as when it rings to
(Modified from Hersch, Lamport, & Coffey, 2005)
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indicate when the baking process is finished.
The nervous system is required for sensory functions involved in
baking challah. One’s fingertips can feel that the warm water is the
correct temperature. If the water is too hot the nervous system
would ensure that the fingers are withdrawn from the water
immediately. The nervous system is responsible for the electrical
impulses that dictate our muscle ability to manipulate the items used
in baking, such as holding the measuring cups and lifting the cookie
sheet into the oven.
Voice and speech structures are involved if baking is done with a
group of people. One person might give instructions to the other
individuals that are helping to make the challah. However, when
baking challah alone, voice and speech structures become less
prevalent.
Cardiovascular and respiratory structures are needed to have the
endurance to stand for the entire baking process, as well as walk
around the kitchen to retrieve needed items. Furthermore, these
structures are important in being able to lift items from the pantry
and lift the cookie sheet into and out of the oven. If baking challah
were done in a group setting with someone with a food allergy, a
mask could be used to avoid inhalation of the ingredients.
The endocrine structures are involved in the regulation of one’s
physical and mental state. It would be difficult to bake if the
individual was overly stressed or easily fatigued, which can be
heavily related to hormonal balance.
Structures related to movement are necessary to ambulate around the
cooking space. Reaching, bending, use of digits for manipulating
(Modified from Hersch, Lamport, & Coffey, 2005)
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Describe required body functions
ingredients and kitchen tools are important.
Mental Functions: Specific Mental Functions
Higher Level Cognitive
Discriminating between the different items and ingredients is
important in the occupation of baking challah. For example, one
must determine to use a large enough bowl to mix and knead the
ingredients in.
Attention
A certain degree of attention is required to ensure accurate
measurements are made and correct oven temperature is set.
If one is able to divide their attention between multiple tasks, challah
baking can be done simultaneously with another activity. For
example, if one is experienced in this activity, they might be able to
make a phone call while mixing the dry ingredients together.
Memory
If one is working in their own kitchen they will likely remember
easily where their kitchen tools and equipment are located.
Reading the recipe and then performing each step will require shortterm memory in order to complete the activity most effectively. For
example, once one has read to mix the salt, yeast, and flour together,
short-term memory would be used to measure these specific
ingredients and mix them.
Long-term memory becomes relevant when one has baked challah
on past occasions and can remember which ingredients are required
without referring to the recipe. This person would be able to go to
their pantry and assess if they have the needed ingredients without
(Modified from Hersch, Lamport, & Coffey, 2005)
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referring to the recipe.
Perception
Discrimination of senses will be used when engaging in the baking
process. One will used tactile, visual, vestibular, and proprioceptive
sensations throughout the process. For example, moving around the
working area will require one to use visual, vestibular, and
proprioceptive functions, especially if walking while carrying things.
Thought
One can generalize and apply previous knowledge to concepts found
in challah baking. If one has used yeast in the past they will already
know that yeast serves to make dough rise and expand. This will
lead to a better awareness of what is required to complete the
activity. The individual will be aware that if the yeast does not
bubble it might be inactive.
Mental Functions of Sequencing Complex Movement
Mixing and kneading require specific movements, such as forming a
fist with your hand, punching the dough to eliminate air bubbles, and
folding the dough.
Emotional
One should have an understanding of their emotional state before
deciding to participate in this activity. Emotional stress might lead
the individual to measure ingredients incorrectly or hinder the ability
to handle baking mishaps in a composed manner.
Experience of Self and Time
An individual who has never baked challah before should have the
motivation and self-esteem to try a new activity.
(Modified from Hersch, Lamport, & Coffey, 2005)
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Mental Functions: Global Mental Functions
Consciousness
One must have a high level of consciousness to prevent harming
oneself, such as being aware of hot surfaces and providing solutions
to potentially dangerous situations. For example, one would be
conscious to wear oven mitts when removing the challah from the
oven.
Orientation
Being oriented in the working environment and knowing where
items are located will make for a more effective baking process.
Temperament and Personality
Different personalities will engage in this activity in different ways.
Someone who is more particular about the way things are done
might become more agitated if their results are not as expected.
Furthermore, someone is very particular might choose to use a
kitchen scale to ensure the ropes for their braided challah are the
same weights. A more relaxed baker would be satisfied estimating
the size of their braiding rope by sight and feel.
Energy and Drive
Motivation is needed to participate in the tasks involved in baking
challah since this process requires time, attention, and energy.
Sensory Functions and Pain:
Visual, auditory, vestibular, taste, touch, smell, pain, temperature,
and proprioceptive senses are all needed throughout the process of
baking challah. At times many sensory functions will be used
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simultaneously, such as when the challah comes out of the oven. At
this time, one will use visual sensory functions to determine that the
challah looks golden brown, as well as smell sensory functions to
sense whether the challahs smell appealing. However, auditory
functions become more prevalent if the individual has never baked
challah before and is relying on the sound of the over timer to signal
the completion of baking time. The individual must also be cautious
to not handle the hot challahs with bare hands, which would cause
pain. Vestibular functions will be necessary when carrying materials
or tools to the working space, often several items at once. One must
be aware of the temperature in the working environment, as well.
Room temperature is usually the best type of environment to bake
challahs in. Proprioceptive sensory functions are necessary
throughout the baking process, from positioning the body in a way
that you can retrieve ingredients to the final element of placing the
hands in a proper way to take the cookie sheet out of the oven.
Though proprioceptive sensory functions usually occur
subconsciously, this type of physical work cannot be done without it.
Neuromusculoskeletal:
Joint Mobility & Joint Stability
Normal range of motion of joints in the entire body is ideal for
carrying out the tasks in the activity. Specifically, shoulder, elbow,
hand, wrist, and finger range of motion are important. These
movements of these joints are required for retrieving item, reaching,
and performing the recipe. Joints must have enough stability so that
the body stays aligned in the correct way.
Muscle Power, Tone, Endurance
Strength of muscles is needed to be able to knead the dough.
(Modified from Hersch, Lamport, & Coffey, 2005)
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Furthermore muscles should not be flaccid in order to have a high
enough tone to complete the tasks in the activity. Muscle endurance
will be required since kneading the dough will take at least several
minutes.
Motor Reflexes, Involuntary Movement Reactions, & Control of
Voluntary Movements
The ability to rapidly move your hand away from hot objects, such
as a cookie sheet coming out of the oven, is vital in any baking
activities. Eye, foot, and hand coordination is also involved
throughout the baking process.
Gait Patterns
A symmetric gait pattern will allow one to move more stability
around the working area. This is especially relevant if walking from
one end of the kitchen, or working area, to the other.
Cardiovascular, Immunological, & Respiratory Functions:
Cardiovascular
Baking challah entails standing and walking around the working
area, therefore one should have proper cardiovascular functioning.
If an individual with cardiovascular problems wishes to bake
challah, certain adjustments to the process should be made.
Immunological
If one is baking challah for a family or social gathering it would be
unwise to perform this activity while ill, as the challah could become
contaminated.
Respiratory
To perform the activity of baking challah one must be capable of
(Modified from Hersch, Lamport, & Coffey, 2005)
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sustaining a light to moderate amount of work, which will require a
certain amount of oxygen intake and output.
Voice and Speech Functions:
If baking with other people, one must be able to verbalize
instructions and use verbal cues to ensure effective communication.
For example, one person might stand at the pantry while the other
person stands at the counter calling out the ingredients that are
needed from the pantry.
Digestive, Metabolic, and Endocrine System Functions:
Digestive and Metabolic
If the baker of the challah plans to eat it when done, they must be
able to consume the ingredients that were used. Adjustments can be
made to recipes to substitute ingredients that the individual cannot
consume, such as using whole wheat flour instead of all-purpose
flour.
Endocrine
Challah is usually made with honey or sugar, therefore an individual
with a glycemic disorder might not be able to eat it, or may only be
able to consume a small amount. This type of endocrine disorder
requires caution in what the individual consumes.
Skin and Related-Structure Functions:
Open wounds, cuts, or abrasions should not be present when baking
challah, as the skin could become irritated. Kitchen gloves might be
an effective way to engage in this activity if there are any skin
issues.
(Modified from Hersch, Lamport, & Coffey, 2005)
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Tactile Components: consider the
following
 Contact with others
 Materials
 Equipment
Contact with others- Contact with others would apply in a situation
when one works in close proximity with others, such as baking
challah with a group of people. If one bakes challah with other
people, objects would be passed among one another and gesturing
would occur to relay messages.
Materials- While baking challah one will come into contact with all
the ingredients in the recipe, such as the flour, yeast, honey, eggs,
water, salt, oil, and cinnamon-sugar.
Performance Patterns: consider the
following:
 Habits
 Routines
 Roles
Equipment- Opening the refrigerator entails gripping the door handle
in order to retrieve perishable items. One will have to open the oven
door by grasping the oven handle. One will also need to slide the
oven racks out to place the cookie sheet in the oven.
Habits- Many individuals have habits that come into play in the
baking process. For example, it might be a habit to use the ½ cup
measure to measure full cups filling up twice. A common habit is to
place packets of yeast in the freezer so they do not spoil. Another
habit could be placing the carton of eggs in a particular spot in the
refrigerator.
Routines- The individual baking the challah may have a certain
preferred order of setting up the working area. An example would
be always grabbing the mixing bowls first, then the dry ingredients
from the pantry, followed by the perishable ingredients from the
refrigerator. One may have a routine of baking challah at certain
times, such as on one Sunday afternoon per month.
Roles- The person baking challah could be a provider for their
family, such as a wife, husband, mother, father, or grandparent.
(Modified from Hersch, Lamport, & Coffey, 2005)
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Roles are often influenced by societal expectations and providing
food is a common expectation of any type of caregiver. Another
role could be an employee of a bakery. The employee might bake
challah as part of the requirements of the job role.
Population: Discuss for whom and
in what way increased occupational
performance can be derived from
use of this activity.
Occupational performance can be increased for those who enjoy
creating and providing food for others, such as friends and family.
Anyone within the household, such as a mother or father, may feel a
sense of enjoyment by baking for their families. In this case, the
occupation would be enjoyment of providing. Challah baking would
increase the occupational performance for those who find it
meaningful to provide food for others.
There are many people who consider baking to be a leisure activity,
and gain satisfaction from creating food from scratch. For those
who have never baked challah before, it would serve as a
challenging way to broaden their baking repertoire.
Section III
Therapeutic
Application
Motor & Praxis Performance Skills
Furthermore, since challah is a traditional Jewish bread, someone
that is making it for a Jewish holiday or for a family gathering may
find that this activity brings them closer to the Jewish culture. Being
able to make this traditional food might contribute to one’s cultural
or religious identity.
In order to begin the baking process one will need to reach and bend
to retrieve the measuring tools, bowl, and ingredients from the
pantry and refrigerator. If the mixing bowl is in a high cabinet, a
stepping stool can be used to reach the item. It will also be
necessary to pace oneself to know which step will require more time
and effort. For example, kneading the dough will require more time
than stirring the dry ingredients together, therefore one must pace
themselves accordingly.
(Modified from Hersch, Lamport, & Coffey, 2005)
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When retrieving items from the pantry, refrigerator, or cabinets, it
might be possible to carry several things to the working to space at
one time. One will have to have a sense of how much is too heavy
to carry and what is reasonable.
When using a packet of yeast, one will need to tear the packet in the
proper place so as not to spill any in the working area. One will also
need to coordinate body movements to scoop and measure flour.
When cracking an egg into the mixing bowl, the amount of force
used must be considered so as not to have any of the eggshell fall
into the bowl.
There might be space limitations in the cooking area, such as a
kitchen table that is close to the working surface. This
environmental element will need to be considered when moving
around the working area in order to plan your movements.
Several steps in baking challah will require coordination of body
movements. For example, when stirring the dry ingredients together
it might be necessary to stabilize the mixing bowl with one hand
while using the other hand to combine the ingredients.
Sensory-Perceptual Performance
Skills
If one has baked challah before they will have several learned motor
activities that will allow them to work more efficiently. When using
the oven, the person will already have an understanding of how to
press the button and set the temperature.
Many times, there will be items in the pantry or refrigerator that are
not visible, but the person can locate based on knowing how the item
feels.
Each item that is used in baking challah has a different texture.
Flour is soft, light, and fairly simple to measure. The yeast that is
(Modified from Hersch, Lamport, & Coffey, 2005)
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used in this recipe comes in a pre-measured packet, so it does not
require a measurement. Honey, on the other hand, is sticky, thick,
and difficult to measure. The honey container will need to be
squeezed with some force in order to obtain the correct
measurement.
One will need to be visually able to confirm the correct
measurements of the ingredients, as well as hearing the often timer
beep to indicate that the oven is preheated or that the challah as
finished baking.
One will need to position their body in such a way that they are close
enough to the oven to place the cookie sheet on the oven rack, while
also being careful not to burn themselves.
Emotional Regulation Performance
Skills
Cognitive Performance Skills
Several emotional regulation performance skills are relevant in
challah baking. While baking if one discovers they are out of a
certain ingredient, the person must be able to contain their
frustration and come up with a suitable solution, such as going to the
grocery store that is nearby. Additionally, if the baker does not
achieve the expected outcome of the final challah product, they may
be disappointed. However, they should be able to handle the
situation in a rational manner, such as planning to bake the challah at
a later date and learning form that experience.
If one is baking challah at a family gathering with others assisting
you in the baking process, it is important to be able to respond
appropriately if they are making the activity more complicated than
it is when baking alone. For example, if you are cooking with your
sister and she hands you sugar instead of salt, you should not allow
yourself to get frustrated.
Prior to baking challah, one must allot a certain amount of time in
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their day to complete the entire activity. This requires reading the
recipe beforehand and then ensuring you have time to complete the
task. Furthermore, one will need to plan a grocery shopping trip to
buy ingredients that are not already in the kitchen.
Baking challah can be a messy activity; therefore it would be
appropriate to plan on wearing either an apron over clothes, or
clothes that one does not mind getting dirty.
One will need to choose the appropriate measuring cups and spoons
as dictated by the recipe. One will also need to multitask when
kneading the dough and adding more flour as needed to make the
dough less sticky
There are several elements require some cognitive planning. When
reading the recipe and seeing that there is honey and oil used, it
would be wise to measure the oil first, followed by the honey. Since
honey is sticky and difficult to pour out of the measuring cup,
measuring the oil first will allow the honey to slide out much more
readily.
Communication & Social
Regulation Performance Skills
Learning how to form the different shapes of challah requires many
cognitive processes. The first time performing a three-braid challah
might require more assistance, such as using picture tutorial or a
YouTube video. Repeating the activity will strengthen memory so
not as many learning materials are needed in the future.
When baking challah with other people certain social and
communication skills are required. When several people are in the
kitchen, and one person is walking with a hot cookie sheet, that
person should verbalize that they are in close physical proximity to
the other person. In addition, if an experienced baker is baking with
a novice baker, they should be ready to answer questions and give
(Modified from Hersch, Lamport, & Coffey, 2005)
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Identify Precautions and
Contraindications
Grading: Activity sequence,
duration, and/or activity procedures
appropriate instructions. One might also gesture to the pantry to let
the other person know where to retrieve a certain ingredient.
Precautions
One should ensure that the smoke detector in the house works in
case of leaving the challah in the oven too long.
One should wear oven mitts when transporting the cookie sheet from
the oven to the counter.
One should ensure that the eggs are not spoiled, and that there are no
blood spots in the yolk.
Contraindications
If one has a food allergy, such as a gluten allergy, one would not be
able to use this recipe as it contains all-purpose flour.
Other diets, such as someone on a Candida diet, should not eat
challah as it contains gluten containing products and honey which
could hinder the healing process of the body.
Grading Up
1. The use of a larger recipe, such as using an entire five pound
bag of flour would require much more time and force to
knead the dough. Furthermore, the larger amount of dough
will leave many more loaves of challah to shape.
2. Using a challah recipe that calls for regular yeast as opposed
to rapid rise yeast will require at least two hours of letting the
dough rise before shaping it.
3. Making a larger batch of challah that yields more loaves
most likely means that all the loaves will not fit into the oven
at one time. Therefore, one will have to leave more time to
bake the loaves in several batches.
4. Having an individual who has already made the challah
recipe previously measure the ingredients by eye rather than
with measuring utensils.
(Modified from Hersch, Lamport, & Coffey, 2005)
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Grading Down
1. Using an electric stand mixer with a dough hook attachment
will decrease the amount of time of recipe but eliminating
much of the physical labor.
2. Using a bread machine will allow you to incorporate all the
ingredients at once. The bread machine will help someone
who does not have the endurance to knead the dough by
hand.
3. If someone else, such as a grandchild, set up the ingredients
and tools on the counter for a grandparent who wanted to
bake challah, this would eliminate the step of retrieving items
from the refrigerator, pantry, and cabinets.
Grading: Working position of the
individual
Grading Up
1. Having the individual stand up to complete one step of
the activity, such as for kneading the dough.
2. Having the individual stand for the entire duration of the
activity, from measuring the ingredients to shaping the
loaves.
3. Positioning the kitchen tools on the far end of the
working surface would require one to reach further to
obtain the tools.
4. Sitting on an exercise ball while kneading the dough
would require additional core strength.
Grading Down
1. Placing the items in closer proximity to your working
space will be easier so one does not have to reach as far
while working. This will allow for better balance
because the center of gravity is closer.
(Modified from Hersch, Lamport, & Coffey, 2005)
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Grading: Tools
 Position
 Size
 Shape
 Weight
 Texture
2. Placing the items on a table where you can sit while
performing the activity with the items easily accessible.
.
Grading Up
1. Position: Having all the kitchen tools, such as measuring
cups and measuring spoons mixed together in a large drawer
so that the individual will need to find the appropriate tools.
2. Size: Using a 2-cup measure instead of a 1-cup measure
would require the individual to be more precise when
measuring small amounts. This would require more bending,
as well, to check for the accuracy of measurements.
3. Shape: Using a mixing bowl without a rim so that the
individual does not have a place to hold onto the bowl.
4. Weight: Using glass or stainless steels bowls are heavier
than plastic bowls, and would be more difficult to retrieve
from the cabinets.
5. Texture: Using a glass liquid measuring cup can be more
difficult to grasp than measuring cups with rubber grips.
Grading Down
1. Position: Using an angled liquid measuring cup which
makes it easier to see the measurement numbers. With this
type of measuring cups there is no need to bend down to read
the measurement.
2. Size: Using a larger mixing bowl to knead the dough would
allow one’s arms to have more freedom to move.
3. Shape: Using a Build Up Spoon for someone who has
difficulty grasping the mixing spoon. Furthermore, using a
mixing bowl with a handle would make it easier for someone
to hold the bowl and stabilize it.
4. Weight: Using a plastic or aluminum mixing bowl will be
(Modified from Hersch, Lamport, & Coffey, 2005)
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Grading: Materials
 Position
 Size
 Shape
 Weight
 Texture
lighter to retrieve from the cabinet.
5. Texture: Using measuring cups with rubber grips on the
handles makes grasping them easier. Furthermore, using a
mixing bowl with a silicone bottom will prevent the bowl
from shifting while kneading.
Grading Up
1. Position: Having all the ingredients on the top shelf of the
pantry, or in back of the refrigerator will make it challenging
to retrieve everything. Furthermore, having the ingredients
spread further apart of the working surface in order to obtain
the items.
2. Size: Using a ten pound bag of flour instead of a five pound
bag will make it harder to scoop flour out to measure.
3. Shape: Using a square shape honey bottle is more difficult to
squeeze since your hand will have to grasp around a large
surface.
4. Weight: Using an 80 oz. container of honey as compared to
a 16oz. bottle will be more difficult to manipulate.
5. Texture: Using an 80 oz. square container has a smooth
texture which would be more difficult to grasp rather than a
honey bear that has a texture which makes grasping easier.
Grading Down
1. Position: Having someone else prepare the ingredients by
un-packaging them and pouring them into the mixing bowl.
This will eliminate the steps of measuring the ingredients
directly from their packages, bottles, or containers.
2. Size: Using a small bag of flour, small bottle of oil, or a premeasured yeast packet are easier to use for measurements, as
well as for maneuvering the materials.
3. Shape: Using a honey bear is easier to squeeze because of its
shape and how it fits into the contour of the hand.
(Modified from Hersch, Lamport, & Coffey, 2005)
OCCT 506: Clinical Reasoning about Occupation
Form #4
Grading: Nature/degree of
interpersonal contact
Grading: Extent of tactile, verbal, or
visual cues provided by practitioner
during activity
4. Weight: Using a smaller bottle of oil will be easier to obtain
from the pantry rather than industrial size bottle
5. Texture: Using an electric mixture rather than using ones
hands to knead the dough will aid an individual that has an
aversion to touching wet items by allowing them to complete
the task.
Grading Up
1. Making challah with another individual who has a social
disorder will challenge the baker to relate with a different
type of person.
2. Making challah with other individuals who have never made
it before will challenge the individual to be patient and
compromise their expectations.
Grading Down
1. Making challah with only one other individual in your own
kitchen would be more comfortable for the individual
baking.
2. Making challah with another experienced challah baker.
3. Making challah with a friend or relative who you
communicate well with.
Grading Up
1. Giving less tactile or visual cueing to the individual making
the challah.
2. Providing the individual with the recipe, but not giving any
additional suggestions or information.
3. Providing minimal instructions as to where to specifically
locate the tools in the kitchen so the individual has to locate
them on their own.
Grading Down
1. The practitioner can give step by step instructions ensuring
what the individual understand what they are supposed to be
(Modified from Hersch, Lamport, & Coffey, 2005)
OCCT 506: Clinical Reasoning about Occupation
Form #4
Grading: Teaching-learning
environment
doing at that point in the recipe.
2. Providing verbal and visual cues, such as pointing to show
where a specific tool is located.
Grading Up
1. Teaching challah baking to several individuals at once will
be challenging due to the lack of individual attention.
2. Teaching the individual how to make challah by hand rather
than by using an electric mixer.
Grading Down
1. Using a combination of visual, auditory, and kinesthetic
teaching styles to offer the maximum amount of learning
opportunity.
2. Teaching challah making on a one-on-one basis in a quiet,
natural kitchen setting. This will help in decreasing
distraction and allow the individual to receive more attention.
Therapeutic Adaptation: Indicate
ways in which this activity can be
changed to increase occupational
performance and state your
reasoning. Consider:
 Orthotic devices
 Prosthetic devices
 Assistive technology
 Adaptive devices
 Architectural modifications
 Environmental modifications
 Wheelchair modifications
1. Orthotic Devices: Shoes with orthotic support may help
an individual who experiences pain when standing for a
long time.
2. Prosthetic: A below the knee prosthetic would
significantly help an individual with a leg amputation be
able to move around the kitchen and stand at the working
area to make challah. Additionally, the use of the
Myoelectric Arm Prostheses with the Electric Greifer
attachment will aid an individual with an arm
amputation. For example, this prosthetic would allow the
individual to grasp and pour oil into a measuring cup.
3. Assistive Technology: The Bioness Foot Drop System
provides mild electric stimulation to allow an individual
to dorsiflex the foot to allow for easier walking. This
(Modified from Hersch, Lamport, & Coffey, 2005)
OCCT 506: Clinical Reasoning about Occupation
Form #4
4.
5.
6.
7.
Energy conservation techniques or
methods
would enable the individual to maneuver around the
baking environment with more ease and stability.
Adaptive Devices: Using a spoon with a Built-Up
Handle when mixing the dry ingredients will aid an
individual who has a difficulty grasping.
Architectural Modifications: Modifying the height of
countertops or adding attachments that are the proper
height for individuals in wheelchairs to be able to access
the countertop to be able to make challah.
Environmental Modifications: High Energy AntiFatigued Mats are designed to alleviate pressure on lower
body joints when standing for long periods of time, such
as when baking challah.
Wheelchair Modifications: A tray attached to a
wheelchair would provide a surface to transport the
ingredients and tools needed for baking challah. Other
architectural modifications, such as changing the layout
of the kitchen, would be important in enabling those in
wheelchairs to access thing in their kitchen.
Energy can be conserved by having an electric stand mixture with a
dough hook knead the dough rather than kneading by hand.
Kneading by hand will take at least several minutes and requires a
fair amount of upper body strength.
Being in a seated position for at least some steps in this activity will
help conserve energy. For example, sitting at a table while shaping
the dough will eliminate some standing time.
Prioritizing how to collect the materials and tools needed for the
recipe will decrease unneeded trips to the pantry, refrigerator, and
cabinets.
(Modified from Hersch, Lamport, & Coffey, 2005)
OCCT 506: Clinical Reasoning about Occupation
Form #4
Adjustments to the recipe can be made if it is there is not enough
time to complete the whole activity within a few hours due to other
obligations. After making and shaping the dough, the dough can be
placed in the refrigerator overnight and be baked the next day.
Work simplification techniques or
methods
Instead of making the entire batch of challah from scratch one can
purchase bread mix that only requires adding certain wet ingredients.
One can choose to form simple shapes rather than trying to attempt
more advanced shapes, such as braided challahs. For example, one
can make a pull-apart style challah which only requires making balls
and placing them next to each other in a round pan.
Joint protection techniques or
methods
Body mechanics – consider
 Proper body mechanics
 Avoiding static or deforming
postures
 Avoiding excessive weightbearing positions
One should plan to have the tools and materials at a level where
significant bending and reaching is not required. For example, if
one was not able to fully flex the shoulder to reach a high shelf, the
needed items should be available at lower height.
If one had a wrist condition, such as Carpal Tunnel Syndrome, it
might be beneficial to wear a wrist brace when measuring
ingredients and braiding the dough.
One should ensure that their working space is an appropriate height
so that bending the back is not necessary when engaging in the
activity. Furthermore, one should cautious not to bend the back
when retrieving items from low shelves. Rather one should bend
their knees and perform a deep squat if necessary so that the back is
not bent. The same concept relates to body positioning when
transporting things in and out of the oven. When transferring items
from one area to another, such as from the pantry to the countertop,
one should carry the items close to their body so as not to maintain a
close center of gravity between the object and oneself.
(Modified from Hersch, Lamport, & Coffey, 2005)
OCCT 506: Clinical Reasoning about Occupation
Form #4
Standing in the same position for too long while kneading or shaping
the dough is not conducive to proper posture. Proper posture
involves weight shifting from time to time to relieve constant
pressure on joints.
How does this activity enhance
occupational performance areas?
ADLs
Eating- It can be satisfying to eat something you have baked from
scratch.
Feeding- Baking challah enables one to engage in self-feeding when
desired.
Functional Mobility- The activity of baking challah enables one to
move around their environment in addition to transporting materials
and tools that are used in baking challah.
IADLs
Community Mobility- One might need to get to the grocery store to
purchase ingredients for the challah. This will require the ability to
mobilize oneself in the community.
Meal Preparation and Cleanup- Baking challah allows you to
prepare part of a meal and experimenting with different ways to
make the bread. For example, one might try to make the challah
without gluten for someone on a gluten-free diet. Baking challah
can also facilitate improving the skill of cleaning up after oneself.
Religious Observance- Baking challah may enhance ones religious
identity since this type of bread is deeply rooted in Jewish culture.
Baking challah may inspire someone to celebrate the Jewish
Sabbath, as well as Jewish holidays.
(Modified from Hersch, Lamport, & Coffey, 2005)
OCCT 506: Clinical Reasoning about Occupation
Form #4
Safety and Emergency Maintenance- The individual baking challah
should be able to maintain a safe cooking environment and be able
to provide solutions if hazards occur. For example, if the house
starts to get smoky from the oven, it would be important to turn the
oven off and open doors and windows to allow smoke to escape.
Furthermore, if one any injuries occur during the baking process one
should be equipped First Aid tools and materials.
Shopping- Baking challah entails preparing a shopping list and
buying ingredients from the grocery store, which is an enjoyable
activity for many people. Shopping requires a level of independence
that enhances ones sense of identity in an environment outside the
home.
Education
Formal Education Participation- Attending a college class that
teaches cultural cooking and baking may enhance their knowledge
of the Jewish culture.
Informal Education Participation-Participating in an organized class
where baking challah is taught may enhance one’s enjoyment of this
activity.
Work
Employment Interests and Pursuits- An individual who bakes as a
profession can broaden their repertoire by learning how to bake
challah.
Job Performance- A baker located in a Jewish neighborhood might
choose to bake and challahs to improve business.
(Modified from Hersch, Lamport, & Coffey, 2005)
OCCT 506: Clinical Reasoning about Occupation
Form #4
Leisure
Leisure Exploration- Individuals often explore different types of
hobbies or leisure activities to enhance their lives. While baking
challah might be a more obligatory task for some, others will
associate challah baking as an enjoyable way to improve baking
skills and learn something new.
Leisure Participation- One might plan one afternoon a month to
engage in baking challah, as an enjoyable way to spend time. One
must balance this leisure activity with other activities that must be
done, such as going to work. The individual must plan appropriate
times to engage in baking challah.
Social Participation
Community- Challah baking can be done as a community function,
such as part of a synagogue bake sale, or as part of neighborhood
potluck gathering.
Family
The mother of a family might bake challah with her teenage
daughter as a way to teach her skills of providing food for oneself.
How does this activity enhance the
satisfaction of the client and/or
caregivers?
How does this activity enhance
quality of life?
Baking challah can be an effective way to relieve stress for some
people. The therapist could teach individuals with impairments how
to modify and adapt their environment to carry out this activity.
Completing this activity would most likely lead to a sense of
accomplishment.
Quality of life will mean different things to different people. For
some, baking challah will be a way to connect to a cultural and
religious identity, which can provide people with a greater sense of
self-identity. Other people might find that baking challah is a way to
(Modified from Hersch, Lamport, & Coffey, 2005)
OCCT 506: Clinical Reasoning about Occupation
Form #4
provide interesting food to family members or friends.
Describe in detail each member’s
specific duties during the
presentation and completion of this
form. How did your view of
occupation change throughout this
process?
Synopsis
Michelle was responsible for creating the PowerPoint presentation
and writing the recipe cards for the class. Rachel was responsible
for providing the recipe, shopping for the materials, and collecting
the necessary cooking tools. Michelle and Rachel completed Form 4
and edited the document together.
In completing this assignment, Michelle came to realize that the
activity of baking challah can be broken down into several steps,
each of which has its own demands. These demands can be
challenging for an individual with certain impairments. She also
realized that there are a multitude of occupations that are involved in
the one activity of baking challah.
Rachel had never really thought about the various adaptive and
prosthetic devices that could aid one in baking challah. She
specifically thought it was interesting to read about the Bioness Foot
Drop System. Learning more about these devices expanded her
knowledge on ways that those with impairments can continue to
engage in the occupations that are meaningful to them.
(Modified from Hersch, Lamport, & Coffey, 2005)