practice framework.csv

ADL's

ADL - includes obtaining supplies; maintaining bath position; transferring to and from bath positions

ADL - includs using equipment for bladder control

ADL - Includes selecting appropriate clothing; obtaining from storage area; applying prothese and orthoses

ADL - ability to manipulate food or fluid in mouth

ADL - process of setting up and bringing food or fluid to mouth

ADL - moving around during daily ax and transporting objects

ADL - using; cleaning; maintaining personal care items

ADL - includes obtaining and using supplies

ADL - engagement

ADL - includes obtaining and using supplies; clothing mgnt; maintaining toilet position; cleaning body

IADLs

IADL - includes selecting and supervising caregivers as well as providing care for others

IADL - arranging; supervising; or providing care for pets

IADL - providing care and supervision to support developmental needs of child

IADL - sending; receiving; interpreting info using a variety of systems and equipment. Including writing tools; computers; call lights

IADL - moving around community via private or public transportation

IADL - using fiscal resources including short term and long term planning

IADL - developing; managing; maintaining routines for health such as exercise; nutrition; med mgnt

IADL - obtaining and maintaining personal and household possessions and environment such as home; yard; car; appliances. Also clothing. Knowing who to contact for help

IADL - planning; preparing; serving nutrional meals and cleanup

IADL - participation in religion

IADL - performing preventive procedures to maintain safe environment. Regognize hazardous situations and initiate action

IADL - preparing shopping list; selecting; purchasing; and transporting items

REST and SLEEP

REST and SLEEP - includes identifying the need to relax

REST and SLEEP -

REST and SLEEP - includes routines such as dressing; grooming; making bed; setting alarm; securing the home

REST and SLEEP

EDUCATION

EDUCATION - includes academic; extracurricular; and lunch recess

EDUCATION

EDUCATION - includes partcipating in classes; programs; and ax

WORK

WORK

WORK - including work skills; time mgnt; relationships; compliance w work norms and procedures

Work - developing skills and selecting appropriate avocational pursuits

WORK

WORK

PLAY

PLAY - identifying appropriate play ax

PLAY - including obtaining; using; maintaining supplies

SOCIAL PARTICIPATION

SOCIAL PARTICIPATION - engaging in ax resulting in successful interaction within the community

SOCIAL PARTICIPATION

SOCIAL PARTICIPATION

ADLs; IADLs; rest and sleep; education; work; play; leisure; social participation

values; beliefs; spirituality; body functions; body structures

CLIENT FACTORS Specific mental functions -Higher-level cognitive

CLIENT FACTORS Specific mental functions - attention

CLIENT FACTORS Specific mental functions -memory

CLIENT FACTORS Specific mental functions - perception

CLIENT FACTORS Specific mental functions -thought

CLIENT FACTORS Specific mental functions -Mental functions of sequencing complex movement

CLIENT FACTORS Specific mental functions -Emotional

CLIENT FACTORS Specific mental functions -Experience of self and time

CLIENT FACTORS GLOBAL mental functions -Consciousness

CLIENT FACTORS GLOBAL mental functions -Orientation

CLIENT FACTORS GLOBAL mental functions -Temperament and personality

CLIENT FACTORS GLOBAL mental functions -Energy and drive

CLIENT FACTORS GLOBAL mental functions -Sleep

CLIENT FACTORS Sensory functions and pain - Seeing and related functions; including visual acuity; visual stability; visual field functions

CLIENT FACTORS Sensory functions and pain - Hearing functions

CLIENT FACTORS Sensory functions and pain - Vestibular functions

CLIENT FACTORS Sensory functions and pain - Taste functions

CLIENT FACTORS Sensory functions and pain - Smell functions

CLIENT FACTORS Sensory functions and pain - Proprioceptive functions

• various textures such as food"
• CLIENT FACTORS Sensory functions and pain - Touch functions

CLIENT FACTORS Sensory functions and pain - Pain (e.g.; diffuse; dull; sharp; phantom)

CLIENT FACTORS Sensory functions and pain - Temperature and pressure

CLIENT FACTORS Neuromusculoskeletal and movement-related functions Functions of joints and bones - Joint mobility

CLIENT FACTORS Neuromusculoskeletal and movement-related functions Functions of joints and bones - Joint stability

CLIENT FACTORS Neuromusculoskeletal and movement-related functions Functions of joints and bones - Muscle power

CLIENT FACTORS Neuromusculoskeletal and movement-related functions Functions of joints and bones - Muscle tone

CLIENT FACTORS Neuromusculoskeletal and movement-related functions Functions of joints and bones - Muscle endurance

CLIENT FACTORS Neuromusculoskeletal and movement-related functions Functions of joints and bones - Motor reflexes

CLIENT FACTORS Neuromusculoskeletal and movement-related functions Functions of joints and bones - Involuntary movement reactions

• midline; fine- and gross-motor control; and oculomotor (e.g.;
• saccades; pursuits; accommodation; binocularity)"
• CLIENT FACTORS Neuromusculoskeletal and movement-related functions Functions of joints and bones - Control of voluntary movement

CLIENT FACTORS Neuromusculoskeletal and movement-related functions Functions of joints and bones - Gait patterns

• hypotension); and heart rate"
• CLIENT FACTORS Cardiovascular; hematological; immunological; and respiratory system function - Cardiovascular system function

CLIENT FACTORS Cardiovascular; hematological; immunological; and respiratory system function

CLIENT FACTORS Cardiovascular; hematological; immunological; and respiratory system function

CLIENT FACTORS Cardiovascular; hematological; immunological; and respiratory system function - Additional functions and sensations of the cardiovascular and respiratory systems

CLIENT FACTORS Voice and speech functions

CLIENT FACTORS Voice and speech functions

CLIENT FACTORS Voice and speech functions

CLIENT FACTORS Digestive; metabolic; and endocrine system function

CLIENT FACTORS Digestive; metabolic; and endocrine system function

CLIENT FACTORS Genitourinary and reproductive functions

CLIENT FACTORS Genitourinary and reproductive functions

• wounds; cuts; or abrasions. Repair function of the skin—wound healing"
• CLIENT FACTORS Skin and related-structure functions - Skin functions

CLIENT FACTORS Skin and related-structure functions

BODY STRUCTURES

BODY STRUCTURES

BODY STRUCTURES

• respiratory systems"
• BODY STRUCTURES

BODY STRUCTURES

• systems"
• BODY STRUCTURES

BODY STRUCTURES

BODY STRUCTURES

ACTIVITY DEMANDS

ACTIVITY DEMANDS Aspects - Objects and their properties

ACTIVITY DEMANDS Aspects - Space demands (relates to physical context)

ACTIVITY DEMANDS Aspects - Social demands (relates to social environment and cultural contexts)

ACTIVITY DEMANDS Aspects - Sequence and timing

• communication; and social performance skills should each be considered. The performance skills demanded by an activity will be correlated with the demands of the other activity aspects (e.g.; objects; space)"
• ACTIVITY DEMANDS Aspects - Required actions and performance skills

• p. 10) that are required to support the actions used to perform the activity. Ex: Mobility of joints; level of consciousness"
• ACTIVITY DEMANDS Aspects - Required body functions

ACTIVITY DEMANDS Aspects - Required body structures

PERFORMANCE SKILLS

• "PERFORMANCE SKILLS - Motor and praxis skills. EX: Bending and reaching for a toy or tool in a storage bin; Pacing tempo of movements to clean the room;
• Coordinating body movements to complete a job task; Maintaining balance while walking on an uneven surface or while showering;Anticipating or adjusting posture and body position in response to environmental circumstances; such as obstacles; Manipulating keys or lock to open the door"

PERFORMANCE SKILLS - Sensory– perceptual skills EX: Positioning the body in the exact location for a safe jump; Hearing and locating the voice of your child in a crowd; Visually determining the correct size of a storage container for leftover soup;Locating keys by touch from many objects in a pocket or purse (i.e.; stereognosis); Timing the appropriate moment to cross the street safely by determining one’s own position and speed relative to the speed of traffic; Discerning distinct flavors within foods or beverages

PERFORMANCE SKILLS - Emotional Regulation Skills EX: Responding to the feelings of others by acknowledgment or showing support; Persisting in a task despite frustrations; Controlling anger toward others and reducing aggressive acts; Recovering from a hurt or disappointment without lashing out at others; Displaying the emotions that are appropriate for the situation; Utilizing relaxation strategies to cope with stressful events

PERFORMANCE SKILLS - Cognitive Skills EX: Judging the importance or appropriateness of clothes for the circumstance; Selecting tools and supplies needed to clean the bathroom; Sequencing tasks needed for a school project; Organizing activities within the time required to meet a deadline;Prioritizing steps and identifying solutions to access transportation; Creating different activities with friends that are fun; novel; and enjoyable; Multitasking—doing more than one thing at a time; necessary for tasks such as work; driving; and household management

PERFORMANCE SKILLS - Communication and social skills EX: Looking where someone else is pointing or gazing; Gesturing to emphasize intentions; Maintaining acceptable physical space during conversation; Initiating and answering questions with relevant information; Taking turns during an interchange with another person verbally and physically;Acknowledging another person’s perspective during an interchange

PERFORMANCE PATTERNS

• "PERFORMANCE PATTERNS—HABITS—EX: Automatically puts car keys in the same place. Spontaneously looks both ways before crossing the street Repeatedly rocks back and forth when asked to initiate a task Repeatedly activates and deactivates the alarm system before entering the home;
• Maintains the exact distance between all hangers when hanging clothes in a closet"

PERFORMANCE PATTERNS—ROUTINES

PERFORMANCE PATTERNS—RITUALS

PERFORMANCE PATTERNS—ROLES

• The term context refers to a variety of interrelated conditions that are within and surrounding the client. Contexts include cultural; personal; temporal; and virtual.The term environment refers to the external physical and social environments that surround the client and in which the client’s daily life
• occupations occur."
• CONTEXTS AND ENVIRONMENTS

CONTEXTS AND ENVIRONMENTS - Cultural

CONTEXTS AND ENVIRONMENTS -Personal

CONTEXTS AND ENVIRONMENTS - Temporal

CONTEXTS AND ENVIRONMENTS - Virtual

CONTEXTS AND ENVIRONMENTS - Physical

CONTEXTS AND ENVIRONMENTS - Social

The initial step in the evaluation process that provides an understanding of the client’s occupational history and experiences; patterns of daily living; interests; values; and needs. The client’s problems and concerns about performing occupations and daily life activities are identified; and the client’s priorities are determined.

The step in the evaluation process during which the client’s assets; problems; or potential problems are more specifically identified. Actual performance is often observed in context to identify what supports performance and what hinders performance. Performance skills; performance patterns; context or contexts; activity demands; and client factors are all considered; but only selected aspects may be specifically assessed. Targeted outcomes are identified.

A plan that will guide actions taken and that is developed in collaboration with the client. It is based on selected theories; frames of reference; and evidence. Outcomes to be targeted are confirmed

Ongoing actions taken to influence and support improved client performance. Interventions are directed at identified outcomes. Client’s response is monitored and documented.

A review of the implementation plan and process as well as its progress toward targeted outcomes.

Determination of success in reaching desired targeted outcomes. Outcome assessment information is used to plan future actions with the client and to evaluate the service program (i.e.; program evaluation).

An occupational therapy practitioner’s planned use of his or her personality; insights; perceptions; and judgments as part of the therapeutic process

Occupations and activities selected for specific clients that meet therapeutic goals. To use occupations/activities therapeutically; context or contexts; activity demands; and client factors all should be considered in relation to the client’s therapeutic goals. Use of assistive technologies; application of universal-design principles; and environmental modifications support the ability of clients to engage in their occupations.

Purpose: Client engages in client-directed occupations that match identified goals. Examples:Completes morning dressing and hygiene using adaptive devices; Purchases groceries and prepares a meal; Utilizes the transportation system; Applies for a job; Plays on playground and community recreation equipment; Participates in a community festival; Establishes a pattern of self-care and relaxation activities in preparation for sleep

• "Purpose: Client engages in specifically selected activities that allow the client to develop skills that enhance occupational engagement.
• Examples:Practices how to select clothing and manipulate clothing fasteners; Practices safe ways to get in and out of a bathtub; Practices how to prepare a food list and rehearses how"

• "Purpose: Practitioner selects directed methods and techniques that prepare the client for occupational performance. Used in preparation for or concurrently with purposeful and occupation-based activities.
• Examples:Provides sensory enrichment to promote alertness; Administers physical agent modalities to prepare muscles for movement; Provides instruction in visual imagery and rhythmic breathing to promote rest and relaxation"

A type of intervention in which occupational therapy practitioners use their knowledge and expertise to collaborate with the client. The collaborative process involves identifying the problem; creating possible solutions; trying solutions; and altering them as necessary for greater effectiveness. When providing consultation; the practitioner is not directly responsible for the outcome of the intervention

An intervention process that involves imparting knowledge and information about occupation; health; and participation and that does not result in the actual performance of the occupation/activity.

Efforts directed toward promoting occupational justice and empowering clients to seek and obtain resources to fully participate in their daily life occupations.

Create; promote (health promotion)a—An intervention approach that does not assume a disability is present or that any factors would interfere with performance. This approach is designed to provide enriched contextual and activity experiences that will enhance performance for all persons in the natural contexts of life

FOCUS: Performance skills EX: Create a parenting class to help first-time parents engage their children in developmentally appropriate play

FOCUS: Performance patterns EX: Promote effective handling of stress by creating time use routines with healthy clients

FOCUS: Context or contexts or physical environments EX: Promote a diversity of sensory play experiences by recommending a variety of equipment for playgrounds and other play areas

FOCUS: Activity demands EX: Serve food family style in the congregate dining area to increase the opportunities for socialization

FOCUS: Client factors (body functions; body structures) EX: Promote increased endurance by recommending year-round daily outdoor recess for all school children; Design a dance program for senior citizens that will enhance strength and flexibility

An intervention approach designed to change client variables to establish a skill or ability that has not yet developed or to restore a skill or ability that has been impaired

FOCUS: Performance skills EX: Provide adjustable desk chairs to improve client sitting posture; Work with senior community centers to offer driving educational programs targeted at improving driving skills for persons ages 65 or older

FOCUS: Performance patterns EX: Collaborate with clients to help them establish morning routines needed to arrive at school or work on time; Provide classes in fatigue management for cancer patients and their families

FOCUS: Client factors (body functions; body structures) EX: Support daily physical education classes for entire population of children in a school aimed at improving physical strength and endurance; Collaborate with schools and businesses to establish universal-design models in their buildings; classrooms; and so forth

An intervention approach designed to provide the supports that will allow clients to preserve the performance capabilities they have regained; that continue to meet their occupational needs; or both. The assumption is that; without continued maintenance intervention; performance would decrease; occupational needs would not be met; or both; thereby affecting health and quality of life.

FOCUS:Performance skills EX: Maintain the ability of the client to organize tools by providing a tool outline painted on a pegboard; Develop a refresher safety program for industrial organizations to remind workers of need to continue to use safety skills on the job

• "FOCUS: Performance patterns EX: Enable client to maintain appropriate medication
• schedule by providing a timer to aid with
• memory; Establish occupational performance patterns to
• maintain a healthy lifestyle after significant
• weight loss"

• "FOCUS: Context or contexts or physical environments EX: Maintain safe and independent access for persons
• with low vision by recommending
• increased hallway lighting; During a natural disaster; work with facilities
• identified as “shelters” to provide play and
• leisure activities for displaced people to allow a
• constructive outlet and semblance of normalcy"

• "FOCUS: Activity demands EX: Maintain independent gardening for persons
• with arthritic hands by recommending tools
• with modified grips; long-handled tools; seating
• alternatives; raised gardens; and so forth"

• "FOCUS: Client factors EX: Provide multisensory activities in which nurs(
• body functions; body structures)
• ing-home residents may participate to maintain
• alertness; Provide hand-based thumb splint for client use
• during periods of stressful or prolonged"

An intervention approach directed at “finding ways to revise the current context or activity demands to support performance in the natural setting; [including] compensatory techniques; [such as]...enhancing some features to provide cues or reducing other features to reduce distractibility”

• "FOCUS: Performance patterns EX: Provide a visual schedule to help a student
• follow routines and transition easily between
• activities at home and school; Simplify task sequence to help a person with
• cognitive issues complete a morning self-care
• routine"

FOCUS: Context or contexts or physical environments EX: Assist a family in determining requirements for building a ramp at home for a family member who is returning home after physical rehabilitation; Consult with builders in designing homes that will allow families the ability to provide living space for aging parents (e.g.; bedroom and full bath on the main floor of a multilevel dwelling)

FOCUS: Activity demands EX: Adapt writing surface used in classroom by fourth grader by adding adjustable incline board; Assist a patient with a terminal illness and his or her family in modifying tasks to maintain engagement

An intervention approach designed to address clients with or without a disability who are at risk for occupational performance problems. This approach is designed to prevent the occurrence or evolution of barriers to performance in context. Interventions may be directed at client; context; or activity variable

FOCUS: Performance skills EX:Prevent poor posture when sitting for prolonged periods by providing a chair with proper back support

FOCUS: Performance patterns EX: Aid in the prevention of illicit chemical substance use by introducing self-initiated routine strategies that support drug-free behavior

FOCUS: Context or contexts or physical environments EX: Prevent social isolation of employees by promoting participation in after-work group activities ; Reduce risk of falls by modifying the environment and removing known hazards in the home (e.g.; throw rugs)

• "FOCUS: Activity demands EX: Prevent back injury by providing instruction in
• proper lifting techniques"

FOCUS: Client factors EX: Prevent repetitive stress injury by suggesting (body functions; body structures) that clients wear a wrist support splint when typing; Consultation with hotel chain to provide an ergonomics educational program designed to prevent back injuries in housekeepers

• "The act of doing and accomplishing a selected activity or occupation that results from the dynamic transaction among the client; the context; and the activity. Improving or enabling skills and patterns in occupational performance leads to engagement in occupations or activities (adapted in part from Law et al.; 1996; p. 16).
• Improvement—Used when a performance limitation is present. These outcomes document increased occupational performance for the person; organization; or population. Outcome examples may include (1) the ability of a child with autism to play interactively with a peer (person); (2) the ability of an older adult to return to the home from a skilled-nursing facility (person); (3) decreased incidence of back strain in nursing personnel as a result of an in-service education program in body mechanics for carrying out job duties that require bending; lifting; and so forth (organizations); and (d) construction of accessible playground facilities for all children in local city parks (populations).

A change in response approach that the client makes when encountering an occupational challenge. “This change is implemented when the [client’s] customary response approaches are found inadequate for producing some degree of mastery over the challenge” (adapted from Schultz & Schkade; 1997; p. 474). Examples of adaptation outcomes include (1) clients modifying their behaviors to earn privileges at an adolescent treatment facility (person); (2) a company redesigning the daily schedule to allow for an even workflow and to decrease times of high stress (organizations); and (3) a community making available accessible public transportation and erecting public and “reserved” benches for older adults to socialize and rest (populations).

Health is a resource for everyday life; not the objective of living. For individuals; it is a state of physical; mental; and social well-being; as well as a positive concept emphasizing social and personal resources and physical capacities (WHO; 1986). Health of organizations and populations includes these individual aspects but also includes social responsibility of members to society as a whole. Wellness is ”[a]n active process through which individuals [organizations or populations] become aware of and make choices toward a more successful existence“ (Hettler; 1984; p. 1170). Wellness is more than a lack of disease symptoms; it is a state of mental and physical balance and fitness (adapted from Taber’s Cyclopedic Medical Dictionary; 1997; p. 2110). Outcome examples may include (1) participation in community outings by a client with schizophrenia in a group home (person); (2) implementation of a company-wide program to identify problems and solutions for balance among work; leisure; and family life (organizations); and (3) decreased incidence of childhood obesity (populations).

Engagement in desired occupations in ways that are personally satisfying and congruent with expectations within the culture

“[H]ealth promotion is equally and essentially concerned with creating the conditions necessary for health at individual; structural; social; and environmental levels through an understanding of the determinants of health: peace; shelter; education; food; income; a stable ecosystem; sustainable resources; social justice; and equity” (Kronenberg; Algado; & Pollard; 2005; p. 441). Occupational therapy promotes a healthy lifestyle at the individual; group; organizational; community (societal); and governmental or policy level (adapted from Brownson & Scaffa; 2001). Outcome examples may include (1) appropriate seating and play area for a child with orthopedic impairments (person); (2) implementation of a program of leisure and educational activities for a drop-in center for adults with severe mental illness (organizations); and (3) access to occupational therapy services in underserved areas regardless cultural or ethnic backgrounds (populations).

The dynamic appraisal of the client’s life satisfaction (perceptions of progress toward one’s goals); hope (the real or perceived belief that one can move toward a goal through selected pathways); self-concept (the composite of beliefs and feelings about oneself); health and functioning (including health status; self-care capabilities; and socioeconomic factors; e.g.; vocation; education; income; adapted from Radomski; 1995; Zhan; 1992). Outcomes may include (1) full and active participation of a deaf child from a hearing family during a recreational activity (person); (2) residents being able to prepare for outings and travel independently as a result of independent-living skills training for care providers of a group (organization); and (3) formation of a lobby to support opportunities for social networking; advocacy activities; and sharing scientific information for stroke survivors and their families (population).

The ability to effectively meet the demands of roles in which the client engages.

Actively promoting or supporting oneself or others (individuals; organizations; or populations); requires an understanding of strengths and needs; identification of goals; knowledge of legal rights and responsibilities; and communicating these aspects to others (adapted from Dawson; 2007). Outcomes may include (1) a student with a learning disability requesting and receiving reasonable accommodations such as textbooks on tape (person); (2) a grassroots employee committee requesting and procuring ergonomically designed keyboards for their computers at work (organization); and (3) people with disabilities advocating for universal design with all public and private construction (population).

Access to and participation in the full range of meaningful and enriching occupations afforded to others. Includes opportunities for social inclusion and the resources to participate in occupations to satisfy personal; health; and societal needs (adapted from Townsend & Wilcock; 2004). Outcomes may include (1) people with intellectual disabilities serving on an advisory board to establish programs offered by a community recreation center (person); (2) workers who have enough of break time to have lunch with their young children at day care centers (organization); (3) people with persistent mental illness welcomed by community recreation center due to anti-stigma campaign (organization); and (4) alternative adapted housing options for older adult to “age in place” (populations).