Occupational therapy Study Guide

📖 Core Concepts Occupational Therapy (OT) – a client‑centred health profession that promotes health and wellbeing through occupation (the everyday activities that give life meaning). Primary Goal – enable people to participate in the activities of everyday life. Occupations – what people need, want, and are expected to do; categories include ADLs, IADLs, work, education, play, leisure, social participation, rest, and sleep. Practice Frameworks Occupational Therapy Practice Framework (OTPF) – divided into Domain (environment, client factors, occupational performance) and Process (evaluation, intervention, outcomes). International Classification of Functioning, Disability and Health (ICF) – universal language describing body functions, activities, participation, and contextual factors. Occupational Justice – fairness in the access to and participation in meaningful occupations; its opposites are deprivation, apartheid, marginalization, imbalance, and alienation. Key Theoretical Models – Person‑Environment‑Occupation‑Performance (PEOP), Model of Human Occupation (MOHO), Canadian Model of Occupational Performance and Engagement (CMOP‑E), Biopsychosocial Model. Frames of Reference – lenses that guide intervention (Biomechanical, Rehabilitative/Compensatory, Neurofunctional, Dynamic Systems, Client‑Centered, Cognitive‑Behavioural, Sensory Integration, Recovery). Sensory Integration (SI) – a sensory‑based, evidence‑based approach (developed by A. Jean Ayres) that provides graded sensory experiences to help clients integrate feedback into purposeful action. --- 📌 Must Remember OT is client‑centred; the therapist adapts tasks, environments, and equipment to support participation. OTPF Process: Evaluation → Goal‑setting → Intervention → Outcome measurement. ICF components: Body Functions & Structures ↔ Activities ↔ Participation ↔ Contextual Factors. Categories of occupations: ADL, IADL, work, education, play, leisure, social participation, rest, sleep. Sensory Integration – primary population: children with developmental delays, autism, SPD, dyspraxia; emerging evidence for adults. Occupational Justice Types Deprivation: external barriers block occupation. Apartheid: systematic exclusion based on characteristics. Marginalization: societal expectations limit choice. Imbalance: role overload limits participation. Alienation: imposed meaningless occupations. Frames of Reference selection depends on the client’s impairment level, goals, and context. Licensure – graduate from an accredited program, complete required fieldwork, pass a national certification exam. --- 🔄 Key Processes OT Evaluation (OTPF Domain) Gather data on client factors, environment, and occupational performance. Map findings to ICF categories for standardized documentation. Goal‑Setting Translate client‑identified outcomes into measurable objectives (SMART). Intervention Planning Choose appropriate frame(s) of reference (e.g., Sensory Integration for sensory processing challenges). Decide on environmental modifications, adaptive equipment, or skill‑building activities. Implementation Deliver occupation‑based activities; embed therapeutic challenges; ensure safety and emotional support. Outcome Measurement Re‑assess using the same ICF‑linked tools; compare to baseline; adjust plan. Sensory Integration Session Flow Assessment → Sensory-rich activity selection → Graded challenges → Integration into purposeful tasks → Review & adjust. --- 🔍 Key Comparisons Biomechanical vs. Rehabilitative (Compensatory) Frame Biomechanical: focuses on movement quality, strength, endurance. Compensatory: emphasizes work‑arounds and adaptive strategies to achieve participation. Sensory Integration vs. Traditional PT SI: uses multisensory experiences to improve processing and purposeful action. PT: primarily targets motor strength and range of motion. OTPF vs. Canadian Model of Client‑Centred Enablement OTPF: U.S.‑focused; separates domain and process. CMCE: emphasizes enablement as the core competency. Occupational Justice vs. Occupational Injustice Justice: equitable access to meaningful occupations. Injustice: includes deprivation, apartheid, marginalization, imbalance, alienation. --- ⚠️ Common Misunderstandings “Busy work” = therapeutic activity – busy work has no therapeutic intent; true OT activities target skill development or participation. SI is only for children – emerging research supports SI for adults with functional deficits. OT = Physical therapy – OT focuses on occupation and participation, not solely on physical impairment. ICF is a diagnostic tool – it is a classification and communication system, not a diagnosis. Occupational justice = social justice – while related, occupational justice specifically addresses access to occupations, not broader societal equity alone. --- 🧠 Mental Models / Intuition “Occupation as Medicine” – think of daily activities as the prescription that heals body, mind, and social identity. PEOP Triangle – imagine a three‑pointed triangle (Person, Environment, Occupation); performance emerges from their dynamic interaction. Sensory Feedback Loop – sensory input → central processing → purposeful action → new sensory input; therapy aims to tighten this loop. Justice Scale – visualize a balance beam; the farther one side tilts (deprivation, apartheid, etc.), the greater the occupational injustice. --- 🚩 Exceptions & Edge Cases Sensory Integration for Adults – use when adult shows sensory processing challenges and functional deficits; evidence is still emerging. Tele‑health OT – effective for education, consultation, and certain home‑based activities, but limited for hands‑on adaptive equipment fitting. Occupational Therapy in Hospice – focuses on meaningful occupation aligned with end‑of‑life goals, not just functional independence. Occupational Apartheid vs. Deprivation – apartheid is systemic exclusion; deprivation can be temporary or situational. --- 📍 When to Use Which Choose a Frame of Reference based on primary client need: Motor weakness → Biomechanical. Functional loss despite ability → Rehabilitative/Compensatory. Sensory processing issues → Sensory Integration. Cognitive‑behavioural patterns → Cognitive‑Behavioural. Use ICF for interdisciplinary documentation and when communicating across settings. Apply Sensory Integration when the client (child or adult) has developmental delays, ASD, SPD, dyspraxia, and the goal is to improve sensory processing and participation. Environmental Modification before prescribing assistive technology when the barrier can be removed by simple changes (lighting, layout, social cues). Occupational Justice interventions when systemic barriers (e.g., lack of community programs) are identified. --- 👀 Patterns to Recognize Skill–Demand Mismatch – client’s ability does not align with task demands → look for need of environmental modification or compensatory strategies. Role Overload – multiple high‑demand roles causing occupational imbalance → assess for stress, burnout, and prioritize role negotiation. Repeated Sensory Crises (e.g., meltdowns) → indicator for Sensory Integration assessment. Barrier Clustering – physical, social, and policy barriers appearing together → signal occupational injustice requiring advocacy. --- 🗂️ Exam Traps Distractor: “OT only treats physical impairments.” – OT also addresses cognition, emotion, and participation. Confusing ICF with diagnosis – ICF categorizes function, not disease. Choosing Sensory Integration for any adult client – only select when sensory processing deficits are documented. Assuming “busy work” is therapeutic – it lacks purposeful occupational goals. Mixing up occupational deprivation and apartheid – deprivation can be temporary; apartheid is systematic exclusion based on personal characteristics. ---