April 16, 2024 • 24 mins
Welcome to Occupational Therapy Month! This week our podcast episode all about occupational therapy interventions! We'll be discussing practical tips and strategies for success, including how to use the Occupational Therapy Practice Framework (OTPF-4) in your everyday practice. Join us as we break down complex ideas into easy-to-understand concepts, offering simple ways to enhance your OT practice and make intervention planning easier.
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Microphone (3- Logitech USB (00:00):
Hi, welcome to animals and aquatics.
This is April occupationaltherapy month, and we've been
focusing on the occupationaltherapy practice framework and
how we use it.
In our practice to guide us andour last session really.
Looked at evaluation thisepisode, I want to take some
time to talk about interventionand in some ways, Intervention
(00:23):
is the most fun part, right.
It's designing what we're goingto do and going out and doing it
with our clients.
Today, we're going to talk abouthow I use the OTPF to do that.
Happy occupational therapymonth.
(00:52):
Hi, welcome to animals andaquatics and occupational
therapy.
I'm Gina, your host.
And this month is occupationaltherapy month, and we're excited
to think about how theoccupational therapy practice
framework can be used ineveryday practice.
From evaluation tointerventions, to discharge,
planning, to setting upprogramming and communicating
(01:12):
our value to otherprofessionals.
This is something that I'mreally passionate about when I'm
working with my occupationaltherapy assistant students.
When I'm taking fieldworkstudents.
And when I'm creating frameworksaround how our practice will
work and how we'll communicateour value to others.
And one of our goals here withthe animals and aquatics podcast
(01:35):
is really to supportoccupational therapy
practitioners.
In these non-traditional areas.
And often when we get a littlebit outside the beaten path,
sometimes it feels like we'relosing our way as far as how do
we evaluate or.
How do we communicate ondocument our sessions?
And I really think that when webring it back to the
(01:58):
occupational therapy practiceframework, we can really see its
significance in guidingoccupational therapy
interventions, even when we'reoutside of the traditional
clinic or hospital or schoolsetting.
So this episode, we're going togive some examples in the
different areas that weprimarily talk about
incorporating animals into ourpractice in the aquatic setting
(02:20):
and in the nature based setting.
And I think it's reallyinteresting to look at.
Occupational therapy in thenature-based setting and
thinking about.
How that can integrate with theOTPF as well as in our other
unique settings.
And if you're not familiar withthe OTPF well, Definitely.
(02:45):
This is a document that you wantto be able to refer to so you
can find.
Free PDF copies online.
And I have a really nice spiralbound covered print copy that I
took to staples and got donebecause I do keep it.
In my school bag with me.
So that way when I'm teachingclass, I can pull it out and
refer to it.
(03:06):
But it really looks at domainprocess and outcomes of
occupational therapy.
And it gives us some reallystandardized language in
communicating with otheroccupational therapy providers,
it defines the domain or scopeof occupational therapy.
Now this is different than howour state defines our scope of
(03:29):
occupational therapy.
And when we're talking aboutpractice, we really need to
follow our state guidelines.
As far as what we're allowed todo within our licensure within
our state.
And it does vary.
By state.
And I think it's reallyinteresting because we keep
considering moving to a newstate and we've pretty much
looked for him everywhere fromMaine to Florida.
(03:50):
As far as where might be theright place to relocate to.
And so we spend a lot of timelooking at the occupational
therapy.
Licensure laws for supervisionrequirements for scope of
practice.
One area of particular interestto us as wellness.
And leisure activities.
(04:10):
Community-based OT practice.
And in some states, wellness isnot included.
It's not explicitly written intothe state practice act.
So that's an area that alwaysjumps out to us.
It's included.
In the domain of occupationaltherapy within the OTPF, but
isn't written into the statelicensure laws.
(04:31):
So that's something that'sreally important when you're
considering using the OTPF as aguide.
It also gives us a process forintervention.
So since our main focus today isreally intervention.
We're going to dive a little bitdeeper into that and take a look
at how it looks at intervention.
(04:53):
And some of the interestingparts of looking at intervention
is a lot of times it includes alittle bit more than we think.
When we're just thinking aboutproviding interventions.
So the intervention process isthe services provided by the OT
practitioner.
(05:15):
In collaboration with theclients, looking at various
service delivery models, thegoals that were going to be
used, what tools that we'regoing to be incorporating in.
And.
It's interesting to think about,it's not just going out and
doing the intervention, thatactual link, direct service kind
(05:36):
of component.
Of it.
But it is also the interventionprocess includes looking at our
frame of reference, looking athow we're going to bring in
those theoretical principlesinto the interventions that
we're selecting.
So some types of occupationaltherapy interventions could be.
(05:59):
Occupations and activities,right?
Those are the ones where reallyfamiliar with.
Interventions to supportoccupation.
So a lot of times this would bewhat we would have considered
like preparatory activities.
The.
Modalities fall into here.
So like our Pam's fall intothere.
Education and training again,there's a new code that came out
(06:21):
with a caregiver education.
And we'll be seeing if that'sgetting paid.
What's that getting paid?
And that may be an interestingarea to explore advocacy group
interventions.
And in any of our settings, wemay be incorporating group
interventions and virtualinterventions.
Again, that's not an area somuch typically that we're
(06:43):
looking at now, we can takedifferent approaches to our
interventions.
We can be creating.
Promoting.
Establishing restoring.
Maintaining modifying orprevention.
And each of those has its owndefinition.
So typically when I'm writing upmy plan of care, I will include
which approaches to myinterventions.
(07:04):
I'm taking.
So that way we already know.
How I'm looking at theinterventions.
Am I trying to create something?
Am I trying to look atestablishing a new skill.
Do I want them to maintain acurrent level of function?
Those are all areas that wemight be looking at.
(07:25):
So when we're thinking aboutthis intervention process, we're
thinking about.
How we're putting together thatintervention plan, then we're
thinking about the setting orthe service delivery model that
we're working into.
Our components are, or that.
Plan part.
(07:45):
The intervention implementation,and then an intervention review.
And so with the interventionprocess, In the plan part, we're
integrating information from theevaluation.
So if you want to hear moreabout that, certainly go back
and episode.
And listen to.
The OTPF and evaluation becausewe're incorporating our theory.
(08:08):
Our frames of reference inthere.
Any research evidence we have onthose interventions and
especially how that's going tosupport occupation or
occupational performance.
And that's going to guide thatintervention planning.
Now the intervention plan isreally where we're looking at.
What are the goals?
And what is the context of theservice delivery?
(08:33):
What client performance skillsor performance patterns are we
trying to address?
What evidence is thereavailable?
And we develop the plan toselect what measure or
measurements that we're going tohave, how we're going to deliver
our services.
And of course our interventionapproaches then.
(08:53):
And I've always looked at thisas right from the beginning.
We're going to look at.
Discharge needs.
And then if we need to make anyreferrals, Now intervention
implementation.
That's the part we think aboutthe most, right.
And that is putting thatintervention plan into action.
It's where we are out andworking with the clients were
(09:15):
bringing in a variety ofdifferent interventions or
intervention steps we might bebringing in the education piece.
We might be doingoccupation-based interventions
or activity-based.
So thinking about how we're.
Delivering that intervention.
And what tools strategies are weactually including there?
(09:39):
And our intervention review isan ongoing continuous process to
see if that intervention plan isworking.
If we're moving us towards ourgoals.
So we really are looking at, dowe need to continue services,
discontinue services refer,modify that, modify the plan.
There's a lot of components aswe're working on that
(10:01):
intervention review.
So what are, what about someactual interventions that we
might be doing now?
If we're incorporating the OTPFin the intervention process, we
can use it as a framework fordesigning, implementing, and
then evaluating are nature-basedinterventions, interventions
with animals or aquatics.
(10:23):
To see if we are moving towardsthose goals, promoting clients,
health wellbeing.
Or a participation, right?
Those are all areas that we'relooking at.
So let's take motor skills as anexample, rain.
So if we're looking atperformance skills and then
motor skills, Some areas that wemight be focusing on that we've
(10:43):
identified in the evaluationphase would be obtaining and
holding objects and moving selfand objects.
So some interventions that wemight do is an activity like
leaf rubbing.
The clients might be collectingdifferent leaves from the
environment using crayons orpencils to create a leaf
rubbing.
This requires pretty precisehand movements and coordination,
(11:03):
both hands of the body.
It requires them to pick up theitems, bring them to a central
location, requires them tostabilize them.
In order to capture the detailsof the leaves.
So this is a very kind ofpopular nature based
intervention activity.
And it does require a lot ofthose performance motor skills
(11:23):
that we would be looking at.
Another one would be somethinglike planting seeds.
So this might be more of agardening type of activity.
This can also be a really nicetake-home activity so we can
look at.
Planting the seeds ortransferring seedlings.
We can look at the fine motorskills we got grasping pinching,
manipulating the small objects,hand, eye coordination, finger
(11:46):
dexterity.
And when we think aboutobtaining and holding objects as
the motor skill component.
There are again, a number ofpieces to this.
If we have to go get theobjects, choose the correct
ones.
Hold them, bring them back.
We have to move ourselves ormove the objects.
So when we're looking from thatOTPF side of things, we have a
(12:07):
variety of different skills thatwe might be looking at within
that area.
And incorporating those in.
When we're looking at again,that documentation piece, we
already have that set up for us.
If we're looking at it throughthis OTPF lens.
We can also look at other natureinspired crafts.
(12:28):
So even if you are in a indoorsetting and you want to start to
incorporate some nature-basedinterventions into your OT, You
can look at some nature inspiredcrafts.
So that's crafting with naturalmaterials, and I'm always
scouting out things that I see.
Things like pine cones, twigsstones.
(12:50):
Maybe that brings nature and italso encourages the clients to.
Use those fine motor skills towork.
In a way that they have tostabilize the task object, they
have to position themselves ortheir body.
In an effective distance fromthe task object, they have to be
able to grip effectivelypinching.
(13:12):
They should be able tomanipulate the object.
They need to be able to lift andcarry the test object.
There's a lot of components andlanguage from the OTPF.
That can help guide the way wemight set up those
interventions.
Now, if we wanted to look atclient factors instead, and we
wanted to look at bodyfunctions, we could look at
(13:33):
neuromuscular and movementrelated functions, and these
look a lot more like a lot ofour gross motor activities.
So something like a hiking or anature walk.
We're going to be addressing alot more of those body functions
component.
And when we look at those, wecan look at body functions in
(13:56):
that neuromuscular and movementrelated functions.
Some of those would be controlof voluntary movement, gait
pattern.
May, and we think about jointmobility or joint stability and
the functions of joint andbones.
Right?
There's a lot of differentcomponents when we start to
break it down into that bodystructure and function.
(14:18):
So these are body functions thatwe're looking at.
Under client factors.
Other outdoor sports and gamesthat we might be setting up
might be another way that we canaddress that area.
We can also look at clientfactors in the body functions
under sensory functions.
(14:40):
So there's an area lookingspecifically at sensory
functions and within that, itcould be visual functions.
So quality of vision, visualacuity, visual stability, visual
field functions, visualawareness of the environment and
various distances forfunctioning.
So when we think about being outin nature, right, we have a lot
(15:00):
of opportunities to work on alot of different visual areas.
And we can do this by Color's bymonoculars with nature,
sketching or journaling.
So we can integrate that visualperceptual piece with what
they're seeing in theenvironment.
With hand movement, spatialawareness, we can do some
nature, scavenger hunts, andhave them visually scan the
(15:22):
environment to see if they canfind.
What is on their list.
And then things like an outdoorobstacle course is not only
going to incorporate the visualfunction, but also the
vestibular function.
Right.
For position balance, securemovement against gravity.
As well as the proprioceptivefunction of the awareness of the
body position and the body inspace.
(15:43):
So there's a whole variety ofsensory functions that we might
be incorporating in there.
When you're incorporating naturebased activities into your
occupational therapyinterventions, we can address a
wide range of motor skills andclient factors that are outlined
in the OTPF.
While engaging clients in a verymeaningful and enjoyable
(16:04):
experience for us, the process.
Is as much important as theoutcome or the product.
Another example would be if wewant to look at process skills.
So these are more of ourcognitive skills and let's use
hippotherapy, as our examplehere.
(16:24):
So we could look at attentionand focus.
So with process skills, we couldlook at their ability to sustain
their performance.
So the movement from the horsein a very natural setting is
going to require the client toattend.
I hate because there's going tobe a variety of sensory
stimulus.
There's going to be changes inmovement.
(16:44):
There's going to beenvironmental sounds.
There's going to be socialinteractions, right?
So their ability to sustaintheir attention of focus would
be a process skill that could beaddressed.
We can also look at organizingand timing from the OTPF.
So following instructions fromthe therapist, coordinating
movements with the horses,movement sequencing and planning
(17:07):
actions, those are all ways thatwe could work on the process
skills, helping them to executetasks in a logical sequence.
Now, if we wanted to look atclient factors, again, that body
functions, we could look atmental functions of sequencing,
complex movements.
Yes.
That is a category.
And responding to unexpectedchanges in the horse's movement
(17:30):
or direction.
Challenges that client toproblem solve in real time.
So we're fostering adaptivethinking decision-making skills.
And again, that's another waythat we could use.
Equine movement.
We could also look at clientfactors, body functions for
specific mental functions inemotional regulation.
(17:52):
And we can use equine movementand hippotherapy, as an
intervention to supportemotional regulation, because we
can have that co-regulation.
With the horses nervous systemthat can be a very calm and
nurturing environment for theclient can help them reduce
stress and anxiety levels.
(18:13):
It promotes emotional wellbeing.
A lot of times we see that ourclients are much well more
well-regulated.
After being in the equineenvironment and experiencing
well regulated equine movement.
So it's really important thatequine movement is cadenced for
(18:36):
what the client needs.
And we can also look at the waythat the client can express
emotions, cope with emotionsthat they're feeling.
And part of that can be a bondbetween the client, the therapy
team and the horse.
That's a real safe space for theclient to express motions,
process emotions, and facilitatethat emotional expression,
(18:58):
coping skill development.
Knowing again that they havethose co-regulating partners.
So when we address processskills within the interventions,
when we incorporatehippotherapy,, we really can
support clients, physical,cognitive, and emotional
wellbeing.
In a really, again, engagingsetting.
(19:19):
If we wanted to look at aquatictherapy.
Let's look at the process skillsfor or the performance skills
for social interaction skills.
And we're going to break it downfor some specific ones.
So turns towards, and in a OTsession in the aquatic
environment, if we're looking atchildren, we could have a small
(19:42):
group interaction.
They could be playing withfloating toys or participating
in a water relay race.
And in this case, we have toturn right, turn our bodies
towards one another face eachother while passing toys,
coordinating movements during arelay race.
And.
And by engaging theseactivities, the children can
learn.
Both from their peers.
(20:03):
And by modeling from thetherapist to attend to others,
make eye contact, communicateeffectively to foster social
interactions in thisenvironment.
And we can look at that in thecontext of being able to turn
towards someone when we'reengaging with them.
We can look at.
The social interaction, skill oflooks, which we think typically
(20:29):
think of is making eye contact.
So we can do a water tag gamewhere the children are taking
turns, chasing us I'm in thepool and the children have to
make eye contact with us, orthey're going to make eye
contact with us to signal theirintention that they are going to
(20:49):
give us a splash for a watertag.
And that's a way to, toencourage that while remaining
regulated and another.
Social interaction skill wouldbe placing self.
So places, self that's positionsat an appropriate distance.
And this could be in a groupsetting or in a one-on-one
(21:10):
setting.
And we can be working.
If we're in a group setting,like in a circle and the
therapist is really gonna guidethat client to position
themselves at an appropriatedistance for passing a beach
ball around the circle, or wecan do some imitation or
synchronize movements in whichwe need to have enough space.
(21:30):
I had a client that was reallyinterested in synchronized
swimming and synchronized.
Like water dance.
And so this was a really goodone because if you're too close
together, you will hit oneanother.
If you're trying to do like aflip underwater.
You don't want to kick the otherperson.
So in this way, the clientpractices, spatial awareness,
social proximity in the waterwhere they're getting additional
(21:51):
sensory input.
And they're learning to navigatesome of those social
interactions and respectingpersonal boundaries either with
the therapist or with theirpeers.
So in these examples, theaquatic occupational therapy is
really looking at that dynamicenvironment for children to
develop those social interactionskills.
(22:12):
But it's still fun andmeaningful for them.
The buoyancy in support of thewater can encourage the children
in those interactions, in thatspatial awareness.
And developing a greater abilityto focus and sustain those
social interaction skills.
And then we have the ability togeneralize those outside of the
(22:34):
aquatic setting.
And that's really what we'relooking for, right?
Whether we're in a nature basedsetting, incorporating
hippotherapy, or in the aquaticsetting, we're looking at that
ability to generalize outside ofour unique treatment environment
into their everyday life.
So as we went through ourinterventions and how we can
(22:56):
incorporate components from theoccupational therapy practice
framework today.
We looked at differentcategories that the occupational
therapy practice frameworkprovides us such as performance
skills or client factors.
And how in our evaluation phase,we may have identified areas.
That we wanted to work on.
And then we can designinterventions around those areas
(23:19):
and the OTPF can be a way toguide our thinking and help us
select activities.
We can also kind of backwardsplan and where we choose the
activity and then refer back tothe OTPF and check it off, say
yes, it's this is required.
Yes.
This is required.
Heeds is required.
Chooses is required.
Paces is required.
(23:40):
And then we know how, when weget to our documentation, to set
everything up.
So I hope if you've enjoyed thisepisode, you'll go ahead and
share rate and like the podcast,we hope that you will reach out
to us, send us a DM or an email.
Let us know what you would liketo hear for future podcast
topics.
(24:00):
And we'll talk to you next week.
Hi, welcome to animals and aquatics.
This is April occupationaltherapy month, and we've been
focusing on the occupationaltherapy practice framework and
how we use it.
In our practice to guide us andour last session really.
Looked at evaluation thisepisode, I want to take some
time to talk about interventionand in some ways, Intervention
(00:23):
is the most fun part, right.
It's designing what we're goingto do and going out and doing it
with our clients.
Today, we're going to talk abouthow I use the OTPF to do that.
Happy occupational therapymonth.
(00:52):
Hi, welcome to animals andaquatics and occupational
therapy.
I'm Gina, your host.
And this month is occupationaltherapy month, and we're excited
to think about how theoccupational therapy practice
framework can be used ineveryday practice.
From evaluation tointerventions, to discharge,
planning, to setting upprogramming and communicating
(01:12):
our value to otherprofessionals.
This is something that I'mreally passionate about when I'm
working with my occupationaltherapy assistant students.
When I'm taking fieldworkstudents.
And when I'm creating frameworksaround how our practice will
work and how we'll communicateour value to others.
And one of our goals here withthe animals and aquatics podcast
(01:35):
is really to supportoccupational therapy
practitioners.
In these non-traditional areas.
And often when we get a littlebit outside the beaten path,
sometimes it feels like we'relosing our way as far as how do
we evaluate or.
How do we communicate ondocument our sessions?
And I really think that when webring it back to the
(01:58):
occupational therapy practiceframework, we can really see its
significance in guidingoccupational therapy
interventions, even when we'reoutside of the traditional
clinic or hospital or schoolsetting.
So this episode, we're going togive some examples in the
different areas that weprimarily talk about
incorporating animals into ourpractice in the aquatic setting
(02:20):
and in the nature based setting.
And I think it's reallyinteresting to look at.
Occupational therapy in thenature-based setting and
thinking about.
How that can integrate with theOTPF as well as in our other
unique settings.
And if you're not familiar withthe OTPF well, Definitely.
(02:45):
This is a document that you wantto be able to refer to so you
can find.
Free PDF copies online.
And I have a really nice spiralbound covered print copy that I
took to staples and got donebecause I do keep it.
In my school bag with me.
So that way when I'm teachingclass, I can pull it out and
refer to it.
(03:06):
But it really looks at domainprocess and outcomes of
occupational therapy.
And it gives us some reallystandardized language in
communicating with otheroccupational therapy providers,
it defines the domain or scopeof occupational therapy.
Now this is different than howour state defines our scope of
(03:29):
occupational therapy.
And when we're talking aboutpractice, we really need to
follow our state guidelines.
As far as what we're allowed todo within our licensure within
our state.
And it does vary.
By state.
And I think it's reallyinteresting because we keep
considering moving to a newstate and we've pretty much
looked for him everywhere fromMaine to Florida.
(03:50):
As far as where might be theright place to relocate to.
And so we spend a lot of timelooking at the occupational
therapy.
Licensure laws for supervisionrequirements for scope of
practice.
One area of particular interestto us as wellness.
And leisure activities.
(04:10):
Community-based OT practice.
And in some states, wellness isnot included.
It's not explicitly written intothe state practice act.
So that's an area that alwaysjumps out to us.
It's included.
In the domain of occupationaltherapy within the OTPF, but
isn't written into the statelicensure laws.
(04:31):
So that's something that'sreally important when you're
considering using the OTPF as aguide.
It also gives us a process forintervention.
So since our main focus today isreally intervention.
We're going to dive a little bitdeeper into that and take a look
at how it looks at intervention.
(04:53):
And some of the interestingparts of looking at intervention
is a lot of times it includes alittle bit more than we think.
When we're just thinking aboutproviding interventions.
So the intervention process isthe services provided by the OT
practitioner.
(05:15):
In collaboration with theclients, looking at various
service delivery models, thegoals that were going to be
used, what tools that we'regoing to be incorporating in.
And.
It's interesting to think about,it's not just going out and
doing the intervention, thatactual link, direct service kind
(05:36):
of component.
Of it.
But it is also the interventionprocess includes looking at our
frame of reference, looking athow we're going to bring in
those theoretical principlesinto the interventions that
we're selecting.
So some types of occupationaltherapy interventions could be.
(05:59):
Occupations and activities,right?
Those are the ones where reallyfamiliar with.
Interventions to supportoccupation.
So a lot of times this would bewhat we would have considered
like preparatory activities.
The.
Modalities fall into here.
So like our Pam's fall intothere.
Education and training again,there's a new code that came out
(06:21):
with a caregiver education.
And we'll be seeing if that'sgetting paid.
What's that getting paid?
And that may be an interestingarea to explore advocacy group
interventions.
And in any of our settings, wemay be incorporating group
interventions and virtualinterventions.
Again, that's not an area somuch typically that we're
(06:43):
looking at now, we can takedifferent approaches to our
interventions.
We can be creating.
Promoting.
Establishing restoring.
Maintaining modifying orprevention.
And each of those has its owndefinition.
So typically when I'm writing upmy plan of care, I will include
which approaches to myinterventions.
(07:04):
I'm taking.
So that way we already know.
How I'm looking at theinterventions.
Am I trying to create something?
Am I trying to look atestablishing a new skill.
Do I want them to maintain acurrent level of function?
Those are all areas that wemight be looking at.
(07:25):
So when we're thinking aboutthis intervention process, we're
thinking about.
How we're putting together thatintervention plan, then we're
thinking about the setting orthe service delivery model that
we're working into.
Our components are, or that.
Plan part.
(07:45):
The intervention implementation,and then an intervention review.
And so with the interventionprocess, In the plan part, we're
integrating information from theevaluation.
So if you want to hear moreabout that, certainly go back
and episode.
And listen to.
The OTPF and evaluation becausewe're incorporating our theory.
(08:08):
Our frames of reference inthere.
Any research evidence we have onthose interventions and
especially how that's going tosupport occupation or
occupational performance.
And that's going to guide thatintervention planning.
Now the intervention plan isreally where we're looking at.
What are the goals?
And what is the context of theservice delivery?
(08:33):
What client performance skillsor performance patterns are we
trying to address?
What evidence is thereavailable?
And we develop the plan toselect what measure or
measurements that we're going tohave, how we're going to deliver
our services.
And of course our interventionapproaches then.
(08:53):
And I've always looked at thisas right from the beginning.
We're going to look at.
Discharge needs.
And then if we need to make anyreferrals, Now intervention
implementation.
That's the part we think aboutthe most, right.
And that is putting thatintervention plan into action.
It's where we are out andworking with the clients were
(09:15):
bringing in a variety ofdifferent interventions or
intervention steps we might bebringing in the education piece.
We might be doingoccupation-based interventions
or activity-based.
So thinking about how we're.
Delivering that intervention.
And what tools strategies are weactually including there?
(09:39):
And our intervention review isan ongoing continuous process to
see if that intervention plan isworking.
If we're moving us towards ourgoals.
So we really are looking at, dowe need to continue services,
discontinue services refer,modify that, modify the plan.
There's a lot of components aswe're working on that
(10:01):
intervention review.
So what are, what about someactual interventions that we
might be doing now?
If we're incorporating the OTPFin the intervention process, we
can use it as a framework fordesigning, implementing, and
then evaluating are nature-basedinterventions, interventions
with animals or aquatics.
(10:23):
To see if we are moving towardsthose goals, promoting clients,
health wellbeing.
Or a participation, right?
Those are all areas that we'relooking at.
So let's take motor skills as anexample, rain.
So if we're looking atperformance skills and then
motor skills, Some areas that wemight be focusing on that we've
(10:43):
identified in the evaluationphase would be obtaining and
holding objects and moving selfand objects.
So some interventions that wemight do is an activity like
leaf rubbing.
The clients might be collectingdifferent leaves from the
environment using crayons orpencils to create a leaf
rubbing.
This requires pretty precisehand movements and coordination,
(11:03):
both hands of the body.
It requires them to pick up theitems, bring them to a central
location, requires them tostabilize them.
In order to capture the detailsof the leaves.
So this is a very kind ofpopular nature based
intervention activity.
And it does require a lot ofthose performance motor skills
(11:23):
that we would be looking at.
Another one would be somethinglike planting seeds.
So this might be more of agardening type of activity.
This can also be a really nicetake-home activity so we can
look at.
Planting the seeds ortransferring seedlings.
We can look at the fine motorskills we got grasping pinching,
manipulating the small objects,hand, eye coordination, finger
(11:46):
dexterity.
And when we think aboutobtaining and holding objects as
the motor skill component.
There are again, a number ofpieces to this.
If we have to go get theobjects, choose the correct
ones.
Hold them, bring them back.
We have to move ourselves ormove the objects.
So when we're looking from thatOTPF side of things, we have a
(12:07):
variety of different skills thatwe might be looking at within
that area.
And incorporating those in.
When we're looking at again,that documentation piece, we
already have that set up for us.
If we're looking at it throughthis OTPF lens.
We can also look at other natureinspired crafts.
(12:28):
So even if you are in a indoorsetting and you want to start to
incorporate some nature-basedinterventions into your OT, You
can look at some nature inspiredcrafts.
So that's crafting with naturalmaterials, and I'm always
scouting out things that I see.
Things like pine cones, twigsstones.
(12:50):
Maybe that brings nature and italso encourages the clients to.
Use those fine motor skills towork.
In a way that they have tostabilize the task object, they
have to position themselves ortheir body.
In an effective distance fromthe task object, they have to be
able to grip effectivelypinching.
(13:12):
They should be able tomanipulate the object.
They need to be able to lift andcarry the test object.
There's a lot of components andlanguage from the OTPF.
That can help guide the way wemight set up those
interventions.
Now, if we wanted to look atclient factors instead, and we
wanted to look at bodyfunctions, we could look at
(13:33):
neuromuscular and movementrelated functions, and these
look a lot more like a lot ofour gross motor activities.
So something like a hiking or anature walk.
We're going to be addressing alot more of those body functions
component.
And when we look at those, wecan look at body functions in
(13:56):
that neuromuscular and movementrelated functions.
Some of those would be controlof voluntary movement, gait
pattern.
May, and we think about jointmobility or joint stability and
the functions of joint andbones.
Right?
There's a lot of differentcomponents when we start to
break it down into that bodystructure and function.
(14:18):
So these are body functions thatwe're looking at.
Under client factors.
Other outdoor sports and gamesthat we might be setting up
might be another way that we canaddress that area.
We can also look at clientfactors in the body functions
under sensory functions.
(14:40):
So there's an area lookingspecifically at sensory
functions and within that, itcould be visual functions.
So quality of vision, visualacuity, visual stability, visual
field functions, visualawareness of the environment and
various distances forfunctioning.
So when we think about being outin nature, right, we have a lot
(15:00):
of opportunities to work on alot of different visual areas.
And we can do this by Color's bymonoculars with nature,
sketching or journaling.
So we can integrate that visualperceptual piece with what
they're seeing in theenvironment.
With hand movement, spatialawareness, we can do some
nature, scavenger hunts, andhave them visually scan the
(15:22):
environment to see if they canfind.
What is on their list.
And then things like an outdoorobstacle course is not only
going to incorporate the visualfunction, but also the
vestibular function.
Right.
For position balance, securemovement against gravity.
As well as the proprioceptivefunction of the awareness of the
body position and the body inspace.
(15:43):
So there's a whole variety ofsensory functions that we might
be incorporating in there.
When you're incorporating naturebased activities into your
occupational therapyinterventions, we can address a
wide range of motor skills andclient factors that are outlined
in the OTPF.
While engaging clients in a verymeaningful and enjoyable
(16:04):
experience for us, the process.
Is as much important as theoutcome or the product.
Another example would be if wewant to look at process skills.
So these are more of ourcognitive skills and let's use
hippotherapy, as our examplehere.
(16:24):
So we could look at attentionand focus.
So with process skills, we couldlook at their ability to sustain
their performance.
So the movement from the horsein a very natural setting is
going to require the client toattend.
I hate because there's going tobe a variety of sensory
stimulus.
There's going to be changes inmovement.
(16:44):
There's going to beenvironmental sounds.
There's going to be socialinteractions, right?
So their ability to sustaintheir attention of focus would
be a process skill that could beaddressed.
We can also look at organizingand timing from the OTPF.
So following instructions fromthe therapist, coordinating
movements with the horses,movement sequencing and planning
(17:07):
actions, those are all ways thatwe could work on the process
skills, helping them to executetasks in a logical sequence.
Now, if we wanted to look atclient factors, again, that body
functions, we could look atmental functions of sequencing,
complex movements.
Yes.
That is a category.
And responding to unexpectedchanges in the horse's movement
(17:30):
or direction.
Challenges that client toproblem solve in real time.
So we're fostering adaptivethinking decision-making skills.
And again, that's another waythat we could use.
Equine movement.
We could also look at clientfactors, body functions for
specific mental functions inemotional regulation.
(17:52):
And we can use equine movementand hippotherapy, as an
intervention to supportemotional regulation, because we
can have that co-regulation.
With the horses nervous systemthat can be a very calm and
nurturing environment for theclient can help them reduce
stress and anxiety levels.
(18:13):
It promotes emotional wellbeing.
A lot of times we see that ourclients are much well more
well-regulated.
After being in the equineenvironment and experiencing
well regulated equine movement.
So it's really important thatequine movement is cadenced for
(18:36):
what the client needs.
And we can also look at the waythat the client can express
emotions, cope with emotionsthat they're feeling.
And part of that can be a bondbetween the client, the therapy
team and the horse.
That's a real safe space for theclient to express motions,
process emotions, and facilitatethat emotional expression,
(18:58):
coping skill development.
Knowing again that they havethose co-regulating partners.
So when we address processskills within the interventions,
when we incorporatehippotherapy,, we really can
support clients, physical,cognitive, and emotional
wellbeing.
In a really, again, engagingsetting.
(19:19):
If we wanted to look at aquatictherapy.
Let's look at the process skillsfor or the performance skills
for social interaction skills.
And we're going to break it downfor some specific ones.
So turns towards, and in a OTsession in the aquatic
environment, if we're looking atchildren, we could have a small
(19:42):
group interaction.
They could be playing withfloating toys or participating
in a water relay race.
And in this case, we have toturn right, turn our bodies
towards one another face eachother while passing toys,
coordinating movements during arelay race.
And.
And by engaging theseactivities, the children can
learn.
Both from their peers.
(20:03):
And by modeling from thetherapist to attend to others,
make eye contact, communicateeffectively to foster social
interactions in thisenvironment.
And we can look at that in thecontext of being able to turn
towards someone when we'reengaging with them.
We can look at.
The social interaction, skill oflooks, which we think typically
(20:29):
think of is making eye contact.
So we can do a water tag gamewhere the children are taking
turns, chasing us I'm in thepool and the children have to
make eye contact with us, orthey're going to make eye
contact with us to signal theirintention that they are going to
(20:49):
give us a splash for a watertag.
And that's a way to, toencourage that while remaining
regulated and another.
Social interaction skill wouldbe placing self.
So places, self that's positionsat an appropriate distance.
And this could be in a groupsetting or in a one-on-one
(21:10):
setting.
And we can be working.
If we're in a group setting,like in a circle and the
therapist is really gonna guidethat client to position
themselves at an appropriatedistance for passing a beach
ball around the circle, or wecan do some imitation or
synchronize movements in whichwe need to have enough space.
(21:30):
I had a client that was reallyinterested in synchronized
swimming and synchronized.
Like water dance.
And so this was a really goodone because if you're too close
together, you will hit oneanother.
If you're trying to do like aflip underwater.
You don't want to kick the otherperson.
So in this way, the clientpractices, spatial awareness,
social proximity in the waterwhere they're getting additional
(21:51):
sensory input.
And they're learning to navigatesome of those social
interactions and respectingpersonal boundaries either with
the therapist or with theirpeers.
So in these examples, theaquatic occupational therapy is
really looking at that dynamicenvironment for children to
develop those social interactionskills.
(22:12):
But it's still fun andmeaningful for them.
The buoyancy in support of thewater can encourage the children
in those interactions, in thatspatial awareness.
And developing a greater abilityto focus and sustain those
social interaction skills.
And then we have the ability togeneralize those outside of the
(22:34):
aquatic setting.
And that's really what we'relooking for, right?
Whether we're in a nature basedsetting, incorporating
hippotherapy, or in the aquaticsetting, we're looking at that
ability to generalize outside ofour unique treatment environment
into their everyday life.
So as we went through ourinterventions and how we can
(22:56):
incorporate components from theoccupational therapy practice
framework today.
We looked at differentcategories that the occupational
therapy practice frameworkprovides us such as performance
skills or client factors.
And how in our evaluation phase,we may have identified areas.
That we wanted to work on.
And then we can designinterventions around those areas
(23:19):
and the OTPF can be a way toguide our thinking and help us
select activities.
We can also kind of backwardsplan and where we choose the
activity and then refer back tothe OTPF and check it off, say
yes, it's this is required.
Yes.
This is required.
Heeds is required.
Chooses is required.
Paces is required.
(23:40):
And then we know how, when weget to our documentation, to set
everything up.
So I hope if you've enjoyed thisepisode, you'll go ahead and
share rate and like the podcast,we hope that you will reach out
to us, send us a DM or an email.
Let us know what you would liketo hear for future podcast
topics.
(24:00):
And we'll talk to you next week.
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