April 9, 2024 • 21 mins
In this episode of Animals and Aquatics, Gina delves into the intricacies of utilizing the Occupational Therapy Practice Framework (OTPF) in the evaluation process. She highlights the significance of understanding the OTPF's components and discusses its applicability in various occupational therapy niches, including nature-based therapy, hippotherapy, and aquatics. Gina provides valuable insights and practical examples to guide listeners through crafting comprehensive evaluations using the OTPF framework. Whether you're a seasoned occupational therapist or a student, this episode offers valuable strategies for optimizing your evaluation processes and enhancing client outcomes.
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Microphone (3- Logitech US (00:01):
Hey, welcome back to animals and
aquatics in April foroccupational therapy month.
This month.
Remember we are taking a deepdive into the occupational
therapy practice framework.
Now if you've downloaded yourcopy and you're ready to follow
along.
Let's get started.
Microphone (3- Logitech USB (00:30):
Hi, welcome to animals and aquatics.
Gina your cohost.
And this month we are taking adeep dive into the occupational
therapy practice framework andhow you can use it in unique
niches, such as hippotherapy,aquatics, animal assisted
therapy and nature basedtherapy.
And today, specifically, I wantto focus on using the OTPF in
(00:50):
the evaluation process.
In fact, we found it invaluablein creating occupational
therapy.
Evaluation framework.
And I'd like to take you throughthat a little bit today.
And as I've mentioned, if youhave your OTPF and want to
follow along, this may help itmake sense to you.
You can find free downloadsonline.
(01:10):
And just pull up the PDF to lookthrough it.
Now the nice thing about theOTPF and I talked to my students
in the occupational therapyassistant program a lot about
the OTPF because.
I feel like if you sit down withthis document for enough time,
It really is like its ownoccupational therapy education.
(01:32):
It talks a lot about what ourscope of practice really is.
And I think it's a greatresource document.
I also think that it really canhelp to guide our process and a
lot of the textbooks that we usereference OTPF and now we're
working on OTPF for.
And they go through theoccupational therapy process
(01:58):
using OTPF the other thing Ireally like about it.
Is, it fits really well with theWHOs international
classification of disability andfunction model.
And I think when we're talkingto our colleagues
internationally, it really is agood starting place where we
have some things in common andsome common language to work
from.
And when you're working in aunique niche, the last thing we
(02:21):
need getting in between us andother occupational therapy
practitioners is language or theway that we're wording our
terminology.
So some of the key aspects thatthe OTPF looks at are of course
occupations.
So our ADL's, IADL's, healthmanagement.
Rest and sleep.
Education work, play.
(02:43):
Leisure and socialparticipation.
We also look at contexts such asenvironmental factors and
personal factors.
We can take time to work withperformance patterns, such as
habits, routines, roles, andrituals.
And then we break it down intoperformance skills.
So this is where I like tofocus.
(03:04):
Most of my occupational therapyevaluation.
This is looking at motor skills,process skills and social
interaction skills.
And we can wrap it up when we'recompleting our evaluation with
client factors, such as values,beliefs, spirituality.
And body functions andstructures.
So with the OTPF, when we wantto look at the OT process.
(03:28):
So that's how he providesservices.
It's really well outlined in theOTPF.
And the evaluation starts withthe occupational profile.
And there's a good example of anoccupational profile on AOTA.
But it starts with why is theclient seeking services and how
is this related to how they'reengaging in occupations in daily
(03:52):
life?
So that's always a good place tostart and it really puts
occupation at the front andcenter.
Then we talk about what is theclient doing successfully and
what barriers are impactingtheir success in what they want
to be able to do.
Then we can look at occupationalhistory, values, interests, and
contacts.
Before we get to thoseperformance patterns.
(04:14):
So when we get to theperformance patterns, that's
where I really like to take thatdeep dive.
And the second part of this isthe analysis of occupational
performance.
And this is where I really wantto take those performance skills
and look at them reallycarefully.
So I'm going to go through someof those, but I do want to
finish up looking at what the OTprocess.
(04:38):
So this is the whole processfirst.
So we're talking about theevaluation and again, the
evaluation is composed of theoccupational profile.
The analysis of occupationalperformance and then the
synthesis of the evaluationprocess.
So this is looking at theirvalues and priorities.
This is interpreting any datathat we've collected.
(05:01):
So for me, that's often the datathat I've collected from a
sensory profile or the PEDI.
So that's a pediatric evaluationof disability inventory, or
maybe it's the BRIEF executivefunction scales.
So I'm going to interpret thatdata then developing and
refining my hypothesis about theclient's occupational
(05:23):
performance.
Both the strengths and thedeficits.
And we'd like to work from astrengths based approach.
So we like to highlight whatthose strengths are and then
explain how we're going toincorporate those into our plan
of care.
Then we might look at anysupport systems that might be
impacting the success of theclient and our interventions in
(05:44):
this process.
And coming up with the goals.
So we create our goals,obviously in collaboration with
the clients.
And usually that's done in aninterview format.
Although when we do want to be abit more formal about it, we'll
use the COPM.
So that's the Canadianoccupational performance
measure.
And then as part of theevaluation, we're already
(06:05):
selecting outcome measures thatare going to determine progress
towards our goals.
And we'll look at whether weneed to.
Repeat the re-evaluation processor move on to discharge.
In our intervention phase.
The intervention plan.
So what exactly are we going toinclude?
(06:27):
What are the timeframes that weexpect this to be?
What is our approach?
Are we looking at promotingwellness?
Establishing or restoringparticular skills, maintaining
where the client is at.
Modifying or prevention.
And then what's our servicedelivery method.
So when, where, and whatapproach will be used.
(06:50):
We might look at what thedischarge plans are going to be,
and we can make anyrecommendations or referrals to
other professionals.
Then we begin to carry out ourinterventions, right?
That's the part we think ofmost, and this could be
one-on-one sessions.
This could be groupinterventions.
This could be virtual.
Although when we'reincorporating animals in, or
(07:13):
we're doing nature basedsessions, these are very
experiencial and face-to-face,but we can do them in a
one-on-one format.
We can do them in group format.
We can be included includingpsychosocial education
components to it.
Right?
So there's a number of differentways that we might be doing our
intervention implementation.
(07:34):
And through this, we're alsomonitoring the client's response
through ongoing observationevaluation and re-evaluation as
needed.
The last part that's actuallypart of the intervention phase
is the intervention review.
We're re-evaluating the plan,how it's implemented.
How it's working to achieve ourgoals and outcomes.
Modifying the plan as needed.
(07:56):
And if you're working withoccupational therapy assistance,
this is something that we'redoing on an ongoing basis as
part of our supervision model.
Now when we get to the end,that's our outcomes.
And we've already determinedsome of our outcomes in the
evaluation section, but we wantto make sure that they're valid,
reliable and very importantlysensitive to change.
(08:20):
And so sometimes we're seeingchange.
The family is seeing change, butif we haven't selected the right
outcome measures, we may notactually see a difference.
And it's really important toknow which assessments.
Our pre-post measures and can beused for outcomes.
And which ones are just used togather data.
So that's really important whenyou're looking at outcome
(08:41):
measures.
With our outcome measures.
We're looking at how that'simpacting goal achievement and
also how that's beingtransferred to daily living
skills or occupationalperformance.
So that's how OTPF lays out theoccupational therapy process.
(09:02):
And the first part of thatprocess, is the evaluation and I
get a lot of questions about theevaluation when you are in a
non-traditional setting.
And the nice thing about it isit doesn't really matter what
setting you're in.
You're going to be using a lotof the same types of evaluation
(09:23):
tools.
But I will also add a caveat tothat.
In that there are some specificthings that we do need to know
that are unique to our setting.
So that might be something likean life-threatening allergy to
insects, right?
If we're in a nature basedsetting, we really need to focus
on that.
If there are any fears or traumarelated to being in the outdoors
(09:45):
or open spaces.
Sensory processing challengesaround.
Eh, any component that we mightexperience in a nature based
setting.
Right.
We want to know those thingsahead of time.
And so as part of our evaluationprocess, it's important that
we're considering anyprecautions, any Contra
indications.
And putting that all together.
(10:06):
Now.
If this is something that you'rethinking about and struggling
with.
They're using the occupationaltherapy practice framework the
OTPF is a great way to getstarted because it really is
pretty structured.
You can take the OTPF and thedifferent categories, make some
check boxes.
And make your questions from.
(10:28):
The components that it gives youin the occupational profile or
download the AOTA.
And get started.
If you're really struggling morewith the niche specific areas,
then that might be somethingthat we're covering in Business
Barn Raising.
When we get started in June,that might be really helpful for
you.
So when we start to look at theoccupational performance, this
(10:51):
is where I said, I really likedto go ahead and break it down to
those process skills, because Ithink the OTPF really does a
nice job of breaking downprocess skills into something
that is not only easy tounderstand, but it's also easy
to explain to others.
And when we're in a uniquesetting, again, we don't want
(11:13):
things that are going to impairour communication with other
professionals, right?
We want to be using kind ofstandardized language.
So that way, anybody in atraditional outpatient clinic or
a hospital based setting, I canreally understand what it is
that we're working on.
And I think this is reallyimportant when we are working in
(11:34):
niche settings.
The performance skills thatwe're looking at include the
motor skills, the process skillsand the social participation
skills.
So we're going to I'm going togive you some examples in how
I'm using those in myevaluations, just so you can get
an idea.
And again, if you've downloadedthe PDF and you can follow along
(11:56):
or you can see how I might beworking through with one of
those.
In motor skills, we have acouple sub categories, including
positioning the body obtainingand holding objects.
Moving self and objects,sustaining performance.
So something like endures.
So the definition for endures ispersist and complete the task
(12:17):
without demonstrating physicalfatigue, pausing to rest or
stopping to catch the breath.
Now, if you've been in a naturebased setting, this will
immediately jump out at you.
And there's examples ofeffective occupational
performance and ineffectiveperformance of this skill, but
we can think about it of a childwho's able to get out to our
(12:37):
outdoor classroom withoutfatiguing, pausing to rest or
stopping to catch their breath.
If we know that they need tostop multiple times, then maybe
they're having trouble with thiscategory of endures in
sustaining performance.
Another area we can think aboutis the moving self and others
(12:57):
and a moving self and others,right?
Coordinates uses two or moreparts of the body together to
manipulate and hold task objectswithout evidence of fumbling or
task objects, slipping fromtheir grasp.
If we're incorporating any ofour nature based materials, we
can look and see how well theclient is able to coordinate
their body.
And those tasks, objects stickscome to mind, right?
(13:19):
Because kids are always pickingup sticks and rocks in our
nature based session.
So we can look at that.
Coordination moves, lifts,walks, transports, calibrates
flows.
Those are all in the motorskills category.
Now when we move from motorskills, we can move into the
performance skill of processskills.
(13:42):
Let me just give you thedefinition.
Process skills are a group ofperformance skills that
represent small observableactions related to selecting,
interacting with and usingtangible task objects.
Carrying out individual actionsand steps and preventing
problems of occupationalperformance from occurring or
reoccurring in the context ofperforming personally and
ecologically relevant daily lifetask.
(14:05):
Of course that's all in OTspeak.
Right?
But we're looking at how theperson is able to do it.
So some components in heresustaining performance.
Now we talked about it from themotor skill side.
But now we can also talk aboutit from the process skill side,
and we can look at the oneattends.
(14:26):
We know a lot of our clientshave trouble with attention.
So attends means does not lookaway from task performance,
maintaining an ongoing taskprogression.
And we can definitely see thatmany of our clients have trouble
with attends.
They look away or they don'tcontinue to progress on a task.
So we might be able to check offthat box and maybe it's mild,
(14:48):
moderate, or severe as far asattends, whether they're able to
do that.
We can look at a process skillunder the applying knowledge
section that is chooses.
Chooses means selects thenecessary and appropriate type
and number of objects for thetask, including tasks, objects
that one chooses or is directedto choose.
(15:09):
And when we think about givingdirections in a nature-based
setting in the evaluation phase,we might say.
Pick up a stick that's longenough to use as a walking
stick.
Are they able to apply?
Or understand what that means.
So they choose a stick that islong enough.
Now there is some context herein that.
(15:31):
If they've never been hikingbefore, they've never heard the
term a walking stick.
All right.
We might have to show them anexample here.
This is my stick.
It's a walking stick.
Can you find yourself a walkingstick?
And if they come back withsomething that's nine inches
long.
We know that they're having sometrouble with choosing.
We could also say, choose acrayon.
(15:52):
That would color the picturesthat you see around you, if
we're providing an activity todo and can they choose the
necessary and appropriatecrayons or markers that they
would need for that.
We can look at under organizingand timing.
We can look at sequencing,performed steps in an effective
(16:13):
or logical order with theabsence of randomness.
In the ordering or inappropriaterepetition of steps.
And when we think about a childwho is having trouble with
sequencing in the nature basedenvironment, sometimes we really
do need to do things in aparticular order.
Especially for, puttingsomething together.
Or we need to follow aparticular trail.
(16:34):
We need the client to be able tosequence them in a logical
order.
And this is a good thing that wecan assess as far as process
skills go in that initialevaluation phase.
To wrap it up there's a ton morethings that go into process
skills.
But I want to make sure I havetime to talk about the social
(16:55):
interaction skills.
This is amazing when we'reworking in a group setting, but
often even when we'reone-on-one, we may have another
professional helper.
We may have an OT student withus.
We may have parents along withus.
So there's a number of differenttimes when we're going to have
social interactions.
Or even if we're in a communitysetting, we're going to have
(17:18):
social interactions.
So we have initiating andterminating, so approaches and
starts or concludes indigenousengages.
And I certainly know some of myclients that have trouble with
both of those either approachingand starting.
So that would be approaches orinitiates interaction with the
social partner in a manner thatis socially appropriate.
(17:41):
So we can see if we're in a parksetting.
Does the client appropriatelyinitiate with a same age peer.
Are they inappropriate andinitiating with someone who is
not a peer or are theyinappropriate and initiating,
with somebody at the park who.
Doesn't want to interact withthem.
(18:03):
Or are they just inappropriatein their initiation.
Such as running up behindsomebody and tapping them on the
back.
Right.
That would not be inappropriateinitiation.
So we could mark that down.
If we saw that or we could setup.
Social interaction of greetingsomeone.
So producing socialinteractions, producing speech,
(18:23):
gesticulates or speaks fluently.
Right.
We can look at those areas.
In the nature based setting whenwe're interacting with other
people.
Physically supporting a socialinteractions, such as turning
towards or looks pace itself,touches and regulates.
We know that a lot of ourclients have trouble with
regulation.
(18:44):
So under regulation does notdemonstrate.
Relevant, repetitive orimpulsive behaviors during
social interactions.
So we would be looking at thatregulation specifically within
those social interactions, butwe would be looking for anything
that was repetitive and thatcould be repetitive actions or
even repeating the same story orcomponent of a story.
(19:09):
And any impulsive behaviors inthat.
So thinking about, Running.
On a Rocky Creek bed, right?
Because they're running with apeer or they're running so that
they can be first.
And so that could be definitelyan impulsive behavior that might
indicate that there were somechallenges with regulation.
(19:31):
There's shaping content ofsocial interactions, such as
questions, replies disclosure,expressing emotion disagreeing,
and thanks.
Maintaining the flow of socialinteractions, such as
transitions, timing responses,times duration.
So that would be an examplespeaks for a reasonable length
(19:51):
of time.
Given the complexity of themessage takes turns.
And if we are running groups, wecan see this a lot taking turns,
but even between thepractitioner and the client, we
can set up a situation forturn-taking.
So, this is how I look at usingthe OTPF.
(20:12):
Now they do have a specificgroup category.
Performance skills for groups.
So if you are runningnature-based groups, this again
is a great section to look at.
It does give you a little bitmore information.
If you're running groups.
When we think about ourevaluation, remember we have the
occupational profile, theanalysis of occupational
(20:34):
performance.
And we have the synthesis of theinformation.
So any of the data that we'vecollected, including using the
OTPF four in the performanceskills, as part of our analysis
of occupational performance.
That's a great way to structureand then write up your
occupational therapy evaluation.
This can be used in our uniquesettings when we're
(20:57):
incorporating animals, or ifwe're an aquatic based setting
around the pool.
All of these still apply.
And I think that it gives usagain, a very standardized
framework to communicate withothers, to show our unique value
and to keep the focus onoccupational performance.
I really hope that this washelpful for you today.
(21:18):
I do love talking about the OTBapp, so we are not done with it
in celebration of April asoccupational therapy month.
Thanks for listening.
Hey, welcome back to animals and
aquatics in April foroccupational therapy month.
This month.
Remember we are taking a deepdive into the occupational
therapy practice framework.
Now if you've downloaded yourcopy and you're ready to follow
along.
Let's get started.
Microphone (3- Logitech USB (00:30):
Hi, welcome to animals and aquatics.
Gina your cohost.
And this month we are taking adeep dive into the occupational
therapy practice framework andhow you can use it in unique
niches, such as hippotherapy,aquatics, animal assisted
therapy and nature basedtherapy.
And today, specifically, I wantto focus on using the OTPF in
(00:50):
the evaluation process.
In fact, we found it invaluablein creating occupational
therapy.
Evaluation framework.
And I'd like to take you throughthat a little bit today.
And as I've mentioned, if youhave your OTPF and want to
follow along, this may help itmake sense to you.
You can find free downloadsonline.
(01:10):
And just pull up the PDF to lookthrough it.
Now the nice thing about theOTPF and I talked to my students
in the occupational therapyassistant program a lot about
the OTPF because.
I feel like if you sit down withthis document for enough time,
It really is like its ownoccupational therapy education.
(01:32):
It talks a lot about what ourscope of practice really is.
And I think it's a greatresource document.
I also think that it really canhelp to guide our process and a
lot of the textbooks that we usereference OTPF and now we're
working on OTPF for.
And they go through theoccupational therapy process
(01:58):
using OTPF the other thing Ireally like about it.
Is, it fits really well with theWHOs international
classification of disability andfunction model.
And I think when we're talkingto our colleagues
internationally, it really is agood starting place where we
have some things in common andsome common language to work
from.
And when you're working in aunique niche, the last thing we
(02:21):
need getting in between us andother occupational therapy
practitioners is language or theway that we're wording our
terminology.
So some of the key aspects thatthe OTPF looks at are of course
occupations.
So our ADL's, IADL's, healthmanagement.
Rest and sleep.
Education work, play.
(02:43):
Leisure and socialparticipation.
We also look at contexts such asenvironmental factors and
personal factors.
We can take time to work withperformance patterns, such as
habits, routines, roles, andrituals.
And then we break it down intoperformance skills.
So this is where I like tofocus.
(03:04):
Most of my occupational therapyevaluation.
This is looking at motor skills,process skills and social
interaction skills.
And we can wrap it up when we'recompleting our evaluation with
client factors, such as values,beliefs, spirituality.
And body functions andstructures.
So with the OTPF, when we wantto look at the OT process.
(03:28):
So that's how he providesservices.
It's really well outlined in theOTPF.
And the evaluation starts withthe occupational profile.
And there's a good example of anoccupational profile on AOTA.
But it starts with why is theclient seeking services and how
is this related to how they'reengaging in occupations in daily
(03:52):
life?
So that's always a good place tostart and it really puts
occupation at the front andcenter.
Then we talk about what is theclient doing successfully and
what barriers are impactingtheir success in what they want
to be able to do.
Then we can look at occupationalhistory, values, interests, and
contacts.
Before we get to thoseperformance patterns.
(04:14):
So when we get to theperformance patterns, that's
where I really like to take thatdeep dive.
And the second part of this isthe analysis of occupational
performance.
And this is where I really wantto take those performance skills
and look at them reallycarefully.
So I'm going to go through someof those, but I do want to
finish up looking at what the OTprocess.
(04:38):
So this is the whole processfirst.
So we're talking about theevaluation and again, the
evaluation is composed of theoccupational profile.
The analysis of occupationalperformance and then the
synthesis of the evaluationprocess.
So this is looking at theirvalues and priorities.
This is interpreting any datathat we've collected.
(05:01):
So for me, that's often the datathat I've collected from a
sensory profile or the PEDI.
So that's a pediatric evaluationof disability inventory, or
maybe it's the BRIEF executivefunction scales.
So I'm going to interpret thatdata then developing and
refining my hypothesis about theclient's occupational
(05:23):
performance.
Both the strengths and thedeficits.
And we'd like to work from astrengths based approach.
So we like to highlight whatthose strengths are and then
explain how we're going toincorporate those into our plan
of care.
Then we might look at anysupport systems that might be
impacting the success of theclient and our interventions in
(05:44):
this process.
And coming up with the goals.
So we create our goals,obviously in collaboration with
the clients.
And usually that's done in aninterview format.
Although when we do want to be abit more formal about it, we'll
use the COPM.
So that's the Canadianoccupational performance
measure.
And then as part of theevaluation, we're already
(06:05):
selecting outcome measures thatare going to determine progress
towards our goals.
And we'll look at whether weneed to.
Repeat the re-evaluation processor move on to discharge.
In our intervention phase.
The intervention plan.
So what exactly are we going toinclude?
(06:27):
What are the timeframes that weexpect this to be?
What is our approach?
Are we looking at promotingwellness?
Establishing or restoringparticular skills, maintaining
where the client is at.
Modifying or prevention.
And then what's our servicedelivery method.
So when, where, and whatapproach will be used.
(06:50):
We might look at what thedischarge plans are going to be,
and we can make anyrecommendations or referrals to
other professionals.
Then we begin to carry out ourinterventions, right?
That's the part we think ofmost, and this could be
one-on-one sessions.
This could be groupinterventions.
This could be virtual.
Although when we'reincorporating animals in, or
(07:13):
we're doing nature basedsessions, these are very
experiencial and face-to-face,but we can do them in a
one-on-one format.
We can do them in group format.
We can be included includingpsychosocial education
components to it.
Right?
So there's a number of differentways that we might be doing our
intervention implementation.
(07:34):
And through this, we're alsomonitoring the client's response
through ongoing observationevaluation and re-evaluation as
needed.
The last part that's actuallypart of the intervention phase
is the intervention review.
We're re-evaluating the plan,how it's implemented.
How it's working to achieve ourgoals and outcomes.
Modifying the plan as needed.
(07:56):
And if you're working withoccupational therapy assistance,
this is something that we'redoing on an ongoing basis as
part of our supervision model.
Now when we get to the end,that's our outcomes.
And we've already determinedsome of our outcomes in the
evaluation section, but we wantto make sure that they're valid,
reliable and very importantlysensitive to change.
(08:20):
And so sometimes we're seeingchange.
The family is seeing change, butif we haven't selected the right
outcome measures, we may notactually see a difference.
And it's really important toknow which assessments.
Our pre-post measures and can beused for outcomes.
And which ones are just used togather data.
So that's really important whenyou're looking at outcome
(08:41):
measures.
With our outcome measures.
We're looking at how that'simpacting goal achievement and
also how that's beingtransferred to daily living
skills or occupationalperformance.
So that's how OTPF lays out theoccupational therapy process.
(09:02):
And the first part of thatprocess, is the evaluation and I
get a lot of questions about theevaluation when you are in a
non-traditional setting.
And the nice thing about it isit doesn't really matter what
setting you're in.
You're going to be using a lotof the same types of evaluation
(09:23):
tools.
But I will also add a caveat tothat.
In that there are some specificthings that we do need to know
that are unique to our setting.
So that might be something likean life-threatening allergy to
insects, right?
If we're in a nature basedsetting, we really need to focus
on that.
If there are any fears or traumarelated to being in the outdoors
(09:45):
or open spaces.
Sensory processing challengesaround.
Eh, any component that we mightexperience in a nature based
setting.
Right.
We want to know those thingsahead of time.
And so as part of our evaluationprocess, it's important that
we're considering anyprecautions, any Contra
indications.
And putting that all together.
(10:06):
Now.
If this is something that you'rethinking about and struggling
with.
They're using the occupationaltherapy practice framework the
OTPF is a great way to getstarted because it really is
pretty structured.
You can take the OTPF and thedifferent categories, make some
check boxes.
And make your questions from.
(10:28):
The components that it gives youin the occupational profile or
download the AOTA.
And get started.
If you're really struggling morewith the niche specific areas,
then that might be somethingthat we're covering in Business
Barn Raising.
When we get started in June,that might be really helpful for
you.
So when we start to look at theoccupational performance, this
(10:51):
is where I said, I really likedto go ahead and break it down to
those process skills, because Ithink the OTPF really does a
nice job of breaking downprocess skills into something
that is not only easy tounderstand, but it's also easy
to explain to others.
And when we're in a uniquesetting, again, we don't want
(11:13):
things that are going to impairour communication with other
professionals, right?
We want to be using kind ofstandardized language.
So that way, anybody in atraditional outpatient clinic or
a hospital based setting, I canreally understand what it is
that we're working on.
And I think this is reallyimportant when we are working in
(11:34):
niche settings.
The performance skills thatwe're looking at include the
motor skills, the process skillsand the social participation
skills.
So we're going to I'm going togive you some examples in how
I'm using those in myevaluations, just so you can get
an idea.
And again, if you've downloadedthe PDF and you can follow along
(11:56):
or you can see how I might beworking through with one of
those.
In motor skills, we have acouple sub categories, including
positioning the body obtainingand holding objects.
Moving self and objects,sustaining performance.
So something like endures.
So the definition for endures ispersist and complete the task
(12:17):
without demonstrating physicalfatigue, pausing to rest or
stopping to catch the breath.
Now, if you've been in a naturebased setting, this will
immediately jump out at you.
And there's examples ofeffective occupational
performance and ineffectiveperformance of this skill, but
we can think about it of a childwho's able to get out to our
(12:37):
outdoor classroom withoutfatiguing, pausing to rest or
stopping to catch their breath.
If we know that they need tostop multiple times, then maybe
they're having trouble with thiscategory of endures in
sustaining performance.
Another area we can think aboutis the moving self and others
(12:57):
and a moving self and others,right?
Coordinates uses two or moreparts of the body together to
manipulate and hold task objectswithout evidence of fumbling or
task objects, slipping fromtheir grasp.
If we're incorporating any ofour nature based materials, we
can look and see how well theclient is able to coordinate
their body.
And those tasks, objects stickscome to mind, right?
(13:19):
Because kids are always pickingup sticks and rocks in our
nature based session.
So we can look at that.
Coordination moves, lifts,walks, transports, calibrates
flows.
Those are all in the motorskills category.
Now when we move from motorskills, we can move into the
performance skill of processskills.
(13:42):
Let me just give you thedefinition.
Process skills are a group ofperformance skills that
represent small observableactions related to selecting,
interacting with and usingtangible task objects.
Carrying out individual actionsand steps and preventing
problems of occupationalperformance from occurring or
reoccurring in the context ofperforming personally and
ecologically relevant daily lifetask.
(14:05):
Of course that's all in OTspeak.
Right?
But we're looking at how theperson is able to do it.
So some components in heresustaining performance.
Now we talked about it from themotor skill side.
But now we can also talk aboutit from the process skill side,
and we can look at the oneattends.
(14:26):
We know a lot of our clientshave trouble with attention.
So attends means does not lookaway from task performance,
maintaining an ongoing taskprogression.
And we can definitely see thatmany of our clients have trouble
with attends.
They look away or they don'tcontinue to progress on a task.
So we might be able to check offthat box and maybe it's mild,
(14:48):
moderate, or severe as far asattends, whether they're able to
do that.
We can look at a process skillunder the applying knowledge
section that is chooses.
Chooses means selects thenecessary and appropriate type
and number of objects for thetask, including tasks, objects
that one chooses or is directedto choose.
(15:09):
And when we think about givingdirections in a nature-based
setting in the evaluation phase,we might say.
Pick up a stick that's longenough to use as a walking
stick.
Are they able to apply?
Or understand what that means.
So they choose a stick that islong enough.
Now there is some context herein that.
(15:31):
If they've never been hikingbefore, they've never heard the
term a walking stick.
All right.
We might have to show them anexample here.
This is my stick.
It's a walking stick.
Can you find yourself a walkingstick?
And if they come back withsomething that's nine inches
long.
We know that they're having sometrouble with choosing.
We could also say, choose acrayon.
(15:52):
That would color the picturesthat you see around you, if
we're providing an activity todo and can they choose the
necessary and appropriatecrayons or markers that they
would need for that.
We can look at under organizingand timing.
We can look at sequencing,performed steps in an effective
(16:13):
or logical order with theabsence of randomness.
In the ordering or inappropriaterepetition of steps.
And when we think about a childwho is having trouble with
sequencing in the nature basedenvironment, sometimes we really
do need to do things in aparticular order.
Especially for, puttingsomething together.
Or we need to follow aparticular trail.
(16:34):
We need the client to be able tosequence them in a logical
order.
And this is a good thing that wecan assess as far as process
skills go in that initialevaluation phase.
To wrap it up there's a ton morethings that go into process
skills.
But I want to make sure I havetime to talk about the social
(16:55):
interaction skills.
This is amazing when we'reworking in a group setting, but
often even when we'reone-on-one, we may have another
professional helper.
We may have an OT student withus.
We may have parents along withus.
So there's a number of differenttimes when we're going to have
social interactions.
Or even if we're in a communitysetting, we're going to have
(17:18):
social interactions.
So we have initiating andterminating, so approaches and
starts or concludes indigenousengages.
And I certainly know some of myclients that have trouble with
both of those either approachingand starting.
So that would be approaches orinitiates interaction with the
social partner in a manner thatis socially appropriate.
(17:41):
So we can see if we're in a parksetting.
Does the client appropriatelyinitiate with a same age peer.
Are they inappropriate andinitiating with someone who is
not a peer or are theyinappropriate and initiating,
with somebody at the park who.
Doesn't want to interact withthem.
(18:03):
Or are they just inappropriatein their initiation.
Such as running up behindsomebody and tapping them on the
back.
Right.
That would not be inappropriateinitiation.
So we could mark that down.
If we saw that or we could setup.
Social interaction of greetingsomeone.
So producing socialinteractions, producing speech,
(18:23):
gesticulates or speaks fluently.
Right.
We can look at those areas.
In the nature based setting whenwe're interacting with other
people.
Physically supporting a socialinteractions, such as turning
towards or looks pace itself,touches and regulates.
We know that a lot of ourclients have trouble with
regulation.
(18:44):
So under regulation does notdemonstrate.
Relevant, repetitive orimpulsive behaviors during
social interactions.
So we would be looking at thatregulation specifically within
those social interactions, butwe would be looking for anything
that was repetitive and thatcould be repetitive actions or
even repeating the same story orcomponent of a story.
(19:09):
And any impulsive behaviors inthat.
So thinking about, Running.
On a Rocky Creek bed, right?
Because they're running with apeer or they're running so that
they can be first.
And so that could be definitelyan impulsive behavior that might
indicate that there were somechallenges with regulation.
(19:31):
There's shaping content ofsocial interactions, such as
questions, replies disclosure,expressing emotion disagreeing,
and thanks.
Maintaining the flow of socialinteractions, such as
transitions, timing responses,times duration.
So that would be an examplespeaks for a reasonable length
(19:51):
of time.
Given the complexity of themessage takes turns.
And if we are running groups, wecan see this a lot taking turns,
but even between thepractitioner and the client, we
can set up a situation forturn-taking.
So, this is how I look at usingthe OTPF.
(20:12):
Now they do have a specificgroup category.
Performance skills for groups.
So if you are runningnature-based groups, this again
is a great section to look at.
It does give you a little bitmore information.
If you're running groups.
When we think about ourevaluation, remember we have the
occupational profile, theanalysis of occupational
(20:34):
performance.
And we have the synthesis of theinformation.
So any of the data that we'vecollected, including using the
OTPF four in the performanceskills, as part of our analysis
of occupational performance.
That's a great way to structureand then write up your
occupational therapy evaluation.
This can be used in our uniquesettings when we're
(20:57):
incorporating animals, or ifwe're an aquatic based setting
around the pool.
All of these still apply.
And I think that it gives usagain, a very standardized
framework to communicate withothers, to show our unique value
and to keep the focus onoccupational performance.
I really hope that this washelpful for you today.
(21:18):
I do love talking about the OTBapp, so we are not done with it
in celebration of April asoccupational therapy month.
Thanks for listening.
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