Chapter 13: Assessment and Treatment of Instrumental Activities of Daily Living and Flashcards
Person factors
Children and caregivers each have abilities and preferences that can influence a child’s IADL performance and satisfaction with participation.
For caregivers, person factors such as their mental health (e.g., stress level), physical or cognitive abilities, and employment status may influence their preferences about the importance of targeting IADLs.
For children, person factors might include things like the child’s capacities. In addition to their abilities, children’s preferences (values, interests) shape decisions about valued IADLs. Children’s prefere
Environment factors
-Caregiver perceptions of home environmental support has been found to mediate the association between child and family factors and the child’s participation
The significant role of environmental support on participation has been replicated in studies involving other cultural contexts and target populations, including children recovering from critical illness
Extrinsic to the child and include a number of dimensions, such as physical features (ex. housing layout, physical items in the home), sensory features (ex. noise and other stimuli), social relationships (e.g., supportive sibling), and attitudes of individuals who are present with and encourage the child (ex. peer advocate) during IADL completion. Can extend to the social and cultural structures as well.
Occupation factors
The physical, cognitive, and social task demands of the occupation are also uniquely considered by occupational therapists when targeting IADLs
Family-centered care
The parent or caregiver is also considered “the client” especially when providing family-centered care.
Ideally, both the child/adolescent and parent/caregiver perspectives on IADL participation and performance are considered during the OT evaluation.
Independent community living
Successful completion of IADLs is one element to support the transition to independent community living
Self-determination has been identified as a factor that promotes independent community living
Instrumental activities of daily living
Generally considered more complex than activities of daily living (ADLs).
For children and adolescents, these activities include care of others, care of pets, child rearing, use of a communication device, driving and community mobility, financial management, health management and maintenance (ex. taking medications, exercise, and nutrition), home management (ex. clothing care, cleaning), meal preparation and clean-up, religious and spiritual activities and expression, shopping, and safety and emergency procedures.
Children’s competence in performing IADLs contributes to their participation in broader sets and sequences of occupations in home, school and/or work, and community life
Learned helplessness
Occurs when actions repeatedly fail to produce results or when individuals are not afforded the opportunity to make repeated attempts with specific activities or tasks.
Many children and adolescents faced with physical, intellectual, and emotional challenges have difficulties making decisions and decisions are often made for them or they defer to others
Life skills
Self-determination encompasses many of the behaviors often referred to as life skills that are both innate and learned
These skills include managing personal care and health needs, taking care of one’s belongings and space, managing home repairs, arranging transportation, and living interdependently with others.
Natural environment
Evidence suggests that the best outcomes occur when IADLs can be addressed within the natural environment, such as the home, grocery store, public transportation, or other community environments.
When intervention cannot occur within the natural environment, occupational therapists can use strategies to increase the likelihood that skills will generalize, such as simulating the natural environment as much as possible and collaborating closely with the child’s family member to identify strategies that will easily carry over at home or in the community.
Prosocial behaviors
Seen as the helping behaviors to pick up toys and assist in basic household chores such as throwing away trash.
These prosocial behaviors of helping in chores are encouraged in toddlers 18 and 24 months
When asked to recall the earliest instances of prosocial (helping) behaviors in their children, parents reported clear situations between 1 to 2 years of age, when children helped with household chores
Self-determination
factor that promotes independent community living (Carter et al., 2013).
Self-determination is conceptualized from both a person-environment interaction and a social-ecological perspective
“a combination of skills, knowledge, attitudes, and behaviors that enable a person to engage in goal-directed, self-regulated, autonomous behavior.
Task and environment modification
While addressing person factors such as strength or attention to task may result in improved participation in IADLs, modifying the IADL task(s) or the environmental context of the IADL may be equally, or more, effective.
When addressing IADLs in intervention, modifying the manner in which an IADL is completed, such as using a handheld vacuum for crumbs instead of sweeping the floor, or the environmental context of the IADL, such as rearranging kitchen cupboards so meal preparation materials are within reach, may be effective methods for improving IADL performance.
Technology supports
Increasingly becoming a part of everyday life and can be an effective support for IADL participation.
Smartphones and other handheld devices can be used to provide reminders (e.g., a reminder to take medication or schedule a doctor appointment) or to remember sequences or lists (e.g. grocery list, bus route).
Mobile devices also been found to be effective for video prompting during IADL tasks (e.g. meal preparation) for middle school students with intellectual disability
Visual supports
May include visual schedules, visual cues in the environment, and video modeling or prompting. Visual activity schedules have been found to improve performance of life skills for children and adolescents with intellectual and develop mental disabilities
-Visual supports can be customized for a variety of IADL tasks and may be created using real life photos or icons
