MOHO

Question 1

Model of Human Occupation (MOHO)

Answer 1

A way to systematically analyze a child’s current occupational situation, understand his/her strengths and challenges, and identify the optimal therapeutic environment that will enable him/her to achieve goals.
• Concerned with child’s motivation for engaging in occupations, child’s ability to perform occupations, and influence of environment on occupations.
• Main concepts are VOLITION, HABITUATION, PERFORMANCE CAPACITY, and ENVIRONMENT
• Evidence-based (30 years of research)
• Most widely-used occupation-focused model in OT

Question 2

9 Therapeutic Strategies

Answer 2

1) Advise (recommend goals/strategies)
2) Coach (instruct, demo, prompt)
3) Encourage (emotional support/reassurance)
4) Give Feedback (share understanding of child’s participation in occupations)
5) Identify (locate/share factors that facilitate participation)
6) Negotiate (give/take with child, parents, etc to achieve common agreement for child)
7) Physical Support (use body to support completion of occupational task when child cannot)
8) Structure (establish parameters/choice for performance)
9) Validate (convey respect for child’s/parent’s experience/perspective)

Question 3

Volition

Answer 3

Child’s motivation for occupations.
Influenced by:
• Interests
• Values
• Personal Causation

Question 4

Personal Causation

Answer 4

Part of volition. Child’s beliefs about his/her ability to effectively perform occupations.
• Gradually built thru continued accomplishments and increases child’s motivation to engage in other occupations.
• Good sense of personal causation will seek new challenges; low sense will avoid new activities.

Question 5

Volitional Process

Answer 5

Method to influence a child’s interests, values, or personal causation.
• How children experience their participation in occupations.
• Includes 4 steps:
1) Anticipation
2) Making Choices
3) Experience
4) Interpretation
• Change child’s volition by changing the way child does these 4 things.
• Ex: Make activity easier; make activity similar to a familiar/achievable one; align activity with one of child’s interest.
• Ask if the activity is: FUN? ENJOYABLE? MEANINGFUL? ACHIEVABLE?

Question 6

Habituation

Answer 6

Internalized readiness to engage in consistent patterns of behavior during certain times of day and days of week, as determined by one’s habits and roles.

HABITS: acquired tendency to respond automatically to specific circumstance/environment. Help children to be efficient in familiar tasks.

ROLES: set of related actions and attitudes that define culturally and socially familiar status. Therapy can be a time for children to learn/practice role-related actions.

Question 7

Performance Capacity

Answer 7

Child’s ability to do things as supported by the status of his/her physical and mental components (ie strength, intelligence, proprioception) as well as his/her subjective experience of living within his/her body (“lived body” experience).

Question 8

“Lived Body” Experience

Answer 8

A child’s own experience of using and living in his/her body. Subjective aspect of performance capacity. Cannot be measured by another person.

Question 9

Environmental Factors of MOHO

Answer 9

Concepts that help us think of the environmental factors that influence participation. Includes:
• Spaces
• Objects
• Social Groups
• Occupational Tasks

Question 10

Occupational Forms/Tasks

Answer 10

Conventional sequences of actions that are oriented to a specific purpose, and understood by and recognizable to members of a shared culture. Conventional/understood way of doing something (ie: play football, bake a cake, take a test).
• OT can modify the steps or propose an alternative way of doing things to enable participation.

Question 11

Environmental Impact

Answer 11

Extent to which spaces, objects, social groups, and occupational tasks provide opportunities, supports/resources, demands or constraints on participation. (ie: are there physical obstacles to child with mobility issues?)
• Consider how environments uniquely affect each child’s participation in occupations, and attempt to provide environment that matches child’s abilities/needs.

Question 12

Skills

Answer 12

Observable, goal-directed actions that the child uses to perform. When the child uses underlying physical/mental capacities to engage in a task. There are 3 types:

1) Motor Skills
2) Process Skills
3) Interaction Skills

Question 13

MOHO-Based Assessments for Children

Answer 13

• COSA (Child Occupational Self-Assessment) – age 7-17; child’s own perceived competence/importance of everyday activities.
• PVQ (Pediatric Volitional Questionnaire) – age 2-7; observation of child’s volition and effect of environment on it.
• SSI (School Setting Interview) – children who can communicate feelings; interview about student-environment fit.
• SCOPE (Short Child Occupational Profile) – age birth-21; range of info gathering to collect personal/environmental factors that facilitate/restrict participation in occs.