OT Process Flashcards
What are the three parts of the OT process?
Evaluation, intervention, outcomes
What are the three parts of the evaluation?
The occupational profile, analysis of occupational performance, synthesis of evaluation process
What are the three parts of intervention?
Intervention plan, intervention implementation, and intervention review
What are outcomes?
Outcomes emerge from the Occupational Therapy process and describe the results clients can achieve through occupational therapy intervention
What is therapeutic use of self?
Occupational therapist develop and manage their therapeutic relationship with clients by using professional reasoning, empathy, and client centered, collaborative approach to service delivery.
What is the evaluation process focus on?
Finding out what the client wants and needs to do; determining what the client can do and has done; and identifying supports and barriers to health, well-being, and participation.
What are some outcomes of occupational therapy?
Improvement enhancement, prevention, quality of life, health and wellness, well-being, occupational justice, occupational performance, role competence
What is the vision for occupational therapy?
Occupation-based, client centered, contextual, evidence-based
What are the steps in the evaluation process?
Referral,
consultation and screening,
occupational profile,
analysis of occupational performance, synthesis of evaluation process
What do you need to find out during the evaluation process?
What the client wants and needs to do, identify supports and barriers to health, well-being, participation and occupation performance and determine what the client can do and what they have to do
What is a referral and where do they come from?
A request for services.
Physicians, clients and other professionals
What is done during the consultation and screening process?
Review client history,
consult with interprofessional team, administer standardized screening tools and assessments (standardized and unstandardized.)
What information is gathered in the occupational profile?
Client and caregiver interview
summary of occupational history, experiences, patterns of daily living, interest, values, needs, relevant context.
understand what is important and meaningful to the client and what the client wants
What is included in the analysis of occupational performance?
Assess occupational performance and client ability to complete occupations,
assesses contexts, client factors
performance skills and performance patterns
identify supports and barriers to health, well-being and participation and identify assets or potential challenges.
What is synthesis of evaluation process?
Review and consolidate information to select occupational outcomes and determine impact of performance patterns and client factors on occupation.
What are the five observation skills?
Structured observation
watching
noticing
systematic
practice
What is validity?
True measure of what it claims.
What is reliability?
Test accurately reflects true performance.
What is test retest reliability?
Result consistency
What is interrater reliability?
Examiner consistency
What are standardized tests?
Normative data
What are non-standardized test?
Not establish Norm data or reliability and validity
What are the OT roles in evaluation?
Responsible for initiating and directing the screening process,
ensures OTA has developed services competency in evaluation
components
What are the OTA‘s Roll in evaluation?
Contributes to the screening process under the direction of an OT
must establish service competency, OTA may have delegated responsibilities
the OTA communicates the results of all evaluation procedures to the OT
How do you develop an intervention plan?
Identify goals,
identify intervention goals,
select outcome measures
What is intervention implementation
Carry out interventions to address specific occupations, contexts and performance patterns
What do you do in an intervention review?
Reevaluate and review response,
review progress toward goals and outcomes,
modify plan as needed
What is an OT’s role in intervention?
OT formulate and documents the treatment plan, provides supervision to the OTA
What is the OTA’s role in intervention?
OTA provides input in program planning
implementation is the central responsibility of the OTA,
OTA conducts intervention under the supervision of the OT
How do you determine the outcome of intervention?
Intervention review,
use measures to access progress towards goals and outcomes,
identify change in occupational participation
What are transitional services?
This involves the coordination and facilitation of services for the purpose of preparing the client for change
What happens when the services are discontinued?
Create a discharge plan which is developed and implemented to address the resources and supports required upon discharge, including services.
Discharge summary which is written to address functional level, changes throughout intervention, plan for discharge, equipment and services recommended and follow up needs.
What is the OT’s role in the outcome process?
OT rights discharge summary with input from OTA
What is the OTA’s role in the outcome process?
Provides input to the OT.
What is test reliability?
It is a measure of how accurately the scores obtained from the test reflect the true performance of the client.
What is interrater reliability?
It is the indicator of the likelihood that test scores will be the same no matter who administers the test.
What is the validity of a test
A test is said to have validity if it is a true measure of what it claims to measure.
What is test retest reliability?
It is an indicator of the consistency of the results from one administration of the test to another.
What are standardized tests?
They go through rigorous process of scientific inquiry to determine its reliability and validity. Each standardized test has a carefully established protocol for administration and scoring the test.
What is normative data or NORMS?
It is data collected from a representative sample that can be used by the examiner to make comparisons of their test subject. Normative data are compiled by administering the test to a large sample of subjects.
What is a patient reported outcome?
It is a report of the status of a patient’s health condition or health behavior that comes directly from the patient, without interpretation of the patient’s response by a clinician.
What is patient reported outcome measure?
These tools measure patient self reported health status. They are very subjective.
What are non-standardized tests?
They are useful for measuring function. They have guidelines for administration and scoring – may not established normative data or establish reliability or validity. Administration and scoring is more subjective and rely on clinical skill, judgment, and experience of the therapist. They are informal – manual muscle testing is an example of a non-standardized assessment
When do OT services stop?
Discharge occurs when client has met long and short term goals, Client has realized maximum benefit of therapy and client wishes to discontinue services
What are the basic premises of the MOHO model of practice?
Volition
Habituation
Performance Capacity
Skills/patterns prior to and following incident
Environment
What are the basic premises of Model of Occupational Performance (CMOP)
Spirituality as core
Emphasizing client centered care
Person, environment and occupations are other important components of this model
Getting to know the client is crucial
Used in behavioral health more frequently
The Canadian occupational performance measure is semi structured interview-based assessment based on this model that provides clients a tool to identify and prioritize problems that affect their occupational performance and participation.
What are the basic premises of Person-Environment-Occupation-Performance
Describes interaction nature of human beings
The person, physical social and psychological
Environment, physical and social. Supports the things that interfere with the clients occupational performance.
Occupation, every day things that people do that give the meaning
Performance, the actions of occupations
What is included in a frame of reference?
Population
Continuum a function/dysfunction
Theory regarding change
Principles
Role of practitioner
Assessment instruments
What is the basic premise of developmental frame of reference?
Development occurs over time and across areas.
OT’s can help fill in those gaps.
Sensoriomotor FOR
Functioning is viewed when a person is able to learn and use all the adaptive skills for their age.
Dysfunction is a lag in development causing the client to function below their age level.
Increase motor skills to the practice of occupation
Lack of motivation comes when the changes to fast and they feel they have failed
Attaining a baseline level must be established through Sensoriomotor assessment
Motor control/motor learning FOR
Motor control examines how one directs and regulates movement whereas motor learning theory describes how clients learn movements.
The interaction among the systems is essential to adaptive control and
movement
Motor performance results from an interaction between adaptable and flexible systems
Dysfunction occurs when movement patterns lacks efficient adaptability to accommodate task demands and environmental constraints
Because task characteristics influence motor requirements practitioners modify and adapt requirements and afford answers of tasks to help client succeed
Clients develop improved neural pathways when they repeat meaningful whole occupation tasks in the natural environment
Motor learning occurs as clients repeat motor tasks that are intrinsically motivated, meaningful and for which they can problem solve
Perceptual motor training FOR 
Computer type games
What skills are they getting from this game?
Looks at increasing memory, increasing visual perception skills, safety awareness and cognitive skills
Biomechanical frame of reference
Based on concepts from kinesiology
Improving range of motion through passive and active means can increase the functional mobility required for activities and movement
Increasing strength can promote stability and balance for engagement in activity
Energy is needed for a person to produce the required intensity or rate of effort over a period of time for an activity or exercise
Neurodevelopmental FOR
Developed with goal of helping children perform skilled movements more efficiently so they can carry out life skills
Facilitation of normal postural alignment and movement patterns
Demand should be placed on the involved side during developmental and functional activities
Sensory feedback is essential to recovering function
Treatment includes looking at the whole person and specific functional needs recovery versus compensation
Therapist must be able to observe and distinguish normal from abnormal alignment and movement patterns
Therapist must be able to make the functional retraining activities meaningful to the patient task specific
Therapist must be able to select the optimal practice method, feedback, and environment for maximum function and independence
Therapist must have stable footwear, good flexibility in lumbar spine and lower extremities for optimal body body mechanics during Matt activities
Behavioral FOR
The behavioral FOR emphasizes on the use of behavioral modification to shape behaviors, which purports to increase the tendency of adaptive behaviors or to decrease the probability of maladaptive learned behaviors.
Cognitive behavioral FOR
The cognitive behavioral FOR emphasizes five aspects of life experience. Thoughts, behaviors, emotion/mood, physiological responses, and the environment. These aspects are interrelated, meaning that changes in one factor can lead to improvement or deterioration and others each is influenced by the social and physical Environments. One key theoretical component in this FOR is the hierarchical levels of cognition
Sensory integration FOR
The organization of sensory input to produce an adaptive response. A theoretical process and intervention approach that addresses the processing of sensory information from the environment and includes discriminating, integrating, and modulating sensory information to produce a meaningful and adaptive response.
What are the levels of care?
Acute
Subacute
Long-term
What are the spheres of practice?
Biological- Nature of health
Psychological- Emotional, cognitive
Sociological- expectations of society
What are the employment trends?
15% employed in schools
11% in hospitals
43% and skilled nursing facilities
2% in mental health
49% of OTA’s work in For-profit company locations
What are the administration of settings?
Public, private not for profit, private for profit
Settings with biological focus
Hospitals, clinics, home health agencies
Settings with social focus
Schools, day treatment, workshops
Settings with psychological focus
Institutions, community mental health centers, supervised living, long-term care
All inclusive settings
Long-term care, address biological, sociological and psychologicalfunctions, residence for people for long periods of time
What are some non-traditional settings
Correctional facilities, industrial settings, hospice, community transition, aqua therapy, hippo therapy senior centers, homeless shelters, vision therapy, telehealth
Private practice and consulting
Pediatrics, hand therapy, schools consultation, skilled nursing facilities
Difference between MOP/FOR
MOP is application of theory to OT practice. Helps organize thoughts. Mental maps that assist clinicians and understanding their practice they are not intervention protocols but serve as a means to view occupation through theory and occupational performance. Provide a basis for decision making. All the models deal with occupation and a central way.
FOR provide specific info on what to do and practice. It guys the intervention process. A narrower view than MOP. It is not used as protocol but offer clinicians away to structure intervention and think about intervention progressions.
