Occupational Analysis & Intervention Plan

Jessica Scott
Touro University Nevada

1


Occupational Profile
1. Client name: Jason Bell
2. Age: 27
3. Sex: Male
Briefly discuss each of the following:
4. Who is the client? Jason Bell is a 27-year-old African American male who lives in a one story
apartment by himself. He works for an engineering company which he loves, but he enjoys his alone
time at his apartment.

5. Why is the client seeking services and/or what are the clients concerns relative to engaging in
occupations and in daily life activities? Jason Bell is receiving services because he wants to maintain
his independence and prevent future problems from developing in daily occupations. He enjoys
coming home to a clean apartment after work to relax.

6. What areas of occupation are successful and what areas are causing problems or risks?
The client is functional with ADLs and IADLs but his major problem is becoming fatigued while
participating in endurance activities. This is a problem because the client often becomes fatigued
and fails to complete his chores.

7. What contexts and environments support or inhibit participation and engagement in desired
occupations? Having a smaller apartment supports the clients engagement in his activities because
he does not have to move around a lot. Being inactive inhibits his participation in his activities
because it is harder for him to complete his meaningful activities.

8. What is the clients occupational history? The client has lived independently by himself in his
apartment for two years now. Jason has no trouble completing his ADLs or IADLs. On a normal
weekday he wakes up, gets dressed, makes breakfast, and leaves for work. When he arrives home
from work, he enjoys making dinner and watching television before bed.

9. What are the clients priorities and desired outcomes? The clients priority and desired outcome is
to come home to a clean house after a hard day at work.

2


Occupational Analysis

1. Occupation:
Area(s) of occupation for the client: Subcategory:
1. Activities of daily living X
2. Instrumental activities of daily living X
3. Education
4. Work
5. Play
6. Leisure
7. Social participation

2. Values, beliefs, spirituality associated with participation:
Values:
i. A clean home
ii. Independence
Beliefs:
i. A clean home is a happy home
ii. Cleanliness is next to godliness
Spirituality
i. God is the way to truth and the life

3. Contexts:
Context Supports Inhibits
Physical/space demands There is not much background
noise during this activity.
There is enough walking room in
the kitchen.
The dim lighting in his apartment
inhibits Jasons visual functions.
Social n/a n/a
Cultural n/a n/a
Personal A 27-year-old male who is a full
time employee of an
engineering company.
n/a
Temporal The length of time for the client
to complete the activity is short.
Jason usually empties his
dishwasher on Sunday mornings
when he wakes up.
Emptying the dishwasher in the
mornings could inhibit his
performance because his body is
not awake yet.
Virtual n/a n/a

4. Objects and their properties used:
3

1. Tools
i. Plates
ii. Bowls
iii. Cups
iv. Utensils
2. Equipment
i. Dishwasher
ii. Cabinet
3. Materials
i. n/a for putting up dishes

5. Social demands: n/a

6. Sequence and timing:
1. Walk over to the cabinet
2. Open the cabinet door
3. Walk over to the dishwasher
4. Open the dishwasher
5. Slide the bottom row out of the dishwasher
6. Take out the big plates
7. Stack the big plates on the counter space above the dishwasher
8. Carry the big plates to the open cabinet
9. Place the big plates on the bottom row of the cabinet
10. Walk back over to the dishwasher
11. Take out the small plates from the bottom rack
12. Stack the small plates on top of the cabinet space above the dishwasher
13. Carry all of the small plates to the open cabinet
14. Place the smaller plates on top of the bigger plates in the cabinet
15. Walk back to the dishwasher
16. Slide open the top drawer of the dishwasher
17. Pick out the bowls
18. Stack all of the bowls on top of the counter space above the dishwasher
19. Carry all of the bows to the open cabinet
20. Stack the bowls on top of the smaller plates
21. Walk back to the dishwasher
22. Take out all the cups from the top rack
23. Stack the cups on the counter space above the dishwasher
24. Carry all of the cups to the open cabinet
25. Place the cups in the second row of the cabinet
26. Close the cabinet door
27. Walk back over to the dishwasher
4

28. Slide the top row back into the dishwasher
29. Take out the utensils rack
30. Place the utensils rack on the counter space above the drawer next to the refrigerator
31. Open the sliding drawer below the counter space under the utensils
32. Place the knifes in the knife spot
33. Place the forks in the fork spot
34. Place the spoons in the spoon spot
35. Close the drawer
36. Put the utensils rack back into the bottom dishwasher rack
37. Push the bottom dishwasher rack into the dishwasher
38. Close the dishwasher drawer

7. Body functions required:
Function How It Is Used None Minimally
Challenged
Greatly
Challenged
Judgment Grouping the
dishes together
i.e. big plate,
small plate,
cups, bowls,
and utensils.
Organizing
where to place
the dishes in
the cabinet.
X
Concept formation Realizing that
the bowls,
plates, utensils
and cups are all
dishes.
X
Metacognition Thinking of
what dishes to
put in the
cabinet next.
X
Cognitive flexibility If the dishes
are not clean,
realizing that
you need to re-
wash them
instead of
putting them
into the
cabinet.
X
Insight/awareness Knowing how
far you can
X
5

squat to reach
the bottom
rack of the
dishwasher.
Sustained attention Maintaining
concentration
while putting
up the dishes
and not
thinking about
things that are
not related to
the activity.
X
Selective attention Drowning out
background
noise while
completing the
activity.
X
Divided attention Taking dishes
from the
dishwasher
while thinking
about which
shelf to stack
them on.
X
Short-term memory Remembering
what steps you
have completed
and which
steps are left.
X
Working memory Using working
memory to
remember what
step comes
next.
X
Long-term memory Recalling how
to put up the
dishes from
your younger
days.
X
Discrimination of senses: Auditory Hearing a dish
bang together
while stacking
them versus
hearing a dish
break while
stacking them.
X
Discrimination of senses: Tactile Touching a
plastic cup
versus a glass
X
6

cup.
Discrimination of senses: Visual Seeing the
different
shapes of the
dishes.
X
Discrimination of senses: Olfactory Smelling the
dishes to see if
they are clean.
X
Discrimination of senses: Vestibular-
proprioception
Keeping proper
body
mechanics
while reaching
into the
dishwasher.
X
Multisensory processing While stacking
the dishes in
the cabinet,
you are
utilizing the
auditory sense
by hearing
them bang
together,
tactile while
touching the
dishes, visual
seeing the
dishes, and you
can use the
sense of smell
while stacking
the dishes.
X
Sensory Memory Seeing what
steps are
complete in
order to know
which step is
coming up
next.
X
Spatial relationships Understanding
where the
dishes are in
the dishwasher
in relation to
yourself.
X
Temporal relationships Seeing a dish
drop but also
hearing it clash
on the floor.
X
7

Recognition Recognizing
the difference
between a big
plate and a
small plate.
X
Categorization Knowing that
plates, bowls,
cups, and
utensils are all
dishes.
X
Generalization Putting up
dishes in your
kitchen and
applying that
to a friends
kitchen.
X
Awareness of reality n/a X
Logical/coherent thought Knowing that If
a dish is dirty,
to not stack it
in the cabinet.
X
Appropriate thought content Thinking about
what is going
on in the
activity and not
something else
that is not
related to the
activity.
X
Execution of learned movements Activating
certain muscles
that you have
previously
learned to be
able to reach
into the
cabinet.
X
Coping Remaining
calm after
dropping and
breaking a
dish.
X
Behavioral regulation Regulating
your emotions
when things do
not go as
planned.
X
Body image n/a X
Self-concept n/a X
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Self-esteem Believing that
you are able to
complete the
activity without
dropping the
dishes.
X
Arousal Keeping calm
while
completing the
activity.
X
Consciousness Being awake
while you are
participating in
this activity.
X
Orientation to self Knowing who
you are during
the activity.
X
Orientation to place Knowing that
you are in your
kitchen in your
house.
X
Orientation to time Knowing what
day of the
week you wash
dishes.
X
Orientation to others n/a X
Emotional stability Being calm and
easy tempered
while putting
away the
dishes.
X
Motivation The internal
incentive to
put away the
dishes in order
for the kitchen
to be clean.
X
Impulse control Controlling
your behaviors
while
completing the
activity.
X
Appetite n/a X
Sleep n/a X



Function How It Is Used None Minimally
Challenged
Greatly
Challenged
Detection/registration Realizing the X
9

difference
between the
different dishes
that are in the
dishwasher.
Visual modulation Processing
visual stimuli
only needed to
complete the
activity, not
processing all
the little items
in the
background
that are not
relevant to the
activity.
X
Integration of senses Seeing and
feeling the
steam arise
from the
dishwasher as
you open it
allows you to
maneuver your
body around
the heat.
X
Awareness at distances Awareness of
your body in
relation to the
objects around
you and how
far away they
are.
X
Tolerance of ambient sounds Tolerating
background
noise like the
air conditioner
while
completing the
activity.
X
Location and distance of sounds n/a X
Moving against gravity Having a sense
of direction and
upright position
while engaging
in the activity.
Bending over
to remove
dishes from the
dishwasher.
X
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Taste n/a X
Smell Smelling the
dishes to see if
they are clean.
X
Body in space Knowing your
body position
in relation to
space.
X
Comfort with touch Being
comfortable
touching the
dishes.
X
Localizing pain n/a X
Thermal awareness Being aware
that the dishes
may be hot
after you take
them out of
the
dishwasher.
X
Joint range of motion It is important
to have a
normal range
of motion with
maximal
flexion to place
the dishes in
the cabinet.
X
Joint stability/alignment It is important
to have a
normal joint
stability when
lifting the
heavy stacks of
dishes to the
cabinet.
X
Strength Carrying the
heavy dishes to
the cabinet
requires a lot
of muscle
power.
X
Muscle tone Normal tone is
required for
your muscles
to work
together while
completing this
activity.
X
11

Muscle endurance Required in
order to
maintain a
static
contraction
while carrying
the dishes to
the cabinet.
X
Stretch reflex n/a X
ATNR n/a X
STNR n/a X
Righting and supporting reflex n/a X
Eye-hand coordination Using visual
information to
control where
you reach into
the cabinet or
into the
dishwasher.
X
Bilateral coordination When opening
the
dishwasher,
one hand holds
onto the
counter while
the other pulls
the dishwasher
open.
X
Crossing midline When holding
a stack of cups
in you right
hand and
stacking them
on the left side
of the cabinet.
X
Fine motor control Picking up and
grasping the
utensils before
placing them in
the drawer.
X
Oculomotor control Focusing on
the dishes
while you are
reaching to
pick them up.
X
Gait patterns Walking to and
from the
dishwasher.
X
Blood pressure Blood pressure X
12

is challenged
during the
activity
because you
are constantly
moving, which
requires the
body to
maintain
normal blood
pressure
values.
Heart rate A steady heart
rate is required
in order to
deliver the
appropriate
about of blood
and oxygen to
the body.
X
Respiratory rate A normal
respiratory rate
is needed to
complete this
activity
because it is
needed to
move your
body.
X
Respiratory rhythm A normal
respiratory
rhythm is
needed to
complete this
activity.
X
Respiratory depth A normal
respiratory
depth is
needed to
complete this
activity.
X
Physical endurance, aerobic capacity The heart
needs to
maintain a
normal rate
and provide
necessary
oxygen
throughout this
X
13

activity
because you
are moving
from the
dishwasher to
the cabinet
multiple times
Voice functions n/a X
Voice rhythm and fluency n/a X
Alternative vocalization n/a X
Digestive system n/a X
Metabolic system Energy is
required to
complete this
activity
X
Endocrine system n/a X
Urinary functions n/a X
Genital and reproductive function n/a X
Protective functions of the skin The skin on
your hands is
challenged due
to the heat of
the dishes.
X
Repair functions of the skin n/a X


8. Muscular analysis of movements required:
Muscle Required?
Shoulder flexion X
Shoulder extension X
Shoulder abduction X
Shoulder adduction X
Shoulder internal rotation X
Shoulder external rotation X
Elbow flexion X
Elbow extension X
Wrist supination X
Wrist pronation X
Wrist flexion X
Wrist extension X
Thumb flexion X
Thumb abduction X
Finger flexion X
Finger extension X
Trunk flexion X
Trunk extension X
Trunk rotation X
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Lower extremities X

9. Body structures required:


Category

Body Structure
Required?
Check If
Yes
Nervous system Frontal lobe X
Temporal lobe X
Parietal lobe X
Occipital lobe X
Midbrain X
Diencephalon X
Basal ganglia X
Cerebellum X
Brain stem X
Cranial nerves X
Spinal cord X
Spinal nerves X
Meninges X
Sympathetic nervous system X
Parasympathetic nervous system X
Eyes, ears, and related Eyeball: Conjunctiva, cornea, iris, retina, lens, vitreous body X
structures Structures around eye: Lachrimal gland, eyelid, eyebrow,
external ocular muscles
X
Structure of external ear X
Structure of middle ear: Tympanic membrane, Eustachian
canal, ossicles
X
Structures of inner ear: Cochlea, vestibular labyrinth,
semicircular canals, internal auditory meatus
X
Voice and speech
structures
Structures of the nose: External nose, nasal septum, nasal
fossae
X
Structure of the mouth: Teeth, gums, hard palate, soft
palate, tongue, lips
X
Structure of pharynx: Nasal pharynx and oral pharynx X
Structure of larynx: Vocal folds X
Cardiovascular system Heart: Atria, ventricles X
Arteries X
Veins X
Capillaries X
Immune system Lymphatic vessels X
Lymphatic nodes X
Thymus X
Spleen X
Bone marrow X
Respiratory system Trachea X
Lungs: Bronchial tree, alveoli X
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Thoracic cage
Respiratory system
(continued)
Muscles of respiration: Intercostal muscles, diaphragm X
Digestive, metabolic, Salivary glands
and endocrine systems Esophagus
Stomach X
Intestines: Small and large X
Pancreas X
Liver X
Gall bladder and ducts X
Endocrine glands: Pituitary, thyroid, parathyroid, adrenal X
Genitourinary and Urinary system: Kidneys, ureters, bladder, urethra
reproductive systems Structure of pelvic floor X
Structure of reproductive system Ovaries, uterus, breast and
nipple, vagina and external genitalia, testes, penis, prostate

Structures related to Bones of cranium X
movement Bones of face X
Bones of neck region X
Joints of head and neck X
Bones of shoulder region X
Joints of shoulder region X
Muscles of shoulder region X
Bones of upper arm X
Ligaments and fascia of upper arm X
Bones of forearm X
Wrist joint X
Muscles of forearm X
Ligaments and fascia of forearm X
Bones of hand X
Joints of hand and fingers X
Muscles of hand X
Ligaments and fascia of hand X
Bones of pelvis region X
Joints of pelvic region X
Muscles of pelvic region X
Ligaments and fascia of pelvic region X
Bones of thigh X
Hip joint X
Muscles of thigh X
Ligaments and fascia of thigh X
Bones of lower leg X
Knee joint X
Muscles of lower leg X
Ligaments and fascia of lower leg X
Bones of ankle and foot X
Ankle, foot, and toe joints X
Muscle of ankle and foot X
Ligaments of fascia of ankle and foot
16

Structures related to Cervical vertebral column X
movement (continued) Lumbar vertebral column X
Sacral vertebral column X
Coccyx X
Muscles of trunk X
Ligaments and fascia of trunk X
Skin and related
structures
Areas of skin: Head, neck, shoulder, upper extremity, pelvic
region, lower extremities, trunk, and back
X
Structure of skin glands: Sweat and sebaceous X
Structure of nails: Fingernails and toenails
Structure of hair


10. Performance skills required:

Skill Required? How the Skill Is Used

Motor/praxis
Yes


Bending and reaching for the dishes in the dishwasher.
Walking back and forth in the kitchen.
Reaching into the cabinet to put up the dishes.
Sensory (perceptual)

Yes

Locating the dishes in the dishwasher.
Visually determining the small plates versus the bigger
plates.
Emotion regulation

Yes

Controlling frustrations after dropping a dish.
Displaying emotions that are appropriate for the situation.
Cognitive

Yes
Perform the steps of putting up the dishes.
Carrying on with the task despite the difficulties.
Categorizing the different dishes.
Communication/social

n/a



n/a


11. Performance patterns:
Parts of this occupation has elements of which of the following: (check all that apply)
Pattern Describe
X Useful habit Automatically closing the dishwasher when done putting up dishes
Automatically shutting the cabinet drawer when finished putting up dishes
X Dominating habit Taking out the big plates first before any other dish

X Routine Opening the dishwasher
Putting the clean dishes into the cabinet
17

Closing the dishwasher

Ritual n/a

X Role An employee who is single and lives by himself thus it is important to put
away his own to maintain his home.



Intervention Plan
1. Identify 1 objective and measurable goal of the intervention: Jasons goal is to have a clean
apartment when he comes home from work by completing all of his chores on Sunday mornings.
a. According to OTPF what type of outcome is this?
i. Occupational performance enhancement is the appropriate type of outcome
because there is not a limitation present with the client.

2. Intervention approach:

Approach Describe
X Create/promote Promote better endurance by recommending exercise at least twice a week.

Establish/restore

X Maintain Maintain a safe environment by recommended increased lighting in the
kitchen area.
Maintaining the ability for the client to successful empty the dishwasher by
practicing proper body mechanics.

Modify

X Prevent Prevent future problems/injures by practicing safe body mechanics during
the activity.


3. Activity selection
a. Activity selection: Identify 1 example of each for the intervention plan


Activity Describe
Occupation-based Putting away the dishes from the dishwasher.
18

intervention
Purposeful activity Putting his books back on the bookshelf when he is done reading them.
Preparatory method Stretching before beginning the activity.



b. Discuss how activity selection relates back to occupational profile and occupational
analysis
i. The occupational profile is helpful to figuring out what is meaningful to the
client and the occupational analysis helps address the demands of the activity.
Both the occupational profile and the occupational analysis help the therapist
decide which intervention approach is appropriate for the client.
c. Discuss how activity selection will support achievement of client identified goals and
goal of the intervention plan
i. The goal is to have a clean apartment when the client comes home from work.
By emptying his dishwasher once a week, he is able to maintain his home by not
having dirty dishes in the sink. The goal of the intervention plan is to promote
safety by using proper body mechanics. By showing Jason the proper
techniques to emptying the dishwasher he is able to preserve his body and
prevent himself from future injuries.


4. Describe how intervention can be graded or adapted and why
a. To grade this activity up the client can stack the dishes in his hands instead of placing
them on the counter.
b. To grade this activity down the client can place all of the dishes on the top row of the
dishwasher.
c. To adapt, the client can place the dishes in lower cabinets.
5. Safety concerns and/or precautions
a. Proper body mechanics while bending down into the dishwasher.
b. Slipping on water from the kitchen floor.
c. Carrying a heavy load of dishes to the cabinet.
d. The heat from the plates may burn the hands.
6. Discuss the role of the occupational therapy practitioner during the intervention
a. To motivate the client to maintain proper body mechanics in order to prevent future
injuries.
b. Encourage the client to engage in the activity once a week.
7. Discuss what is expected of the client during the intervention
a. The client is expected to continue using proper body mechanics to prevent injuries to his
back or other extremities.