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Stendel Occanalysis Intervention
Stendel Occanalysis Intervention
a) The client has played a variety of sports; tennis, soccer, boxing, judo, and
more over the course of his lifetime. He began playing different musical
instruments in his teens and into his early twenties. He enjoys writing
music as well. The client has also been a student for many years attaining
his bachelors, masters, and is now pursuing a second masters and a PhD.
He also likes learning languages and speaks four languages fluently. All
other basic ADLs and IADLs are properly maintained independently.
9. What are the clients values and interests?
a) The client is an immigrant from Italy and holds many Italian cultural
values important. He moved from Italy to the United States to be with his
daughter and has a great commitment to his family here and for those
that he left behind in Italy. Most of his interests revolve around his family,
school, research, learning language, and music.
10.What are the clients daily life roles?
a) The client is a full time student, and a part time graduate student teacher
of Italian. He is also a father, and a musician.
11.What are the clients patterns of engagement in occupations?
a) The client has a set morning routine before going to school. The client also
frequently takes naps in the afternoon though, it is not every day. The
client also has an evening routine where he smokes anywhere from 2-5
cigarettes throughout the evening before turning in to read a book
typically for 30-60 minutes. Smoking cigarettes could also be considered a
habit that the client engages in but only during the evening.
b) The client may also see his daughter on weeknights and weekends
depending on her school schedule.
c) The client practices, plays, and writes music anywhere from 4-7 days a
week.
12.What are the clients priorities and desired targeted outcomes related to
occupational performance?
a) The client would like to be able to play the guitar without having to adapt
and modify from the correct technique to do so. In that, motor skills and
proper processing skills should be at an optimal occupational functioning
level.
Occupational Analysis
1. Occupation: Practice playing the guitar.
Categorization of occupation for the client:
a) Activities of daily living
b) Instrumental activities of daily living
c) Education
d) Work
e) Play
f) Leisure
g) Social participation
Subcategory:
Leisure Participation
3. Contexts:
Context
Physical/sp
ace
demands
Supports
Stefano has a small, but
comfortable space within
his home to play.
Social
Cultural
Personal
Temporal
Inhibits
There is not a lot of room to
walk around or play in multiple
places within the home. He
must pull the chair away to
clear space to play in front of
the computer.
The neighbor may not
appreciate the noise so he must
play when the neighbor is not
home.
Playing the guitar can also be
an act of melancholy. Writing
music and playing along to it
can inhibit his good feelings
of home.
Although Stefano lives alone,
he does have neighbors and
must be conscious of their daily
life schedules that he may
interrupt.
Time may also be contributing
to the lack of being able to play
if his muscles, tendons, or other
body parts are degrading over
time.
Virtual
27.
28.
29.
30.
31.
32.
33.
34.
35.
How It Is Used
Judgment
Concept formation
Metacognition
Cognitive flexibility
Insight/awareness
Concentration
Sustained attention
Non
e
Minimal
ly
Challen
ged
Greatly
Challeng
ed
Selective attention
Divided attention
Short-term memory
Working memory
Long-term memory
Discrimination of senses:
Auditory
Discrimination of senses:
Tactile
Discrimination of senses:
Visual
Discrimination of senses:
Olfactory
Discrimination of senses:
He selectively attended
to certain cues within the
backup music to play a
certain note.
Stefano divided his
attention between what
he was playing and what
was playing on the
computer.
When playing in a
freestyle way, the client
merely played what he
wanted and did not
repeat it more than once.
Stefano was constantly
using his working
memory. While playing,
he learned, processed,
and stored the new
information that he took
in through each song.
The client used long term
memory when playing
old songs that he had
already learned. He used
some of these songs as a
warm up.
Stefano was able to
distinguish which notes
were being played
correctly and which
notes were not played
correctly according to its
sound effect.
He distinguished
between the smoothness
of the guitar and the
rough feel of the strings.
Stefano discriminated
between different items
he looked at such as the
computer and the guitar
itself.
No olfactory senses were
used.
Stefanos internal
x
x
Vestibular-proprioception
Multisensory processing
Sensory Memory
Spatial relationships
Temporal relationships
Recognition
vestibular and
proprioceptive
respondents reacted to
external stimuli and
therefore kept the client
upright with slight flexion
to play the guitar.
Stefano experienced
multiple sensory stimuli.
He listened to the
backup music, and his
own. He received tactile
cues on his fingers from
the guitar. He saw the
difference between the
guitar, computer screen,
and a person in the
room. All of these were
taken into consideration
when playing the guitar.
Sensory memory was
established through
auditory (music), visual
(the guitar or screen)
and tactile sensation
(playing the guitar)
which translated to short
term memory.
Stefano took into
consideration his space
demands prior to
playing. He cleared the
way to practice and set
up an environment to
play well. Optimal
performance was
achieved when all
relationships were taken
into consideration.
Stefano had an idea
about when the song
may be coming to an
end by identifying
segments within the
song.
He recognized a beat to
Categorization
Generalization
Awareness of reality
Logical/coherent thought
Mental functions of
sequencing complex
movement
Regulation and range of
emotion
Appropriateness of emotion
Coping
Behavioral regulation
Body image
Self-concept
Self-esteem
Arousal
Consciousness
Orientation to self
Orientation to place
Orientation to time
Orientation to others
Energy level
Function
How It Is Used
Motivation
x
x
x
x
Non
e
Minimal
ly
Challen
ged
Greatly
Challeng
ed
Impulse control
Appetite
Sleep
Stefano remained awake
during this occupation to
complete it.
Detection/registration
Visual modulation
Integration of senses
Awareness at distances
Taste
Smell
Body in space
Localizing pain
Thermal awareness
Joint mobility
Joint stability/alignment
Muscle power
x
x
x
Muscle tone
Muscle endurance
Stretch reflex
ATNR
STNR
Righting and supporting
reflex
Eye-hand coordination
Bilateral coordination
x
x
x
Crossing midline
Occulomotor control
Gait patterns
Blood pressure
Heart rate
Respiratory rate
guitar.
Stefano crossed the
midline with his right
upper extremity when
slinging the guitar over
his back and body.
He used fine motor
control to pic each
specific string that he
wanted to play.
Stefano exerted gross
motor movement
through movement of
the trunk when standing
and/ or rocking with his
legs.
He used the concept of
saccades when visually
looking at one end of the
guitar, such as at the
neck, and at the other
end of the guitar, such
as at the sound hole.
Stefano had normal but
minimal gait pattern
usage. He may have take
a small step forward,
backward, or to the sides
when playing the guitar
or using the computer.
Stefano engaged in this
occupation to release
stress. During this time,
his blood pressure may
have drop due to an
acquisition of stress
relief.
The heart may have
been pumping at a
normal rate or a slightly
elevated rate depending
on the physical exertion
being applied during the
activity.
He maintained a normal
respiratory rate during
Respiratory rhythm
Respiratory depth
Voice functions
Alternative vocalization
Digestive system
Metabolic system
Endocrine system
this activity.
Stefano maintained a
normal respiratory rate
therefore he most likely
had a normal or low
respiratory rhythm as
well.
Stefano took deep
breaths as compared to
shallow ones during the
activity if he was singing
along to the music.
He used minimal
physical endurance to
overcome besides
standing with heavy
equipment over his body.
He used voice functions
if he was singing along to
the song.
His voice flowed with the
tempo of the music or
along with the other
person singing in the
backup music.
Stefano sang along to
the music or words of the
song playing.
Stefano could have been
digesting food he ate
before beginning the
activity.
He may have ben
metabolizing the food to
create energy to sustain
playing the guitar for an
extended amount of
time.
The endocrine system is
in constant use to
regulate hormone levels
including those that
cause an influx in stress.
With that in mind,
playing the guitar could
neurologically change
How It Is Used
Urinary functions
Non
e
Minimal
ly
Challen
ged
x
x
Not used
Minimally
challenged
X
X
X
X
X
Greatly
challenged
X
X
X
X
X
X
X
X
X
Greatly
Challeng
ed
Finger flexion
Finger extension
Trunk flexion
Trunk extension
Trunk rotation
Lower extremities
X
X
X
X
X
X
How It Is Used
Aligns
Stabilizes
Positions
Reaches
Bends
Grips
Non
e
Minimal
ly
Challen
ged
Greatly
Challen
ged
Manipulates
Coordinates
Moves
Lifts
Walks
Transports
Calibrates
Flows
Endures
Paces
Skill- Process
How It Is Used
Paces
Attends
Heeds
Chooses
Uses
Handles
Inquires
Non
e
Minimal
ly
Challen
ged
Greatly
Challen
ged
Initiates
Continues
Sequences
Terminates
Searches/locates
Gathers
Organizes
Restores
Navigates
Notices/responds
to play a song.
He initiated the next step
in playing a song after it
was chosen on the
computer.
He continued to play the
same few notes over and
over, to increase his
memory of how to play a
particular portion of a
song.
Stefano moved slowly to
promote the safety of the
expensive equipment.
He decided to end the
activity when tired or in
pain and then turned off
the computer.
When Stefano looked for
the pic, he first looked
where he would normally
keep it on the right side of
his desk.
Stefano gathered his
music books in an area
close by to consult if he
should need help.
He had the computer,
keyboard, and mouse all
at a reasonable level and
within reach to use as
needed in a timely
fashion.
Stefano took off the guitar,
and placed it back onto
the guitar stand to keep it
from falling on its side.
He moved the guitar
through space in his
environment to put it back
in its appropriate place
until he played the
instrument again.
Before beginning the task,
he noticed the chair
needed to be moved out of
the way to make room to
Adjusts
Accommodates
Benefits
Turns Toward
Looks
Places self
Touches
Regulates
Questions
Replies
Discloses
Expresses emotion
Disagrees
Thanks
Transitions
Times response
Times duration
Takes turns
Matches language
Clarifies
Acknowledges and
play.
He adjusted the speaker
sound knob on the speaker
to produce a lower or
higher sound effect.
Stefano cleared the
workspace prior to
beginning the activity to
ensure that he would play
at an optimal level.
Stefano modified his
performance to keep
problems from reoccurring
such as finger flexion over
a particular string that he
may need to overcome
with intervention.
How It Is Used
Non
e
Minimal
ly
Challen
ged
Greatly
Challen
ged
encourages
Empathizes
Heeds
Accommodates
Benefits
10.Performance patterns:
Parts of this occupation has elements of which of the following: (check all that
apply)
Pattern
Describe
Useful habit
One useful habit for this activity is when the client places the
pic in his mouth while changing the music on the computer.
This avoids placing the pic in a place where it may become
lost or difficult to pick back up.
Dominating
habit
Routine
Ritual
Role
Intervention Plan
1. Identify 1 objective and measurable goal of the intervention:
a. Stefano will independently play the guitar chords that he is struggling
to play 5 times a week in 15-20 minute sessions to improve finger
dexterity.
b. According to OTPF what type of outcome is this?
i. There could potentially be multiple types of outcomes such as,
Occupational performance: Improvement, and Participation.
2. Intervention approach:
Approach
Describe
Create/promote
Establish/restore
Maintain
Modify
Prevent
3. Activity selection
a. Activity selection: Identify 1 example of each for the intervention plan
Activity
Occupation
Describe
The client will play the guitar as usual, but with certain
participation goals to increase both flexion and extension of
the digits.
Activity
As a part time teacher, the client can explore the usage of a
whiteboard marker, or even chalk, to present information to
the class (versus a PowerPoint) to increase finger flexion
while working.
Preparatory
method
Preparatory task
a. The client is expected to complete the goals set for them by the OT
and themselves. The client is also expected to comply with precautions
and safety concerns that the therapist may describe to them for
certain activities.