THE OTPF-4

ADLs – activities done for the self

IADLs – activities done outside the home or for other people

Achieving health, well-being, and participation in life through engagement in occupation.

OT DOMAIN
1. Occupations
2. Contexts
3. Performance Patterns
4. Performance Skills
5. Client Factors

OT PROCESS
1. Evaluation
2. Intervention
3. Outcomes

 OT DOMAIN

 OT PROCESS
EVALUATION – find out what the client wants and needs to do or are expected to do.
- Determines what the client CAN do and CAN be done.
- Identifies support and barriers to health, well-being, and participation.
- OCCUPATIONS ARE BOTH A MEANS AND AN END
- Establish what still can be done.
- Difference between establishing and restoring – establish skills in kids;
restore skills in adults
- Barriers – weaknesses
- Strengths – what clients can do; the environment such as emotional and
financial support or if they are living alone; social support; PEO model
applies
- Occupations – both a means and an end; part of intervention plan
 SOAP
o SUBJECTIVE – establishing rapport with clients; verbatim
 Occupational Profile – summary of the client’s occupational history and
experiences, patterns of daily living, interests, values, needs, and relevant
context. Gathers information about the client. Should be detailed.
- Information of the client
- Chief complaint
- HPI – onset of condition/what was felt during the
condition
 - Goals *do not promise anything*
- Doctor’s order *interprofessional*
- Precautions
- Medical history
- Family history
- Family background
- Occupational history
- Living situations *architecture/description of home*
- Routines
o OBJECTIVE – occupational performance analysis (OPA) = assessment of perf. Skills and CF
- Accomplishment of selected occupation resulting from dynamic
transaction among clients, contexts, and occupations.
- OTs identify the client’s ability to effectively complete desired
occupations.
- Use of standardized assessment tools:
 FIM for adult clients – it gauges how much assistance the
client needs to do everyday activities
 COPM – know the desires of the client; detects changes in a
client’s self-perception of occupational performance
overtime.
 DYNAMIC PERFORMANCE ANALYSIS – observation-based;
what you use every time you meet a client
1. Is the performance competent?
2. Where in the performance is there a breakdown?
PERSON-OCCUPATION-ENVIRONEMENT
3. Regarding each point of breakdown:
- does the client know what to do?
- does the client want to do it?
- can the client do it?
 Do they have the capacity?
 Are the occupational demands/supports
appropriate?
 Are the environmental demands/supports
appropriate?
o ASSESSMENT – we assess what outcomes we want for the client; sees the connection in
the “S” and “O”.
 Good prognosis
 Guarded prognosis
 Poor prognosis
OT DIAGNOSIS – use top-down approach (targets occupation first) OR bottom-up
approach (targets skills first)

o PLAN – consists of then intervention and the intervention plan

- Intervention – consists of services the OT provides in collaboration with
the client
- Intervention Plan – directs the action of the OT; describes the approaches
we use; types of OT interventions we choose to target the outcomes
 Observable Problems
 Occupations to be targeted
 Activities (with gradation)
 Environmental modification techniques
 Recommendations
 Activities
 - preparatory method targets client factors
- purposeful activities target performance skills
- occupation-based activities target occupations

o INTERVENTION IMPLEMENTATION – the process of putting the intervention plan into

action; happens after acquiring information from the occupational profile, OPA, and the
development of the intervention plan.
o INTERVENTION REVIEW – continuous process of reevaluating and reviewing the plan,
effectiveness of delivery, and progress towards outcome.

 align – ability to keep the self upright while moving

 position – ability to properly position body at an appropriate distance
 stabilize - walking