Analysis of Performance Skills in Occupational Therapy

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Occupational Analysis and Therapy
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Table of Contents
Introduction......................................................................................................................................3
First Section.....................................................................................................................................5
Second Section.................................................................................................................................9
Conclusion.....................................................................................................................................11
Reference List................................................................................................................................12
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Introduction
Occupational therapy is a type of assessment and intervention used for developing, recovering or
maintaining meaningful activities or occupations for individuals, groups or communities. In this
regards, the occupational therapists often take assistance from some framework or model, which
guides their professional reasoning, in order to ensure a client-cantered, top-down and
occupation-based approach. In this context, these models are guiding the professionals for
client’s performance assessment, through professional reasoning, to ensure client-cantered, top
down and occupation based approach for assessment and intervention. The following assignment
is going to emphasize upon occupational analysis and therapeutic assessment of client with the
help of selected model proposed by Fisher and Griswold (2014).
Occupational analysis is significantly different from activity or task analysis, which is often
confused by people. For instance, “occupational analysis” is referred to the systematic analysis
of what and how individual or group of people is conducting an activity. On the other hand, the
“activity analysis” is referred to a generic concept about how things are usually done to complete
an activity. The activity analysis or task analysis process engages four key steps to be completed,
including “activity awareness, identifying the steps required, determining the activity demands
and analysis for therapeutic interventions (Peurala et al., 2012). The key goal of activity analysis
is to “analyze an activity in abstract within a given culture, not specific to an individual”. On
contrary, the goal of occupational analysis is to “observe and understand the occupation and
performance of the specific client related to the occupation in the given context”. Thus,
compared to activity or task analysis, occupational analysis process is highly individualized and
dependent on person and context (Schell et al., 2013). Unlike the activity analysis, occupational
analysis could be emphasized upon a particular task, as demonstrated in the case, making coffee,
which is an activity of daily life. In order to understand how people coordinate several aspects of
occupational performance into daily life, determines how effective worker they are.
Occupational performance is included within the social and physical environment, situating in a
performance context, within which the client is performing their occupation (Berger et al., 2013).
In this context, the occupational analysis and therapy attempts to improve the “occupational
orchestration”, which will reflect the individual’s capacity for enacting their occupation on
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regular basis for meeting their own needs and expectations of several environments through
which they needs to perform. In this context, the key model that would be considered to assist
the occupational analysis process is the model, named “Occupational Therapy PRACTICE
FRAMEWORK PERFORMANCE SKILLS” was proposed by Fisher and Griswold, (2014) for
client’s performance skill analysis or occupational analysis. Through this model, Fisher (2009)
proposed how to measure the performance skills, which are the “goal directed actions, carried
out by individual, during naturalistic and relevant daily life task performances. It is different than
body function, which is simply referred to the function individual person’s body system can
perform (Fisher, 2014). The following task is going to emphasize upon occupational analysis of
the video case scenario, for assessing performance skills of the individual with the help of OT
PRACTICE FRAMEWORK PERFORMANCE SKILLS by Fisher and Griswold, (2014).
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First Section
Using Fisher’s performance skills analysis framework/alternative framework used by
occupational therapists, analyse at least 5 motor and 5 process skills you observe the
individual performing in the video
The occupational analysis mainly emphasizes upon analysis of individual’s performance skills
related to his or her occupation and based on the assessment effective intervention is provided.
Performance skills include “motor skills, process skills and social interactions”. In this regards,
here, “OT PRACTICE FRAMEWORK PERFORMANCE SKILLS” by Fisher and Griswold,
(2014) has been utilized. In the framework, the authors proposed that the performance skills are
the observable elements of actions, which have embedded functional purpose. These skills are
considered by the authors as classification of actions, addressing diverse range of capacities of
individual, considering different body structure and functions. When these capacities are
combined, the underlined ability for participating and accomplishing the desired occupations and
activities can be assessed. Considering this, the authors investigated the key capacities required
for occupational performances and enlisted those categorizing under the motor skills, process
skills and the social interaction skills (Chen et al., 2013).
This framework was proposed for guiding the professional reasoning of the occupational
therapists in such a manner that ensures that the analysis is done considering client-centered, top
down and occupation-based approach for assessment and intervention. It is ensuring that the
client’s perspective is being honored and respected and the goals are being set accordingly.
Client constellation is a key feature of the model. Unlike the bottom-up approach, which
evaluates the body functions and makes assumptions regarding the occupational performance of
individual, the model involves the top-down approach (Fisher et al., 2017). This approach
initiates from a wider area of analysis and then observes the specific individualized occupational
performance issues, for interpreting the causes. In the occupation therapy’s domain, performance
skill is one of the core domains the occupation therapists need to consider, besides the other two,
including the client factors and performance patters. How the performance skill is being used in
the occupational therapy has been demonstrated in the “Occupational Therapy Intervention
process Model” by Fisher (2009).
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Figure: Occupational Therapy Intervention Process Model
(Source: Fisher, 2009)
In the case scenario, the daily performance of a staff of Costa Coffee has been represented,
showing her daily performance of coffee making. With the help of OT PRACTICE
PERFORMANCE SKILLS FRAMEWORK, her occupational analysis has been conducted,
analyzing and observing specifically her performance of coffee making. Through this practice, a
range of performance skills have been assessed, which has been listed in the OT PRACTICE
PERFORMANCE SKILLS FRAMEWORK by Fisher and Griswold, (2014). Mainly five motor
skills and five process skills have been found and analyzed through the framework of
performance skill analysis.
Motor skills
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Reaches – While grabbing the kettle from the stand, grabbing the coffee mug, the milk jar as
well as the bowl of sugar, the individual has been seen to show effective capacity of spreading
her arm, bend the trunk to effectively grasp or place the object on the desired place, which was
out of reach. The key players involved in this motor skill performance are “flexor retinaculum,
wrist extension, finger flexion and extension and thumb movement”. In wrist extension,
dgitorum muscle and radiocarpal joint are involved; whereas, for finger flexion, flexor digitorum
superficialis” muscles are involved (Page et al., 2015). In the case scenario lady, no
abnormalities in the function of these muscles have been found.
Bends – In the video, it has been seen that the person has grasped the coffee bag from the
cabinet, when she had to bend on her knees, showing enough flexibility of the upper limb and
associated muscles. Further, when she was seen to grab the milk jar from refrigerator, she again
bended. At this time, normal functioning and stabilization of abdominal muscle, i.e. rectus
abdominis has been observed, which indicated no abnormalities or additional forces have been
found to be needed (Brown and Bourke-Taylor, 2014).
Coordinates – Coordination indicates using two or more body parts together working for
stabilizing an object. While pouring the coffee from the kettle to the coffee mug, the individual
has been seen to coordinate her visual and hand griping skills to stabilize her moves. A feedback
mechanism effectively worked within the muscle of forearm, controlling grip and the visual
control centre at brain (Mulligan, 2017). Movement involves major body muscle, including
upper, lower as well as the abdominal muscle and bone joints also, which functioned normally in
case of Costa coffee employee, to meet her occupational needs.
Lifts – Through the video, in several aspects, the lady has been observed to lift several objects,
including the kettle, coffee mug, bowl of sugar as well as the milk jar. All the functions she did
effectively and no abnormality was seen regarding increased effort (Daremo et al., 2015). It
indicated that the key muscles in grasp and lifting including long and short flexors, wrist flexor
muscle worked effectively for promoting her work.
Transports – While completing her task, she did not used any additional means, but her forearm
to transport things like kettle, coffee mug, bowl of sugar as well as the milk jar from one area to
other, with no difficulties.
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Process skills
Attends – This skill emphasizes upon how people attentive, while conducting a particular task,
without interruption. It has been revealed that the Costa coffee employee successfully performed
her task, without any interruption, indicating her high attention (Classen and Brooks, 2014). This
cognitive ability is controlled by frontal part of brain, which works effectively for her.
Sequences – This is another cognitive performance skill, enabling people to identify and conduct
a task in a logical and systematic manner, eliminating randomness or repetition of steps. In the
video, it has been revealed that the employee performed her job in a sequential manner, with no
repetition. It indicates her intelligence and problem solving skill, which is a significant
perceptual skill for performing occupational role (Désiron et al., 2013).
Gathers – The person gathers all the materials or tools in the same workplace, to eliminate
misplace, slip or fall. It has been seen in the video that the lady has already gathered all the
ingredients and equipments required for completing her task, showing no abnormality in
perception or cognition or information processing.
Restores – It is indicated by keeping materials at their original location, immediately after the
work has been completed. In the video, the lady returned the milk jar into the same location
within the refrigerator, from where it was grabbed. It indicates a well-trained culture, which
might come from her occupational background, indicating effective perceptual learning (Piernik-
Yoder and Beck, 2012).
Organizes – The lady in the video has been seen to be enough able to place things and
equipments logically at their places, to avoid the place to become messy (Schaaf et al., 2012). It
is again indicated her effective sensory interaction with the environment and socio-cultural
components, which improved her perceptual learning and perceptual performance through
improved experience.
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Second Section
Discuss what assessments an occupational therapists might use with the person in the video
to assess occupational performance, strengths and needs
As occupational therapy is being used for a range of purposes, the occupational therapists uses a
range of assessment tools and techniques for assessing their occupational performance, strengths
and needs. In this regards, from the case scenario, it has been revealed that the lady is working in
Costa Coffee and performing her daily task of coffee making. Now, for identifying her strengths,
needs, weaknesses through evaluation of her occupational performance would be done through
an effective assessment tool. In this regards, the “Assessment of motor and process skills
(AMPS)” would be used by the occupational therapist (Pergolotti et al., 2015). It is because, this
tool could be aligned with the Fishers’ performance skill framework and enables the
occupational therapists to evaluate the motor and process skills of the employee simultaneously,
so that their impact on the ability of the Costa coffee employee could be analyzed, for
performing the complex task. This assessment allows the therapist to assess 16 motor and 20
process skill items. Further, the occupational therapist could also use the “adolescent / adult
sensory profile”, which helps to assess the behavioural response of the adults, so that the impact
of sensory processing in functional performance could be measured. In addition, the Kinematic
assessment would be done by the occupational therapist, which would include crucial
information in the analysis, about her motor skills and coordination, which affects individual’s
performance highly. In addition, the “Routine task inventory” could be used, for identifying the
strengths and needs of the client (Gildengers et al., 2012). Through this tool, the client could be
empowered to monitor her own activity and performance and skill development.
Why is it important to be able to complete kinematic and performance skills analysis to
support effective occupational therapy practice?
Saether et al., (2013) revealed that motor coordination is the combination of body movements,
developed with the kinematic and kinetic parameters, resulting in the intended actions. The
quantitative measurement of movements, through the use of movement analysis, i.e. Kinematic
analysis could add significant information about the strengths and needs of the person,
undergoing occupational therapy. Upon learning new motor skills, a progressive modification of
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movement kinematics is reflected in the learning process. Understanding the movement of joints
is crucial for helping individuals with movement difficulties or understanding people’s needs for
performing a task related to his or her job or daily activities. For instance, while working with
the lady in the scenario, Kinematics analysis would help the occupational therapist to understand
the type of movements and how these actions are affecting her occupation, where correction is
needed (Pendleton and Schultz-Krohn, 2017). On the other hand, from the Occupational Therapy
Intervention Process Model, the importance of performance skills in occupational therapy has
already been understood. Performance skills include the “motor skills, process skills and social
interaction skills”, which are crucial for performing everyday tasks or task required to perform
during job; indicating the importance of their assessment, while attempting to understand
individual’s needs by the occupational therapist.
Consider how this person’s occupational performance might be affected by a health
condition or disability
Health conditions or disability, including physical, psychological or emotional could affect the
occupational performance of a person significantly. For example, mental health issue, like
depression cause significant interference with the occupational performance of an effective
employee (Liberman et al., 2013). Depression causes significant interference in the cognitive
process or information processing, coordination, social interaction, perceptual learning and
process skills. As the motor coordination as well as performance skills are dependent on the
cognitive information processing, interference of this process would significantly affect the
overall occupational performance of the person.
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Conclusion
Through conducting the above assignment, a lot of things have been learnt, which would shape
the knowledge of a student’s knowledge base as a occupational therapist. The common
occupational therapy interventions include assisting children with disabilities for participating
fully in school and social situations, injury rehabilitation and offering supports for the older
adults, who are experiencing physical and cognitive issues. The occupational therapists often
needs to work with diverse other professionals from other disciplines, including “physical
therapy, speech therapy, audiology, nursing, social work, clinical psychology, and medicine” for
meeting holistic needs of the patients”. In this regards, from the assignment, the key “OT
PERFORMANCE SKILLS PRACTICE FRAMEWORK” has been identified and its use in
occupational therapy has also been explored. Further, the need for selecting the best appropriate
assessment tool by the occupational therapist, which is individualized to the patient, is crucial for
addressing his or her needs for the occupational therapy.
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Reference List
Berger, S., McAteer, J., Schreier, K. and Kaldenberg, J., 2013. Occupational therapy
interventions to improve leisure and social participation for older adults with low vision: A
systematic review. American Journal of Occupational Therapy, 67(3), pp.303-311.
Brown, T. and Bourke-Taylor, H., 2014. Children and youth instrument development and testing
articles published in the American Journal of Occupational Therapy, 2009–2013: A content,
methodology, and instrument design review. American Journal of Occupational Therapy, 68(5),
pp.e154-e216.
Chen, C.L., Kang, L.J., Hong, W.H., Chen, F.C., Chen, H.C. and Wu, C.Y., 2013. Effect of
therapist-based constraint-induced therapy at home on motor control, motor performance and
daily function in children with cerebral palsy: a randomized controlled study. Clinical
Rehabilitation, 27(3), pp.236-245.
Classen, S. and Brooks, J., 2014. Driving simulators for occupational therapy screening,
assessment, and intervention. Occupational therapy in health care, 28(2), pp.154-162.
Daremo, Å., Kjellberg, A. and Haglund, L., 2015. Occupational Performance and Affective
Symptoms for Patients with Depression Disorder. Advances in Psychiatry, 2015.
Désiron, H.A., Donceel, P., de Rijk, A. and Van Hoof, E., 2013. A conceptual-practice model for
occupational therapy to facilitate return to work in breast cancer patients. Journal of
occupational rehabilitation, 23(4), pp.516-526.
Fisher, A.G., 2009. Occupational therapy intervention process model. A model for planning and
implementing top-down, client-centered, and occupation-based interventions, pp.15-22.
Fisher, A.G., 2014. Occupation-centred, occupation-based, occupation-focused: Same, same or
different? Previously published in Scandinavian Journal of Occupational Therapy 2013; 20: 162–
173. Scandinavian journal of occupational therapy, 21(sup1), pp.96-107.
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