1. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 46 Introduction to Evaluation, Intervention, and Outcomes for Occupations Glen Gillen and Barbara A. Boyt Schell

2. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Learning Objectives 1.Understand classification systems used to discuss areas of occupation 2.Appreciate the complexity of occupation and the potential difficulties in applying these classification systems

3. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Categories of Occupation World Health Organization’s International Classification of Functioning, Disability, and Health (ICF): Activities (Limitations) and Participation (Restrictions) AOTA Practice Framework Edition 2: Areas of Occupation

4. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Areas of Occupation Activities of daily living (ADL) focus on caring for one’s body and are directed toward basic survival –Such as bathing, grooming and sexual activities Instrumental activities of daily living (IADL) activities necessary for daily life, but go beyond basic bodily care and survival –Such as home management, pet care and meal preparation

5. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Areas of Occupation Educational occupations are focused on formal and informal learning. Such as: –formal educational participation (academic, nonacademic, extracurricular, and vocational participation); –informal personal educational needs or interests exploration; and –informal personal education participation

6. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Areas of Occupation Work includes: –productive activities such as employment and volunteer activities; –employment interests and pursuits; –employment seeking and acquisition; –job performance; and –retirement preparation and adjustment

7. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Areas of Occupation Play and leisure activities characterized by: –enjoyment or diversion; and –interests and motivation of the person Rest and sleep includes sleep preparation and participation. Examples include: –bedtime routines; –ability to manage cues for waking such as the use of wake-up signals; and –management of the physical environment

8. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Areas of Occupation Social participation refers to the interweaving of: –occupations to support desired engagement in community and family activities; and –the involvement of peers and friends

9. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Discussion Points Cautions about categorizations: 1)It is critical to know how the person perceives the occupation; and 2)Consider the relative mix within a particular activity

10. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Discussion Points Evaluate a person’s occupational engagement as a whole Occupational therapy may be too focused on an occupation of particular interest

11. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Discussion Points (Continued) Client Values and Choice: It is of critical importance to understand the value that our clients place on chosen occupations

12. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Discussion Points (Continued) Practitioners must not only consider specific occupations and engagement in occupations but… –also understand how clients orchestrate their engagement over time and within various environments