Occupational Therapy Frame of Reference / EBP / CDC

Frame of Reference

a guidance tool for practical application

how-to device for evaluation and intervention

Acquisitional FoR

Obtaining skills and behaviors used to optimize performance within a given environment using the teaching-learning process

OT used positive and negative reinforcement strategies to help children shape and achieve target skills and behaviors

Target population - children; all disabilities

Biochemical FoR

Focus on physical impairments and how they affect IADLs

Purposeful activities restore ROM / Strength / Endurance

Body must be rested and then stressed during the activity

Target population - all ages, physical and neurological disabilities

Motor Learning FoR

Process involving acquiring and refining motor skills

Ability, characteristics of the task, required skills, the environment, regulatory conditions

target - children/adolescents with developmental delays

Psychodynamic FoR

Roots theories of freud - ego and it’s roles in developing and maintaining health relationships. Conflicts occur when there is a breakdown in the ego defrense mechanism.

Focuses on explorative and supportive

Explorative - aid in surfacing conflicts from the unconscious mind to the conscious mind in order to resole the issue and promote expressions of feelings

Supportive - keep conflicts hidden in the unconscious while strengthening the ego defense mechanism

Goal - enhance typical psychosocial development and social interactions

Target - all age groups / psychological/mental health disorders

Therapy - drawing the night out picture

Neuro-Developmental Treatment FoR (NDT)

assist patient with motor functions due to neurological deficit

used to treat posture and movement related impairments (common in cerebral palsy and post-stroke)

Alignment, planes of movement, ROM, base of support, postural control, weight shift, mobility, muscle strength

Target - all ages, neurological CNS impairments

Therapy - putting on the coat

Sensory Integration FoR

Neurobiological process of organizing sensations and using them effectively

Auditory, visual, gustatory, interoceptive, tactil, vestibular, proprioceptive - how they interact with integration from the environment.

Sensory modulation, sensory discrimination, sequencing, self-regulation, postural and ocular control, and praxis

Target - Children / people with sensory processing disorders

Therapy - used the yoga ball to balance

Rehabilitation FoR

Personized process that helps patient in regaining or maintain their ability to perform meaningful occupations and daily activities

Energy conservation, work simplification, home modifications

target - all ages, all disabilities

Therapy - folding towel

Developmental FoR

Human development happens in a pattern of sequence from infancy to adulthood. people are dynamic and individual behavior is influence from mastery of previous stages of development.

6 skill areas - sensory integration, cognitive skill, dyadic interaction, group interaction, self-identity and sexual identity.

target - all ages / all disabilities

CDC guidelines

wash hands before and after session

Wear gloves when in contact with body fluids

wear full-body gowns, face masks and eye protections (PP) when there is a possibility of blood or body fluid splashing

Disposed contaminated sharp objects in a puncture proof container

dispose of all contaminated ppe in biohazardous waste container

evidence based practice is….

approach to practice that integrates a systematic search, appraisal and synthesis of relevant research, clinical expertise, and patient preferences and values

EBP forum introduced in 1999

WHAT IS EVIDENCE BASED?

Randomized control trials (RCTs) - strict criteria / specific minimal limiting factors
GOLD STANDARD

Meta analysis - scientific method of gathering a variety of research studies on similar topic / statistical analysis to interpret, compare, summarize findings

How to become EBP

Research
Gain experience
Listen to patient

Abreu & Change

Frame the question
Search, sort and make sense of evidence
Communicate the findings
Reevaluate the evidence

Three step process to finding peer-reviewed research

ID your information needs
Select databases
Develop search terms

PICO

Population (characteristics of client)

Intervention (what terms have been described in other publications)

Comparison

Outcome (what might improve as result of the intervention)