501 Block 2

OTs, OTAs, OT Aides, etc all fall under what name

OT Personnel

Degree needed for OTR

Masters or OTD

Degree needed for OTA

Associates or bachelors

Standards are delineated into four areas:

I.   Professional standing and responsibility

II.  Screening, evaluation, and reevaluation

III. Intervention

IV. Outcomes

Evaluation: OTs are responsible for…

all aspects of evaluation implementation & analysis

Evaluation: OTA responsibility is to…

contribute to the process

Intervention: OTR has….

overall responsibility for developing the intervention plan and for implementation of that plan

Intervention: OTA is…

responsible to know client’s occupational therapy goals

vselects, implements, and makes modifications to therapeutic activities

Outcomes: OT is responsible for…

selecting, measuring, and interpreting outcomes

OTA is responsible for…

being knowledgeable about the client’s targeted outcomes and for providing information and documentation regarding outcome achievement

Accrediting body for OT education

ACOTE

What defines OT Practice in each State

State Law

In NYS, an OT may supervise up to _____ FTE OTA/Permittee

5

What is Service Competency?

The determination, made by various methods, that two people performing the same procedure will obtain the same result.

What is Professional Development?

Organizing and managing one’s work experiences to add to one’s knowledge, motivation, perspectives, skills, and job performance

OTs and OTAs must document _____ hours of experience as a practitioner and ____ hours of service delivery in the certification area over ____ calendar years

2000, 600, 3

Qualitative Research

Exploratory gathering of in-depth detailed descriptions of problems or conditions from the point of view of the individual

Quantitative Research

Use of the scientific method to gather data that can be analyzed statistically to describe population characteristics or determine the relationship between variables

Quality of Evidence

The degree of confidence a practitioner can have in the trustworthiness, accuracy, relevance, and usefulness of the information from a published research project, for making practice decisions

Research pyramid model consists of

descriptive research

experimental research

outcomes research

qualitative research

descriptive research

Takes advantage of naturally occurring events or available information in order to generate new insights

Experimental Research

– Intent to establish, through statistical tests, the probability that an intervention (independent variable) caused change in one or more clinical findings (dependent variables)

outcomes research

Seeks to understand the end results of particular health care practices and interventions.  Used to improve quality and value of care

what is theory

-set of ideas

-Helps us describe, predict behavior, and/or relationships between concepts or events

Paradigm

Fundamental body of knowledge of OT!

• an agreed upon set of concepts (philosophy, values, etc)

OT Paradigm

holistic, client centered, system oriented

Occupation based models are..

applied body of knowledge

used to organize one’s thinking

focus on: person, context, occupation (relationships)

MOHO

a persons environment can facilitate or inhibit occupational performance

ecology of human performance

env. limits the range of tasks that can be performed

frames of reference are..

specific theories that address impairments

guides a plan of action within a specific OT domain

describes process of change

supported by research

who invented MOHO

Mary Reilly’ student: Gary Kielhofner

MOHO’s views:

—Holistic and Client Centered

—Importance of subjective view on life occupations

—Complexities of each personperson

—Environment role in occupational performance throughout life span

3 concepts of MOHO

person, environment, doing

3 interrelated parts within a person

1.    Volition

2.   Habituation

3.   Performance Capacity

volition definition

—Process by which people are motivated toward and choose what activities they do; desire to engage (all humans)

personal causation, values, interests

habituation

—Organizing one’s actions into patterns and routines (patterns of behavior)

Habits

automatic/learned ways of doing which influence how we use our time

Roles

give us identity and sense of obligation; rules are expectations go along with each particular role

Performance capacity

Motor, cognitive, and emotional capabilities required to act upon the environment

3 levels MOHO identifies

Occupational participation

occupational performance

skills

Occupational Participation

—Engaging in work, play, ADLs

Ex: self-care, working fulltime

Occupational Performance

—Purposeful actions/tasks related to participation in major life areas

Ex: Studying for an exam, working out at the gym

Skills

—Goal-directed actions that a person uses while performing

3 types of skills

Motor skills-grasping weights, typing on a computer

Process skills- sequencing directions, gathering data

Communication & interaction skills-gestures, engaging in conversation

Person + Occupational Performance =

outcomes

3 types of outcomes

—Occupational Identity

—  Occupational Competence

—  Occupational Adaptation

Occupational Identity

Cumulative sense of who we are or who we wish to become

Occupational Competence

A sustained pattern of occupational participation that reflects one’s occupational identity

    Occupational Adaptation

Constructing a positive occupational identity and achieving occupational competence overtime

MOHO premise:

All change in occupational therapy is driven by a client’s engagement in occupation.

Occupational Engagement

Moving a client from dysfunction to function

—Client’s doing, thinking, and feeling under certain environmental conditions in/of therapy

Therapeutic reasoning 6 steps

1)Generating questions

2)Gathering information

3)Creating a theory based understanding of client

4)Generating therapy goals and strategies

5)Implementing and monitoring therapy

6)Collecting information to asses outcomes of therapy

Biomechanical FOR

Remediate (fix, improve) motor deficits in muscle strength, joint rom, endurance, edema, pain, that impact occupational performance

Biomechanical outcome

•OT biomechanical goals need to communicate a change in performance

Rehabilitative FOR

Maximize engagement and/or independence [despite persistent impairments] in chosen occupations/tasks through adaptation, compensation, and environmental modification

sample assessment tools for biomechanical FOR

Goniometry, manual muscle testing, Coordination tests, Measuring edema, observation of impact of deficits on occupation/tasks

sample assessments for rehabilitative FOR

ADL assessment (FIM, Barthel), Work assessment, home/environment assessment, general task analysis

rehabilitative FOR outcomes

Use of the adaptive equipment/device/process to improve client’s engagement and/or independence in a task/occupation

adaptation to the environment

task oriented FOR

Movement emerges as an interaction between many *systems in the brain and is organized around a goal and constrained by the environment

-used primarily for brain damage

sample assessment for task oriented FOR

•Canadian occupational performance measure (Copm)

•Role performance

•Task analysis (observe tasks-what motor problems exist)

Motor relearning FOR

Directed toward enhancing motor performance through practice of specific tasks, training of controllable muscle action, and control over movement components of the task

-typically for neuro diagnoses

sample assessments for motor relearning FOR

Client factor, performance skills related to motor performance

ADL assessments, hand function assessments, baseline of client’s abilities in required/chosen tasks

biomechanical approach

considered a remediation approach. It is focused at the level of the client factor/impairment when these impairments are limiting occupational performance

rehabilitative approach

the concepts of adaptation, compensation, and environmental modifications

Task-oriented approaches

the most current approach related to impaired motor function and motor control for those living with brain damage

Motor Relearning Program

specific to the rehabilitation of patients following stroke. The program is based on four factors that are thought to be essential for the learning of motor skills and assumed to be essential for the relearning of motor control:

(a) elimination of unnecessary muscle activity, (b) feedback, (c) practice, and (d) the interrelationship of postural adjustment and movement.

motor learning

“a set of processes associated with practice or experience leading to relatively permanent changes in the capability for skilled movement”

Motor development

process during which a person acquires skills and movement patterns