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Occupational therapy is intended to enhance a person's ability to do basic self-care activities, useful work, and leisure activities. This therapy focuses on the coordination of many abilities required for even simple activities:
These abilities can be impaired in many ways.
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| What Can Interfere With Doing a Simple Task? |
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Ability Needed
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Type of Ability
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Possible Impairments
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To feel and move
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Sensorimotor
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Impaired sensation and perception
Restricted range of motion
Weak muscles
Short endurance
Poor balance
Loss of dexterity and coordination
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To create and execute a plan
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Cognitive
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Difficulty paying attention
Distractibility
Loss of concentration
Impaired judgment
Indecision
Memory problems
Poor problem-solving skills
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To want to do the task and to persevere until it is completed
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Psychologic
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Apathy
Depression
Anxiety
Perceived incompetence
Frustration
Lack of persistence
Decreased coping skills
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Occupational therapists may detect impairments by observing the person, by doing specific tests (such as balance tests), and by talking with other health care practitioners, family members, or caregivers. Therapists assess needs by observing the person doing a task in a natural environment. They try to identify potential problems with the social and physical environment. For example, family members' attitudes or inadequate lighting may interfere with the person's ability to do a task, or electrical cords across walkways may make walking hazardous.
People with impairments work with the occupational therapist to determine and prioritize goals and to select appropriate techniques and activities. For example, if people have difficulty eating with utensils, therapy may include activities that develop fine motor skills, such as inserting pegs on a peg board. A memory game may improve recognition and recall. Adaptive techniques can help people use their strengths to compensate for impairments. For example, a person with a paralyzed arm can learn new ways to dress, tie shoes, and fasten buttons. Activities are made more challenging as people improve.
Assistive Devices:
Occupational therapists recommend devices that can help people function more independently (assistive devices). For example, a person with arthritis can be fitted with a splint to prevent joints from freezing in an abnormal position (deformity) or with a device to support damaged joints, ligaments, tendons, muscles, and bones (orthoses). Therapists may construct as well as fit such devices. Or for a person who has had an arm amputated, therapists may recommend an artificial arm (prosthesis) that includes a pincer needed to hold a utensil. Most occupational therapists can recommend appropriate wheelchairs and train people who have had an arm amputated to use their artificial limb or other devices to help them with daily tasks.
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| Devices That Help People Function |
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Problem
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Device
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Poor balance, weak legs, or dizziness
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Canes, walkers, or wheelchairs
Shower chairs
Grab bars on the side and back of the bathtub or toilet
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Weak grip
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Built-up handles on eating utensils or shoehorns
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Limited reach or movement
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Grabbers that can pick items off the floor or from a shelf
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Hand problems
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Tools with built-up handles or with spring-loaded or electronic controls
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Difficulty standing up because of back problems or weak legs
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Raised toilet seats
Seat-lifting chairs
Chair leg extenders (to make the seat higher)
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Paralysis (including quadriplegia) and other disorders that severely limit function
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Sophisticated computer-assisted devices
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Impaired vision
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Larger dials on telephones
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Impaired hearing
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Telephones with a flashing light to replace the ring
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Impaired memory
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Automatic dialing telephones
Drug organizers and reminders
Pocket devices that record and play back messages (reminders, instructions, and lists) at the appropriate time
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Last full review/revision July 2007 by Masayoshi Itoh, MD, MPH; Mathew H. M. Lee, MD
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