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:

• The ability to feel and move
• The ability to create and execute a plan
• The ability to want to do the task and to persevere until it is completed

These abilities can be impaired in many ways.

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What Can Interfere With Doing a Simple Task? Ability Needed Type of Ability Possible Impairments To feel and move Sensorimotor Impaired sensation and perception Restricted range of motion Weak muscles Short endurance Poor balance Loss of dexterity and coordination To create and execute a plan Cognitive Difficulty paying attention Distractibility Loss of concentration Impaired judgment Indecision Memory problems Poor problem-solving skills To want to do the task and to persevere until it is completed Psychologic Apathy Depression Anxiety Perceived incompetence Frustration Lack of persistence Decreased coping skills

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.

Did You Know... Occupational therapists focus on helping people do specific daily tasks that have become difficult to do because of a disorder or injury. Many specialized devices, such as grabbers and large-handled utensils and tools, are available to help people function.

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 Problem Device Poor balance, weak legs, or dizziness Canes, walkers, or wheelchairs Shower chairs Grab bars on the side and back of the bathtub or toilet Weak grip Built-up handles on eating utensils or shoehorns Limited reach or movement Grabbers that can pick items off the floor or from a shelf Hand problems Tools with built-up handles or with spring-loaded or electronic controls Difficulty standing up because of back problems or weak legs Raised toilet seats Seat-lifting chairs Chair leg extenders (to make the seat higher) Paralysis (including quadriplegia) and other disorders that severely limit function Sophisticated computer-assisted devices Impaired vision Larger dials on telephones Impaired hearing Telephones with a flashing light to replace the ring Impaired memory Automatic dialing telephones Drug organizers and reminders Pocket devices that record and play back messages (reminders, instructions, and lists) at the appropriate time

Last full review/revision July 2007 by Masayoshi Itoh, MD, MPH; Mathew H. M. Lee, MD