Role-based practice- A conceptual illustration

McDonnell, E., Tan, C., Kerrison, J., Sydney-Jones, A. & Ranka, J. (2006, October). Role-based practice: A conceptual illustration of occupational therapy in HIV/AIDS Care. Poster presented at the 18th Annual Conference of the Australasian Society of HIV Medicine, Melbourne.

Occupational therapists who work in residential and supported living contexts with clients who have AIDS Dementia Complex (ADC) face unique problems in identifying ‘doing’ goals when the potential to ‘do more’ is questionable. In particular, therapists find it difficult to identify specific task performance goals, measure progress and provide objective evidence of outcome when change is slow.

The purpose of this paper is to present an assessment method being used by occupational therapists working in Sydney with clients who have ADC, and to demonstrate how this method is being used to set goals, tailor intervention to the specific performance needs of clients and to measure program effectiveness.

The assessment method is derived from a standardized, criterion-referenced occupational therapy tool known as the Perceive, Recall, Plan & Perform System of Task Analysis (PRPP System). Stage One of this instrument is based on procedural task analysis methods whereby everyday tasks are broken down into the key procedural steps required for task completion. Clients are then observed performing identified tasks and errors noted using the protocol of the assessment. These may include errors of omission (a step is left out), errors of accuracy (a step is performed inaccurately), errors of repetition (a step is repeated too many times), or errors of timing (too much time is spent on a particular step). Percentage calculations are then carried out to determine a mastery score. Sub-scores are also calculated to determine the percentage impact of error type. Therapists use mastery scores to set specific task performance goals and measure change. Error typology scores are used to identify the aim and focus of intervention as well as specific instructional strategies required to achieve improved mastery.

A case study of a client with ADC performing the familiar everyday tasks of preparing a shopping list and shopping for food will be used to illustrate key points in this paper, and demonstrate how this assessment method contributed to the design of ongoing therapy for this client.

A major expectation of occupational therapists is to identify the occupational performance limitations of clients, to identify the causes of these limitations and to design intervention to restore or compensate for lost skills and abilities. Although numerous assessments of task performance and measures of impairment exist, few examine the motor, cognitive, perceptual, intrapersonal or interpersonal component operations that support occupational performance within the context of everyday task performance. The lack of occupation-embedded assessments of occupational performance skill and component ability requires that occupational therapists rely on skilled observation. However, there is also a lack of formal structures of skilled observation.

The purpose of this session is to present a suite of structured skilled observation tools that have evolved out of the Occupational Performance Model (Australia). These tools are based on a method of procedural task analysis that results in calculation of a mastery score. This is followed by an assessment of the reasons for reduced mastery using a comparative format, the Comparative Analysis of Performance (CAP). CAPs exist for motor operations (CAP-M), sensory operations (CAP-S), cognitive operations (CAP-C), intrapersonal operations (CAP-IAP) or interpersonal operations (CAP-IER). Findings from CAP assessments provide therapists with specific information on which to design intervention to achieve mastery outcomes.

This session is designed for therapists who wish to learn more about skilled observation and educators who teach occupational therapy process and task analysis. At the end, participants will be able to carry out an assessment of mastery and the component operations that support mastery for selected videotaped case examples.

A personal blueprint for occupational performance

Hillman, A., & Chapparo, C. (2006, 23-28 July). A personal blueprint for occupational performance in the presence of chronic illness. Poster presented at the 14th Congress of the World Federation of Occupational Therapists, Sydney

Occupational therapists who work in residential and supported living contexts with clients who have AIDS Dementia Complex (ADC) face unique problems in identifying ‘doing’ goals when the potential to ‘do more’ is questionable. In particular, therapists find it difficult to identify specific task performance goals, measure progress and provide objective evidence of outcome when change is slow.

The purpose of this paper is to present an assessment method being used by occupational therapists working in Sydney with clients who have ADC, and to demonstrate how this method is being used to set goals, tailor intervention to the specific performance needs of clients and to measure program effectiveness.

The assessment method is derived from a standardized, criterion-referenced occupational therapy tool known as the Perceive, Recall, Plan & Perform System of Task Analysis (PRPP System). Stage One of this instrument is based on procedural task analysis methods whereby everyday tasks are broken down into the key procedural steps required for task completion. Clients are then observed performing identified tasks and errors noted using the protocol of the assessment. These may include errors of omission (a step is left out), errors of accuracy (a step is performed inaccurately), errors of repetition (a step is repeated too many times), or errors of timing (too much time is spent on a particular step). Percentage calculations are then carried out to determine a mastery score. Sub-scores are also calculated to determine the percentage impact of error type. Therapists use mastery scores to set specific task performance goals and measure change. Error typology scores are used to identify the aim and focus of intervention as well as specific instructional strategies required to achieve improved mastery.

A case study of a client with ADC performing the familiar everyday tasks of preparing a shopping list and shopping for food will be used to illustrate key points in this paper, and demonstrate how this assessment method contributed to the design of ongoing therapy for this client.

Position of OT within Vienna Retirement Residences

Wisenöcker, E. (2004). The project: Position of occupational therapy within the Vienna Board of Retirement Residences (English abstract). Ergotherapie (2), _-_.