Occupational Profile

1. Client name: Helen Palmer

2. Age: 56
3. Sex: Female
Briefly discuss each of the following:
4. Who is the client?
The client is a mother of three and has been married for 25 years. She is also the owner of three
dogs which keeps her busy. She grew up in Green Bay, Wisconsin but has lived in Las Vegas for the
past 30 years of her life. She works for the Clark County School district in an elementary school as an
aid for a class with students with learning disabilities. Helen swims at her home for exercise in the
summer months. In the winter months, she swims at a local gym that has an indoor swimming pool.
She also walks her dogs, as weather permits.

5. Why is the client seeking services and/or what are the clients concerns relative to engaging in
occupations and in daily life activities?
The client wants to maintain her health and enhance her performance in her daily occupations. The
client does have some weakness in her wrist when performing strenuous activities that involves her
wrist. The client would like to restore her strength in her wrist and prevent her wrist from getting
any worse or painful.

6. In what occupations does the client feel successful and what barriers are affecting his or her
success?
The client is very successful at baking and cooking for her family. The client also loves to swim laps in
the pool for exercise. The client loves taking care of her three dogs and is always taking them for
walks around her neighborhood. She also enjoys hosting family social gatherings and working as an
aid for her special needs class. A barrier that is affecting her success is weakness in her wrist.
Throughout her occupations, the client is constantly using her wrist. Some examples are: holding the
leashes when walking the dogs, stirring and mixing ingredients for meals, and stroking the water
during her daily swims. Also, working as an aid, a mother and a wife can be time consuming which
can affect her success in her occupations.

7. What apsects of his or her environments or contexts does the client see as supporting engagement
in desired occupations and what aspects are inhibiting engagement?
The client is a mother of two and, because of societal expectations, is expected to clean, cook, take
care of the children and maintain the house. The client is sometimes overwhelmed with all the work
around the house which can sometimes inhibit her occupations. At times, she does not have enough
time or energy to swim laps in the pool or take her dogs out for walks which are some of her desired
occupations. But she does love the cooking and baking aspect of this social expectation. The client is

surrounded by family who supports her occupations of hosting family social gathering and baking
and cooking for the family. The client is also happy to have a large kitchen that lets her
accommodate her family and her cooking activities.
8. What is the clients occupational history?
The client was a student and graduated from University of Wisconsin with a degree in Recreation
Resource Management. She started swimming for exercise when she was in college and still
continues this occupational of health management today. The client was a Wild Land Dispatcher for
Bureau of Land Management in Las Vegas, Nevada. The client participated on a coed softball league
where she met many of her lifelong friends. She became a stay at home mom when her children
were first born, taking care of them and the house, while her husband was at work.
9. What are the clients values and interests?
The clients top value is family. She is committed to her family and loves spending time with them.
She also values trust and loyalty with her husband as well as her entire family. Another important
value of the clients is equal opportunity for all which she has developed through working with
learning disabled children. The client is very interested in football. Growing up in Green Bay,
Wisconsin, the client is a huge Green Bay Packer fan. She also loves to read; would rather read than
watch television. The client is also interested in staying active and enjoying the outdoors with her
family and dogs.
10. What are the clients daily life roles?
The client is a mother of two children. Her oldest is in graduate school and is living at home and her
youngest is a freshman at Washington State University. The client is also a wife. She has been
married for 25 years and does most of the cooking, cleaning, and taking care of the children. The
client is an aid in a special needs class at Ruthe Deskin Elementary School. She works with 3rd
graders who have intellectual/learning problems. She is also an owner of three dogs.
11. What are the clients patterns of engagement in occupations?
The client swims laps in the pool three mornings a week. The client is a special needs aid Monday
through Friday through the Clark County School District year. The client also bakes, cooks, and hosts
family gatherings at least one time a week, usually on Saturday nights and also on holidays. For
leisure, the client socializes with friends and family, plays cards and board games, goes out to eat
and likes to read her book every night before she goes to bed. She also watches the Green Bay
Packers play every week during football season. The client is taking care of the house, and cooking
every day. She also is constantly checking in with and taking care of her children and husband every
day.
12. What are the clients priorities and desired targeted outcomes related to occupational
performance?
The client would like to have more strength in her wrists so, when she is performing her
occupations, she does not get tired too easily. The client also does not want to cause any permanent

damage to her wrists from overusing them. Currently, there is no pain involved with her wrists and
does not want to have any future pain when performing occupations that involve her wrist.

Occupational Analysis
1. Occupation: Baking Brownies
Categorization of occupation for the client:
1. Activities of daily living
2. Instrumental activities of daily living
3. Education
4. Work
5. Play
6. Leisure
7. Social participation

Subcategory:

Leisure participation

2. Values, beliefs, spirituality associated with participation:

The client values her family and spending time with them. Most Saturday night, she organizes a dinner
with her extended family. She makes brownies almost every Saturday dinner because she values her
family and her family loves her brownies. The client believes that if you work hard, it will pay off in the
long run. She could go buy premade brownies from the store, but she says that her brownies taste
better because she had to work in order to make them. A huge aspect of the clients life that brings
meaning is spending time with her family. Making brownies is one small aspect that brings her family
together each weeks so they can enjoy each others company.
3. Contexts:
Context
Physical/space demands
Social

Supports
Large kitchen counter space in
order to make the brownies.
The client makes brownies
every Saturday night which is
when all of her extended family
comes over to eat dinner
together.

Inhibits
Small kitchen that is hard to
move around.
The client is obligated and
expected to make brownies for
her family every Saturday night.

Cultural

Personal

Temporal

Virtual

The client is a women and is

responsible for the baking and
cooking in her family, which is a
behavioral standard accepted
by the society.
The client is a mom who has
baked throughout her life for
her family.

The client is relied on to do the

cooking and baking in the family.
If she does not prepare for
meals then the family does not
have food.
The client is getting older and it
is a little harder to make the
brownies than when she was
younger.
The client is 56 years old and
The client makes the brownies in
has been making brownies for a the summer time, which having
very long time, and has
the extreme heat of Las Vegas
discovered what her favorite
and the oven on made it very
brand of brownies are.
hot in the kitchen.
No virtual context involved.
N/A

4. Objects and their properties used:

Tools: Mixing bowl, spatula, glass pan, knife, plate
Materials: one white, undamaged egg, cup of filtered water, cup vegetable oil, and cooking oil
spray
Equipment: Oven to bake the brownies, uncluttered counter top to place the tools and materials on
to complete the brownie making process, and dishwasher
5. Social demands:
No social demands needed. The client does this leisure activity by herself.

6. Sequence and timing:

1. The client walks to the pantry in the laundry room.
2. The client opens the pantry door.
3. The client grabs the box of brownie mix from the top shelf.
4. The client closes the cabinet door.
5. The client walks back to the kitchen counter and places the brownie mix on the kitchen table.
6. The client walks to the cabinet above the oven.
7. The client opens the cabinet door.
8. The client reaches and grabs the oil and cooking oil spray
9. The client closes the cabinet door.
10. The client walks to the kitchen counter and places the oil and cooking oil spray on the kitchen
table.
11. The client walks to the cabinet under the kitchen table
12. The client bends down.
13. The client opens the cabinet doors.
14. The client reaches and grabs the mixing bowl and the glass pan.

15. The client closes the cabinet door.

16. The client raises up from the ground.
17. The client places the mixing bowl and the glass pan on the kitchen counter.
18. The client walks to the refrigerator.
19. The client opens the refrigerator door.
20. The client grabs the container of eggs.
21. The client closes the refrigerator door.
22. The client carries the container of eggs and walks to the kitchen counter.
23. The client places the container of eggs on the kitchen counter.
24. The client opens a drawer to her right underneath the kitchen counter.
25. The client grabs a spatula.
26. The client closes the drawer.
27. The client places the spoon on the kitchen counter.
28. The client grabs the box of brownie mix.
29. The client reads the instructions on the back of the box of brownie mix.
30. The client then opens the box of brownie mix.
31. The client opens the plastic bag of brownie mix.
32. The client lifts the plastic bag of brownie mix and pours it into the mixing bowl.
33. The client opens the container of eggs
34. The client grabs one egg and breaks it on the mixing bowl.
35. The client pours the egg into the mixing bowl.
36. The client walks over to the trash can.
37. The client throws away the egg shell into the trash can.
38. The client walks back to the kitchen counter.
39. The client opens the cap of the oil.
40. The client lifts the oil and pours the oil into the mixing bowl
41. The client estimates cup of oil pours and then stops pouring the oil.
42. The client puts the oil down.
43. The client lifts the mixing bowl off the kitchen table.
44. The client walks to the kitchen sink with the mixing bowl.
45. The client holds the mixing bowl and turns on the water.
46. The client estimates and puts in cup of water into the mixing bowl.
47. The client turns the water off.
48. The client carries the mixing bowl back to the kitchen table.
49. The client grabs the spatula with her right hand.
50. The client holds the bowl with her left hand.
51. The client mixes the ingredients together.
52. The client takes a break from mixing.
53. The client continues to mix.
54. The client takes another break from mixing the brownies.
55. The client tastes the batter to make sure it is mixed.
56. The client grabs the glass pan.
57. The client opens the lid on the cooking oil spray.

58. The client sprays the cooking oil spray on the glass pan.
59. The client puts the cooking oil spray down.
60. The client lifts the mixing bowl.
61. The client pours the brownie batter into the glass pan.
62. The client puts the mixing bowl onto the counter.
63. The client lifts the glass pan and walks to the oven.
64. The client forgets to preheat the oven before starting the brownie making process so the client
preheats the oven now.
65. The client opens the oven.
66. The client puts the glass pan full of brownie batter into the oven.
67. The client closes the oven.
68. The client sets the timer on the oven to 30 minutes.
69. The client walks back to the kitchen counter.
70. The client picks up the mixing bowl and spatula.
71. The client walks the mixing bowl and spatula to the sink.
72. The client places the mixing bowl and spatula in the sink.
73. The client turns the water on.
74. The client rinses the mixing bowl and spatula.
75. The client turns off the water.
76. The client opens the dishwasher door.
77. The client loads the mixing bowl and spatula into the dishwasher.
78. The client closes the dishwasher door.
79. The client walks back to the kitchen counter.
80. The client grabs the brownie box container and plastic bag.
81. The client walks to the trash can.
82. The client throws away the brownie box container and plastic bag.
83. The client grabs the container of eggs.
84. The client walks to the refrigerator.
85. The client opens the refrigerator.
86. The client places the container of eggs in the refrigerator.
87. The client closes the refrigerator door.
88. The client walks back to the kitchen counter.
89. The client grabs the oil and the cooking spray oil.
90. The client walks back the cabinet over the oven.
91. The client opens the cabinet door.
92. The client places the oil and cooking spray back in the cabinet.
93. The client walks back to the kitchen counter.
94. The client walks to the oven when the timer goes off.
95. The client turns off the timer.
96. The client puts on oven mitts.
97. The client opens the oven door.
98. The client grabs the glass pan.
99. The client lifts the glass pan on top of the oven.

100. The client closes the oven door.

101. The client looks to see if the brownies are done.
102. The client waits until the brownies are cool.
103. The client walks to the kitchen counter.
104. The client opens the drawer until the kitchen counter.
105. The client grabs a knife.
106. The client closes the drawer.
107. The client walks back to the oven.
108. The client cuts the brownies.
109. The client walks to the cabinet by the refrigerator.
110. The client opens the cabinet.
111. The client grabs a plate.
112. The client walks back to the oven.
113. The client puts the brownies onto the plate with the knife and her fingers.
114. The client then lifts the empty glass pan.
115. The client walks to the kitchen sink.
116. The client turns the water on.
117. The client washes the glass pan.
118. The client opens the dishwasher door.
119. The client puts in the glass pan in the dishwasher.
120. The client closes the dishwasher door.
121. The brownies are complete.

7. Body functions required:

Function

How It Is Used

Judgment

The client does

not use
measuring cups
to measure
how much oil
and water to
put in the
brownies. The
client
estimates and
judges how
much of each
should go into
the brownies.

None

Minimally
Challenged

Greatly
Challenged

Concept formation

Metacognition

Cognitive flexibility

Insight/awareness

Concentration

The client looks

at the box of
brownies and
sees how the
brownies
should look
like.
The client takes
a moment
before starting
to make the
brownies and
thinks about
the entire
process and
what she
needs. She
talks out loud
to herself
concerning the
materials and
tools that she
needs and
what
temperature
the oven
should be set
at.
The client uses
a glass pan
instead of a tin
pan because
the tin pan is in
the dish
washer.
The client
knows she
could make the
brownies from
the box
because she
had made
them many
times before.
The client
needs to focus
in order to
make sure she
has all the right
ingredients

Sustained attention

Selective attention

Divided attention

Short-term memory

Working memory

Long-term memory

needed in the
mixing bowl
before she
starts mixing.
The client puts
all the
ingredients in
the bowl, and
spends
adequate time
mixing the
ingredients so
they are all
mixed
together.
The client pays
attention to
what she is
doing and
ignores the two
little dogs that
are scratching
at her legs.
The client is
listening to the
TV while she
makes the
brownies.
The client
remembers
what
ingredients she
put into the
brownie mix
and what
ingredient she
still needs.
The client
reads the
instructions on
the box before
starting to
make the
brownies and
did not refer
back to them
throughout the
activity.

Discrimination of senses: Auditory

Discrimination of senses: Tactile

Discrimination of senses: Visual

Discrimination of senses: Olfactory

Discrimination of senses: Vestibularproprioception

The client is
listening to the
TV while also
listening for
the timer to go
off to let her
know the
brownies are
done.
The client is
able to tell the
difference in
the feel
between an
egg, spatula,
and a bowl.
The client sees
the ingredients
and has to
determine
what
ingredients
have been
added and
what still needs
to be added.
The client
smells the
brownies when
they are
cooking in the
oven and
distinguishes
that smell from
the smell of a
scented candle
in the room.
The client uses
vestibular
proprioception
when using her
arm to move
the spoon to
stir the
brownie mix
and when
handling the
different
materials. The
client also uses

Multisensory processing

Sensory Memory

Spatial relationships

Temporal relationships

this sense
when walking
around the
kitchen to
gather
supplies.
The client
knows by
looking at the
brownies if
they are done
or if they need
more time to
cook. The
client also uses
tactile sense by
touching the
brownies to
see if they are
ready to be
taken on out of
the oven or if
they need
more time in
the oven.
The client feels
the mixed,
smooth
brownie
mixture in
order to see if
it is the right
texture to
bake.
The client
knows the
relation of the
mixing bowl to
the spatula
when mixing
the brownie
mix together.
The client
needs to make
the brownies
before her
family arrives
for dinner. So
the client
makes sure she

Recognition

Categorization
Generalization

Awareness of reality
Logical/coherent thought
Appropriate thought content
Mental functions of sequencing
complex movement

Regulation and range of emotion

knows how
much time she
has and how
much time she
should take for
each step in
the brownie
making
process.
The client is
able to
recognize the
oil from the
other materials
needed for
making
brownies.

X
The client has
made cakes
before and the
mixing method
was similar and
can be applied
to making
brownies.

X
X
X
The client
creates a
motor plan to
walk to the
different
cupboards to
get the tools
and materials
the client
needs for
making
brownies. The
client also uses
a motor plan in
order to pick
up the brownie
mix box and
open it.
The client gets
mad at herself
when she

Appropriateness of emotion

Coping
Behavioral regulation

Body image
Self-concept
Self-esteem

Arousal

Consciousness

forgets to
preheat the
temperature
on the oven
but then
regains her
composure
quickly.
The client
maintains a
neutral
emotion
mostly
throughout the
brownie
making
process.

X
The client deals
with her
frustration of
not preheating
the oven and
gets over this
emotion very
quickly.

X
X
The client is
very confident
that she has
the ability to
make the
brownies.
The client
remains awake
and alert to the
environment
throughout the
brownies
making
process.
The client is
very conscious
and awake
when following
the steps of
making
brownies.

Orientation to self
Orientation to place
Orientation to time
Orientation to others

Energy level

X
X
X
The client is
aware of me
watching her
and made sure
she is not in my
personal space.
The client has a
lot of energy
which allows
the client to
stay alert and
complete the
task in a timely
manner.

Function

How It Is Used

Motivation

The client has

internal
motivation to
make the
brownies in
order to serve
them at dinner
for her family.
The client does
eat the
brownie batter
off of the
spoon but she
uses control so
as not to eat all
of the brownie
batter before it
is cooked.
The client is
saving her
appetite for
the brownies
until dinner
with her family.

Impulse control

Appetite

Sleep

Detection/registration

None

Minimally
Challenged

The client
identifies the
desired
materials and

Greatly
Challenged

Visual modulation

Integration of senses

Awareness at distances

Tolerance of ambient sounds

desired tools
needed for the
brownie
making
process.
The client is
able to
distinguish the
materials on
the table from
the
background of
the granite
table top. The
client also is
completely
focused on the
brownie
making process
and not
distracted by
the television.
The client sees
the spatula and
also touches
and feels the
spatula while
mixing the
brownie mix.
The client is
able to identify
the brownie
mix box from
far away when
it is on the top
shelf of the
cupboard and
when it is up
close on the
table top.
The client is
able to
concentrate on
the brownie
making process
without being
distracted by
the noise of
the television
that is on.

Location and distance of sounds

Moving against gravity

Taste

Smell

Body in space

The client is
listening to the
TV which is in
the family
room and also
is listening for
the timer to go
off in the
kitchen to tell
her that her
brownies are
done.
The client
moves against
gravity when
walking
throughout the
kitchen
gathering
materials. The
client also
moves against
gravity when
picking up the
materials and
putting them
into the mixing
bowl.
The client
tastes the
brownie mix to
make sure it
had the right
consistency
and that it
tastes good.
The client
smells the
brownies
cooking from
the oven.
The client is
aware of
where her
body is in
relation to the
counter top
and the
supplies and

Comfort with touch

Localizing pain
Thermal awareness

Joint mobility

Joint stability/alignment

Muscle power

materials on
the table top.
The client is
comfortable
touching the
brownie batter
when testing
the
consistency.

X
The client is
aware that the
oven is hot and
uses oven mitts
when handling
the hot
brownie pan.
The client
utilizes upper
extremity
range of
motion when
reaching for
supplies in the
cabinets.
The client
utilizes joint
stability and
alignment
when reaching
for materials
and holding the
materials over
the mixing
bowl when
pouring.
The client
exhibits a
moderate
amount of
power when
mixing the
brownie mix
with all of the
ingredients.
The clients
wrist are weak
and the client
needs to take
breaks when

Muscle tone

Muscle endurance

Stretch reflex
ATNR
STNR
Righting and supporting reflex
Eye-hand coordination

Bilateral coordination

mixing. The
client exhibits
minimal
muscle power
when lifting
the materials
and tools and
opening the
brownie mix
box.
The client
shows normal
tone when
holding and
pouring the oil
and water into
the brownie
mix.
The client
shows muscle
endurance
when mixing all
the ingredients
together in the
mixing bowl.
The client stops
twice in order
to give her
wrists a break,
but continues
mixing until the
brownie batter
is complete.

X
X
X
X
The client
pours the
ingredients of
water and oil
into the mixing
bowl without
spilling.
The client
holds the
brownie box
and then opens
the box. Also
uses when the

Crossing midline

Fine motor control

Gross motor control

Occulomotor control

Gait patterns

Blood pressure
Heart rate
Respiratory rate

client is holding
the bowl while
mixing the
ingredients
together.
The client
reaches across
the kitchen
table in order
to grab the oil i
to add it to the
brownie mix.
The client
utilizes fine
motor control
when opening
the brownie
box, gripping
the spatula,
unscrewing the
lid to the oil,
and opening
the box of
eggs.
The client
walks all over
her kitchen to
gather supplies
and materials
in order to
make the
brownies.
The client looks
throughout the
kitchen in
order to find all
of the supplies
and materials
she needs.
The client
walks
throughout the
kitchen when
gathering her
supplies and
materials.

X
X
X

Respiratory rhythm
Respiratory depth
Physical endurance, aerobic capacity

Voice functions
Voice rhythm and fluency
Alternative vocalization
Digestive system

X
X
The client uses
minimal
physical
endurance
when walking
through her
kitchen to
gather supplies
and materials.

X
X
X
The client uses
her digestive
system when
eating and
digesting the
brownie batter
she consumes.

Metabolic system
Endocrine system

X
X

Function

How It Is Used

Urinary functions
Genital and reproductive function
Protective functions of the skin

None

Minimally
Challenged

Greatly
Challenged

X
X
The client
touches the
hot brownies
to see if they
are done.

Repair functions of the skin

8. Muscular analysis of movements required:

Muscle
Shoulder flexion
Shoulder extension
Shoulder abduction
Shoulder adduction
Shoulder internal rotation
Shoulder external rotation
Elbow flexion
Elbow extension
Wrist supination
Wrist pronation
Wrist flexion

Not used

Minimally
challenged
X
X
X
X
X
X
X
X

Greatly challenged

X
X
X

Wrist extension
Thumb flexion
Thumb abduction
Finger flexion
Finger extension
Trunk flexion
Trunk extension
Trunk rotation
Lower extremities

X
X
X
X
X
X
X
X
X

9. Performance skills required:

Skill- Motor

How It Is Used

Aligns

The client leans

up against the
counter when
making the
brownies.
The client loses
her balance
and catches
herself when
she trips over
her dogs.
The client puts
her body in an
appropriate
position in
front of the
kitchen
counter in
order to reach
for objects and
stir the
brownie mix
without any
awkward body
positioning.
The client is
able to extend
her arm and
grab the oil
from the top
cabinet.

Stabilizes

Positions

Reaches

None

Minimally
Challenged

Greatly
Challenged

Bends

Grips

Manipulates

Coordinates

Moves

Lifts

Walks

The client
bends her body
when she
reaches and
grabs the bowl
which is out of
her immediate
reach.
The client
grasps the
spatula when
she is mixing all
the ingredients
together in the
bowl.
The client
unscrews the
lid of the oil
container. The
client also has
to crack the
eggs into the
mixing bowl.
The client
holds the bowl
with one hand
and uses the
other hand to
hold onto the
spatula while
stirring.
The client pulls
open the
refrigerator
door to grab
the container
of eggs.
The client lifts
the pan full of
brownie batter
and puts it into
the oven.
The client
moves and
walks through
the kitchen,
but is unstable
when having to
walk over dogs
to get to the

Transports

Calibrates

Flows

Endures

refrigerator
and the oven.
The client
carries the pan
full of brownie
batter from the
kitchen
counter to the
oven. Also the
client
transports the
eggs from the
fridge to the
kitchen
counter and
transports the
oil from the
cupboard to
the kitchen
counter.
When stirring
the batter the
client uses the
appropriate
amount of
force and
speed without
causing the
batter to fly
out of the
bowl.
When mixing
the brownie
batter, the
client uses
smooth
movements of
the wrist in
order to mix
the batter.
The client
makes the
brownies but
becomes tired
when mixing
the batter and
takes two small
breaks because
her wrists are
tired.

Paces

The client
makes the
brownies at an
even pace
except she has
to slow down
her pace when
mixing the
ingredients
because her
wrists have
become tired.

Skill- Process

How It Is Used

Paces

The client plans

out the entire
brownie
making process
and tries to
keeps to a
consistent
tempo.
The client is
actively
engaged
making
brownies and
did not look
away from this
activity.
The client
completes the
entire
occupation of
making
brownies
which is what
the client set
out to do.
The client
chooses the
right amount
and the right
tools and
materials for
making
brownies.
The client uses
the tools and
materials

Attends

Heeds

Chooses

Uses

None

Minimally
Challenged

Greatly
Challenged

Handles

Inquires

Initiates

Continues

Sequences

appropriately.
The client uses
the spatula to
mix the
brownie batter
and uses the
bowl to put all
the ingredients
in.
The client
stabilizes the
bowl before
mixing the
ingredients in
order to
prevent the
bowl from
moving while
mixing.
Before the
client starts
making the
brownies, she
reads the
instructions on
the back of the
brownie box.
The client
starts to make
the brownies
without any
hesitation or
problems.
The client goes
through all the
steps of
making
brownies with
small pauses
and delays.
The client goes
through the
steps in order
on the back of
the brownie
box. The steps
on the back of
the brownie
box are logical
and effective

Terminates

Searches/locates

Gathers

Organizes

Restores

for the brownie

making
process.
The client stops
mixing when all
of the
ingredients are
fully mixed
together.
The client looks
for her tools
and materials
in her kitchen,
which is where
the needed
kitchen
supplies should
be.
The client picks
out tools and
materials
related to
making
brownies and
puts them all
on the kitchen
table.
The client puts
the ingredients
in order on the
table of when
they needed to
be added to
the brownie
batter.
After making
the brownies,
the client
cleans and puts
away the tools
and throws
away any trash.
The client
makes sure the
kitchen
counter is
clean and clear
like how it was
before making
brownies.

Navigates

Notices/responds

Adjusts

The client
moves through
the kitchen
efficiently but
runs into her
dogs, who are
sitting at her
feet.
The client
realizes that
she left the
refrigerator
door open
when she is
getting the
eggs and then
immediately
goes to close it.
The client turns
on the oven
and adjusts the
temperature
she needs to
cook the
brownies.

Accommodates
Benefits
Skill- Social interaction
(Social interaction was not needed for
this occupation.)

X
X
How It Is Used

None

Approaches/starts
Produces speech
Gesticulates

X
X
X

Speaks fluently

Turns Toward
Looks
Places self
Touches
Regulates
Questions
Replies
Discloses
Expresses emotion
Disagrees
Thanks
Transitions
Times response
Times duration
Takes turns

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

Minimally
Challenged

Greatly
Challenged

Matches language
Clarifies
Acknowledges and encourages
Empathizes
Heeds
Accommodates
Benefits

X
X
X
X
X
X
X

10. Performance patterns:

Parts of this occupation has elements of which of the following: (check all that apply)

Pattern
Useful habit

Dominating habit

Describe
The client always puts the eggs on the top shelf of the refrigerator. The
client also puts the oil on the right side of the cupboard and the mixing
bowl in a cupboard underneath the kitchen counter. These are useful
habits because it allows the client to always know where her cooking
materials and tools are.
The client always turns the television on when baking brownies. The client
likes to listen to the television while baking. This habit is dominating
because the client has to have the television on while baking brownies.
She does not like the silence when baking.

Routine

The client follows the sequence of steps on the back of the brownie mix
box. It allows the client to make sure she is making the brownies correctly
and shows the clients exactly what she needs and how much of each
ingredient she needs. It gives order and structure to the clients life.

Ritual

This occupation is something the client performs every week. She makes
brownies every Saturday night for her family dinner. Her entire family
comes over to eat dinner and expects brownies for dessert every time.
This event is a huge social gathering that allows the family to bond and
talk over food and brownies.

Role

As the mother, she is expected by her family to prepare the meal and
have the brownies ready for dessert on Saturday night. It is her role in the
family to fix the meal and have the family gathering at her house every
week.

Intervention Plan
1. Identify 1 objective and measurable goal of the intervention:
-The client will make brownies for her family independently, without having her wrist become
too tired, within two weeks.

a. According to OTPF what type of outcome is this?

-Restore, because the client is having some weakness in her wrists, and wants to restore
her strength so she can continue making brownies for her family without it getting any
worse or have any pain.

2. Intervention approach:

Approach
Create/promote

Describe

Establish/restore

The client wants to restore strength in her wrists. Her wrists are weak and
she tires easily when she is mixing the ingredients together when she is
making brownies. She wants to restore the strength in her wrists so she
can continue to make brownies without losing any more strength in her
wrists or having any pain.

Maintain
Modify
Prevent

3. Activity selection
a. Activity selection: Identify 1 example of each for the intervention plan

Activity
Occupation

Describe
To make the activity as realistic and functional as possible, the client will
make brownies. The client will make brownies in the kitchen with the
occupational therapist watching.

Activity

The client will practice mixing water and flour together in a bowl which
would be the same action of mixing the brownie mix and ingredients
together.
The client will wear a splint on her wrist in order to give support to the wrist
when mixing the brownies.
The client will do wrist exercises with the use of exercise bands. The
exercise bands will add resistance, stretch, and help restore the strength in
the wrist.

Preparatory method
Preparatory task

b. Discuss how activity selection relates back to occupational profile and occupational
analysis

The activity selection needs to be meaningful to the client and relate to the occupations
the client said she enjoyed doing in her occupational profile. The activity selection also
needs to follow the clients values and beliefs which is information found from the
occupational analysis. The clients context, activity demands, client factors all affect
what activity would best fit the clients needs. The client will engage in activities that are
meaningful to her and that will help her in her goal. The client will not engage in routine
activities that have nothing to do with her occupations or values and beliefs.

c. Discuss how activity selection will support achievement of client identified goals and
goal of the intervention plan
The clients goal is to make brownies without becoming too tired or straining her wrists.
The activity selection of occupation correlates to exactly what the clients goal is, which
is making brownies. The activity will prepare the clients goal because the client will be
practicing making brownies with the therapist so she can complete the whole process
by herself with restored strength in her wrists.

4. Describe how intervention can be graded or adapted and why

This activity could be graded down by having assistance from the therapist when it comes to
mixing the brownies. Mixing the brownies uses a lot of wrist movement which tires the client
easily. The activity could be graded up by making a double batch of brownies. This would require
more mixing for the client to do which would be more difficult for the client. The intervention
could be adapted by having a hand held mixer, so the client would not having to use as much of
her wrist strength when mixing the brownies.
5. Discuss any safety concerns and/or precautions
The client will have to ensure she does not over do her wrists usage during intervention. If there
is any pain, she should tell the therapist immediately. The client should also be careful when
using the oven. The oven will be set at 350 degrees. The client should use oven mitts when
taking the brownies out of the oven. Also, the client should be careful of the hot pan when
cutting the brownies. The client should be careful when using the knife to cut the brownies.
6. Discuss the role of the occupational therapy practitioner during the intervention
The occupational therapist is there to work with the client to figure out the clients goal and
then help the client reach her goal. The occupational therapist needs to build a rapport with the
patient and explain every step of the process with the client. The occupational therapist will
create a plan which will be used to track and chart the progress of the patient throughout the
treatment session. The occupational therapist will be right there with the client, step by step,
helping her reach her goal. It is the occupational therapists job to find activities that will
challenge the patient and help her strengthen her wrists. It is also the occupational therapists
role to create activities that are meaningful to the client. The occupational therapist needs to

upgrade if the activity is too easy or downgrade the activity if it is too difficult. It is up to the
occupational therapist to watch and determine if the goal is attainable or if the goal needs to be
adjusted.
7. Discuss what is expected of the client during the intervention
The client is expected to be engaged in the intervention and to give her full effort. If the client
really wants to strengthen her wrist, then she needs to put in the effort. The client should ask
questions and tell the occupational therapist her concerns and goals. She should also be honest
with the occupational therapist. The client should also always tell the occupational therapist if
there is any pain or discomfort when completing an activity. The client should look at the
occupational therapist as a confident professional and not someone they should be afraid of.