Professional Documents
Culture Documents
Tiffany is a 19-year-old young woman who lives with her three older sisters in
a 3-bedroom apartment. She works as a hostess at a caf in Henderson,
Nevada, and has lived in Nevada for the past year. Before that she lived in
Wisconsin with her father and three younger sisters, and within the last year
she graduated from high school.
5. Why is the client seeking services and/or what are the clients concerns
relative to engaging in occupations and in daily life activities?
-
Tiffany feels that she cannot cook a complex meal without making a
significant mistake. She has difficulty with successfully completing complex
cooking activities, and has expressed that she believes that she cannot cook
anything that requires more than a few steps without making a grave error in
the process.
6. In what occupations does the client feel successful and what barriers
are affecting his or her success?
-
7. What aspects of his or her environments or contexts does the client see
as supporting engagement in desired occupations and what aspects are
inhibiting engagement?
-
Tiffany expressed that having access to a kitchen and the support of her
sisters helps her engage in cooking activities, but she believes that her own
limitations in her understanding of general cooking procedures inhibits her
ability to engage in the activity.
Tiffany recently graduated from high school and left the occupation of being a
student, and currently spends a great deal of her time working at a caf as a
hostess. She has enjoyed playing video games, drawing, and caring for pets
for most of her life, and actively participates in these activities every day. She
also considers grooming, hygiene, and driving activities to be an important
part of her daily occupations.
10.
Tiffanys daily life roles include going to work (sometimes driving, other times
being driven there by her sisters), helping to care for the four puppies that she
and her sisters live with, caring for herself by grooming and feeding herself, and
participating in leisure activities.
11.
-
12.
What are the clients priorities and desired targeted outcomes
related to occupational performance?
-
Occupational Analysis
1. Occupation: Cooking Spaghetti
Categorization of occupation for the client:
Subcategory:
1. Activities of daily living
2. Instrumental activities of daily living Cooking (Meal Preparation)
3. Education
4. Work
5. Play
6. Leisure
7. Social participation
2. Values, beliefs, spirituality associated with participation:
-
Tiffany values the ability to successfully prepare a meal by herself. She will
often eat nothing more than a Hot Pocket for dinner or will purchase fast food
because she does not feel comfortable with preparing a more complex meal
on her own. She believes that being able to make herself a meal like this,
without help from her older sisters, is a skill that she should have as an
emerging adult.
3. Contexts:
Context
Physical/space
demands
Supports
Kitchen environment;
appliances, utensils, and
tools available to
complete the activity.
Social
Cultural
Personal
Inhibits
There are no
physical/space demands
that specifically inhibit
Tiffanys ability to
successfully participate in
the cooking activity.
Sometimes Tiffanys sisters
tease her about not being
able to cook, and she
sometimes finds that to be
discouraging.
There are no cultural
contexts that specifically
inhibit Tiffanys ability to
successfully participate in
the cooking activity.
Temporal
Virtual
Counter surfaces
Stove
Sink
Refrigerator
Tools:
-
Cooking pot
Strainer
Plate
Fork
Stirring spoon
Hot pads
Materials:
-
with cooking
independently, and this
inhibits some of her
understanding of basic
cooking procedures.
Tiffany cannot spend more
than a few hours cooking,
or else she may impact her
sisters ability to complete
their own cooking
activities, and she must
have time to complete
other activities in the
evening before she has to
go to bed.
Tiffany keeps her mobile
phone with her at all times,
and if she receives a call or
a text message during a
cooking activity, she may
become distracted from
the activity.
5. Space demands:
Size: A large enough space to accommodate the counter space and appliances
that Tiffany would need to cook the spaghetti; at least the size of a standard
apartment kitchen.
Arrangement: Specific arrangement of the tools and materials was not required
for the completion of the cooking activity, though Tiffany benefited from having
the tools and materials in close proximity while she was cooking. This allowed
her to use them more quickly and efficiently.
Surface: Tiffany utilized countertops, a stovetop, and the basin of a sink while
participating in the activity.
Lighting: Tiffany had all lights on in the kitchen so that she would have enough
lighting to visualize what she was doing.
Temperature: The temperature in the kitchen was warm, which was ideal for
Tiffany to be able to perform the activity effectively. Having cold hands or feeling
fatigued from too much heat may have hindered Tiffanys ability to complete the
activity effectively.
Humidity: This did not play a significant role in Tiffanys ability to complete the
activity.
Noise: Having minimal noise going on in other areas of the apartment allowed
Tiffany to concentrate more easily on the activity.
Ventilation: Proper ventilation was required during the activity, as steam from
the boiling water would have quickly overheated the kitchen otherwise.
6. Social demands:
Social Environment: There are not any specific demands from a social
environment that are involved with preparing a meal of spaghetti, especially
when Tiffany is only intending to feed herself.
Cultural and virtual contexts: There were no cultural contexts that
specifically applied for Tiffany in this activity. Virtual contexts were taken into
consideration, however, due to the fact that Tiffany felt the need to utilize her
phone several times during the activity.
Rules and Norms: It is a rule among Tiffany and her roommates that Tiffany
must be conscious of safety concerns while using the kitchen, and she must also
clean up after herself after preparing a meal. Otherwise, there were no specific
social demands in relation to rules and norms that influenced Tiffany as she
participated in the activity.
7. Sequence and timing:
1. Tiffany walked to lower kitchen cupboard to the right of the stove and
opened it.
2. She looked for the cooking pot, but failed to find it there.
3. She closed the cupboard and moved over to the lower kitchen
cupboard to the left of the stove.
28.She opened the kitchen cupboard where she had found the cooking
pot.
29.She retrieved the strainer.
30.She carried the strainer to the sink and placed it in the right basin.
31.She retrieved two hot pads from the counter beside the stove.
32.She grasped the handles of the cooking pot with the hot pads resting
directly against the handles, and lifted the pot off of the stovetop.
33.She carried the pot over to the sink.
34.She poured the contents of the pot into the strainer and allowed the
hot water to run down the drain.
35.She walked back to the stove and placed the pot on a cool burner on
the stovetop.
36.She walked back to the sink and opened the kitchen cupboard beside
the sink.
37.She retrieved a plate.
38.She closed the kitchen cupboard.
39.She placed the plate on the counter beside the sink.
40.She walked back to the stove and retrieved a pair of tongs from the
counter beside the stove.
41.She walked back to the sink and used the tongs to transport noodles
from the strainer to the plate, until the plate was about half full.
42.She walked to the refrigerator and opened it.
43.She retrieved the jar of spaghetti sauce.
44.She closed the refrigerator.
45.She walked back to the plate.
46.She removed the lid from the jar of spaghetti sauce.
47.She poured desired amount of sauce over the noodles on the plate.
48.She replaced the lid on the jar of spaghetti sauce and set it on the
counter.
8. Body functions required:
Function
How It Is Used
Judgment
Concept formation
Non
e
Minimally
Challeng
ed
Greatly
Challenge
d
Metacognition
Cognitive flexibility
Insight/awareness
Concentration
Sustained attention
Selective attention
to be conscious of
temporal requirements at
certain times (such as
when she allowed the
noodles to boil for too
long).
Tiffany was able to
concentrate on the
cooking activity well
enough to complete each
required task
component, but she also
became distracted by her
phone at several points
in time during the
activity.
Tiffany used this to
complete components of
the activity effectively.
Certain steps of the
activity, such as the step
wherein she was filling
up the cooking pot with
water, required sustained
attention so that she
could watch for the
moment when the pot
had enough water in it.
Tiffany used this to be
able to focus on one step
of the activity at a time,
so that she would be able
to be more thorough and
methodical in the task
components. Tiffany also
displayed selective
attention while she was
using her phone, which
sometimes caused her to
forget that she was
waiting for a step in the
cooking activity to be
completed until she was
reminded by something
(e.g. not checking to see
if the water was boiling
Divided attention
Short-term memory
Working memory
Long-term memory
Discrimination of senses:
Auditory
Discrimination of senses:
Tactile
Discrimination of senses:
Visual
Discrimination of senses:
Olfactory
Discrimination of senses:
Vestibular-proprioception
Multisensory processing
Sensory Memory
differentiate between
ingredients and utensils,
and observe what was
taking place in the
activity to ensure that
the tasks were being
done correctly and that
there were no safety
concerns.
Tiffany used this while
she was determining
whether the noodles
were cooked or not. She
used both taste and
smell to determine this.
Tiffany used this in order
to maintain her balance
while carrying items
between appliances
(such as from the stove
to the sink), and to be
able to effectively
navigate through the
kitchen without causing
any concern for safety.
Tiffany used this at
various points
throughout the activity,
such as when she used
both taste and smell to
determine whether the
noodles were cooked or
not, and when she used
sight and touch to
differentiate between
kitchen utensils.
Tiffany used this so that
she could rely on senses
like sight and touch to
know which ingredient
she last used. She also
used it for safety
reasons, such as when
she accidentally touched
the part of a spoon that
had been in the boiling
Spatial relationships
Temporal relationships
Recognition
Categorization
Generalization
Awareness of reality
Logical/coherent thought
Appropriate thought
content
Mental functions of
sequencing complex
movement
Appropriateness of
emotion
Coping
Behavioral regulation
Body image
Self-concept
Self-esteem
Arousal
Consciousness
Orientation to self
Orientation to place
Orientation to time
Orientation to others
Energy level
Function
How It Is Used
Motivation
Tiffany displayed
motivation to complete
the cooking activity. She
wanted to be observed
so that she could identify
potential areas for
improvement in relation
to the activity, and this
motivated her
throughout the process.
Tiffany maintained
control over most
impulses that she may
have experienced during
the cooking activity,
particularly any impulses
that may have had to do
with giving up on the
activity due to the
mistakes she made. She
did not, however, resist
the impulse to check her
phone when it went off.
Tiffany expressed that
she was hungry before
the activity began, and
her appetite was likely
another motivating factor
Impulse control
Appetite
Non
e
Minimally
Challeng
ed
Greatly
Challenge
d
Sleep
Detection/registration
Visual modulation
Integration of senses
Awareness at distances
Tolerance of ambient
sounds
Taste
Smell
Body in space
Localizing pain
Thermal awareness
Joint mobility
Joint stability/alignment
Muscle power
Muscle tone
Muscle endurance
Stretch reflex
ATNR
STNR
Eye-hand coordination
Bilateral coordination
Crossing midline
Occulomotor control
Gait patterns
Blood pressure
Heart rate
Respiratory rate
Respiratory rhythm
Respiratory depth
Physical endurance,
aerobic capacity
Voice functions
Alternative vocalization
ability to maintain
control of her eye
movement.
Tiffany was required to
have functional gait
patterns in order to
effectively walk between
appliances and
cupboards in the kitchen.
This was required to be
normal in order for
Tiffany to effectively
complete the activity.
This was required to be
normal in order for
Tiffany to effectively
complete the activity.
This was required to be
normal in order for
Tiffany to effectively
complete the activity.
This was required to be
normal in order for
Tiffany to effectively
complete the activity.
This was required to be
normal in order for
Tiffany to effectively
complete the activity.
Tiffany was required to
have adequate physical
endurance and aerobic
capacity in order to
effectively complete the
activity. If she had
fatigued due to a deficit
in these areas, she would
have had difficulty
completing the activity.
Tiffany was not required
to use this to complete
the activity.
Tiffany was not required
to use this to complete
the activity.
Tiffany was not required
to use this to complete
Digestive system
Metabolic system
Endocrine system
the activity.
This system was required
to be functioning
normally in order for
Tiffany to complete the
activity particularly
because she had to
consume a noodle in
order to know that the
noodles were cooked.
This system was required
to be functioning
normally in order for
Tiffany to complete the
activity effectively.
This system was required
to be functioning
normally in order for
Tiffany to complete the
activity effectively.
Function
How It Is Used
Urinary functions
Non
e
Minimally
Challeng
ed
Greatly
Challenge
d
Not used
Shoulder flexion
Shoulder extension
Shoulder abduction
Shoulder adduction
Shoulder internal
rotation
Shoulder external
rotation
Elbow flexion
Elbow extension
Wrist supination
Wrist pronation
Wrist flexion
Wrist extension
Thumb flexion
Thumb abduction
Finger flexion
Finger extension
Trunk flexion
Trunk extension
Trunk rotation
Lower extremities
10.
Minimally
challenged
Greatly
challenged
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Skill- Motor
How It Is Used
Aligns
Stabilizes
None
Minimally
Challenge
d
Greatly
Challen
ged
Positions
Reaches
Bends
Grips
Manipulates
Coordinates
Moves
Lifts
Walks
Transports
Calibrates
Flows
Endures
Paces
How It Is Used
Paces
Attends
None
Minimally
Challenge
d
Greatly
Challen
ged
Heeds
Chooses
Uses
Handles
Inquires
Initiates
Continues
Sequences
Terminates
Searches/locat
es
Gathers
Organizes
Restores
Navigates
Notices/respon
ds
Adjusts
Accommodate
s
Benefits
How It Is Used
None
*Social
interaction was
not required for
this activity;
Tiffany
performed this
activity alone.
Approaches/st
arts
Produces
speech
Gesticulates
Speaks fluently
Turns Toward
Looks
Places self
Touches
Regulates
Questions
Replies
Discloses
Expresses
emotion
Disagrees
Thanks
Transitions
Times
response
Times duration
Takes turns
Matches
language
Clarifies
Acknowledges
and
encourages
Empathizes
Heeds
Accommodate
s
Benefits
X
X
X
X
X
X
X
X
X
11.
Performance patterns:
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Minimally
Challenge
d
Greatly
Challen
ged
Parts of this occupation has elements of which of the following: (check all that
apply)
Pattern
Useful habit
Describe
Tiffany has some useful habits in place that pertain to
cooking activities, such as having the habit of turning off
the water faucet after using it.
Dominating
habit
Routine
Ritual
Role
Intervention Plan
1. Identify 1 objective and measurable goal of the intervention:
-
Tiffany will independently complete one spaghetti meal without error, within
one week.
a. According to OTPF what type of outcome is this?
Participation
2. Intervention approach:
Approach
Create/promote
Establish/restor
e
Maintain
Describe
Modify
Prevent
3. Activity selection
a. Activity selection: Identify 1 example of each for the intervention
plan
Activity
Occupation
Describe
The occupation that Tiffany will engage in is meal
preparation.
Activity
Preparatory
method
Preparatory task
Tiffany will follow through with each step of the cooking tasks until the
activity is complete, and she will perform as much of the activity
independently as she possibly can. Tiffany will be self-motivated and
conscious of any safety risks throughout the cooking activity, and she will not
stop to use her mobile phone at any point during the activity.