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Occupational Form and
         Occupational Performance
                             Or
               How to think about occupations!


October 2005                J.Taylor             1
Occupations
• Occupations are fundamental to health,
  well-being and identity.
• Occupations are the therapeutic media
  employed by the occupational therapist.
• And so …….
• We need to have a sophisticated
  understanding of occupations (Creek 1996)
October 2005        J.Taylor                  2
Two ways we can use
                   occupations
• As the end     • As the
  point that we    means to
  are aiming for   improve
  in our           someone’s
  intervention     impaired
                   abilities

October 2005           J.Taylor      3
Occupation as end point
• These occupations are part of the person’s
  normal roles
     – They organise the person’s time
     – They help the person to participate in life
       /society
     – They have purpose and meaning for the person



October 2005             J.Taylor                     4
Occupation as end point
• The O.T. can help the person learn / relearn
  these occupations, and / or can make
  adaptations if necessary




October 2005             J.Taylor                5
Occupation as a means to an end
• We can introduce occupation as
  intervention to help improve someone after
  illness or when disabled
• Enables eventual occupational functioning
• We choose occupations which interest the
  client and which have therapeutic value
• They should be challenging but enable
  success
October 2005        J.Taylor                   6
Two ways we can analyse
            occupation
• Occupational         • Occupational
  form                   performance




October 2005     J.Taylor               7
Nelson’s question about baseball
• What is an occupation?
• Is the format of the game (the structure) the
  occupation?
• Or is the playing of the game (the doing)
  the occupation?



October 2005          J.Taylor                    8
His answer ….
• Occupation is the relationship between
  occupational form and occupational
  performance
• Occupation is the relationship between the
  ‘something to be done’ and the ‘doing’ of it
     – Playing a game of Monopoly
     – Cooking a meal for a special occasion

October 2005             J.Taylor                9
Occupational Form
• ‘an objective set of circumstances,
  independent and external to a person’
  (p633)
• a ‘pre-existing structure that elicits, guides,
  or structures subsequent human
  performance’ (p634) (Nelson 1988)


October 2005           J.Taylor                 10
Occupational form has two
               dimensions
                 The physical dimension
                           and
               The sociocultural dimension

October 2005              J.Taylor           11
The physical dimension
    can be observed and measured

• The objects and their properties
• The environment
• The temporal aspects
• The human aspects
October 2005    J.Taylor           12
The sociocultural dimension –
    the social and cultural aspects

• Symbols, norms, sanctions,
  roles
• These operate at different levels
  of society
• Language
October 2005      J.Taylor            13
OCCUPATION


Occupational                  Occupational
   form                       performance




 October 2005      J.Taylor           14
Occupational Performance
• ‘to go through or carry out the
  occupational form’
• ’the doing, the action, the active behaviour,
  or the active responses exhibited within the
  context of an occupational form.’
Nelson (1988, p634)


October 2005          J.Taylor                15
Occupational performance has
            two aspects
               Overt
                And
               Covert
October 2005    J.Taylor           16
Overt occupational performance
            can be observed
•   Gross and fine movement
•   Speech and related vocalisations
•   Facial expressions
•   All movements and postures under
    voluntary motor control



October 2005         J.Taylor          17
Covert occupational performance
 may not be observed directly
• Cognitive processes
• Emotional reactions




October 2005        J.Taylor   18
Chains of occupational
                    performance
Occupational Performance        Aspects of form
Walks to                        the refrigerator
Opens                           The fridge door
Looks for                       Milk
Picks up                        Milk
Pushes shut                     Fridge door
Walks to                        Table
Pours                           Milk into glass
 October 2005              J.Taylor                19
Opening a fridge door is a
            complex activity!!!
• Reach out to handle
• Grasp handle
• Firmly pull the handle (to break the hold of
  the rubber seal)
• Gently pull the handle
• Stop pulling


October 2005         J.Taylor                    20
What might go wrong?
• What if some of the muscles are weak?
• What if you cannot initiate muscle action?
• What if you cannot control muscle action?
• What if you have no movement in one or
  more of your joints?
• What if you cannot recognise the handle?
• What if you cannot see it?
October 2005           J.Taylor                21
The developmental structure of
            the human
• The human has
     – Sensorimotor     }
     – Cognitive        } abilities
     – Psychosocial     }
• These have developed over time



October 2005          J.Taylor        22
Occupational performance
              depends on …..
• The occupational form which is
  encountered PLUS
• The unique developmental structure of the
  individual
• The specific features of that one-off
  occasion


October 2005        J.Taylor                  23
Occupation


Occupational               The                   Occupational
                 meaning               purpose
form                       person                performance




  October 2005              J.Taylor                     24
References
• Creek, J (1996) Making a cup of tea as an honours
  degree subject British Journal of Occupational
  Therapy 59 (3) 128-130
• Nelson, D.L. (1988) Occupation: Form and
  Performance The American Journal of
  Occupational Therapy 42 (10) 633-641
• Trombly, C.A., Radomski, M.V.(eds) (2002)
  Occupational Therapy for Physical Dysfunction 5th
  edition Philadelphia:Lippincott Williams &
  Wilkins
October 2005           J.Taylor                   25

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Occupational form and occupational performance 2005

  • 1. Occupational Form and Occupational Performance Or How to think about occupations! October 2005 J.Taylor 1
  • 2. Occupations • Occupations are fundamental to health, well-being and identity. • Occupations are the therapeutic media employed by the occupational therapist. • And so ……. • We need to have a sophisticated understanding of occupations (Creek 1996) October 2005 J.Taylor 2
  • 3. Two ways we can use occupations • As the end • As the point that we means to are aiming for improve in our someone’s intervention impaired abilities October 2005 J.Taylor 3
  • 4. Occupation as end point • These occupations are part of the person’s normal roles – They organise the person’s time – They help the person to participate in life /society – They have purpose and meaning for the person October 2005 J.Taylor 4
  • 5. Occupation as end point • The O.T. can help the person learn / relearn these occupations, and / or can make adaptations if necessary October 2005 J.Taylor 5
  • 6. Occupation as a means to an end • We can introduce occupation as intervention to help improve someone after illness or when disabled • Enables eventual occupational functioning • We choose occupations which interest the client and which have therapeutic value • They should be challenging but enable success October 2005 J.Taylor 6
  • 7. Two ways we can analyse occupation • Occupational • Occupational form performance October 2005 J.Taylor 7
  • 8. Nelson’s question about baseball • What is an occupation? • Is the format of the game (the structure) the occupation? • Or is the playing of the game (the doing) the occupation? October 2005 J.Taylor 8
  • 9. His answer …. • Occupation is the relationship between occupational form and occupational performance • Occupation is the relationship between the ‘something to be done’ and the ‘doing’ of it – Playing a game of Monopoly – Cooking a meal for a special occasion October 2005 J.Taylor 9
  • 10. Occupational Form • ‘an objective set of circumstances, independent and external to a person’ (p633) • a ‘pre-existing structure that elicits, guides, or structures subsequent human performance’ (p634) (Nelson 1988) October 2005 J.Taylor 10
  • 11. Occupational form has two dimensions The physical dimension and The sociocultural dimension October 2005 J.Taylor 11
  • 12. The physical dimension can be observed and measured • The objects and their properties • The environment • The temporal aspects • The human aspects October 2005 J.Taylor 12
  • 13. The sociocultural dimension – the social and cultural aspects • Symbols, norms, sanctions, roles • These operate at different levels of society • Language October 2005 J.Taylor 13
  • 14. OCCUPATION Occupational Occupational form performance October 2005 J.Taylor 14
  • 15. Occupational Performance • ‘to go through or carry out the occupational form’ • ’the doing, the action, the active behaviour, or the active responses exhibited within the context of an occupational form.’ Nelson (1988, p634) October 2005 J.Taylor 15
  • 16. Occupational performance has two aspects Overt And Covert October 2005 J.Taylor 16
  • 17. Overt occupational performance can be observed • Gross and fine movement • Speech and related vocalisations • Facial expressions • All movements and postures under voluntary motor control October 2005 J.Taylor 17
  • 18. Covert occupational performance may not be observed directly • Cognitive processes • Emotional reactions October 2005 J.Taylor 18
  • 19. Chains of occupational performance Occupational Performance Aspects of form Walks to the refrigerator Opens The fridge door Looks for Milk Picks up Milk Pushes shut Fridge door Walks to Table Pours Milk into glass October 2005 J.Taylor 19
  • 20. Opening a fridge door is a complex activity!!! • Reach out to handle • Grasp handle • Firmly pull the handle (to break the hold of the rubber seal) • Gently pull the handle • Stop pulling October 2005 J.Taylor 20
  • 21. What might go wrong? • What if some of the muscles are weak? • What if you cannot initiate muscle action? • What if you cannot control muscle action? • What if you have no movement in one or more of your joints? • What if you cannot recognise the handle? • What if you cannot see it? October 2005 J.Taylor 21
  • 22. The developmental structure of the human • The human has – Sensorimotor } – Cognitive } abilities – Psychosocial } • These have developed over time October 2005 J.Taylor 22
  • 23. Occupational performance depends on ….. • The occupational form which is encountered PLUS • The unique developmental structure of the individual • The specific features of that one-off occasion October 2005 J.Taylor 23
  • 24. Occupation Occupational The Occupational meaning purpose form person performance October 2005 J.Taylor 24
  • 25. References • Creek, J (1996) Making a cup of tea as an honours degree subject British Journal of Occupational Therapy 59 (3) 128-130 • Nelson, D.L. (1988) Occupation: Form and Performance The American Journal of Occupational Therapy 42 (10) 633-641 • Trombly, C.A., Radomski, M.V.(eds) (2002) Occupational Therapy for Physical Dysfunction 5th edition Philadelphia:Lippincott Williams & Wilkins October 2005 J.Taylor 25

Notas do Editor

  1. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford
  2. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford These occupations are part of the person’s normal roles WE WANT TO GET OUR CLIENT BACK TO THEIR NORMAL LIVES, IF POSSIBLE They have purpose and meaning for the person - purposeful means they help people to achieve their goals - meaning is very individual e.g. what does walking in the countryside mean to you? They organise the person’s time They help the person to participate in life /society
  3. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford The O.T. can help the person learn / relearn these occupations, and can make adaptations if necessary - e.g. ramps, small pieces of equipment – a large handled trowel for someone with stiff joints to return to gardening
  4. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Occupational Therapy for Physical Dysfunction by Trombly and Radomski is excellent around this. We can introduce occupation as intervention to help improve someone after illness or when disabled e.g. improve muscle strength, standing tolerance, improve insight, social skills Enables eventual occupational functioning e.g. being able to cook a meal, return to work, make and keep a social network We choose occupations which interest the client and which have therapeutic value They should be challenging but enable success
  5. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Main reference here is Nelson 1988 – don’t worry about getting hold of it – it is summarised in several OT text books. This lecture introduces some simple concepts – you’ll be eager to know more – but they will be elaborated on later in the course.
  6. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Write down a celebration or special occasion when you have a special meal
  7. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford ‘ an objective set of circumstances, independent and external to a person’ (Nelson 1988 p633) Occupational form is a ‘pre-existing structure that elicits, guides, or structures subsequent human performance’ - what other people are aware of – they can see it, hear it or know about it. We, most of us in this room, know what a game of Monopoly looks like, many of know what the pieces and board look like, some of know what the rules are.
  8. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Think about how you got to university this morning Did you catch a bus? Drive a car? Get a lift? Walk? Think of an occupation you carried out yesterday evening Did you cook a meal? Go for a drink with friends? Write an essay? Watch the TV?
  9. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Can be measure and described The objects and their properties e.g. a bus, a car, what type – size, shape, colour, tickets? Bus passes? Bus stops? The temporal aspects e.g. the sequence of events, the time it took, the movement of objects over time, the changes in objects over time The human aspects the presence of other people, where they are, characteristics? E.g. other passengers, the driver
  10. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Symbols, norms, sanctions, roles symbol – when something stands for something, and we all understand, e.g. red traffic light norms – what is normally done, and therefore expected of us (by law, or social expectation) e.g. stopping at traffic lights, letting people get off the bus before we get on. (E.G. OF CROSSING THE ROAD IN Antwerp or using a sauna in Finland)) sanctions – typical social rewards and punishments associated with norms roles – set of expectations involving others, e.g. student, worker, mother SOMETIMES WHEN WE ENCOUNTER A NEW OCCUPATIONAL FORM, WE DO NOT KNOW WHAT IS EXPECTED Levels of society Some sociocultural aspects are universal – we all, everywhere, understand them – eg water is for drinking Some only work at a national level (symbols, norms, laws, sanctions, roles etc), or at a religion level, or ethnic group, professional group, region, community, family smaller groups Language Speech is part of most occupational forms – it is part of sociocultural life – again their may be symbols, norms, there are rules of grammar etc – and these are all dependent on the various levels we operate at. E.g. families may have their own jokes and short cuts to communicating. Writing is included here.
  11. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford OCCUPATIONAL FORM IS ‘ an objective set of circumstances, independent and external to a person’ (p633) a ‘ pre-existing structure that elicits, guides, or structures subsequent human performance’
  12. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Cognitive processes e.g. problem solving, thinking, recalling Emotional reactions e.g. anxiety, enjoyment, sorrow, fear
  13. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Think about what could go wrong! What if someone tells you to get the milk from the fridge, but you have never seen one before in your life! What if you have forgotten what a fridge is? What if you can’t walk? What if the milk carton is coloured orange and all the writing is in Chinese? BUT THESE STEPS IN THE CHAIN CAN BE BROKEN DOWN FURTHER
  14. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford What might go wrong? Which parts of the arm do you use when reaching for the handle? Which mental processes do you use?
  15. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford No two people are alike in the way they approach an occupational form, and the way they perform. The occupational form, on the face of it, looks as though it demands certain responses and behaviours and attitudes, but not so!….
  16. 07/03/13 J.Taylor / Intro to Key Concepts / University of Salford Have you discovered the journals in the library yet?