Occupational Therapy Interventions

A number of diagnostic assessments and treatment interventions are available, including:

Activities of Daily Living (ADL)

Occupational therapists assess patients' ability to participate in life activities, such as bathing and dressing. They also identify contributing factors to dependence, such as lack of motor control or sensory impairment. They also recommend environmental adaptations such as a tub bench for bathing, to ensure safety.

Behavioral Assessment and Training

Occupational therapists use group therapy as their primary form of intervention with patients who have psychiatric illnesses. These groups focus on patients' ability to participate in life activities, such as work and leisure. Occupational therapists also teach specific coping strategies, such as relaxation techniques.

Cognitive Assessment and Training

Occupational therapists evaluate patients' cognition, particularly if there has been a traumatic brain injury (TBI), stroke, brain tumor, or other brain impairment. They also will observe their patients perform routine daily tasks, such as eating a meal or brushing teeth, to determine if these are affected by the injury. Treatment is focused on developing cognitive skills to improve attention, memory and problem solving. Therapists often teach patients compensatory skills to improve their ability to function independently.

Developmental Assessment

An occupational therapist specializing in pediatrics assesses premature newborns at risk for developmental delay. The primary role is to consult with the treatment team on sensory integrative techniques to enhance sensory processing and promote adaptive responses of the infants to environmental demands. The occupational therapist also is available to teach parents how to participate in the care of their infant.

Home Safety Assessment and Training

One of the key roles for inpatient occupational therapists is to provide discharge recommendations to the patient, family and treatment team. Occupational therapists are concerned about patient safety, both in the home and in the community. They may ask detailed questions about the home environment, such as the kitchen set-up, to determine whether or not it is safe for a patient to return home. They will then simulate the home environment by having, for example, the patient prepare a hot beverage in the unit's kitchenette, if appropriate. They may also recommend home occupational therapy services and will write discharge recommendations for the home therapist.

Instrumental Activities of Daily Living Assessment (IADL)

Occupational therapists evaluate patients' potential to return to their communities and participate in those life activities which are important to them. For example, determining whether or not patients can continue to drive is a decision that the treatment team often faces. Occupational therapists may recommend that their patients be evaluated by an occupational therapist specializing in driving safety, such as BIDMC's DriveWise program. They may also evaluate their patients' ability to shop for groceries, manage their finances or return to work. They consult with the treatment team on a discharge plan that will assure patient safety.

Upper Extremity Management

Management of the upper extremity is necessary when patients have had hand surgery, trauma or neurological impairment. Surgeons may request that occupational therapists fabricate custom splints for various joints in order to immobilize them or in some cases to allow for limited movement. Patients may also have swelling and limited range of motion or strength. Therapists perform therapeutic activities which help prevent functional limitation and also teach their patients home exercise programs.