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October 2005 J.Taylor 1
Occupational Form and Occupational Performance
Or
How to think about occupations!
October 2005 J.Taylor 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 3
Two ways we can use occupations
• As the end point that we are aiming for in our intervention
• As the means to improve someone’s impaired abilities
October 2005 J.Taylor 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 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 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 7
Two ways we can analyse occupation
• Occupational form
• Occupational performance
October 2005 J.Taylor 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 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 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 11
Occupational form has two dimensions
The physical dimension
and
The sociocultural dimension
October 2005 J.Taylor 12
The physical dimensioncan be observed and measured
• The objects and their properties
• The environment
• The temporal aspects
• The human aspects
October 2005 J.Taylor 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 14
OCCUPATION
Occupational form
Occupational performance
October 2005 J.Taylor 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 16
Occupational performance has two aspects
Overt And
Covert
October 2005 J.Taylor 17
Overt occupational performancecan be observed
• Gross and fine movement
• Speech and related vocalisations
• Facial expressions
• All movements and postures under voluntary motor control
October 2005 J.Taylor 18
Covert occupational performance may not be observed directly
• Cognitive processes
• Emotional reactions
October 2005 J.Taylor 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 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 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 22
The developmental structure of the human
• The human has– Sensorimotor }– Cognitive } abilities– Psychosocial }
• These have developed over time
October 2005 J.Taylor 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 24
Occupation
meaning purposeOccupational form
The person
Occupational performance
October 2005 J.Taylor 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