Activities of daily living (ADLs)
Activities oriented toward taking care of one’s own body (adapted from Rogers & Holm, 1994, pp. 181–202). ADL also is referred to as basic activities of daily living (BADL) and personal activities of daily living (PADL). These activities are “fundamental to living in a social world; they enable basic survival and well-being” (Christiansen & Hammecker, 2001, p. 156) (see Table 1 for definitions of terms).
A class of human actions that are goal directed.
“…addresses the typical demands of an activity, the range of skills involved in its performance, and the various cultural meanings that might be ascribed to it” (Crepeau, 2003, p. 192).
The aspects of an activity, which include the objects and their physical properties, space, social demands, sequencing or timing, required actions or skills, and required underlying body functions and body struc- tures needed to carry out the activity (see Table 3).
The response approach the client makes encoun- tering an occupational challenge. “This change is implemented when the individual’s customary response approaches are found inadequate for pro- ducing some degree of mastery over the challenge” (Schultz & Schkade, 1997, p. 474).
The “pursuit of influencing outcomes—including public policy and resource allocation decisions within political, economic, and social systems and institutions—that directly affect people’s lives” (Advocacy Institute, 2001, as cited in Goodman- Lavey & Dunbar, 2003, p. 422).
Analysis of occupational performance
Part of the evaluation process. Collecting infor- mation via assessment tools designed to observe, measure, and inquire about selected factors that support or hinder occupational performance.
Areas of occupations
Various kinds of life activities in which people engage, including the following categories: ADLs, IADLs, rest and sleep, education, work, play, leisure, and social participation (see Table 1).
“Specific tools or instruments that are used during the evaluation process” (AOTA, 2005, p. 663).
Any cognitive content held as true by the client (Moyers & Dale, 2007).
“The physiological functions of body systems (including psychological functions)” (WHO, 2001, p. 10) (see Table 2).
“Anatomical parts of the body such as organs, limbs, and their components [that support body function]” (WHO, 2001, p. 10) (see Table 2).
The entity that receives occupational therapy ser- vices. Clients may include (1) individuals and other persons relevant to the individual’s life, including family, caregivers, teachers, employers, and others who also may help or be served indi- rectly; (2) organizations such as business, indus- tries, or agencies; and (3) populations within a community (Moyers & Dale, 2007).
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An orientation that honors the desires and priori- ties of clients in designing and implementing interventions (adapted from Dunn, 2000a, p. 4).
Those factors residing within the client that may affect performance in areas of occupation. Client factors include values, beliefs, and spirituality; body functions; and body structures (see Table 2).
“Complex multi-faceted cognitive process used by practitioners to plan, direct, perform, and reflect on intervention” (Crepeau et al., 2003, p. 1027).
Communication and social skills
Actions or behaviors a person uses to communi- cate and interact with others in an interactive envi- ronment (Fisher, 2006).
Actions or behaviors a client uses to plan and man- age the performance of an activity.
Refers to a variety of interrelated conditions with- in and surrounding the client that influence per- formance. Contexts include cultural, personal, temporal, and virtual (see Table 6).
Activities that implicitly involve at least two peo- ple (Zemke & Clark, 1996).
“Customs, beliefs, activity patterns, behavior stan- dards, and expectations accepted by the society of which the [client] is a member. Includes ethnicity and values as well as political aspects, such as laws that affect access to resources and affirm personal rights. Also includes opportunities for education, employment, and economic support” (AOTA, 1994, p. 1054).
A sphere of activity, concern, or function (American Heritage Dictionary, 2006).
Includes learning activities needed when partici- pating in an environment (see Table 1).
Emotional regulation skills
Actions or behaviors a client uses to identify, man- age, and express feelings while engaging in activi- ties or interacting with others.
The act of sharing activities.
The external physical and social environment that surrounds the client and in which the client’s daily life occupations occur (see Table 6).
“The process of obtaining and interpreting data necessary for intervention. This includes planning for and documenting the evaluation process and results” (AOTA, 2005, p. 663).
“The result or achievement toward which effort is directed; aim; end” (Webster’s Encyclopedic Unabridged Dictionary of the English Language, 1994, p. 605).
“Automatic behavior that is integrated into more complex patterns that enable people to function on a day-to-day basis…” (Neistadt & Crepeau, 1998, p. 869). Habits can be useful, dominating,
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or impoverished and either support or interfere with performance in areas of occupation.
Health is a resource for everyday life, not the objective of living. It is a state of complete physi- cal, mental, and social well-being, as well as a pos- itive concept emphasizing social and personal resources, as well as physical capacities (adapted from WHO, 1986).
“[T]he process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental, and social well-being, an individual or group must be able to identify and realize aspirations, to satisfy needs, and to change or cope with the environment” (WHO, 1986).
“[C]reating the conditions necessary for health at individual, structural, social, and environmental levels through an understanding of the determi- nants of health: peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice, and equity” (Trentham & Cockburn, 2005, p. 441).
The real or perceived belief that one can move toward a goal through selected pathways (Lopez et al., 2004).
“A composite definition of the self and includes an interpersonal aspect…an aspect of possibility or potential (who we might become), and a values aspect (that suggests importance and provides a stable basis for choices and decisions)…. Identity can be viewed as the superordinate view of our- selves that includes both self-esteem and self-con- cept but also importantly reflects and is influenced by the larger social world in which we find our- selves” (Christiansen, 1999, pp. 548–549).
“A self-directed state of being characterized by an individual’s ability to participate in necessary and preferred occupations in a satisfying manner irrespective of the amount or kind of external assistance desired or required
• Self-determination is essential to achieving and maintaining independence;
• An individual’s independence is unrelated to whether he or she performs the activities related to an occupation himself or herself, performs the activities in an adapted or mod- ified environment, makes use of various devices or alternative strategies, or oversees activity completion by others;
• Independence is defined by the individual’s culture and values, support systems, and ability to direct his or her life; and
• An individual’s independence should not be based on preestablished criteria, perception of outside observers, or how independence is accomplished” (AOTA, 2002a, p. 660).
Instrumental activities of daily living (IADLs)
Activities to support daily life within the home and community that often require more complex inter- actions than self-care used in ADL (see Table 1).
The “reliance that people have on each other as a natural consequence of group living” (Christiansen & Townsend, 2004, p. 277). “Interdependence engenders a spirit of social inclusion, mutual aid, and a moral commitment and responsibility to rec- ognize and support difference” (p. 146).
“What one finds enjoyable or satisfying to do” (Kielhofner, 2002, p. 25).
The process and skilled actions taken by occupa- tional therapy practitioners in collaboration with
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the client to facilitate engagement in occupation related to health and participation. The interven- tion process includes the plan, implementation, and review (see Table 7).
Specific strategies selected to direct the process of interventions that are based on the client’s desired outcome, evaluation date, and evidence (see Table 9).
“A nonobligatory activity that is intrinsically moti- vated and engaged in during discretionary time, that is, time not committed to obligatory occupa- tions such as work, self-care, or sleep” (Parham & Fazio, 1997, p. 250).
Motor and praxis skills Motor Actions or behaviors a client uses to move and physically interact with tasks, objects, contexts, and environments (adapted from Fisher, 2006). Includes planning, sequencing, and executing novel movements. Also see Praxis.
“Goal-directed pursuits that typically extend over time have meaning to the performance, and involve multiple tasks” (Christiansen et al., 2005, p. 548).
“Daily activities that reflect cultural values, provide structure to living, and meaning to indi- viduals; these activities meet human needs for self- care, enjoyment, and participation in society” (Crepeau et al., 2003, p. 1031).
“Activities that people engage in throughout their daily lives to fulfill their time and give life
meaning. Occupations involve mental abilities and skills and may or may not have an observable phys- ical dimension” (Hinojosa & Kramer, 1997, p. 865).
“[A]ctivities…of everyday life, named, orga- nized, and given value and meaning by individu- als and a culture. Occupation is everything people do to occupy themselves, including looking after themselves…enjoying life…and contributing to the social and economic fabric of their communi- ties” (Law et al., 1997, p. 32).
“A dynamic relationship among an occupa- tional form, a person with a unique developmen- tal structure, subjective meanings and purpose, and the resulting occupational performance” (Nelson & Jepson-Thomas, 2003, p. 90).
“[C]hunks of daily activity that can be named in the lexicon of the culture” (Zemke & Clark, 1996, p. vii).
A type of occupational therapy intervention—a client-centered intervention in which the occupa- tional therapy practitioner and client collabora- tively select and design activities that have specific relevance or meaning to the client and support the client’s interests, need, health, and participation in daily life.
“Justice related to opportunities and resources required for occupational participation sufficient to satisfy personal needs and full citizenship” (Christiansen & Townsend, 2004, p. 278). To experience meaning and enrichment in one’s occu- pations; to participate in a range of occupations for health and social inclusion; to make choices and share decision-making power in daily life; and to receive equal privileges for diverse participation in occupations (Townsend & Wilcock, 2004).
The act of doing and accomplishing a selected activity or occupation that results from the
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dynamic transaction among the client, the con- text, and the activity. Improving or enabling skills and patterns in occupational performance leads to engagement in occupations or activities (adapted in part from Law et al., 1996, p. 16).
A summary of the client’s occupational history, pat- terns of daily living, interests, values, and needs.
An interdisciplinary academic discipline in the social and behavioral sciences dedicated to the study of the form, the function, and the meaning of human occupations (Zemke & Clark, 1996).
The practice of occupational therapy means the ther- apeutic use of everyday life activities (occupations) with individuals or groups for the purpose of partici- pation in roles and situations in home, school, work- place, community, and other settings. Occupational therapy services are provided for the purpose of pro- moting health and wellness and to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy addresses the physical, cognitive, psychoso- cial, sensory, and other aspects of performance in a variety of contexts to support engagement in every- day life activities that affect health, well-being, and quality of life (AOTA, 2004a).
Entities with a common purpose or enterprise such as businesses, industries, or agencies.
What occupational therapy actually achieves for the consumers of its services (adapted from Fuhrer, 1987). Change desired by the client that can focus on any area of the client’s occupational performance (adapted from Kramer, McGonigel, & Kaufman, 1991).
“Involvement in a life situation” (WHO, 2001, p. 10).
Patterns of behavior related to daily life activities that are habitual or routine. They can include habits, routines, rituals, and roles (see Table 5).
The abilities clients demonstrate in the actions they perform (see Table 4).
Individuals, including families, caregivers, teachers, employees, and relevant others.
“Features of the individual that are not part of a health condition or health status” (WHO, 2001, p. 17). Personal context includes age, gender, socioe- conomic, and educational status. Can also include organizational levels (i.e., volunteers, employees) and population levels (i.e., members of a society).
The natural and built nonhuman environment and objects in them.
“Any spontaneous or organized activity that pro- vides enjoyment, entertainment, amusement, or diversion” (Parham & Fazio, 1997, p. 252) (see Table 1).
Large groups as a whole, such as refugees, home- less veterans, and people who need wheelchairs.
Skilled purposeful movements (Heilman & Rothi, 1993). The ability to carry out sequential motor acts as part of an overall plan rather than individual acts (Liepmann, 1920). The ability to carry out learned
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motor activity, including following through on a ver- bal command, visual spatial construction, ocular and oral–motor skills, imitation of a person or an object, and sequencing actions (Ayres, 1985; Filley, 2001). Organization of temporal sequences of actions with- in the spatial context; which form meaningful occu- pations (Blanche & Parham, 2002).
Also see Motor.
Methods and techniques that prepare the client for occupational performance. Used in preparation for or concurrently with purposeful and occupa- tion-based activities.
“[H]ealth promotion is equally and essentially concerned with creating the conditions necessary for health at individual, structural, social, and environmental levels through an understanding of the determinants of health: peace, shelter, educa- tion, food, income, a stable ecosystem, sustainable resources, social justice, and equity” (Kronenberg, Algado, & Pollard, 2005, p. 441).
Promoting a healthy lifestyle at the individual, group, organizational, community (societal), gov- ernmental/policy level (adapted from Brownson & Scaffa, 2001).
A description of the way in which occupational therapy practitioners operationalize their exper- tise to provide services to clients. The process includes evaluation, intervention, and outcome monitoring; occurs within the purview of the domain; and involves collaboration among the occupational therapist, occupational therapy assistant, and the client.
A goal-directed behavior or activity within a ther- apeutically designed context that leads to an occu-
pation or occupations. Specifically selected activi- ties that allow the client to develop skills that enhance occupational engagement.
Quality of life
A client’s dynamic appraisal of life satisfactions (per- ceptions of progress toward identified goals), self- concept (the composite of beliefs and feelings about themselves), health and functioning (including health status, self-care capabilities), and socioeco- nomic factors (e.g., vocation, education, income) (adapted from Radomski, 1995; Zhan, 1992).
A reassessment of the client’s performance and goals to determine the type and amount of change.
Quiet and effortless actions that interrupt physical and mental activity, resulting in a relaxed state (Nurit & Michel, 2003, p. 227).
Symbolic actions with spiritual, cultural, or social meaning, contributing to the client’s identity and reinforcing the client’s values and beliefs (Fiese et al., 2002; Segal, 2004). Rituals are highly symbolic, with a strong affective component and representa- tive of a collection of events.
Roles are sets of behaviors expected by society, shaped by culture, and may be further conceptual- ized and defined by the client.
Patterns of behavior that are observable, regular, repetitive, and that provide structure for daily life. They can be satisfying, promoting, or damaging. Routines require momentary time commitment
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and are embedded in cultural and ecological con- texts (Fiese et al., 2002; Segal, 2004).
Understanding your strengths and needs, identify- ing your personal goals, knowing your legal rights and responsibilities, and communicating these to others (Dawson, 2007).
Actions or behaviors a client uses to locate, identi- fy, and respond to sensations and to select, inter- pret, associate, organize, and remember sensory events via sensations that include visual, auditory, proprioceptive, tactile, olfactory, gustatory, and vestibular sensations.
“A natural periodic state of rest for the mind and body, in which the eyes usually close and con- sciousness is completely or partially lost, so that there is a decrease in bodily movement and responsiveness to external stimuli. During sleep the brain in humans and other mammals under- goes a characteristic cycle of brain-wave activity that includes intervals of dreaming” (The Free Dictionary, 2007) (see Table 1).
A series of activities resulting in going to sleep, staying asleep, and ensuring health and safety through participation in sleep involving engage- ment with the physical and social environments.
Is constructed by the presence, relationships, and expectations of persons, organizations, and pop- ulations.
“Ethical distribution and sharing of resources, rights, and responsibilities between people, recog- nizing their equal worth as citizens. [It recognizes] ‘their equal right to be able to meet basic needs, the need to spread opportunities and life chances
as widely as possible, and finally the requirement that we reduce and where possible eliminate unjustified inequalities’” (Commission on Social Justice, 1994, p. 1).
“The promotion of social and economic change to increase individual, community, and political awareness, resources, and opportunity for health and well-being” (Wilcock, 2006, p. 344).
“Organized patterns of behavior that are charac- teristic and expected of an individual in a given position within a social system” (Mosey, 1996, p. 340) (see Table 1).
“[T]he personal quest for understanding answers to ultimate questions about life, about meaning, and about relationship with the sacred or tran- scendent, which may (or may not) lead to or arise from the development of religious rituals and the formation of community” (Moreira-Almeida & Koenig, 2006, p. 844).
“Location of occupational performance in time” (Neistadt & Crepeau, 1998, p. 292). The experience of time as shaped by engagement in occupations. The temporal aspects of occupations “which con- tribute to the patterns of daily occupations” are “the rhythm…tempo…synchronization…duration…and sequence” (Larson & Zemke, 2004, p. 82; Zemke, 2004, p. 610). It includes stages of life, time of day, duration, rhythm of activity, or history.
A process that involves two or more individuals or elements that reciprocally and continually influence and affect one another through the ongoing relationship (Dickie, Cutchin, & Humphry, 2006).
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Principles, standards, or qualities considered worthwhile or desirable by the client who holds them (Moyers & Dale, 2007).
Environment in which communication occurs by means of airways or computers and an absence of physical contact. Includes simulated or real-time or near-time existence of an environment, such as chat rooms, email, video conferencing, and radio transmissions.
“An active process through which individuals become aware of and make choices toward a more successful existence” (Hettler, 1984, p. 1117). Wellness is more than a lack of disease symptoms. It is a state of men- tal and physical balance and fitness (adapted from Taber’s Cyclopedic Medical Dictionary, 1997, p. 2110).
“Activities needed for engaging in remunerative employment or volunteer activities” (Mosey, 1996, p. 341) (see Table 1).