Areas of Occupation Performance Skills Context and Environment Activities of Daily Living (ADL) Sensory-Perceptual Skills Cultural Instrumental ADL and Praxis Skills Personal. Rest and Sleep Emotional Regulation Skills Physical Education Cognitive Skills Social Work Communication and Social Skills Temporal. Play Virtual Leisure Social Participation Performance Patterns Activity Demands Habits Objects used and properties Client Factors Routines Demands Values, Beliefs and Spirituality Roles Social Demands Body Functions Sequencing and Timing Rituals Body Structures Required Actions Required Body Functions Required Body Structures Most common services priorities (check all that apply) (Double Click on boxes to check) Direct service Meetings(team, department, family) Consultation Billing Discharge planning Client education In-service training Documentation Evaluation Intervention of OT Interventions addressed in this setting (check all that apply): * ACOTE Standards A.5.3, B.10.1, B.10.3, B.10.11, B.10.13, B.10.15, B.10.19, B.10.20 Areas of Occupation addressed in this setting - within client’s own environmental context (check all that apply): (Double Click on boxes to check) Activities of Living (ADL) Instrumental Activities of Daily Living (IADL) Education Bathing/showering Care of others (selecting/supervising caregivers) Formal education participation Bowel and bladder mgmt Care of pets Informal personal educational needs or interests Dressing Child rearing exploration Eating Communication management Informal personal education participation Feeding Community mobility Work Functional mobility Financial management Employment interests & pursuits Personal device care Health management & maintenance Employment seeking and acquisition Personal hygiene & grooming Home establishment & management Job performance Sexual activity Meal preparation & clean up Retirement preparation & adjustment Toilet hygiene Religious observance Volunteer exploration / participation Safety procedures & emergency maintenance Rest and Sleep Shopping Social Participation Rest Community Sleep Leisure Family Sleep preparation Leisure exploration Peer/friend Sleep participation Leisure participation Play Play exploration Play participation Types of Occupational Therapy Interventions: (Double Click on boxes to check) Preparatory Methods practitioner selects – Education Process imparting knowledge and – Occupation-based Intervention – directed methods and techniques that prepare information occupation, health and participation client engages in client-directed the client for occupational performance. occupations that match identified that does not result in actual performance of the goals occupation/activity Consultation Process using knowledge and – expertise to collaborate with the client
Areas of Occupation Activities of Daily Living (ADL) Instrumental ADL Rest and Sleep Education Work Play Leisure Social Participation Client Factors Values, Beliefs and Spirituality Body Functions Body Structures Performance Skills Sensory-Perceptual Skills and Praxis Skills Emotional Regulation Skills Cognitive Skills Communication and Social Skills Performance Patterns Habits Routines Roles Rituals Context and Environment Cultural Personal. Physical Social Temporal. Virtual Activity Demands Objects used and properties Demands Social Demands Sequencing and Timing Required Actions Required Body Functions Required Body Structures Most common services priorities (check all that apply) (Double Click on boxes to check) Direct service Discharge planning Evaluation Meetings(team, department, family) Client education Intervention Consultation In-service training Billing Documentation of OT Interventions addressed in this setting (check all that apply): * ACOTE Standards A.5.3, B.10.1, B.10.3, B.10.11, B.10.13, B.10.15, B.10.19, B.10.20 Areas of Occupation addressed in this setting - within client’s own environmental context (check all that apply): (Double Click on boxes to check) Activities of Living (ADL) Instrumental Activities of Daily Living (IADL) Education Bathing/showering Bowel and bladder mgmt Dressing Eating Feeding Functional mobility Personal device care Personal hygiene & grooming Sexual activity Toilet hygiene Rest and Sleep Rest Sleep Sleep preparation Sleep participation Play Play exploration Play participation Care of others (selecting/supervising caregivers) Care of pets Child rearing Communication management Community mobility Financial management Health management & maintenance Home establishment & management Meal preparation & clean up Religious observance Safety procedures & emergency maintenance Shopping Leisure Leisure exploration Leisure participation Formal education participation Informal personal educational needs or interests exploration Informal personal education participation Work Employment interests & pursuits Employment seeking and acquisition Job performance Retirement preparation & adjustment Volunteer exploration / participation Social Participation Community Family Peer/friend Types of Occupational Therapy Interventions: (Double Click on boxes to check) Occupation-based Intervention – client engages in client-directed occupations that match identified goals Preparatory Methods – practitioner selects directed methods and techniques that prepare the client for occupational performance. Consultation Process – using knowledge and expertise to collaborate with the client Education Process – imparting knowledge and information occupation, health and participation that does not result in actual performance of the occupation/activity
AOTA%20FW%20DATA%20FORM%20(GOTEC%20version%20Belmont%20modified)%20%20OTD%20-%20Revised%2010-19-15(1).docx