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