A number of diagnostic assessments and treatment interventions are
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
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.