OT 500- Ch. 4 (Step 3: Determine the Sequence and Timing)

Limitations of to the Method of Engaging in Activities Yourself

-Time is often the greatest limitation. We don't always have the time to experience all of the occupations that our clients do -The contexts in which the occupations occur also limit our participation (physical, social, personal) -access to special equipment needed for the activity may not be available -some activities also require a certain level of skills and body functions -demands of activites can limit us participating in the activities that our clients do -also limited by cost, safety, our knowledge, the physical environment, and access to the tools and equipment

Talk to Your Client

-by asking your client to explain an activity step by step may give you an overall idea of how a task is done and the objects and equipment needed -client may be able to give you information regarding aspects of the activity that cannot be seen by an observer -keep in mind that client may leave out essential details, assuming that you already know about certain aspects of the activity or because he or she is unsure of how much detail to give you -it is important that you ask probing questions to gather all the pertinent details about the activity that the client is describing -gather information regarding all aspects of the activity, including the objects and properties, space demands, and social demands -might have speech or cognitive impairments

Step 11 of Writing out the sequence and timing for an activity analysis

-conditional statements( if/then statements) -Some tasks are not a simple as following numbered steps that follow a logical sequence -there are times when the outcome of an action or an environmental situation has implications on the next action take -may choice to graph the steps in an algorithm if the tasks you are analyzing has many of these "if/then" situations

Limitations of talking to someone who performs this activity

-coordinating time between the clinician and the experienced person to fit both individual's schedules -not everyone will be willing to talk to you, especially in situations where the occupation or activity is uncommon: participants of the occupation are very busy or the information is seen as private information

Cultural or language barriers will talking to someone who performs the activity of interest

-those you attempt to talk to may not understand why you are asking or may be hesitant to share information with you

Watch Someone Perform the Activity

-watching your client or another person perform an activity can give you great information on the physical actions required, as well as the timing and sequence of steps -through careful observation, the clinician can gather information regarding the strength, range of movements, coordination, and duration of movements required for giving activity -clinican can get a sense of the mental, sensory, and speech functions required -you may also need to observe another person participating in the activity if your client is not able to perform the activity completely or if you need more information than your client can provide -the timing, sequencing, and actions used by another person may not always be the same as those used by your client

Talk to Someone who performs this activity

-when talking to the client is not feasible or does not give you enough information, talking to another person who performs that activity can often elicit valuable information -it is best to be prepared with a list of questions for the person you are talking to -this person may also not give much detail or leave key elements out of their description because he or she assumes that you already know certain details -preface your convo with a brief explanation of what you are looking for and the depth of your current understanding of the activities you will be discussing

Procedural Task analysis- steps and timing

1) Determine activity you're analyzing 2) Prep and cleanup should be included ONLY if necessary 3) Begin statement with action verb 4) Follow with object being acted on 5) Include HOW the object should be acted on 6) Include elements in the timing or length if it's essential to the task 7) List steps in correct sequence as normally occur 8) Keep steps simple and concise 9) Be specific as the the amount of certain material used during a step 10) Be specific about directions given 11) Some tasks are not as simple as following numbered steps 12) Do not indicate right or left hand/foot unless necessary 13) Do not list physical/mental requirement of task 14) Include precautions and warnings for certain steps in parenthesis 15) Do not include proper nouns or specific regarding object and properties unless necessary 16) Clinical must construct steps in logical order that considers socioculture norms

Ways to Understand the steps/timing of an occupation

1. Mentally Process the Steps 2. Engage in the Activity yourself 3. Talk to your Client 4. Talk to Someone Who Performs This Activity 5. Watch Someone Perform the Activity

Step 9 of Writing out the sequence and timing for an activity analysis

Be specific as to the amount of a certain material that is needed or used during a step -describe the amount needed if each amounts such as cups, inches, or numbers are not called for

Step 10 of Writing out the sequence and timing for an activity analysis

Be very succinct and specific in the directions that you give your client

Why is Determing the Sequence and Timing important to an activity analysis?

Being able to identify the steps and timing of an activity provides the foundation for a thorough analysis and allows for successful completion of the remaining steps

Step 1 for Writing out the sequence and timing for an activity analysis

Determine what activity you will be analyzing -make sure to break down larger occupations into smaller activities or tasks

Step 15 of Writing out the sequence and timing for an activity analysis

Do not include proper nouns or specifics in regard to the objects and properties unless absolutely necessary -in some instances, it is very important to include the name brand or type of material being used, as in recipes

Step 13 for Writing out the sequence and timing for an activity analysis

Do not list the physical or mental requirement of the task -a good way to check your directions is to read them aloud to someone, having them act upon each step

Step 3 for Writing out the sequence and timing for an activity analysis

In writing out a step, be sure to begin the statement with an action verb -these actions should be observable

Step 14 of Writing out the sequence and timing for an activity analysis

Include precautions and warnings for certain steps in parentheses

Step 6 for Writing out the sequence and timing for an activity analysis

Include time elements if the timing of certain steps or the length of an action is essential to the task

Step 8 for Writing out the sequence and timing for an activity analysis

Keep the Steps simple and concise -keep out unnecessary details and avoid including multiple instructions in one step -a sign that you may be including too much info into one step is if there is the word "and" linking 2 action verbs in your directions

Step 7 for Writing out the sequence and timing for an activity analysis

List the steps in the correct sequence, as they normally occur -if a step or a sequence of steps recurs, state which steps to repeat and for how long

Methods for Determining Key Steps

Once the activity or occupation has been clearly defined, you must begin to list the key steps -experience may allow you to mentally recall the steps of an activity that is familiar to you, but it is impossible to know the details of every imaginable occupation

Step 5 for Writing out the sequence and timing for an activity analysis

One of the most important aspects of the statement is how the action should be completed. - this can be a simple word, such as "slowly", or more descriptive words, such as "in the shape of a figure eight"

Step 2 for Writing out the sequence and timing for an activity analysis

Preparatory and cleanup tasks should be included in the steps only if absolutely necessary. Otherwise, these can be separate activities

Step 4 for Writing out the sequence and timing for an activity analysis

The next part of a direction statement should include what the objects or environmental aspects are being acted upon.

Why is determining which steps are essential to success in an activity or occupation helpful in the activity analysis process?

While each person may complete an activity differently than another person, it is important to understand which steps or timing elements are essential for successful performance of an activity -in many cases the essential steps may seem subjective or rely on what the client sees as successful completion

Step 16 of Writing out the sequence and timing for an activity analysis

While most activites can be completed in many different ways, Lin and Browder (1990) stated that in considering the steps of a task, clinicians must construct the steps in a logical order that considers sociocultural norm, "logical positioning of objects safety, hygiene, and cost-effectiveness -doing tasks according to the social norm is only conducted if you are conducting an activity analysis and not a occupation- based activity analysis -since it is not an occupation-based analysis, then be careful not to creat special circumstances or "could be" situations -when listing the sites of an activity, think of how the activity is typically done

Engage in the Activity Yourself

While not always possible, engaging in the activity yourself gives you a perspective not possible with other methods -even though the experience of an activity is different for each person, participating in an activity allows you to "feel" what it is like to participate in the activity and pick up on steps and elements what may not be detected through mental visualization or by watching others -There may be timing elements that are difficult to determine, such as the exact moment something should happen or the next step should occur. For example, If someone gave a kite and asked you to set it into flight, you would find that there were many elements of timing that are not evident by just watching someone else do it or mentally visualizing it -Understanding this complex sequence and timing and the actions required is not easily "seen" but is felt -It is often difficult to break down an occupation into a sequence of actions when the actions are not observable, or each step is reliant on external occurrences, or the outcome of a previous step -participating in an occupation or activity allows the clinician to gather and broader understanding of an activity, allying for a more accurate analysis

Mentally Process the Steps

With simple, everyday tasks, the easiest way to determine the steps is to mentally visualize each step. -However, with more complex activities, this may not be feasible. By simply relying on your own memory and understanding of an activity, many steps may be left out. -The benefits of this method are that it takes very little time or expense -Through experience, practice, and exposure to common occupations, the ability to mentally visualize steps evolves and the ease in which this occurs improves

Algorithms

a visual diagram of the steps of a task based on information collected during the acuity, and then specific options are given for the next step based on that information -used in profession such as mathematics and engineering to help with decision making and to standardize procedures -heathcare use them to design protocols and clinical pathways -for complex situations, they can become very large and detailed, especially when there are multiple possible outcomes for each step -the purpose is not to list the details of each step, but rather to help clarify the sequence of steps banned on conditional aspects

Step 12 for Writing out the sequence and timing for an activity analysis

do not indicate to use the right or left hand unless absolutely necessary

Why is the process of breaking down an activity into its component parts important?

it is essential to understanding the complexity of an activity -it includes identifying those aspects of the action you can see, such as actions, as well as those you can not see, such as writing for a specific period of time -it is important to identify those steps that are essential to successful participation and completion of the activity and the order in which they occur

Co-occupations

occupations that involve more than one person -Many occupations and activities are not done alone and require engagement with others -includes occupations in which social interaction is required or that rely on another person's actions

Nested occupations

several occupations are conducted at the same time and co-occur -may be distinct occupations that occur together or separate occupations, such as listening to music and surfing the Internet -analysis of these types of activities requires that each activity be looked at individually but that engaging in the other activities is recognized in the analysis

Defining success

success is determined in the first step of the analysis process -For common activities, there are clear ways to determine success such as brushing your teeth with the success being making your teeth clean and healthy.

Procedural Task Analysis: Determing Sequence and Timing

used by OT practitioners to help determine the sequence of steps for an activity -adopting a method that lends itself to a more accurate description of the essential steps leads to a precise analysis of the activity demands and greater ability to explain to or teach a client or caregiver