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the University of Idahos lacrosse team for four years throughout college. After graduating with his
undergraduate degree he became the head lacrosse coach at the University of Idaho while pursuing his
masters degree.
Currently, the client works at an advertising agency where much of his day is spent sitting and
working at a computer. John makes a point of getting outside and being active whenever he has free
time. He stays active by engaging in various physical activities and enjoys getting a group of friends
together to play basketball, throw the football, or golf. He just recently accepted a coaching position for
lacrosse at the University of Washington and will begin in the fall.
9. What are the clients values and interests?
The client enjoys coaching lacrosse and has made it a main occupation that he engages in during his
spare time. He believes that everyone should be treated with respect and that everyone should be
given the benefit of the doubt. This phenomenon outlines his coaching philosophy and how he brings a
strong team together. He also believes in the Lord to give him strength and to make positive decisions
in life.
10. What are the clients daily life roles?
Much of the clients day is spent at work as an Account Executive at Hacker Agency in downtown
Seattle, Washington. This role includes managing client expectations, schedules and working in a
collaborative environment with his coworkers. He recently got engaged to his girlfriend in May of 2014
and is now currently fulfilling the role of a fianc as well. This includes showing that he cares about his
future wife through various emotional as well as physical acts.
11. What are the clients patterns of engagement in occupations?
A typical work day begins when the client wakes up around 5:45am, shaves and showers. He then
gets dressed in work appropriate attire (slacks, button down shirt, nice work shoes) and cooks breakfast
for himself. After cleaning up from breakfast, he packs a lunch for himself that he will eat at his office
around lunchtime. He packs everything in his backpack, locks up his house, and walks to the bus stop.
He brings his bicycle with him on the bus in the morning so he can ride it home in the evening after
work. The bus ride usually lasts around 15 minutes and then drops him off one block from his work. He
walks to his office from the bus stop, rides the elevator up to the 21st floor, and begins his work day. At
work he typically sits at a desk, answers multiple emails, talks on the phone to his clients, and attends
many meetings. He spends a lot of time typing on the computer sending emails or managing advertising
campaigns. After his work day is finished, he brings his bicycle to the elevator, rides the elevator back
down to the 1st floor, carries his bicycle outside, and rides it three miles home. He then cooks dinner for
himself, watches TV, and gets ready for bed.
When John has a day off from work, his routine is much different. He has more time to engage in
extracurricular activities such as getting together with friends to play basketball, throw the football, or
play lacrosse. Johns fianc is currently attending graduate school in Nevada. Due to this new change
his occupations have shifted slightly. He spends more time talking on the phone, traveling to Nevada,
and doing video calls through FaceTime.
12. What are the clients priorities and desired targeted outcomes related to occupational
performance?
The client is primarily concerned with maintaining his current level of health and well-being. He would
like to gain a better understanding of his body and how the actions he places upon it can directly affect
it. He hopes to learn and take away different skills from the occupational therapy session to improve his
overall occupational performance and engagement in lifes activities, primarily lacrosse. The client
would like to exhibit skills including endurance and fine motor skills. With a high level of endurance,
hand strength, and finger dexterity he hopes he will be able to play in an entire game of lacrosse.
Occupational Analysis
1. Occupation: Sending an email
Categorization of occupation for the client:
1. Activities of daily living
2. Instrumental activities of daily living
3. Education
4. Work
5. Play
6. Leisure
7. Social participation
Subcategory:
Communication management
Job performance
Supports
At the clients office, his desk
surface and cubicle area is large
enough for him to place all the
needed tools and materials he
will utilize throughout the work
day.
Inhibits
The clients desk is arranged in
an open floor plan near other
coworkers desks. By not having
a personally enclosed office, the
client may get distracted by
employees nearby. For
example, throughout the day,
his and his coworkers phones
Social
Cultural
Personal
Temporal
Virtual
Function
How It Is Used
Judgment
When sending an
email, the client
formed an opinion
about whether the
content in his email
was not offensive to
the receiver.
The client mentally
formed ideas or
thoughts when he
created the body of
his email.
When the client was
writing his email, he
had to remember
what he was going to
Concept formation
Metacognition
None
Minimally
Challenged
Greatly
Challenged
Cognitive flexibility
Insight/awareness
Concentration
Sustained attention
Selective attention
Divided attention
Short-term memory
X
After the client looked
up the email address
of who he was
sending a message to,
he was able to store
Working memory
Long-term memory
Sensory Memory
X
When appropriately
placing his fingers on
the keyboard, the
client felt where the
bumps were on the F
key and J key for
placement of his right
and left index finger.
The client looked at
the lap top screen
while typing the email
to make sure that
there were not
grammatical errors.
X
X
When typing an email,
the client utilized
visual as well as tactile
senses.
When the client was
typing his email, he
was watching the lap
top screen as each
word was typed, this
would tell him which
Spatial relationships
Temporal relationships
Recognition
Categorization
Generalization
Awareness of reality
Logical/coherent thought
Appropriateness of emotion
Coping
Behavioral regulation
Body image
Self-concept
to relay the
information correctly.
When explaining the
changes made to the
advertisement in his
email, the client had
to explain in
reasonable words
what those changes
were.
When the client wrote
his email he was
thinking about the
information he
needed to share with
his client about the
changes to the
advertising campaign.
Throughout the
process of writing the
email, the client
mentally planned the
order of keys to push.
The client did not
agree with one of the
changes that the
creative team made
to the advertising
campaign and he
controlled his
emotions when
sending an email
pertaining to the
changes.
When the client sent
an email, he displayed
appropriate emotions
by not becoming
frustrated or angry in
the process.
When the client made
a typing error he went
back to the error,
fixed it, and moved
onto the next word.
X
X
The client knew his
role and job position
Self-esteem
Arousal
Consciousness
Orientation to self
Orientation to place
Orientation to time
Orientation to others
Energy level
when sending an
email to the email
recipient.
When the client sent
an email he displayed
confidence in the
information being
sent.
When typing on the
keyboard, the client
was fast and quick to
react. This utilized his
reflex reaction and
allowed him to type
quickly while at the
same time looking at
the screen and
viewing any errors
that arose.
The client was awake
when he typed an
email.
The client was aware
of his job title and
roles when he was
sending an email to
one of his work
clients.
The client knew that
he was in his office
and in a working
environment when he
sent an email.
When the client sent
an email, he was
aware of what day it
was and when he
should respond to the
email.
The client was aware
of who the email
receiver was.
The client had enough
energy to finish
writing an entire
email.
Function
How It Is Used
Motivation
None
Minimally
Challenged
Greatly
Challenged
Impulse control
Appetite
Sleep
Detection/registration
Visual modulation
Integration of senses
Awareness at distances
Tolerance of ambient sounds
X
X
X
The client ignored
noises from the
surrounding
coworkers when he
was sending his email.
X
X
X
X
When the client was
typing his email, he
was aware of the
position of his hands
Localizing pain
Thermal awareness
Joint mobility
Joint stability/alignment
Muscle power
Muscle tone
Muscle endurance
Stretch reflex
ATNR
STNR
Righting and supporting reflex
Eye-hand coordination
in in accordance to
the keyboard.
The client was able to
tolerate the feeling of
the keys on the
keyboard when
typing.
X
X
When typing the
client was able to
move his fingers at
the
metacarpophalangeal
joints, interphalangeal
joints, and distal
phalangeal joints.
When the client was
typing his email, his
elbow joint was flexed
to approximately 90
degrees to allow for
effective typing.
The client used the
muscle strength of all
of his digits and wrist
when typing on the
keyboard.
The client displayed
normal muscle tone in
his upper extremities
and hands to
adequately type on
the keyboard.
The client maintained
muscle endurance of
his upper extremities
and trunk throughout
the entire length of
typing an email.
X
X
X
X
The client viewed the
words being typed on
the lap top screen as
he typed the keys on
the keyboard.
Bilateral coordination
Crossing midline
Fine motor control
Oculomotor control
Gait patterns
Blood pressure
Heart rate
Respiratory rate
Respiratory rhythm
Respiratory depth
X
The client used the
smaller muscles of the
fingers and hands
when he typed on the
keyboard.
The client used gross
motor control when
he gripped each side
of the office chair and
scooted it forward
toward the office
desk.
The client watched
the letters on the lap
top screen appear as
he typed on the
keyboard. He
followed the
progressive
movement of the
letters form words as
he typed the email.
The client used slight
gait patterns as he
stepped toward the
desk to pull the office
chair closer.
X
X
The client had a
normal respiratory
rate when typing his
email.
The client had a
normal respiratory
rhythm when typing
his email.
The clients
respiratory depth was
normal when writing
an email.
X
X
X
Alternative vocalization
Digestive system
Metabolic system
Endocrine system
X
X
X
x
Function
How It Is Used
Urinary functions
None
Minimally
Challenged
Greatly
Challenged
X
When the client was
typing, his skin
protected him from
any injury from
occurring to his
fingers or hands.
Not used
Minimally
challenged
X
X
X
X
X
X
Greatly challenged
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Skill- Motor
How It Is Used
Aligns
Stabilizes
Positions
Reaches
Bends
Grips
Manipulates
None
Minimally
Challenged
Greatly
Challenged
Coordinates
Moves
Lifts
Walks
Transports
Calibrates
Flows
Endures
Paces
typing quickly on
the keyboard.
The client used
both his right and
left hand on the
bottom and top of
the closed lap top
to open it.
The client pulled
the office chair
along the floor
when he was
moving the chair in
closer to the desk.
The client lifted the
lap top screen with
his left hand from a
closed to an open
position.
When the client
moved his chair in
closer to his office
desk, he took a few
steps forward
towards his desk.
X
The client used an
appropriate
amount of force
and speed when
pushing down the
various keys while
typing his email.
The client used
smooth finger and
hand movements
as he typed on the
keyboard.
The client
continued typing
the email until he
was finished with
the content and
the email was sent
to the email
receiver.
As the client typed
his email, he
maintained a
consistent speed
throughout the
entire activity of
writing the email.
Skill- Process
How It Is Used
Paces
Attends
Heeds
Chooses
Uses
Handles
Inquires
Initiates
None
Minimally
Challenged
X
After the client
opened his lap top,
he brought his
index finger to the
mouse pad directly
Greatly
Challenged
Continues
Sequences
Terminates
Searches/locates
Gathers
Organizes
X
The client
positioned his lap
top in the center of
his desk which
allowed for 90
Restores
Navigates
Notices/responds
Adjusts
Accommodates
degree flexion of
his elbow joint
during typing.
The client put his
lap top in sleep
mode and closed it
after completion of
writing his email.
When the client
pulled his office
chair closer to his
desk, he did so
without bumping
his arms or legs
into any objects
near him.
When the client sat
down in his office
chair, he noticed
that due to the
placement of his
chair, his upper
extremities were
too far from his
keyboard for
accurate typing.
He responded by
gripping each side
of his chair and
pulling it closer
toward his desk.
The client pushed
on the handle
located on the
bottom of his
office chair to
adjust the height
of the chair to a
higher level.
The client sat with
an upright posture
and a slight
anterior pelvic tilt.
This prevented
incorrect body
mechanics that
could possibly lead
to pain or injury of
the trunk or upper
Benefits
Approaches/starts
Produces speech
Gesticulates
Speaks fluently
Turns Toward
Looks
Places self
Touches
Regulates
Questions
Replies
Discloses
Expresses emotion
Disagrees
Thanks
Transitions
Times response
Times duration
Takes turns
Matches language
Clarifies
Acknowledges and encourages
Empathizes
Heeds
Accommodates
Benefits
extremity joint or
muscles.
When the client
first began writing
his email, he was
typing fast and
many spelling
errors were arising
that he had to go
back to and fix. He
slowed down his
typing pace in
order to prevent
multiple spelling
errors to keep
arising throughout
the remainder of
the email.
How It Is Used
None
Minimally
Challenged
Greatly
Challenged
9. Performance patterns:
Parts of this occupation has elements of which of the following: (check all that apply)
Pattern
Useful habit
Dominating habit
Routine
Ritual
Role
Describe
Every night before bed the client places his building key, work badge, and
work lap top in the same location of his house. This is a useful habit in
that it prepares the client for success for the following day. By placing his
lap top in a useful place, it ensures the client that he will not forget it the
next morning for work and will be able to engage in the many demands
placed upon him in a work day including writing and sending emails.
N/A
The client has a routine of waking up early in the morning to prepare for
his work day. He is usually the first to arrive in the morning of his work
place (Hacker Agency). By doing so, he has time to fully prepare for
various meetings assigned to him throughout the work day and reply to
any emails he received while not at work.
The client ends each email with a closing statement thanking the email
receiver for taking time to read the email content.
As an Account Executive, the client is required to either call or email back
his clients in a timely manner, generally within the hour of receiving the
phone call or email. He is also in concerned with the satisfaction of his
clients as well as other coworkers.
Intervention Plan
1. Identify 1 objective and measurable goal of the intervention:
Throughout the lacrosse season, the client will independently maintain an exercise routine
aimed at strengthening the muscles surrounding the knee joint, specifically the quadriceps and
hamstrings, to prevent injuries as he begins to play lacrosse again.
a. According to OTPF what type of outcome is this?
This goal is a participation outcome. The client will be enhancing his competence of proper
body alignment to allow for future engagement in the sport of lacrosse.
2. Intervention approach:
Approach
Create/promote
Describe
Establish/restore
The client has had four knee surgeries in the past that prevented him
from further engagement in playing lacrosse. This intervention will
restore his past skill of playing lacrosse in a safe, healthy manner.
Maintain
Modify
Prevent
3. Activity selection
a. Activity selection: Identify 1 example of each for the intervention plan
Activity
Occupation
Activity
Preparatory method
Preparatory task
Describe
The client will play an entire lacrosse game at least once a week.
The client will participate in three lacrosse practices a week to prepare him
for engagement in an entire lacrosse game.
The client will become educated on the different types of knee braces and
find which one works best for him. By wearing knee braces on both knees,
the client can keep his body safe from further injuries occurring.
The client plays an attacker position in lacrosse where he takes many shots
at the goal throughout the game. The client will take part in shooting drills
in front of a lacrosse goal.
b. Discuss how activity selection relates back to occupational profile and occupational
analysis
The client explained during his interview that he has had four previous knee
injuries due to his engagement in lacrosse. He is still extremely passionate about the
sport and is no longer able to participate in playing due to these injuries. The activities
selected will teach him proper body alignment and enhancement of fine motor skills
which will decrease the chance of further injury. By doing various shooting drills with
the occupational therapist, the client will be improving muscle endurance, fine motor
skills, and joint mobility while manipulating the lacrosse stick. Most importantly, these
activities will help the client get back into playing the game rather than solely coaching
on the side line.
During the occupational analysis of typing an email, the client was educated on
proper body alignment when he is working in the office. He learned how to properly
position his lower extremities, trunk, and upper extremities for efficient performance
when sitting at his desk writing an email. It was observed that the client exhibits great
bilateral coordination, eye hand coordination, muscle endurance, and fine motor
control. All of which are skills that can be translated to the lacrosse playing field and
enhance the clients level of success during engagement in this occupation. These
learned skills will translate to the lacrosse field and play a role in keeping his body safe.
c. Discuss how activity selection will support achievement of client identified goals and
goal of the intervention plan
The goal of the intervention plan is that throughout the lacrosse season, the client will
maintain an exercise routine aimed at strengthening the muscles surrounding the knee
joint, specifically the quadriceps and hamstrings, to prevent injuries as he begins to play
lacrosse again. The activities that are selected throughout the intervention plan will not
only educate the client on how to avoid a further knee injury, but will also enhance the
clients endurance level and fine motor control while manipulating the lacrosse stick.
Educating the client on knee safety through shooting goals with the occupational
therapist will also be working on boosting the clients endurance level and increasing
fine motor control of the fingers and hand at the same time.
4. Describe how intervention can be graded or adapted and why
Grade up The intervention can be graded up by having the client engage in more than three
lacrosse practices and more than one lacrosse game each week.
Grade down The sport of lacrosse is an open task and requires the client to quickly respond to
changes in the environment. Instead of having the client participate in a game with multiple
players, the client could practice with just one other person and pass the lacrosse ball directly back
and forth.
Adaption If the client had weakened grip strength at the beginning of the intervention, the
lacrosse stick could be adapted by widening the stick handle.
5. Discuss any safety concerns and/or precautions
Lacrosse is an extremely physical sport and produces numerous injuries every season. Depending
on the position that an individual plays, different injuries are of higher concern. The client played an
attacker position where a lot of cutting and dodging occurs and produces ankle and knee sprains
often. Other common injuries include concussions, bruises, and rib fractures.
6. Discuss the role of the occupational therapy practitioner during the intervention
The occupational therapy practitioner will educate and guide the client on things that he can do to
avoid any future knee injuries when engaging in lacrosse.
7. Discuss what is expected of the client during the intervention
The client is expected to be self-motivated and actively participate in the activities that were created
by the occupational therapy practitioner. Through completion and engagement of the shooting
goals activity, the client will be able to attain the intervention goal of engaging in an entire lacrosse
game set by the practitioner.