0-6
(N/A)
(7-10)
Type of media. Include some of the history of the media in OT. ________ X 0.05=
Special consideration to ensure safety of the activity. In addition specify any reason for which you would not use this activity for a patient. ________ X 0.05=
This includes anything the therapists need to do before the patient is in. ________ X 0.05=
Tools, materials and equipment. Include inherent properties of objects, if applicable, such as heavy, sharp, caustic, loud, etc. ________ X 0.05=
Space demands: Physical environment requirements of the activity. ________ X 0.05=
Social Demands: Rules, expectations, and others ______ X 0.05=
List of all steps to do the activity and how much time each step takes. If there are any special considerations regarding how to do a step to be successful they need to be explained. ________ X 0.1=
Actions and performance skills required (as per OTPF 2nd ed). Required skills to perform this activity and why. (It helps it you include the step (s) in which they are needed. Do they have to be WNL’s or can they be somewhat impaired or absent altogether? REMEMBER, SOME DEFICITS WILL BE PRESENT, IF NOT WHY ARE YOU USING THIS ACTIVITY IN THERAPY? ________ X 0.15=
required (as per OTPF 2nd edition). This is briefly. What are the required body functions to perform this activity and why are they required (It helps it you include the step (s) in which they are needed. Do they have to be WNL’s or can they be somewhat impaired or absent altogether? REMEMBER, SOME DEFICITS WILL BE PRESENT, IF NOT WHY ARE YOU USING THIS ACTIVITY IN THERAPY? ________ X 0.15=
Aspectsof the activity that can affect the values, beliefs, and spirituality of the client. _______ X 0.05
How could you adapt and grade the activity ________ X 0.10=
Check what is appropriate for Populations, Skills, and Performance Areas ________ X 0.05=
Complete all pertinent client information _________ X 0.05=
Goals need to be related to the patient's interests and problems areas