Overview of Occupational Therapy Assessment and Intervention in Cerebral Palsy

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Introduction[edit | edit source]

Occupational therapy enables people to participate in activities of everyday life. The occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want, need, or are expected to do by modifying the occupation or the environment to better support their occupational engagement.[1]Paediatric occupational therapy programs that are family-centered, meet children’s needs, and focus on structured play and recreation enhance the development of children with cerebral palsy (CP) and can be delivered in hospitals, clinics,rehabilitation and daycare centres, home care programmes, special schools, community centres or private entreprises.[2] [1] Occupational therapy for client's with cerebral palsy addresses problems related to movement disorders, but also life long issues that include cognitive dysfunction and behavioural or emotional problems.[3]This article provides an overview of the occupational therapy interventions appropriate for children with cerebral palsy.

Assessment[edit | edit source]

The occupational therapist can choose one from several client and family-centred models as a framework for the assessment and treatment when providing service to children with cerebral palsy. These models are:[4]

    1. The Person-Environment-Occupation-Performance Model –it's main components are complex interactions between the person and the environment.
    2. The Person-Environment-Occupation Model- focusing on "occupational performance and its link to people, occupation, roles, the environment, work, and play as a dynamic, interwoven process".[4]
    3. Occupational Adaptation Model-identifying occupations to allow the client to experience adaptation.
    4. The Model of Human Occupation-assisting with habits and roles that guide a person’s occupational choices.
    5. The Kawa Model- trying to enable, assist, restore and maximise clients’ life experiences.

Individual Evaluation[edit | edit source]

" The evaluation process is focused on finding out what the client wants and needs to do, how to determine what the client can do and has done, and also identify supports and barriers to participation in everyday life."[1]--Teona Darchia

Client's Occupational Profile[edit | edit source]

The occupational profile includes the following:

  • Occupational history
  • Experience
  • Information about his daily living
  • Interests
  • Values
  • Contexts

Occupational Performance Analysis[edit | edit source]

  • Occupational performance is an interaction and interdependence of a person, environment, and occupation components
  • Include daily activities, work, productive activities, and play or leisure activities.

Observation and analysis of the client's performance in specific occupations and evaluation of specific aspects can be used to assess occupational performance.[1]

Synthesis of the Evaluation[edit | edit source]

  • Helps to establish goals, intervention plans, and desired outcomes

Intervention Planning[edit | edit source]

Intervention planning is conducted in collaboration with client, their family members, or other professionals and include the following three steps:

  1. Intervention plan
  2. Intervention implementation
  3. Intervention review

Intervention can be direct or indirect and must consider the following two elements:

  • Environment
  • Person's participation in everyday activities

General rules for applying an intervention:

  • Use simple and clear verbal instructions
  • Show the person what you are asking him to do
  • Carry out activities together and if necessary, use the hand-in-hand technique, which involves performing actions together, holding hands, and helping physically
  • Give the person enough time to complete the activity
  • Provide only as much help as the person needs
  • Do not do part of the activities or tasks for the person if they cannot do it
  • Use only handling strategies that do not have a negative effect on the person's muscle tone
  • Choose assistive technologies that can increase client's participation in daily activities

Outcome Evaluation[edit | edit source]

Resources[edit | edit source]

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or

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References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 Darchia T. Cerebral Palsy OT Assessment and Intervention. Plus course 2024
  2. ↑ McCoy SW, Palisano R, Avery L, Jeffries L, Laforme Fiss A, Chiarello L, Hanna S. Physical, occupational, and speech therapy for children with cerebral palsy. Dev Med Child Neurol. 2020 Jan;62(1):140-146.
  3. ↑ Vitrikas K, Dalton H, Breish D. Cerebral palsy: an overview. American family physician. 2020 Feb 15;101(4):213-20.
  4. ↑ 4.0 4.1 Rehabilitation Guideline for the Management of Children with Cerebral Palsy (2018). Available from https://pdf.usaid.gov/pdf_docs/PA00TTGF.pdf [last access 11.03. 2024]
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