1

What Is Activity Ana1y~’~ LYaLP

o e~
o

OsiEcTivEs List the steps included in the activity analysis

process.
The ability to analyze activities and the occupa
o Define activity analysis.
tions in which people engage is fundamental to the
o Describe the difference between occupation-based
practice of OT. Activity analysis is part of the OT
activity analysis and activity analysis. process, allowing practitioners to understand and
7 e Identify the current definitions of occupations.
address the skills and externa! components needed for

‘fr,
1%
• Distinguish between occupations, activities, and the performance of any given activity. Activity analy
tasks. sis is defined as the process used by OT practitioners

1a o Identify why occupational therapy (OT) practi that “addresses the typical demands of an activity, the
tioners utilize occupations and the goals of inter range of skills involved in its performance, and the
vention, as well as the method by which they can various cultural rneanings that might be ascribed to
reach those goals. it” (Crepeau, Cohn, & Boyt Schell, 2003, p. 192). The
• Describe how activity analysis is utilized by OT process of analyzing activities allows the practitioner
practitioners. to understand the demands placed on the person who
engages in the activity. A thorough activity analysis
e Explain how the Occupational Therapy Pi-a ctice
will allow for an understanding of the tools and equip
Framewo,* 3rd Edit ion. (the Pranzework) is uti
ment needed; where and with whom the activity takes
>~
lized as a basis for understanding activity analysis.
place; the sequence of steps and timing of those steps;
o Understand how the International Class€fication
and the body functions, performance skills, and body
of Functioning, Disability, and Healtli and the
structures required to perform the activity. Thus, OT
‘as World Health Organization (WHO) influence the
y professionals learn how to look not only at activities
a Franiework.
as a whole, but also at their component parts and

a; Thomas II,
—1 Occispation—Bascd.4ctsvüy~1nz/v,uSccasdEdi,ç,n (pp 1—11).
© 2015 SLACK Incorporated.

a’
a
 2 Chapter 1

how internal and external contexts contribute to the analysis as a fundamental cornponent of practice. The
activities. OT perspective looks not oniy at how an activity might
Activity analysis has its roots at the very beginnings be typically done, but also at how it is done and expe
of our profession. As eariy as 1917, activity analysis, rienced by an individual, examining the internal and
or moflan study, was introduced to OT practitioners. external influences on performance and the meaning
Principies guiding how to conduct these analyses carried behind the activity. The Framework describes
were created and pubiished by engineers, establishing two types of activity analysis: (1) activity analysis
rnethods whereby to study the movernents of workers that looks at the typical demands of an activity and
on the job (Giibreth, 1911; Taylor, 1911). Foilowing this, (2) occupation-based activity analysis, which “takes
OT professionals began using these principies to find into account the particular person’s interests, goals,
“what motions are possible or irnpossible, desirable, abilities, and contexts, as weil as the demands of the
or undesirable; then he finds sorne occupation which activity itself” (Crepeau, 2003, p. 192). To get a basic
involves those possibie and desired motions” (Newton, understanding of the demands of an activity, without
1919, pp. 4-5). Other professions—such as physical a particular person in mmd, you would conduct an
therapy, speech therapy, and engineering—have used activity analysis. If you were analyzing the activity of
these principies in their fields of practice as weli. a specific person, you would conduct an occupation
While analyzing activities may be part of the based activity analysis. Both types of activity analyses
dornain of other professions, for OT practitioners it are used throughout the process of OT.
is essentiai to the process of OT. The. process of OT To further clarify the difference between an activ
inciudes evaluation, intervention, and outcomes. Dur ity analysis and an occupation-based activity analysis,
ing each of these steps, activity analysis is part of the let’s take a look at the activity of making a peanut
process. During the evaluation, the OT practitioner butter and jelly sandwich. We can determine how
must deterrnine the discrepancy between what the cli much range of motion and strength it takes and how
ent needs or want to do and his or her performance. much sensory information is required to perform the
An OT evaluation begins with an occupational pro activity as it might typically be done. Howeve~ let’s
file, which is an interview with the client. During say we go to Lisa’s house and anaiyze how she makes
this interview, the OT gets a fuller picture of what a peanut butter and jeliy sandwich for her daughtet
occupations the client is struggling with, the rneaning The demands of the activity are very different. Her
behind those occupations, and iii which contexts those cupboards have child locks on them, which require the
occupations occur. This will lead to a list of occupa use of both hands to open them. The peanut butter she
tions, each of which will need to be analyzed by the uses for her daughter is extra chunky aM is very thick
OTto determine the demands of the occupations. The (thus much more difficult to scoop out). Her daughter
OT wili then evaluate the client’s performance and use may be placing extrasensory and attention demands
selected assessrnents to identify and measure specific on her (as a 3-year-old often would), Thus, an analysis
client factors, skills, or environrnents. Comparing the of the activity demands of Lisa making a peanut butter
demands of the occupation with client performance and jelly sandwich might be better understood as an
and environment ailows the OT to identify needs. occupation-based activitv analysis (Figure 1-1).
Occupation or activity analysis is an evaluation of
the dernands of the activity, not an evaluation of the
client.
THE AcTIvITY ANALY5I5 PRocEss
1. Actii’ity alvarencss: The first Dar: of activitv analy—
TYPE5 OF ANALYSE5 sis is to establish what vou are :rulv analyzing.
Often, activities overlap or Secome ennieshed in
An activity or occupation-based analysis can be other occupations. Separaze:he acz:vizies into sep
conducted for an individual, a group of individuals arate and unique act:v:::es ;v}. en nossihle. From
(such as a farnily or group of students), or popula this, you ~vill he ahle te ¿e:er~:ne which area of
tions (groups of people iiving in a specific areas or occupation the act:vi: y :es :r~ :r~nne vou a fuller
people who share similar concerns or backgrounds). picture of xvhat ís :nc~fef :~:s activity and
We have a unique and holistic perspective to activity those surrounding :t.
 1vVlzat Is Actii’ity Analysis? ~
2. You then need to decide what type of analvsis you
will be conducting. There are essentiallv two types
of activity analysis: (a) occupation-based activity
analysis, which is based on a particular client and
how he or she engages in the occupation in bis or
her contexts, and (b) activity analysis of how the
activity is typically done, with no particular client
in mmd. Ifyou are conducting an activity analysis
for a client, you will conduct an occupation-based
activity analysis; otherwise you will conduct a
standard activity analysis. Using either rnethod,
the activity or occupation being analyzed must be
clearly identified, with specifics that clarify how,
where, or in what manner an activity takes place.
For instance: “Making a cheese and onion omelet Figure 1-1. Lisa making a sandwich asan occupation.
frorn scratch.” For occupation-based activity anal
ysis, this step in the process includes gathering
further information about the activity and its rel which an occupation takes place rnay be a barrier
evance and importance to theclient. This step is to a client’s performance. It is in understanding
described in full detail in Chapter 3. the physical environment in which an activity
takes place that we can view how external forces
3. Determining dic relevance and importance to dic
play a role in occupational perforrnance. This is
client: This step is included only mf you are con
also described in Chapter 5.
ducting an occupation-based activity analysis.
It requires the practitioner to delve into clients’ 7 Deterrnining social dc,nands: Justas space demands
understanding and defmnition of their occupations can be an external influence on perforrnance, so
as well as the importance that these occupations too can social dernands. Social demands of sorne
have. Gathering this information is the key to suc activities are a necessary part of engaging in an
cessful analysis and the completion of subsequent activity (such as taking turns in a garne). How
steps. The ways of collecting this information are ever, in sorne occupations, the social dernands
presented in Chapter 3. rnay challenge the client to a greater extent than
he or she is able to rnanage (e.g., expectations
4. Ident~fying dic steps required: This is where you
frorn others to work 16-hour days). The process of
break down the activity into the specific steps and
deterrnining the social dernands of an activity is
the sequence and timing of each step. By listing
described in Chapter 5.
the steps required by the activity, the practitioner
is able to identify the dernands of the activity. This 8. Detennining required body functions: This step
process is explained in detail in Chapter 4. in the analysis process is often seen as the rnost
detailed and extensive. Many of the concepts par
5. Determining dic objccts and properties: Consider
allel those used in other professions. However, the
ing each of the steps of the activity, specific tools,
OT activity analysis process goes further. Body
supplies, and equiprnent rnay be needed. Identify
functions are those “physiological functions of
ing the needed objects allows the practitioner to
body systems” (WHO, 2001, p. 10) that include
understand what rnust be manipulated or interact
not just physical functions such as strength and
ed with and how. An understanding of the objects
rnobility of joints, but also sensory, cognitive, and
and their properties rnay also lead the practitioner
emotional functions. Deterrnining the body func
to understand deficits in perforrnance. This is
tions required of an activity provides informa
described in Chapter 5.
tion regarding what is dernanded of the client in
6. Detennining dic space denzands: The physical
regard to engagernent in the ocdupation or activ
environment in which an activity or occupation
ity. The body functions are described in detail in
take place can have a great irnpact on performance.
Chapter 6.
Sorne activities require specific space, noise con
9. Determining required body structures: Most activi
trol, and lighting in order to be engaged in. There
ties require the presence of certamn body structures.
n~ay be tin~es when the phvsical environrnent in
 Ckr~er

TABLE 1-1
CASE ExAMPLE: TRAvIS
7: Define te activity: What are we going to analyze? What meaning hes behind the activties
and what defines success? Decide on how you would divide the parts of bis job so that you could
ana~yze them accurately (see Chapter 2).
Srep Z List te steps of the activity: Write out the steps Travis must follow in order ro successfully
complete each activity or task. You may have several lists, one for each activity (see Chapter 3).
Srep 3: Define the objects, properties, space, and social demands: What are te objects, materials,
and equipment tat Travis must use (see Chapter 4)?
Srep 4: Define the space demands: What are te environmental requirements for the activity to be
performed successfully (see Chapter 5)?
Step 5’ Define the social demands: What are the social rules or expectations of the activity (see
Chapter 5)?
Step 6: Define te required body functions: What mental, physical, neurological, and other body
functions are utilized and challenged during te activities that Travis must perform (see Chapter 5)?
Step 7 List the required body strudures: What parts of the body are required to complete the
activities (see Chapter 6)?
Step 8’ Define the performance skills: What motoç praxis, sensory emotional, cognitive, and
communication/social skill levels are needed to complete the activities (see Chapter 7)?

Body structures are “anatomical parts of the body of machinery and lost consciousness. He works at a
such as organs, limbs, and their components”
factory tbat malces and packages potato chips. Tra
(WHO, 2001, p.lO). In the activityanalysis process,
vis works on an assembly line, putting small bags of
we look at which body structures are required for
potato chips into variety-pack boxes. He has come to
the activity beyond what is required for sustaining
OT to receive a return-to-work assessment. To do this,
life. This is described further in Chapter Z
we ~vill use our activity analysis skills. Because this is
10. Deterinining required perforniance skills: Perfor an activity analysis for a specific client, we will be con
mance skills are actions that te client dernon ducting an occupation-based activity analysis.
strates. Deterrnining the level of specific skills To begin the analysis, we intervjew Travis and he
required allows the practitioner to better under telis us about bis job and what bis job entails. XVe
stand what is expected frorn the client for suc then separate the different activities that he described,
cessful engagernent. The performance skills are which are part of his job. During the interviex~ Travis
explained in detail in Chapter 8. defines each activfty, delineating what success rneans
11. Analyzingfor the;’apeutic intervention: This is the in each. X’Ve begin with one activit); listing each step.
step of the process in which the practitioner evalu The next step is to evaluate what obiects are needed
ates an activity as well as the needs of the client so and the properties of each of these obiects, Next, we
as to find possible outcomes. An activity can also look at the space and social dernands that Travis has
be analyzed in order to find ways to adapt or grade in the work setting for the activitv. ~Ve ten analyze
the activity to either decrease or increase the chal what body functions and structures are needed for
lenge for the client. This is be explained in detail hirn to do the activity. The final step requires that we
in Chapter 9. identify which performance skills are required and to
To better understand how this process works, let’s what extent,
take a look at a real case example (Table 1-1). Travis Once the activity analysis is complete, a full evalu
is a 31-year-old male who was injured on the job ation of Travis’ performance and ahilities ~vill need to
2 months earlier when he bit bis head on a large piece be conducted.
 V’/hat Is Activi(y Analysis? s
After these steps, you will be able to develop an
intervention pian and make recommendations for Box 1-1
adaptations that ~vi1l hopefully aiiow Travis to return The term occupation is not used to describe our
to work. profession in some countries, where terms that stem
from the ideas of ergonomics or recovery are used.
The following are a few examples of what occupa
WHAT ARE OccuPATJoNs tional therapy is called in other countries:
Austria: Ergotherapie
VERsus AcTIvmEs? Belgium: L’ergothérapeute
Finland: Toimintaterapia
The term occupatian can often be misunderstood India: Ergornedicine
and may be misleading. If you were to asic someone Malaysia: Pernulihan Cara Kerja
off the street, perhaps someone without a medical Sweden: Arbeitsterapeuter
background, what his or her occupation was, he or
she wouid probably begin to teil you about the jobs Adapted frorn World Federation of Occupational Thei’apy. (2009-
2010). Definitions of occupational therapy from meinher countries,
he or she has had in the past. As a student, you may draft 9. Retrieved from http://www.wfot.org/resourceccntreaspx
have aiready had the experience of trying to teli family
members and friends what you will be studying and
that “No, it’s not about heiping people get jobs.” Mci
riani-Webstcr~s Collegiate Dictionary (2012) defines rest. It refers to ah aspects of actual human
occupation in several ways: doing, being, becoming, and belonging. The
1. An activity in which one engages practicai, everyday medium of self-expression
or of making or experiencing meaning, occu
2. The principie business of one’s life: vocation
pation is the activist element of human exis
3. The possession, use, or settlement of land: tence whether occupations are contemplative,
occupancy reflective, and meditative or action based.
4. The hoiding and control of an area by a foreign (\~Tjlcock & Townsend, 2014, p. 542)
rnilitary force
Activities of everyday life, named,
...

Thus, it is understandable that when people hear organized, and given value and meaning
the term occupation in respect to therapy, numerous by individuals and a culture. Occupation is
configurations of this profession may come to mmd. everything people do to occupy themselves,
This also explains why sorne countries use a term inciuding looking after themselves enjoy ...

other than occupation to describe our profession (Box ing life,.. and contributing to the social and
1-1). However, medical dictionarjes define the term economic fabric of their communities. (La~
occupation in a much broader, yet personal, wa)ç In Polatajko, Baptiste, & Townsend, 1997, p. 32)
Taber~s Cyclopedic Medical Dictionary, ‘lenes (2001)
Goal-directed pursuits that typically extend
defines occupation as foHows:
over time, have meaning to the performance,
1. Any goal-directed pursuit in which one works for
and involve multiple tasks. (Christiansen
a wage, salary, or other income et al., 2005, p. 548)
2. Any goal-directed use of time
The things that people do that occupy their
3. Any activity or pursuit in which one is engaged time and attention; meaningful, purposeful
outside of one’s work activity; the personal activities that individu
The second and third definitions listed better match als chose or need to engage in and the ways
how health care professionais, inciuding OT profes in which each individual actually experiences
sionais, understand the term. Scholars of OT have them. (Boyt Schell, GuIen, & Scaffa, 2014, p.
defined occupation in severai ways: 1237)
Occupation is used to mean aH the things Given these definitions, occupations are more than
peopie want, need, or have to do, whether of just activities;~ they are the activities that give our
physical, mental, social, sexual, political, or hves meaning. Many articles have been written and
spiritual nature and is inclusive of sieep and discussjons conducted on the differences between
6 Chapter 1

AcTIvITY 1-1
Take a second to think about the occupations in which you engage. List a few of thern below. Then ask
yourself: Has each one met the four criteria of an occupation as described by Carison and Clark?

INTENTIONAL
OCCUPATION START AND END AND REPEATABLE MEANINGFUL LABELED BY CULTURE

occupations, activities, and tasks (Gray~ 1998; Nelson, Occupations are intentionally executed and
1988; Pierce, 2001; Trombly, 1995). Many authors agree repeatable, such that something that is out
that occupations comprise a greater, more personal side of the person’s control of repeating, such
jzed definition of activities, within which srnaller tasks as an illness or accident, are not considered
lic (Law et al., 1997; Trombly, 1995). The Frarnework occupations.
identifies occupations as including multiple activi Occupations are meaningful to the person
ties. Occupations occur within the context of a person and bring meaning to who they are as a per
or group, having unique purpose and meaning to son. This meaning may be fairiy insignificant,
the person engaging in a given occupation. Contexts or even unheaithy (smoking, for example~,
include the physical environment, the tools and mate yet they stiil piay a part in the meaning of the
rials that the person uses, and the social complexities person’s life.
and demands of the occupation. Thus, occupations
Occupations are labeled by our culture.
are “personalized” activities—those that hold personal
New occupations are created every da)~ and
meaning and requirements for a particular person or
the occupations people engage in change over
group. An occupation is much more complex than an
time.
activit)~
To give further clarity to the domain of our practice The profession of OT views occupations not only
of occupations, Larson, Wood, and Clark (2003) have as the ends of our interventions, but also as the means
delineated how occupations differ from activities: by which ~ve reach those goals. Thus, it is important to
understand the depth of how much more occupation
There are definitive start and end points. The
means vs activity (Activity 1-1).
participant can choose to begin and to end.

Activity: Making a peanut butter and jeiiy WHY OccuPATIoNs?

sandwich.
Wc now understand that our goal is to be able to
Occupation: Lisa making a peanut butter and analyze the activities that hring meaning to our cli
jelly sandwich for her daughter at home. ents’ lives—which we cali occuDa:ions. Bm why do we
need to analyze these occupa:~o~s? ~Ve use occupa
Tasks: Taking a plate out of the cupboard, get tions (and activities)’ ¡mt oni’. as o~r goais. but also as
ting the peanut butter out of the refrigerator, etc. the means by which “-e mee: :hose zoais; thus, occupa
tions and activities are our t~cs No other profession
 What Ls Activity Analysis? ~

Figure 1-3. Occupations encourage greater and origer engagement,

can claim to use occupations as a therapeutic modal • Engaging in a meaningful activity will often help
ity, as we do. We use occupations or rneaningful the client go farther and longer toward a goal than
activities as interventions because we understancl the other methods. If the attention is on the goal or
greater benefit of using activities that are meaningful the enjoyment of the process, then the client rnay
versus other techniques or approaches, The benefits becorne “engaged” and lost in participating in the
or rewards are often hidden behind the “norrnalcy” of activity. For example, when 1 go to the gym, 1 wilI
everyday activities. The following are just sorne of the often try to ride the stationary bike. In the coid,
many benefits of using occupations as the center of our boring gym, 1 can usually last about 15 minutes
interventjons; before calling it quits. However, if 1 get on rny
o Engaging in occupations allows clients to achieve
bike at home and ride around the neighborhood,
rnastery in the environrnent. It allows thern to feel 1 can ride for hours. Why? The bike ride around
that they have sorne sense of control. Por example, my neighborhood is a more meaningful activity
if our client Kay does overbead reaching exer to me (Figure 1-3). ‘tOccupations eflcouragegreater
cises using a dowel, she rnay build up her shoulder and longer engagelnent.” 1 get lost and occupied in
strength to eventually reach into her cupboards. the surroundings and variety. While both are very
However, ifyou have her actually move cups frorn similar and provide the sarne physical challenges,
a lower position, up into cupboards, she will not one will end up with a greater result, simply
only build up shoulder strength, but also learn because it is able to get me “engaged” in it.
strategies for how she can continue to do this at • Occupations allow for greater transference toward
horne, thus gaining a sense of mastery over being the client’s goals. Intervention that engages the
able to utilize her kitchen again (Figure 1-2). client in occupations or parts of the greater occu
o Engaging in occupations often results in sorne pation ensures that the intervention time will lead
thing that the client can either see or feel. The to application toward the goal. For example, let’s
result may be a tangible object (although many say you have your client Lance spend a lot of time
times it is not) or the result may be something the in therapy picking up beans and putting them
client can feel. Using the example of putting cups in a cup. However, when it comes time for Lance
away in the cupboard, Kay can see the results of to be able to pick up and take his own medica
her efforts; the cups are put away in the cupboard tions, there is no guarantee that the time picking
and she feels a sense of accomplishment. Par up beans will have helped. This is often termed
ticipating in an occupation can result in a sense of generalization. Can clients generalize what you
accomplishment. are doing with them or during therapy to the real
world? For many clients with cognitive deficits,
 zhis is very difficult. Thus, using activities that document, the OT process is described as involving
are closer to the clients’ desired occupations helps evaluation, intervention, and outcomes (AOTA, 2014).
to ensure that they will be able to apply what they The abihity to examine and analyze the activities that
have learned or gained to their own lives. are important to the client is essential in alI steps,
Engaging in occupations requires a coordina especially in evaluation and intervention. The analysis
tion of different skills and body systems. To help of activities becomes instinctjve and second nature to
clarify this point, let’s take another look at Kay’s seasoned practitioners, as it is a part of understanding
ability to put dishes away in her cupboards. One each client, estabhishing goals, creating interventions,
treatment strategy to help her reach the goal of and determining outcomes. The information from an
putting dishes away might be to have her do upper activity analysis provides essential information in the
extremity exercises. During these, she utilizes her following ways:
upper body strength, range of motion, propriocep o It identifies needed equipment, materials, space,
tion, and ability to follow directions. However, if and time.
we have her actually put cups in a cupboard, she
o It provides a knowledge base for instructing others
will be working on upper body strength; range of
by outlining each step and how it is done.
motion; proprioception; and the skills of stabiliza
o It gives information on how an activity might be
tion, reaching, coordjnatjon, manipulation, grip,
handling objects, sequencing, spatial organiza therapeutic and for whom.
tion, and accommodation of movements. Kay is o It helps to grade or adapt the activity to allow for
not just working on one skill or client factor in greater success.
isolation, but rather on many together, learning o It gives specifics for clear documentation.
how to use ah of them to accomplish the task. • It assists in discovering how contexts influence the
o By engaging in occupations, the client receives performance of an occupation.
immediate feedback on performance. Peedback • It helps to select appropriate activities and find the
on performance can come from the task itself, the “just-right challenge.”
therapist, or the clients themselves. Por example, o It identifies areas in which the client needs help
say Kay is trying to reach up and put a cup on a and interventjon.
shelf. She is struggling and not quite able to reach.
Thus, we begin our journey with our clients by
The therapist can give her feedback and sugges
analyzing their activities and looking carefuhly at
tions, such as, “Step closer to the shelf,” or encour
the details of the occupations they wish to engage in
agement, such as, “You are almost there.” But Kay
and what defines success in the performance of these
is also getting visual feedback by seeing how far
occupations. This includes being able to analyze ah of
away she is from the goal of reaching the shelf, and
the demands of the activity for that person in his or
she receives feedback from her body on how it feels
her contexts. In order to create challenging interven
to reach that high. Perhaps her shoulder is weak or
tion strategies, activities are analyzed to find their
becomes painful when she is reaching. This is ah
therapeutic benefit. The steps and requirements of
feedback that is immediate and directly related to
the activity may be teased apart in order to adapt the
her goal.
activity. Before working with a client, therapists will
often mentally analyze multiple activities in order to
find the ideal challenge for the client during the com
WHY Do WE LEARN TO ANALYzE ing session. The analyses often continue during the
session as the therapist ;vatches a client struggle or
AcTIvmEs AND OCCUPATiONS? succeed, and the activitv may need to be adapted or
graded to allow for greater challenges or successes. At
Being able to analyze the meaningful activities (the the time of reevaluation or assessment of outcomes,
occupations) of our clients’ lives is essential to every the therapist must once again analvze the chient’s
aspect of our practice. The Pramework is a fundamen activities and occupations ir order to establish what
tal document published by the American Occupa defines success for that client ir his or her contexts.
tional Therapy Association (AOTA) that describes the The occupational thérapist. as an ex~ert at everyday
domain and process within which OT occurs. In this activit)~ utilizes his or her experrse ~r activitv analysis
throughout practice.
 Whai: Is Activity Analysis? 9
AOTA published the second edition in 2008 and the
Ti-tE OccuPATI0NAL THERAPY third edition in 2014, with each revision refining and
PRAcTIcE FRAMEw0RK, 3Ro enhancing the original document •as the profession
continued to evolve and grow.
EDITIQN: THE BAsis FOR The Framework did more than define terminol
AcTIvITY ANALY5I5 ogy for the profession of OT by establishing a clear
definition of our domain and the process in which OT
practice occurs. What is our focus when ~ve work with
Mentioned earlier in this chapter, the Framework is
a client? How are we different from other disciplines?
the basis on which this text was developed. Therefore,
Jf “everyday life activity” is our focus, what does that
it shoúld be explained why and how this document
mean? The Framework demonstrates the cornplexity
was established. Previous to the establishment of the
of everyday activities and how each component works
Frarnework, the document guiding OT terminology
together to allow for participation in rneaningful
was the Universal Terrninology III (UT-III), published
activities. In describing the focus of practice, it also
by the AOTA in 1994 (AOTA, 2014). Since then, the
provides a foundation for activity analysis and will
profession has evolved and grown. Much of the lan
thus be the basis on which we analyze activities and
guage used in the UT-III was exclusively used by OT
occupations in this book (Table 1-2).
practitioners and was not recognized by other profes
sions, A committee was developed in 1998 to begin
revising this document. This committee decided that
instead of revising a document that only defined ter CoNcLusloN
minology, they would develop a new document that
would not only establish terrninology but also define The ability to analyze activities and occupations is
and clarify the domain of our professional practice. a skill essential to the practice of OT. OT practitioners
The UT-III was rescinded and a new document ;vas have a unique view of what comprises daily activi
created, using the WHO’s International Classification ties and what contributes to a person’s engagement
of Functioning, Disability, and Health (ICF) as a guide. iii an activity. Our focus is not simply on activities,
The WHO is the leader and coordinator of global but on meaningful activities that are part of people’s
health-related issues within the United Nations. This lives—occupations. Occupations are the focus of our
organization directs research agendas, sets standards profession, not only as a goal for our clients, but also
and norms, and studies health trends on a global level as the means by which we help thern meet those goals.
(WHO, 2001). The ICF is a docurnent that was created Thus, it is important to understand alI of the elements
by the WHO as a framework for classifying health and that contribute to a person’s ability to participate in
disability. It redefined for many what ivas thought of the occupations that are meaningful to hirn or her.
as disability, recognizing that disability has a social Using the activity demands section of the Framework
aspect and is not always a biological disorder but can as a basis on which to analyze occupations and activi
be a result of socioeconornic or environmental factors ties allows the clinician to gain a fuil understanding
as well. Another purpose of the ICF is to provide a of what aspects should be included in an analysis. The
comrnon language and terminology for health profes steps to activity analysis usted earlier in this chapter
sionais internationally and across multiple disciplines. are explained in greater detail in the chapters follow
This document is available publicly through the WHO ing, walking the reader through the process of activity
website (ç~rww~rhojn~/ej~) analysis.
By using the terminology and classifications used
in the ICP, the language used in the Franiework is
internationally and interprofessionally recognized.
The first edition of the Framework was created by the QuEsTIoNs
AOTA’s Commission on Practice and was published
in 2002 (AOTA, 2014). The Framework was created 1. How are occupations different than activities?
as a docurnent that would serve to ‘<define and guide 2. In what ways are occupations used in OT practice?
occupational therapy practice’ (AOTA, 2008, p. 625). 3, \\Tfr,r do OT practitioners use occupations during
As the profession continued to grow and progress, the i ntervention?
 io Chapter i

TABLE 1-2 1
ACTivITY DEMAND5 4
4
Relevance and imporrance to client: Client~ goals, values, beliefs, needs, and perceived utility
Objects and theirproperties: The tools, supplies, and equipment used in te process of carrying out
te activity
Space deniands:The physical environment requirements of te acrivity
_______________ eA
Social demands:The social environment, virtual environment, and cultural contexts that may be
required by te activity.
Sequence and t/ming:The process used to carry out te activity (specific steps, sequence, timing
requirements~.
Required actions: The usual skills that would be required by any performer to carry out te activity 4’
Sensory, perceptual, motor praxis, emotional, cognirive, communication, and social performance
skUls should each be considered. The performance sl<ills demanded by an activity will be correlated /

wit te demands of the oter activity aspects (Le., objects, space).

Requíred body functions: “Physiological functions of body systems (induding psychological
functionsy’ (WHO, 2001, p. 10) that are réquired to support te actions used to perform the activity.
Required body structures: ‘Anatomical parts of te body such as organs, limbs, and their components ~
(that support body function)” (WHO, 2001, p. 10) that are required to perform te activity
¡ Adapted(3rd
orocess Fromed,).
Ameñcan Occupariona)
American Therapy Association.
Jaurnal of Occuparional T/ierapy(20)4) 1), 51-548. therapy
Occupar~onat
68(supp[, Retrievedpractica framework: Domain and
from http:lldx,doLorg/10.5014/
AP

ajot.2014.58200i5

4. What does conducting an activity analysis provide REFERENcES 4/

E/
for the practitioner? How does it help with the A

intervention process?
5. What are the basic steps of an activity analysis? American Occupational Therapy Association.
6. Read the Occupational Therapy Practice Fra me- (2008). Occupational therapy practice framework: .4
work, 3d Edition. Why is this docurnent used to Domain and process (2nd cd.). American Journal of
guide the activity analysis process? Otion~~ Therapy, 62(6), 609-639.
American Occupational Therapy Association. 4
(2014). Occupational therapy practice frame- *
‘4
ACTIVmES work: Domain and process (3rd ed.). American
Journal of Occupational Therapy, 68(Suppl. 1),

1. Look up the ICF on the WHQ websfte How does

S1-S48. Retrieveci from http://dx.doi.org/1o.5o14/
ajot.2014.682005
it’
the ICF define disability? Boyt Schell, B. A., Guien, G., & Scaffa, M. (2014).
2. Interview an OT practitioner. Ask how he or she Glossary. In B. A. Boyt Scheli, G. Gillen, & M.
utulizes activity analysis in everyday practice. Scaffa (Eds.). Willard and Spackman~s occupational
3. Create a visual representation of the steps required thei~ipy (l2th ed., pp. 1229-1243). Phuladelphia, PA: 1~
for activity analysis. Use a variety of objects and Lippincott ~ATu1liams & ‘Nulkins.
materials to represent this process. Christjansen, C., Baum, C. M., & Bass-Haugen, J.
(Eds.) (2005). Occupational therapy: Peiformance,
participation, and well-being. Thorofare, NJ: SLACK
Incorporated. ,