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Case Study: Jimmy, an 8-year old boy, fell during soccer practice and sustained a dominant radiocarpal fracture. He was placed in a cast for 6 weeks with a non-weight bearing status. This limits his handwriting and safety on the playground at school and requires OT services to assess handwriting ability during class and safety during play.

Reference

Alterio, C. J. (2019) Clinically Oriented Theory for Occupational Therapy. Philadelphia, Pennsylvania. S4 Carlisle Publishing Services.

Ecology of Human Performance Model

Establish/Restore relevant skills and abilities according to their environment

Create adaptations to enhance occupational engagement

Case Study: OT will educate patient on strategies to perform handwriting while wearing a cast.

Case Study: encourage activities with less involvement of upper extremities, such as hopscotch or kickball.

What is EHP?

  • "Occupational Therapy is most effective when embedded in real life" (Alterio, 2019, p.63).
  • This is used when there is an imbalance within the person, the task they are completing, and the environment in which they are completing the task
  • During the assessment, there is an emphasis on considering occupational performance in relevant environments
  • During the intervention, emphasis on 5 contextual factors: establish/restore, alter, adapt, prevent, create

Prevent possible injury or harm to individual while performing the occupation

Alter the conditions within the environment in which occupations take place

Case Study: provide information on safe falling techniques when playing.

Case Study: a scribe would come in and take notes for the student.

Adapt features within their environment

Case Study: adapt the angle of the table to compensate for lack of range of motion in the wrist.

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