Running head: OCCUPATIONAL ANALYSIS AND INTERVENTION

Occupational Analysis and Intervention

Orah Kabaei
Touro University Nevada

Occupational Profile
1. Client name: Chana Kabaei
2. Age: 10
3. Sex: Female
Briefly discuss each of the following:
4. Who is the client?
Chana is a ten year old female who is currently in the fifth grade at an Orthodox affiliated
Jewish private school. Chana lives with both of her parents and is the youngest of five
children. There is an age gap of ten years between Chana and the second youngest sibling in
the family. At the moment, three of Chanas older siblings are out of state, one of them being
her older sister Orah, whom she is very close to. Two of Chanas siblings including Orah visit
home often. Chana looks up to her siblings and enjoys spending time with them when they
come home for visits. Chana especially enjoys going out to ice cream and going on hikes
with her siblings. Being the youngest in the family means that Chana spends a lot of one on
one time with Mom, and on occasion Chana goes swimming at the YMCA with her mother
as well. Chanas mother mentioned that being the youngest child also has its challenges since
there is a big age gap between Chana and her other children. Chanas mother demonstrated
her point by explaining that Chana refuses to go to bed by her designated bed time because
her older siblings are up and the house is hectic around 8 pm.

5. Why is the client seeking services and/or what are the clients concerns relative to engaging
in occupations and in daily life activities?
Chanas sleeping habits is of concern to Chanas mother. Chana is not getting enough
sleep per night. Consequently, Chana has trouble getting up on time in the mornings and is
often tired in class. Chanas teacher has reported to Chanas mother that Chana does not
concentrate or participate in class as much as she is required. Occasionally, Chana forgets to
bring her homework home; when she does bring her assignments home she has difficulty
remembering how to complete the assignment even though her teacher gave instructions the
same day in class. Chanas mother states that while Chana does not have any problems with
the actual process of sleep preparation, Chana always tries to avoid sleeping.
6. In what occupations does the client feel successful and what barriers are affecting his or her
success?
Chana demonstrates proficiency in her performance skills when grooming and getting
dressed for bed. Chana displays a lot of excitement when using the mechanical toothbrush
her father bought her to brush her teeth with. However, upon completion of preparing for
sleep, Chana finds every excuse possible to avoid going into her bed. She either claims to be
hungry, uncomfortable with the temperature or scared of the dark. When all these excuses are
proven to be invalid, Chana starts whining that it is not fair that her older siblings do not have
to go to bed as early as she does. The house is noisy at this time and lack of a quiet

environment is a contributing factor to Chanas inability to rest. Many times Chana asks to
use her mothers IPad or her sisters laptop in bed to make her sleepy enough to fall asleep.
At times her wish is granted. Overall, the client is faced with many distractors that are
preventing her from engaging in a good nights sleep.
7. What aspects of his or her environments or contexts does the client see as
supporting engagement in desired occupations and what aspects are inhibiting
engagement?
According to Chanas mother, Chana is a very social and active child. Chana loves the social
aspect of school. Chanas mother notices that when Chana has a friend over and they to complete
homework assignments together, Chana is a lot more engaged in the assignment. Likewise, when
Chanas siblings go to bed at the same time as Chana, Chana does not display as much trouble
falling asleep. It seems like the lack of social and family support Chana feels by her bedtime is
not ideal to her sleep participation.
8. What is the clients occupational history?
Chana enjoys spending time with her siblings. One of her favorite things to do is go out
for ice cream and sushi. Chana demonstrates interest in art and design and the Chanas
mother mentioned that her daughter is artistic and has taken a few art courses with her older
sister. Chanas mother also added that her daughter loves designing her room and moves the
furniture around on occasion. She has a collection of stuffed animals and decorates her room
with them.
9. What are the clients values and interests?
Chana greatly values and cherishes her family and friends. She is naturally loving and
generous with her affection when approached by members in her family. Chana looks
forward to going to school to be with her friends and to partake in recess, and academic
related activities. She also enjoys using the schools library to check out books. Chanas
mother recently bought an IPad, and Chana delights in playing downloaded games on it.
Sometimes Chana has a hard time putting away the IPad by bed time when asked to.
10. What are the clients daily life roles?
The client is currently a student. Her daily life roles involve around dressing for school,
attending school and participating in formal education. As a student her job is to pay attention
is class, participate in class discussions and submit assignments. She studies for exams, too.
11. What are the clients patterns of engagement in occupations?
The client wakes up and starts her day by brushing her teeth and washing her hands and
face. She dresses in her school uniform and has a small breakfast before she is driven to
school. At school she listens to her teacher lecture, completes worksheets and socializes with
her friends during recess and lunch. Once school is over, she is picked up by the carpool line
and driven home. When the client arrives home she snacks and watches television until her

mother calls her to dinner. Once the client is done eating dinner with the family, the client
works on her homework while taking breaks periodically. The client then plays on her
mothers IPad until her mother calls her to bed. The client prepares for bed by following a
sequence of bathing, dressing in her pajamas, brushing her teeth and using the toilet. Once
she is ready for bed, the client attempts to participate in rest and sleep.
12. What are the clients priorities and desired targeted outcomes related to occupational
performance?
The clients mother would like her daughter to go to engage in sleep earlier to
ensure that she receives more sleep per night so that her daughter is up and alert in the
classroom. The clients mother would also like her daughter to get up earlier in the
mornings in order to feed her daughter a more nutritious breakfast instead of rushing out
in the mornings with a small snack.
Occupational Analysis
1. Occupation: Rest and Sleep
Categorization of occupation for the client:
Subcategory:
1. Activities of daily living
2. Instrumental activities of daily living
3. Rest and sleep
Rest, Sleep Preparation and Sleep
participation
4. Education
5. Work
6. Play
7. Leisure
8. Social participation
2. Values, beliefs, spirituality associated with participation:
The clients mother believes that getting an ample amount of sleep per night is crucial to her
daughters participation in school. She places a lot of value on this theory.

3. Contexts:
Context
Physical/space
demands

Social

Supports
Client feels most comfortable
in her own bed, which has a
mattress that is not too hard,
nor too soft. Client needs the
bedroom to have a dim night
light lit prior to shutting off
the room lights.
Client finds it helpful to
engage in sleep when sharing

Inhibits
Room that is fully lit is
bothersome to the client.
Additionally, any noise from
the television or outside
conversation is disrupts the
clients sleeping pattern.
When other members in the
household are up and about

a bed with her sister or

mother.

Cultural

Personal

Client is able to participate in

sleep feeling secure only after
praying the Shema with one
of her parents or siblings.
Client is now in the 5th grade.
Her school requires her to
attend class earlier than she
did in 4th grade. Thus, client is
aware that she needs to get up
earlier for school and will
attempt to go to sleep earlier
at times.

Temporal

Clients mother mentioned

that during the winter her
daughter has an easier time
going to sleep early due to it
getting dark earlier.

Virtual

Client calls her sister who is

out of state using her
mothers cell phone to wish
her a goodnight before
partaking in sleep.

during the clients bedtime, the

client feels the need to stay up
too, and this inhibits the
clients sleep participation.
N/A

Client is the youngest of five

siblings. Consequently, she
receives a lot of attention from
her family. That being said, she
knows that if she lags for time
before actually sleeping,
someone will be there to keep
her company until she chooses
to sleep.
Mother also reported that client
used to share a room with her
older sister before her sister
went away for school.
Recently, the client is having a
harder time falling asleep since
she is in her room be herself.
Client texts her sister using her
mothers cell phone while in
bed prior to sleeping. This is
distracting and inhibits
participation in sleep.

4. Objects and their properties used:

Tools one Mickey Mouse nightlight, one footstool, linen sheets, one soft lightweight
blanket, one memory foam pillow, one digital alarm clock.
Materials extra small light bulb (for the nightlight).
Equipment one firm mattress and bed frame.

5. Social demands:
The clients mother expects her daughter to be in bed by a certain time. In the Kabaei
residence, every child is expected to brush their teeth, change into their pajamas and recite a
small prayer before partaking in sleep.

6. Sequence and timing:

1. Enters the room.
2. Closes the door.
3. Turns to the right of the room.
4. Bends downward towards the night light.
5. Turns on the night light by adjusting the switch.
6. Realigns body to a standing position.
7. Reaches for the room light which is placed superior to the night light.
8. Turns off the room light.
9. Turns body towards the bed.
10. Walk towards the bed.
11. Turns to the alarm clock placed on the nightstand near the bed.
12. Sets the alarm on.
13. Walks to the footstool positioned near the bed.
14. Climbs up the bed using the footstool.
15. Reaches for blankets and sheets.
16. Pulls blanket and sheets over to the end of the bed.
17. Sits up on bed with back against the wall.
18. Recites the shema with her mother.
19. Responds to her mothers hug by reciprocating her hug.
20. Lets go of her mother.
21. Wishes her mother a goodnight.
22. Moves body parallel to the bed.
23. Reaches to pull blanket and sheets over her body.
24. Lays body down.
25. Places head on pillow.
26. Turns head and body to the right.
27. Closes eyes.
28. Moves from side to side in her bed.
29. Calls out to her mother.
30. Once her mother enters the room, tells her mother she is hungry since she had
dinner very early in the evening.
31. Waits a few minutes.
32. Has a quick snack.
33. States that she is full.
34. Places head back onto pillow.
35. Closes eyes again.
36. Hears noise coming from the television downstairs.
37. Opens eyes.
38. Lifts head and upper trunk in a sitting position.
39. Calls out for quiet.
40. Waits a few seconds.
41. Calls out for quiet again.
42. Once the noise subsides, client places head back onto pillow.
43. Closes eyes.
44. Counts sheep until she reaches a hundred.

45. Opens eyes again.

46. Reaches down.
47. Grips onto her mothers IPad.
48. Turns the IPad on.
49. Uses finger to search for desired game.
50. Plays game until she is tired (about 45 minutes).
51. Bends over and places IPad down onto the floor.
52. Lays back down.
53. Closes eyes again.
54. Client wavers in and out of consciousness.
55. Clients eyes partially open.
56. Client shuts eyes.
57. Client is asleep at last.

7. Body functions required:

Function
Judgment

Concept formation

Metacognition
Cognitive flexibility

How It Is
Used
Client weighs
options to
determine
which excuse
would be
most effective
to lag for time
to avoid
sleeping on
time.
Client
understands
that setting
and turning
on an alarm
will ensure
that the alarm
rings at the
time set.
N/A
Clients sleep
is disrupted
by outside
noise. To fix

None

Minimally
Challenged
x

x
x

Greatly
Challenged

Insight/awareness

Concentration

Sustained attention

Selective attention

this problem,
the client asks
for quiet.
Client is
aware that if
footstool is
missing, she
will not be
able to climb
up to her bed.
As a result,
client will run
down the
stairs and find
a chair to use
instead.
Client
displays
concentration
when
counting
sheep as an
attempt to fall
asleep.
The client
displays that
she has the
capacity to
sustain
attention
while setting
the alarm to
ensure that
the alarm is
set as desired.
Only once the
client is
feeling
extremely
tired she
ignores
external

Divided attention

Short-term memory

Working memory

stimuli to
prevent
disruption of
sleep. Client
has a hard
time ignoring
external
stimuli when
she is not
feeling tired
enough to
engage in
sleep.
The client
repositions
herself in
sitting
position while
reciting the
shema until
she is
comfortable.
The client
recalls that
she has
already shut
the door and
lights to her
room.
The client
recalls the
next step that
needs to be
taken to reach
her bed. For
example, she
remembers
that she needs
to turn the
nightlight on,
and she bends
down to

10

Long-term memory

Discrimination of senses:
Auditory

Discrimination of senses: Tactile

switch the
light on.
The client
utilizes past
experiences to
switch the
light bulb of
the nightlight
when it is
burnt.
The client
knows the
difference
between the
voices coming
from the
actors on
television and
her family
members.
The client can
also detect
when
someone
leaves or
enters the
house from
the noise of
the door
shutting. This
is very
disruptive to
her sleep.
The client is
able to
differentiate
between her
sheets and
blankets in
the dim lit
room through
tactile

11

Discrimination of senses: Visual

Discrimination of senses:
Olfactory

Discrimination of senses:
Vestibular-proprioception

discrimination
.
The client is
able to see the
blanket and
sheets and
recognize that
they have not
been pulled
over her to
keep her
warm while
she sleeps.
The client is
able to
distinguish
between
freshly
washed sheets
from sheets
that have been
slept with for
over a couple
of weeks.
The client is
able to
position
herself in a
sitting
position,
against the
wall while
reciting the
shema. Her
proprioceptio
n sense allows
her to be
aware of
flexing and
extending her
limbs as she is
reaching for

12

Multisensory processing

Sensory Memory

Spatial relationships

her sheets and

blanket.
The client
utilizes sense
of touch,
proprioceptio
n, and
vestibular
perception to
understand
the sensations
that are
occurring
while she is
twisting and
turning in her
bed,
attempting to
fall asleep.
The client
recognizes the
lighting of the
room once the
room light has
been shut off
and the dim
night light is
on.
The client
positions the
footstool
closer to the
bed
demonstrating
that she
understands
that the stool
needs to be at
a certain
position in
relation to the
bed in order

13

Temporal relationships

Recognition

Categorization

Generalization

Awareness of reality

to be able to
climb up the
bed.
The client is
aware of the
time elapsed
tossing and
turning in her
bed.
The client
recognizes her
bed, her
blanket and
pillow.
The client
categorizes a
dark room
with monsters
and scary
creatures
under her bed.
The client is
capable of
generalizing
skills related
to setting an
alarm clock,
which were
previously
acquired and
now utilized
to setting up
her own
alarm.
The clients
mother
mentioned
that the client
is able to
separate
dreams from
what is
occurring in

14

Logical/coherent thought

Appropriate thought content

the true
environment.
However,
there are
times when
the client has
nightmares
and fear from
what may
seem to be
realistic from
these scary
dreams
usually has
her calling for
her mother.
In the case
where the
client is
climbing into
her bed and
pulling over
her covers,
the client
exhibits
logical and
coherent
thoughts as
she
manipulates
her blanket
and pillow to
a position in
which she is
comfortable.
In the case
where the
client is
attempting to
sway her
mother for

15

Mental functions of sequencing

complex movement

Regulation and range of emotion

more play
time before
partaking in
sleep, the
client exhibits
appropriate
thought
content when
giving her
reasoning as
to why she
cannot sleep
right away.
For example,
the client
complains
that the
temperature is
too cold in the
winter, or that
she is hungry
on days when
dinner is
served earlier
in the
evening.
From the time
the client
enters her
room, until
she closes her
eyes to rest,
mental and
motor plans
are utilized
when closing
the door,
turning lights
on and off,
walking to the
bed etc.
The client has

16

Appropriateness of emotion

Coping

to deal with
feelings of
frustration
when she is
tired and
trying to fall
asleep and
there is too
much noise
coming from
family
members.
Emotions
range from
being patient
at first, then
feelings of
irritation
when the
noise does not
subside.
The client
shows
frustration
when there is
too much
noise.
The client has
been trying to
cope with the
fact that her
older sister no
longer sleeps
in the same
room as her.
The client;s
mother
reported that
occasionally,
her daughter
sleeps in her
room so as

17

Behavioral regulation

Body image
Self-concept
Self-esteem

Arousal

Consciousness

Orientation to self
Orientation to place

not to feel
alone in her
room at night.
The client
displays
appropriate
affect when
displaying
emotions. For
example,
when her
mother brings
her a small
snack, the
client
demonstrates
excitement
and smiles.
N/A
N/A
Client
displays selfesteem when
asking family
members to
lower the
noise level.
The client
exhibits a low
level of
arousal when
playing with
the IPad.
Once the
client is tired,
the client
wavers in and
out of
consciousness
.
N/A
The client is
aware that she

x
x
x

x
x

18

Orientation to time

Orientation to others

Energy level

Function
Motivation

Impulse control

is in her bed,
which is
designated for
sleeping.
The client is
aware that it
is past her bed
time and it is
time for her to
sleep.
The client is
able to
identify her
mother when
her mother
enters her
room to give
her a snack.
Client
requires
energy to
continue
playing on the
IPad.
How It Is
Used
Clients
motivation to
sleep is at a
minimum
when she is
not tired.
Client
attempts to
exercise
impulse
control when
family
members do
not comply
with the
clients request
to lower the

None

Minimally
Challenged

Greatly
Challenged
x

19

Appetite

Sleep

Detection/registration

Visual modulation

Integration of senses

noise level.
Client has a
natural desire
to eat before
sleeping.
Only once the
client is tired,
she puts away
the IPad,
closes her
eyes and
entails
physical and
mental
disengagemen
t from her
environment.
While
reaching for
her bed
covers, the
client is
visually
detecting
where they
are placed.
The client is
able to
recognize her
bed from her
sisters bed.
When the
client is
climbing up
her bed using
the footstool,
she uses
visual as well
as tactile and
proprioceptiv
e information

20

Awareness at distances

Tolerance of ambient sounds

Location and distance of sounds

Moving against gravity

Taste

Smell

Body in space

to move her
body towards
the bed.
The client is
aware of the
distance
between the
door and her
bed.
Client does
not seem
fazed by the
sound of the
air
conditioning.
The client is
aware that the
disruptive
noise she
hears is
coming from
outside her
room.
Client moves
against
gravity by
sitting up in
her bed to
recite the
shema.
Client utilizes
taste buds
when eating
her snack.
Client detects
normal smell
of the room.
Client is
aware of
where limbs
are when
reaching for
covers.

21

Comfort with touch

Localizing pain
Thermal awareness

Joint mobility

Joint stability/alignment

Muscle power

Muscle tone

Muscle endurance

Client feels
the touch of
her blanket
and sheets
over her body.
N/A
x
When client is
adjusting the
night light,
she avoids
touching the
bulb since she
is aware that
it is hot.
Client extends
and flexes
knee and hip
join when
walking up
the footstool.
Clients joints
are aligned
properly when
client is
moving
around her
room.
Client uses
leg strength to
walk up the
footstool.
Clients
movements
are smooth
when closing
the door.
Muscle
endurance is
slightly
utilized when
client needs to
use leg
muscles to

22

Stretch reflex

ATNR
STNR
Righting and supporting reflex

Eye-hand coordination

Bilateral coordination

Crossing midline

Fine motor control

Gross motor control

walk to her
bed.
Clients
muscles are
stretched
when she
bends down
to turn on the
night light.
N/A
x
N/A
x
Client restores
body to a
natural
upright
position after
turning on the
night light.
Client utilizes
eye-hand
coordination
when setting
her alarm.
Integrated
when client
uses one hand
to stabilize
the alarm
clock and the
other to press
on buttons.
Client crosses
her midline
when pulling
her sheets and
blanket.
Client grasps
onto sheets
and blanket
with fingers.
Client uses
arm muscle to
shut the door.

23

Occulomotor control

Gait patterns

Blood pressure

Heart rate

Respiratory rate

Respiratory rhythm

Respiratory depth

Client scans
under her
blanket to
localize her
sheets.
Utilized when
client walks
from door to
her alarm
clock.
Client lays
body down to
rest/sleep,
which may
cause a slight
drop in her
blood
pressure.
Heart rate
increases
from feeling
frustrated
from the
noise.
Once client is
sleeping, her
respiratory
rate is slightly
lower.
Client
regulates the
rhythm of
respiration
when
munching on
her snack.
Asking her
family
members for
quiet requires
client to take
deep breaths
to avoid

24

Physical endurance, aerobic

capacity

Voice functions

Voice rhythm and fluency

Alternative vocalization

Digestive system

Metabolic system

Endocrine system

Function
Urinary functions
Genital and reproductive function
Protective functions of the skin

feelings of
frustration.
Utilized when
client climbs
up the
footstool to
her bed.
Utilized when
client calls
out for quiet.
Client
transitions
from one
word to
another when
communicatin
g to members
of her family.
Utilized when
client is
calling for
attention of
family
members.
Utilized when
client is
eating her
snack.
Utilized when
client
consumes her
snack and
feels satiated.
Shutting the
lights may
release
melatonin.
How It Is
Used
N/A
N/A
Skin
surrounding

None

Minimally
Challenged

x
x
x

Greatly
Challenged

25

clients
fingers
protects her
from bacteria
entering her
body which
she may come
in contact
with when
touching
objects in her
room.
N/A

Repair functions of the skin

8. Muscular analysis of movements required:

Muscle

Not used

Shoulder flexion
Shoulder extension
Shoulder abduction
Shoulder adduction
Shoulder internal rotation
Shoulder external rotation
Elbow flexion
Elbow extension
Wrist supination
Wrist pronation
Wrist flexion
Wrist extension
Thumb flexion
Thumb abduction
Finger flexion
Finger extension
Trunk flexion
Trunk extension
Trunk rotation
Lower extremities

Minimally
challenged
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x

Greatly
challenged

9. Performance skills required:

Skill- Motor

How It Is
Used

None

Minimally
Challenged

Greatly
Challenged

26

Aligns

Stabilizes

Positions

Reaches

Bends

Grips

Manipulates

While
standing to set
the alarm, the
clients body
is aligned
with the
center of
gravity and
she maintains
strong trunk
mobility.
Client is able
to stabilize
body when
climbing up
the footstool
and
maintaining
her balance.
Client is able
to position
self against
the wall in a
sitting
position to
recite the
shema.
Client is able
to abduct arm
when
reaching for
her blanket.
Client flexes
trunk to bend
over to turn
on the night
light.
Client grips
onto the
blanket and
sheet to pull it
over herself.
Client

27

Coordinates

Moves

Lifts
Walks

Transports
Calibrates

Flows

Endures

Paces

Skill- Process

manipulates
the light
switch to turn
it off.
Client uses
both hands to
set the alarm.
Client moves
blanket
towards self.
Client lifts
head up.
Client walks
from the
nightlight to
her alarm.
N/A
x
Client exerts
enough force
to shut the
door.
Clients arm
movements
are smooth
and fluid
when shutting
the door.
Client does
not show any
sign of fatigue
after climbing
up her bed.
Client
maintains a
constant rate
when
preparing her
environment
for rest and
sleep
participation.
How It Is
None
Used

x
x

Minimally
Challenged

Greatly
Challenged

28

Paces

Attends

Heeds

Chooses

Uses

Handles

Inquires

Initiates

Continues

Like
mentioned
above, client
maintains
pace when
preparing for
sleep.
Client attends
to reciting the
shema with
her mother.
Client
attempts to
fall asleep by
shutting eyes
and
disengaging
from her
environment.
Client
chooses her
bed to sleep
in.
Client uses
pillow to lay
head on.
Client moves
the sheets and
blanket over
self to keep
warm.
Client is
aware that
closing her
eyes will help
her rest.
Client begins
climbing up
the footstool
once her
alarm is set.
Client is not
able to keep

29

Sequences

Terminates

Searches/locates

Gathers
Organizes
Restores

Navigates

Notices/responds
Adjusts

Accommodates

eyes closed to
engage in
sleep since
she is
distracted by
outside noise.
Client turns
on the
nightlight
before
shutting off
the room light
to avoid being
in a dark
room.
Client ceases
to play with
the IPad.
Client
searches for
her mothers
IPad.
N/A
N/A
Client puts
away IPad
once she is
done playing
her games.
Client moves
body through
room without
bumping into
the closet or
nightstand.
N/A
Client adjusts
the lighting of
the room by
using a
nightlight.
Utilized when
client asks

X
x
x

x
x

30

Benefits
Skill- Social interaction
Approaches/starts

Produces speech

Gesticulates
Speaks fluently

Turns Toward

Looks

Places self

Touches

family
members for
quiet in order
to maintain a
conducive
environment
for sleep
participation.
N/A
How It Is
None
Used
Client calls
for her
mother.
Client
communicates
through the
use of speech.
N/A
x
Client speaks
with an even
pace and
without
pauses.
Client faces
mother to
communicate.
Client makes
eye contact
with her
mother when
communicatin
g with her.
Client
positions self
at an
appropriate
distance when
reciting the
shema with
her mother.
Client gives
mother a good

Minimally
Challenged
x

Greatly
Challenged

31

Regulates

Questions

Replies

Discloses

Expresses emotion

Disagrees

Thanks

night kiss and

hug before the
mother leaves
the room.
Appropriate
interaction is
demonstrated
when client
socializes
with her
mother.
Client asks
family
members for
quiet.
Client is
interactive
when
communicatin
g with her
mother.
Client tells
mother that
she is hungry
and cannot
sleep.
Client
displays
frustration
when the
noise levels
are too high.
Client
expresses
opposition to
noise when
asking for
noise levels to
be kept at a
minimum.
Client thanks
mother for the
snack she

32

Transitions

Times response

Times duration

Takes turns

Matches language

Clarifies

Acknowledges and encourages

Empathizes
Heeds
Accommodates
Benefits

provides her
with.
Clients brief
conversation
with mother is
smooth.
Client
responds to
mother in an
appropriate
time frame.
Client keeps
conversation
at a minimum.
Client allows
mother to
converse, too.
Client raises
voice when
asking for
quiet.
Client lets her
mother know
that she is
hungry and
cannot fall
asleep.
Client is
responsive
when
conversing
with her
mother.
N/A
N/A
N/A
N/A

x
x
x
x

10. Performance patterns:

Parts of this occupation has elements of which of the following: (check all that apply)

Pattern

Describe

33

Useful habit
Client lights a night light prior to partaking in sleep.
Dominating habit

Ritual

Client plays with her mothers IPad before bed.

Client follows a nightly sequence of getting ready for bed. After
dressing into her pajamas and brushing her teeth, the client sets her
night light and alarm clock.
The client recites a prayer prior to sleep.

Role

Client engages in sleep and rest.

Routine

Intervention Plan
1. Identify 1 objective and measurable goal of the intervention:
Client will engage in rest and sleep, independently, within half an hour of bedtime
once, within the next two weeks.
a. According to OTPF what type of outcome is this?
Through the intervention process, the client will achieve outcomes related to
improvement of occupational performance, quality of life, and participation. The
client will engage in better sleep nightly, and this will improve overall
occupational performance. The client will see enhanced quality of life and will be
more attentive and cooperative in the classroom. The client will participate in
sleep in a quiet and non-distracting environment.

2. Intervention approach:

Approach
Create/promote

Describe

Establish/restore
Maintain
x

Modify

Modify the clients environment to make it more conducive to sleep

participation. Family members will keep the noise level to a
minimum, and the client will not have access to an IPad or any other
electronic device one hour prior to her bedtime.

34

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 eat a small, healthy snack prior to brushing her teeth
for bed to ensure that she will feel satisfied when it is time for her to
go to sleep.
The client will put her stuffed animals to bed.
Different preparatory methods can be used to in order to prepare the
client for the intervention. The clients mother will gently massage her
daughter to help her relax and make her drowsy in order for the client
to be able to sleep more readily.
The client will complete 15 minutes of yoga stretches to relax her
body in order to be able to partake in sleep participation more
efficiently.

b. Discuss how activity selection relates back to occupational profile and

occupational analysis
When selecting an activity for the client, it is important for the
occupational therapy practitioner to select an activity that is of relevance
and importance to the client. The occupational profile gives information
about the clients interest and concerns in regards to occupation, while the
occupational analysis analyzes the clients occupational performance
through observing, measuring, and inquiring factors that may help or
hinder the clients occupational performance. Based on the information
retrieved from the profile and analysis, the practitioner will be able to
select an activity that is meaningful to the client.
c. Discuss how activity selection will support achievement of client identified goals
and goal of the intervention plan
All of the activities selected by the practitioner will help the client
engage in sleep earlier than usual. The client complains of being hungry
and as a result not being able to sleep. Thus, eating a small snack prior to
bedtime will prevent this problem from happening. The client loves her
stuffed animal collection and putting them to bed before the client goes to
bed will help her feel not feel lonely during bed time since all of her other
siblings are still awake. Having the mothers client massage the clients
back will make the client feel relaxed and sleepy, and allow the client to

35

engage in sleep easily. Doing yoga stretches will do the same for the
client.
4. Describe how intervention can be graded or adapted and why
Interventions are graded up or down to find the just right challenge for the client.
The intervention can be graded up by having the clients mother read a short story to the
client instead of massaging the client. Intervention can be graded down by allowing the
mother to lie down with her child until the client is asleep. Depending on the night and
clients level of energy, the mother will determine whether the intervention should be
graded up or down.
5. Discuss any safety concerns and/or precautions
To secure good results, the mother should take precaution and not allow her
daughter to take advantage of time when being massaged or doing yoga stretches. The
mother should be firm with the rules once the time is up.
6. Discuss the role of the occupational therapy practitioner during the intervention
The occupational therapist role is to guide the client to ensure that she achieves
the best outcome possible. The occupational therapist collaborates with the client and the
clients mother to provide a client centered approach. The occupational therapist will
educate the clients family on the importance of keeping a quiet environment during the
clients bedtime to ensure that the client will not be disrupted when attempting to sleep.
7. Discuss what is expected of the client during the intervention
The client is expected to comply with the intervention to the best of her abilities.
She will take extra measures to prevent herself from calling for her mom. The client will
not play with any electronics and hour before bedtime.