Centennial vision

In 2017, the profession of OT will be 100 years old. AOTA has adopted a Centennial Vision that recognizes OT as a science-driven and evidence-based profession that continues to meet the occupational needs of clients, communities, and populations. AOTA is actively promoting OT practitioners to assume leadership roles and contribute to outcome databases that support evidence-based practice.¹

The centennial vision addresses areas of pediatric practice, including the health and wellness of children and youth (including programs to prevent childhood obesity), and the psychosocial needs of children and youth.⁷ AOTA, through its vision, suggests that practitioners continue to provide evidence of the importance of occupation and intervention.¹ The vision encourages practitioners to become leaders in the profession and to support the profession through participation in AOTA, scholarship (at many different levels) and clinical practice.¹

The Occupational Therapy Practice Framework (OTPF) defines both the process and domain of occupational therapy.⁶ Subsequent chapters discuss the OT process and domain in detail.

Occupational therapy practice framework

The OTPF was developed to assist practitioners in defining the process and domains of OT.⁶ The OTPF is designed to be used by occupational therapists, certified occupational therapists, consumers, and health care providers. Figure 1-1 illustrates the framework.

The OTPF defines the process of OT as a dynamic, ongoing process that includes evaluation, intervention, and outcome. Evaluation provides an understanding of the clients’ problems, occupational history, patterns, and assets.⁶ Intervention includes the plan (based on selected theories, models of practice, frames of reference, and evidence), implementation, and review. Outcome refers to how well the goals are achieved. The domain of OT practice is occupation, defined as “activities…of everyday life, named, organized, and given value and meaning by individuals and a culture. Occupation is everything people do to occupy themselves, including looking after themselves, enjoying life, and contributing to the social and economic fabric of their communities.” ^{11 (p.32 ).} See Figure 1-2 for an illustration of the process. Occupation is viewed as both a means and an end.⁶ Using occupation as a means includes such things as participating in school activities to improve the ability to function in school; it follows the “learning by doing” philosophy. Occupation is also viewed as an end in that the goal of therapy sessions is to enable the child to function in his or her occupations. For example, therapy sessions focusing on handwriting skills are intended to improve the child’s ability to function in an academic occupation. The OTPF defines the areas of occupation as activities of daily living (ADLs), instrumental activities of daily living (IADLs), education, work, play, leisure, and social participation.⁶ Clinicians examine performance skills (motor, processing and communication) and patterns (habits, routines, roles) associated with areas of occupation. Clinicians analyze the demands of activities and client factors required for an occupation in order to develop intervention plans. However, the OTPF focuses on the occupation instead of its components. Equally important is an examination of the contexts and environments in which an occupation occurs. According to the OTPF, these contexts and environments are cultural, personal, temporal, virtual, physical, and social (Table 1-1). Contexts influence how an occupation is viewed, performed, and evaluated. For example, when considering the temporal context, practitioners would expect differences in social behavior between a 2-year-old toddler and 6-year-old child.