Framework of Occupational Gradation (FOG)

  • The Framework of Occupational Gradation (FOG) focuses on one’s active movements with the more involved upper extremity. There are two versions of FOG, one for young children (C-FOG) and one for older children and adults (A-FOG). Both aim to provide occupational ideas in preventing learned non-use of the more involved upper extremity for clients with neurological impairment. These ideas can be incorporated into daily lives to increase use of the extremity. Appropriateness of task for each client is determined by hand dominance and perceived meaningfulness. Activities are provided in various levels under this framework. The person, task or object properties, and environment can each be manipulated by occupational therapists, to optimize or challenge a client’s performance on each level. The personal factor can be manipulated by reducing the degrees of freedom using splinting or positioning. For example, a thumb splint may stabilize the thumb and improve prehension movements in children with spastic hemiplegic cerebral palsy. Manipulation on tasks and/or objects factors can also determine the speed, smoothness, force, and accuracy of movement. Properties of objects such as weight, size, shape, and nature of task, like eating with different utensils can be manipulated. The environment can also be manipulated with the object’s orientation, use of stationary/mobile objects, height of task (against gravity/gravity assisted, etc.), to reduce or increase degrees of freedom of movement requirements. In designing the intervention, firstly, the therapists consider both person and family goals and the person factors. From that, the therapists select meaningful tasks from the FOG, and manipulate factors in person, task, and environment to level the task suitably. With mass and organized practice in context and feedback (intrinsic and extrinsic), the final goal is to improve motor control and occupational performance that can be generalized to performing environments.

Summarized by

  • Macey Cho

Type

  • Framework

Population

  • Child
  • Adolescent
  • Adult
  • Elderly

Disability

  • Neurological disorder

Domain of occupation

  • Unspecified

Application Note

  • Combination of this approach with compensation/adaptation may be optimal for intervention.

Key Reference

  • Poole, J. L., Burtner, P. A., & Stockman, G. (2009). The Framework of Occupational Gradation (FOG) to treat upper extremity impairments in persons with central nervous system impairments. Occupational Therapy In Health Care, 23, 40-59.

Year Published

  • 2009

Primary Developer

  • Janet Poole

Primary Developer Email

  • jpoole@salud.unm.edu

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Children’s Hand Skills Framework (CHSF)

  • The Children’s Hand Skills Framework (CHSF) is used as a conceptual guide to analyze and describe children’s hand skills in the assessment and intervention process. The CHSF divides children’s hand skill use into six major categories, based on the extent to which the hands contact objects/parts of the body or not. The first two categories are manual gesture and body contact hand skills that do not contact specific objects.

A clinical reasoning framework for children with autism spectrum disorder experiencing sensory challenges

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Biomechanical Frame of Reference

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Model of Playfulness

  • The Model of Playfulness suggests that playfulness can be determined within any transaction of the evaluation of three elements, each of which can be represented as a continuum. The three elements are (1) source of motivation (from intrinsic to extrinsic), (2) perception of control (from internal to external), and (3) the suspension of reality (from free to not free). Intrinsic motivation, such as mastery or pure sensation of movement, is the aspect(s) of activity itself that provides motivation for the individual to involve in an activity.

Model Type

Population

Disability

Domain of Occupation

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