Physical disability

The Occupational Functioning Model (OFM) is a framework used in occupational therapy to guide assessment and intervention for individuals with physical dysfunction. It emphasizes the development of competence and satisfaction in the performance of tasks associated with valued life roles to support a sense of efficacy and control over one’s life. The model organizes functioning hierarchically, from roles, tasks, and activities to abilities, developed capacities, first-level capacities, and the underlying organic substrate.

This model comprises the complexity and multi-dimensionality of the relation between persons with motor disabilities and their environment. It addresses the personalized accessibility (i.e., unique needs of a person living in a specific environment that is central to this person). It defines the relationship of the person-environment interaction using six concepts, they are:

The theoretical base of biomechanical frame of reference (FOR) is considered as a remedial approach focusing on impairments that limit occupational performance. This FOR assumes clients are able to acquire the voluntary motor skills necessary to perform the desired human occupation, meaning that the underlying impairment is amenable to remediation. It also assumes that engaging in occupation and therapeutic activities has the potential to remediate the underlying impairment, and results in improvement in occupational performance.

The Biomechanical frame of reference for positioning children for function is applied to individuals who are unable to maintain posture from appropriate automatic muscle activity caused by neuromuscular or musculoskeletal dysfunction. The goals of this frame of reference are (1) to enhance development of postural reactions, which can be done by reducing the demands of gravity and aligning the body, and (2) to improve functional performance by providing external support for proximal stability to improve distal function.

The social participation frame of reference emphasizes the power of emotion to motivate and engage children’s social participation. Early relationship with parents provides the foundation for children’s social development, because children give meaning to their own emotions and learn strategies in regulating their emotional states based on how others and environment responses to their emotions. At the same time, the children regulate the caregivers’ behaviors and then they learn how to regulate their own and others’ emotions during future social interactions.

The Neuro-Developmental Treatment (NDT) frame of reference is used to analyze and treat posture and movement impairments based on kinesiology and biomechanics. To identify difficulties and plan for intervention, the following concepts are to be considered in NDT, including planes of movement, alignment, range of motion, base of support, muscle strength, postural control, weight shifts, and mobility. NDT assumes that posture and movement impairments are changeable. Thus, it utilizes movement analysis to identify missing or atypical elements.

The Partnership for Change (P4C) model emphasizes the therapists’ partnership with the educators and parents to change the life and environment of a child who has motor difficulties (or developmental difficulties). The partnership focuses on the collaboration of building capacities for the teachers and parents in enhancing daily environment for the child. The core activities of occupational therapists under the P4C model are relationship building and knowledge translation with the school and parents. It consists of three steps. The first step is universal design for learning.

The Life Needs Model of Pediatric Service Delivery is a practice model that values the intrinsic worth, dignity, and strengths of individuals. This model focuses on the concept of need, emphasizes the values of family-centered services, and recognizes strengths and capacities of the child and family. It is used to guide pediatric service delivery to meet the long-range goals for promoting community participation and quality of life of children and youth with disabilities.

The Client-Centred Model for Equipment Prescription is a model that guides the use and efficacy of equipment that therapists prescribe for individuals with physical dysfunction.