Data Driven Decision Making (DDDM) is a framework for therapists to implement clinical reasoning within occupational therapy process and has a focus on the use of observation, testing and intervention results to guide and measure outcomes. This framework consists of 11 steps. Step 1, the therapists have to identify the participation challenges and goals. In step 2, therapists need to describe the level of the client’s functioning in each part of the body or the brain. In step 3, therapists make observation to identify the factors that may affect the participation for each identified goal, consider the client’s history, and discuss with the client and other family members. In step 4, the therapists conduct standardized assessments to evaluate the impacting factors and, meanwhile, in step 5, the therapists identify the strengths and barriers to the participation. Thus, the environmental strengths and factors can be ascertained to provide support or eliminate barriers to the clients. In step 6, therapists generate hypothesis with regards to the factors that may lead to improvement of the participation based on the assessment findings. After that, therapists design the interventions in step 7 and identify the outcomes in step 8. In step 9, therapists conduct the intervention and, in step 10, they collect, display, and analyze the intervention results with charts or tables. Finally in step 11, therapists have to monitor the progress and make modifications based in the outcome data. It is expected that the therapists can use this DDDM to systematically identify and test their clinical reasoning process regarding occupational therapy intervention with specific clients.
Domain of occupation
The therapists should make record of the clients at the beginning, in the middle and after the intervention by using charts or other statistical figures so as to obtain a complete vision of the progress.
Schaaf, R. C. (2015). Creating evidence for practice using data-driven decision making. American Journal of Occupational Therapy, 69, 6902360010p6902360011-6902360016.
The Sensory Integration (SI) frame of reference focuses on how the interaction between the sensory systems including auditory, vestibular, proprioceptive, tactile, and visual systems, provides integrated information that contributes to a child’s learning and adaptive behaviors. The key consideration is that children have the abilities to make adaptive responses to constantly changing sensory environments. The sensory integrative abilities include sensory modulation, sensory discrimination, postural-ocular control, praxis, bilateral integration, and sequencing.
The behavioral frame of reference (FOR) emphasizes on the use of behavioral modification to shape behaviors, which purports to increase the tendency of adaptive behaviors or to decrease the probability of maladaptive learned behaviors. The key concepts in this FOR include:
This model is symbolized as an infinity symbol, which emphasizes that independence is a continuum without a start or an end. An individual’s independence can exist at any point within this continuum. Inside the symbol, there are two sides representing two themes, they are personal factors and environmental factors. The lighter (left) side of the model represents personal factors, which consists of personal attributes.
This model aims to guide occupational therapists in decision-making with the elderly who have cognitive impairment to continued community living. Client-defined decision-making processes are suitable for non-cognitively impaired, non-dependent people, while negotiated decision-making processes are suitable for clients with cognitive impairment, dependent on others/putting others at risk.
The Occupational Performance Process Model is based on the concepts of occupation and client-centered practice; that is, therapists should solve the clients’ occupational performance problems through the client-centered approach. To facilitate clinical decision-making in this model, the first stage is to name, validate, and prioritize occupational performance issues through collaboration with the clients. The Canadian Occupational Performance Measure is an assessment that can be used to identify the clients’ perception of problems and importance in their life.