Acquiring motor skill is a process that requires practices, feedback, and involvement of the learner. This frame of reference employs several principles from learning theory. It focuses on the child’s ability, characteristics of the task, skills required, environment, and regulatory conditions. Regulatory conditions are aspects of the environment that determine movement specifics, which are described in a continuum between closed and open tasks. Closed tasks are tasks that are performed in stationary environments, some with little variability (e.g., brushing teeth) and some with larger variability (e.g., self-feeding). The other side of continuum, open tasks, is the task that is performed in an environment in motion and includes some variability in movement in each trial (such as playing soccer). Learning of motor skill consists of many stages. In the early stage, the child must engage in active problem solving to find strategies to match features of task and environment. The child also needs to plan a movement and evaluate it based on feedback. At the later stage in which skill is developed, the child needs to develop self-evaluation to meet different requirements based on the context and function of the task. Evaluation of this frame of reference is a dynamic process and does not follow a specific order. The child, task, environment and their interaction must be considered during the process. Therapists collect information from observations of child’s performance, their caregivers on daily performance, analysis the task, analysis on demands and characteristics of the environment. In interventions, therapists act as a facilitator who structure learning situations that promote the child’s ability to perform the tasks, which often are functional activities that fit the child’s occupation.
Frame of reference
Domain of occupation
Child’s ability, task requirements, environmental demands, and interaction between all three must be considered
Kaplan, M. (2010). A frame of reference for motor skill acquisition. In P. Kramer & J. Hinojosa (Eds.), Frames of reference for pediatric occupational therapy (3rd ed., pp. 390-424). Philadelphia: Lippincott Williams & Wilkins.
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 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 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.
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.
This frame of reference identifies functions and dysfunctions in five areas of handwriting for children, including proximal posture, components, use of writing tools, grasp, and handwriting. Good proximal control is required for functional and effective distal control of the writing tools. Either excessive postural stability or lack of postural stability during writing tasks is considered as dysfunctions. Components including ocular-motor skills, attention, and memory are considered as essential.