Follow-up

OT Dude Academy’s Free NBCOT® Exam Prep Course Process Follow-up
  • After a client is discharged from occupational therapy services, additional intervention may be required at a later date.
  • Instances needing follow-up:1 
    • The client improves or regresses
    • Medical interventions are planned, e.g., surgeries
    • The context changes: age, developmental stage, life cycle, physical, and social environment
    • The role changes, e.g., new parent
    • New assistive technology is available and appropriate
    • The level of assistance changes
    • Program changes
    • Environmental changes
    • Other life stage changes
  • Use measurable and tangible outcome measurements that are sensitive to changes for follow-up.2 
  • Some groups of pediatrics who may be at high risk for needing further health interventions include those born preterm, with low birth weight, are small for gestational age, with neonatal encephalopathy, who received positive pressure ventilation for more than 24 hours, with congenital brain or heart malformations, genetic syndromes, who failed the newborn hearing screening, with CNS infections, have or will require major surgery, have hyperbilirubinemia, or with neurobehavioral abnormalities.
    • Family and environmental variables for children who are at high risk include high social risk (e.g., domestic violence, poverty), substance abuse by a parent, a major psychiatric history by a parent, or a developmental disability in either parent.
    • Reasons for follow-up include clinical services requiring case management until school entry, education for parents at optimal life events (e.g., school), screening for developmental disorders (e.g., ASD), monitoring for medical conditions (e.g., hypertension), advocacy for families, providing resources3 , the adoption of environmental modifications4 , and assistive technology as appropriate.5 
  • Long-term follow-up of independent-living older adults who received occupational therapy intervention showed a long-term benefit in response to preventative OT for physical functioning, role functioning, vitality, social functioning, role emotional, and general mental health. 90% of the therapeutic gain was observed following OT treatment in follow-up.6 
  1. Moyers, P. A. (1999). The guide to occupational therapy practice. American Journal of Occupational Therapy, 53(3), 247-322.[↩]
  2. American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001[↩]
  3. Doyle, L. W., Anderson, P. J., Battin, M., Bowen, J. R., Brown, N., Callanan, C., … & Woodward, L. J. (2014). Long term follow up of high risk children: who, why and how?. BMC pediatrics, 14(1), 1-15.[↩]
  4. Wielandt, T., McKenna, K., Tooth, L., & Strong, J. (2006). Factors that predict the post-discharge use of recommended assistive technology (AT). Disability and Rehabilitation: assistive technology, 1(1-2), 29-40.[↩]
  5. Copley, J., & Ziviani, J. (2004). Barriers to the use of assistive technology for children with multiple disabilities. Occupational Therapy International, 11(4), 229-243.[↩]
  6. Clark, F., Azen, S. P., Carlson, M., Mandel, D., LaBree, L., Hay, J., … & Lipson, L. (2001). Embedding health-promoting changes into the daily lives of independent-living older adults: long-term follow-up of occupational therapy intervention. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 56(1), P60-P63.[↩]
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