Occupational Therapy Activity Analysis Form / Cheatsheet / Guide

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1 Occupation
2 Values, Beliefs, Spirituality
3 Contexts
4 Objects
5 Social Demands
6 Activity Breakdown – Sequence and Timing
7 Clinical Considerations
8 Sources

Occupation

What is the purpose or meaning of the activity?

How does this activity relate to occupational performance? What occupation are you analyzing? An activity may belong to more than one category.

  • [  ] Activities of Daily Living (ADLs)
  • [  ] Instrumental Activities of Daily Living (IADLs)
  • [  ] Rest and Sleep
  • [  ] Productivity (Work, Education)
  • [  ] Leisure
  • [  ] Social Participation
  • [  ] Health Management

Values, Beliefs, Spirituality

  • What does the client value? ____________________
  • What are their beliefs? ____________________
  • How is spirituality is associated? ____________________

Contexts

  • Physical environment 

Strengths/Supports ____________________ Barriers ____________________

  • Personal

Strengths/Supports ____________________ Barriers ____________________

  • Cultural

Strengths/Supports ____________________ Barriers ____________________

  • Social

Strengths/Supports ____________________ Barriers ____________________

  • Temporal

Strengths/Supports ____________________ Barriers ____________________

  • Virtual

Strengths/Supports ____________________ Barriers ____________________

Objects

  • What objects are required?
    ____________________________________________________________
    ____________________________________________________________
    ____________________________________________________________
  • What are their properties?
    ____________________________________________________________
    ____________________________________________________________
    ____________________________________________________________

Social Demands

____________________________________________________________
____________________________________________________________
____________________________________________________________

Activity Breakdown – Sequence and Timing

Complex activities can be further broken down into additional steps.

  1. _____________________________________
  2. _____________________________________
  3. _____________________________________
  4. _____________________________________
  5. _____________________________________
  6. _____________________________________
  7. _____________________________________
  8. _____________________________________
  9. _____________________________________
  10. _____________________________________
  11. _____________________________________
  12. _____________________________________
  13. _____________________________________
  14. _____________________________________
  15. _____________________________________
  16. _____________________________________
  17. _____________________________________
  18. _____________________________________
  19. _____________________________________
  20. _____________________________________

Clinical Considerations

  1. How can the activity be graded down or up (difficulty)?
  2. Can the activity be modified or adapted?
  3. How can the activity be completed differently (thinking outside the box)?
  4. Can this activity generalize to different environments?
  5. Can this sequence or timing be used as a cue (visual, audity, etc.) to assist in the activity?
  6. How can the interdisciplinary team be used to maximize occupational performance?

Sources

Adapted from Thomas, H. (2012). Occupation-Based Activity Analysis. Thorofare, NJ: SLACK Incorporated