Grading & Adapting OT Interventions: Methods & Examples

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  • 0:04 Considering…
  • 0:46 Grading Interventions
  • 2:43 Adapting Interventions
  • 4:39 Lesson Summary
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Lesson Transcript
Instructor: Clio Stearns

Clio has taught education courses at the college level and has a Ph.D. in curriculum and instruction.

As an occupational therapist, one of your important jobs is learning to match the interventions to the client's needs. This lesson discusses what it means to grade and adapt a variety of OT interventions.

Considering Interventions in OT

Dennis has been working as an occupational therapist for many years, and now he has the opportunity to work with and train some new therapists in his agency.

One thing which Dennis' students are particularly interested in is how they can alter the interventions they do in order to really meet the needs of their clients. Dennis is impressed; he knows that differentiating, or changing OT interventions depending on a specific client's needs and goals, is a really crucial aspect of responsive practice.

Dennis explains that there are two major ways to differentiate an OT intervention: grading and adapting. He offers an overview of each of these approaches until his students are confident.

Grading Interventions

Dennis helps his students learn that grading an intervention means using the same intervention, but with increases or decreases in the level of the activity. For example, if patients are getting sensory input from a brush, this can happen for shorter and longer time duration and with more or less pressure on their body. If they're working on activities for dressing themselves, they might button only one large button, or they might button seven tiny buttons in a row.

Let's take a look at different needs addressed in grading interventions.

1. Psychosocial Needs

Dennis explains that sometimes, grading is done based on the clients' psychosocial needs, or their emotional well-being and social interactions. For instance, a client on the autism spectrum who is very easily upset by noisy stimuli might benefit from very short exposures to sound, while someone with hearing loss who is learning to turn to where the sound is coming from might be able to do the same activity for a longer time because it is not emotionally grueling.

2. Cognitive Needs

Cognitive needs, or those pertaining to learning, knowledge, and memory, are also relevant to grading interventions. Dennis explains, for example, that when a client is only able to remember one letter at a time, he only makes them look at one letter and trace it for five minutes as part of pencil control work. A patient who remembers the whole alphabet can do the same activity for a longer period of time and with fewer visual support.

3. Developmental Abilities

Finally, Dennis takes developmental abilities, or capacities related to age and overall development, into consideration when grading activities. He doesn't usually expect children to do activities with the same intensity and duration as adults, for instance. At the same time, some of his elderly patients also require shorter and less intense durations for different interventions.

Adapting Interventions

Next, Dennis explains that to adapt an intervention is to actually change it to meet a client's needs, interests, and goals. In contrast to grading, which has to do with intensity, duration, and activity level, adaptation sees an actual alteration in the nature of the activity. Let's look at the same needs we looked at before, but this time in the context of adapting interventions.

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