Occupational Therapy

Focus

Enabling fullest participation in meaningful, everyday activities

Principal Metaphors

  • Knowledge is … capable engagement
  • Knowing is … competent functioning
  • Learner is … an impaired actor
  • Learning is … overcoming (or coping with) an impairment
  • Teaching is … therapeutic remediation

Originated

1910s

Synopsis

Occupational Therapy is focused on enabling fullest participation in “occupations” – where the word is interpreted broadly to encompass any/all meaningful, everyday activities of individuals of all ages, social groups, or communities. That is, “occupation” refers to whatever occupies – fills, dominates, absorbs, engages – one’s attentions or existence. The foci of the field include therapeutic remediation of and/or support for the development of coping mechanisms for mental health issues and physical impairments. Associated discourses include:
  • Occupational Culture – the “personality” of an occupation or profession – that is, its distinguishing habits of thinking and acting, as manifest in communications, customs, and priorities
  • Occupational Health Psychology – a branch of Psychology that focuses on the mental and physical well-being of those in the workplace
As a well-established field, the variety of discourses at play in Occupational Therapy is comparable to that of education – and so, properly represented, associated discourses on learning would be distributed in a similar way. With that in mind, a small subset of associated discourses follows (categorized by principal client focus, and then sequenced by date of original publication).
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Child-Focused Models
  • Model of Playfulness (Anita Bundy, 1990s) – This model defines “playfulness” on a continuum (from playful to nonplayful), according to a systematic observational analysis of three sub-continua: Intrinsic|Extrinsic Motivation, Internal|External Control, and Free|Not-Free to Suspend Reality. It’s intended to support interpretation and development of treatment for children.
  • Children’s Play Model (Jennifer Sturgess, 2000s) – This model focuses on “play,” seen as the principal occupation of children – and, therefore, a site both to diagnose threats to well-being and to intervene therapeutically. Healthy play is seen to contribute to physical, cognitive, and social development while affording opportunities to exercise creativity, concentration, organization, problem-solving, and other emergent skills.
  • Dynamic Model for Play Choice (Elissa Miller, 2000s) – a model in which playful therapeutic challenges are structured around “just-right challenges,” defined in terms of match between ability level and difficulty level. Four inextricably intertwined categories of analysis are considered, all centered on the child: personal traits, relationships/relationality, context/situation, and affiliation with the activity.
  • Infant Space Theory (Doris Pierce, 2000s) – This model focuses on the infant’s development of Spatial Reasoning, offering details on developmental milestones (e.g., motor skills, capacity to focus) to assist in the structuring appropriate experiences and programs for young children.
  • Model of Children’s Play (Rodney Cooper, 2000s) – This model focuses on “play style” in relation to the developments of one’s skills (cognitive, motor, language, and social), one’s motivations, and one’s social-and-cultural identity – which are understood as shaping and shaped by the milieu. Consequently, play can serve as a site both to detect detrimental childhood experiences and to ameliorate their consequences.
  • Partnering for Change Model (Cheryl Missiuna, 2010s) – This model emphasized collaboration among therapists, educators, and caregivers. Concerned mainly with children with developmental difficulties., its multiple foci include enhancing stakeholder insight, optimizing the child’s environment, adapting learning tasks and modes of teaching, and ongoing dynamic performance analysis.
Disability-Remediation Models
  • Sensory Integration Theory (Jean Ayres, 1970s) – This model begins with the premise that serious learning disabilities are often rooted in Sensory Processing Disorder (Sensory Integration Dysfunction; see Medical Model of (Dis)Ability), and so it focuses on structuring safe and rewarding environments to support sensorially rich tasks that promote integration of perceptions along with regulation of focus and emotion. Subdiscourses include:
    • Sensory Smart Classroom (Christina Sparker, 2010s) – building on Sensory Integration Theory, a term that encompasses all efforts to structure physical classrooms and learner experiences in ways that address each child’s sensory needs
  • Allen’s Cognitive Disabilities Model (Claudia Allen, 1990s)– a diagnosis-based model that is aimed at both maintaining the client’s current skills and developing new coping strategies. It is structured around two categories of analysis: client performance (based on a six-level taxonomy of cognitive function: Automatic, Postural, Manual, Goal-Directed, Exploratory, and Planned), and task/activity evaluation (to ensure match with client cognitive function).
  • Model of Social Interaction (Susan Double, 1990s) – This approach to Occupational Therapy is based on a conception of the individual as an open system comprising three relevant hierarchical subsystems – volition, habituation, and social performance – each of which comprises their own subprocesses. Deficits anywhere in the subsystems or subprocesses can culminate in impaired social interactions, as so such deficits serve to orient interventions.
  • Model of Occupational Empowerment (Grace Sheldon Fisher, 2000s) – This model focuses on interrupting patterns of unhealthy living and Learned Helplessness (see Mindset) that are assumed to arise from disempowering circumstances (e.g., poverty, isolation, physical abuse). Emphasis include training in assertiveness, wellness, home management, social skills, and work skills.
  • Life Balance Model (K. Matuska, 2010s) – Structured around a set of four “need-based dimensions” (biological and safety requirements; nourishing relationships; meaningful engagements; healthy self-perception), this model focuses on analysis of current patterns and development of time-management strategies to ensure needs are met in a balanced manner.
  • Vona du Toit Model of Creative Ability (Vona du Toit, 2010s) – Framing creativity in terms of a sequence of developmental levels, each with distinct motivations and abilities, this model focuses on diagnosing developmental lapses and intervening with activities and challenges intended to prompt the growth of creativity.
Awareness-Focused Models
  • Sensitivity Training (various, 1940s & 1950s) ­– efforts to increase one’s awareness of (i.e., sensitivity to) one’s goals, one’s prejudices, others’ ways of being, and social dynamics. The phrase is often used in the workplace to refer to interventions that are targeted at employees who have violated policies on harassment, discrimination, or other standards of conduct.
  • Dunn’s Model of Sensory Processing (Winnie Dunn, 2000s) – a model of four modes of sensory processing – sensory seeking, sensory avoiding, sensory sensitivity, and low registration – which are generated in a 2-by-2 matrix by crossing “neurological threshold” (the level of sensory stimulation needed to prompt one to notice) and “self-regulation” (one’s level of agency to alter levels of sensory stimulation). Extreme responses are indexed to life difficulties, as so serve as  foci for therapists.
  • Expanded Awareness Model (Joan Toglia, 2000s) – This model is structured around a distinction between one’s “metacognitive knowledge” (i.e., relatively stable, memory-based self-understandings) and “online awareness” (i.e., more fluid, perhaps-unstable knowledge summoned by a task). Discrepancies between these are taken as indicators of lacks of awareness, and interventions are focused on reducing such discrepancies through structured tasks.
  • Kawa Model (Michael Iwama, 2000s) – a model the incorporates Eastern notions of harmony (vs. balance), interdependence (vs. independence), and systemic well-being into therapeutic interventions
  • Value and Meaning in Occupations (Denise Persson, 2000s) – This model frames “occupation” in terms of interactions of a “person–task–performance triad” and focuses on personal narrative as integral to the ongoing structuring of occupational and life meaning. It includes a formal tool to assess”occupational value.”
  • Meaning Perspectives Transformation Model (C.J. Dubouloz, 2010s) – a model that emphasizes critical self-reflection as a means to affect one’s identity. Personal transformation is articulated across three phases (trigger, changing, and outcome) that operate across physical, emotional, cognitive, and spiritual dimensions.
  • Model of Occupational Wholeness (Farzaneh Yazdani, 2010s) – This model involves a comparison of one’s actual situation to one’s wished-for situation, analyzed in terms of four “dimensions of occupation” (being, becoming, belonging, and doing) that are seen to contribute of one’s well-being. Therapy is focused on strategies designed to reduce dissonances between actual and wished-for.
Activity-, Interactivity-, and Systems-Focused Models
  • Model of Human Occupations (Gary Kielhofner, 1980s) – an early attempt to incorporate insights of Complex Systems Research into Occupational Therapy. This model focuses on the dynamic interactions and recursive development of three personal subsystems – volition, habituation, and performance.
  • Ecology of Human Performance (Winnie Dunn, Catana Brown, Ann McGuigan, 1990s) – Aligned with Embeddedness Discourses, a framework based on the principle that ecology affects human behavior, thus emphasizing considerations of one’s relationships and context when structuring therapeutic interventions
  • Theory of Occupational Adaptation (Janette Schkade & Sally Schultz, 1990s) – This theory is properly included among Embeddedness Discourses. It frames the individual in terms of three interacting subsystems (sensorimotor, cognitive, and psychosocial) that are nested in a similarly structured environment (comprising physical, social, and cultural subsystems) – thus framing therapy in terms of facilitating appropriate internal adaptations through meaningful engagement in situations.
  • Model of Co-Occupation (Noralyn Pickens, 2000s) – The model characterizes co-occupations – that is, activities involving others – in terms of three sites of sharing (physicality, emotionality, and intentionality). It is organized around the assertion that participation in co-occupations is negatively correlated to disabilities or impairments, and thus calls for nuanced research into co-occupations to facilitate engagements.
  • Model of Neuro-Occupation, Intention, Meaning and Perception (Ivelisse Lazzarini, 2000s) – Drawing on Complex Systems Research, this model interprets cognition in terms the dynamic interrelationships of intention, meaning, and perception. Interventions are understood as observation-informed perturbations – that is, deliberate, focused triggers designed to have disproportionate influences on a client’s goals, attitudes, and understandings.
  • Theory of Occupational Reconstructions (Gelya Frank, 2010s) – This theory is properly included among Embodiment Discourses. It defines “occupational reconstructions” as “hopeful experiments” that are aimed at responding effectively to disabling situations. The theory provides a model of designing and evaluating initiatives as social transformation across multiple scales and levels of organization.

Commentary

Occupational Therapy is usually identified as a healthcare profession, and that detail is manifest in a consistent alignment with Medical Model of (Dis)Ability (contrast: Social Model of (Dis)Ability). Indeed, even though the bulk of activities in Occupational Therapy are clearly education-oriented, it is rarely explicitly aligned with the field of education, despite the obvious and extensive overlaps of both defining responsibilities and orienting theories. For a much wider and deeper survey of discourses in the domain, we recommend the HOTheory database.

Authors and/or Prominent Influences

Eleanor Clarke Slagle, Adolf Meyer

Status as a Theory of Learning

Occupational Therapy is not a theory of learning.

Status as a Theory of Teaching

Despite being defined as a “healthcare profession,” Occupational Therapy is overwhelmingly focused on educational activities. As such, it is properly construed as a domain that is principally concerned with teaching.

Status as a Scientific Theory

Occupational Therapy tends to be founded and grounded on scientific research.

Subdiscourses:

  • Allen’s Cognitive Disabilities Model
  • Children’s Play Model
  • Dunn’s Model of Sensory Processing
  • Dynamic Model for Play Choice
  • Ecology of Human Performance
  • Expanded Awareness Model
  • Infant Space Theory
  • Kawa Model
  • Life Balance Model
  • Meaning Perspective Transformation
  • Model of Children’s Play
  • Model of Co-Occupation
  • Model of Human Occupations
  • Model of Neuro-Occupation, Intention, Meaning and Perception
  • Model of Occupational Empowerment
  • Model of Occupational Wholeness
  • Model of Playfulness
  • Model of Social Interaction
  • Occupational Culture
  • Occupational Health Psychology
  • Partnering for Change Model
  • Sensitivity Training
  • Sensory Integration Theory
  • Sensory Smart Classroom
  • Theory of Occupational Reconstructions
  • Theory of Occupational Adaptation
  • Value and Meaning in Occupations
  • Vona du Toit Model of Creative Ability

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Please cite this article as:
Davis, B., & Francis, K. (2023). “Occupational Therapy” in Discourses on Learning in Education. https://learningdiscourses.com.


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