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This case report describes the use of the Occupational Therapy Task-Oriented Approach with a client with occupational performance limitations after a cerebral vascular accident. The Occupational Therapy Task- Oriented Approach is often suggested as a preferred neurorehabilitation intervention to improve occupational performance by optimizing motor behavior. One common critique of this approach, however, is that it may seem inappropriate or have limited application for clients with cognitive deficits. This case report demonstrates how an occupational therapist working in an inpatient rehabilitation setting used the occupational therapy task-oriented evaluation framework and treatment principles described by Mathiowetz (2004) with a person with significant cognitive limitations. This approach was effective in assisting the client in meeting her long-term goals, maximizing her participation in meaningful occupations, and successfully transitioning to home with her daughter.
KEY WORDS
* cognition disorders
* psychomotor performance
* stroke
* task performance and analysis
The aim of the Occupational Therapy Task-Oriented Approach is to improve occupational performance by optimizing motor behavior (Bass-Haugen, Mathiowetz, & Flinn, 2002; Flinn, 1995). This approach is based on a systems model of motor behavior and emphasizes the interrelatedness of client, task, and environment factors on motor performance (Gillen, 2000; Mathiowetz, 2004; Mathiowetz & Bass-Haugan, 1994, 2002). The Occupational Therapy Task- Oriented Approach is often cited as a preferred neurorehabilitation intervention to improve occupational performance, especially for clients with neurological conditions such as cerebral vascular accident (CVA) and traumatic brain injury. People with neurological conditions frequently receive occupational therapy services (National Board for Certification in Occupational Therapy, 2004), and these conditions often result in changes in multiple body functions including mental, sensory, and neuromusculoskeletal and movement-related functions.
The Occupational Therapy Task-Oriented Approach, however, has been critiqued as inappropriate or having limited application for clients with considerable cognitive limitations (Bass-Haugen, Mathiowetz, & Flinn, 2008; Mathiowetz & Bass-Haugan, 1994). It has been suggested in the literature that some of the key principles of the approach may still be useful for clients with cognitive limitations; however, none of the published case studies of the application of this approach (e.g., Bass-Haugen et al., 2002, 2008; Flinn, 1995; Mathiowetz, 2004) have illustrated how it can be used with clients with significant cognitive limitations. Therefore, the purpose of this case report is to explain how...