Areas of Occupation

Hey readers! Now that we all know what occupational therapy is (if you missed my blog post about it, be sure to check it out!), let’s talk more in-depth about areas of occupation. As a reminder, an occupation is any activity that occupies your time and is meaningful and purposeful. There are 8 areas of occupation that OTs are trained in:

• Activities of daily living (ADLs)
• Instrumental activities of daily living (IADLs)
• Sleep and rest
• Work
• Education
• Play
• Leisure
• Social participation

In this blog post, I will talk about what each of these areas of occupation is and what it looks like in practice. In other words, what an OT might do to intervene in each of these areas! (Disclaimer: I am still a student! There are so many ways that an OT can intervene in each of these areas. I will only mention one or two that I have either learned about in school or seen in fieldwork thus far. Maybe I will update this post as I learn even more about each of these areas! OTs and OT students: comment below some of the ways that you intervene in any of these areas!)

Activities of Daily Living

Activities of daily living are tasks that you do on a daily basis such as eating, bathing, dressing, toileting, functional mobility, and more. These are activities that you must complete to take care of yourself, and they may be things that many people either don’t think about or take for granted each day. However, OTs intervene when individuals are unable to perform these tasks independently due to illness, injury, or disability.

OT in Practice: ADLs

Patients may be unable to perform ADLs on their own if they experience a stroke, amputation, total hip replacement, etc. For example, if an individual is having difficulty dressing due to precautions after a total hip replacement, an OT may suggest adaptive equipment and work with the patient on dressing while following hip precautions. Some equipment that an OT may recommend include a reacher, dressing stick, shoehorn, and sock-aid.

Instrumental Activities of Daily Living

Instrumental activities of daily living are similar to ADLs, however, they require more planning and thought. These are tasks that support daily living at home and in the community. For example, an individual needs to be able to balance a budget, write a check/pay bills, go grocery shopping, take care of family members (children) or pets, manage a household, prepare a meal, and/or interact with and move within the community in order to remain independent.

OT in Practice: IADLs

Individuals who experience a traumatic brain injury, stroke, or other disability may have difficulty performing IADLs due to decreased cognitive functions. For example, a patient who experienced a TBI may be unable to go grocery shopping independently in order to prepare a meal. An OT may create a mock grocery list and have the patient gather certain items around the clinic/hospital in order to prepare a meal together. This will enable the patient to work on cognitive skills required to plan and shop for a meal.

Sleep and Rest

Sleep and rest include the process of preparing for sleep, the act of sleeping, and any quiet action that results in relaxation. Individuals who experience mental health difficulties, sleep disorders, and other conditions may be unable to engage in adequate sleep or rest.

OT in Practice: Sleep and Rest

An example of this is among individuals who experience post-traumatic stress disorder and have difficulty sleeping. OTs are skilled in creating and modifying routines and teaching healthy habits. An OT may be able to suggest ways in which the client could engage in a sleep preparation routine, which will help them engage in better quality sleep. (I don’t know about you, but I love my sleep prep routine! Lighting a candle or diffusing essential oils while having some time to watch Netflix or read a book is the best way to end my day.)

Work

Work is the act of seeking employment, maintaining/performing a job, preparing for retirement, or volunteering. Individuals who experience mental illness, intellectual or developmental disabilities, stroke, TBI, etc. may experience difficulties in any of these areas of work.

OT in Practice: Work

An individual who has autism spectrum disorder, a developmental disability, may experience difficulties in seeking and maintaining employment. An OT may intervene by teaching skills related to job performance, such as social skills, time management, problem-solving, memory, communication, safety, and more.

Education

Education is one of the main occupations during childhood, but also extends throughout the lifespan. This occupation includes any activity required for learning and engaging in the learning environment. Individuals who have intellectual or developmental disabilities are one example of who may benefit from OT in a school context.

OT in Practice: Education

A child who has sensory processing disorder may experience difficulties in a school setting. The bright lights, colorful/busy classroom environments, necessity to sit still for prolonged periods of time, and many other factors may play into disruption or disengagement in education. An OT may step in by creating a sensory diet for the child and/or modifying the environment in order to support engagement in education.

Play

Play is another essential occupation during childhood. Play is what allows children to develop physically, cognitively, emotionally and socially. This is any activity that provides enjoyment, entertainment, amusement, or diversion. Children with any number of disabilities may experience difficulties in the occupation of play.

OT in Practice: Play

For example, a child who has autism spectrum disorder may be challenged by the social aspect of play. An OT can intervene using groups and teaching social skills to help engage the child in play. Another example of play intervention that I remember from observation at a pediatric clinic was using a game called “Pop The Pirate.” The OT used play as the means of intervention (the child just thought he was playing a fun game with a nice lady), however, she challenged him physically and cognitively with posture (no W-sitting!), pincer grasp of the game pieces, crossing midline, taking turns, and following rules. How cool is that?! (Can you tell this is the area that I am most passionate about?)

Leisure

Leisure and play are quite similar occupations. Typically, play is seen in children and leisure is seen in adults, but this is not necessarily always true. Leisure is any nonobligatory activity that is intrinsically motivated and engaged in during free time. These are typically activities that individuals value highly and provide meaning and fulfillment to their lives. Individuals who experience occupational deprivation, occupational marginalization, or occupational imbalance often lack opportunities to pursue leisure occupations beyond their control. Recently retired individuals may also experience a lack of leisure occupations.

OT in Practice: Leisure

An example of this can be observed among individuals experiencing homelessness or incarceration. Individuals in these situations do not have the opportunities or choice of leisure occupations, and therefore may be missing significant meaning or purpose in life. A way that an OT can intervene is by educating clients about what opportunities are available to them and building social skills to allow the person to engage positively in occupations of their choosing. Of course, there are many factors that play into occupational choice in both of these groups. (OTs can also hold groups for emotional regulation, build up ADL and IADL skills, and empower and prepare individuals for work, among other roles.) The goal of OT among these populations is to assist the person in returning to a self-sustaining, independent life. Furthermore, individuals who retire often feel a loss of purpose. This can be due to a lack of structure to their day and loss of social contacts. An OT can intervene by identifying interests and assisting the individual in finding and engaging in meaningful leisure activities.

Social Participation

Social participation includes engaging in the community and among friends, family, peers, coworkers, etc. Those who may have difficulty engaging in social participation are elderly or aging individuals, among many other populations. This may be due to inability to drive or community mobility difficulties (ex. inaccessibility for those who use wheelchairs).

OT in Practice: Social Participation

An elderly individual who is unable to drive could benefit from OT intervention because an OT can assess driving (if applicable) and can practice community mobility with the individual. A person may not know how to use the local train system, which is impairing their community mobility and social participation. An OT can assist here.

As you may already know, the areas of play and education (and the implication of sensory needs on these occupations) are by far the ones that I am most interested in. BUT, all occupations are vital to all of us as humans! Engaging in meaningful, purposeful activity is proven to lead to better health outcomes and an overall happier, healthier life.

Thanks for reading!