Department of Occupational Therapy, Bangladesh Health Professions Institute

2. Introduction
• The Occupational Therapy Practice Framework:
Domain and Process, 3rd edition (hereinafter
referred to as “the Framework”), is an official
document of the American Occupational Therapy
Association (AOTA).
• Intended for occupational therapy practitioners and
students, other health care professionals,
educators, researchers, payers, and consumers, the
Framework presents a summary of interrelated
constructs that describe occupational therapy
practice.

4. Occupations
• Activities of
daily living
(ADLs)
• Instrumental
activities of
daily living
(IADLs)
• Rest and
sleep
• Education
• Work
• Play
• Leisure
• Social
participation
Client factors
• Values,
beliefs, and
• spirituality
• Body
functions
• Body
structures
Performance
skills
• Motor skills
• Process skills
• Social
interaction
skills
Performance
patterns
• Habits
• Routines
• Rituals
• Roles
Contexts and
environments
• Cultural
• Personal
• Physical
• Social
• Temporal
• Virtual

5. Occupation
• “Occupation is used to mean all the things people
want, need, or have to do, whether of physical,
mental, social, sexual, political, or spiritual nature
and is inclusive of sleep and rest. It refers to all
aspects of actual human doing, being, becoming,
and belonging.
• The practical, everyday medium of self-expression or
of making or experiencing meaning, occupation is
the activist element of human existence whether
occupations are contemplative, reflective, and
meditative or action based” (Wilcock & Townsend,
2014, p. 542).

6. Areas of Occupation
• Activities of daily living (ADLs)
• Instrumental activities of daily living (IADLs)
• Rest and sleep
• Education
• Work
• Play
• Leisure
• Social participation

7. Client factors
• Client factors are specific capacities, characteristics, or
beliefs that reside within the person and that influence
performance in occupations.
• Client factors are affected by the presence or absence of
illness, disease, deprivation, disability, and life experiences.
• Although client factors are not to be confused with
performance skills, client factors can affect performance
skills.
• Thus, client factors may need to be present in whole or in
part for a person to complete an action (skill) used in the
execution of an occupation.
• In addition, client factors are affected by performance skills,
performance patterns, contexts and environments, and
performance and participation in activities and occupations.

8. CLIENT FACTORS
• Client factors include:
(1) values, beliefs, and spirituality;
(2) body functions; and
(3) body structures that reside
within the client that influence the
client’s performance in
occupations.

9. Performance Skills
• Performance skills are goal-directed actions
that are observable as small units of
engagement in daily life occupations.
• They are learned and developed over time and
are situated in specific contexts and
environments (Fisher & Griswold, 2014).
• Fisher and Griswold (2014) categorized
performance skills as motor skills, process skills,
and social interaction skills (Table 3).

10. List of performance skills
Motor skills Process skills Social interaction skills
Aligns Paces Gathers Approaches/Starts Thanks
Stabilizes Attends Terminates Concludes/disengages Transitions
Positions Heeds Searches Produces speech Time response
Reaches Choose Organizes Gesticulates Time duration
Bends Uses Restores Speaks fluently Takes turns
Grips Handles Navigates Turns toward Matches
languageManipulates Inquires Notices Looks
Coordinates Initiates Adjust Places sell Acknowledges &
encouragesMoves Continues Accommodates Touches
Lifts Sequences Benefits Regulates Empathizes
Walks Questions Heeds
Transports Replies Accommodates
Paces Discloses Benefits
Express emotion Disagrees
Clarifies

11. Performance pattern
• Performance patterns are the habits, routines,
roles, and rituals used in the process of engaging in
occupations or activities that can support or hinder
occupational performance.
• Habits refers to specific, automatic behaviors; they
may be useful, dominating, or impoverished.
• Routines are established sequences of occupations
or activities that provide a structure for daily life;
routines also can promote or damage health.
• Roles are sets of behaviors expected by society and
shaped by culture and context; they may be further
conceptualized and defined by a client.

12. Performance Pattern
Individual Group
Habits Routines
Routines Rituals
Rituals Roles
Roles

13. Context and environment
• Engagement and participation in occupation take
place within the social and physical environment
situated within context.
• In the literature, the terms environment and context
often are used interchangeably.
• In the Framework, both terms are used to reflect the
importance of sconsidering the wide array of
interrelated variables that influence performance.
• Understanding the environments and contexts in
which occupations can and do occur provides
practitioners with insights into their overarching,
underlying, and embedded influences on
engagement.

14. Context and Environment
Environment Context
Physical Cultural
Social Personal
Temporal
Virtual