General Environmental Considerations Definition and Maior Concepts - ANSWER and
Maior Concepts 1. The environment "the aggregate of phenomena that surrounds individual
and influences (her) development existence" (Mosey, 1996, p. 171). environment which
lives, and exposure to various settings, influences his or her development and adaptation.
The environment facilitate because for adaptation problem-solving strategies to developed.
Conversely, environment can hinder develop- and adaptation impoverished hostile. 5. A
person's abilities, limitations, problems, activities, occupations be fully under- stood without
considerations his/her current and expected environment. 6. Physical/nonhuman
environment. Everything nonhuman (i.e., buildings, objects, tools, devices, animals, trees).
Sensory environment. Visual: lighting, colors, posters all over Auditory: loudness of
loudspeakers, class- room noise. c. Tactile: seating textures. d. Olfactory: pleasant offensive
odors. Gustatory: pleasant offensive 8. Social-cultural/human environment. a. Social roles:
organized pattern behavior that characteristic enerauem defined position social system"
(Mosey, 1996, p. 64); for example, student, parent, worker. Social network: "the of voluntary
relationships that make individual's social environment" (Mosey, 1996, 184). aspects: "the
social structures, values norms, and expectations that accepted shared of people" d.
Psychological aspects: environmental character- istics that affect mood and stress level (e.g.,
a calming, cheerful envi chaotic, uncomfortable, depressing setting). 9. The AOTA description
environment beyond the physical and social environment to include concept In the AOTA
Practice Framework, context "refere law expected occupant environment Practice ramework
expanded variety interrelated conditions are within and surrounding the interrelated less
tangible physical and sto 15
Definition and Maior Concepts - ANSWER social environments nonetheless exer
influence performance" (AOTA 2008, Contexts include cultural, personal, tempor virtual. (1)
"cultural context includes customs activity patterns, behavior standards, and tations
accepted by the society of whi client is a member" (AOTA "personal context demos
individual such age, socioeconomic status, educational that not health condition" 2008, p.
"temporal context includes stages time year, time of day and duration activity, history"
(AOTA 2008, The virtual context refers the "enviro in which communication by mea airways
or computers absence of cal contact" (AOTA 2008, 645); exan e-mail, video-conferencing,
web-based networking.
1
,Legislation Related to the Environment - ANSWER Environment 1. Americans with
Disabilities Act (ADA): civil law aimed at allowing full participation in society people with
disabilities. Several sections mandate accessible environie for persons with disabilities. b.
Included are policies dealing with public sevic employment, public accommodations. 2.
Omnibus Budget Reconciliation Act dates that restraints cannot be used without
justification, agreement, and documentation 3. Individuals with Disabilities Education Act
(IDEA mandates that children disabilities geine education in least restrictive and most
environment. a. Inclusive models are be used to enable chil to be taught a regular
classIOom. b. Education must prepare iving and emplovment environme child for indepgnd
The role of practitioners environmental ase ment and modification has increased with
mentation of the OBRA, and IDEA. (See 4 more specific information on OR IDEA.)
me Role of Occupational Therapy (OT) Practitioners - ANSWER 2. OT practitioners
advocate for and design environ- ments that use principles of universal design meet physical,
sensory, sociocultural, psychological needs individual. Table 15-1. OT practitioners can help
identify settings and approaches implement the OBRA, and IDEA. porson's environment-
living, vocational, a-whether takes place hospital, nursing school, practitioners familiar with
me Role of Occupational Therapy (OT) Practitioners - ANSWER practitioners can
advocate for ADA, OBRA, IDEA compliance to enable individuals function independently-and
with least restriction-as possible, their environment.
The Role of the Team - ANSWER 1. practitioners part of an interdiscipli- nary team that
determines the needs abilities of an individual with disability specific environ- ment. Basis
team construction. a. The facility which the individual disability presently resides and/or
participates. The individual's needs and her abilities/func tional Geographical location.
Funding ity (ie., third-party payers and/or offices individuals with disabilities). Support
caregivers. The should always include the consumer and caregivers. 4. Professional team
members may belong to Rehabilitation Engineers Society of North America (RESNA) and/or
Registry Rehabilitation Technology Suppliers (NRRTS). Both professional organizations help
develop standards measuring tools to ensure proper design, prescription, and delivery of
rehabilitation technology. available the individual with a disabil-
The Role of the Team - ANSWER 5. professional team members. Assistive technology
professional (ATP): analzE consumer needs, help select appropriate assistive technology
2
,identified and proid. training in use the b. Computer design provision of efficient technology.
c. trainer: for driving adaptations. subsequent section driver rehabilitation. Nurse: ensure
medical care medication regimes prescribed the doctor. e. Occupational and occupational
assistant: refer section. Physical therapist: mobility difficulties individual encounter the
environment. Physician: and assess services and purchases. Psychologist: assist adjustment
indicated. i. Rehabilitation counselor: assess and advise vocational issues. j. Speech language
pathologist: to assess mend augmentative communication aids. Rehabilitation design
equipment assist with modifications adaptive equipme 1. Seating mobility specialist (SMS):
seating, positioning, mobility needs and appropriate recommendations. Social worker: to
obtaining funding. evaluae n. Teacher: children the school system, help any modifications
within classroom setting
The Role of the Team - ANSWER payer their respective case man- to approve and/or
provide funding for the lividual's needed environmental modifica. dors: provide items
requested therapists and required the individual to function Environmental
individual function Purposes Environmental Evaluation Intervention - ANSWER Lientify
and prioritize needs, goals, desires, blem areas individual with disability within his/her
environments. huablish the regarding everyday functional activities within his/her
environment. functional use devices being considered lor particular individual facilitate
mastery the environment.
Purposes of Environmental Evaluation and Intervention - ANSWER Environmental
Identify device's availability, safety, cs. Determine device's frequency 6. Determine funding
financial resources for equip- ment and/or modifications. a. questionable ethics inter- of the
with show him/ her device order top-of-the-line equipment that is covered his/her
insurance, he/she does financial resources self-pay. Determine environmental constraints.
For example, individual be living in flight walk-up apartment device locked up lobby, opening
of vandalism theft. 8. individual with a disability and device allow reevaluation. Ensure
device will for possible modifica tions, upon reassessment of individual change in found. and
everyday Chapter 15
Overall Environmental Evaluation Evaluation of Performance Skills Client Factors*** -
ANSWER role the occupational contributes to the evaluation process collaboration
with the supervisor. Supervision required. (2) level supervision required mined by
experience established service competence. h. Service competency be established. OTA
3
, cannot independently or inter- evaluation results. Performance are essential when
conducting environmental evalua- for they are allow person function in his/her
environment. LUpon establishment service competency, OIA following areas: Sensory (eg,
assess Getermine there impairment discrimi- nation inluence safety the manipula- devices).
driving Visual perceptual processing skills of Test, standardized to assess visual motor for
poten- tial difficulties computer Musculoskeletal skills range of motion, strength, endurance,
assess (1) (4) (5)
Evaluation Performance and Client Factors - ANSWER physically devices optimal
capability). d. Neuromuscular (eg. coordination, assess person's mically and environmental
manipula- tion). skills (eg., following directions and judg- ment, assess is of limitations and
able to follow recall operation assistive technology wheelchairs) use of f. Psychosocial (e.g.,
support, assess if individual ask assis- tance, needed the right person). utilize rhyth-
Contextual Evaluation - ANSWER manipula- to The contributes evaluation process with
OT supervision. targeted evaluation include: a. Physical considerations. (1) Arrangement
furniture. Accessibility items needed activi- ties safe (3) Housing/workplace Neighborhood
characteristics.
Contextual Evaluation - ANSWER Environment: Intervention the individual with
disability (3) Opportunities for socialization (4) Sociocultural norms, values, and expectations
Social roles: expectations for performance Availability and of transportation. Overall
accessibility. Sociocultural considerations. independent function. (5) Community resources
available. individual's network relation ships between individual disability
Home Evaluation General Considerations*** - ANSWER General Considerations OTAS
perform home assessments and make adap- tations, modifications, and recommendations
to anticipated dwelling to increase safe, independent functioning with OT supervision 2. an
individual with disability discharged to home from facility, evaluation should be discharge
The person's current status (abilities and and risks in home determine need for home
modifications adapta-
Overall Characteristics of the Home - ANSWER good private one-family, family,
apartnment, walk-up, elevator access. 2. Protection from weather/environmental changes.
Presence and of driveway. 4. Level which person lives. Entrance dwelling wheelchair raimp.
4
Maior Concepts 1. The environment "the aggregate of phenomena that surrounds individual
and influences (her) development existence" (Mosey, 1996, p. 171). environment which
lives, and exposure to various settings, influences his or her development and adaptation.
The environment facilitate because for adaptation problem-solving strategies to developed.
Conversely, environment can hinder develop- and adaptation impoverished hostile. 5. A
person's abilities, limitations, problems, activities, occupations be fully under- stood without
considerations his/her current and expected environment. 6. Physical/nonhuman
environment. Everything nonhuman (i.e., buildings, objects, tools, devices, animals, trees).
Sensory environment. Visual: lighting, colors, posters all over Auditory: loudness of
loudspeakers, class- room noise. c. Tactile: seating textures. d. Olfactory: pleasant offensive
odors. Gustatory: pleasant offensive 8. Social-cultural/human environment. a. Social roles:
organized pattern behavior that characteristic enerauem defined position social system"
(Mosey, 1996, p. 64); for example, student, parent, worker. Social network: "the of voluntary
relationships that make individual's social environment" (Mosey, 1996, 184). aspects: "the
social structures, values norms, and expectations that accepted shared of people" d.
Psychological aspects: environmental character- istics that affect mood and stress level (e.g.,
a calming, cheerful envi chaotic, uncomfortable, depressing setting). 9. The AOTA description
environment beyond the physical and social environment to include concept In the AOTA
Practice Framework, context "refere law expected occupant environment Practice ramework
expanded variety interrelated conditions are within and surrounding the interrelated less
tangible physical and sto 15
Definition and Maior Concepts - ANSWER social environments nonetheless exer
influence performance" (AOTA 2008, Contexts include cultural, personal, tempor virtual. (1)
"cultural context includes customs activity patterns, behavior standards, and tations
accepted by the society of whi client is a member" (AOTA "personal context demos
individual such age, socioeconomic status, educational that not health condition" 2008, p.
"temporal context includes stages time year, time of day and duration activity, history"
(AOTA 2008, The virtual context refers the "enviro in which communication by mea airways
or computers absence of cal contact" (AOTA 2008, 645); exan e-mail, video-conferencing,
web-based networking.
1
,Legislation Related to the Environment - ANSWER Environment 1. Americans with
Disabilities Act (ADA): civil law aimed at allowing full participation in society people with
disabilities. Several sections mandate accessible environie for persons with disabilities. b.
Included are policies dealing with public sevic employment, public accommodations. 2.
Omnibus Budget Reconciliation Act dates that restraints cannot be used without
justification, agreement, and documentation 3. Individuals with Disabilities Education Act
(IDEA mandates that children disabilities geine education in least restrictive and most
environment. a. Inclusive models are be used to enable chil to be taught a regular
classIOom. b. Education must prepare iving and emplovment environme child for indepgnd
The role of practitioners environmental ase ment and modification has increased with
mentation of the OBRA, and IDEA. (See 4 more specific information on OR IDEA.)
me Role of Occupational Therapy (OT) Practitioners - ANSWER 2. OT practitioners
advocate for and design environ- ments that use principles of universal design meet physical,
sensory, sociocultural, psychological needs individual. Table 15-1. OT practitioners can help
identify settings and approaches implement the OBRA, and IDEA. porson's environment-
living, vocational, a-whether takes place hospital, nursing school, practitioners familiar with
me Role of Occupational Therapy (OT) Practitioners - ANSWER practitioners can
advocate for ADA, OBRA, IDEA compliance to enable individuals function independently-and
with least restriction-as possible, their environment.
The Role of the Team - ANSWER 1. practitioners part of an interdiscipli- nary team that
determines the needs abilities of an individual with disability specific environ- ment. Basis
team construction. a. The facility which the individual disability presently resides and/or
participates. The individual's needs and her abilities/func tional Geographical location.
Funding ity (ie., third-party payers and/or offices individuals with disabilities). Support
caregivers. The should always include the consumer and caregivers. 4. Professional team
members may belong to Rehabilitation Engineers Society of North America (RESNA) and/or
Registry Rehabilitation Technology Suppliers (NRRTS). Both professional organizations help
develop standards measuring tools to ensure proper design, prescription, and delivery of
rehabilitation technology. available the individual with a disabil-
The Role of the Team - ANSWER 5. professional team members. Assistive technology
professional (ATP): analzE consumer needs, help select appropriate assistive technology
2
,identified and proid. training in use the b. Computer design provision of efficient technology.
c. trainer: for driving adaptations. subsequent section driver rehabilitation. Nurse: ensure
medical care medication regimes prescribed the doctor. e. Occupational and occupational
assistant: refer section. Physical therapist: mobility difficulties individual encounter the
environment. Physician: and assess services and purchases. Psychologist: assist adjustment
indicated. i. Rehabilitation counselor: assess and advise vocational issues. j. Speech language
pathologist: to assess mend augmentative communication aids. Rehabilitation design
equipment assist with modifications adaptive equipme 1. Seating mobility specialist (SMS):
seating, positioning, mobility needs and appropriate recommendations. Social worker: to
obtaining funding. evaluae n. Teacher: children the school system, help any modifications
within classroom setting
The Role of the Team - ANSWER payer their respective case man- to approve and/or
provide funding for the lividual's needed environmental modifica. dors: provide items
requested therapists and required the individual to function Environmental
individual function Purposes Environmental Evaluation Intervention - ANSWER Lientify
and prioritize needs, goals, desires, blem areas individual with disability within his/her
environments. huablish the regarding everyday functional activities within his/her
environment. functional use devices being considered lor particular individual facilitate
mastery the environment.
Purposes of Environmental Evaluation and Intervention - ANSWER Environmental
Identify device's availability, safety, cs. Determine device's frequency 6. Determine funding
financial resources for equip- ment and/or modifications. a. questionable ethics inter- of the
with show him/ her device order top-of-the-line equipment that is covered his/her
insurance, he/she does financial resources self-pay. Determine environmental constraints.
For example, individual be living in flight walk-up apartment device locked up lobby, opening
of vandalism theft. 8. individual with a disability and device allow reevaluation. Ensure
device will for possible modifica tions, upon reassessment of individual change in found. and
everyday Chapter 15
Overall Environmental Evaluation Evaluation of Performance Skills Client Factors*** -
ANSWER role the occupational contributes to the evaluation process collaboration
with the supervisor. Supervision required. (2) level supervision required mined by
experience established service competence. h. Service competency be established. OTA
3
, cannot independently or inter- evaluation results. Performance are essential when
conducting environmental evalua- for they are allow person function in his/her
environment. LUpon establishment service competency, OIA following areas: Sensory (eg,
assess Getermine there impairment discrimi- nation inluence safety the manipula- devices).
driving Visual perceptual processing skills of Test, standardized to assess visual motor for
poten- tial difficulties computer Musculoskeletal skills range of motion, strength, endurance,
assess (1) (4) (5)
Evaluation Performance and Client Factors - ANSWER physically devices optimal
capability). d. Neuromuscular (eg. coordination, assess person's mically and environmental
manipula- tion). skills (eg., following directions and judg- ment, assess is of limitations and
able to follow recall operation assistive technology wheelchairs) use of f. Psychosocial (e.g.,
support, assess if individual ask assis- tance, needed the right person). utilize rhyth-
Contextual Evaluation - ANSWER manipula- to The contributes evaluation process with
OT supervision. targeted evaluation include: a. Physical considerations. (1) Arrangement
furniture. Accessibility items needed activi- ties safe (3) Housing/workplace Neighborhood
characteristics.
Contextual Evaluation - ANSWER Environment: Intervention the individual with
disability (3) Opportunities for socialization (4) Sociocultural norms, values, and expectations
Social roles: expectations for performance Availability and of transportation. Overall
accessibility. Sociocultural considerations. independent function. (5) Community resources
available. individual's network relation ships between individual disability
Home Evaluation General Considerations*** - ANSWER General Considerations OTAS
perform home assessments and make adap- tations, modifications, and recommendations
to anticipated dwelling to increase safe, independent functioning with OT supervision 2. an
individual with disability discharged to home from facility, evaluation should be discharge
The person's current status (abilities and and risks in home determine need for home
modifications adapta-
Overall Characteristics of the Home - ANSWER good private one-family, family,
apartnment, walk-up, elevator access. 2. Protection from weather/environmental changes.
Presence and of driveway. 4. Level which person lives. Entrance dwelling wheelchair raimp.
4
