OTs and OTAs use clinical reasoning to assesses how a specific activity’s requirements relate to a particular individual’s condition and circumstances. For example, cooking bacon can be challenging for a patient with a hand injury due to the physical requirements involved (i.e., opening the package, separating and placing slices in pan) yet challenging in a very different way for an individual with intellectual disability (i.e., safety concerns for cooking at stove, problem-solving what to do with grease, time management).

For each meal preparation task that your patient performs, consider the particular activity demands such as the number of steps involved, the overall level of complexity, performance skills and other factors required. Note if the task involves safety considerations (such as open flames or heat, use of electric appliances or sharp objects); sequencing, problem-solving, and organizational skills; reading directions or interpreting pictures or diagrams; opening packages; measuring; using specific cooking utensils or appliances; clean up and time management; etc.

Depending on the situation, you may come up with other categories/methods for grading the progression of meal preparation.

General Guidelines for grading meal preparations 

1- Access A Prepared Meal
2- Prepare A Cold Meal
3- Prepare A Hot Beverage, Soup, Or Prepared Dish
4- Prepare A Hot One Dish Meal
5- Prepare A Hot Multi-Dish Meal


Examples of Graded Meal Preparation Tasks (Easier to Harder)

1. Obtain a snack (granola bar, get yogurt or fruit from refrigerator, cheese and crackers)
2. Simple cold meal preparation (cereal and milk, bologna sandwich)
3. Cold meal preparation involving safety/small appliance or utensil use/multiple steps (salad, canned tuna, smoothie)
4. Toaster or toaster oven use (toast, waffles, frozen pizza)
5. Simple stovetop task/1 to 2 steps (tea, soup)
6. Min complex stovetop task (grilled cheese, pudding, scrambled eggs)
7. Mod complex stovetop task/follow multi-step directions (tacos, macaroni and cheese)
8. Complex meal preparation (following a recipe; 2-, 3-, 4-course meal)