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Occupational Therapy Frames of Reference

A frame of reference is a theoretical basis for a treatment approach. This chart outlines the frames of reference commonly used in occupational therapy treatment and provides examples of how these frames of references are applied. Frames of reference that use more complicated or structured approaches are sometimes called models.

Frame of Reference or Model Author or Research Base Description Examples of use during occupational therapy treatment Video Examples
Allen Cognitive Model Claudia Allen, MA, OTR, FAOTA Model of assessment and treatment that is built around functional cognition, or the interaction between cognitive abilities and the activity setting that results in performance. An occupational therapist administers the Allen Cognitive Levels screening test to determine how much assistance a new patient with mild dementia will need to follow precautions following hip replacement surgery

A cooking activity is structured by the occupational therapist to accommodate the cognitive skills of a patient with schizophrenia, based on the outcome of the Routine Task Inventory (RTI)

Interview with Catherine Earhart about the Allen Cognitive Model
Sample home consultation for an elderly woman functioning at Allen Cognitive Level 4
Behavioral Modification Based on the principles of operant conditioning, developed by B.F. Skinner Positive or negative reinforcement is used to elicit a desired response. In a public school setting, an occupational therapist asks a student to write three sentences, after which he may choose an activity that he would like to do.

A head injury patient is required to clean up the occupational therapy treatment area after throwing objects while refusing treatment.

A simple explanation and examples of how to use behavior modification techniques with young children.
Biomechanical Frame of Reference Unknown – this is the oldest frame of reference used in rehabilitation. Therapeutic exercise is used to improve range of motion, strength and endurance, which is then thought to lead to improvements in functional abilities. For an outpatient who has had rotator cuff surgery, an occupational therapist leads active range of motion exercises, and then has the patient reach for plastic glasses in a cupboard.
An occupational therapist has a patient complete upper body strengthening exercises to improve the patient’s ability to push up from a chair during transfers.
An occupational therapist explains the principles and different movements associated with range of motion.
An occupational therapist demonstrates basic arm strengthening exercises.
Brunnstrom Movement Therapy Frame of Reference Signe Brunnstrom, PT Synergies and reflexes that occur in early normal development are also a normal part of the recovery process for patients with hemiplegia following a stroke. These synergies should be facilitated and encouraged during the course of treatment. During occupational therapy treatment for a woman who has hemiplegia following a stroke, the occupational therapist has the woman perform a reaching activity with her unaffected arm while the therapist moves the affected arm in the same manner. Occupational therapy assistants demonstrate the six stages of Brunnstrom Movement Therapy
Canadian Model of Occupational Performance Canadian Association of Occupational Therapists A framework that illustrates the interaction between people, their environments, and their occupations related to self care, productivity, and leisure. An occupational therapist develops a treatment plan for a woman with rheumatoid arthritis, based on the woman’s desire to resume playing the organ at her church. -Occupational therapy students explain the Canadian Model of Occupational Performance.

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