It Is Not About “Function”

A brilliant insight into the real power and focus of Occupational Therapy by OT, Frances Worster.

The Vandellous

Is it about the degrees of motion in your shoulder? That you can flex your wrist against gravity? Do you pronate or supinate to grasp and manipulate objects?

….huh?

It’s Not About the Shoelaces: An Occupation as Site of Conflict

A young man with Cerebral Palsy, shortly to be transitioning into adulthood. He and his parents have one Occupational Therapy goal: for him to tie his shoelaces independently.

Functionally, he has all of the components: fine motor dexterity and requisite upper limb skills, cognitive skills, visual skills – with effort and concentration, he could do it. He could tie his tie, a half-windsor, with no problem. Bottom-up, there was no reason he could not tie his laces. Analysing his attempts, his sequencing was off, and he could not replicate my instructions. He had the component skills and the idea of making loops and tying knots. But, something else was going on…I needed to step back.

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