Box #1: The
model of functional therapy requires that services focus on improving concrete
functional skills representing a child and family's priority areas that will
help them more fully participate in everyday life experiences. The team can
develop outcomes using the information around routines, daily life, and priorities
that the family shares along with information obtained through observation and
will use playground equipment, play in the sandbox, and explore the outdoors.
Why is this important? We like to take our kids to the park and want both of our daughters to enjoy this activity. We want Katy to have things she can do with her sister, on her own and with other kids whether she is at the neighborhood park, in our backyard, or in some other outdoor location on family visits.
How will you know you have met your outcome? Katy will have 3 things she likes to do and can do at the park with her sister, and one thing she likes to do by herself at home and in the park.
Box #2: Fill
in the general routine in which this outcome takes place.
outside at the park or family playground.
Box #3: Use
of this box provides the team, which includes the parents, with an opportunity
to analyze what is needed to achieve this outcome. Analysis needs to include
identification of what is working and identification of what is not working.
This not only includes skills that the child needs to establish, but supports
and adaptations that could be made to the task and the physical, social, and
cultural environment. (For additional information, please see the Appendix at
the end of this document.)
and Adaptations Needed to Work on This Outcome
What's already working?
Box #4: This
is the what question. What is, or could be, possible for this family
and child to do within their everyday experiences that would allow them to focus
on this outcome. These should be natural learning environments and activity
settings that are easy for the family to access and where needed services can
What possible opportunities exist within the routine or environment for meeting this outcome?
Box #5: This
is the who question. Who, within the family, the community, and of all
the possible providers, can assist the child in achieving this outcome?
Who can help?
(Brainstorm a list of possibilities.)
Who are the family members, professionals/providers, and others who can help child/family achieve this outcome?
Box #6: This
is the where question. Where would it be appropriate to work on this
Where could child/family work on this outcome?
Supports, and Adaptations Needed to Work on This Outcome
by WPDP for the Wisconsin Birth to 3 Program from: W. Dunn, C. Brown, & A. McGuigan,
(1994). The Ecology of Human Performance: A Framework for Considering the Effect
of Context. The American Journal of Occupational Therapy, Vol 48, (9),
A child's overall function in daily life is not only the result of their unique experiences and skills, but it is also influenced by the environment or context in which they live. The contextual influences that impact function come from physical surroundings, social expectations, and cultural factors. Intervention to infants and toddlers must incorporate both working with the child to increase skills and experiences, and analyzing those contextual influences impacting their function. Providing contextual supports is an important aspect of influencing function, and one that should be considered above, or at least equal to, attempts to increase skill level within the child.
Consider the list
below to ensure that the team has focused on all areas of potential intervention
when analyzing what is needed to assist a child in achieving a particular outcome.