2012

Practice Analysis of the

Occupational Therapist
Registered

Executive Summary

CONTENTS
Executive Summary
Review of existing test content outline

Panel of subject matter experts

Validation survey development

Survey process

Demographics, education and practice experiences

9-16

Task and domain analysis findings

17

Assignment of weights to test content outline

18

Summary

19

Appendix 1 - Validated domain, task & knowledge statements comprising the OTR
test blueprint

23-29

Tables & Figures

Table 1:

Ethnicity of OTR survey respondents

Table 2:

Number and percentage of OTR respondents by employment status at their

primary OT practice location

10

Table 3:

Number and percentage of OTR respondents by proportion of work hours

spent communicating in a language other than English at their primary OT
practice location

12

Table 4:

Number and percentage of OTR respondents providing services across

diagnostic categories

Table 5:

Test blueprint for the OTR examination

19

Figure 1:

Proportion of respondents by areas of practice for primary OT employment

11

13-16

About NBCOT
The National Board for Certification in Occupational Therapy, Inc. (NBCOT) is the
national certification body for occupational therapy professionals in the United States.
The Mission of NBCOT is to serve the public interest by advancing client care and
professional practice through evidence-based certification standards and the validation
of knowledge essential for effective practice in occupational therapy.
Currently, 50 states, Guam, Puerto Rico and the District of Columbia require NBCOT
initial certification for occupational therapy state regulation, (i.e., licensing).
NBCOT certification programs are accredited by the American National Standards
Institute (ANSI) and the National Commission for Certifying Agencies (NCCA). NBCOT
is a member of the Institute for Credentialing Excellence (ICE).

Executive Summary
National Board for Certification in
Occupational Therapy, Inc. (NBCOT)
is a not-for-profit certifying body for
individuals with education and experience
in the practice of occupational therapy.
As with other certification programs, the
NBCOTs program aims to establish that
individuals have the knowledge necessary
to perform tasks critical for the safe and
competent practice as an entry-level
occupational therapist practicing under
U.S. jurisdiction.
In 2012, the NBCOT began the process
of reviewing the test blueprint for
the NBCOT Occupational Therapist
Registered (OTR) Examination. The
NBCOT worked with Castle Worldwide,
Inc., a certification and licensure design,
development, and administrative service
company, to ensure that its certificate
examinations meet guidelines and
standards for examination development
(e.g., Standards for Educational and
Psychological Testing, American
Educational Research Association,
1999; Uniform Guidelines on Employee
Selection Procedures, EEOC, 1978).
A number of steps were undertaken for
the analysis of the practice requirements
for newly certified occupational therapists.
First, feedback was obtained from the
existing NBCOT examination item writers,
exam development personnel, and a
review of feedback from candidates
and other persons to identify task areas
on the existing occupational therapist
test content outline that were no longer
current or duplicated in other areas of
the outline. A panel of subject matter
experts (SMEs) was then assembled.
The panel reviewed the existing material
and feedback, establishing a revised

test content outline that consisted

of important occupational therapy
activities to be assessed. The outline
was incorporated into a survey sent to
a sample of entry-level occupational
therapists to validate the panels work.
A final panel of SMEs was assembled
to assign the proportion of items to the
content areas.

Review of the existing test

content outline
The existing test content outline
developed in the 2007 practice analysis
study consists of 17 tasks in four
domains.
A review of candidate comments
and discussions with test and exam
development personnel identified areas
of improvement in the test content
outline. Based on these comments and
feedback, NBCOT constructed a revised
test content outline.

NBCOTs program
aims to establish
that individuals
have the knowledge
necessary to perform
tasks critical for the
safe and competent
practice as an entrylevel occupational
therapist

Panel of subject matter experts

In September 2012, a 10-member panel
of SMEs was assembled to review and
revise an outline of the areas of practice
required for competent performance as
a newly certified occupational therapist.
The panel members worked with or
supervised the practice of recently
certified occupational therapists or had
been certified within the last two to three
years. Panel members represented
varied practice settings and a variety of
geographic areas in the United States.
Ethnicity and gender make-up of the
panel was representative of the larger
certificant population.

A total of 73
occupational therapist
statements - four
domains, nine tasks,
and 60 knowledge
statements - were
incorporated into
an online practice
analysis validation
survey.

The panel members initially reviewed the

revised practice analysis test content
outline prepared by NBCOT. Based on
this review and their own experiences,
the panel members established a test
content outline consisting of nine core
tasks in four domains of practice.
The panel also developed a series of
critical knowledge statements for each
task, producing a total of 60 knowledge
statements.

Validation survey development

A total of 73 occupational therapist
statements - four domains, nine tasks,
and 60 knowledge statements - were
incorporated into an online practice
analysis validation survey. The survey also
included a number of questions about
participants education, practice
experiences, and demographics. The
entire survey was conducted online. For
the tasks, and knowledge statements,
survey participants were provided an
opportunity to identify critical elements of
practice that had not been captured by
the proposed content outline.
The survey was reviewed by members of
NBCOT, Castle, and a subset of the SME
panel to ensure fidelity with the panels
work as well as appropriate survey
design.

Validation Survey Process

Sample selection
The NBCOT identified a sample of 2,826
currently certified OTRs who had been
certified for less than three years as of
October 2012.

Contact procedures
The potential respondents were
contacted by email on a prescribed
schedule. All potential respondents were
assured confidentiality regarding their
participation and responses. Data was
collected and analyzed by Castle and
summary results were provided to the
NBCOT. The survey was conducted
from November 12 through December 5,
2012.

selecting all applicable categories. Table

1 provides a breakdown of the proportion
and number of candidates who selected
the options.
Table 1.
Ethnicity of OTR survey respondents.
Answer Options

0.7%

13

Asian

8.2%

163

Black or African American

3.0%

60

Hispanic/Latino of any race

3.8%

76

Multi-racial

1.6%

31

Native Hawaiian or Other Pacific Islander

0.5%

10

80.1%

1,584

4.9%

97

White
Prefer not to answer

Of the 2,826 requests sent, a total of

2,235 respondents started the survey,
an overall response rate of 79%. This
response rate is similar to experiences
with other practice analysis surveys.

answered question

Gender and ethnicity

Eighty-two percent of the 2,235
respondents reported their gender as
female, 7 percent reported as male, and
11 percent did not respond. Candidates
were asked to report ethnicity by

Count

American Indian or Alaska Native

Return rates

Not all individuals responded to every

question or provided valid responses;
therefore, the total number of responses
per question varied. For example, the last
knowledge statement was rated by a total
of 1,983 respondents, 89% of those who
began the survey. Experience with similar
surveys shows a completion rate typically
between 75% and 85%.

Percent

skipped question

1,977
258

Education
Of the 1,980 respondents who reported
their education, 94% reported completing
an entry-level masters degree, 2.6%
reported an entry-level doctoral degree,
and 3.2% reported an Occupational
Therapist Early Determination (OTED)
(including internationally educated). A
total of 1,942 respondents provided a
valid response concerning the year they
had completed their occupational therapy
education. The majority of respondents
reported graduating between 2009
and 2012, with the earliest graduation
reported as 19911.
1 Survey respondents were selected based on
the timeframe since initial certification. Some
respondents may have graduated well before
becoming certified.

Practice
Of the 1,976 respondents who completed
the question on current employment,
97% indicated that they were actively
working in a position that requires an
occupation therapist, less than 1% (20)
indicated working in a position other
than occupational therapy, and 2.7%
(53) reported that they were not currently
working. The majority of respondents
employed in an OT role were hourly
employed, with salaried almost equivalent
(Table 2).
Table 2.
Number and percentage of OTR
respondents by employment status
at their primary OT practice location.
Status

Percent

Self-employed

Count

2.3%

44

Salaried

41.8%

806

Hourly employed

48.7%

939

Temporary contract

4.2%

82

Other (please specify)

3.1%

59

answered question
skipped question

1,930
305

The majority who indicated other

provided details that were a mix of
salaried, contract, self-employed, per
diem, and per visit.

10

Approximately 20% of respondents

reported that their primary OT area of
practice was skilled nursing, followed
by pediatrics (19%) and rehabilitation
(17%). Respondents who indicated
other typically noted a mix of pediatrics,
skilled nursing, and rehabilitation. Further
breakdowns are provided in Figure 1.

Figure 1.
Proportion of respondents by areas of practice for primary OT employment.

Twenty-nine percent
The average number of hours worked
was 37.5 hours per week, with an almost
equal split between salaried and hourly
employment.
Twenty-nine percent of the respondents
indicated that they communicated in
languages other than English in their
primary OT employment setting. Of the
568 candidates who indicated that they

communicated in languages other than

English at their primary OT employment
setting, over 70% communicated in
Spanish. Table 3 details the proportion of
time spent communicating in a language
other than English.

of the respondents
indicated that they
communicated in
languages other
than English in
their primary OT
employment setting.
11

Table 3.
Number and percentage of OTR
respondents by proportion of work
hours spent communicating in a
language other than English at their
primary OT practice location.
Time Spent

Percent

Count

1% 5%

47.3%

283

6% 25%

32.3%

193

26% 50%

10.7%

64

51% 75%

4.7%

28

76% 100%

5.0%

30

answered question
skipped question

598
1,637

Respondents were asked to reflect on

their caseload and indicate the top three
diagnoses from each of six diagnostic
categories. Table 4 details the number
and percent of respondents who reported
providing services across different
disorder classifications collected via the
survey.

12

Table 4.
Number and percentage of OTR respondents providing services across
diagnostic categories.
Disorders

Percent

Count

Neurological Disorders
I do not provide services to this diagnostic category.

10.4%

201

Cerebral vascular accident

60.7%

1,173

Traumatic brain injury

26.0%

502

Spinal cord injury

9.4%

181

Multiple sclerosis

4.8%

93

ALS

0.4%

Parkinsons

22.4%

433

Dementia

46.8%

906

4.9%

94

Cerebral palsy

22.4%

433

Low vision

13.8%

267

Neurogenic back pain

4.5%

87

Complex regional pain syndrome

2.7%

52

Peripheral nerve lesion

1.4%

27

Peripheral neuropathy

14.0%

270

Other (please specify)

7.2%

140

Spina bifida

answered question
skipped question

1,934
301

13

Developmental Disorders
I do not provide services to this diagnostic category.

Percent

Count

47.4%

910

Congenital anomalies

9.4%

180

Developmental delay

42.0%

807

Visual processing deficit

12.7%

243

Fetal alcohol syndrome

2.0%

39

Malnutrition

4.8%

92

Intellectual disability

18.6%

358

Learning disorder

15.6%

299

Sensory integrative disorder

31.7%

608

1.9%

37

Other (please specify)

answered question

1,920

skipped question

315

Musculoskeletal/orthopedic Disorder
I do not provide services to this diagnostic category.

28.5%

545

Fractures

61.5%

1,178

Upper and/or lower extremity amputations

26.9%

514

Osteoarthritis

42.6%

816

Tendinopathy

4.5%

87

53.6%

1,026

Sprains/strains

5.3%

102

Other (please specify)

3.8%

72

Joint replacements

answered question
skipped question

14

1,914
321

Cardiopulmonary Disorders

Percent

Count

I do not provide services to this diagnostic category.

36.5%

692

Myocardial infarction

53.5%

1,016

Chronic obstructive pulmonary disease

58.7%

1,114

Congestive heart failure

58.1%

1,103

Tuberculosis

0.3%

Other (please specify)

4.5%

86

answered question

1,898

skipped question

337

Psychosocial Dysfunction Disorders

I do not provide services to this diagnostic category.

22.7%

436

Schizophrenia

16.0%

307

Mood disorders

24.0%

461

Anxiety disorders

41.5%

796

Substance abuse

23.1%

443

Autism spectrum disorders

33.0%

633

Attention deficit hyperactivity disorders

29.7%

571

Behavior disorders

32.1%

616

Personality disorders

6.2%

119

Other (please specify)

1.9%

37

answered question
skipped question

1,920
315

15

General Medical/Systemic Disorders

I do not provide services to this diagnostic category.

Count

29.1%

552

2.3%

44

Cancer

37.6%

714

Diabetes

48.6%

921

Rheumatoid arthritis

28.4%

538

4.2%

79

51.9%

984

Burns

3.4%

64

Lymphedema

5.3%

100

11.1%

210

1.5%

29

HIV/AIDS

Fibromyalgia
General deconditioning/debilitation

Open wounds/decubitis
Other (please specify)
answered question
skipped question

16

Percent

1,897
338

Task and domain analysis findings

Frequency

To assess the tasks and domains,

respondents were asked to rate the
criticality and frequency of the concept.
Respondents were also asked to rate the
knowledge statements on criticality only.

Frequency was defined as:

Reliability of ratings

Respondents were asked to rate the

frequency with which they performed the
tasks and domains on a 4-point scale
from 1 (Rarely) to 4 (Often). Average
frequency statistics were calculated for
each task and domain.

Reliability indices were calculated to

assess the capability of the survey to
measure the activities relevant to safe
and effective practice of newly certified
occupational therapists. The scales used
had reliability indices above 0.7 for the
ratings of domain criticality and frequency,
and task criticality and frequency. These
reliability indices indicate that the survey is
reliably measuring the activities that form
the basis for competent occupational
therapy practice.

Criticality
Criticality was defined as:
The degree to which a member of the
public or other stakeholder would be
physically, emotionally, or financially
harmed if the OTR failed to perform
the described duties competently.
Respondents were asked to rate the
criticality of the tasks, domains, and
knowledge statements on a 4-point scale
from 1 (No Harm) to 4 (A Great Deal of
Harm). Average criticality statistics were
calculated for each task and domain.

The time that a competent OTR

spends performing the described
duties.

Importance
Consistent with the Standards for
Educational and Psychological Testing
(American Educational Research
Association, 1999), an importance weight
was calculated for each respondents
ratings of a task or domain. The formula
was designed to create an importance
weight that was as straightforward as
possible and that highlighted the impact
of the consequences of failure to perform.
By emphasizing criticality, the importance
formulation that was used supports
the NBCOTs mission of protecting the
public from harm. Average importance
statistics were calculated for each task
and domain.

17

Assessment was also made as to the

critical values for the obtained importance
weight. A 95% confidence interval (CI) for
mean rating was calculated. Following
review of the data, none of the tasks were
removed from the content outline. See
appendix 1 for a complete listing of the
validated domain, task and knowledge
statements which comprise the OTR test
content outline.

Assignment of weights
to test content outline
In January 2013, a nine-member panel
of SMEs experienced in item writing was
assembled to assign the proportion of
items to each domain assessed by the
validated test content outline.
The webinar meeting consisted of three
rounds of review of the test content
outline. For each round, the panel
members were asked to independently
determine the percentage of items they
felt should be allocated to each of the
domain areas. Following each round,
a discussion was held to review overall
average, highest/lowest ratings, and how
the ratings and average reflects the OTR
content outline. Participants were asked
to revisit the purpose of the meeting
and talk about how the ratings support
concepts. Domain 4 was identified as
an area where much of the knowledge is
infused throughout the other domains in
the document. The proportion of items
assigned to each domain was established
as 17% for Domain 1, 28% for Domain 2,
45% for Domain 3, and 10% for Domain
4 see table 5 for details.

18

Table 5.
Test blueprint for the OTR examination.
Percent
of exam

OTR Domain Descriptions

Domain 01

Acquire information regarding factors that influence

occupational performance throughout the
occupational therapy process.

17%

Domain 02

Formulate conclusions regarding client needs and

priorities to develop and monitor an intervention plan
throughout the occupational therapy process.

28%

Domain 03

Select interventions for managing a client-centered

plan throughout the occupational therapy process.

45%

Domain 04

Manage and direct occupational therapy services to

promote quality in practice.

10%

Summary
The 2012-13 occupational therapist
practice analysis study used wellestablished methods to describe and
validate the practice of newly certified
occupational therapists in North America.
This included:
a. A review of existing test content
material.
b. SME knowledge.
c. A large scale survey.
Respondents to the 2012 NBCOT
occupational therapist practice analysis
survey validated the tasks and domains
appropriate for inclusion on a certification
exam for entry-level occupational
therapists. The representativeness
and reliability of the survey instrument
were very good. In addition, there was
evidence to support the validity of the
domain, task, and knowledge statements.

Based on the final SME panel

deliberations and the validated test
content outline, the final proposed test
content outline consists of nine tasks in
four areas of domain practice, with 60
associated knowledge statements.
Additionally, the proportion of items
assigned to each domain area was
established for the OTR examination.
Based on evidence, the findings of this
study can be used to evaluate and
support an entry-level occupational
therapist certification examination. This
test content outline will guide NBCOT
examination construction for the OTR
examinations beginning 2014.

Based on evidence,
the findings of this
study can be used
to evaluate and
support an entrylevel occupational
therapist certification
examination.

19

References
Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests.
Psychometrika, 16, p. 297-334.
De Champlain, A. F., Cuddy, M. M., & LaDuca, T. (2007). Examining
Contextual Effects in a Job Analysis: An Application of Dual Scaling.
Educational Measurement: Issues and Practice, 26(3), p. 3-11.
Equal Employment Opportunity Commission (EEOC), U.S. Civil Service
Commission, U.S. Department of Labor, and U.S. Department of
Justice. (1978). Uniform Guidelines on Employee Selection Procedures.
Federal Register, 43 (166), p. 38290-38315.
Joint Committee on Standards for Educational and Psychological Testing
(American Educational Research Association, American Psychological
Association, National Council on Measurement in Education) (1999).
Standards for Educational and Psychological Testing. Washington,
D.C.: AERA.
National Council of State Boards of Nursing (NCSBN). (2009). The 2008 RN
Practice Analysis: Linking the NCLEX-RN Examination to Practice.
(Research Brief Vol. 36). Chicago: Anne Wendt.
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric Theory (3rd ed.).
New York: McGraw-Hill.

21

Appendix 1
Validated domain, task and knowledge statements comprising the OTR test
blueprint
Domains are specified in bold with a two-digit number, tasks are grouped under each
domain (four-digit number), and the tasks associated knowledge statements are listed
with a six-digit number.
Code

Description
DOMAIN 1

01

0101

Acquire information regarding factors that influence occupational

performance throughout the occupational therapy process.
Acquire information about a clients functional skills, roles,
context, and prioritized needs through the use of available
resources and standardized and non-standardized assessments
in order to develop an occupational profile.

010101

Normal development and function across the lifespan

010102

Expected patterns, progressions, and prognoses associated with

conditions that limit occupational performance (e.g., stages of disease,
secondary complications, outcomes)

010103

Processes and procedures for acquiring client information (e.g., client

records, observation, interview, occupational profile)

010104

Administration, scoring, purpose, indications, advantages, and limitations

of standardized and non-standardized screening and assessment tools

010105

Influence of client factors, context, and environment on habits, routines,

roles, and rituals

010106

Methods for recognizing and responding to typical and atypical

physiological, cognitive, and behavioral conditions

0102

Analyze evidence obtained from the occupational profile

to identify factors that influence a clients occupational
performance.

010201

Therapeutic application of theoretical approaches, models of practice,

and frames of reference

010202

Activity analysis in relation to the occupational profile, practice setting,

and stage of occupational therapy process

010203

Internal and external influences on occupational performance (e.g.,

environment, context, condition, medication, other therapies)

23

Code

Description
DOMAIN 2

02

0201

Analyze and interpret standardized and non-standardized

assessment results, using information obtained about the clients
current condition, context, and priorities in order to develop and
manage client-centered intervention plans.

020101

Methods for analyzing results from screening and assessments

020102

Integration of screening and assessment results with client occupational

profile, client condition, expected outcomes, and level of service delivery
to develop a targeted action plan, monitor progress, and reassess the
plan

020103

Methods for determining program development and client advocacy

needs (e.g., aging in place, falls prevention, health and wellness
programs, community support groups, inservices)

0202

24

Formulate conclusions regarding client needs and priorities

to develop and monitor an intervention plan throughout the
occupational therapy process.

Collaborate with the client, the clients relevant others,

occupational therapy colleagues, and other professionals and
staff, using a client-centered approach to manage occupational
therapy services guided by evidence and principles of best
practice.

020201

Interprofessional roles, responsibilities, and care coordination (e.g.,

referral to and consultation with other services)

020202

Management of collaborative client-centered intervention and transition

plans based on client skills, abilities, and expected outcomes in relation
to level of service delivery, frequency and duration of intervention, and
available resources (includes communication with family, caregiver, and
relevant others)

020203

Prioritization of goals based on client skills, abilities, and expected

outcomes in relation to level of service delivery and frequency and
duration of intervention (e.g., expected length of stay, transition plan)

Code

Description
DOMAIN 3

03

Select interventions for managing a client-centered plan

throughout the occupational therapy process.

0301

Manage interventions for the infant, child, or adolescent client,

using clinical reasoning, the intervention plan, and best practice
standards consistent with pediatric condition(s) and typical
developmental milestones (e.g., motor, sensory, psychosocial,
and cognitive) in order to support participation within areas of
occupation.

030101

Influence of pediatric condition(s) and typical developmental milestones

on areas of occupation

030102

Intervention activities for supporting participation in occupations based

on current sensory, cognitive, motor, and psychosocial skills and abilities

030103

Intervention methods for facilitating or inhibiting sensory, motor, or

perceptual processing based on pediatric condition(s), tasks, and
environmental demands

030104

Intervention methods for improving range of motion, strength, and

activity tolerance based on pediatric condition(s) in order to promote
occupational performance

030105

Group facilitation methods appropriate to pediatric condition(s) and

developmental level

030106

Splint design and fabrication, and types, functions, and use of orthotic
and prosthetic devices based on pediatric condition(s) and task
demands

030107

Assistive technology, adaptive devices, and durable medical equipment

based on pediatric condition(s), task, and environmental demands

030108

Methods for adapting intervention techniques, activities, and

environments in response to behaviors and developmental needs

030109

Intervention methods for enabling feeding and eating skills based on

pediatric condition(s) and developmental level

030110

Transfer and positioning techniques based on pediatric condition(s), task,

and environmental demands

030111

Prevocational and vocational interventions that support transition

planning

25

Code
030112

Seating options, positioning devices, and mobility systems based on

pediatric condition(s), developmental level, and environmental demands

030113

Environmental modifications for maximizing accessibility and mobility

within various contexts based on pediatric condition(s), developmental
level, and task demands

030114

Methods for adapting or grading an activity, task, or an environment

based on pediatric condition(s), developmental needs, and task
demands

030115

Methods and techniques for promoting the continuation of the

interventions within multiple contexts based on current pediatric
condition(s), developmental level, and expected outcomes (e.g., home
program, caregiver instructions, teacher consultation)

0302

26

Description

Manage interventions for the young, middle-aged, or older adult

client, using clinical reasoning, the intervention plan, and best
practice standards consistent with general medical, neurological,
and musculoskeletal condition(s) in order to achieve functional
outcomes within areas of occupation.

030201

Influence of medical, neurological, and musculoskeletal condition(s) on

activity selection and areas of occupation

030202

Rehabilitative strategies and procedures specific to medical,

neurological, and musculoskeletal condition(s) (e.g., joint protection,
work simplification, energy conservation)

030203

Methods and strategies for improving range of motion, strength,

and activity tolerance based on general medical, neurological,
and musculoskeletal condition(s) in order to promote occupational
performance

030204

Strategies and procedures for facilitating or inhibiting sensory, motor,

and perceptual processing based on general medical, neurological, and
musculoskeletal condition(s)

030205

Methods for selecting and effectively applying superficial and deep

thermal, mechanical, and electrotherapeutic physical agent modalities as
an adjunct to participation in an activity

030206

Splint design and fabrication, and types, functions, and use of orthotic
and prosthetic devices based on general medical, neurological, and
musculoskeletal condition(s) and task demands

Code

Description

030207

Assistive technology (i.e., high and low tech), adaptive devices, and
durable medical equipment based on client needs and general medical,
neurological, and musculoskeletal condition(s)

030208

Intervention methods for enabling feeding and eating skills based on

client needs and medical, neurological, and musculoskeletal condition(s)

030209

Transfer methods and positioning techniques based on client needs;

general medical, neurological, and musculoskeletal condition(s); task;
and environmental demands

030210

Seating options, positioning devices, and mobility systems based on

client needs; medical, neurological, and musculoskeletal condition(s);
task; and environmental demands

030211

Environmental modifications for maximizing accessibility and mobility

within context based on client needs; medical, neurological, and
musculoskeletal condition(s); and task demands

030212

Ergonomic principles and universal design for health promotion and

injury prevention

030213

Methods for adapting and grading tasks and activities based on client
needs and medical, neurological, and musculoskeletal condition(s)

030214

Methods and strategies for promoting the continuation of the intervention

within context based on medical condition(s) and expected outcomes
(e.g., home program, caregiver instructions)

0303

Manage interventions for the young, middle-aged, and older adult

client, using clinical reasoning, the intervention plan, and best
practice standards consistent with psychosocial, cognitive, and
developmental abilities in order to achieve functional outcomes
within areas of occupation.

030301

Influence of psychosocial, cognitive, and developmental abilities on areas

of occupation

030302

Methods for facilitating groups to enhance participants psychosocial,

cognitive, and developmental skills

27

Code

28

Description

030303

Approaches (e.g., remediation, compensation, prevention) and

interventions (e.g., problem solving, medication management, memory
strategies) appropriate for psychosocial and cognitive models of practice
(e.g., cognitive, behavioral, acquisitional, developmental)

030304

Environmental modifications to enhance community safety and wellbeing consistent with occupational roles and client needs

030305

Assistive technology and adaptive devices to enhance participation in

occupation consistent with psychosocial, cognitive, and developmental
abilities

030306

Methods for adapting and grading an intervention based on

psychosocial, cognitive, and developmental abilities

030307

Methods and techniques for promoting the continuation of the

interventions within multiple contexts based on psychosocial, cognitive,
and developmental abilities (e.g., home program, caregiver instructions,
job coach)

Code

Description
DOMAIN 4

04

0401

Manage and direct occupational therapy services to promote

quality in practice.
Maintain and enhance competence, using professional
development activities relevant to practice, job responsibilities,
and regulatory body in order to provide evidence-based services.

040101

Professional development activities

040102

Methods of analyzing and interpreting research and its application to

practice

040103

Methods for evaluating, monitoring, and documenting service

competency (e.g., self-assessment, peer review)

0402

Manage occupational therapy service provision in accordance

with laws, regulations, accreditation guidelines, and facility
policies and procedures governing safe and ethical practice in
order to protect consumers.

040201

Influence of policies, procedures, and guidelines on service delivery

040202

Licensure laws, federally mandated requirements, and reimbursement

policies related to occupational therapy service delivery (e.g.,
client confidentiality, levels of supervision, plan of care certification/
recertification, referral policy)

040203

Methods for incorporating risk management techniques and monitoring

safety related to occupational therapy service delivery

040204

Methods for applying continuous quality improvement processes and

procedures to occupational therapy service delivery (e.g., program
evaluation, outcome measures)

040205

Scope of practice and practice standards for occupational therapy (e.g.,

delegation, supervision, role delineation)

040206

Accountability processes and procedures using relevant technology

(e.g., documentation guidelines, components of an intervention plan,
coding systems, electronic medical records, written documentation)

29

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