First scenario – Diabetes CDSM

1. Greetings
a. Intro self
b. Explain role
2. Focus
a. Purpose of session – referral
3. Check knowledge with client
a. Build it
b. You understand why you have these symptoms?
c. Link underlying knowledge back to symptoms
4. Current strategies being used to manage condition
a. Occ impact
b. Health management
c. Medical management
d. Family support
e. Have you tried something in the past? What worked and what didn’t?
5. Emotional impact of condition and validate it
6. (If ask about Ax then mention what sort of Ax can be done/Or just mentioned briefly what Ax to diagnose
conditions)
7. Agenda setting (CDSM discontentment)
a. Biggest issue/priorities (meaningful or purposeful occs to being healthier)
b. Build motivation – is this one of your main priorities where you want to achieve good outcomes
c. Goals – rate importance of it (needs to be over >7)
i. If not then can you imagine yourself doing this in the future
d. SMART goal
e. Set time limit
f. Explore pros and cons of the change we’re suggesting
8. End session
a. Final questions
b. Check their understanding of the issues
c. Spend some time going over things to do/homework for client to do for themselves/repeat
intervention activities
d. Set date for next session and brief outline to session content
Second scenario – DCD STRENGTHS BASED APPROACH FOREMOST

1. Greeting
a. Intro self
b. Chit chat with placement supervisor
2. Talk about purpose of today and how the first meeting with child went
a. Observations of any visible delays
3. Refer to upcoming Ax session of child with DCD
a. Confirm with them their understanding/experiences of DCD
b. Explain/reaffirm your own understanding of DCD
i. Difficulty developmental of motor skills or coordinating movements to perform common
everyday tasks
4. Talk about the different standardised Ax you can possibly use with child (specify age appropriate tests)
a. And ask supervisor whether they’ve had much experience using them
b. Focus of first Ax to be more hands on and easier to build that initial rapport
c. Miller Function & Partic. Scale (MFUN) – related to child’s functional school performance & suitable
to diff level of motor impairments (60 mins)
i. Tests 3 domains of: visual motor, fine motor, gross motor + participation
ii. School act. involves writing, drawing, tracing, cutting
iii. Home & gym act. involves jumping, hopping, kicking
d. Beery VMI – visual and motor abilities + integration (15 mins)
i. Trouble with tasks of: cutting, colour, writing, tie shoes, catch ball
ii. 3 parts: visual motor integration, visual part, and motor control part
iii. ID exact difficulties is key to dev plan to increase confidence and participation in everyday
activities
e. Knox Preschool Play Scale (PPS) – evaluate play in children and its developmental age (60 min half
indoor half outdoor)
i. Observes space management, material management, pretense/symbolic, participation
f. Perceived Efficacy and Goals Setting System (PEGS) – semi structured interview with child about
school tasks and everyday activities, questionnaire for parents as well
g. Sensory profile (optional) – filled by parents/caregivers
i. Whether diff settings affects child engagement
ii. Technical terms may need explanation to parents
5. How to provide feedback to parents of their child’s Ax results
a. Client-centred language
b. Their understanding of the condition
c. Talk about the each test’s purpose to parents, what the Ax results are, how they’re scored and what
they mean to the parents – de-jargonise terms of what tests involve
d. Take about developmental approach on working with child’s further development
e. Develop plan collaboratively for them to follow – look at fam background and other factors so plan
to seamlessly fit into their existing daily routines
f. Talk about emotional impact of the condition affecting their daily life (+provide strategies to cope
with it, maybe external support etc)
g. Possibility of referring them to see diff allied health professionals depending on results
h. Link them to different services
6. Conclude chat with supervisor
a. Final thoughts on the whole plan and approach with this family
Third scenario – ASD STRENGTHS BASED APPROACH FOREMOST

1. Greeting
a. Intro self
b. Chit chat with placement supervisor
2. Talk about purpose of today with supervisor
a. Referral from parents worried about child
b. Observing child with behaviours he’s been showing
c. Opinions from you to maximise partnership so child can play, engage and learn
3. Talk about how the first meeting with child with possible ASD went
a. Child play environment
b. Home situation and behaviours observed from parents
c. Any toys he has fixation on/comfort/+ve or –ve from
d. What different stimulus are he has positive or negative reaction from
e. What the parents think of the situation
f. Observations of any visible signs etc
g. Strengths based first
h. Reference the ASD checklist
i. Common obs incl:
1. Difficulty comms – convo skills and express wants/needs
2. High level of stress over minor change – plays same toys, upset new toys given to
him, change placement of items
3. Sig time seeking sensory input – preferred corner, spin circles, tight spaces
4. Repetitive motor movements/behaviour
4. Refer to upcoming session with parent and conveying results to them
a. Client-centred language
b. Check what their understanding of ASD and health literacy
c. Introduce aim of meeting them – done ASD pre-screening test and explaining results to them and
whether further evaluations are needed
d. Tell them our obs – strengths first
e. Show them screen checklist and ask whether they’ve notice any of this
f. Ask about their general experiences and obs
g. Check emotional impact seeing child showing these behaviours (+provide strategies to cope with it,
maybe external support etc)
b. Discuss value of early intervention – EBP
c. Reiterate we follow developmental approach
d. Refer them to see diff allied health professionals
e. Link them to different services – NDIS applications focus on deficits affecting daily life approach to
get approval/funding, talk about set goals with child and ASD and accessing NDIS
5. Conclude
a. Next step to get diagnosis of ASD (Ax and services) can be done by paediatrician, psychiatrist, or
clinical psychologist experienced in Pervasive Developmental Disorders using DSM-V diagnostic tools
to start NDIS application
b. See what supervisor says of all this and finish
Fourth Scenario – RA

1. Greetings
a. Intro self
b. Explain role
2. Focus
a. Purpose of session
3. Check knowledge with client
a. Build it
b. You understand why you have these symptoms? (biological –autoimmunity and physical-cartilage
wear & tear, friction -> inflammation causes/phenomena)
c. Link underlying knowledge back to symptoms
4. Ask about symptoms
a. What a normal day looks like
b. How it changed since the diagnosis and dev of RA
c. Occ impact (maybe use PEO model to direct this)
5. Current strategies being used to manage condition
a. Health management
b. Medical management
c. Family support
d. Have you tried something in the past? What worked and what didn’t?
6. Emotional impact of condition and validate it
7. Recommend an item to them to use and aid for their specific troubles
a. Demo in front of them, talk about how it helps manage their condition with this task specifically +
rationale
b. Give it to client for demo test
c. Ask how it feels
d. And whether they use it for the future
8. Talk about alternative strategies for condition management
a. Energy conservation – balance activity and rest, prioritise important activities, day of time for act.
b. Work simplification – reduce steps needed to do a task, easy reach for stuff, sit down when possible
c. (Joint protection – reduce strain on smaller joints – carrying things closer to body, use larger
muscles, proper posture support joints/even pressure) – maybe for next week to talk about
d. (Respect pain – avoid pressure that pushes wrist toward ulnar side (pinkie), avoid strong grasp and
pinch) – maybe for next week about
9. End session
a. Final questions
b. Check their understanding of the issues
c. Spend some time going over things to do/homework for client to do for themselves – keep diary of
pain levels, times and activities doing – so next time more thorough investigation of wider range of
act. for home Ax
d. Set date for next session and brief outline to session content
Fifth Scenario – Chronic Pain

1. Greetings
a. Intro self
b. Explain role in RTW context
2. Focus
a. Purpose of session – referral
3. Ask about symptoms
a. What a normal day looks like – present and past hobbies, activities
b. How it changed since the diagnosis
c. Occ impact (maybe use PEO model to direct this)
4. Current strategies being used to manage condition
a. Health management
b. Medical management
c. Family support – open to more support around the house
d. Have you tried something in the past? What worked and what didn’t?
5. Emotional impact of condition and validate it
6. Check knowledge with client
a. Build it
b. Pain is very complex, it can allow you to move differently, can sometimes go away and sometimes
come back. It can also jump from places to places and is influenced by many things. However, pain is
a good thing. It is our body’s way of telling us that danger is near, and we should do something
about it.
c. Pain is an output of brain as a protective mechanism to tell something is wrong with our body &
there’s danger to muscle, joint or tissue to prevent injury or damage. In some cases following an
injury, brain can rewire nerves on how it interprets pain and become more sensitive than before
where it can fire off danger response of pain when not necessary
d. Further explain pain is complex using pain models and stories
i. Pain model, draw twin peak model -> build threshold
ii. Stories of pain, personal experience – gym example, metaphors etc -> build threshold
e. Link underlying knowledge back to symptoms
7. Recommend them back into doing activities that cause pain recently
a. Referencing what was said before – say it in a gentle manner
8. Establish goals
a. Ask for their priority of which they want to get back doing
9. Explain concept of graded program
a. Aims to reduce pain sensitivity in you, and slowly increase personal functions (ref model again)
10. Collaborate how graded program will happen
a. If it gets too much, reduce activity and intensity to continue to build up
11. Talk about alternative strategies for condition management – when pain gets too much during our specified
plans, you can incorporate these in to help management
a. Energy conservation – balance activity and rest, prioritise important activities, day of time for act.
b. Work simplification – reduce steps needed to do a task, easy reach for stuff, sit down when possible
12. End session
a. Introduce pain diary to monitor levels of pain, times and activities doing – so next time more
thorough investigation of wider range of act. to investigate
b. Final questions
c. Check their understanding of the issues
d. Set date for next session and brief outline to session content
Sixth Scenario – MS Falls

1. Greetings
a. Intro self
b. Explain role
2. Focus
a. Purpose of session – referral & home visit
3. Ask about symptoms
a. What a normal day looks like & mobility around house
b. Occ impact (maybe use PEO model to direct this)
4. Check knowledge with client
a. Build it
b. You understand why you have these symptoms?
c. Link underlying knowledge back to symptoms (of fatigue and mobility issues)
5. Current strategies being used to manage condition
a. Health management
b. Medical management
c. Family support
d. Have you tried something in the past? What worked and what didn’t?
6. Emotional impact of condition and validate it
a. Importance of confirming that house is a safe area to traverse in
b. Reaffirm his motivation for these changes
7. Ask about house plan in general and explore and potential hazards with client
a. Ask specifically about common falls hazards in home and whether client has that
i. Shower lip, clutter, front door access steps, stairs
8. Talk about the upcoming home visit
a. About further analysis of home environment and work together to understand how their activities
may be affected within the environment
b. I can briefly do a quick Ax of occ analysis within your home straight after this talk
9. Briefly run through recommendations that can be done in house
a. Hand rails, walking stick to push self more, non-slip mats, reorganise space
10. Ask about transfers, activities they are doing that they struggle with current condition
a. Which one of them is main priority in addressing -> occ analysis -> link to home env affect this
11. Talk about strategies for condition management
a. Energy conservation – balance activity and rest, prioritise important activities, day of time for act.
b. Work simplification – reduce steps needed to do a task, easy reach for stuff, sit down when possible
12. End session
a. Final questions
b. Check their understanding of the issues
c. Spend some time going over things to do/homework for client to do for themselves – keep diary of
pain levels, times and activities doing and slowly incorporate strategies
d. Set date for next session and brief outline to session content
e. Let’s look at your home then now
Seventh Scenario – MS/Dementia Scooter

1. Greetings
a. Intro self
b. Explain role
2. Focus
a. Purpose of session – referral & scooter
3. Outline scooter process
a. Initial Ax, home Ax, functional Ax, vision Ax, liaised with Dr for med clearance, funding talk, trial, alt
options if needed
4. Before I talk more about the scooter, I want to know more about you!
a. Ask about symptoms
i. What a normal day looks like
ii. Occ impact (maybe use PEO model to direct this)
5. Check knowledge with client
a. Build it – problems with vision, fatigue, pain, coordination issues with movement
b. You understand why you have these symptoms?
c. Link underlying knowledge back to symptoms
6. Current strategies being used to manage condition
a. Health management – current balance and strength
b. Medical management
c. Family support
d. Have you tried something in the past? What worked and what didn’t?
7. Emotional impact of condition and validate it
8. Scooter details – so for the purpose of ID whether scooter is appropriate, I’ll be using PEO model to assess
this + explain PEO model
a. Person
i. Previous driving experience (why they stopped driving)
ii. Memory and concentration
iii. How would they feel about driving one
b. Occupation
i. What they want to use with scooter
c. Environment
i. Where using it? How are they doing this currently
ii. If home use, ID more home environment and space/access points/storage space
iii. Terrain around residency
d. Are there any other concerns relating to potential use of scooter
e. Talk about scooter accessories
f. Also noteworthy I briefly talk about laws surrounding scooter, 10kmh, footpath/nature strip/LHS
9. Conclude: I will use the answers you’ve provided into consideration and inform you next time whether a
scooter is appropriate, please note it is an ongoing process so may need to Ax further you in everyday
activities next time to give consideration/recommend of scooter
a. Outline further Ax needed – functional/Occ Ax, vision Ax
b. If scooter, funding Q – NDIS, DVA or self-funded
10. Alternative options for community mobility for the meantime to access
a. Taxis (can apply for vouchers), community buses, friends/family support, powered wheelchair
11. End session
a. Final questions
b. Check their understanding of the issues
c. Set date for next session and brief outline to session content
Eighth Scenario – Dementia Caregiver

1. Greetings
a. Intro self
b. Explain role
2. Focus
a. Purpose of session – referral
3. Check knowledge with client
a. Build it, fill in
b. You understand why they have these symptoms?
c. Link underlying knowledge back to symptoms of fear, wandering or sundowning
d. Interest in accessing resources to provide optimal care for someone?
4. Ask about symptoms
a. What a normal day looks like caring for dementia and dementia person & underlying causes/pattern
b. Occ impact (maybe use PEO model to direct this)
5. Emotional impact of condition and validate it
a. Feel concerned about meaningful behaviours and life roles
b. Balance of it is hard right now, but with appropriate support it can be achieved
c. Recommend/refer support groups to join
6. Current strategies being used to manage condition
a. Health management
b. Medical management
c. Family support
d. Have you tried something in the past? What worked and what didn’t?
7. Explore management strategies with specific issues
a. Sundowning
i. Napping earlier in day
ii. Doing main self-tasks earlier in day
iii. Prepare food etc earlier
iv. ID a meaningful occ to caregiver and dementia to do that is calming around tough period
b. Wandering - manage or prevent it
i. Noise of env/sensory overload?
ii. Clutter of env, clean it up
iii. Visual prompts/cues in house, so if wander know where things are
iv. Lack of act/bored? Distract dementia person with meaningful occ
c. Shower fear
i. Sensory? Change to bathing
ii. Change to normal premorbid routine? Shower diff time of day
iii. Lighting of area when showering?
iv. Have him in a good mood to be more willing to shower
v. Too many steps/forgot purpose? Simplify steps/prep beforehand/offer 1-2 choices
8. Talk about alternative strategies for self when caring for others
a. Simplify carer routine
b. Suggest other carers helping around home?
c. Further training to better equip with situation and into the future
d. Community support groups
9. End session
a. Final questions
b. Check their understanding of the issues
c. Set date for next session and brief outline to session content