Gradation of Activity Definition
The course of gradial progress
- Add new challenges so the client builds abilities
- Requires imagination and logic
Graduation of Activity Purpose
Clients begin where they are capable and make progress
-You want the client to have an internal validation of success while getting the just right challenge to move them further in treatment
Grading an activity follows…
Much like normal development
Challenge the patients ability by progressively changing the…
-Objects and tools
-Rules
-Supporting structures
-Practitioner
-Environment
-Process
To gradually increase or decrease performance demands
Grade Up
- Making the task more challenging
- Able to accomplish at current level
- Further progress is desired
- Increase challenge level
Grading Down
- Making the task less challenging (still want them to progress but you are meeting them where they are)
- Allowing them to succeed and build upon them (not a negative)
- Having difficulty with performance
- Too frusterating
Caution when grading
- Do not cause undue strain
- Do not “tease”
- Is the focus away from the activity?
- Grade up one skill area at a time
Grading Activities for Development of Independence and Self-Direction
- Grade how much the client must rely on others for help
- Begin with activity where the client relies on the practioner for help
- Work towards client needing less help (doesnt mean client will stop asking for help but the practitioner must express that they believe they can do alone)
- Encourage the client to reflect on performance and the amount of assistance needed
Scenario 1: The therapeautic activity you want to complete is to prepare a simple sandwich with your client in inpatient rehab. You are asking the client to stand at the counter and make a peanut butter and jelly with the items already set up and placed within arms reach. You would like them to cut the sandwich in half and bring it to the table to eat.
How do we grade up/down?
We are looking to change objects, rules, support stucture, practitioner, environment, or process.
Objects: Can you make it easier with different tools
Environment: Make it at counter
Process: Make them take out items
Practioner: Setting up, stand-by, cleaning up
Your client is struggling with locating the correct bus time on the large table. You fold the paper so he only has to look at one line of the schedule.
Downgrade
Your client is able to locate his bus and the correct time frame using the large schedule. You decide to have him try it in the original PDF format on his smart phone.
Upgrade
