This assessment requires you to design and construct a static thermoplastic splint/orthosis. This assessment piece is designed to facilitate your understanding of how a custom-made assistive technology is an environmental intervention supporting occupational performance. You will have an opportunity to work with thermoplastic materials in practical classes scheduled in OCCT12006 and you will be taught the theory about splinting/orthosis fabrication for upper limb pathology. Prior to your assessment piece, you will be supported during class contact time to fabricate some key orthosis e.g. thumb spica, resting pan splint and the wrist extension cock up splint. You will also learn about contemporary nomenclature for these commonly-fabricated orthoses. At the commencement of term, you will be supplied with a brief case study in the form of a client referral, upon which you will base a client profile and understanding of the rationale for the orthosis. This will guide the information you provide to the examiner/s during your practical assessment.

Prior to the assessment intensive, you are required to research the type of conditions that may necessitate the fabrication of your assigned orthosis. Following the fabrication, you will undergo a brief viva, in which you will verbally communicate to the examiner/s the following:

• A brief synopsis of the condition
• How does the pathology of such conditions affect a person's occupational performance?
• Why is the orthosis you are fabricating the best option for this clinical condition?
• What evidence can you cite to support your argument?

The assessment will be recorded so that the teaching team can perform moderation of marking afterwards.

The full rubric will be made available to you on Moodle.

The full rubric will be made available to you on Moodle.

A summary of the assessment criteria is as follows:

• technical design of the splint (5 marks)
  
• construction and fabrication skills (10 marks)
  
• thermoplastic material handling and safety (10 marks)
  
• knowledge of the rationale for the splint (10 marks)
  
• reflection on splint design and fabrication (5 marks)
  

Assessment Overview:  This presentation assessment further develops your knowledge of the way in which environmental adaptations and assistive technology support occupational performance and participation.  It builds on the knowledge you have obtained in your first year of studies, and requires you to deeply explore barriers and facilitators in a person's environment, and ways in which we can adapt that environment through equipment, modifications, and assistive technology. There is a group component and an individual component.

Grouping Details:  You will prepare and deliver a 20-minute group presentation to your peers.  Group numbers for this assessment are dependent upon enrolment numbers and will be determined in week 1.  You will undertake this assessment in groups of 3-4 (depending on enrolled numbers), with groups determined in week 1 of term. 

Task Details:  A comprehensive case study will be presented to you at the commencement of term.  This will include a written summary, a range of videos of the client performing daily activities, and depending on his availability, a classroom visit from our client.  The client is a young man who has many productive, self care and leisure occupations that he wishes to participate in as fully as possible.  He has a functional impairment which is cerebral palsy with spastic quadriplegia, mild kyphosis and some of the mild sensory, cognitive and neurological issues that can be associated with that diagnosis.  

Your primary task as a group is to select and prescribe an appropriate assistive technology for him - specifically, a wheelchair.  You must use your developing professional reasoning to select the most appropriate assistive technology (wheelchair) for him with full justification of your decisions.  This may include but not be limited to the following:

• understanding the client profile - his preferences, goals, priorities, and the nature of his functional impairments 
• family-centred practice - a consideration of the goals that his family has for him
  
• an exploration of the barriers and facilitators in his environment (consider all elements of the environment)
• financial considerations and subsidy schemes available e.g. NDIS
• the features required in the assistive technology, the shortlisting and selection process - this may involve visiting your local supplier, trying out and taking photographs of the relevant assistive technologies
• comprehensive consideration of any accessories required for the assistive technology as well as additional assistive technology/daily living aids that may be required in his home

Students will learn about the relevant NDIS General Assistive Technology Assessment Template in classroom lectures and tutorials but there is no requirement to complete the NDIS template for this assessment. 

Note:  Presentations must be comprehensive yet concise and fall within +\- 2 minutes of the allowable 20 minutes.  Penalties will be applied for presentations falling outside of those limits.   

Individual component:  The individual component of this task is to submit a 500-750 word reflection (guided by prompts on a template) on your experience of the professional reasoning process and decision-making about the assistive technology. 

• complete and correct description of the assigned functional impairment (10 marks)
  
• analysis of the relationship between the functional impairment and the environmental barriers and facilitators to occupational performance (10 marks)
  
• generation of appropriate intervention solutions to optimise occupational performance and participation (20 marks)
  
• professional verbal and non verbal communication (10 marks)
  
• effective use of multimedia and skilled organisation of content (10 marks)
  
• use of evidence-based literature to support presentation content, inclusive of correct APA in-slide citations and reference list (10 marks)
• individual reflection (10)
  

Written assessment - Home Assessment and Modification

Home assessment and recommending assistive technology devices and home environmental modifications are all common practice areas for occupational therapists.

This assessment task is designed to replicate the clinical reasoning and assessment process used by occupational therapists in this practice area. State and federal government funding initiatives such as the Medical Aids Subsidy Scheme (MASS) and the National Disability Insurance Scheme (NDIS) permit new graduate occupational therapists to select and recommend a range of AT and basic home modifications for clients. Students therefore need to develop the skills to assess, modify, research, locate, price and compare options. 

Task

This individual written assignment is worth 40% of the final subject mark. It requires you to:

1. develop a client profile in which you will consider all aspects of the impact of the diagnostic presentation on ADLs and IADLs

2. conduct an assessment of an actual home environment

3. make recommendations for environmental modifications and assistive technology products (AT) attending specifically to a) access to the house via one entrance and b) client use of the bathroom and toilet

4. justify your recommendations

5. explain your professional reasoning guided by  the PEOP model as studied within classes in OCCT12006

6. ensure APA referencing is adhered to throughout your written assessment and an evidence-based reference list is supplied

1. Develop a client profile

Select a client scenario from the options provided below and develop a brief, realistic client profile. The profile could be based on a person you know, someone you have worked with during placement or could be completely fictional.

The detail in the provided client scenarios is limited in order to give you the flexibility to craft your own client profile. You need to ensure the client will experience occupational issues in your chosen home environment and that these occupational issues can be overcome with appropriate environmental modifications and AT products. Any identified occupational issues need to be realistic and consistent with the client’s condition or diagnosis and prognosis. Include citations of the references used to ensure you have created a realistic scenario and to show you understand the nature of the client’s occupational issues.

Client Scenario One:  A married woman in her thirties recently diagnosed with multiple sclerosis.  She is an architect who works for herself and primarily works from home.  She and her husband live in the home and have no children.

Client Scenario Two:  A male now mid 40s and working professionally as a solicitor in a conveyancing firm - complete C6 spinal cord injury sustained in the mid-20s during a motorbike accident

Client Scenario Three: A male or female in their early 60s living with chronic rheumatoid arthritis - increased pain and joint deformities in the hands. She/he volunteers with meals on wheels, plays social card games and works part-time at a gardening centre.

2. Conduct an assessment of an actual home environment

Conduct an environmental assessment of a home of your choice, imagining that it is the home of your client.

Take photographs and measurements of the entrance/s, toilet and bathroom and record other relevant information e.g. number of rooms, floor surfaces, exterior structure, yard, proximity to shops/services etc.

Include at least one photo of each environment (i.e. the toilet, bathroom and entrance/s) for context when you describe this in your report.

Consider your client’s strengths and occupational issues in this environment.

3. Make recommendations to support your client’s ability to:

i. enter/exit the house via one entry

ii. use the bathroom and

iii. use the toilet

Any recommendations need to be realistic and consistent with the client profile. Ensure your client will require a range of both appropriate assistive technology products (AT) and structural environmental modifications in your chosen home environment.

AT recommendations need to include a description of the required product features, potential supplier/s and approximate prices. Include pictures of the selected items where possible. When recommending environmental modifications, refer to and cite the current suite of Australian Standards for Access and Design (AS1428.1, 1428.2, 1428.3).

Include technical drawing/s and photos to explain and describe the proposed environmental modifications. At least three and no more than four technical drawings (drawn to scale using technical drawing conventions) are required and should be included as appendices. It is possible to include technical drawings drawn by hand or by using computer software such as SketchUp Make. The use of accurate technical drawing conventions is the most important component of this task, not the ability to use computer software.

Include before and after technical drawings of either the entrance, toilet or bathroom to illustrate the existing environment and the proposed structural modifications. An adjoining toilet and bathroom should be represented in a single technical drawing.

As you can include a maximum of four technical drawings, the drawings included need to convey the most important and relevant information within your proposed modifications (e.g. it is more important to show technical drawings of the changes required to install a ramp for access into the house than drawings to install a grab rail in the toilet). You may choose to include photos/images as additional appendices to support your description of the environment and/or proposed modifications (e.g. a photo showing the position of a proposed hand rail), but these do not replace the technical drawings.

It is not necessary to include quotes or approximate costs for environmental modifications.

4. Justify your recommendations

Provide the rationale for each recommendation. This explains why you have recommended the specific AT items and environmental modification/s for your client and how these are required to support your client’s occupational performance. Each option needs to clearly and realistically relate to the client profile and convey any client opinions or preferences.

Each recommended AT solution needs to be selected and justified using a feature-matching process. Solutions need to be clearly relevant to the occupational issues identified in the client profile and consistent with the client’s health condition.

Refer to and reference the relevant Standard within the current suite of Australian Standards for Access and Design (1428.1, 1428.2, 1428.3) any other appropriate sources/references when recommending environmental modifications.

Your rationale needs to explain how your recommendation/s comply with the selected Australian Standard or why they do not comply. Explain how and why the modified environment is needed to support the person’s occupational performance. Ensure there is consistency with the client profile.

Submit your work using the report template provided.

• development of the client profile (15)
• recommendations and rationale for access to the physical environment (20)
• recommendations and rationale for modifications to the bathroom/toilet (20)
• execution of technical drawings (15)
• written expression and referencing (10)