Quick Notes: Activity Analysis
10 minute guide to Activity Analysis
Activity Analysis: What is it?
The ability to analyse activity in minute detail is one of the unique skills of an OT (Hagedorn 1992). Activity analysis or "the exploration of the typical contexts, demands and potential meanings that could be ascribed to activity" (Crepau 2003 p191) has two main purposes - to identify difficulties and problems experienced by the individual in activities and provide specific interventions that are meaningful and purposeful to the individual.
All three of these words sound pretty similar - so much so that many use them interchangeably. However, as is so common in the world of OT there is argument as to not only what they mean but also how they should be used. Often it is seen as hierarchical where tasks are smaller components of activities and activities are components of occupations (Trombly 1995). Others see activity on par with task but distinguishing between the two by suggesting that activity is context free and task refers to a person's actual performance in context (Hagedorn 1992 Watson 1997 in Crepau 2003). Context, or "a variety of interrelated conditions within and surrounding the client that influence performance" (AOTA in Crepau 2003) can include cultural, physical, social, personal, spiritual, temporal (including chronological and developmental) or virtual environments. This may sound like another argument over syntax which seems so common in the world of OT but just bear in mind that OT needs to be aware of how people engage in activities and make them their own - the transformation from activity to occupation. As such its necessary to understand the range of ways an activity can be performed, where and the potential meanings it may have in a individuals own environment. (For more info see Crepau 2003).
How?
The content of the activity must be analysed and evaluated. Note that there is no one set way to achieve activity analysis - different authors vary in their approach and terminology. The first stage in any method however is to understand what is required of an individual to perform the activity competently. Items to consider should include (Hagedorn 1992):
- Performance components required (e.g. cognitive, motor, interpersonal - the headings for each may depend on the model being used)
- Degree of complexity
- Positive or negative social or cultural aspects
- Structured or Unstructured activity?
- Familiar to a person?
- Tools and environment required to perform the activity
- Safety and risk concerns
- Potential for engagement of patient interest and participation
- The tasks that make up the activity:
- sequence and flexibility of order
- task components (some define this as "task analysis")
Remember this first stage is to investigate activity - which remember is context-free (See box). Think of it as how someone would 'normally' perform the task*.
The next stage is to investigate the activity in context and discover how the person in question performs the required elements. Although often innately achieved by a therapist, there are a number of formats to achieve this. Lamport, Coffey and Hersch (2001) give some suggested forms to discover expected performance and for therapeutic intervention. The AOTA (in Crepau 2003) suggest one format that breaks down performance components into motor skills, process skills and communication/interaction skills (Crepau 2003 p193). A form that investigates expected and actual performance for a activity can be downloaded to use for your own use here (word, pdf). This is largely based on the Lamport et al text and you will need to refer to descriptions of the performance components to understand this form although its relatively straightforward. Note that some elements are missing from the form; these are mainly the performance contexts and should be taken into account within any activity analysis.
What now?
With the understanding of normal function and ability and being able to highlight those areas of difficulty seen by the individual it is possible to combine the two and formulate meaningful treatment plans. This will typically involve the use of graded activity - sequentially increasing the demands of an activity on a person to stimulate improvement in their functional ability (Crepau 2003). This will differ depending on the nature of the identified problems and theoretical approaches being taken (including Model, Approaches and Frames of Reference). Adapting the activity may also be required. Both adaption and grading requires modification and planning of not only the activities steps but also the context (e.g. environment).
* Im not keen on the word 'normal' but for clarity it is used here.
References
Lamport N.K., Coffey M.S, Hersch G.I (2001) Activity Analysis & Application, 4th Edition, NJ: Slack
- A nice text. Its slightly unrealistic to expect a practitioner to carry out all 5 forms suggested in the book but note that it has been designed to facilitate learning rather than for practice. What is useful is that the authors have gone to some effort to create steps to perform activity analysis and use terminology that is common - making full use of the AOTA Uniform Terminology; repeated for reference in the appendix of the book. If you buy it you also get access to the forms for downloading (once only).
Crepau E.R. (2003) Analyzing occupation and activity: A way of thinking about occupational performance in Willard & Spackman's Occupational Therapy pp 189-198
Hagedorn R (1992) Occupational Therapy: Foundations for Practice, Edinburgh UK: Chuchill Livingstone
Trombly, C.A (1995) Occupation, purposefulness and meaningfulness as therapeutic mechanisms (Eleanor Clarke Slagle Lecture), American Journal of Occupational Therapy 47, 960-972
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