Can observing a client in one context allow us to predict ability in another?

I created this scenario to explain how, for example, assessing “Mary’s” ability to get ready in the morning (her “occupational performance”) can tell me a lot about her likely performance in making a simple meal.

(A modification of this would be great to use with OT/OTA students in the classroom or on fieldwork. Sharing how Mary does in her morning routine, then asking them to predict what she would be like in the kitchen.)

Mary is a 75-year-old woman who wants to be able to independently make a simple meal, while using hip precautions, her walker, and energy conservation techniques. She is currently in inpatient rehab. If we [OTs] work with her during her morning routine , even if we haven’t seen her in the kitchen yet, we will learn valuable information to predict how she would do in the kitchen. We may see she is forgetting to use- or doesn’t understand- her hip precautions. We may see that she is inefficient in her method, walking back and forth across the bathroom to get one item at a time. That she sequences tasks incorrectly, putting on makeup then realizing she hasn’t washed her face. That she is unsafe, with seemingly no awareness of fall hazards or an ability to remember to turn off her curling iron. All of these components will demonstrate to the OT that she may not be ready to safely make a meal by herself that involves anything that needs to be turned off, and that she may need items grouped together for efficiency reasons, such as keeping the peanut butter, jelly, bread, and a butter knife all in one area. She may also benefit from a written or visual list of instructions. We haven’t even seen her in the kitchen yet, but by watching her in the bathroom, we already have information that will guide our intervention and possibly fill in some of the blanks on an assessment tool. There are many safety similarities between getting ready in the morning and making a meal, as it pertains to slippery surfaces, heated objects, sequencing, underlying skill deficits both physically and cognitively, etc.

*I’m using more laymen terms here for easier understanding, but in medical documentation I would use more professional terminology

*Born out of a discussion in one of my post-professional OTD classes, involving assessment of various occupational performance areas.

(Prediction of occupational performance in varying activities of daily life (ADLs)