Table 2.
Session description | Partnership Agreement was signed by T and P. It describes the importance of participation and sharing ideas for challenging task practice, mitt orientation, and outside-of-session action planning |
Identification of 6 meaningful tasks (2 each from dexterity, bimanual, strength categories) for session practice/performance. Tasks identified: tying shoes, turning pages, opening a water bottle, ironing a shirt, using a weed-eater, using a paint brush | |
Selection of the priority task: P: “I want to be able to use a paintbrush to paint a wall with my affected hand.” | |
P rated self-efficacy for priority task performance (1, “not confident at all I can complete the task”). | |
P attempted performance of the priority task | |
P/T collaborated on identifying the problem with task performance | |
Task performance and dialogue | T: “Would you like to give [your priority task] a try with this brush?” |
[TASK PERFORMANCE: Sitting at a table, the participant was unable to grasp a paintbrush from the table top.] | |
T: “What do you think is difficult about picking up the brush?” | |
P: “I can’t open my hand, … unable to raise my shoulder enough, … can’t seem to keep my hand flat on the table.” | |
[TASK PERFORMANCE: P was still unable to pick up the brush.] | |
T: “Would a different position be better?” | |
P: “I could stand.” | |
T: “What do you think is difficult about picking up the brush in this position?” | |
P: “I can’t raise my arm.” | |
T: “What would you like to work on?” | |
P: “Raising my arm.” | |
Elements/comments | A skill focus and motivational enhancements (for collaboration and choice) are reflected in therapist/participant dialogue |
P was limited in manual dexterity and strength for functional grasp of the brush | |
T and coach determined the challenge threshold (for raising the arm) to enhance motor capacity | |
P was encouraged to problem solve as the therapist assumed the role of a “coach” | |
Principles emphasized: 1, 2, 4, and 6 |
Abbreviations: ASAP, Accelerated Skill Acquisition Program; P, participant; T, therapist.