Example CMOP-E analysis - James - young child PDF

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CMOP-E: Analysing the Impact of enablers and barriers on occupational performance and engagement

WHO: James with dyspraxia – from http://www.nhs.uk/Video/Pages/Childhooddyspraxia.aspx?searchtype=Tag&searchterm=Disability& Which self-care occupations or occupational roles are you analysing? SELECTED OCCUPATION/ROLE: Student and friend at school List ALL the current enablers and barriers in ALL the domains of CMOP-E

PERSON

ENABLERS Physical • walk, run, lif • flex/extend/rotate trunk • good balance e.g. bike with feet on ground • coordinate fine motor movements with use of aids Cognitive • Appears to be able to follow simple sequences and instructions when delivered clearly and in a structured way Affective  able to express emotions  happy, bright affect  swing calms SPIRITUALITY e.g. Motivating life forces and drivers for participation in occupations.

   

BARRIERS diagnosed with dyspraxia poor static and dynamic balance history of falls difficulty with mobility and grip

 took a while to learn to talk  poor motor planning and execution grip, fine motor movement  can get overwhelmed by too much choice  difficulty regulating emotion, gets frustrated  state of flight  gets upset when out of routine  He may not feel a sense of self efficacy in his ability learn  Not enough information given

ENVIRONMENT

 Appears driven to participate in drawing, bike riding activities Physical  Swing seat and trampoline calm and helps with body awareness  Pencil grips and writing slope board  own bedroom  playroom and large garden Institutional  Access to school and healthcare services

Cultural  English child living in a family and good house  Schools more accepting of disability compared to a few decades ago

OCCUPATION

Social  Caring mother    

Has developed daily routines Strong occupational role as son enjoys playing with Lego riding a bike, drawing students at local school

 Trips over objects  Cluttered house

 mainstream school might not be understanding to disability  family might earn too much money to qualify for benefits  other people making assumption nothing is wrong  stigma of disability

 Because he has a hidden disability, people in society e.g. teachers, other kids and parents, may not understand why he is having some difficulty with some tasks  difficulty finishing tasks  needs prompting from parents, teacher to comply with daily routines

PERSON

Describe how the barriers and enablers from each domain of CMOP-E are impacting OCCUPATIONAL PERFORMANCE in the/these occupational/roles.

Physical Person enablers and barriers  James’ dyspraxia may impact his ability climb on play equipment at school making it difficult to play with friends sometimes thus he may be lef out  His fine motor control is poor and may result in poor handwriting or slower at writing sentences/stories Cognitive enablers and barriers  He may struggle to follow complex instructions or sequences during classroom activities and get lef behind which may hinder his learning of new concepts Affective enablers and barriers  He has difficulties regulating his emotions especially when out of routine, so new activities in the class room or with friends in the playground may be difficult for him control his emotions  He may become upset more easily than peers and have difficulties making friends  He may not feel a sense of self efficacy in his ability learn and be a student SPIRITUALITY enablers and barriers  He may lack energy and enthusiasm for school and learning as he has difficulties keeping up with school tasks/learning  He may feel different to his peers and not committed to his student role

ENVIRONMENT

Physical Environment enablers and barriers  James’ dyspraxia may impact his ability climb on play equipment at school  Pencils or texts may not have the appropriate pencil grips and thus his writing, drawings, painting may be messier than other kids Institutional enablers and barriers  The teacher may not understand dyspraxia which may result in her getting frustrated or giving directions that are too complex  The teacher (if she does understand) has to spend extra time with James which may impact other kids Cultural enablers and barriers  No problems identified Social enablers and barriers  His Mum may be able to spend extra time afer school to assist James with writing, reading etc  His peers may not understand his problems and leave him out of play activities Occupation enablers and barriers  His daily routines enable to arrive at school on time Gi i hi i t ti th t f hi t f ll ll hi t f l i hi l t d t

Analysis of occupational performance and engagement: using 3-5 of the most relevant headings from CMOP-E, describe how the enablers and barriers are interacting to impact occupational performance and engagement in the selected occupations/occupational roles.

Occupational performance • Overall, James has some significant occupational performance problems that are impacting on his student role and learning in the classroom and playing with peers. • James attends school (Institution-Environment) where a barrier for might be the teachers and fellow students (barrier: Social-Environment) might be the lack of understanding about how his condition impacts his performance as a student (Productivity-Occupation) or player in the playground (Leisure - Occupation). • James demonstrates some difficulty when griping objects (barrier: Physical – Person). With verbal prompting from his mother (enabler: Social – Environment) and the use of physical aids such as pencil grips (enabler: Physical- Environment), James is able to write and draw pictures at school (Productivity - Occupation). • Another barrier, is the presentation of too much choice, in the Physical/Social-Environment, which will lead James to becoming confused (Cognitive-Person) and upset (Affective-Person). This is a barrier as he struggles to regulate his emotions Affective-Person. • An enabler helping him in social scenarios, is that James is able to express that he is happy and when enjoying himself, Affective-Person. He uses the Leisure Occupation of the trampoline or hammock to manage his emotions and cope with his mood swings, which is an enabler. Engagement e.g. the impact of the enablers and barriers on the person’s sense of involvement, choice, positive meaning and commitment to the occupation. The meaning ascribed to an occupation by a person can be positive (leading the person to participate) or negative (leading them to participate less).

Because of his dyspraxia (barrier: Physical – Person), James may be struggling to make and maintain friendships (Social – Environment) at school, which reduces the positive meaning and involvement that he attains from being at school (Engagement). Because he struggles to regulate his emotions, he is offered less choices which might impact on the meaning he attains from participating in only a few occupations....