Occupational therapy (OT) helps people across the lifespan participate in the activities they want and need to do every day, collectively called “occupations.” When an individual faces challenges engaging in these daily tasks, the occupational therapist conducts a thorough evaluation. A major component of this assessment involves examining the individual’s “Client Factors,” which are the specific attributes of the person that influence their ability to perform occupations. These intrinsic factors can be capacities, characteristics, or beliefs that either support or hinder participation in life’s activities. Understanding these factors provides the foundation for creating a personalized intervention plan aimed at restoring or enabling independence.
Personal Beliefs and Meaning
This category of client factors explores the non-physical elements that determine a client’s motivation and purpose in life. It includes Values, Beliefs, and Spirituality, which are deeply personal and heavily influenced by culture and life experience. These intrinsic drivers explain why a client might choose one goal over another, making them central to client-centered practice.
Values represent the principles or qualities an individual considers important to their life. For example, valuing self-sufficiency motivates a person to focus on relearning dressing and grooming skills independently. These values shape priorities and dictate the activities a person wants to engage in, influencing the therapeutic process.
Beliefs are the cognitive content an individual holds as true about themselves, others, or the world. A belief such as “hard work pays off” can foster persistence, while a belief like “I am too old to learn new things” can become a significant barrier to progress. Occupational therapists assess these views to understand potential self-limiting thoughts or supportive frameworks that affect performance.
Spirituality refers to the way individuals seek and express meaning and purpose, and how they experience connectedness to themselves, others, or the sacred. This is not always related to formal religion but rather to an inner quest for understanding one’s place in the world. An OT practitioner explores this to ensure that therapeutic goals align with the client’s deepest sense of meaning, which significantly influences their drive to engage in purposeful occupations.
Body Functions
Body Functions encompass the physiological and psychological functions of body systems necessary for an individual to execute performance skills. This category focuses on the process of how the body and mind operate, and impairments here directly affect the ability to complete daily tasks. The functions are grouped into sub-areas that an occupational therapist evaluates.
Mental Functions are a broad set of cognitive and psychological processes, with higher-level cognitive skills relevant to daily organization and planning. These include executive functions, which act as the brain’s “management system,” governing working memory, cognitive flexibility, and inhibitory control. For instance, a person with impaired planning may struggle to sequence the steps required to cook a simple meal or manage a complex medication schedule.
Attention is a mental function encompassing sustained, selective, and divided attention. A deficit in sustained attention can prevent a client from focusing long enough to complete a work task or read a book. Poor divided attention can make driving or engaging in a conversation while doing a household chore unsafe. Emotional functions, such as emotional control and regulation, determine a person’s ability to respond appropriately to stress and manage anxiety, which impacts social participation and task engagement.
Sensory Functions involve receiving, processing, and interpreting information from the environment and the body itself. This includes vision, hearing, taste, smell, proprioception (awareness of body position in space), and vestibular function (balance and movement in relation to gravity). An issue with vestibular function, for example, can make walking on uneven ground or quickly turning one’s head a challenge, impacting community mobility. The sensation of pain, whether acute or chronic, is also a body function that significantly limits a person’s willingness and capacity to participate in occupations.
Neuromusculoskeletal and Movement-Related Functions pertain to the control of voluntary movement and the physical capabilities of the body, covering joint mobility, muscle power (strength), and muscle endurance necessary for physical tasks. A client with reduced muscle power in their hands will have difficulty gripping a toothbrush or opening a jar, affecting self-care and home management. Motor control and coordination, such as fine motor skills (needed for buttoning a shirt) and gross motor skills (needed for walking or lifting), are also assessed to determine the efficiency of movement.
Functions of the Cardiovascular, Hematological, Immunological, and Respiratory Systems are considered because they govern the body’s overall physical capacity and stamina. Respiratory function, for instance, dictates the client’s endurance, or the ability to sustain physical exertion over time. Low endurance can limit how long a person can stand to do dishes or walk before needing a rest, directly restricting their involvement in daily life.
Body Structures
Body Structures are the anatomical parts of the body, such as organs, limbs, and their components, that support body functions. These structures provide the foundation upon which the functions operate. Occupational therapists assess the integrity of these structures because damage or dysfunction often leads to limitations in body functions and occupational performance.
The structures include the nervous system (brain, spinal cord, nerves), the eyes and ears, and the structures related to movement, such as bones, joints, and muscles. For example, the structure of the shoulder joint, which consists of the humerus, scapula, and clavicle, must be intact and properly aligned for the function of full range of motion to occur. If the structure, such as a bone, is fractured, the function of lifting the arm will be impaired.
Structures also include the cardiovascular, respiratory, digestive, and genitourinary systems. While the function is the rhythmic pumping of the heart or the exchange of oxygen in the lungs, the structure is the heart muscle itself or the alveoli within the lungs. The occupational therapist evaluates the structure separately to identify the physical location of a problem, even though the resulting functional limitation is the focus of the intervention.