Adult Occupational Therapy Clinic


The Adult Occupational Therapy Clinic serves adults and older adults who have neurological diagnoses such as cerebral vascular accidents and traumatic brain injuries, orthopedic conditions such as knee and hip replacements, fractures and other chronic orthopedic conditions, and cognitive impairments such as dementia. Additionally, the adult clinic will also serve individuals with psychological conditions such as depression, adult developmental delay and autism. Referral sources include clinics, physicians, and hospitals in the greater Kalamazoo area. Clients may also self-refer. The focus of the adult clinic is to provide skilled evaluation and intervention from a holistic perspective to assist clients in achieving their highest level of safety, occupational performance, and well-being. Through an extensive evaluation process, the adult clinic helps to determine the client’s potential for rehabilitation and independent living. Intervention is designed to improve independent living skills, motor skills, and cognitive skills through one-to-one sessions that target the individual client’s needs.

The role of the OT interns, under supervision of the OTRL, includes providing in-depth evaluation consisting of formal and informal assessments, and designing client- centered intervention directed toward improving performance in ADLs and IADLs by remediating underlying problems and/or assisting clients to compensate for persistent deficits through adapted means. Interns will be guided in developing client-centered and occupation-based intervention plans supported by appropriate theoretical approaches and empirical evidence. Interns will also establish a strong therapeutic relationship based upon client-centered principles and guided by the theoretical concepts such as the Model of Human Occupation.

Client evaluation process

The evaluation is scheduled over three, one-hour sessions and consists of interview, standardized and non-standardized assessments, functional assessments, and structured observations of occupational tasks. These assessments help to identify issues that may impact work and/or other independent living skills in the areas of gross motor and fine motor, visual motor integration, and cognition and perception. While the primary focus of the evaluation is on client’s physical, visual integration and cognitive factors that impact occupational performance, screens may also be provided to identify and provide intervention for psychosocial factors that may impact progress in therapy and performance of desired occupations. The evaluation identifies strengths, needs and potential related to independent living and may also provide recommendations for additional services as is appropriate.

Each student manages a caseload of clients following the client for the duration of the academic semester. Documentation includes an evaluation note, treatment plan, daily and weekly SOAP notes, and a semester discharge summary. Communication with the client’s family and caregivers is an essential component of the process and if appropriate, significant others will participate in part or all of the evaluation sessions. If clients also have Unified Clinic speech therapy, students will be encouraged to communicate with SLP in order to provide a coordinated plan of intervention. On occasion, students will have the opportunity to participate in formal team meetings if more than one discipline is involved with intervention.

Students administer the following formal and informal evaluations. Additional assessments will be provided if needed: 



Occupational Profile Interview



Performance of meaningful ADL and IADL tasks

Performance Capacity/Self- Care/Independent Living Skills


Vitals: BP, pulse, and pulse oximetry for blood oxygen levels

Functional Range of Motion (FROM) and AROM

Functional Manual Muscle Testing (MMT)

Pinch and Grip Strength

Visual Screening

Modified Ashworth Scale for spasticity

Tinetti Balance Assessment

Sensory Test

Client intervention process

Intervention is scheduled for one hour, once-twice weekly sessions. Intervention is designed to improve independence in ADLs, motor skills, and cognitive and perceptual skills through participation in one-on-one sessions to target specific skill areas for the individual client. An individualized intervention plan is developed in collaboration with the client and any individuals identified as significant by the client. Intervention approaches will be selected based upon the needs of the client. Intervention approaches commonly used in the adult clinic include MOHO as the occupational model and frames of reference/treatment approaches such as rehabilitative, cognitive rehabilitation, motor control such as NDT and PNF, contemporary motor control, biomechanical and applicable psychosocial approaches.

By the end of the semester it is expected that students will have developed the following basic competencies regarding working with adults with neurological, orthopedic and cognitive disorders. On occasion students will also develop competencies working with clients with mental health disorders.

  • Evaluation and intervention process

  • Building therapeutic relationship and therapeutic use of self

  • Developing client-centered and occupation-based intervention plan supported by appropriate theoretical approaches and empirical evidence

  • Providing intervention directed toward improving independent living using the applicable remediation and/or compensatory approaches as indicated by client’s condition and situation.