This study will evaluate the use of the personal computer (PC) in occupational therapy. The
results of the study will help occupational therapists develop improved treatment activities
Patients enrolled in various NIH clinical trials who are referred for occupational therapy
may be eligible for this study. Each patient will have at least four computer sessions
within 6 months. They will use the PC to achieve goals they set for themselves-for example,
to build work skills, improve concentration, or simply have fun. At the end of each session,
the occupational therapist will interview the patient, asking, for example, about the goal
of the session and what may have occurred during the session to make it more helpful or less
helpful. The interviews will be tape recorded and used to help determine how computers may
be used most therapeutically.
Occupational therapy approaches rehabilitation through the concept of "occupation", the
component of human behavior regarding one's engagement in self-initiated, self-directed,
adaptive, purposeful, culturally relevant, organized activity. Rehabilitation through
occupation is a process, stemming from interactions among the three domains: (a)
performance areas; (b) performance components; and (c) performance contexts. At the core of
the occupational therapy is a sub-process created by patients and therapists through their
actions and reactions to treatment. It is a significant sub-process because it sets into
motion the use of occupation as therapy. It is believed that the appropriate, therapeutic
use of occupation affects "performance" or how one functions.
There is a need to develop ways to articulate and measure complex therapeutic interventions
themselves. This is especially true of those treatment approaches which integrate human
relationships, collaborative problem-solving, and the targeted doing of unique, personally
relevant occupations. Occupational therapy is a health profession characterized by such
interventions. The capacity to delineate key process variables may lead to credible
examination of process-outcome relationships. Ultimately, results from the proposed study
may provide information needed to further establish patient outcomes from occupational
Men, women and children from across the United States and from around the world who
participate in clinical research at the National Institutes of Health, and who have been
referred to occupational therapy as part of their routine care, are eligible to be
considered for this study.
Patients whose occupational therapy treatment plan recommends the personal computer
intervention will be eligible to participate.