Clinical pathway

ADLs

Dressing, grooming, feeding, or self-care routines take much longer than expected or require adult supervision.

Step 1

Occupational performance problem

Dressing, grooming, feeding, or self-care routines take much longer than expected or require adult supervision.

Step 2

Clinical reasoning

  • Locate the visual demand inside the routine — finding, orienting, aligning, or monitoring the result.
  • Contrast between item and background often explains more than skill level does.

Step 3

Likely limiting level

  • Level 1: Visual Access

    Low contrast in clothing, food, and bathroom surfaces.

  • Level 4: Visual-Motor Integration

    Aligning fasteners and utensils under visual guidance.

Step 4

Intervention options

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Step 5

Movement-based options

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Step 6

Teacher strategies

  • Contrast in cafeteria and bathroom routines; consistent placement of personal items.

Step 7

Parent carryover

  • High-contrast plate, placemat, and towel choices.
  • Lay clothing out in order of use, oriented as it will be worn.

Step 8

Progress monitoring

  • Level of assistance on a defined routine.
  • Time to complete the routine independently.

Step 9

Reassessment

Re-screen the limiting level after 6–8 weeks of consistent intervention. If the occupational problem has not changed while the contributing level has, look upstream for a different limiting factor. If neither has changed, or symptoms are worsening, refer out rather than continuing to treat.