I was assigned a 58‑year‑old stroke survivor with hemiplegia, aphasia, and severe spasticity who was being considered for discharge to home care.

My task was to conduct a comprehensive functional assessment to determine safe discharge level and identify therapy goals.

I used the Fugl‑Meyer Assessment for motor function, the Modified Ashworth Scale for spasticity, and the Functional Independence Measure to gauge ADL abilities. I collaborated with the speech therapist to evaluate communication barriers and consulted the physician for medical stability. I documented findings in a detailed report and presented them at the interdisciplinary team meeting.

The team approved a tailored home‑based OT program focusing on upper‑limb functional training and caregiver education, which reduced the patient’s readmission risk and improved independence scores by 15% over six weeks.

I worked with a 4‑year‑old diagnosed with cerebral palsy who had limited hand function, poor trunk control, and delayed self‑care skills.

I needed to establish a hierarchy of therapy goals that would maximize functional independence and align with the family’s daily routines.

I first conducted a goal‑setting interview with the parents to understand their priorities, then performed a Pediatric Evaluation of Disability Inventory (PEDI) to identify current performance levels. I ranked goals using the SMART framework, focusing first on trunk stability to enable seated play, followed by hand‑function tasks for feeding, and finally fine‑motor activities for dressing. I incorporated parent‑mediated activities into the home program and scheduled weekly progress reviews.

Within three months, the child achieved independent sitting for 30 minutes, could self‑feed using adaptive utensils, and parents reported a 40% reduction in assistance needed for dressing.

During a post‑operative knee replacement case, the PT advocated for early aggressive gait training, while I was concerned about the patient’s limited shoulder mobility affecting wheelchair transfers.

My goal was to reach a consensus that ensured safe progression without compromising either therapist’s objectives.

I scheduled a brief interdisciplinary huddle, presented objective data from the patient’s shoulder range‑of‑motion measurements, and highlighted the PT’s gait milestones. I suggested a phased approach: start with modified gait training using a walker while I implemented shoulder strengthening and transfer training. We agreed to reassess shoulder function after two weeks before intensifying gait work.

The patient achieved safe independent transfers by week three and progressed to full weight‑bearing gait by week six without any falls or shoulder setbacks, satisfying both therapy goals.

A 72‑year‑old post‑stroke client and his spouse were overwhelmed by the prescribed home exercise regimen.

I needed to simplify the program and boost confidence to improve adherence.

I broke the program into three short sessions, created illustrated handouts with step‑by‑step photos, and demonstrated each exercise using a mirror for visual feedback. I taught the spouse a cueing technique and set up a weekly phone check‑in. I also linked exercises to meaningful daily activities, like reaching for a cup, to increase relevance.

Adherence rose to 90% over the next four weeks, and the client’s UE functional scores improved by 20%, with the spouse reporting increased confidence in supporting the therapy.

In my previous outpatient clinic, we faced audits due to inconsistent OT notes that delayed insurance reimbursements.

I was tasked with standardizing documentation to meet Medicare and state regulations while maintaining clinical relevance.

I reviewed the latest CMS guidelines, created a template aligning with the SOAP format, and incorporated required elements such as diagnosis code, functional goals, objective measures, and justification for each intervention. I conducted a training session for the OT team, instituted a peer‑review checklist, and set up monthly audits to catch deviations early.

Documentation compliance improved to 98% within two months, audit findings dropped to zero, and claim denial rates decreased by 35%, accelerating reimbursement cycles.

At a community health center, we lacked specialized adaptive equipment for a client with severe hand weakness post‑trauma.

I needed to deliver effective hand therapy using only the limited supplies available.

I improvised by using everyday items: rubber bands for resistance, kitchen tongs for grasp training, and textured fabrics for sensory stimulation. I also collaborated with a local nonprofit to obtain donated therapy putty. I documented each improvised activity with clear objectives and outcomes to satisfy documentation standards.

The client achieved a 30% increase in grip strength over eight weeks and reported greater confidence in performing daily tasks, despite the equipment constraints.