Why adopt a Context Oriented Task Based Approach to Therapy?

In recent years there has been a shift away from the almost exclusive use of process based approaches to intervention (such as neurodevelopmental therapy and sensory integration therapy) towards using task and context oriented approaches with an emphasis on improving function and participation. 
 
There are two basic reasons for changing from a process to a task  / context  based approach: 
  • Firstly  the evidence shows that task based approaches are more effective in bringing about  changes in children’s motor abilities and participation.  
     
  • The second reason is that advances in our understanding of motor development, control and learning from the latest neuroscience research  literature provides a host of  new insights into the many factors that contribute to task performance – and how the specifics of motor control are tightly linked to the task and context.  You cannot separate sensorimotor control from the context and task demands. 

In this video clip I talk about the reasons for adopting a task based and context oriented  approach to intervention for children with movement difficulties. 

I will argue that because both motor control and motor learning are task and context specific and involve a complex set of interactions between many systems. They also depend on the ability to predict the what is going to happen next depending on the continuous back- and forth interplay between sensory information and motor outputs.
 
Another argument is linked to the reason parents and children consult to a physical or occupational therapist: it is usually  because the child is not able to do something – or has difficulty doing some task or activity.  
 
The baby is 9 months old and still not sitting, a four year old child refuses to walk up the stairs, a 6 year old does not like drawing and is having trouble with getting herself dressed. Another child may trip and fall a lot or bump into things all the time, another child may have difficulty sitting erect at the dinner table. 
 
The therapist’s task is to understand WHY the child is having difficulties and then to implement a training program to improve task performance.  
 
Now we would all probably agree that understanding the WHY allows for better clinical decisions about HOW to go about improving performance. 
 
This is where our expanding understanding of  motor control and learning is shifting the landscape and putting us all in a very different clinical decision making place than we were 20-30 years ago. 
 
In this video presentation I look at aspects of task complexity and specificity and make he following argument for adopting a ask based and context oriented approach: . 
 
Firstly only a task based approach can deal with the complexity of task performance.
 
Secondly  many aspects of motor control are task and context specific – and rely on the ability to predict future events based on present estimations of state. 
 
Lastly understanding the many aspects of the child– task-context  interface allows all aspects of a child’s abilities and difficulties to be held in one clinical decision making pool of insights and solutions. 

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