The Seeds OT Model · Part 3 of five · 3:08
Work with conditions
Use influence and reach to identify a workable starting point, and distinguish conditions to change, accommodate or respect.
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Video transcript
0:00A long list is not yet a plan
Once you start looking across conditions, it can be easy to produce a very long list. Part three is about turning that list into a workable plan. The most important condition is not always the one you can change today. The easiest condition to change may not matter much to the pattern. The Seeds OT Model asks the clinician to consider both influence and reach, with the child and family’s priorities in view.
0:25Influence meets reach
Influence means how strongly a condition seems to shape the pattern. Reach means how realistic it is to work on that condition now. These are clinical judgements to discuss and review, rather than scores produced by a test. A possible starting point is a condition that seems influential and is genuinely within reach. Reach depends on the family’s time, energy, support and circumstances, not only on what a clinician thinks would be helpful.
0:54Three different responses
The model describes three responses. Change a condition where a useful adjustment is possible. Accommodate a reality by adapting the activity, support or environment around it. Respect a limit by recognising it clearly and not asking the family to carry an impossible task. Those responses can sit together in one plan. They do not mean giving up on participation. They help make the work proportionate to what people can actually influence.
1:24Look before the visible moment
The most visible moment may be where several demands finally meet. If the concern is a difficult school arrival, it can be useful to understand the morning before the school gate, the transition itself and the support available on arrival. This is an illustrative situation from the written model. It does not tell us in advance what is causing a particular child’s distress. It gives us places to ask, observe and compare before choosing an intervention.
1:55Make the first change workable
A workable plan identifies what the family wants to become easier, the adjustment being tried, and what would tell everyone whether it is helping. That may involve a routine, the sensory demands of a task, pacing, a different support or direct skill-building. The model does not prescribe the intervention. The clinician still chooses an appropriate approach using assessment, relevant evidence and professional judgement. Beginning with one or two useful changes can also make it easier to understand the response.
2:30Keep the limits in the picture
Housing, resourcing, disability or a long wait for support may not be moveable within a therapy session. Naming a limit can prevent a plan from quietly implying that a family should solve it through more effort. Advocacy or referral may still be part of the response. As a reflection, look at a current plan and ask whether each action is realistic for this family now. Part four turns to the clinician’s own attention: how we keep this wider view when pressure pulls us towards a quick explanation.