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Occupational Therapy Skills Checklist

Please rate your experience / frequency within the last year

0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1 – 2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

MM slash DD slash YYYY

AGE OF PATIENTS CARED FOR

Newborn/ Neonate (birth to 30 days)(Required)
Infant (31 days to 12 months)(Required)
Toddler/Preschool (13 months to 5 years)(Required)
School Age Child/adolescent (6 years to 18 years)(Required)
Young Adults Middle Adult (19 years to 64 years)(Required)
Adolescents (12 years to 18 years)(Required)
Older Adults/Elderly (65+ years)(Required)

SETTINGS

Acute Care/ Hospital(Required)
Sub Acute(Required)
Rehabilitation - Acute(Required)
Rehabilitation - Long Term(Required)
Home Health(Required)
Outpatient(Required)
Adults/ Adult ICU(Required)
Pediatrics/PICU(Required)
Psychiatric Hospitals(Required)
Skilled Nursing Facility(Required)
School Setting(Required)
Early Intervention(Required)

NEUROLOGICAL

Adaptive Equipment(Required)
Alzheimer's/Dementia(Required)
CVA(Required)
Degenerative Diseases of the CNS(Required)
Functional Splinting/Bracing(Required)
Head Trauma(Required)
Peripheral Nerve Injuries(Required)
Multiple Sclerosis(Required)
Parkinson's Disease(Required)
Spinal Cord Injury(Required)
Stroke Rehabilitation(Required)
Traumatic Brain Injury(Required)
Wheelchair Evaluation(Required)
Neurodevelopmental testing (NDT)(Required)

ORTHOPEDICS

Arthritis Programs(Required)
Joint protection(Required)
Hip Fractures(Required)
Mobilization Techniques(Required)
Total Joint Replacements upper extremities(Required)
Total Knee/Hip Replacement(Required)
Lower back/spinal surgery(Required)
Soft tissue Injury(Required)
Prosthetics/amputations(Required)

PEDIATRICS

Developmental Testing(Required)
Neurodevelopmental testing (NDT)(Required)
Feeding/swallowing/oral motor(Required)
Equipment Assessment(Required)
Orthotics(Required)
Sensory Integrative Testing(Required)
Visual Perceptual Skills Testing(Required)
Wheelchair Positioning Device(Required)
Muscular Dystrophy(Required)
Cerebral Palsy(Required)
Cystic Fibrosis(Required)
Birth Defects(Required)

PROSTHETICS/ORTHOTICS

Above/Below Knee Prosthetics(Required)
Dynamic Splints(Required)
UE Prosthetics(Required)
Orthoplast(Required)
Serial/inhibitory Casting(Required)
Static Splints(Required)

ADAPTIVE EQUIPMENT

Assessment(Required)
Fabrication(Required)

Functional Activities:

ADL's(Required)
Home Environment(Required)
Pre-discharge Planning(Required)
Splinting(Required)
Wheelchair(Required)

VOCATIONAL TRAINING

Cognitive Assessment(Required)
Functional Capacity Evaluation(Required)
Job Task Analysis(Required)
Perceptual Assessment(Required)
Work Hardening(Required)
BTE(Required)
Valpar(Required)

MODALITIES

Anodyne(Required)
Biofeedback(Required)
Community Re-Entry(Required)
Feeding Techniques(Required)
Fluidotherapy(Required)
Gait Training(Required)
Massage(Required)
Muscle Stimulation(Required)
Oral Motor Facilities(Required)
Paraffin Bath(Required)
TENS(Required)
Therapeutic Pool(Required)
Ultrasound(Required)
Wound Management(Required)

GENERAL SKILLS

Electronic Documentation(Required)
Universal Precautions(Required)
Working with patients in isolation(Required)
Working with patients in restraints(Required)
Patient/Family teaching(Required)
Patient Identification(Required)
Specialty beds(Required)
End of life care/palliative care(Required)
Knowledge of "Do Not Use Abbreviations"(Required)
End of life care/palliative care(Required)
Do you have charge/supervisor experience?(Required)
Knowledge of current Joint Commission National Patient Safety Goals(Required)
Knowledge/familiarity with HCAHPS scores(Required)

OTHER SKILLS

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