Objectives. Research has suggested that using an adaptive approach to provide direct training in occupational behaviors is more effective than using a remedial approach to retrain component skills. This survey was done to see whether occupational therapy practice in physical dysfunction reflects that research.

Method. Surveys from a convenience sample of 269 (70.2% response rate) occupational therapy directors in adult physical rehabilitation facilities throughout the United States were analyzed to determine the relative rankings of remedial and adaptive activities by therapists in those settings.

Results. For all facilities combined, the four most frequently used types of activities, in order of frequency, were self-care, upper extremity exercise, functional mobility, and neuromuscular training. Facilities using multiple formal methods to assess client priorities used functional activities more frequently than other facilities.

Conclusion. Occupational therapists in adult physical dysfunction settings are not routinely providing client training in the full spectrum of occupational behaviors.