Occupational therapy approaches rehabilitation through the concept of "occupation", the component of human behavior regarding one's engagement in self-initiated, self-directed, adaptive, purposeful, culturally relevant, organized activity. Rehabilitation through occupation is a process, stemming from interactions among the three domains: (a) performance areas; (b) performance components; and (c) performance contexts. At the core of the occupational therapy is a sub-process created by patients and therapists through their actions and reactions to treatment. It is a significant sub-process because it sets into motion the use of occupation as therapy. It is believed that the appropriate, therapeutic use of occupation affects "performance" or how one functions.

There is a need to develop ways to articulate and measure complex therapeutic interventions themselves. This is especially true of those treatment approaches which integrate human relationships, collaborative problem-solving, and the targeted doing of unique, personally relevant occupations. Occupational therapy is a health profession characterized by such interventions. The capacity to delineate key process variables may lead to credible examination of process-outcome relationships. Ultimately, results from the proposed study may provide information needed to further establish patient outcomes from occupational therapy interventions.

INCLUSION CRITERIA:

Men, women and children from across the United States and from around the world who participate in clinical research at the National Institutes of Health, and who have been referred to occupational therapy as part of their routine care, are eligible to be considered for this study.

Patients whose occupational therapy treatment plan recommends the personal computer intervention will be eligible to participate.