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ADLs and IADLs: Occupational Therapy Terms Explained

ADLs and IADLs

If you’ve been to occupational therapy, either for yourself or your kiddo, you’ve likely heard the terms ADLs and IADLs and been left scratching your head. There are so many new terms to learn when you start OT that it can be really overwhelming and make it hard to know what questions to ask.

Activities of Daily Living (ADLs) are the basic tasks we need to do everyday to survive, like bathing, eating, and toileting. Instrumental Activities of Daily Living (IADLs) are tasks that are more complex like child rearing, shopping, and driving. 

In this post, we’re going to explain what ADLs and IADLs are in a very simple way so that you can feel empowered during treatment. As you’ll see ADLs and IADLs are a fundamental part of OT, so it’s important to have a good grasp of what they are and how they relate to your kiddo’s goals.

The 8 Occupations of Occupational Therapy

As I explained in depth in my occupational therapy post, occupational therapy aims to improve quality of life by increasing independence in daily tasks. “Daily tasks” is very broad and all encompassing, so it’s important that we have a way to break up these daily tasks into various categories. This makes it easier to set goals, organize treatment, and basically keep our heads on straight.

Occupational therapy breaks up our daily tasks into 8 occupational categories as follows:

  • Activities of Daily Living (ADLs)
  • Instrumental Activities of Daily Living (IADLs)
  • Rest and Sleep
  • Education
  • Work
  • Leisure
  • Play
  • Social Participation
8 stages of occupation

When you combine these 8 categories, you get a comprehensive view of what we all do every day. Occupational therapists will focus on various categories depending on the settings in which they work and the goals of their clients. For example, a school-based OT is much more concerned with education than an OT working in a hospital who is helping their client return to a job following a car accident.

If your kiddo struggles with occupations because of communication, check out my review of free communication apps for special needs.

What are Activities of Daily Living (ADLs)?

Think of ADLs as those bare necessity activities that we all need to do every day in order to survive. The OT Practice Framework puts the following activities into the category of ADLs:

  • Bathing and showering
  • Toileting and associated hygiene
  • Dressing
  • Eating and swallowing
  • Feeding
  • Functional mobility (any movement we need to do as we complete tasks)
  • Personal device care (using and cleaning prosthetics, hearing aids, orthotics, etc.)
  • Personal hygiene and grooming
  • Sexual activity

In many cases, occupational therapists are immediately on the lookout for ADL deficiencies in their clients, as these are skills that are absolutely necessary for daily functioning. While there are exceptions, ADLs are often a top priority for OTs to work on with their clients.

Here are some examples of ADLs that our OTs may work on with our kiddos with sensory processing challenges:

  • Helping a kiddo with tactile defensiveness learn to tolerate fabrics so that they can wear a wider array of clothing.
  • Working on various balance activities with kiddos who struggle with their vestibular systems and shy away from movement as a result.
  • For kiddos with food sensitivities, introducing new foods and developing a comfort with feeding oneself if necessary.

When it comes to working on a kiddo’s ADLs, occupational therapists will often want to involve parents and caregivers as much as possible. Given that these are routine and necessary tasks that need to be completed every day, it’s important that the OT understands what the current routine is and what can done to improve it. Some questions you may hear include:

  • How are these activities being completed at home right now?
  • How much help does the kiddo need on a daily basis? To what extent and how often?
  • What strategies can we implement to help the kiddo achieve more independence?

What are Instrumental Activities of Daily Living (IADLs)?

IADLs take ADLs to the next level. IADLs are more complicated than ADLs and require a higher degree of mental and physical coordination and effort. Don’t worry though, many of the IADLs that the Occupational Therapy Practice Framework identifies would not apply to kiddos until they are much older. Here is what’s included in the category of IADL:

  • Care of others
  • Care of pets
  • Child rearing
  • Communication management (via computers, cell phones, augmentative communication systems, etc.)
  • Driving and community mobility
  • Financial management
  • Health management and maintenance
  • Home establishment and management
  • Meal preparation and cleanup
  • Religious and spiritual participation and expression
  • Safety and emergency maintenance
  • Shopping

If “care of pet” includes horses, hippotherapy can be a great choice!

IADLs become increasingly important as kiddos get older. While the need for communication management is coming at an earlier and earlier age these days, many IADLs are the focus of treatment for adults or teens coming into adulthood.

That said, OTs are very good at taking unique circumstances into account and will be sure to design treatment plans that meet a kiddo’s needs. If it’s necessary to work on IADLs in order to hit a kiddo’s goals, they’ll definitely do so.  

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Diana Fitts is a certified and licensed Occupational Therapist who specializes in sensory processing disorders and autism. Check out my About page to read my story and get a free therapy journal page to record your kiddo’s sessions!

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