Bailey D M, DeFelice T
Tufts University-Boston School of Occupational Therapy, Medford, Massachusetts 02115.
Am J Occup Ther. 1991 Jan;45(1):76-9. doi: 10.5014/ajot.45.1.76.
Miranda's family members are most supportive of the goal for her to have a powered wheelchair and encourage her when they visit. Motivation has been the key to Miranda's success at learning to operate switches in order to explore and learn from her environment. As long as the outcome available from operation of a switch is desirable for Miranda, she works hard at controlling her movements so as to activate it. Conversely, if the ultimate advantage of operating the switch is unclear to her, she is unwilling to make the effort. The occupational therapist's role is crucial, in that she realizes the importance of motivation and consequently designs activities and rewards that are important and meaningful for Miranda. Miranda's life has been considerably enriched by the introduction of mechanical aids into her leisure sphere. She has become more interested in her surroundings and is excited about exploring possibilities for future rewarding activities, such as academics. A notable additional benefit has been that Miranda now displays a more assertive attitude on her own behalf.
米兰达的家人非常支持她拥有电动轮椅的目标，并在探望她时鼓励她。动力是米兰达成功学会操作开关以便探索环境并从中学习的关键。只要操作开关能带来令米兰达满意的结果，她就会努力控制自己的动作来激活它。相反，如果操作开关的最终好处对她来说不明确，她就不愿意付出努力。职业治疗师的角色至关重要，因为她意识到动力的重要性，因此设计了对米兰达来说重要且有意义的活动和奖励。通过在她的休闲领域引入机械辅助设备，米兰达的生活得到了极大丰富。她对周围环境更感兴趣，并且对探索未来有意义的活动（如学业）的可能性感到兴奋。一个显著的额外好处是，米兰达现在为自己表现出更坚定的态度。
