An occupational therapist completes a thorough assessment. The client's needs are clear, the goals are agreed, everyone is aligned. So why does the finished adaptation sometimes still fail to meet the need?

This session argues that the problem rarely starts with the assessment; it starts with what happens after it. OTs and building professionals share the same goal but speak different professional languages: one thinks in occupation, function and need; the other in specification, dimension and buildability. Critical information, such as the fixture position that has to stay exactly there or the clearance that can't be compromised, gets lost somewhere between the assessment and the site.

Drawing on doctoral research into how OTs' clinical reasoning survives (or doesn't) the journey into design and construction, this session unpacks where and why that information gets lost, what OTs and designers each need from one another to stop it happening, and how digital tools like Moddy are being used to capture assessment information in a design-ready format, flagging what's fixed, what's flexible, and what should never be quietly value-engineered away.