Mobility

The hierarchy of mobility skills is as follows: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and lastly community mobility and driving. This order is somewhat what I expected it to be because you always have to start with the simplest step first. If someone tries to go to the restroom but can't successfully transfer into their wheelchair, there is no way this would work. The least important occupation in the list is driving, so that is why it is listed last. I think this sequence is beneficial because if a person is not able to do bed mobility tasks, then there is no way they would be able to do anything else. The first step to independence is bed mobility. 
Although I observed in a rehab hospital, I never got to witness transfers of any kind. I would have to stay in the therapy room while the OT went to get the client. I wish I could have gotten to see more of the bed mobility skills and transfers. 
I definitely agree with this approach. It is always better to start with something simple and work your way up. You do not want your client to get discouraged because he/she can't complete a task. I think you should always make the task achievable and then increase in difficulty each session. The simulation labs definitely helped me grasp the concept of transfers since I had never seen them done before. I think it is way easier to learn by doing rather than just watching. 

Assistive Devices

The correct fitting of an assistive device is crucial when working with clients. There are many reasons why a client would need an assistive device but the 2 main reasons are decreased balance, strength, and ability and to increase safety and security. For a client with decreased strength, a correct fitting assistive device would be crucial in helping them gain their independence back. Instead of using a wheelchair, the client could use a walker, crutches, or even a cane. All of these options are easier and less bulky than a wheelchair. If the devices are not fitted to your client properly, this could cause them danger, and even result in an injury. Also, if you do not properly fit the devices to your client, they will be difficult and awkward to use. If a walker or a cane is not fitted directly to a client, they will not get the full benefit from them, and in return, decrease mobility and confidence with the devices.
To fit your client for a cane or a walker, the hand grips should be at the level of the ulnar styloid, wrist crease, or the greater trochanter, The elbows should be relaxed and flexed 20-30 degrees to get the right measurements. A platform walker would be used for a client who has a fracture or something wrong with their arm but also need support while walking. A rolling walker would be used for clients who fatigue easily, but have good balance. To fit your client for crutches, the hand grips should be at the level of the ulnar styloid, wrist crease, or greater trochanter, and the axillary rest should be approximately 5 cm below the floor of the axilla to prevent putting pressure on the brachial plexus. When your client is using Lofstrand crutches. you fit them the same way, but make sure the hand rests are facing forward when the client is moving to prevent an awkward angle of their arms.