An Overview of Assessments
Occupational therapists (OTs) help enable clients to participate in meaningful activities. Assessments help determine clients' needs, whether they require direct or indirect services or referral to other medical health professionals. Assessments examine behavioural, cognitive, affective, psychomotor, and environmental domains to determine a client's strengths and limitations related to occupational performance issues. Many assessment methods or tools are available, including interviews, observations, standardized and non-standardized assessments, and OTs often use various methods when working with a client.
What are Interviews?
Interviews are often the first assessment method OTs utilize. Interviews help build client rapport and gather information about a client to determine how their issues affect participation in occupations. During the interview, an OT may learn how a client perceives themself in various roles or settings. It also helps set the stage for future interactions and is crucial for developing the client-therapist relationship.
What are Observations?
Observations help to gather additional information about a client's occupational performance. More specifically, observations can be used to identify if a client is processing information necessary to perform a particular activity in the context of their environment. Observation techniques are divided into two categories: naturalistic and structured observation.
Naturalistic Observation
Naturalistic observation is a method that involves observing clients in their natural environment without intervention. The goal is to look at behaviour in a natural setting without intervention. Observation of a child interacting with their friends on a playground without interference is an example of naturalistic observation.
Structured Observation
Structured observations occur primarily in structured environments, like kitchens, where Occupational Therapists have control of contextual factors and can complete assessments in a standardized format.
What are Standardized Assessments?
Results of the study indicated that there was a significant impact on determining the treatment plan for clients followed standardized assessments. Occupational therapists who select the use of nonstandardized measures must be aware of the limitations related to accuracy and reliability and the potential impact on professional credibility and the welfare of service users. (Moorthy, S. D., 2017)
Occupational Therapy Assessments With Children and Adolescents
Let's look at some assessments used by occupational therapists when working with children and adolescents.
School Assessment of Motor and Process Skills
provides a measure of schoolwork task performance
assesses tasks such as cutting, writing, drawing
is an occupation-focused intervention
can efficiently and thoroughly assess children and youth between the ages of 3-15
Functional Independence Measure for Children (WeeFIM)
assesses functional ability involving self-care, cognition and mobility
measures need for assistance in six areas: self-care, mobility, sphincter control, communication, locomotion, and social participation
can be administered in 15 minutes and used with children between six months and seven years of age
Pediatric Activity Card Sort
offers an interactive way to develop an occupational profile with youth
consists of 75 photocards portraying activities and occupations for children
categories include personal care, productivity, hobbies and sports
can be used for children between 5 and 14 years of age
Canadian Occupational Performance Measure (COPM)
is an outcome measure created for occupational therapists to assess client outcomes in self-care, productivity, and leisure
helps occupational therapists and clients develop occupational performance goals based on client perceptions of problem areas
can be used with children as young as four years of age
"The Canadian Occupational Performance Measure is an evidence-based outcome measure designed to capture a client's self-perception of performance in everyday living over time. Originally published in 1991, it is used in over 40 countries and has been translated into more than 35 languages." (Canadian Occupational Performance Measure)
Occupational Therapy Assessments with Adults
Let's look at some assessments used by occupational therapists when working with adults.
Functional Independence Measure (FIM)
is an 18-item tool to explore a person's physical, psychological and social function
examines six areas such as self-care, sphincter control, transfers, locomotion, communication, and social cognition
is a reliable and valid tool to help identify problem areas and set goals
Assessment of Motor and Process Skills (AMPS)
is an observation assessment that evaluates motor and process skills
examines a person's ability to perform instrumental or activities of daily living
consists of 16 motor and 20 process items
there are 85 tasks to select from and include more manageable tasks like brushing or combing hair and demanding tasks like cleaning a bathroom
can only be administered by people who have completed the training
Montreal Cognitive Assessments:
a relatively straightforward assessment that examines several cognitive domains such as short-term memory recall and executive function, amongst others
can be administered in approximately 10 minutes
SAFER-HOME v3
uses interviews and observations to assess functional performance and safety
assesses 75 items around the home and rates level of safety using a 4 point scale
requires approximately 60 minutes to complete
Canadian Occupational Performance Measure (COPM)
is an outcome measure created for occupational therapists to assess client outcomes in self-care, productivity, and leisure
helps occupational therapists and clients develop occupational performance goals based on client perceptions of problem areas
References:
Canadian Occupational Performance Measure, COPM, https://www.thecopm.ca/. Accessed 30 Dec. 2021.
Lane, Shelly J., and Anita C. Bundy. Kids Can Be Kids: A Childhood Occupations Approach. F.A. Davis, 2011.
Law, Mary C., et al. Measuring Occupational Performance: Supporting Best Practice in Occupational Therapy. 2017
Moorthy, S. D. (2017). The Importance of Using Minimum Two Standardized Assessments as Initial Evaluation to Determine the Effective Treatment Plan. Indian J. Occup. Ther.| Volume, 49(3), 80-84.
Wilson, Elaine, and Helen Edwards. Occupational Therapy for Children with Special Needs. Wiley, 1998.
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