Assessment skills for practice

• Assessment


  A term used to describe both a process and a tool
• The process of assessment

  • Aims to develop practitioners' understanding of clients as occupational beings, recognizing their strengths and difficulties
  • Ensures that interventions meet the needs of clients, can measure change, and reflect the unique contribution of occupational therapy practice
  • Is the initial stage of the occupational therapy process
• Without appropriate assessment, therapy may not meet the requirements of clients
• Assessments


  • Used at the evaluation stage of the occupational therapy process, identifying changes from the initial assessment and determining the effectiveness of the interventions
  • There is a variety of different forms that assessments can take
  • Can be standardized or non-standardized
• Who benefits from assessment

  • Client
  • Practitioner
  • Service
  • Profession (when outcomes are published)
• Benefits for the client

  • To be listened to and understood by the practitioner
  • Establishing a collaborative relationship
• Benefits for the practitioner

  • Better understanding of client initially and throughout therapy
• Benefits for the service

  • To ensure that resources are being used in the most efficient way
  • To evidence the need for new resources to develop new services
• Benefits for the profession

  • Developing an evidence base that other practitioners may draw on
  • To allow others to build on previous work
• When assessment may occur

  • Beginning of OT involvement
  • Throughout OT involvement
  • End of OT involvement
• Purposes of assessment at the beginning of OT involvement

  • To determine need for occupational therapy intervention
  • To understand a client's current strengths and needs in relation to their occupational performance
  • To gain an accurate picture of a client's occupational lifestyle prior to illness or injury
  • To determine current and predict future functionality ability
  • To provide a baseline assessment prior to intervention
  • To assist in goal setting for intervention
• Purposes of assessment throughout OT involvement

  • To evaluate the effectiveness of an intervention programme
  • To review, adapt or redesign an intervention
  • To identify needs best met by other services leading to referral onto other agencies
• Purposes of assessment at the end of OT involvement

  • To identify appropriate time for discharge from services
  • To determine on-going needs for support and make recommendations for further services
• Why OT's assessment is important

  • Determining the specific areas a person is experiencing a deficiency in
  • Building a working relationship with the client and relevant family members as well as appraising characteristics, attitudes, behaviors, and social context
  • Engaging clients and families in effective helping processes despite the challenges of working with clients with diverse values and who are sometimes aggressive or resistant
  • Using assessment tools with an intended purpose to better guide intervention planning and to provide baseline and outcome measures in order to track progress and/or change among clients
• Factors to consider when selecting an assessment

  • The type of information required
  • The ability of the client to participate in the assessment process
  • The timing of the assessment
  • Forms of assessment
• Case note review


  Multidisciplinary notes from other health-care professionals
• Observation


  Structured or unstructured
• Interviews


  Structured - Fixed format, may be the basis of an initial assessment<|>Unstructured - not following standardized interviews
• Self-Report questionnaires and checklists


  Generic (measures depression, anxiety)<|>Occupation specific
• Assessment that combine information-gathering methods

  From Clients<|>From practitioners<|>From caregivers
• Standardized assessment


  Assessments can be standardized in two main ways: The process, materials & scoring instructions<|>By normative standardization (statistic norms, validity/reliability)<|>Can provide objective information about the health status or occupational functioning of a client<|>Objective information is important as it provides a very useful outcome measurement of the client's progress and forms the basis of decision-making that is more defensible that a practitioner's judgment alone
• Non-standardized assessment


  Flexibility<|>Lack of training or confidence in using standardized assessment<|>Assessment of the qualitative aspects of performance and dynamics between key individuals<|>Standardization of the assessment process is perceived as a lack of flexibility<|>Lack of time<|>Lack of an existing structured (standardized) assessment<|>Clients resistance to completing a standardized assessment<|>Lack of accountability (Practitioners are not ready)
• Skills needed for assessment

  • Before an Assessment Session: Provide a Comfortable Setting, Positioning, Prepare materials/ assessment forms/ read history/records/referral
  • During an Assessment Session: Ask Open-ended Questions, Practice Active Listening, Reflect and Interpret, Maintain eye-contact, Observe body language, Two-way communication, Do not ignore the client when interviewing parents/caregivers
• Brief Occupational Profile


  Includes: Personal History, Family History, Social History, Medical History, Case History, Occupational History, Diagnosis, Reason of Referral, Clients main concern
• Practical session: Divide into 5 groups, choose 1 video scenario, discuss positioning, skills used, client/therapist behaviour, assessment used, positives, negatives, and other relevant information, present in less than 10 minutes