Intro to Assessment & Evaluation

Two parts of an eval

Occupational profile & analysis of occupational performance

Screening

Quick review of clients situation to determine if OT treatment is warrented

Evaluation

Obtaining and interpreting information for intervention planning

Assessment

A specific tool, instrument, or systematic interaction used to collect profile and performance data

Descriptive assessments

Used to describe individuals

Evaluative assessments

Uses criteria to measure indiviuals’s traits over time

Predictive assessments

Uses criteria to predict traits or skills

Criterion referenced assessments

Focuses on mastery of a skill without comparison to the “norm” or others

Normative assessments

Compares scores to “norm” in clients population

Sensitivity

A test's ability to correctly identify those with the condition

SnNOut

• if high sensitivity, negative results rules out condition

Specificity

A test's ability to correctly identify those without the condition

SpPIn

• if high specificity, positive rules in

Reliability

The consistency of results

Validity

The ability of a test to measure what it’s intended to

Standard error of measurement

Considers sources of error and gives a range of where the possible “true” score may lie

Face validity

Cannot be tested, agreed upon with peer review that assessment is testing what they want it to

Content validity

The extent the assessment covers or reflects the phenomenon being assessed

Construct validity

Degree to which the test measures the concept and how accurate it is at describing the complete phenomenon

Top-down approach

Starts by gathering info to get to root of problem

Bottom-up approach

Starts at the specific issue and works up to examine other related aspects

What is the purpose of the OT evaluation process?

To gather information about occupational performance, identify strengths and barriers, and develop a client-centered intervention plan.

What is an occupational profile?

A summary of the client's history, interests, goals, routines, values, and priorities.

What are characteristics of effective client interviews?

Open-ended questions, active listening, empathy, respect, and collaboration.

What is occupational analysis?

Breaking down an occupation into its individual demands and components.

What are client factors?

Values, beliefs, spirituality, body functions, and body structures that influence occupational performance.

What are performance patterns?

Habits, routines, roles, and rituals.

What are contexts?

Personal and environmental circumstances that influence occupational performance.

What should OTs observe during occupational performance?

Safety, independence, efficiency, effort, quality, performance skills, and client factors.

What are standardized assessments?

Formal assessments administered and scored using consistent procedures.

What are non-standardized assessments?

Flexible evaluation methods without standardized administration or scoring.

Examples of non-standardized assessments include?

Clinical observations, interviews, checklists, questionnaires, activity analyses, and informal assessments.

Can an assessment be reliable but not valid?

Yes. It can consistently measure the wrong thing.

What should be considered when selecting an assessment?

Client goals, diagnosis, age, setting, psychometric properties, time, cost, and purpose.

What are norm-referenced assessments?

Assessments comparing a client's performance to a normative sample.

What are criterion-referenced assessments?

Assessments measuring whether a client meets a specific standard or skill level.

What is a performance-based assessment?

An assessment requiring the client to perform actual tasks.

What is clinical reasoning?

The process of making informed decisions using evidence, client information, and professional judgment.

Why is documentation important in OT?

It communicates findings, supports clinical reasoning, demonstrates medical necessity, and ensures continuity of care.

What should be included in an OT evaluation report?

Occupational profile, assessments used, observations, clinical interpretation, occupational performance problems, goals, and recommendations.

How do standardized and non-standardized assessments complement each other?

Standardized assessments provide objective data, while non-standardized assessments provide individualized, contextual information.

Psychometrics

The science of measuring human abilities, behaviors, or characteristics. It determines whether an assessment can be trusted.

Clinical Utility

How useful and practical an assessment is for a specific client and setting.

Inter-Rater Reliability

Consistency between different examiners scoring the same assessment.

Internal Consistency

Determines whether items on a test measure the same concept.

Cronbach Alpha

A statistical measure used to determine internal consistency.

Split-Half Reliability

Reliability method where a test is divided into two halves to see if both parts produce similar results.

Alternate Forms Reliability

Consistency between two different versions of the same test.

Criterion Validity

Whether an assessment agrees with a gold standard or established measure.

Observed Score Formula

Observed Score = True Score + Error.

BOT-3

Bruininks-Oseretsky Test of Motor Proficiency, Third Edition. A standardized assessment measuring fine and gross motor proficiency.

BOT-3 Purpose

To identify strengths and motor deficits and assist with intervention planning by measuring motor proficiency.

BOT-3 Population

Children and young adults ages 4 years 0 months-25 years 11 months.

BOT-3 Format

Standardized and norm-referenced assessment.

BOT-3 OTPF Domains

Client factors (neuromusculoskeletal and movement functions) and performance skills (motor skills).

Scaled Score

A score that compares subtest performance to same-age peers.

Standard Score

A composite score that combines multiple subtest scores.

Percentile Rank

The percentage of peers that a client scored better than.

Basal Level

The lowest level where a client consistently passes items.

Ceiling Level

The point where a client consistently fails items and testing stops.

COPM Purpose

To identify occupational problems and measure changes in occupational performance from the client's perspective.

COPM Format

Semi-structured interview and client-reported outcome measure. (non-standardized)

COPM Population

Individuals ages 6 years and older.

COPM Occupational Areas Measured

Occupational performance and satisfaction in self-care, productivity, and leisure.

COPM OTPF Domains

Occupations, performance patterns, client factors, and body functions.

COPM Process

Identify occupational problems → rate importance → choose top 5 priorities → rate performance → rate satisfaction → calculate averages → re-evaluate.

COPM Clinically Meaningful Change

A change of 2 or more points indicates meaningful improvement.

Fugl-Meyer Assessment (FMA)

A standardized assessment used to measure sensorimotor recovery after stroke.

FMA Measures

Motor function, sensation, range of motion, balance, and joint pain.

FMA Format

Standardized and performance-based.

FMA Reference Type

Criterion-referenced.

Re-evaluation Purpose

Determine whether goals were achieved and whether the intervention plan should change.