Exam 2- Practical Aspects of Eval: Setting up the Environment and Process to Avoid Errors

Referral

a written order or prescription for OT eval and intervention services

Who can prescribe referrals?

Doctors, NP, PA

T/F: OTs must accept referrals based on state regulations

True

T/F: In PA, a chiropractor can make a referral for an OT.

False. The referrals can only come from physicians, optometrist, podiatrist, NP, or PA

T/F: If working in a school and offering services that are not medically oriented you need a referral.

False. If the services are not medically based, then you do not need a referral.

T/F: The eval does not have to address all area noted in the referral.

False

Questions to consider when setting up the eval environment:

- What is the space thats required?

- Will the client be comfortable in the space?

- What other people will be in the environment?

- What objects do I need?

- How much time am I permitted for the eval and to complete documentation?

- Setting the mood- adjusting your style based on the needs of the client.

3 things to check in the assessment environment

1. Check assessment manual to determine necessary environment and process

2. If you need to make modifications, determine if they are possible

3. If not and they are still needed, document the reason and make sure to avoid using the standardized test scores as they may not reflect accurate results

3 Variables to address to Prevent Errors

1. Person bias (test-taker)

2. Rater bias (OT)

3. Item bias (actual assessment)

Item Bias

When people of similar abilities perform differently on a given assessment or test item because of age, gender, ethnic, cultural, socioeconomic, or other group differences.

- Items can be biased when they contain content or language that is unfamiliar to, or interpreted differently by different groups

Rater Bias

AKA observer bias

- Occurs when different evaluators disagree in their assessment of the same person OR when the same evaluator scores the same person differently on repeated testing

- To eliminate this possibility, therapists needs special training on utilizing these testing measures

Interater Reliability

when different evaluators disagree in their assessment of the same person

Intrarater Reliability

when the same evaluator scores the same person differently on repeated testing

Person Bias (Test-Taker Variables)

client having a bad day, anxiety, paranoia, physical ability, beliefs, learning from previous testing, demands of multiple assessments, level of motivation

Performance

Client's ability in natural environment, guides eval and identification of needs

Capacity

clients ability in optimal environment, guider intervention approach, shows up when writing goals

How to accommodate diversity

adaptation and accommodations

Adaptation

Expert review and analysis of eval to identify recommendations for cultural context

- Standardized according to new recommendations

- Ex. translated

Accommodations

any change in the conditions under which a standardized assessment is administered/must be documented and results can't be used if accommodations not listed as acceptable

Types of Accommodations

1. Admin Environment

2. Presentation of items

3. Response (what will you accept? they can't say yes/no, but they can point)

4. Cultural (may have to re-phrase)

5. Temporal (Extending, breaks, etc.)

Referral