Midterm I: Roadmap to Success

screening

a quick review of available data or brief observation to determine if a client needs a full OT evaluation. It is not used to determine intervention

Evaluation

the entire comprehensive process of obtaining and interpreting data to understand the person and plan intervention

-requires synthesis of the occupational profile and analysis of performance

assessment

specific tool, instrument, or systematic interaction (COPM, MoCA) used during the evaluation to gather specific data

re-evaluation

a formal reappraisal of a client’s performance and goals to determine the type and amount of change that has occurred

Intervention

the process and skilled actions taken by OT practitioners to facilitate engagement in occupation

Outcome measure

assessments used at the end of the OT process to determine the effectiveness of the intervention (measuring the “satisfaction” change in COPM)

Occupational profile

summarizing the client’s history, experiences and patterns

analysis of occupational performance

observing performance in desired activities (activity analysis)

synthesis of information

identifying specific client factors and contexts

selecting assessments

choosing tools to identify factors influencing performance

interpreting data

identifying strengths and barriers

hypothesis development

determining why performance is limited

Goal setting

collaborating with the client for outcomes-based goals

OTR (Registered OT)

leads and is ultimately responsible for all aspects of the evaluation, including selecting assessments and interpreting results

COTA (Certified OT Assistant)

contributes to the evaluation process by performing delegated assessments once they have demonstrated service competency

-report observations and data back to the OTR

Notice (clinical observation)

focus on the environment, client affect, and performance (both positive and negative)

Connect (Clinical Observation)

determine how environmental or client factors are impacting performance

analyze (clinical observation)

identify strengths and needs, and determine if results can be generalized or if the evaluation needs modifications

Strengths-based lens (clinical observation)

explicitly look for what the client can do, not just their deficits

Top-down evaluation

starts with the foundational components or client factors (e.g. “Lets test your grip strength and ROM first”)

-assumes that fixing a component will automatically improve occupational performance

Standardized assessments

have specfic, fixed protocls for administration and scoring

Non-standardized assessments

flexible; may include observations or open-ended interviews without a rigorous scoring manual

Normative (norm-referenced) assessments

compares a client’s score to a “normal” population (e.g. PDMS-3, MoCA)

criterion-referenced assessments

compares performance against a set of standards or mastery level (e.g. IRF-PAI/ GG codes)

Ipsative assessments

compares the client’s performance to their own previous performance (e.g. COPM, OPHI-II)

reliability

the consistency and stability of a measure (coefficient of .90+ is expected)

inter-rater reliability

two different therapists get the same result when testing the same client

Test-retest reliability

getting the same result when the same test is given to the same at two different times

validity

does the test measure what it claims to measure? (coefficient of .80+ is preferred)

content validity

do the items adequately sample the skill/domain being tested

construct validity

does the test data fit the theoretical framework (e.g. does it actually distinguish between healhy controls and those with MCI)?

Predictive validity

can the test score predict a future outcome (e.g. can this score predict a student’s sucess)

Kawa Model

based on an eastern perspective of life flow and environmental interconnectedness

MOHO (Model of human occupation)

underlies the OPHI-II, focusing on roles, habits, and volition

COPM

client rates importance, performance, and satisfaction of self-selected goals

-change of +2 points is significant

OPHI-II

historical interview (MOHO based)

-rates occupational identity, competence, and settings. not for children under 12

KAWA (purpose)

uses metaphor (river, rocks, driftwood) to describe life flow and environment

IRF-PAI (GG codes)

scores 01 (dependent) to 06 (independent). higher is better. used in inpatient rehab for reimbursement

MoCA

rapid screen for mild cognitive impairment

-max score 30

-26+ is normal

-add one point for low education

PDMS-3

measures motor skills in children 0-5 years 11 months

-uses basals (3”2”s) and ceilings (3”0”s)

Purdue Pegboard

measures gross movements of hands/arms and fingertip dexterity

For IRF-PAI GG codes, if ____ helpers are required to compelte a task, the score is automatically 01 (dependent) even if the client does most of the work

two