OT eval (week 3)

What is the purpose of goal writing in occupational therapy?

To establish realistic, measurable outcomes that guide treatment and evaluate client progress.

Who is responsible for developing occupational therapy goals?

The occupational therapist, collaborating with the client or caregiver.

What are the six types of goal directions?

Restorative, habilitative, maintenance, modification, preventive, and health promotion.

What are restorative goals?

Goals that help clients regain skills or functions lost because of illness, injury, or disability.

What are habilitative goals?

Goals focused on teaching new skills that the client has never developed.

What is the difference between restorative and habilitative goals?

Restorative goals recover lost abilities; habilitative goals develop new abilities.

What are maintenance goals?

Goals designed to preserve a client's current level of functioning and prevent deterioration.

What are modification goals?

Goals that change the environment, equipment, or activity demands to improve occupational performance.

What are preventive goals?

Goals intended to reduce the risk of future injuries, disabilities, or occupational performance problems.

What are health promotion goals?

Goals focused on improving health, wellness, participation, and occupational performance.

What is the difference between short-term and long-term goals?

Short-term goals measure smaller steps toward progress; long-term goals describe the overall desired outcome.

Why should occupational therapy goals use action verbs?

Action verbs describe observable, measurable behaviors that demonstrate client progress.

What are examples of appropriate action verbs?

Demonstrates, completes, identifies, performs, dresses, prepares, transfers, and participates.

What types of verbs should be avoided when writing goals?

Vague or unobservable verbs such as knows, understands, feels, believes, and learns.

What are the main ways to measure progress toward a goal?

Frequency, duration, assistance level, performance quality, task complexity, and participation.

What are the common levels of assistance in occupational therapy?

Maximum assistance (75% or more), moderate (25-74%), minimum (1-24%), standby, setup, and independence.

What does ABCD stand for in goal writing?

Audience, Behavior, Condition, and Degree.

What does each component of ABCD describe?

A: Who performs the activity. B: What action is performed. C: Under what conditions. D: How well the action must be performed.

What does ABCDE add to the ABCD format?

Expected time—the deadline for achieving the goal.

What does COAST stand for?

Client, Occupation, Assistance level, Specific conditions, and Timeline.

What is the purpose of the COAST goal-writing format?

To create occupation-focused goals that specify the client's activity, required assistance, conditions, and completion time.

What does RHUMBA stand for?

Relevant, How long, Understandable, Measurable, Behavioral, and Achievable.

What does SMART stand for in the textbook?

Significant, Measurable, Achievable, Related, and Time-limited.

What is the main difference between ABCD, COAST, RHUMBA, and SMART?

ABCD identifies goal components; COAST emphasizes occupation and assistance; RHUMBA and SMART emphasize goal quality and measurability.

Why must occupational therapy goals be measurable and achievable?

To objectively evaluate progress and establish realistic expectations for treatment.

What is the purpose of descriptive words in progress notes?

To communicate observable changes in a client's physical, social, cognitive, and occupational performance.

What are the main categories of descriptive words used in progress notes?

Physical behavior, social behavior, cognition, participation, appearance and touch, and speech.

What are examples of descriptive words for physical and cognitive performance?

Physical: coordinated, steady, shaky, independent. Cognitive: attentive, alert, distractible, forgetful.

What should occupational therapy practitioners document about client participation?

Observable engagement, initiation, responsiveness, interaction, and involvement in therapeutic activities.

What are intervention strategies, and why are they documented?

Intervention strategies are specific techniques, methods, or approaches used to help clients achieve their goals.

What is psychometrics?

The science of measurement that evaluates the quality of assessment instruments through statistical analysis.

Why is understanding the construct important when selecting an OT assessment?

It ensures that the assessment measures the specific ability or behavior the therapist wants to evaluate.

What are psychometric measurement properties?

Characteristics used to evaluate assessment quality, primarily reliability, validity, and responsiveness.

What is the difference between a measurement and a construct?

A construct is the ability or characteristic being assessed, while a measurement is the numerical value used to represent that construct.

What are the four levels of measurement, from simplest to most advanced?

Nominal, ordinal, interval, and ratio.

What is an example of each measurement level in occupational therapy?

Nominal: Yes/no responses. Ordinal: Manual muscle testing grades (0-5). Interval: Pinch dynamometer readings. Ratio: Joint range of motion measured in degrees.

Why is the ratio level of measurement considered the highest level?

It includes categories, order, equal intervals, and a true zero, allowing all standard mathematical operations.

What is assessment standardization?

Using established instructions, administration procedures, and scoring methods to ensure assessments are conducted consistently.

What is the purpose of correlation analysis in psychometric studies?

To determine the strength and direction of relationships between variables, such as scores from two assessments.

What does a correlation coefficient of 0 indicate?

No linear relationship between the two variables.

What does a correlation coefficient of -0.90 indicate?

A strong negative relationship, meaning that as one variable increases, the other tends to decrease.

What does the coefficient of determination (r²) represent?

The proportion of variance in one variable statistically explained by its linear relationship with another variable.

What does the proportion of variance in one variable indicate?

It is statistically explained by its linear relationship with another variable.

What does a p-value indicate in correlation analysis?

How compatible the observed results are with the null hypothesis.

Why should correlation not be interpreted as causation?

Because two variables may be associated without one directly causing changes in the other.

What are the two main ways reliability can be expressed?

Through the standard error of measurement (SEM) and reliability coefficients.

What does a smaller standard error of measurement indicate?

Less measurement error and greater precision in the assessment score.

What is a score band of uncertainty?

A range around an observed score that accounts for measurement error.

What factors can affect test-retest reliability?

Time between tests, memory of previous answers, fatigue, natural recovery, development, medications, and environmental changes.

Why is recalibration important for assessment raters?

It helps maintain consistent scoring and administration procedures.

What is rater severity?

Differences in how strictly or leniently examiners score performance.

What is the split-half reliability method?

A method that divides test items into two groups and examines the correlation between their scores.

What does an extremely high Cronbach's alpha potentially indicate?

Test items may be overly similar or redundant.

Why is reliability necessary but insufficient for validity?

An assessment may produce consistent scores but still fail to measure the intended ability accurately.

What is a test blueprint?

A plan outlining the assessment's content areas and the proportion of items assigned to each area.

What is factor analysis?

A statistical method used to identify underlying dimensions represented by groups of assessment items.

What is unidimensionality?

The assumption that all items within an assessment measure one underlying construct.

What is the difference between minimal detectable change (MDC) and minimal clinically important difference (MCID)?

MDC is a change greater than expected measurement error; MCID is a change large enough to be meaningful.

Why are floor and ceiling effects problematic?

They limit an assessment's ability to detect further improvement or decline.

How does known-groups validity support an assessment's usefulness?

It demonstrates that an assessment can distinguish between groups expected to have different levels.

What is the unified view of validity?

An approach that considers multiple sources of evidence when evaluating score interpretations.

What does the formula X = T + E represent in Classical Test Theory?

X is the observed score, T is the true score, and E is the measurement error.

What is the Rasch model?

A one-parameter Item Response Theory model that examines item difficulty in relation to a person's ability.

What are the three parameters used in Item Response Theory?

Difficulty, discrimination, and guessing.

What is a computer adaptive test (CAT)?

A computerized assessment that adjusts the difficulty of subsequent questions based on previous responses.

What is the difference between a raw score and a converted score?

A raw score is the original score, while a converted score transforms it into a standardized format.

What is the difference between a standardized assessment and a nonstandardized survey?

Standardized assessments use established procedures, while nonstandardized surveys gather descriptive information.

How do you calculate the mean of a set of scores?

Add all scores together and divide by the total number of scores.

How do you calculate the median?

Arrange scores from lowest to highest and identify the middle value.

How do you calculate the range and interquartile range (IQR)?

Range is the highest score minus the lowest score; IQR is Q3 minus Q1.

What is standard deviation?

A measure of how spread out scores are around the mean.

What percentage of scores fall within one, two, and three standard deviations in a normal distribution?

Within 1 SD: 68%; Within 2 SD: 95%; Within 3 SD: 99.7%.

What is a Likert scale?

A rating scale that measures agreement or frequency.

What is a semantic differential scale?

A rating scale that asks individuals to indicate where they fall between two opposite characteristics.

What is the difference between hand scoring and computerized scoring?

Hand scoring requires manual calculations, while computerized scoring uses software.

What are the four types of normative groups?

Multiple norm groups, local norm groups, national norm groups, and special norm groups.

What is the difference between norm-referenced and criterion-referenced test scores?

Norm-referenced scores compare performance to a reference group; criterion-referenced scores compare to established standards.

What are percentile ranks?

Percentile rank indicates the percentage of the reference group scoring at or below a particular score.

What is a stanine?

A nine-category standardized scoring system with a mean of 5 and standard deviation of approximately 2.

How are z-scores calculated?

Z-score is calculated using the formula z = (x - x̄) / SD, with a mean of 0 and SD of 1.

How are T-scores calculated?

T-score is calculated using the formula T = 10z + 50, with a mean of 50 and SD of 10.

What is the difference between total scores, subscale scores, and cutoff scores?

Total score is the overall assessment result, subscale score is for a specific domain, and cutoff score is a predetermined threshold for classification.

Why must occupational therapists interpret and communicate assessment scores carefully?

Scores must be interpreted according to the assessment's purpose, psychometric evidence, and the client's context to aid understanding and decision-making.

What is evidence-based practice (EBP) in occupational therapy?

EBP is the combination of the best available research evidence, clinical expertise, and client values to guide clinical decision-making.

What is the difference between evidence-based practice and evidence-informed practice?

Evidence-based practice emphasizes using the best available research evidence, while evidence-informed practice integrates multiple sources of evidence.

What is professional reasoning in EBP?

The process of using clinical knowledge, experience, evidence, and client information to make evaluation and intervention decisions.

What are the main steps occupational therapists follow when engaging in EBP?

1. Identify client needs and formulate a clinical question. 2. Search for relevant research. 3. Critically evaluate the evidence. 4. Combine findings with expertise and client preferences. 5. Apply findings and evaluate outcomes.

What is a peer-reviewed journal?

A publication where experts evaluate research before publication.

What is an impact factor?

A measure of the average number of citations received by articles published in a journal over a specified period.

What is the traditional hierarchy of quantitative research evidence?

1. Meta-analyses of randomized controlled trials 2. Experimental studies 3. Quasi-experimental studies 4. Nonexperimental studies 5. Respected professional opinions.

What is quantitative research?

Research that uses numerical data and statistical analysis to investigate relationships, differences, or intervention effectiveness.

What are the three main types of nonexperimental research?

1. Descriptive/observational studies 2. Case studies 3. Correlational studies.

What is the difference between experimental and quasi-experimental research?

Experimental research manipulates an independent variable and randomly assigns participants, while quasi-experimental research does not randomly assign participants.

What is a randomized controlled trial (RCT)?

An experimental study where participants are randomly assigned to intervention and control groups to evaluate intervention effects.

What is a meta-analysis?

A statistical method that combines results from multiple studies to estimate an overall effect, increasing statistical power and precision.

What is the difference between internal validity and external validity?

Internal validity assesses how confidently results can be attributed to the intervention, while external validity assesses generalizability to other clients or settings.

What is qualitative research?

Research that examines nonnumerical information, such as experiences and beliefs, to understand clients' needs and participation.

What is researcher bias in qualitative research?

When a researcher's personal beliefs influence data collection, analysis, or interpretation.

What is the difference between single-hierarchy EBP models and the Research Pyramid?

Single-hierarchy models rank research designs by methodological rigor, while the Research Pyramid considers multiple types of evidence.

What are the three faces of the Research Pyramid?

1. Experimental research 2. Qualitative research 3. Outcome research.