Assessments Flashcards
(23 cards)
Pros of self-report assessments
- They demonstrate OT’s belief that clients are the experts on their own lives
- They help capture client’s subjective thoughts and feelings
- They promote client engagement by:
- showing respect, developing a partnership
- supporting CCP
- using joint problem-solving to shape intervention planning and outcomes
- facilitating client insight
Cons of self-report assessments
- They may not be reliable.
- Report from other family members or caregivers may corroborate OR refute what client says (hard to know what is really going on)
*That’s why performance observation should follow!*
4 MOHO self-report assessments
- Modified Interest Checklist (MIC)
- Role Checklist
- Occupational Questionnaire (OQ)
- Occupational Self-Assessment (OSA)
(Remember: 2 checklists, 2 occupationals)
Use of MOHO self-assessments?
- good for initial data-gathering but should be followed with client / therapist dialogue
- can be paper-based, verbal, or done as group exercise
- help establish baseline
- can also be used to track progress over time
Modified Interest Checklist
- inventory of 68 leisure interests
- fits MOHO constructs
- has been modified to other cultures
- measures strength of interest, present participation, anticipated future engagement
Client must be able to read and write. Takes 15-30 minutes.
Modified Interest Checklist (UK)
UK version of MIC. Very similar but organizes interests into 9 categories:
- health and fitness
- sports
- creative
- productivity at home
- leisure at home
- social
- outdoor pursuits
- out and about / entertainment
- educational
Occupational Questionnaire
- records regular weekday in 30-minute intervals
- client lists each activity as work, daily living, recreation, rest
- client rates competence, value and enjoyment of each activity
*OQ can reveal how time use (habituation) matches personal causation, values and interests (volition)
Client must be able to concentrate, read and write. Takes 15-35 minutes.
Occupational Self-Assessment (OSA)
- captures client perception of occupational competence (they rate activities on 4-pt scale)
- looks at variety of everyday items (11 performance skills, 5 habituation items, 5 volition items)
- facilitates client awareness of probs / priorities
- facilitates client role in strategizing / goal-setting
Client must be able to concentrate, read and write. Takes 15-35 minutes.
Role Checklist
RC assesses client’s perception of past, current and future participation in different roles; AND valuing of those roles
Client must be able to concentrate, read and write. Takes 10-15 minutes.
Routine Task Inventory - Expanded (RTI-E)
A CDM* assessment to determine client function using the 6 CDM levels (but no modes).
Physical (8 subscales)
Communication (4 subscales)
Community (6 subscales)
Work Readiness (6 subscales)
*Can be done by observation, so good with nonverbal clients.* Can also be answered by client or proxy.
*Cognitive Disabilities Model
Allen Cognitive Level 3
Manual actions: global cognition severely impaired. 30-minute attention span, unpredictable actions, distractible, not always logical or safe.
ADLs: hand them familiar items (toothbrush, comb) to tap into procedural memory of how to use. Will need at least verbal cueing (1-step directions) to bathe, groom, dress, toilet, take meds, and to finish tasks to completion. 1:1 supervision to follow instructions. IADLs not possible
- 3.0 - 3.4: 24-hour supervision
- 3.6 - 3.8: close supervision
Allen Cognitive Level 4
Goal directed actions: global cognition is moderately impaired. Aware of cause and effect; can do familiar routines but new tasks difficult. Cannot generalize learning.
ADLs: Person initiates bathing, grooming, dressing based on environmental cues but has trouble with parts they can’t see, like head or back. Can follow pictures, not words. Complex tasks and IADLs need to be done by others.
- 4.0 - 4.4 can live with someone for supervision and be alone part of day
- 4.4 independent in self-care
- 4.6 scanning ability
- 4.6 - 4.8 can live alone with daily assistance
Allen Cognitive Level 5
Exploratory actions: cognition is mildly impaired. Can learn from trial and error (doing) but don’t think or plan first. Can be impulsive.
Independent with basic ADLs. Need check-in (or more) support with IADLs like meal planning, shopping, finances, schedules, complicated med schedule, driving.
- 0 can live alone with weekly checks
- 4 self-directed learning
- 6 INSIGHT! considers social standards; anticipates safety. can use written directions and diagrams
MOHOST - overview
- gets baseline of occ. perf. by assessing volition, habituation, skills, and environment
- uses observation; good for nonverbal clients or those unable to self-assess
- observation supplemented by chart review, staff notes, family interview, etc.
- broad scope so can’t complete in single session (period of two weeks or more OK); each area should be observed for 30-40 minutes, then rated in 10-20
MOHOST - rating scale
- F = Facilitates
- A = Allows
- I = Inhibits
- R = Restricts
(occupational performance)
MOHOST areas
6 areas, 4 items each:
- motivation for occupation
- pattern of occupation
- communication / interaction skills
- process skills
- motor skills
- environment
OCAIRS - overview
- Format: semi-structured interview
- Purpose: a structure for gathering, analyzing and reporting on subject’s occupational adaptation
- Uses: discharge planning, self-eval, treatment planning, community adjustment of client
- Population: mental health, forensic, physical rehab
- Time: 20-35 to administer, 30-50 to score / interpret
Contextual Memory Test
Purpose: to investigate awareness and strategy use in adults with memory impairment
Assesses:
- awareness of memory capacity
- recall of line-drawn items
- strategy use
For use with Dynamic Interactional Model (Toglia)
Ribbon cards
for moderate cognitive impairment, 4.0 - 5.0
- 0 - 4.4 should do an A card, where ends alternate on outside and inside of card
- 6 - 5.0 should do a B card, where ends alternate but on inside of card only (i.e. person loses visual cue on outside edge)
Canvas Placemat
for suspected severe to moderate impairment, 3.0 - 4.6; can be done bedside
5 total Self-Report assessments
MOHO:
- Modified Interest Checklist
- Roles Checklist
- Occupational Questionnaire
- Occupational Self-Assessment
OTHER: (CDM) Routine Task Inventory - Expanded
Interview assessments
OCAIRS: semi-structured interview
OPHI-II: semi-structured interview that explores a client’s life history in the area of work, play and self-care (MOHO assessment but also good with PEO and IRM)
COPM: semi-structured interview designed to identify the client’s OPIs *according to the client.*
observation assessments
MOHOST
RTI-E, Volitional Questionnaire (VQ)
