Assessment is probably the most vital part of the process for Occupational Therapists. When studying at university, we are trained to Assess, Plan, Intervene and Evaluate. This is an ongoing cycle, and in reality, we assess all the way through our involvement with a client – constantly re-evaluating what we are seeing and how we are addressing presenting issues.
The Occupational Therapy Assessment is the first time that I meet my families face to face. We will have sometimes spoken on the phone beforehand and often we will have emailed or chatted via Facebook. I offer several different levels of assessment and whereas some families will know what they need (for instance an assessment which leads to a report which they can use as evidence in the Additional Learning Needs process), but some families do not know very much about Occupational Therapy or how it may help their child.
I quite often meet families and complete a “Short Assessment”. This is an introductory visit which gives me the chance to meet you and for you to meet me. This visit normally happens in your own home. From this visit I can then recommend a plan of action – potentially I can write you a report based on this visit alone with some simple strategies that you can try as a family. Often though, it helps to continue with a “Full Assessment”, perhaps a visit to observe your child at school, etc.
It is best practice wherever possible to complete a comprehensive assessment of a child or young person’s needs. This enables me to hypothesise causation of difficulties and to identify targeted intervention strategies that can support your child to achieve their goals. A comprehensive assessment based on advanced training and clinical reasoning can provide strong evidence of a child or young person’s needs and how they can be met. Often, a comprehensive assessment is more cost effective than intervention which is not specifically targeted and is more “trial and error”.
Preparing for the Assessment
I will either post or email some forms for you to complete and hand back to me at our first appointment. These forms help me to gain some useful background information about your child and family and mean that I can spend more time with you talking about the issues you are facing and observing/interacting with your child during the appointment. Quite often I also send out a sensory checklist which will help me to start to understand your child’s sensory needs (if appropriate).
It is really helpful if the parent/carer is able to write a list of the main issues that their child is facing and any questions that they may have.
If you feel it is appropriate, please tell your child that I will be coming to meet them, and show them my photo (click here to see more About Me).
The First Appointment
I will discuss any concerns with you, with or without your child present (as you feel is most appropriate). I will then aim to interact and play with your child. If they are willing to engage, I will likely complete some “Clinical Observations”. These are simple tests that look at how a child is able to function and can give an indication of possible areas of skill deficit that can be explored further at a later date. If you are happy, I will film these observations for analysis and future reference – these are stored in your child’s electronic file and are not shared without your consent.
The first appointment will take between one and two hours, depending on how much there is to chat about and how well your child tolerates the session. The benefit of being in the family home is that I can see how your child functions in their own surroundings.
After the First Appointment
At the end of this appointment, I will suggest what we need to do next. Often this will include me going away and analysing the forms that you have completed for me and the information that I have gained during my visit. I will write a short report with the information that I have gained during the appointment with you. I will also make recommendations for further assessment if required, strategies that you can introduce at home (if appropriate at this stage) and anything else that I feel may be of help for you.
I send my invoice at the time that I send my report and this is due for payment within 30 days. If further assessment is recommended, I will also send you a quote for this work. At this point, I am happy to discuss my report via telephone or email.
It is extremely useful to meet a child or young person in more than one setting and to gain information from others that work with them such as their teaching staff if they attend school. A school visit can often give opportunity to complete more formal assessments that are norm-referenced. These assessments enable the Occupational Therapist to demonstrate the child’s function in relation to age-related peers. This can provide strong evidence as to where the child’s difficulties lie and support identification of treatment strategies.
If a school visit is not possible, or your child is home educated, these assessments can also be completed at home. I own various assessments* which can explore gross and fine motor skills, sensory perception, occular, postural and bilateral motor functions, praxis, handwriting, functional activities of daily living skills, visual perceptual skills, etc.
Following completion of the appropriate observations and/or assessments, I will then write a thorough report that identifies your child’s functional difficulties and recommend strategies to address these. I aim to include both the child and family when setting goals for therapeutic interventions.
*Movement Assessment Battery for Children, Sensory Integration and Praxis Tests, The Detailed Assessment of Speed of Handwriting, The Roll Evaluation of Activities of Living, The Developmental Test of Visual Perceptual Skills, The Sensory Processing Measure (Child and Preschool)
Ongoing Occupational Therapy
Many children will benefit from ongoing Occupational Therapy intervention, to work on the skill areas that have been identified through assessment. I do although absolutely understand that private Occupational Therapy can become expensive. Therefore I recommend that my report is shown to Statutory Services as it may provide enough evidence that your child has needs that should be met via the Statutory Services themselves. If you do wish for me to provide ongoing Occupational Therapy, I am more than happy to quote for this.
I hope that this helps you to understand the process that I go through a little more. Please Contact Me if you have an questions.