Upgrade to remove ads

Only $35.99/year

657: Evaluation Midterm

Terms in this set (163)

Evaluation Definitions:
Includes evaluating data, client observation; should not be used to determine services or intervention planning; do not need an order

Evaluation Definitions:
Requires synthesis of all obtained data, data interpretation, results of any testing, and identifiable for intervention

Evaluation Definitions:
Occurs after evaluation; identify any need to modify intervention plan or change intervention approach

Evaluation Definitions:
Used during (re)evlaution; refers to a specific tool or instrument to obtain particular information

Evaluation Definitions:
Continual reviewing of client performance to determine if intervention needs to be altered, continued, etc. Does not occur during initial eval

Evaluation Definitions:
Gathering initial data collection to make your starting point

Evaluation Definitions:
Conclusion process; used during evaluation and intervention

Evaluation Sequence (4 steps):

1. Data Gathering (Formative)
2. Initial Evaluation (Summative)
3. Reevaluation (Formative)
4. Reevaluation or conclusion of discharge (Summative)

Areas of evaluation include:

ADLs, IADLs, Education, Work, Play, Leisure, Social Participation

4 Factors that influence the areas of evaluation include:

Client factors (visual, cardiovascular, sensory, etc.)
Habits, Routines, Roles
Contexts (cultural, spiritual, temporal)
Performance Skills (motor, communication)

When an OT evaluation is complete, one should be able to develop a statement including:

Prioritize areas of occupational performance needs
Measuring occupational skills
Gauging impact of person factors
Appraising contextual and environmental supports/barriers

A comprehensive evaluation includes _________ & _______ assessments while utilizing _____ _____ skills.

standardized; nonstandardized; clinical reasoning

Evaluation Roles of ___:
Initiates and completes evaluation process

Evaluation Roles of ___:
Supervise COTA throughout process

Evaluation Roles of ___:
Select assessments to be utilized

Evaluation Roles of ___:
Interprets ALL data

Evaluation Roles of ___:
Develop plan for intervention

Evaluation Roles of ___:
Participates under supervision of OTR

Evaluation Roles of ___:
Implements assessments as part of reevaluation process

Evaluation Roles of ___:
Provides reports of observation - written and verbal

OT and OTA must:

1. Work together
2. Share responsibility
3. Practice within standards

ACOTE standards: Entry-level OT should be able to _____, _______, & _______ both standardized and nonstandardized assessments.

select, administer, and interpret

Code of Ethics:
Prevent bias in testing, obtain a precise picture of client performance and function

Code of Ethics:
HIPPA, ensure client privacy, accurate evaluation reporting

Autonomy & Confidentiality

Code of Ethics:
Evidence-based, accurate comparison of results with norms, competent to complete evaluation process

Steps to which section of evaluation sequence:
Review chart
Interview
Diagnosis research
Problem areas

Steps to which section of evaluation sequence:
Patient function
Baseline (to note improvement)

Steps to which section of evaluation sequence:
Reestablish baseline
Can add/remove goals

Steps to which section of evaluation sequence:
Decide to continue or D/C
Collaborate with patient
May have to decide to stop even if patient doesn't want to

Reevaluation/Discharge

What is the difference between reassessment and reevaluation?

Reassessments are done continuously each treatment plan. The OT is constantly observing the client for any changes in function.
Reevaluation is a formal treatment in which an OT reevaluates the client for changes to modify intervention.

OT evaluation should consider the person's:

- Biological and individual development
- Cultural and social context
- Relationship with family and significant others
- Quality of occupational performance
- Unique occupations in relationship to their physical and psychological development

Evaluation Process:
The first step in the evaluation process. This step may or may not occur

The initial evaluation will provide a ______ ______ of client performance

baseline measurement

Evaluation may be approached from different theories/FOR and viewed as:

Top-down (looks at occupation first, broad view)
Bottom-up (looks at specific components that affect occupations, narrow view)
Contextual (looks at environment, blended view)

Goals and interventions must be developed based on _____ collected

Goals should be _______, _______, & _______

realistic, functional, and achieveable

Authors recommend developing no more than __ long-term goals

A comprehensive evaluation summary includes:

Key information - age, diagnosis, etc
All tests administered
Factors influencing client performance
Test scores and interpretation
Objective baseline of client performance
Baseline data that can be used to formulate an intervention

4 primary responsibilities associated with evaluations are:

Administration
Scoring
Interpretation
Reporting (document)

Evaluation Process:
Determines need for further evaluation; not a reimbursable service

__ minutes = _ unit

A screening may or may not occur during the evaluation process - T or F

A good rule of thumb to follow if it takes more than 1 unit, then an _______ is warranted.

The therapist and client will determine the route the evaluation process will take. This is typically discovered by what two things?

Client interview and formulation of the occupational profile

Evaluation Process:
A _______is typically a written order for specific services

An OT must comply with ____ ____ and ______ _____ in regards to referrals

state laws and practice settings

Most referrals come from ......?

physicians, physician assistants, and optometrists

When investigating assessments, therapists should consider the :

Purpose of the assessment
Theoretical approach
Clinical utility of the results
Target population
Assessment reliability
Validity of the assessment

Physical factors of environment and evaluation:

Size and type of space
Seating and positioning
Objects and materials
Temperature
Sound
People

Emotional factors of environment and evaluation:

Client mood
Therapist mood
Communication style
Create trusting environment
Avoid use of medical and therapy jargon

OTs will have the same timeframe to respond to referral requests no matter the setting and state guidelines - T or F

False - timeframe is dependent upon the setting and state guidelines

Evaluations are always completed within one session - T or F

False - may be completed within one session, however may require more time

_________ assessments should be utilized when possible as part of best practice in OT

When administered correctly, standardized assessments provide _____ and _____ data

reliable and valid

Standardized assessments can be utilized during _______ to assess change in client performance

What are the three types of standardized assessments?

Normative
Criterion-Referenced
Ipsative

Standardized Assessments:
- Compare data obtained against a normal sample
- Data obtained (client performance) during assessment is used to compare to a sample "normal" group of people

Standardized Assessments:
Mini-Mental State Exam, Sensory Integration and Praxis Test, LOTCA

Standardized Assessments:
- Measure how well a person performs against a set of criteria rather than against another person
- Generally provides an established score that reflects mastery
- These do not compare scores, behaviors, or performances to norm, looking for mastery in particular area

Criterion-Referenced

Criterion-referenced assessments generally provide an established score that reflects ______

Standardized Assessments:
School Function Assessment, Klein-Bell Activity, Kohlman Evaluation of Living Skills

Criterion-Referenced

Standardized Assessments:
- Has standardized procedures and is individualized, individual compares him or herself in the same domain across time
- A standardized order of questions are utilized

Standardized Assessments:
Two common forms of ipsative assessments

Observation and Interview-based

Standardized Assessments:
COPM, Pediatric Interest Profile, Occupational Performance History Interview

Reliability measures the ________ of the results an assessment provides

Validity measures how ____ the measure is to the underlying theory and concepts

Reliability range

A score greater than or equal to __ indicates it is reliable; __ = excellent reliability

Many OT assessments do not meet reliability standards - T or F

________ - therapist directly perceiving the actions of client and then recording what they see

______ ____ - used to measure functional limitations; often focus on a specific bodily function and its associated impairment

Performance Assessments

________ - can be structured - specific questions therapists ask in a specific order or open-ended

_______ - can be multiple choice or true/false - referred to as forced choice responses

Developing Competence Administering Evaluations - steps

- Read the assessment manual thoroughly
- Review published literature about the assessment
- Become competent in administration of the assessment
- Get feedback on your administration from an experienced OT
- Have an experienced OT review your interpretation of an assessment
- Use a combination of standardized and nonstandardized assessments to get a complete picture of the client
- Write an accurate report, including strengths and areas of concern

Contexts and Environment:
1) Impact on client eval - Affects scheduling, assessment options, communication, SES, D/C planning, and OT personal interpretation
2) OTs look for - customs, beliefs, activity patterns, and behavioral standards
3) Methods used to evaluate - Observation and interview

Contexts and Environment:
1) Impact on client eval - affect eval process b/c they have an effect on performance and has a direct influence on assessment results
2) OTs look for - features of the individual, not related to health condition/status; age, gender, education level, SES, ethnicity, race
3) Methods used to evaluate - MUST pick assessments tailored to each individual b/c all assessments have certain criteria (age, population, etc.) for which the assessment is intended

Contexts and Environment:
1) Impact on client eval - Stage of life, time of year/day, duration of activity
2) OTs look for - each individual needs appropriate assessments based on their development
3) Methods used to evaluate - Observation and interview

Contexts and Environment:
1) Impact on client eval - Varies generationally, see how it affects social context
2) OTs look for - whether it has + or - impacts on occupations
3) Methods used to evaluate - skype, text, cell phone, - to evaluate cognition, socialization skills, safety and fine motor

Contexts and Environment:
1) Impacts on client eval - Natural (geographic terrain, sensory qualities of environment, plants & animals) and built (buildings, furniture, tools, devices) nonhuman environment and the objects in them
2) OTs look for - physical environments that will affect the patient such as home, work, etc.
3) Methods used to evaluate - Assessments

Contexts and Environment:
1) Impacts on client eval - constructs by presence, relationships, and expectations of persons, groups, or populations --> influence accessibility & expectations
2) OTs look for - what their social life is like, who is involved
3) Methods used to evaluate - observation, interview, open-ended questions of client interaction with others

Terms to Know:
Consists of a series of questions that the therapist asks a client during the initial interview; common ipsative assessment & standardized procedures

Activity Configuration

Terms to Know:
What a person can do in a hypothetical or optimal situation

Terms to Know:
measure how well a person performs against a set of criterion rather than against another person

Criterion-referenced Assessments

Terms to Know:
involves a conversation between the therapist and client, or a proxy; structured or open-ended

Terms to Know:
has standardized procedures and is individualized so the person compares him or herself in the same domain across time; interview & occupation based

Ipsative Assessment

Terms to Know:
occurs when people of similar abilities perform differently on a given assessment/test because of age, gender, ethnicity, culture, socioeconomic status, or other group differences

Terms to Know:
identify a client's overall strengths and limitations; include comprehensive descriptions of behavior/performance; can establish client's baseline occupational performance; observation, checklist, interviewing, screening

Nonstandardized Assessments

Types of nonstandardized assessments:

Observation
Checklist
Interview
Screening

Terms to Know:
data using research conducted by the normative group in which a therapist can compare the client's performance against the normed sample

Normative Assessment

Terms to Know:
"normal" population

Terms to Know:
involves therapists directly perceiving the actions of a client and then recording what they see; aided (using assessment) or unaided

Terms to Know:
allow the interviewee to tell his/her story in the manner that is most comfortable, sharing his/her lived experience

Open-ended Interview

Terms to Know:
what a person can and does do in the real world; provides a true picture of functional status

Terms to Know:
measure functional limitations; focus on a specific bodily function and its associated impairment or a particular body part; independent of individual judgement and not as susceptible to influence; tend to ignore environment and the person as a whole

Performance Assessments

Terms to Know:
someone who has sufficient knowledge of the client's situation to act on his/her behalf; used if client is a minor or legally incapable of being interviewed

Terms to Know:
ease of administration and low cost are advantages; provides highly reliable information; client can complete at convenience and can be interrupted or easily stopped

Terms to Know:
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

Terms to Know:
measures the consistency of the results an assessment provides

Terms to Know:
provide reliable and valid data; appropriate for re-eval because therapists can compare test scores, performance measures, or behavioral indicators

Standardized Assessments

Terms to Know:
contain specific questions that therapists ask in a specific order; when highly structured, more likely to be consistent across interviews

Structured Interview

Terms to Know:
affect an assessment; coaching, tolerance for pain/discomfort, fatigue, and the realization of being evaluated can influence a client's score

Test-taker Variables

Terms to Know:
measures how true the measure is to the underlying theory and concepts; does it measure what is says it measures

Terms to Know:
includes a person's cultural, personal, temporal, virtual, physical and social aspects; it is within these environments that a client's daily life occupations occur

Terms to Know:
look at specific discrete body impairments that affect larger daily life activities; poles of function

Bottom-up Approach

Terms to Know:
function should be defined and measured by the client's performance of life roles and meaningful activities that are a part of that role; poles of function

Top-down Approach

Terms to Know:
guides how an OT evaluates performance strengths and concerns, selects goals, plan interventions, and evaluates the effects of an intervention program

Client-centeredness

Terms to Know:
means sharing with others, taking part in an activity, or being involved in a life situation

Terms to Know:
using observation, interviews, photos, and engagement in an activity to gain insightful information about a client's life

Nonstandardized Assessment of Context

Terms to Know:
refers to demographic features of the person such as age, gender, SES, and education level that aren't part of a health condition

Personal Context

Terms to Know:
constructed around the significant others and important activities in a person's life

Terms to Know:
important to select assessment that was standardized on an appropriate population with same demographics and disabilities as the client being assessed

Standardized Assessment of Context

Terms to Know:
goes a step further and looks at what about the disability experience can help shape occupations

Strengths-based Assessment

Terms to Know:
includes stages of life, time of day/year, duration, rhythm of activity, or history

Temporal Context

Terms to Know:
includes communication by means of airwaves or computers with no physical contact with another person; becoming increasingly important in people's lives

Virtual Environment

________ data may not exist for nonstandardized assessments

Psychometric (validity, reliability)

Individualized assessments are referred to as .....?

Ipsative-referenced assessments

What acronym is used to avoid testing bias in standardized and nonstandardized assessments?

P = person related bias (evaluator & test-taker)
I = item bias
E = environment bias

What are the two types of person related bias?

evaluator and test-taker

The degree to which the specific element being tested fits the actual occupation the test taker performs in real life

The degree to which the testing context matches the appropriate natural environment

Environment bias

4 categories of nonstandardized assessments:

Observation
Interview
Questionnaire
Occupational Performance Assessment

Describe the setting, assess the social/emotional tone, conduct an activity analysis, reflection - is performance acceptable, make notes, document findings, make interpretations; The most commonly used nonstandardized assessment

Nonstandardized Assessment:
looking at posture, symmetry, ADL performance, social interaction

Nonstandardized Assessment:
using prompts, probes, and questions (usually unstructured)

Nonstandardized Assessment:
analyzes how a client carries out a task in a context; cooking lunch in a kitchen - use specific performance/task/occupation

Occupational Performance Assessment

A standardized assessment provides:

Objectivity (results not dependent on personal opinion)
Quantifications
Communication
Scientific generalizations

Standardized Assessments:
contains procedures for administration, scoring, reliability, and validity

Standardized Assessment

Standardized Assessments:
a measure of reliability of the obtained score; the standard deviation of the distribution of error in measurement

Standard Error of Measurement (SEM)

Standardized Assessments:
the scorer ensures they are scoring assessment the same every time

Scorer Reliability

Standardized Assessments:
consistent administration of the assessment by the therapist

INTRArater Reliability

Standardized Assessments:
two different raters will consistently arrive at the same score

INTERrater Reliability

Standardized Assessments:
how well a measurement conforms to theoretical constructs

Construct validity

Standardized Assessments:
the ability to accurately detect people with a condition

Standardized Assessments:
the ability of assessment to not identify or detect people who do not have a condition

____ __ ______ = to determine intervention needs or changes in established assessment-based intervention --> re-eval

Goal of Evaluation

Goal of ______ __ _______ = to transform an observed or acquired performance on a test item to an accurate and meaningful interpretation

scoring an assessment

3 basic steps of scoring:

1. Mark the raw score for the observed performance or response
2. Using the assessment manual, transform the raw score into meaningful information = derived or obtained score
3. In some cases, the derived score is then converted to a standard score

Once you have the final assessment score, the evaluation in complete - T or F

False, the final assessment score is only part of the evaluation! You need to use your observations, clinical reasoning, and all other obtained information to complete a thorough evaluation.

4 Common response methods and rating scales:

Observation of performance
Likert scales
Checklist scales
Forced-choice scales

Common response methods and rating scales:
standardized protocol that directs attention to preidentified issues

Observation of performance

Common response methods and rating scales:
these numbers have no true meaning

4 Measurement Scales:

Nominal
Ordinal
Interval
Ratio

Measurement Scales:
identifiable features - male/female, pain/no pain

Measurement Scales:
ranks the features, measurable - uses Likert scale: tallest to smallest, high to low stress, pain scale

Measurement Scales:
standard unit of measurement - temperature, time to run a race

Interval Scales

Measurement Scales:
usually used for physical measures, has a true zero - feet/second, miles/hour

The estimate of variance that accompanies the mean

Standard Deviation

Correlates exactly with the percentage areas under the normal distribution

Percentile Score

Scores are based on a comparison of expected performance of children in the same grade

Percentile Ranks

5 is midpoint, developed by the military

Average and range of stanines?

Average: 5
Range: 3 to 7 (5 + or - 2)

Average and range of Qs?

Average: 50
Range: 85 to 115

provides an easy way to compare how a person performed in relation to others

Standard Scores

Z-score average and range:

Average: 0
Range: -1.0 to 1.0
(0 + or - 1)

T-score average and range:

Average: 50
Range: 40 to 60 (SD is + or - 10) 50 + or - 10

Interpretation requires:

reflection, theoretical knowledge, clinical reasoning, and practice

____ bias can influence evaluation and must be considered during the interpretation of results

What are some general documentation recommendations? (hint: 7)

~Follow guidelines for documentation
~Respect the reader
~When in doubt, leave it out
~Explain professional jargon
~Use appropriate terminology
~Separate judgments from descriptions
~USE SPELL CHECK (Prof M)

4 main purposes of OT formal assessments

Descriptive
Discriminative
Predictive
Evaluative

OT formal assessments:
information about client's current functional status; baseline

OT formal assessments:
determine whether a client is performing or developing in the specified range of typical performance or development

OT formal assessments:
classify people onto predefined categories of interest in an attempt to predict an event or functional status in another situation

OT formal assessments:
detect magnitude of change over time in performance, competence, or satisfaction

Sets with similar terms

OTH 350: Types of assessments and Role of OTA in E…

36 terms

Ch. 8 Exam of Function

24 terms

OT 405 Occupational Performance Analysis Final

68 terms

Fundamentals I Lecture I: Evaluation, Intervention…

42 terms

Other sets by this creator

657: Final

39 terms

657 Quiz #2

35 terms

Research Exam #2

26 terms

643: Midterm

77 terms

Other Quizlet sets

Clin Med Lecture 13 (Breast and Axillae)

74 terms

Lecture Test #4 Part 2

10 terms

Quiz 4 - Descriptive Statistics Pt 2 & Database an…

10 terms

Transport of Glucose and Amino Acids_CMB…

59 terms