Eval and intervention for perf in areas of occ (ch 15) Flashcards
Scales of functional performance: (total assist, max assist, etc… define each)
- Total assistance: need for 100% assistance by one or more people to perform all physical activities and/or cognitive assistance to elicit a functional response to an external stimulation.
- Max assist: need for 75% assistance by one person to perform gross motor actions in response to direction.
- Mod assist: need for 50% assistance by one person to sustain/complete simple, repetitive activities safely.
- Min assist: need for 25% assistance by one person to perform functional activities safely.
- Standby assist: need for supervision when error and need for safety precautions are not always anticipated by patient
- Independent.
Intervention should follow a __________ progression- considering the person’s areas of occupation first, rather than a __________ approach which focuses initially and/or solely on performance skills and client factors.
top down; bottom up
Assessment of Motor and Process Skills (AMPS) (focus, method, scoring, population)
- focus: assessment of effectiveness, efficiency, or safety of a person’s ADL performance, including PADL, IADL, and some leisure.
- method: interview to determine 3-5 relevant tasks that are sufficiently challenging; OT observe the quality of performance in 2-3 selected tasks; *training required to administer.
- scoring: rater scores quality of motor skills and process abilities; entered into computer program; interpretation allows OT to determine person’s difficulty, abilities, quality of change after tx.
- population: anyone with developmental age older than 2 years with any diagnosis that limits ADL function.
Barthel Index (focus, method, scoring, population)
- focus: measurement of person’s independence in BADL and functional mobility before and after tx, and the level of personal care needed by the person.
- method: direct observation of task performance, interview, review of medical records.
- scoring: based on performance and assistance needed; determines need for personal assistance with BADL- NOT ability to live indep at home.
- population: adults and elders with phys dis and/or chronic illnesses. (Used typically in medical model settings)
Cognitive Performance Test (CPT) (focus, method, scoring, population)
- focus: assessment of six functional ADL tasks that require cognitive processing skills (based on ACL): dressing, shopping, making toast, making phone call, washing, traveling.
- method: person does each task.
- scoring: based on ACL. scores range from 6-36 (higher is better). determines person’s capabilities and ability to live indep.
- population: adults and elders with psych and/or cognitive dysfunction.
FIM System and WeeFIM System (focus, method, scoring, population)
- focus: assessment of severity of a disability as determined by what the person actually does and the amount of assistance needed to complete each task. 6 areas: self care, sphincter management, mobility, locomotion, communication, social cognition.
- method: observation of activity performance.
- scoring: each item given 1-7; higher score better. (when WeeFIM used for less than 3 y/o scoring is 1-3).
- population: adults with disabilities who are not functionally indep for the FIM; WeeFIM= 6 months-7 years.
Katz Index of ADL (focus, method, scoring, population)
- focus: assessment of level of indep and type of assistance required in 6 ADLs: bathing, dressing, toileting, transferring, continence, feeding.
- method: observation/interview
- scoring: each item rated indep, some assistance req, or dependent. Then individual ratings converted into global letter score. Used to eval intervention outcomes and prognosis in a broad, general manner.
- population: adults and elders with chronic illnesses
Kitchen Task Assessment (KTA) (focus, method, scoring, population)
- focus: measurement of the judgment, planning, and organizational skills used to perform a simple cooking task.
- method: observation of making cooked pudding from a mix.
- scoring: 0-3 (indep to totally incapable) rated for initiation, organization, perf all steps, sequencing, judgement/safety, and completion of task. higher scores= increased impairment.
- population: adults and elders with cognitive dysfunction.
Klein-Bell Activities of Daily Living Scale (K-B Scale) (focus, method, scoring, population)
- focus: assessment of independent functioning in ADL in 6 areas: dressing, elimination, mobility, bathing/hygiene, eating, emergency phone communication.
- method: observation.
- scoring: 170 items rated as achieved or failed.
- population: 6 months to elderly with any diagnosis
Kohlman Evaluation of Living Skills (KELS) (focus, method, scoring, population)
- focus: determination of person’s knowledge and/or performance of 17 basic living skills needed to live indep in 5 areas: self-care, safety/health, money management, transportation/telephone, work/leisure.
- method: task completion; standard questions.
- scoring: score of indep or needs assistance is given according to criteria. Total score of 5.5 or less indicates presence of skills for indep living. Score of 6+ = doesn’t have skills for indep living.
- population: adolescents/adults with diversity of diagnoses
Milwaukee Evaluation of Daily Living Skills (MEDLS) (focus, method, scoring, population)
- focus: assessment of actual or simulated performance of basic living skills needed to function in the person’s expected enviro. (basic communication, personal care, medication management, personal device care, time awareness, eating, dressing, home/community safety, phone skills, transportation, clothing maintenance, use of money)
- method: task completion
- scoring: according to criteria in booklet.
- population: adults with ADL deficits.
Routine Task Inventory (RTI) (focus, method, scoring, population)
- focus: measurement of level of impairment in ADL according to ACL. (grooming, dressing, bathing, walking, feeding, toileting; housekeeping, food prep, spending money, taking meds, laundry, shopping, phone use, and traveling.)
- method: 3 possible methods… observation, self-report, caregiver report.
- scoring: rated based on ACL 1-6. Interpretation can be used to design intervention based on Allen model.
- population: adults/elders with cognitive impairment
Scoreable Self-Care Evaluation (focus, method, scoring, population)
- focus: measurement of functional performance and identification of difficulties in 18 basic living tasks in 4 main areas: personal care, housekeeping, work/leisure, financial management.
- method: motivational questionnaire, task performance and observation.
- scoring: based on inability to do task. Tx can be planned based on deficits.
- population: adolescents, adults, and elders with psychiatric illnesses in acute hospital settings or living in community.
Test of Grocery Shopping Skills (TOGSS) (focus, method, scoring, population)
- focus: determination of person’s ability to shop for groceries in grocery store using a grocery list.
- method: eval completed in the person’s community grocery store; person given a list of 10 items in specific size and asked to locate and select at lowest price; OT observation.
- scoring: based on accuracy, time, redundancy, strategies person uses to shop.
- population: patients with cognitive impairments which interfere with community living skills.
Self-care abilities of SCI level C1-C3
Totally dependent in all-self care but can instruct others in preferences for care. Can chew and swallow.
Self-care abilities of SCI level C4
Totally dependent in all-self care but can instruct others in preferences for care. Can drink from a glass with a long straw.
Self-care abilities of SCI level C5
Feeding requires total assist for setup; then indep with AE. AE includes: mobile arm support or suspension sling; dorsal wrist splint with u-cuff; dycem; scoop dish/plate guard; angled utensils.
Dressing req min to mod A with UB dressing. Dependent in LB.
Bathing req mod to min A.
Grooming req setup A; with splint and u-cuff can be indep with toothbrush and combing hair; indep using electric shaver fit to hand.
Self-care abilities of SCI level C6
Feeding: indep using AE: u-cuff or tenodesis splint; rocker knife; scoop dish/plate guard; cup with large handle.
Dressing: indep in LB dressing in bed; req max A with socks/shoes. indep with UB dressing using button hook, zipper pull, and velcro.
Bathing: min A using hand-help shower, tub bench, and sliding board transfer.
Grooming: indep using tenodesis grasp/splint.