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OCT 1131 midterm > OT Assessments Exam 1 > Flashcards

OT Assessments Exam 1 Flashcards

1
Q

Everything people do to occupy themselves

Groups of activities and tasks of everyday life that are organized, have value and are meaningful to the individual

A

Occupations

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2
Q

Self- care: getting ready for the day (dressing, showering, eating)

Productivity: Contributing to the environment (working or volunteering)

Leisure: How a person relaxes ( socializing, reading, sports, watching TV)

A

Types of occupations

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3
Q

The ability to choose, organize and satisfactorily perform meaningful occupations

Ex: dressing oneself

A

Occupational performance

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4
Q

Any problem or issue related to meaningful and purposeful doing

A

Occupational Performance Issues (OPI)

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5
Q

The satisfactory experience of a person participating in everyday occupations

Comes from a person values, roles and interests

A

Optimal Occupational performance

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6
Q

The art and science of enabling engagement in everyday living though. occupation

Enabling people to perform the occupations that Forster health and well-being

Enabling just and inclusive society so that all people may participate to their potential in the family occupations of life

A

Occupational therapy

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7
Q

level of satisfaction brought to an individual when performing an occupation

A

Occupational Therapy goals

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8
Q

OT’s increase the potential for occupation by using these factors

Personal factors
Environmental factors
Occupational factors

A

Person Occupation-Environment Interaction

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9
Q

The set of tasks involved in finding out about a client and their occupational performance. Helps us determine OPI’s

A

Assessments

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10
Q
  • What people need to do
  • What people want to do
  • What people are required to in every day life
A

What do OT’s assess

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11
Q

-To describe a clients status at a point in time
- To predict a clients future performance/status
- To evaluate a change in status over tome

A

Why do OT’s assess

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12
Q
  • Organizing frameworks (CPPF)
  • Theoretical Considerations
  • Guiding principles
A

How do OT’s assess

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13
Q

Steps of the organizing framework: CPPF

A

1st: Enter/Initiate
2: Set the stage
3. Assess/Evaluate

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14
Q

Theory of client’s disability and corresponding frame of reference can guide choice of assessment

Theory of why OPI’s are happening and what we are going to focus on

A

Theoretical considerations

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15
Q

Biomechanical: body movement

Compensatory: environment

Cognitive-Behavioural: Thoughts and emotions

A

OT Frame of reference

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16
Q

COTO is an examples

They provide different stages for practicing as an OT

A

Guiding principles

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17
Q

a systematic approach to assessment

should involve a standardized assessment tool

we gain more trustworthy information when we do this

A

measurement

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18
Q

Client is actively involved in choices related to assessment, intervention and interpreting outcomes

Partnership that respects autonomy

A

Client-centered practice

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19
Q

Method used to gather information about a clients ability to perform occupations

goals are to
1. learn about the clients
2. identify the OPI’s
3. establish trust
4. gather subjective information
5. understand values, strengths and interests

A

Interview

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20
Q

we can hear the clients story and situations

we can communicate effectively to get the client to tell us their limitations

A

benefits on an interview

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21
Q
  • set up an inviting space
  • prepare to listen
  • Minimize distractions
  • Housekeeping (informed consent, time, confidentiality, note taking)
  • COTO standards
A

Beginning on an interview

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22
Q
  • Exploration of the client
  • Gather information on OPI’s and Occupations
  • Open ended questions, closed ended questions direct questions, indirect questions
  • Allow for silence
A

Middle of an interview

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23
Q
  • refocus if you lose track of time
  • Summarize to make sure you understand what client said
  • Ask if you missed anything
  • Come up next appointment
  • “do you have any questions for me”
A

End on an interview

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24
Q
  • False reassurance
  • Projecting personal values
  • Giving advice
  • Bombarding
  • Abruptly changing the topic
  • Inappropriate language
A

Pitfalls

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25
Q
  • Keeps focus and helps ensure key issues are not missed
  • Related assessments more explicitly to theoretical frameworks or models
  • increased validity and reliability of responses
A

semi-structured interviews

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26
Q

What is COPM?

A

Canadian Occupational Performance Measure

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27
Q

An individual, evidence based, client-entered outcome measure designed to capture a clients self-perception of performance of everyday living overtime

it is not a goal setting tool, it is an OPI identification tool

Standardized assessment

A

COPM

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28
Q

semi-structured interview
visual rating scale
paper or online

A

How to COPM is administered?

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29
Q
  1. demonstrated evidence based practice
  2. demonstrates client-centred practice
  3. enables the identification of OPI’s
  4. provides a vehicle for continuity of care
  5. provides focus for reporting and documenting change
  6. may improve continuity of care
A

Why use the COPM?

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30
Q

Clinical utility
- improves goal setting

Reliability
- Moderate to high

Validity
- Content validity

A

COPM Psychometric properties

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31
Q
  1. identify OPI’s
  2. Rate and choose most important OPI’s
  3. Score performance and satisfaction
  4. Reassessment
A

How to administer the COPM?

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32
Q

How do you identify OPI’s in the COPM?

A

Using an interview in the first step (identifying OPI’s)

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33
Q

Explain 2. Rate and choose most important OPI’s

A
  • you try to address the things they rate as most important
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34
Q

Explain 3. scoring in the COPM?

A

using the scoring card you :
1. ask the client to rate how they are currently performing on the OPI’s they names
2. Ask the client to rate how satisfied they are with their performance on the OPI’s they names

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35
Q

Explain 4. Reassessment

A

start from the beginning and get the client to rescore their performance and satisfaction

if it goes up by 2, it would be considered clinically significant

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36
Q
  • keep an open mind
  • explore less obvious occupations
  • family members can be proxies
A

Clinical considerations to the COPM

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37
Q
  • lack of uptake
  • not acknowledging
  • abrupt topic changes
  • making assumptions
  • failure to explore
A

Communication pitfalls during the COPM interview

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38
Q

The end result of clinical activity

A

What is an outcome?

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39
Q

An instrument that has been shown to measure desirable traits accurately

A

Outcome measure

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40
Q

Example of an outcome measure?

A

COPM

Use it to measure the outcome measure of clients in occupational therapy practice

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41
Q

Fundamental component of evidence based practice

helps us determine status at the start of an intention and if someone is actually improving

Improves clinical decision making, care and client outcomes

A

Why do we measure

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42
Q

How do we choose which assessment to use?

A

Instrument Evaluation Process

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43
Q
  • Clinical Applicability
  • Specificity
  • Availability
  • Time/Training Demands
  • Acceptability to clients
  • Cost
A

Factors to consider when determining if an assessment is clinically useful

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44
Q

test questions, methods and conditions for the administrating, scoring and interpretation of the results are consistent

Assessment allows for trustworthy comparison of score from one time to the next

When a test have very explicit instructions

A

What is a standardized assessment?

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45
Q
  • Assessment manual
  • instructions for administration
  • Standardized equipement/questions
  • Data on test construction, reliability, validity
  • Normative data
A

How to tell if a test is standardized?

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46
Q
  1. description measures
  2. predictive measures
  3. evaluative measures
A

3 aspects of instrument purpose

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47
Q

describes the status of the person or group

describes the person or group occupational repertoire

information collected can be use to identify problems and to evaluate the needs/plan intervention

A

Descriptive measures

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48
Q

predicts the client future status

predicts something specific about the client

can be used to screen individuals to determine their eligibility for intervention or benefit from a program

A

Predictive measures

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49
Q
A
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50
Q

an instrument that has been shown to measure desirable traits accurately

EX: COPM: used to measure the _____ of clients in occupational therapy practice

A

what is outcome measure?

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51
Q

Fundamental component of evidence based practice

Helps us determine status at the start of intervention, if someone is actually improving, and if improved by the end of intervention

Improves clinical decision-making, care and client outcomes

A

Why do we measure outcomes?

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52
Q

How do we choose which assessment to use?

A

Using the instrument evaluation process

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53
Q
  • Clinical Applicability
  • Specificity
  • Availability
  • Time/Training demands
  • Acceptability to clients
  • Cost
A

How to determine is an assessment in clinically useful?

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54
Q

test questions, methods and, conditions for the administrating, scoring and, interpretation of the results is constant

Assessment allows for trustworthy comparison of scores from one time to the next

A test that has very explicit instructions

A

What makes an assessment standardized?

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55
Q
  1. Assessment Manual
  2. Instructions for administration
  3. Standardized equipment/questions
  4. Data on test construction, reliability, validity
  5. Normative data
A

How to tell if a test is standardized?

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56
Q
  • descriptive measures
  • predictive measures
  • evaluative measures
A

3 aspects of instrument purpose

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57
Q

describes the status of the person or group

describes the person or groups occupational repertoire

can be used to classify am individual via comparison with norms

information collected can be used to identify problems and to evaluate the need/plan for intervention

A

Descriptive Measures

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58
Q

predict the clients future status

used to predict something specific about the client

often have norms that can be used to screen individuals to determine eligibility for intervention or benefit from a program

A

Predictive Measures

59
Q

Evaluate the change in status of a client overtime

used at more than one point

must be sensitive to change

EX: COPM

A

Evaluative Measures

60
Q

instrument development process
- the way the instrument was constructed and developed

Item inclusion and exclusion
- does the instrument include questions would would expect to see?

scaling/weighting
- How does the scoring work? How is the total weighted?

A

Test Construction

psychometric properties

61
Q

measures of the average or typical performance from the basis of how instrument scores are interpreted

involves comparing an examinee’s test score to scores obtained by people included in a normative sample

important to consider characteristics of the sample

A

Norm-Referenced Measures

62
Q

trustworthiness of a measure and it’s results

A reliable measure yields dependable and consistent measurement of what you are trying to remember

A

Reliability

psychometric properties

63
Q

the difference between the true value of a phenomena and its measured value

caused by factors that are irrelevant to what is being measured by the test and having an unpredictable effect on the test scores

A

measurement error

64
Q

fatigue
anxiety
distraction
motivation
instructions

A

factors that cause measurement error

65
Q
  1. test construct
    - test questions worded unclear, instructions unclear, scoring
  2. test administration
    - test environment issues, test-taker motivation/attention, examiner-related variables
  3. test scoring
    - scoring by hand vs computer, level of training, subjectivity
  4. test interpretation
A

Sources of measurement error

66
Q
  • choose an assessment with strong psychometric properties
  • pilot-test assessment and instructions
  • follow standardized instructions
  • train admin
  • making observations
  • keep test environment and equipment as similar as possible
  • double check data
A

Tips to minimize measurement error

67
Q
A
68
Q

what does poor reliability look like

A

0.1

69
Q

what does high reliability look like

A

0.9

69
Q
  • Pearson product moment correlation coefficient (r)
  • Intra-class correlation coefficient (ICC)
  • Spearman rank-order coefficient (rho_
  • Kappa Statistic (k)
  • Cronbach’s Alpha
A

Statistics to measure reliability correlations

70
Q

stability of the measure overtime

determine by calculating the agreement of scores at two different times for a characteristic that has not changed

ICC>0.70 would be acceptable

A

Test-retest

70
Q

test-rest
inter-rater
internal consistency

A

Measures of reliability

71
Q

health assessment questionnaire
- r=0.87-0.99

reintegration to normal living index
- r=0.12

A

Examples of test-retest

72
Q

The degree to which the scores by different raters yield the same results

Applies to assessments where test administrators assess the results

determined by having several measures of the same phenomena

descriptive, predictive and evaluative assessments should have this

A

inter-rater reliability

73
Q

kitchen task assessment
- r=0.85

A

Example of inter-rater reliability

74
Q

The degree of interrelatedness among the items of an instrument

used to determine if items on the test are consistent or not

A

Internal consistency

75
Q

Barthel Index
- r=0.87=0.92

A

example of internal consistency

76
Q

extent to which the assessment measure what is intended to measure

A

validity

77
Q
  • Face
  • Content
    -Criterion (concurrent and predictive)
  • Construct (convergent, divergent, discriminative)
  • Responsiveness
A

Types of validity

78
Q

As assumption of validity based on a measures appearance

least reliable validity `

A

Face validity

79
Q

the degree to which the instrument items are a comprehensive reflection of what the instrument reports to be measuring

an assessment contains all content it should for what it is measuring

A

Content validity

80
Q

Extent to which the scores of an assessment relate to gold standard or a valid external criterion

assessed by correlating the scores of a sample of individuals on the predictor with the scores on the criterion

A

Criterion validity

81
Q

Criterion data collected at the same time as the dad on the predictor side

EX: TB Skin test ( skin test= predictor, chest x-ray= criterion)

A

Concurrent validity within Criterion validity

82
Q

Criterion data collected after the predictor test was administered

EX: scores on MCAT= predictor, predicted performance in medical school= criterion

A

Predictive validity within criterion validity

83
Q

The degree to which the scores of an assessment are consistent with a hypothesis about how they should be performed

Based on testing a measure against an idea that is based on a theory

Most interesting and difficult of all validities

A

Construct validity

84
Q

the degree to which the scores of an assessment are consistent with a hypothesis that the assessment will correlate with another measurement

EX: COPM scores will correlate with RNLI scores
- COMP performance scores and the RNLI scores: r=0.72
- COPM ratification scores and the RNLI scores: r=0.93

A

convergent validity within Construct validity

85
Q
A
86
Q

The degree to which the scores of an assessment are consistent with a hypothesis that the assessment will not correlate with another measurement

EX: COPM performance scores will not correlate with standardized performance measures that are not client reported
- Barthel index: r=-0.025
- Rankin scale: r=0.209

A

Divergent validity within Construct validity

87
Q

The degree to which the scores of an instrument are consistent with a hypothesis concerning the differences between groups

A

Discriminative validity within Construct validity

88
Q

the ability of an assessment to detect change overtime in what it reports to be measuring

It is done by taking a group that does in face change and seeing fi the measure picks up on the change

Results expressed in effect size

A

Responsiveness validity

89
Q

Minimal Detectable Change (MDC)

Minimal Clinically Important Differences (MCID)

A

Responsiveness Validity Concepts

90
Q

what amount of change, taking error into account, means that the change has actually occurred

A

Minima Detectable Change

91
Q

What a patient would notice to be a meaningful change

A

Minimal Clinically Important Differences

92
Q

The degree to which the performance of an item on a translated/culturally adapted measure are an adequate reflection of the performance of the items in the original version of the assessment

A

Cross-cultural validity

93
Q

The degree to which a measure reflects real life

A

Ecological validity

94
Q
  1. obtain a copy of that measure
  2. refer to books that evaluate the measure
  3. read literature
  4. check the wide-range of literature
  5. follow a template for evaluation and do your own evaluation
A

Tips for how to evaluate a measure

95
Q
  • use search engines
  • textbooks
  • library database
  • measurement cupboard
A

how to find an assessment

96
Q

questionnaire that ask about symptoms and the ability to do certain things

a good assessment

A

DASH

Disabilities of the arm, should and hand

97
Q
  • it matters
  • characteristics
  • helps with occupational engagement
  • in line with OT models (CMOP-E, PEO)
  • embedded in OT competencies (C3.6)
  • In line with current best practice
A

Why we assess the environment

98
Q
  • Environment is one of the 3 core constructs
  • OT’s are interested in aspects of the environment and how they relate to occupation
  • Assessments of the physical, institutional, cultural environment is a role of an OT because it related to a persons occupational engagement
A

Using CMOP-E to assess environment

99
Q
  • The greater the overlap, the more optimal the occupational performance will be
  • by changing the environment, there is more overlap which leads to better occupational performance
A

Using PEO to assess environment

The Person-Environement Occupation Model

100
Q
  • CASE
  • CAFI (Child and Adolescent Factors Inventory )
  • CASP (Child and Adolescent Scale of Participation)
A

Examples of environmental assessment

101
Q

used to assess physical, cognitive and psychosocial characteristics

A

CAFI (Child and Adolescent Factors Inventory )

102
Q

used to assess the Childs participation in certain occupations

A

CASP (Child and Adolescent Scale of Participation)

103
Q
  • practice setting
  • whose perspective? Childs, parents, teacher, OT?
  • Wording- deficit vs strength based
  • Stand alone of complimentary use
A

considerations for selecting an OT paediatric environmental assessment

104
Q
  • psychometrics
  • cost/accessibility
  • Training/Certification
  • Completion/scoring time
  • Format/Methods (interview, self-report?)
  • Population (would it be useful for a child with learning disabilities)
  • Domains assessed
A

general considerations for selecting an environmental assessment

105
Q
  • Whose perspective (child, parent, teacher, OT?)
  • Wording (deficit vs strength based)
  • Stand alone of complementary use
A

paediatric considerations for selecting an environmental assessment

106
Q

What does AMPS stand for

A

Assessment of motor and process skills

107
Q

Standardized evaluation of ADLS

It is unique because it is standardized

A

AMPS

108
Q
  1. OT performs an interview and learns what tasks the client wants to priotrize
  2. The OT observes the client doing at least 2 of the tasks and evaluates the quality of the task performed
  3. OT scores the quality of the observed tasks performance using criteria from the manual
  4. OT enters scores into computer software and generates report
A

AMPS process

109
Q
  • we are attending to occupational performance skills
A

What are looking at when using AMPS

110
Q

the smallest units of observable goal directed actions that are linked together one by one in the process of building a task performance

A

Occupational performance skills

111
Q

what are the 2 categories of AMPS

A
  1. ADL motor skills
  2. ADL process skills
112
Q

Goal-directed task action observed when the person:
- Moves around the task environment
- Interacts with and moves task objects

A

ADL motor skills

113
Q

Goal-directed task action observed when the person
- Selects, interactions and, uses a task tool or material
- carries out individual actions and steps of the task in a spatial-temporally effective manner
- prevents task performance problems from reoccurring by finding another way

Adaption is very important

A

ADL process skills

114
Q

4= competent performance
3= questionable performance
2= ineffective performance
1= unacceptable performance

A

AMPS scoring criteria

115
Q
  1. Severity of the OT
    - The OT must be training to administer
  2. Adjusts for the challenges of the task that the person did
  3. Difficulty of the item or specific motor or processing Skills
    - All people are more likely to get lower scores on harder tasks
A

AMPS software adjusts the persons score for 3 things

116
Q
  1. to share with client or other party
  2. goal setting and intervention
  3. demo states effectives or intervention
A

why AMPS results come in several reports

117
Q

supports our clinical judgement of someones needs for assistance when living in the community

ADL process: <1.0
ADL motor: <1.5
Person would need assistance

ADL process: <0.7
ADL motor: <1.0
Person would need maximal assistance

A

AMPS

118
Q
  • if the person is under the age of 2 or the person has no desire/need to engage in ADLS
A

only reason you shouldn’t consider using the AMPS

119
Q

the meaning and satisfaction derived from taking care of yourself

foundation for participation in other types of occupations

A

ADLS

Activities of Daily Living

120
Q

2 types of ADLS

A

BADL nad IADL

121
Q

Examples of BADL’S

Basic Activities of Daily Living

A
  • eating
  • dressing
  • grooming
  • toileting
  • functional mobility
  • communication
122
Q

FIM= functional independence measure
WEEFIM= fim for children 6mos-7 years

A

measures used in assessing BADL’S

123
Q

measures the severity of disability in terms of the need for assistance

used in rehabilitation settings

measure 18 items in 6 areas
1. Self-Care
2. Sphincter Control
3. Mobility
4. Locomotion
5. Communication
6. Social Cognition

Higher score= more independence

A

FIM

Functional Independence Measure

124
Q

1: Motor Self-Care Based Tasks
2: Cognitive Self-Care Based Tasks

A

FIM and WEEFIM subscales

125
Q

is the FIM a good test?

A

Yes

126
Q

Examples of IADL’s

Instrumental Activities of Daily Living

A
  • managing money
    -using phone
  • taking medications
  • travelling
  • shopping
  • preparing meals
  • laundry
  • housekeeping
127
Q

KELS= Kohlmans Evaluation of Living Skills

A

measure used in assessing IADL’s

128
Q

assess IADL skills required for community living

can be used with adults of all ages

17 items address these areas
1. Self-Care
2. Safety and Health
3. Money Management
4. Community mobility and telephone
5. Employment and leisure participation

Higher score= less dependence

A

KELS

Kohlmans Evaluation of Living Skills

129
Q

2 ADL measures

A
  1. Diagnosis Specific
  2. Generic
130
Q

allows for comparison to be made between groups with different diagnoses

may not be as sensitive to particular problems associated with a specific diagnosis

A

Generic ADL Measures

131
Q

Examples of Generic ADL Measures

A

FIM
KELS
Barthel Index

132
Q

Items only address ADL skills that tend to be affected by that diagnosis and this may not be sensitive to change

cannon compare disability levels across diagnoses

A

Diagnosis -Specific ADL Measures

133
Q

Example of Diagnosis -Specific ADL Measures

A

DASH

134
Q

1: Observational Assessment
2: Self-Report
3: Proxy Report
4: Chart Review

A

Approaches to collecting ADL information

135
Q

Pro: Accurate, detect unsafe methods, determine reason tasks can’t be performed, guide intervention

Con: Time consuming, costly, inconsistent performance day-to-day, need specific environment, might need training

A

pros and cons of observational assessment

136
Q

pro: easy, fast, inexpensive, good for screening, gets clients perspective

con: validity is controversial, doesn’t capture what client is capable of

A

pros and cons of self-reporting

137
Q

pro: easy, fast, inexpensive, allows for inclusion with range of clients

con: limited research, don’t know how valid on an answer is being given

A

pros and cons of proxy reports

138
Q

pro: easy and fast

con: depends on the quality and the sounds may not be included

A

pros and cons of chart reviewing

139
Q

most ADL assessments ask the dame set of items for everyone which makes assumptions about “typical activities”

IADLS can be individualized

what a person does for ADLS is influenced by gender, culture, roles and environment

A

Psychometric and Clinical Issues of ADL measures

140
Q

important to consider this if you are using an assessment for predictive measures

try to assess an environment as close to real environment if possible

A

generalizing to real-world setting in ADL measures

141
Q

many current ADL scales are reflective of North American values of independence and individualism

construction and scoring don’t often reflect different cultures

A

philosophical underpinnings in ADL measures

OCT 1131 midterm (2 decks)

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