Screening and Assessment Flashcards
What are the roles of the OTR and COTA in assessments?
OTR: select, perform, interpret
COTA: perform, offer input
Collaborative
Top down approach
Big picture
Occupations –> performance skills
Or just adapting and remediating occupations
Bottom up approach
Performance skills –> occupations
Developmental
When working with geriatrics, are you more likely to use top down or bottom up?
Top down.
You are typically trying to find ways to adapt and compensate to perform their occupations.
At some point they were independent with occupations so they are relearning.
What is the value of an occupation based assessment vs a performance skills based assessment?
The focus on a performance skill is more likely to occur in outpatient rehab because those clients are likely independent.
What are advantages and disadvantages of using interviews, questionnaires, and self assessments?
They’re often free or cheap, may have standardized number with objective data, quick, easy, allows you to get to know the client, may be a required FOM by insurance
But they may lie on them due to cognitive decline, they could be embarrassed, fear, they want to go home.
What are performance based assessments?
We watch the client perform the skill.
Standardized vs ecologically based assessment
Standardized:
- structure
- printed and published manual
- score is norm referenced
Ecologically based:
- what they’re doing, where they are
- top down approach
- short sighted, may not look beyond environment
- culture and social determinants
* can talk to family to understand culture (can’t trust pt)
* social determinants: access, opportunities
What is validity?
The assessment tests what it’s supposed to test.
EX: Using the Barthel Index to assess ADLs in SNF.
What is reliability?
Able to pick up minimal changes
Interrater reliability: multiple people give the test and get the same results
Test-retest: test today, test tomorrow
What is level of intrusiveness?
Level of attention and effort by the client
Time of day, part of normal day or outside of the norm
- Baseline or max ability
Complexity of the assessment
What are the levels of data?
Nominal: categories (ICD10 codes, gender)
Ordinal: levels of independence
Interval: differences between values
- I with dressing 50% of the time
What is sensitivity?
snOUT
Ability to rule out a disease if the test is negative
What is specificity?
spIN
Ability to rule in a disease if the test is positive
What is responsiveness?
Ability to detect change
With the elderly, we may need small changes
