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Methods Used in OT Evaluation in Psychosocial Rehab

The most basic methods used by OT:

1. clinical observation - therapist observe patient's verbal and non-verbal cues. Verbal cues such as comments that the patient makes as an aside or to family members, other clients or directly to the therapist. Non-veerbal cues included patient facial expression, body language, gestures, or signs of depression, anxiety, sadness and pleasure.
2. projective testing - use unstructured but standardized procedure to gain insight into client's personality structure and dynamics of behavior.
3. machine monitoring - this procedure involves the recording of physiological and motor responses, such as in biofeedback training and muscle reeducation. Examples of machine monitoring include heart rate monitor, Electromyogram(EMG), and blood pressure cuff.
4. initial interview- this method provides opportunity to establish alliance between therapist and client. During initial interview, therapist evaluating the client's personal strengths and weaknesses, interests and level of motivation.
5. functional task-this method require client to accomplish simulated tasks. this method used to evaluate client's ability to perform Activity of Daily Living and self-care activities with or without assistance. Such activities might include personal hygiene, feeding or cooking and driving a mobile.
6. work sampling- this methods needs client to do well-defined activities that similar to those performed on actual job. This method can be used to assess vocational attitude, vocational interest, and work characteristics. Examples of work samples include test published by Valpar.
7. behavioral assessment-these assessment rates the clients as he or she perform the task in unstructured manner or non-standardized setting.
8. standardized test- These are published and unpublished test that have standardized procedure, normative data, validity and reliability.
9. computerized assessment- A number of instruments has been adapted to computer to ease of scoring and analysis.
10. self-report inventories- checklists and surveys filled out by the client either alone or in company of the therapist comprise this method. The information gathered are 'self-reporte' by the client.

source:Psychosocial Occupational Therapy;A Hollistic Approach

(F.Stein,Susan K)

sensory profile

Sensory Profile is a standard method for professional to measure child’s sensory processing abilities and to profile the effect of sensory processing on functional performance of daily life of a child. SSP can be used for children 3-10 years old. In Sensory Profile, there is Caregiver Questionnaire that needs to be filled by the caregiver and interpreted by the examiner. There also Summary Score Sheet that need to be filled by the examiner to find out the exact problem of the child using the information filled by the caregiver in the caregiver questionnaire. In the Caregiver Questionnaire, the caregiver needs to check the box that best describes the frequency with which the child does the behavior that stated in the questionnaire.
SUMMARY SCORE SHEET
The examiner needs to fill the summary score sheet to interpret the caregiver questionnaire and find out the child’s exactly problem in sensory processing. In summary score sheet, there are four parts that needs to be filled by the examiner. First part provides space to record demographic data of the child. Second part is the factor grid. Each factor is divided into three columns. First column contains the icon to indicate the category from which the item originated. Second column contains the item number that corresponds to the item number in the caregiver questionnaire. The third column contains the item raw scores.
Item number that corresponds to the item number in the caregiver questionnaire.
Item raw scores.
One of the factor taken from the factor grid.
Icon to indicate the category from which the item originated. Ex: this icon indicate visual category








Third part is the Factor Summary. The factor summary provides an additional way to consider the child’s scores. The examiner has to transfer the child’s score for each factor to the corresponding Factor Raw Score total column on the Factor Summary. Plot the child’s factor raw score total by marking an ‘x’ in the appropriate classification column, that correspond to the raw score total for each factor.

Fourth part is the Section Summary. The section summary provides a summary for the child’s sensory processing, modulation and behavior/ emotional response abilities. The examiner have to transfer the child’s score for each section from the caregiver questionnaire to the corresponding column labeled section raw score total. Mark an ‘x’ in the classification column that correspond the raw score total for each section.


If the

If the child is classified as definite difference, the child is interpreted as having problem with the sensory processing. If the child classified as probable difference, the child has questionable areas of sensory processing abilities. Typical performance indicates that the child has typical sensory abilities (normal).



Sensory profile also provides Modul Category that contains of the interpretation of the score and helps the examiner to plan treatment based on the child’s problem. Example: (for sensory seeking category).
Modul Category
Associated Factor
Related Section Headings
Behavior Indicators
Intervention Approach
Sensation seeking
- Factor 1(sensory seeking)

- Section H (modulation related to body position and movement)
-active
-continuosly engaging
-fidgety
Excitable
Incorporate additional sensory input into the child’s routines so that thresholds can be met while conducting daily life.
In paediatrics area, an occupational therapist needs to use play therapy and behavior modification to cooperate with the patient. Be patient with the patient that always crying or don’t want to mplement treatment. Children needs time to suit themselves in new situation, people or place. That’s why OT is all about love, patient and empathy. That’s all that I can share with the readers. Good luck to all. Don’t afraid to ask your senior if you have any question.



For more information, log on to http://www.upanzi.com/index.php?option=com_content&task=view&id=3&Itemid=3, http://harcourtassessment.com/hai/Images/resource/samprpts/Sensory_profile_Sample_rpt.pdf,

CEREBRAL PALSY

DEFINITION-non-progressive motor disorder that causes by damage to the brain before, during or shortly after birth.

TYPES - spastic, hypotonia, athetoid and mixed.

1.spastic - increase in muscle tone. if not treated, can cause contracture.

2.hypotonia - diminish muscle tone. firstly, appear flaccid and gradually develop spasticity and sometimes athetoid. Can be easily see by the inability of the infants to gain any head control when pulled by the arms to sitting position.

3 athetoid - means fluctuates tone.

4.mixed - multiple syndromes with combination of the various forms of CP.

AETIOLOGY

-premature

-genetic disorder

-infection of the brain such as viral meningitis

-head injury from trauma(vehicle accident)

-child abuse

-congenital CP cause by faulty cell development in the embryo in the early stages of pregnancy.

-maternal infection with the rubella virus (German meascles) during pregnancy

-severe jaundice of the newborn

ROLES OT

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