Sunday, September 7, 2014

Evaluating and assessing your child

Evaluation and Assessment for Effective Therapy

The goal of Evaluation is to create the child's Occupational Profile

This involves understanding the child’s diagnosis, the child’s strength and challenges related to the contexts and occupations (age appropriate meaningful activities of interest or importance to the child) in which they participate in. 

The parents, siblings, other professionals such as teachers,doctors, psychologists etc are integral to the evaluation process. The child’s occupational profile should also include his likes and dislikes, temperament, peer and family relationship, learning history and school program information.

Evaluation information maybe gathered through standardized and non standardized assessments.
Some popular standardized neurological based assessments include:

Pediatric Evaluation of Disability Inventory (PEDI;Haley,Coster et al.,1992) which assesses child’s functional skill ability and caregivers capability.

The School Function Assessment (SFA;Coster et al.,1998) evaluates the child capabilities in school settings, how appropriate and assistive devices to be added for optimal learning and social skills to take place.

Peabody Developmental Motor Scales (Folio & Fewell, 1983) evaluates age developmental milestones (fine and gross motor skills)

Assessment for sensory dysfunction include Sensory integration and praxis (SIPT; Ayres 1989) of which is the gold standard for all other sensory tests.

Sensory Profile (Dunn.1998) which helps to understand a child sensory needs and processing and modulation abilities.

Toddler and infant Motor Evaluation is used for Assessment of reflexes, postural control, muscle tone (TIME; Miller& Roid, 1994).

Nonstandardized Assessment/Clinical Observation

Neuromusculoskeletal Evaluation: Clinical observation of muscle tone, joint range of motion, automatic balance responses, posture, gait and physical strength.

Play Skills Evaluation: Informal evaluation of play interactions may be set up during the assessment. This is used to observe functional use of motor skills in play, and play occupations such as independent initiation, use of toys, symbolic play, creativity and imagination, and enjoyment of play. There are a limited number of occupational therapy play assessment tools, and those are largely designed for administration in the child's functional environment of home or school.

Oral Motor feeding Evaluation: This may include the assessment of the oral structures, oral-motor control (suck, swallow, chew), behavioral responses during feeding, parent/child interaction, self-feeding skills.

Although standardized assessments increase the reliability of the evaluator’s judgement,it maybe difficult for non-verbal or kids who have significant motor impairments and /or behavioural challenges. Therefore, keen observations of children performing occupations in relaxed and natural settings provide valuable information.

The Final phase of evaluation involves the synthesis of information gathered from Standardized and Non-standardized assessments done and information gotten from the other team members (doctors,psychologists,teachers etc).

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