Authentic Occupational Therapy Evaluation

“The way a question is asked limits and disposes the ways in which any answer to it — right or wrong — may be given.” — Susanne Langer, Philosopher

As we pursue authenticity in our occupational therapy practices, where do we begin? We could go all the way to the roots of practice, to theories and frames of reference, or to the philosophers and founders. Or we can cut to the chase, clinically-speaking, and start with the questions we ask, i.e. the evaluations we select and use.

The sequence and content of our evaluation process dictates what we identify as strengths and limitations, and the goals that we design. If the evaluation process begins and ends with evaluating the client’s strength, range of motion and endurance, the intervention will focus on these (and will look like a PT session). If the evaluation consists of observing a client’s basic ADLs, then the goals and intervention will consist of things like dressing, grooming, bathing and using the toilet. While these abilities are necessary for independent living, they are not the sum total of anyone’s most valued activities or roles.

In order to provide authentic occupational therapy, we are required to specifically and deliberately learn about our clients’ daily routines, interests, values, hopes and needs. This can be done as simply as a homemade semi-structured interview and a picture card sort (I’ll share my methods for this at another time). A home visit with a tour of the daily routine path, and questions about what is hoped for can be very enlightening. More structured approaches include standardized tools such as the Occupational Self Assessment (Children’s and Adolescent/Adult versions) or Canadian Occupational Performance Measure.

If you want to amp up your OT practice approach, start by asking the right questions during your evaluation.