Friday, February 24, 2012

Pediatric Assessments I Use the Most

Just thought I'd go through a list of assessments I use for different ages and diagnoses of peds clients. Obviously it's different from location to location, but this is what I use the most often. I remember my first travel assignment not really knowing what assessment to use for what types of clients. Now I work a lot more often and consistently with pediatric clients, so it's gotten a lot easier. I still have a long way to go, but here's a start at least!

:::Pediatric Outpatients:::
-With all of our pediatric clients, the PEDI (Pediatric Evaluation of Disability Inventory) is completed. It gives us (OT, PT, and some with ST) a pretty good idea of where we are at functionally at time of the evaluation, and we also use it as an outcome tool to see how they progress in these areas during treatment. It's also really nice for functional goal writing as well. It goes over things like fasteners, opening snacks, jumping on one foot, etc.
-If they're younger (birth-5) or will have difficulty completing higher level tasks, I'll usually complete the Peabody (Developmental Motor Scales). I think that the Peabody is a bit hard to follow as it jumps around a bit, but it gets easier as you get more experience. If they are older than 5 but can't do something like the BOT, I will sometimes do Peabody tasks to at least get an age equivalence for insurance companies. The Peabody includes everything from reflexes in babies to holding a marker and lacing beads.
-For school aged kids (4-21), I usually complete the BOT-2 (Bruininks-Oseretsky Test of Motor Proficiency, Second Edition). I really like this assessment and it's fairly easy to administer. Everything comes in one bag and it's easy to keep it all together. Scoring isn't bad either. I also complete the Beery VMI (test of Visual Motor Integration) often with kids that are able to use a pencil. It's for ages 2-100, includes 3 parts, and is easy to administer. Hard for kids that have a hard time with sustained attention though.
-If they have sensory needs, I will go over one or two of the following with the parents: the Sensory Profile (short or caregiver), TABS (Temperament and Atypical Behavior Scale for kids 11-71 months), or the BRIEF (Behavior Rating Inventory of Executive Function, 5-18 years).

We usually do multiple assessments in an evaluation which is typically and hour. The PEDI is always completed, and we'll pair together the BOT-2 and the VMI or the Peabody and TABS. Often, if there are sensory based concerns, we also complete additional sensory based assessments that were listed as well. It's nice to get a broad view of who the client is -- both their strengths and weaknesses. Time constraints are the worst in evals, so we always encourage them to come early to get some of the admission paperwork finished before the appointment. I like to at least have some small talk with them before I drag out all of my tests, but will do things like offer them a piece of gum (much better concentration in many kids), or have some quick fun breaks between tests to jump, play on a ball, etc. Afterward, I like to give them a tour so they can be excited to hang out in the super fun gym the next time they come instead of sit in a room and do 'homework'. :)

Most insurance companies require 1-2 assessments, and usually require that children are a certain number of standard deviations (SD) from the mean in at least 2 areas to give approval for therapy. Some insurance companies require them to be 1 SD away, but many require 2 SD away from the mean. Ha, I wasn't sure I'd ever reuse my stats knowledge after I graduated, so I guess I got Punk'd!! If they're long-term kids, insurance companies require that you complete the assessments every 3-6 months to see how they are progressing.

Anyway, that's enough for now as I'm sure I'm totally boring you. :) I'll have to do another one with adult assessments. Hopefully this was helpful!


Luna said...

not boring at all!...I'm an first year OT student....I still don't know all of the assesment you mentioned but it was nice to know how they are used in the practice.

leehuck said...

A career as an occupational therapy assistant will offer you a great number of benefits, rewards and other positive factors. From one person to the next, every individual may have a different reason for getting started down this path, or for why they love it as much as they do.

Lee Huck @ Occupational therapist schools