OTA Assessments?

Should OTAs be doing assessments in Peds?

Recently we had the opportunity to do a standardized assessment on a child at our FW assignment. I learned a lot from doing it, and now that I have finished all the paperwork and can take a step back from it all, these are my overall thoughts.

I think that having standardized test is a great idea, the same exact activities, done in the same way, scored the same etc. It is not that hard for an OTA to learn and perform this test just as an OT would, and do a competent job with reliable results. I can see that in a real job, an OTA could establish competency quickly and easily. The glitch to me, came in when it came time to interpret the results. I think a lot of us had a hard time accepting the results of our tests and the implications of these scores. We looked at the numbers, the percentiles and established in black and white what percentile our student fell into, but I think each of us quickly realized that it was not all just that easy. Numbers don’t tell the whole story. For example, how do you factor in the fact that a child could easily have completed an activity for a perfect score, but just refused to do so and got a 0 because really, she was just having a bad day and didn’t “feel” like doing that activity. On paper it looks like she was lacking that skill and in interpreting that result, we would tend to analyze that skill category and name her deficit, but in actuality, to be fair, we would have to try to document a bad day, what category is that?

A lot of us had questions like that and as we discussed things like this randomly, I realized that this kind of depth of knowledge and understanding was not just a matter of experience, that maybe this had a bit to do with the level of learning and training that separates an OTA from an OT.

I love the idea of competency, it means “I can handle this, I have the skill and intelligence to deal with this situation”, but as I have learned from past professional experience, going out and really trying to do what you have learned teaches you how much you don’t know (yet). When it comes to interpreting results, it’s not just a matter of stating facts, it’s a matter of using both what we learned in class and what we have experienced in practice. Realistically there is a pretty big difference between what we have learned in 1.5 years and what an OT with 6 years and maybe many years of practice, knows and understands.

We have learned that professionally we are allowed to perform assessment tests if we have established service competency, but we have to allow the OT that supervises us and therefore our clients to interpret the results of this assessment. I think that is logical, practical and fair for our clients. As I gain knowledge I may feel comfortable making suggestions to my supervisor but in the meantime I respect my level of ability.

The following link explains this scope of practice, particularly under the heading "Supervision and the Collaborative Process - Scope of practice." http://www.aota.org/Practitioners/Ethics/Advisory/OTOTA.aspx