Definition of Evaluation
評估-用以了解一個人的情況
Occupational Therapy
Evaluation in Pediatrics
2009/11/17
大三 職能治療評估學
Occupational Therapy
Evaluation in Pediatrics
• The evaluation process is one of the
most fundamental aspects of
occupational therapy services.
• Occupational therapists evaluate
children and their environments to
gather information helpful in making
decisions about intervention services.
要多收集治療室以外的資訊-如學校、家庭
• The process of obtaining and
interpreting data necessary for
understanding the individual, system,
or situation (AOTA, 1998).
美國職能治療師協會
SID-sensory intergrate disorder 感覺統合問題
assessment:specific tools,instruments,test,interaction
that used during evaluation process
評估時所用的工具及方法
除refer來的資訊，用更全面的評估工具找出問題點
Evaluation Purposes (I)
• To decide whether the child should
be further evaluated using more
comprehensive assessments
DCD-動作協調困難
• To decide whether the child is
eligible for occupational therapy
services 評估小朋友需不需要做OT
• To assist in the diagnostic process
早期療育-團隊有小兒醫師 OT SP PT社工
1
 設立目標
Evaluation Purposes (II)
再評估的過程-以評 • To develop an intervention plan 介入計畫
估接受治療，再去 • To evaluate the child’s progress in therapy
看他有沒有進步 and determine whether further therapy is
warranted
• To research the efficacy of intervention
services and clinical outcomes or to
describe patterns of development and
functional changes in children with specific
diagnoses 偏研究-看某個介入有無效果
,挑選評估工具,看信度效度
如同量尺一般
Conceptual Framework for
重要 OT Pediatric Evaluation
• Developing an occupational profile of the
child 建立職能檔案(包涵過去到現在)
Ø base on referral concerns, interviews with了解家人的concern,
caregivers and the child (if possible)
和小孩、家人會談
Ø direct observations of the child ex.了解作息.喜好等
performing self-care, play, and school-
related activities
此為學校OT系統較可能,醫院OT太忙

• Analyzing the child’s occupational ■ Performance in Areas of Occupation

performance 例如ADL,IADL,BADL,play,work - Activities of Daily Living (ADL)*

- Instrumental Activities of Daily Living (IADL)
Ø performance skills
- Education/Work/Play/Leisure/Social Participation
Ø performance habits
Ø contexts * Also referred to as basic activities of daily living
Ø activity demands (BADL) or personal activities of daily living (PADL).

Ø Client factors

2
 了解他ADL的作息-分析performance
■ Performance Skills
■ Context
- Motor Skills
- Cultural / Physical / Social / Personal
- Process Skills
/ Spiritual / Temporal / Virtual
- Communication/Interaction Skills
■ Client Factors
■ Performance Patterns
- Body Functions
- Habits
- Body Structures
- Routines
- Roles 探討此人平常的生活..寫故事一樣
ex.8點在衝三小...

ex.躲避球..抓不到timing..被打
重要
■ Activity Demands
- Objects Used and Their Properties
- Space Demands
- Social Demands
- Sequencing and Timing
- Required Actions
- Required Body Functions
- Required Body Structures
• Wendy Coster (1998):
Ø A top-down approach to evaluation
- Find out what the child wants and needs to
do, then identifies those factors that act
as supports or barriers to the child’s
participation in those childhood
occupations. 找出他想要什麼.需要什麼.ex.他也想打球
Ø Occupation-centered assessments:
evaluate the “overall process of
participation”
評估哪些活動做不好.評估參與度...而不是小地方看
例如SFA-school function assesment
給老師填的問卷

3
 觀察人際互動 粗大
Screening 都是screening篩選工具 動作
• Primary purpose: to determine whether age:1m~6y
Ø First level (type I): children’s general health,
children warrant further, more growth, and development are checked.
comprehensive evaluation 看有無問題.refer給PT.ST EX: time:20mins
• OT may participate in two levels of • Bayley Scales of Infant Development (Second
Edition)
screening:
‚ First STEP: Screening Test for Evaluating age:2y9m到6y2m使用
Ø First level (type I): basic screening 較屬於身體檢查 Preschoolers 目前少用 時間.15分鐘 偏認知語言
Ø Second level (type II): OT usually ƒ Denver Developmental Screening Test (Revised)
involved (Denver-II) 目前少用
Miller assessment of preschooler(MAP)
age:2y9m~5y8m
eva:1.motor sensory abilities
2.cognitive abi.
3.combined
time:30~40mins

生態評估 ex.SFA//
已經有醫師老師覺得小孩怪怪的refer給你 Comprehensive 屬occupation center
Evaluation assesment
考量目前所處環境如何
ØSecond level (type II): • Methods
Ø Standardized Assessments 標準化評估工具
usually occurs after the child has -Norm-Referenced Tests
been identified by a health or -Criterion-referenced Tests
Ø Ecologic Assessments
educational professional as begin Ø Skilled Observations直接觀察再學校的情況.ex.給老師填分數分級
at risk for development or Ø Interviews 跟家長老師作會談/
functional deficits. Ø Inventories and Scales canadian occupational
沒時間作完整的evaluation PEDI,pediatric evaluation of performance measure,
可用short form短版評估工具...ex.BOT2 disability inventory 兒童日常功能量表 COPM
age:6m-7y6m評量disability,障礙程度有無改善

4
 ex.以一個專業人員為主,其他專業
再旁觀察.偶爾評估,訪問家長 重要必考
重要必考
Ø Arena Assessments • Purposes
跨專業的評估 Ø Eligibility purposes
- use a transdisciplinary approach that
allows the child and primary caregiver to -Use standardized, norm-referenced常模參照測驗
interact with one professional throughout measures; Consider cultural validity考量文化層面,ex.用中文版的工具
the evaluation session while other Ø Diagnostic purposes
professionals observe and, on occasion, -Combine norm-referenced tools,
directly test the child or interview the caregiver interviews, and skilled
caregiver. observations.
結合質的資訊,而不只是常模量的資訊
和家長老師會談(量質結合兼顧)

評估治療後是否有進步
Ø Intervention Planning Purposes Ø Reevaluation purposes
-Often use criterion-referenced and
curriculum-based measures 校標參照
知道有無進步，再評估一次
-Observations of the child’s performance Ø Clinical Research
within natural environment 直接觀察 - evidence-based occupational therapy
-Interview with parents and other adults
working with the child 問家屬 (EBOT)
-Goals needed to be function 實證職能治療-作的要有依據,為何這樣作

5
 Evaluation Process (I)
• Referral
• Development of the Child’s
Occupational Profile
• Administration of Evaluation
• Analysis of the child’s Occupational
Performance
Evaluation Process (III)
• Documentation of Evaluation Results
and Recommendations
- Describe the child’s current
abilities and limitations on functional
tasks
- Use “positive and supportive” words when
documenting a child’s evaluation results
Evaluation Process (II)
• Development of Recommendations
Based on Evaluation Results
Consider:
(1) functionality of the recommendations
(2) priorities of the child and family
(3) type of service delivery model
Use of Standardized Tests
in Pediatric Practice
• Definition of Standardized Tests
A test that has been standardized
has uniform procedures for
administration and scoring
(Anastasi & Urbina, 1997)
6
 Characteristics of Types of Standardized
Standardized Tests Tests
• Have a test manual • Norm-referenced tests
• Composed of a fixed number of items
• A fixed protocol for administration
• A fixed guideline for scoring • Criterion-referenced tests

Becoming a Competent Others about

Test User Standardized Testing
• Choosing the appropriate test • Ethical consideration in standardized
• Learning the test testing
• Checking inter-rater reliability
• Selecting and preparing the optimal
testing environment • Advantages and disadvantages of
• Administering test items standardized testing
• Evaluating the clinical usefulness of the
test

7
 Major Pediatric Assessments
Learned in This Semester
• Peabody Developmental Motor Scales (2nd
Edition) (PDMS-2)
• Bruiniks-Oseretsky Test of Motor
Proficiency (2nd Edition) (BOTMP-2)
• Movement Assessment Battery for
Children (2nd Edition) (MABC-2)
• Developmental Test of Visual-Motor
Integration (VMI)
References
• Stewart, K. B. (2005). Purposes, processes,
and methods of evaluation. In J. Case-
Smith (Ed.), Occupational therapy for
children (pp.218-245). St. Louis, Mosby.
• Richardson, P. K. (2005). Use of
standardized tests in pediatric practice.
In J. Case-Smith (Ed.), Occupational therapy
for children (pp.246-275). St. Louis, Mosby.

共4個評估工具
Syllabus
11/17 小兒評估導論
11/24 PDMS-2 (lecture)
12/1 PDMS-2 (practice) 2人一組
12/8 Movement ABC-2 (lecture)
12/15 Movement ABC-2 (practice) 關於兒童動作的評估
12/22 BOT-2 (lecture)
12/29 BOT-2 (practice)
1/5 VMI (lecture & practice) 視動整合的評量
1/12 期末考

筆試可參考國考題XD