Occupational Therapy Assessments

Occupational Therapy Assessments

This blog entry will cover adult occupational therapy assessments including: The COPM, Berg Balance Scale, MoCA, the Kettle Test, Nine-hole peg test, ACLS, FIM and AMPS.

Selecting Occupational Therapy Assessments for Adults

The practice setting and context of occupational therapy for adults varies widely. From geriatrics to physical disabilities, and acute rehabilitation to mental health, client needs, occupational profile, goals, and length of stay will vary greatly. As will the occupational therapy assessments you select. Some settings will call for a very complex evaluation with multiple assessments, while others may only allow for a 15 minute informal screen. Below are selected occupational therapy assessments and tools that can be used with a diverse range of clients.

Canadian Occupational Performance Measure (COPM)

The COPM is sometimes described as an ‘objective-subjective’ test. This may sound like a contradiction but the tool actually quantifies subjective measures. Here is how it works: The client identifies what they consider to be ‘problem’ areas in their daily lives. The client then rates their performance on a scale of 1-10 and their satisfaction with their performance the same scale. This provides excellent information about the client’s priorities and is a great tool for collaborative goal planning. As a bonus, the COPM is inexpensive and comes in both paper and digital formats.

Berg Balance Scale

The Berg Balance Scale is another occupational therapy assessment tool designed to provide objective measures to quantify the ability of a client to balance in a variety of scenarios. It is a quick assessment and only requires a few materials: Two chairs (with and without armrests); a stopwatch; a step; a ruler; and a clear area 15ft long. Items the therapist will observe and rank include transfers, picking up an item from the floor, and reaching forward. The scale is easy to score and contains a cut-off score in which clients are at risk of falling. The Borg Balance Scale may also inform the therapist of other performance areas to address.

Montreal Cognitive Assessment (MoCA)

The MoCA is a cognitive screen that takes only about 15 minutes to administer. In that 15 minutes, you will learn about your client’s short term memory, working memory, attention and concentration, executive functioning, visuospatial abilities, and orientation to time and place. Not only is the paper screen easy to both administer and score, but now there is a MoCA application with automatic scoring. This assessment is an excellent choice for teletherapy evaluations as well.

The Kettle Test

The Kettle Test is unique in that it is a free performance-based test. However, some materials are required, including an electric kettle, kitchenware, ingredients to make coffee and tea, and distractor items. Depending on your client, it will take 10-30 minutes to administer. When the task is broken down, there are 13 points of measurement that are scored on a 4-point scale based on their performance. For example “client turns on the kettle” or “client indicates that they are finished” could be scored high (performed independently) or low (needed physical demonstration or assistance). A nice benefit of the Kettle Test is that it is both functional and honors client choice (the client selects which hot beverage they would like to make).

Nine-Hole Peg Test

The nine-hole peg test is a timed activity that assesses fine motor dexterity. The materials consist only of nine pegs, a peg-holder, and a stopwatch. After a demonstration the client is instructed to use one hand to fill the holes with pegs and then take them out. It only takes a few minutes to teach and administer the test and is generally done on both left and right sides. The therapist uses the time to compare to a list of norms. This assessment is often used for clients with brain injury, Parkinson’s, spinal cord injuries or other neurological diagnoses.