Foundations of Practice

Occupational Therapy Practice in Pediatrics

Assessment Strategies

Assessment Tools

Service Models & Intervention Strategies

Practice Settings


Contribution to the Interdisciplinary Process

Training and Certification


Credits and Acknowledgements

Last updated: 15-oct-12

Assessment Strategies

Occupational performance is influenced by the dynamic relationship of person, occupation and environment. The occupational therapist must consider all aspects of this relationship when performing an assessment.

Relationship of person, occupation and environment.

The occupational therapist assesses and considers factors within the child, the environment, and occupation to determine what changes or adaptations are needed in any of these arenas to improve the desired occupational performance and success.

The following case example illustrates the strategies and process of an occupational therapy assessment. Keep in mind that the assessment process is very dynamic and interactive. Although it is diagramed below as a linear process, the assessment actually is the culmination of multiple interweaving actions.

Case Example:

Patrick is 10 years old and is the third grade. He is diagnosed with ADHD. Patrick has difficulty staying in his seat at school during academic work, he is easily distracted by movement and sounds in the classroom, and he is disorganized in his strategies to complete self-directed academic assignments. Patrick’s desk is messy and his handwriting is poor for his age. Patrick’s family has requested that their son be evaluated by the school occupational therapist, psychologist, and behavioral consultant for the purpose of improving Patrick’s performance and learning in school. The occupational therapist takes the following steps to assure a thorough assessment.


Occupational Profile
The occupational therapist interviews Patrick and his parents on separate occasions. A review of school and medical records is completed. The therapist learns:

  • Patrick would like to stop losing his classroom privileges (field trips and recess), a consequence of repeated disruptive behaviors in the classroom
  • Patrick’s mother and father want their son to remain in the regular classroom and develop more legible handwriting
  • Pertinent information about Patrick’s academic and behavioral record in school
Analysis of Occupational Performance
  Assessment of Context
The occupational therapist observes Patrick in several settings at school – classroom, recess and lunch room. Careful attention is given to the physical and sensory aspects of the classroom, interactions between the teacher and Patrick, and Patrick’s social interactions with peers.
  Assessment of Performance Skills & Client Factors
The occupational therapist administers standardized evaluations to assess Patrick’s fine motor skills, handwriting, visual-motor skills, sensory processing, and sequencing/organization skills. Some of the tests are completed in a testing room, other evaluations are conducted in the natural school environment.
Teaming with Patrick’s parents, classroom teacher, psychologist, behavioral consultant and occupational therapist to determine the intervention plan

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