Parents often wonder what’s involved in an occupational therapy assessment? This really varies amongst Occupational Therapists based on our experience and interests, what the parents want  the child’s individual needs.  In my practice, this is how it generally goes.
PHONE CALL:
Initially, parents call and we have a phone conversation where they tell me about their child, their concerns and reason for an occupational therapy assessment. I prefer to talk about any sensitive topics during this time versus discuss in front of children, particularly older kids. We then determine whether or not an assessment is necessary.
INFORMATION AND DATA COLLECTION:
Next, I send parents information regarding scheduling, what the assessment entails, and any questionnaires to complete. For children who are in school or have other therapists and support team members, I attempt to get as much baseline information I can prior to the assessment such as:
Birth history and medical history
Report cards
Drawings or handwriting samples
Photos of younger children in various positions to give me an idea of their motor skills
Reports from other therapists including educational psychologists, consultants, and speech therapists.
Completed questionnaires or sensory profiles by parents and school.
ASSESSMENT:
The actual assessment varies based on each child and their needs. No two children are alike.
For the first part of the assessment, I usually chat with the child and parent to get to know each other. During this time, the child often explores the clinic and engages in free play while I make initial observations of how they move, interact, and play. For older children, I ask about their hobbies and interests, how they find school, and what they’d like to do. Both parents and children are involved in this discussion as appropriate.
We then complete formal and informal tasks (standardized testing and clinical observations) to assess the following as it applies to the child:
-*****Child’s STRENGTHS.  This is so important as we will want to continue and encourage these in the child and also, use this to build on areas that need help. We are not trying to change the child but want to embrace them for who they are.
-Sensory processing: tactile processing, body and spatial awareness, balance, motor planning, organizational skills, does the child avoid or seek sensory inputs, how do they play with and figure out new toys
-Gross motor skills (head control, trunk control, body alignment, core strength, movement patterns)
-Shoulder and pelvic girdle stability, joint stability, upper and lower extremity strength and coordination, endurance
-Postural control, bilateral integration, rhythm / timing / coordination of movements
-Fine motor skills (reach, grasp, release, object manipulation, in-hand manipulation, 2-handed use, hand preference / dominance), eye-hand coordination
-Self-help and self-care skills
-Visual motor and perceptual skills, visual processing (eye tracking, motility, convergence / divergence, how both eyes are working together)
-Auditory processing, following directions, attention and focus
-Sensory regulation, how the child transitions, manages multi sensory input, copes with daily challenges and demands, attends and focuses during self- and adult directed tasks.
-Social skills – how the child initiates interactions, joint play / reciprocal interactions, recognizes their own feelings and how to manage them
-Organizational skills and executive functions for child’s age
-Consider adaptations, strategies, sensory supports for home or school
-Provide ideas of useful and meaningful sports, extra curricular activities and games are provided according to the child’s individual needs
Throughout the assessment, parents are involved and present. I provide suggestions of exercises and activities to try at home. We will try some exercises and activities together.
Summary and recommendations: Towards the end, we review findings of the assessment, prioritize concerns of parent and child, discuss home exercises, and come up with a plan of what to do and how to work together with the child’s home and school team.
Based upon the child and parents, the initial assessment can take from 1-2 hours.
