OTA role in assessments

Should OTA's be allowed to perform an assessment? As a professional, both OTs and OTAs are ALWAYS "assessing" their clients. We will be assessing our clients each and every session, for progress, decline and all factors influencing their performance.

In terms of a formal assessment, I think that OTAs are and should be allowed to do them, only after establishing competency in that area. As a student, I feel confident in the assessments I have learned, and feel that I should be allowed to use my knowledge in these areas just as an OT would. As an OTA, we are still under the "legal" responsibility of our supervising OT, so it is both the OT and OTAs responsibility to make sure competency is established. It is important to remember that there is a huge difference between assessing someone, and doing an evaluation.

OTA's Role in Pediatric Assessments

According to AOTA.org, "An OT initiates and directs the screening, evaluation, and re-evaluation process and analyzes and interprets the data . . . An OTA contributes to the screening, evaluation, and re-evaluation process by implementing delegated assessments and by providing verbal and written reports of observations and client capacities to the OT . . . "

My interpretation of these guidelines is that the assessment process is intended to be highly collaborative between the OT and OTA. I would imagine that if there is good rapport between these 2 clinicians, this is a mutually beneficial relationship because the workload is dispersed. However, if there is some level of dysfunction in the OT/OTA relationship, the OT may not delegate as much as much of the assessment process to the OTA. This lack of delegation could stem from the OT's lack of confidence in the OTA's abilities and dependability. If the OT feels this way, other action should be taken in order to bring the OTA up to the level at which they need to be in order to contribute. If the OTA has proven themselves to be competent and dependable, the OT would not be performing at the most efficient level possible in not delegating assessment tasks. At that point, the OTA should respectfully and constructively convey to their OT how much of an asset they would be to the assessment process.

According to ncbot.org, "The OT must initiate the evaluation. In OT practice, the term initiate is understood to mean making the first, in person, face-to-face contact with the client. After the initial contact with the client by the OT, the OTA may implement specifically delegated assessments for which service competency has been established, demonstrated, and documented. The OT is then responsible for completing the evaluation, interpreting the information provided by the OTA who completed the assessments, establishing intervention priorities, and developing the intervention plan."

It is clearly in the best interest of students in the school systems to have OT's/OTA's take full advantage of the collaborative approach to assessments afforded them by their professional guidelines. The more clinicians working together, the greater number of children will be helped in a shorter amount of time. Clinicians need to work through whatever issues may be interfering with providing the most efficient services to these children.

Getting Your Competency Up to Par!!

Everyday when a COTA is working they make decisions about how to adjust their patients care. Whether they are being challenged enough, or if the activities presented are too difficult for their current level. So, if as a COTA we are allowed to make adjustments during the treatment session why would we not be allowed to be involved in the assessment process?

Some OTs believe that COTAs should not be able to do assessments. Some think that it would take away from their jobs, while others think that COTAs don't have enough training, or the clinical reasoning skills adequate to give tests of this nature. Yes, the treatment program is put into motion considering all of the testing. Which raises another question. Would it not be better if the person implementing therapy be the one to give the assessments they are based from. Therapy would be more focused, and less time spent in communication & debate over the results of the test between the OT and OTAS. I am not saying that OTs don't need to check in and make sure everything is accurately working for the patient & COTA, but rather more people would have more client focused therapy, which could only be more beneficial.

Now, you also have to consider the experience and competence of the COTA giving the tests. All employees at a facility should be checking in with each other regularly to make sure their tests & results are proving accurate and equal to one another. If there is a problem with a COTA's skills not being up to par enough to give assessments, then perhaps that individual should take some continuing education classes to improve their knowledge and skills before assessing clients. But, if like the school I attended COTAs are being trained well enough, and have the knowledge and skill base, they should not be held back from helping to perform assessments for patients after service competency has been proven. After all, this will only give OTs more time to treat more people, and allow for more therapy planning so every patient's therapy is more client centered.

If, as a COTA you are wondering if your skills are up to par, check out this self assessment tool manual put out by the NBCOT, and the different specialty practice area resources.

Assessments: Should COTAs do them?

The question this week is "Should COTAs be allowed to do assessments especially in the pediatric setting?" According to the NCBOT Practice Act & Rules (Section .0905 Delineation of Clinical Responsibilities) and the AOTA's Standards of Practice (Standard II: Screening, Evaluation and Re-Evaluation), both documents state that OTAs contribute to the evaluation process by performing delegated assessments in which service competency has been established. So legally we CAN perform assessments but SHOULD we? If we are talking about standardized assessments, there is no reason we should not be allowed to perform them in any setting, including pediatrics. The whole design of a standardized test is to have specific protocols of administration and scoring to gather the most objective data possible. As such, it is training and experience that produces expertise in administrating a standardized assessment and not the level of education of the administrator. Pros and Cons of Tools for Doing Assessments lists various methods of assessments in the school setting, standardized assessments are one way OTAs can help gather information on a child. The direct observation in the classroom is another method that needs more skill and interpretation but that is not to say that OTAs cannot contribute in this area also, given experience and a sound collaborative relationship with the supervising OT. As with any area of practice, it is not so much whether or not an OTA SHOULD do something or not in all instances but rather in any practice setting, has service competency been established and is there proper supervision.

OTA and Assessments?

The question posed to us this week was...Should OTA's be able to give assessments? As an OTAS, I would have to agree that COTA's should be able to administer assessments. I believe our teachers have strived to teach us an array of assessments that we may use in our professional field of choice As students, we have practiced and passed competencies on several of assessments,such as ROM,MMT and The FIM.
As we go from students to professionals, we will need to successfully complete competencies from our supervisors before being allowed to run assessments. Only having OT's to administer assesssments would have far reaching consequences.SNF's and school budgets would be over loaded from hiring OT's, whose salaries are much higher then a OTA and the clients would have a much longer wait to be evaluated.