OYH Assessment Manual

OCCUPATIONAL
THERAPY
ASSESSMENT
MANUAL
Acknowledgements
We would like to extend our thanks to Orygen Youth Health, especially Sonya
Vargas and Gina Woodhead, for supporting and guiding this project, as well
as contributing their time, expertise, and invaluable knowledge and resources
that helped shape this Assessment Manual.
In addition, thanks is given to the occupational therapy staff at Orygen Youth
Health, Barwon Health, Latrobe Regional Hospital, Alfred Health and Monash
Health for their contributions both in person and via phone/email
correspondence, to aid our understanding of the assessment process in
adolescent mental health. We value their contribution towards the project
objectives, and we thank them sincerely for sharing their time, suggestions
and knowledge with us.
Without the assistance of the aforementioned people, the success of the
Assessment Manual would not have been possible.
Antigone Koutoulas, Elizabeth Pattison and Joshua Woollard
La Trobe University Masters of Occupational Therapy Students
Contents Page:
INITIAL ASSESSMENT
Occupational Performance History Interview
Model of Human Occupation Screening Tool (MOHOST)
Occupational Circumstances Interview and Rating Scale (OCAIRS)
4
5
7
9
INDEPENDENT LIVING SKILLS AND FUNCTIONAL ASSESSMENT

Assessment of Motor and Process Skills (AMPS)
Assessment of Occupational Functioning
11
12
13
COMMUNITY AND DOMESTIC ACTIVITES OF DAILY LIVING

Domestic and Community Skills Assessment- Revised Addition
Orygen Youth Health Modified DACSA Interview Assessment
Cooking Assessment Summary
14
15
17
19
SENSORY MODULATION
Adult / Adolescent Sensory Profile
NWMH Sensory Safety Tool
20
21
23
SOCIAL SKILLS
Evaluation of Social Interaction
Assessment of Communication and Interaction Skills
24
25
26
INTERESTS, LEISURE AND GOAL SETTING

Modified Interest Checklist
Adolescent Leisure Interest Profile
Canadian Occupational Performance Measure (COPM)
Volitional Questionnaire
28
29
30
31
33
HABITS, ROLES AND ROUTINES

Role Checklist
Occupational Self Assessment
Routine Task Inventory
34
35
37
39
SCHOOL/ VOCATION ASSESSMENT

School Setting Interview
Worker Role Interview
41
42
44
REFERENCES

46
INITIAL
ASSESSMENT
Occupational Performance History Interview II (OPHI II)

Assessment Overview: The OPHI II is informed by the Model of Human
Occupation (MOHO) and involves the use of a semi-structured interview
approach to help an Occupational Therapist understand their client as an
occupational being.
Key areas of this Assessment:
The OPHI II is a three-part assessment that includes:
A semi-structured interview that explores a clients occupational life
history.
The OPHI II manual provides a set of interview questions, which
are organised into five different areas:
o Occupational Roles
o Daily Routine
o Occupational Behaviour Settings
o Activity/Occupational Choices
o Critical Life Events
Rating scales which provide measures of a clients occupational
identity, occupational competence and the impact of their occupational
settings/occupational environment.
A life history narrative which is designed to identify and discuss all
prominent features of their occupational life history.
This assessment is appropriate for use with people from adolescence through
to older adulthood, which means it is appropriate for use within the youth
population. The main consideration when using this assessment is whether or
not the young person is able to meaningfully and effectively engage in a
history-taking interview. Mental Illness symptoms or medication side effects
may affect their ability to participate.
When should it be used?
This assessment can be used as a guide for an initial consultation with a
client in order to gain an understanding of the client as an occupational being.
It covers all aspects of a clients life and allows a client to express what is
important to them in their lives. This interview also allows an Occupational
Therapist to identify the interaction between the person, environment and
occupational.
How to Administer/Scoring:
Firstly, the therapist conducts the semi-structured interview using the

interview questions provided as a guide. Once all of the relevant sections of
the interview have been conducted the therapist scores the three rating scales
based on the information gathered. The therapist rates each of the items on a
four point rating scale which indicates the clients level of occupational
adaptation and environmental impact. The therapist selects the rating (1, 2, 3
or 4) that corresponds most accurately to the criteria outlined for each item for
that client. These scales create a profile of the clients strengths and
challenges related to occupational identity, competence and environmental
impact. This profile is used in developing an intervention plan for the client.
Following the completion of the scales the life history narrative form (provided
in the manual) is completed. This involves plotting the clients life story in both
written and graphic form.
This is a fairly lengthy assessment, however each part can be done at a
separate time and the interview itself can be conducted in stages or sections if
the client struggles to engage and concentrate.
Is Training Required?
No training is required. A detailed manual is used to educate the therapist on
how to administer the assessment. The manual provides guidelines on how to
conduct the interview, as well as detailed instructions for completing the rating
scales and life story.
Length of Assessment (Average Duration):
The Interview part of the assessment takes approximately 45 to 60 minutes,
however the interview process can be broken up into parts. The three rating
scales consist of 29 items which can take 10-15 minutes to complete.
Benefits/Strengths:
The OPHI-II gives a therapist a great overall understanding of the client
as an occupational being.
This assessment can be broken up into smaller parts if a client
struggles to engage.
Evidence supporting the Assessment
The OPHI-II has been developed over the past 25 years. The OPHI-II has
been found to have a good level of inter-rater and test-retest reliability, as well
as construct and predictive validity. An international study of the OPHI-II found
evidence supporting the internal consistency and the construct validity of the
assessment. Studies have shown that the OPHI-II has been beneficial with
the adolescent population across a number of different settings.
The OPHI-II is available through the MOHO clearing House. If you would
like to use it in practice, please go to the following website. Please be
aware that it is $40 to purchase.
http://www.cade.uic.edu/moho/products.aspx
THE MODEL OF HUMAN OCCUPATION SCREENING TOOL (MOHOST)

Assessment Overview:
The Model of Human Occupation Screening Tool (MOHOST) is an
assessment which is used to gain an understanding of a clients strengths.
The screening tool emphasises the impact that MOHO concepts such as
volition, habituation, skills and the environment can have on occupational
performance and participation.
Key Areas of Assessment:
The MOHOST is made up of 24 items representing MOHO areas such as
volition, habituation, skills and the environment. Each item has its own four
point rating scale, and the criteria for these rating scales are shown for each
item.
This assessment should be used to gather information about a client when
screening referrals, determining the need for future assessment or developing
an intervention plan for that client. This assessment can be used to gain an
understanding of the factors that can impact upon a clients occupational
performance and participation.
The information required to fill in this assessment is often gained through
observation, however information can also be gathered through conversation
with clients, their relatives, or a carer. Information can also be gathered from
medical records or files. The MOHOST is designed so that the therapist
conducting the assessment can gain information through the most practical
means. The therapist scores each of the 24 items in the MOHOST on a four
point scale. Criteria for each rating are specified for each item, which makes
the process of filling out the form more straightforward for the therapist.
Ratings are recorded on the summary forms which are provided with the
assessment.
No training is required to conduct this assessment; however it is important to

be familiar with the assessment items and process before administering it.
The duration of the MOHOST is dependent upon the means of information
gathering. It may take a therapist a number of sessions to develop an
understanding of all items included in the assessment.
Benefits/Strengths:
The MOHOST can be used for screening referrals, identifying the need
for future assessment and planning future intervention.
Easy to administer and can be used as an outcome measure.
This assessment can be used with a wide range of clients including
those with psychosocial and/or physical impairments.
Research has shown that the MOHOST items and rating scales are able to
distinguish between patients who have differing levels of occupational
participation. The MOHOST has also been proven to be used in a valid
manner across a number of different settings such as in the community,
forensic mental health and acute mental health settings. Further research is
needed into the psychometric properties of this assessment; however the
assessment is currently used in other services.
The MOHOST is available through the MOHO clearing House. If you
would like to use it in practice, please go to the following website.
Please be aware that it is $40 to purchase.
OCCUPATIONAL CIRCUMSTANCES INTERVIEW AND RATING SCALE

(OCAIRS)
The OCAIRS assessment uses a semi-structure interview and rating scales to
gather information about a clients life and their occupational performance and
participation. The OCAIRS assessment has been designed so that it is
relevant to both adolescent and adult clients who may be from a wide range of
backgrounds.
The OCAIRS provides three different semi-structured interviews which are
targeted at different population groups. These population groups are physical
rehabilitation, mental health and forensic mental health. The appropriate semistructured interview is conducted and the information is used to rate clients on
12 different items using a four point rating scale.
The OCAIRS, like the OPHI-II, is used to identify and gain an understanding
of the factors that are impacting upon a clients occupational performance and
participation. It can also be used to allow the therapist to gain a greater
understanding of the clients current circumstances if these are not yet known
or are unclear.
The OCAIRS assessment manual has detailed information with regards to
completing the interview as well as how to complete the scales. The semistructured interview has been developed so that it can be tailored to each
client. After the interview has been conducted using the interview guide, the
therapist completes the rating scales for the 12 items. Each item is rated
according to how it facilitates, allows, inhibits or restricts occupational

participation. Each of the ratings has descriptive statements which help the
therapist to make a decision about the rating. Following the completion of both
parts of the assessment, the therapist can fill out an OCAIRS summary form
which will determine the need for intervention.
No training is required to administer this assessment; however it is important
for the therapist to have an understanding of the assessment and its purpose,
and to use the assessment manual.
With practice the OCAIRS interview can be completed in approximately 20-30
minutes. Obviously this depends on the level of engagement of the client, as
well as the therapists familiarity with the assessment. The rating scales then
take a further 5-15 minutes to complete.
Benefits/Strengths:
Once a therapist is familiar with the assessment it does not take long to
complete.
It is suitable for use with clients from different backgrounds and clients
with a variety of impairments.
The descriptors for each rating save time for the therapist and allow
more time to reflect on what is next for the client.
The OCAIRS can be administered simultaneously with assessments
like the Worker Role Interview and the MOHOST.
Research has established that the OCAIRS has good inter-rater reliability, as
well as internal, construct and person response validity. The OCAIRS is
internationally recognised as being a cross-cultural assessment of
occupational functioning, meaning it is a useful assessment for young people
from a variety of backgrounds. OCAIRS scores have also been used to
establish whether a client is in need of occupational therapy services or not.
The OCAIRS is available through the MOHO clearing House. If you
would like to use it in practice, please go to the following website.
Please be aware that it is $40 to purchase.
10
INDEPENDENT
LIVING SKILLS
AND

11
FUNCTIONAL
ASSESSMENT
AMPS (ASSESSMENT OF MOTOR PROCESS SKILLS)
The AMPS is an assessment that considers both motor and process skills
directly affecting occupational performance by observing the client performing
selected ADLs, including PADLs, DADLs or IADLs.
When should it be used? Key areas of this Assessment:
The AMPS can help to determine a clients performance of motor and process
skills; specific to ADLs the client would usually participate in. The client is
asked to select three ADL tasks from a list of over 50. Motor and process
skills are scored using a four-point rating scale that considers the
effectiveness, efficiency and safety of the clients performance.
How to administer / Scoring:
The therapist is required to observe the client participating in the chosen
activities; therefore it is important either the client or the clients carer is aware
of that before testing begins
The AMPS is scored by a computer and identifies what parts of the activity the
client found difficult (i.e. skills) and how difficult a task is for the client to
perform.
There are 16 motor and 20 process skills items. AMPS scoring takes into
consideration how difficult the task is.
Training Required?

12
Training is required to complete the AMPS

Time to administer:
The AMPS takes approximately 30-60 minutes to administer
Strengths/Benefits:
The AMPS can be used for the adolescent population
Tasks are chosen by the client, therefore the assessment is client
centred
The computer program takes into account what activities are deemed
more difficult than others when scoring
Evidence supporting the Assessment (Reliability and Validity)
Evidence suggests that the AMPS demonstrates validity as a crosscultural measure.
Fisher (2003) documents inter-rater reliability as excellent (r=0.93).
Test-retest reliability to be r=0.88 for motor skills and r=0.86 for
process skills.
Excellent reliability and validity. Effective response rate, as the client
chooses tasks, therefore they are meaningful to them and their real life
situations
Specific Training is required to perform the AMPS; if you receive this
training you will be given the AMPS User Manual
ASSESSMENT OF OCCUPATIONAL FUNCTIONING (AOF)
The AOF is a screening tool used by clinicians to collect a range of
information believed to influence and be indicative of a persons occupational
performance, which is useful in identifying what areas require a more in depth
evaluation.
When should it be used? Key areas of Assessment:
The AOF should be administered when a client is capable of responding to an
interview. Based on responses the therapist will rate the client on core
components of MOHO - Volition, Habituation and Occupational Performance
Skills. This screening tool is based on MOHO and does not evaluate specific
ADLs or environmental variables, but more so creates a picture of numerous
complex interrelated factors that influence a persons ability to function.
How to administer/Scoring:
The AOF can be administered either by a therapist as a semi-structured
interview or self-report, with follow up from a therapist. Therapists are
encouraged to obtain clarification from the client if answers are ambiguous or
not clear.
The assessment comes with its own Rating Form, on which therapists rate
the clients Communication/Interaction Skills initially. Following this, the
13
therapist must use a 5-point scale to rate the client on the core components of
MOHO mentioned above, as each question answered relates specifically to
one of these components.
Training required?
No training is required to administer the AOF, but therapists administering this
assessment are encouraged to be familiar with the theoretical framework of
MOHO.
Time to administer:
The AOF takes approximately 20-30 minutes when administered as an
interview, or 12 minutes as a self-report tool with follow up.
Strengths/Benefits:
Screening tool that can highlight specific barriers in occupation and
guide the intervention process.
Results show both strengths and weaknesses of clients
If the clinician is time limited the assessment can be self-reported, and
therefore given as homework and discussed in the next session.
Evidence supporting the Assessment:
Content validity revealed that the instrument covered domains
adequately (Brollier, Watts, Bauer & Schmidt, 1989).
14
COMMUNITY AND
DOMESTIC ADL
ASSESSMENTS
DOMESTIC AND COMMUNITY SKILLS ASSESSMENT REVISED EDITION

2 (DACSA-R2)
The Domestic and Community Skills Assessment- Revised Edition 2 is a
comprehensive set of task-area assessments that are considered essential for
living in the community. This assessment is based on the Domestic and
Community Skills Assessment (Collister & Alexander, 1991), and has been
revised for individuals with a psychiatric illness.
The DACSA-R2 should be used when occupational therapists are assessing
an individuals capacity to live in the community. Furthermore, the DACSA-R2
enables occupational therapists to determine the level of assistance the
15
individual requires for tasks carried out in the home and wider community
settings.
Occupational therapists should use the DACSA-R2 when determining,
The most appropriate future accommodation for the client
Baseline functional abilities for domestic and community tasks
Level of community support required to assist the client to maintain
safe community living
Making recommendations to legal bodies (e.g. Guardianship and
Administration Board)
The Key Areas of this Assessment include:
Meal Planning
Grocery Shopping
Meal Preparation
Personal Presentation
Budgeting
Bill Paying
Banking
Laundry
House Cleaning
Telephone Use
Making and Keeping Appointments
Basic First Aid
Communication Services
Medication Management
How to administer/Scoring
When commencing the assessment, the occupational therapist uses the
DACSA Screening Assessment Tool to determine which task areas require
assessing. This is established using semi-structured interviews to identify
areas of concern. After these areas are identified, further assessment is
required through practical, descriptive and observational tasks. The tasks
assist the occupational therapist in identifying skill strengths and deficits that
enable or impair a clients performance in the task area. Whilst the task is
being completed, the occupational therapists completes an Observational
Checklist which allows the therapist to record their observations related to the
quality of the clients task performance.
Furthermore, overall task performance is measured using a three-point rating
scale to determine the level of intervention required for the client to live in the
community, 3= no intervention required, 2= basic intervention required and 1=
direct support required.
All relevant information obtained during the assessment is transferred to the
DACSA Report. The DACSA Report also contains the clients background
information, reason for referral, strengths and weaknesses and area for
recommendations.
16
Training Required?
No formal training is required but the DACSA-R2 must only be administered
by a qualified occupational therapist
Time to Administer:
The DACSA-R2 Screening Tool takes approximately 10 minutes to
administer. Following this, the DACSA-R2 will take 30-45 minutes to
complete, depending on the number of areas being assessed.
Strengths/Benefits
Designed for the psychiatric population over the age of 16
The DACSA-R2 contains a screening tool, which allows therapists to
identify areas of concern, followed by completion of further assessment
in these target problem areas. This saves time for both the therapist
and client, promoting client engagement in this assessment.
Covers a variety of community and domestic skill domains
DACSA-R2 is a recently revised edition of the DACSA (Collister &
Alexander, 1987), and has been updated to ensure relevance to
todays adolescent and adult population.
There is currently no evidence supporting the use of this Assessment as it
was revised in 2010 by La Trobe University. However, it is supported by
occupational therapists working in the field of youth mental health as the
preferred assessment of community and domestic skills.
ORYGEN YOUTH HEALTH DOMESTIC AND COMMUNITY SKILLS

ASSESSMENT INTERVIEW
The Domestic and Community Skills Assessment Interview has been
developed by occupational therapists at Orygen Youth Health, based on the
DACSA Assessment (Collister & Alexander, 1987). This semi-structured
interview assessment aims to assess skills that are considered essential to
living in the community, and has been used by occupational therapists at
Footscray Inpatient Unit.
17
When should it be used? Key areas of the Assessment

The OYH Domestic and Community Skills Assessment Interview should be
used by occupational therapists when assessing an individuals capacity to
live in the community.
Key areas of this Assessment include:
Clients living situation
Budgeting
Activities of Daily Living
Meal Preparation
House Cleaning
Laundry
Personal Presentation
Support Services
Community Contacts
Making and keeping appointments
Transport
Telephone Use
Medication Management
Sleep
Employment
Education
How to administer / Scoring
This assessment is administered via interview and requires no scoring. The
client is asked a number of questions for each domestic and community skills
domain. The occupational therapist documents the clients responses and any
key observations noted throughout the assessment.
To help build rapport, the Occupational Therapist should use it more as a
guide, as opposed to a questionnaire, as it could be difficult to elicit responses
from the client. This assessment is used as a screening tool and helpful to
generate conversation with clients
Training required?
No formal training is required to complete the OYH Domestic and Community
Skills Assessment Interview
Time to administer
The OYH Domestic and Community Skills Assessment Interview takes
approximately 30-45 minutes to administer
Strengths / Benefits
Covers a variety of community and domestic skill domains
Administered via informal interview
Allows therapists to identify areas of concern and target intervention
specific to these problem areas

18

As this assessment has been developed internally by OYH occupational
therapists, there is currently no evidence supporting the use of this
Assessment
COOKING ASSESSMENT SUMMARY

The Cooking Assessment Summary has been developed by North Western
Mental Health and is currently used at Footscray Inpatient Unit. This
assessment aims to assess an individuals cooking skills and the level of
assistance and supervision required when cooking a meal.

19
When should it be used? Key areas of the Assessment

The Cooking Assessment Summary should be used by occupational
therapists when assessing an individuals cooking abilities and safety in the
kitchen environment.
Key areas of the Assessment include:
Hygiene
Safety, and
Cooking Process
This assessment is administered through the client partaking in practical
cooking tasks whilst the occupational therapist observes. Whilst the task is
being completed, the occupational therapist observes the clients performance
in three key domains, hygiene, safety and cooking process. Each domain
contains a number of subdomains of which a score is given and comments
noted. Scoring is utilised to determine the level of assistance, supervision or
prompting required to complete the cooking tasks. Scores range from
0= needs maximum assistance
1= supervisions/verbal prompting/demonstration
2= minimal supervision/occasional verbal prompting
Independent
Training required?
No formal training is required to complete the Cooking Assessment Summary
Time to administer
The Cooking Assessment Summary takes approximately 30-45 minutes to
administer
Strengths / Benefits
Allows the therapist to observe the clients cooking abilities firsthand
and determine the level of assistance needed
Areas of concern are easily identified and thus, intervention is targeted
to these problem areas
As this assessment has been developed internally by North Western Mental
Health, there is currently no evidence supporting the use of this assessment
20
SENSORY
MODULATION
ASSESSMENTS
ADOLESCENT/ADULT SENSORY PROFILE

21
The Adolescent/Adult Sensory Profile is a self-report measure that is used to

evaluate behavioural a clients responses to everyday sensory experiences.
This assessment is a standardised measure and allows the clinician and
client to understand the effect sensory processing can have on functional
performance.
Key Areas of Assessment
This assessment measures how a client generally responds to specific
sensations, as opposed to how they respond to specific events or situations.
The profile is used to develop a clients awareness of their sensory processing
needs, and strategies to create the most beneficial sensory environment.
The Adolescent/Adult Sensory Profile can be used when it is suspected that a
client may be experiencing sensory processing issues which may be
impacting their functional performance in their everyday activities (e.g., selfcare, family relationships, bonding with friends and family, job
satisfaction/performance, school performance).
The Adolescent/ Adult Sensory Profile produces four scores which correspond
to the four quadrants of sensory processing proposed in Dunns model of
sensory processing.
Low registration
Sensation seeking
Sensory sensitive
Sensation avoiding
Each quadrant is assessed using 15 questions which cover sensory
processing, visual, auditory, touch, taste, smell, movement and a general
category for activity level.
There are a total of 60 items or questions in the profile. Individuals complete
the questionnaire by reporting how frequently they respond in the way
described by each item by using a 5 point Likert scale (nearly never, seldom,
occasionally, frequently or almost always). It is scored by an occupational
therapist or professional trained in sensory processing theory.
Scores that fall within one standard deviation of the mean for each category
represent Typical Performance. Scores that fall between one to two standard
deviations below the mean fall into the Probable Difference category. Finally,
scores that fall more than two scores below the mean indicate a Definite
Difference. Scores that fall in the probable or definite difference categories
may warrant intervention.

22
No training is required; however it is helpful to have an understanding of

sensory processing theory. The assessment manual contains information
regarding rationale, theory and development of the profile. It also contains
information about administration, scoring and interpretation of results, as well
as suggestions for interventions for each of the four categories of sensory
processing.
This assessment takes 10-15 minutes to complete, however the duration of
the assessment depends on the clients ability to engage.
Benefits/Strengths:
Gives an understanding with regards to why individuals engage in
certain behaviours.
Gives an understanding as to why an individual prefers certain
environments and experiences compared to others.
Enables informed intervention planning, which takes into account the
results of the assessment and the individuals preferences.
Can be used in a variety of settings schools, clinics, hospitals, long
term care facilities, community based centres and wellness centres.
Non-intrusive and quick and easy to use.
Psychometric evidence with regards to this assessment has shown that the
scores provided by the Adolescent/Adult sensory profile can be used to
provide reliable and valid interpretations about a clients sensory processing
patterns and preferences (Brown & Dunn, 2002).
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NORTH-WESTERN MENTAL HEALTH SENSORY SAFETY TOOL

The North-Western Mental Health Sensory Safety Tool has been developed
by North-Western Mental Health for use with clients who are on the Inpatient
Unit of Orygen Youth Mental Health in Footscray. The tool is designed as a
questionnaire which is used to gain an understanding of a clients sensory
preferences, triggers for certain behaviours, warning signs and prevention
strategies. It is also used to gain a better understanding of the clients history.
The tool is used to better understand a clients unique needs and provide
them with the best possible care and treatment plan.
The assessment covers areas such as:
Triggers to becoming angry or upset e.g. being touched, loud
noises, being ignored, yelling or sudden movements.
Warning signs of when a client feels they may lose control e.g.
sweating, clenching fists, crying or swearing.
Crisis prevention strategies e.g. listen to music, watching TV, talking
to a family member or friend.
Any medical conditions a client may have.
Clients trauma history.
History of violence and suicidality/self-harm.
History of seclusion and restraint.
Medications.
This tool should mainly be used on an in-patient unit; however parts of the
assessment may also be useful in an out-patient setting or crisis team. It is a
good tool for both the client and therapist to identify triggers and warning
signs, and then determine ways these can be prevented.
The tool can either be completed by the client with the therapist there as a
guide, or a therapist can answer the questions on the clients behalf. It is
recommended that the tool is completed with as much input from the client as
possible. If this is not possible, the therapist can complete the form through
observation, obtaining information from a clients file or possibly through
consultation with a significant other if this is appropriate.
Training is not required. The questionnaire is quite self-explanatory. The
therapist should be familiar with the assessment and be able to explain its
purpose to a client.
This assessment tool takes approximately 20-30 minutes to conduct.

24
SOCIAL SKILLS
ASSESSMENTS
25
Evaluation of social interaction (ESI)

The ESI aims to evaluate a clients quality of social interaction during natural
social exchanges with typical social partners. The ESI tests the client as they
engage in social situations prioritised by them, as they interact with other
social partners. The ESI helps to measure to what extent the interaction is
polite, respectful, well timed, relevant and mature.
The ESI is appropriate to use for the adolescent population, and for anyone
who is or is at risk of experiencing challenges with social interaction and/or
behaviour in social contexts.
How to administer/scoring
The ESI is an observational assessment that scores the quality of 27 social
interaction performance skills. Performance skills include: motor skills,
process skills and social interaction skills.
Training required?
Yes, training is required to perform the ESI. Once this is completed, the
therapist is provided with a manual, which includes computer software and
scoring sheets.
Time to administer:
The ESI takes up to 1 hour to administer
Strengths/Benefits:
Can be used before intervention to obtain baseline results and again
after intervention to document the effectiveness of the intervention
Can be used in any relevant and familiar environment. Hargie (2006)
advocates for the assessment of social interaction skills in the context
of real social interactions.
Evidence supporting the assessment:
Simmons, Griswold and Berg (2010) reported excellent internal scale validity,
with 95% of the observations fitting the Rasch model
A separation reliability of .89 and item separation reliability of .98 was
reported (Simmons et al., 2010)
Specific Training is required to perform the ESI; if you receive this

training you will be given the ESI User Manual, computer software and
scoring sheets
26
Assessment of Communication and Interaction skills (ACIS)

The ACIS (Forsyth et al., 1998) is a formal tool designed to measure an
individuals performance in an occupational form/task within a social group.
The Occupational Therapist is able to determine the clients strengths and
weaknesses whilst interacting and communicating with others during daily
occupations.
When should it be used? Key areas of assessment:
The ACIS can be used when clients appear to have issues communicating
and interacting in social situations. The ACIS contains a single scale that
consists of 20 skill items divided into three communication and interaction
domains:
Physicality
Information exchange
Relations
These items are rated on a 4-point scale. The scale considers whether others
are made comfortable, appropriately informed and helped by the clients
actions.
How to administer/ Scoring:
The ACIS is administered via observation, where 20 communication and
interaction skills are observed. It is important that the context closely
resembles a situation that is meaningful to the client.
Following training the therapist is provided with a details manual designed to
instruct and guide the tools use.
Training required?
Training is not required to administer the ACIS.
Time to administer:
Administration time can range from 20-40 minutes.
Observation time ranges from 15-45 minutes
Rating time ranges from 5-20 minutes
Strengths/Benefits:
Observations are carried out in settings that are meaningful and
relevant to the clients lives.
No training required
MOHO based assessment

27
Evidence supporting assessment:

Forsyth et al (1999) determined the ACIS had both intra-rater and interrater reliability, but some raters were inconsistent in their rating. This
was due to a lack of rater understanding of how communication and
interaction were defined.
Construct validity is supported as the items are arranged in an order
that makes clinical sense. The easiest items that reflect simple
communication skills are toward the beginning of the assessment, but
get harder, and require more sophisticated responses as the
assessment continues (Forsyth et al., 1999).
Internal validity was also established (Forsyth et al., 1999)
The ACIS is available through the MOHO clearing House. If you would
28
INTERESTS
LEISURE
& GOAL SETTING
ASSESSMENTS

29
MODIFIED INTEREST CHECKLIST

The Modified Interest Checklist is a leisure interest inventory appropriate for
adults and adolescents and indicates clients current interests, how interests
have changed and desired future interests.
The Modified Interest Checklist gathers information about a clients level of
interest and participation in 68 different activities, such as football, dancing
and gardening.
For each activity, clients indicate their level of interest over the past year, and
past ten years. The rating given to each item ranges from no interest to some
interest to strong interest. Furthermore, clients indicate whether they currently
participate in this activity and if they would like to pursue each potential
interest in the future.
Training Required?
No formal training is required to administer the Modified Interest Checklist.
Time to Administer:
The Modified Interest Checklist takes 10-15 minutes to administer
Strengths/Benefits
Quick to administer
Relevant to the youth population
Wide range of activities can be assessed
Provides activity ideas for treatment planning
Reliability and Validity:
Evident face validity
Good test-retest reliability (0.92) within 3- week interval of using the
Modified Interest Checklist
30
ADOLESCENT LEISURE INTEREST PROFILE

The Adolescent Leisure Interest Profile (ALIP) is the only leisure assessment
tool that was designed for adolescents and includes activities relevant to
present-day teenagers. It is similar to the Modified Interest Checklist, however
is designed specifically for adolescents.
The Adolescent Leisure Interest Profile will enable occupational therapists to
determine leisure interest or satisfaction and establish leisure goals for
adolescents. This assessment tool contains 86 items, grouped into 10
categories; exercise activities, social activities, creative activities, sport
activities, family activities, outdoor activities, relaxing activities, intellectual
activities, clubs and organizational activities and other activities.
For each item, the respondent is asked, How interested are you in this
activity? and How often do you do this? on a Likert scale of 3 points and 5
points respectively. Participants who indicate that they are interested or
participate regularly in this activity and asked to complete questions related to
how well they feel they perform the activity, how much they enjoy it, and with
whom they do it.
Training Required?
No formal training is required to complete the Adolescent Leisure Interest
Profile
Time to Administer:
The Adolescent Leisure Interest Profile takes approximately 30 minutes to
administer
Strengths/Benefits
Only assessment tool specific to the adolescent/youth population
Effective in establishing leisure goals with clients
31
Covers a wide range of activities

Evidence supporting the Assessment (Reliability and Validity)
Henry (1998) supports the use of the Adolescent Leisure Interest
Profile in clinical settings amongst adolescents with psychiatric,
learning and physical difficulties, as well as adolescents without any
apparent difficulties. The internal consistency, 0.93, and test-retest
reliability, 0.83-0.93, were proven, highlighting that the ALIP is a valid
and reliable assessment tool
Trotter, Brown, Hobson and Miller (2002) highlights that the ALIP is a
useful assessment tool during initial assessment, intervention and
outcome evaluation.
CANADIAN OCCUPATIONAL PERFORMANCE MEASURE (COPM)

The Canadian Occupational Performance Measure (COPM) is a semistructured interview assessment that is widely used to evaluate a clients
perception of his/her occupational performance.
This assessment will enable occupational therapists to identify clients
concerns with occupational performance, assist in goal setting and measure
change in defined problem areas over the course of therapy.
The COPM is client-centered and addresses roles, role expectations, and
activity performance within the clients own environment. Specifically, this
assessment evaluates a clients occupational performance issues within the
areas of self-care, productivity and leisure occupations.
How to administer // Scoring
This assessment is administered via semi-structured interview. The client is
asked to identify any activities that are difficult to perform across the areas of
self-care, work and leisure. The client is then asked to identify the five most
important problems on a scale of 1 (not important at all) to 10 (extremely
important). Following this, the client scores his or her performance (1= not
being able to perform the task, to 10= able to complete the task well) for each
identified problem area and their level of satisfaction in these activities (1= not
satisfied, to 10= extremely satisfied).
The performance and satisfaction scores of the selected activities are
summed and averaged over the number of problems, to produce scores out of
10. A difference between the initial and subsequent score (change score) of
two or more is considered clinically significant.
Training Required?

32
No formal training is required to administer the COPM.

Time to Administer:
The COPM takes 20-40 minutes to administer
Strengths/Benefits
Client-centred assessment; this assessment considers the importance
to the client of the occupational performance areas, as well as the
clients satisfaction with present performance
The COPM supports the notion that clients are responsible for their
health and own therapeutic process
Studied across a wide range of diagnoses
Used in more than 35 countries around the world
Available in 20 languages

Test-retest reliability demonstrates the COPM is a reliable assessment
tool (0.80)
COPM is a valid assessment measure of occupational performance as
Boyer et al (2000) state that the COPM was a helpful addition to their
planning and intervention
33
VOLITIONAL QUESTIONNAIRE
The Volitional Questionnaire assesses the persons inner motives and the
environments impact on motivation. This observational assessment for
adolescents and adults rates the individual in terms of three stages of
volitional development: exploration, competency, and achievement.
The Volitional Questionnaire can be used with clients who are experiencing
difficulty formulating goals or expressing interests and values. The Volitional
Questionnaire is composed of 14 items that describe behaviours reflecting
values, interests and personal causation.
Occupational therapists administer this scale by observing and rating patients
while they engage in work, leisure or daily living tasks. Each item is scored
using a four-point rating (passive, hesitant, involved and spontaneous). Due to
the nature of this scale, the observing therapist can provide support and
structure if it is necessary to elicit volition.
Training Required?
No formal training is required. Occupational therapists are advised to be
familiar with the Volitional Questionnaire manual and guidelines prior to
administering the assessment.
Time to Administer:
The Volitional Questionnaire takes approximately 30 minutes to administer
and score

34
Strengths/Benefits
The sole assessment tool that indicates the extent to which a client
readily exhibits volitional behaviours versus the amount of support,
encouragement and structure that is necessary to elicit them
Allows the therapist to determine the environmental contexts and
strategies that enhance the individuals volition
Can be administered as part of a therapy session
Research demonstrates that the volitional questionnaire has good
content validity, as well as sensitivity, as it is able to detect differences
between patients with different levels of volition.
Kielhofner (2004) states that therapists must be familiar with the Model
of Human Occupation concepts and Remotivation Process when
administering the volitional questionnaire to ensure consistency
amongst assessors.
35
HABITS, ROLES
AND ROUTINE
ASSESSMENTS
ROLE CHECKLIST
The Role Checklist was developed in order to gain information regarding a
clients participation in occupational roles throughout their life, and the value
that they place on these occupational roles. The checklist is used to identify
problems with continuity of role performance.
Clients respond to each of the ten roles listed in the assessment tool with one
of the following responses:
Whether they have held the role in the past.
36
Whether they are currently in the role.

Whether they expect to be in the role in the future.
The client then indicates how much they value that role with one of the
following responses:
Not at all valuable.
Somewhat valuable.
Very valuable.
A definition of each of the roles is provided in the manual, as well as
examples of that role. The roles included in The Role Checklist are:
Student
Worker
Volunteer
Care giver
Home maintainer
Friend
Family member
Religious participation
Hobbyist/Amateur
Participant in organisations
An Occupational Therapist can choose to conduct this assessment if they
would like to gain an understanding of the roles a client has undertaken in the
past and whether the client has any goals to fulfil specific roles in the future. It
can be used as a tool to guide intervention, as fulfilling a certain role can
become an important goal for that client.
Please refer to Key Areas of Assessment section above for details.
Following explanation of the checklist, the client can choose to either fill out
the assessment themselves, or have the occupational therapist go through
the assessment with them. Following the completion of the checklist the
therapist can facilitate a conversation about the roles in the checklist. This
discussion can be about the roles they have been successful in, the roles they
have avoided, and determining why some roles are deemed more valuable
than others.
Is Training Required? No specific training is required. The assessment
manual explains how to administer the Role Checklist.
The Role Checklist can take 15-30 minutes to complete depending on the
clients level of engagement and discussion related to their roles following
completion of the checklist.
Benefits/Strengths:
Quick and easy to administer.
Can be used as a guide for goal setting.

37
Helps to determine what a client has been successful in and why a

client values one role more than another.
Can be used across a number of different diagnostic categories.
Appropriate for use across age groups.
The Role Checklist has been used in numerous research studies as an
instrument for examining role performance. A study conducted by Oakley,
Kielhofner, Barris & Reichler (1986) concluded that the Role Checklist had
satisfactory test-retest reliability. Another study and literature review
established that the Role Checklist had satisfactory content validity of role
classification.
OCCUPATIONAL SELF-ASSESSMENT
The Occupational Self-Assessment is used to identify a clients occupational
competence in performing everyday occupations through client self-report.
This assessment also encourages a client to express their personal values
and set goals/priorities for change. The OSA gives the client a role in
determining their goals and strategies for intervention in collaboration with the
38
therapist. Often, client centred practice can be difficult to implement. The OSA
is designed to facilitate this client centred practice for therapists.
The assessment is made up of two self-report scales, where the client
indicates how well they believe they perform a task (occupational
competence) and how important they believe that task is. The process of
administration and scoring is outlined below.
This assessment should be used when a therapist feels a client can adopt a
larger role in their own treatment process. The OSA has mainly been
developed for use with clients who are 18 years of age and older. The
Occupational Self-Assessment can be used as an outcome measure, if so
then it should be administered at the beginning of therapy and then near the
end of therapy to see how far the client has come.
The Occupational Self-Assessment is made up of a two part self-report. The
therapist firstly presents the client with 21 everyday activities, and then using
a four point scale the client rates how well they believe they do each activity.
This scale is an indication of occupational competence. Following this, the
client uses another four point rating scale which gives an indication as to how
important an activity is to them.
The items on the assessment and the scales are written using simple and
easy to understand language to ensure that the client understands what is
being asked. Following completion of the scales the responses are reviewed
with the client in order to identify priority areas. This can then be used to guide
occupational therapy intervention.
No training is required to administer the Occupational Self-Assessment,
however the therapist needs to be familiar with the assessment and use the
assessment manual as a guide.
The Occupational Self-Assessment takes 20-30 minutes to administer,
however more time is required to explain the assessment to the client. The
duration can also vary depending on the level of function and engagement
shown by the client.
Benefits/Strengths:
Easy, timely and straight forward to administer.
Gives the client a role in determining their own goals and ways of
achieving those goals.
The OSA can be used as an outcome measure which is able to identify
self-reported client change.

39

A study by Kielhofner, Dobria, Forsyth & Kramer (2010) supported the use of
the Occupational Self-Assessment as a client directed outcome measure. The
studys results suggest that the constructs of occupational competence and
value placed on performance are stable over time (Kielhofner, 2010). The
results also suggest that the rating scales are stable over time. Furthermore,
the study shows that the OSA is able to detect both increases and decreases
in competence and value in everyday tasks over time (Kielhofner et al, 2010).
The OSA is available through the MOHO clearing House. If you would
ROUTINE TASK INVENTORY - EXPANDED

40
The Routine Task Inventory-Expanded is an assessment of activities of daily

living. The Inventory helps to provide an indication of the clients cognitive
function as well as being a form of activity analysis and a functional evaluation
instrument. The assessment determines if a client is able to perform all of the
tasks required in their daily lives.
This assessment looks at routine task behaviour, which can be defined as
Occupational Performance in areas such as self-care, instrumental activities
at home and in the community, social communication through verbal and
written comprehension and expression, and readiness for work relations and
performance (Katz, 2006). The assessment determines how well a client is
able to manage these tasks, and informed intervention planning can take
place.
The aim of assessing routine task behaviour is to promote safe, routine
performance of a clients valued occupations and to maximise a clients
occupational participation in daily activities. This assessment should be used
if a therapist or family member/carer is concerned with a clients ability to look
after themselves in their daily lives.
The Routine Task Inventory-Expanded is quite a lengthy assessment and can
involve the combined utilisation of client self-report, care giver consultation
and therapist observation. Ideally the therapist would observe the client
performing the ADL task; however this may not always be possible, especially
with some of the self-care ADLs. Where observation is not possible the client
is consulted, and if this is not appropriate then a reliable care giver is asked
how the client manages the ADL tasks outlined in the assessment. The
assessment is administered as a checklist during an interview. The client or
care giver are given a copy of the RTI-E scoring criteria and asked to pick the
best description of what the client is likely to exhibit. The therapist explains
items as required and encourages the client/caregiver to give a detailed
description of how the client normally performs the task. Each ADL has six
options as to how a client may complete a task; the therapist, client or
caregiver selects the most appropriate option. The scoring is very similar to a
FIM score.
A detailed description of the administration procedure and scoring process is
outlined in the manual, which is located following this information sheet.
Not all of the sections within the assessment may be relevant or necessary for
a client, so the therapist can pick and choose which parts of the assessment
they deem necessary.

41
No training is required; however, the RTI-E should be used by professional

occupational therapy personnel. Administering this assessment requires
knowledge of the cognitive disabilities model, interview skills, and observation
and activity analysis skills. The assessment manual should be used as this
details the assessment process, scoring and interpretation of results.
The duration of the assessment is quite variable, and is dependent upon the
information gathering method that is used. If the assessment becomes to
lengthy, it can be split up into different parts and can be completed over more
than one session if required.
Benefits/Strengths:
Gives the therapist an understanding of a clients cognitive level within
functional tasks.
Utilises therapist observation, client self-report and care giver analysis
which can develop a holistic picture of how a client performs a task.
Can be used in intervention planning and goal setting.
Four separate studies have shown that the original Routine Task Inventory
had high inter-rater and test-retest reliability, as well as high internal
consistency (Allen, 1985; Heimann et al 1989; Wilson et al, 1989; Allen et al,
1992). However these studies are quite old and the results may not be
relevant now. More recent studies were unable to be located. The internal
consistency was established in a study by Heimann, Allen & Yerxa (1989) for
the original RTI. This led to the authors extending the task analysis to other
activities. Activities added to the expanded version were child care,
communication and work readiness. The authors believe the RTI-E is a
comprehensive assessment of daily activities.
For full details of the psychometric properties and a list of research into the
assessment please refer to pages 21 and 22 of the assessment manual (Katz,
2006).
42
SCHOOL AND
VOCATIONAL
ASSESSMENTS
43
School Setting Interview (SSI)

The SSI is designed to assess the impact of the school environment on the
student. MOHOs conceptualisation of the social and physical environment is
conceptualised within the SSI. The SSI uses a client-centred interview to
assist the occupational therapist in intervention planning. The SSI considers
the student's occupational performance in all environments.
When should it be used? Key areas of this assessment:
The SSI is a semi-structured interview designed to assess studentenvironment fit and identify the need for accommodations for students with
disabilities in the school setting. The assessment is made up of 16 items that
make up a students participation at school and address the following items:
Writing
Reading
Speaking
Remembering things
Doing mathematics
Doing homework
Taking examinations
Going to art, gym and music
Getting around the classrooms
Taking breaks
Going on excursions
Getting assistance
Accessing the school
Interacting with staff
When administering the SSI, the student must be able to communicate
enough to discuss their experiences
The SSI is administered via interview, where the therapist explores each of
the 16 items mentioned above with the student. The therapist investigates
how the student has functioned and is currently functioning in the area,
whether the student believes there is a need for accommodation to perform in
the area and whether anything has been put into place prior to help the
student perform.
The 16 items are scored on a 4-point rating system.
Scoring requires two forms. One allows for identification of whether there is a
need for accommodation in each area and whether they are met. The second

44
allows recording of recommendations for accommodation. Recommendations

could include changes to:
Objects
Spaces
Occupational forms/tasks
Social groups
The assessment also records who is responsible for the changes and how
they will be implemented.
Training required?
No training is required to complete the SSI.
It is available for purchase through the MOHO website for $40.00
Time to administer:
The SSI takes approximately 40 minutes to administer
Strengths/Benefits:
Empowers the students to collaborate with the therapist to determine
what accommodations are necessary for them to be able to participate
at school
Client centered, allowing the client to verbalize what is not working for
them at school
Evidence supporting this assessment:
Hemmingsson & Borell (1996) explored inter-rater reliability, where a
kappa between 0.76 and 1.0, which indicated good agreement
between pairs of raters.
10 of the content areas had kappa values between 0.91 and 1 which
indicates very good agreement between raters
Content validity was judged as adequate for the assessments intended
purpose.
Hemmingson, Kottorp & Bernspang (2004) concluded the SSI displays
evidence of construct validity.
Hemmingsson & Borell concluded the SSI has 0.96 sensitivity and 0.88
specificity (both adequate) for identifying the needs of students within
the school setting.
The SSI is available through the MOHO clearing House. If you would like
to use it in practice, please go to the following website. Please be aware
that it is $40 to purchase.
45
Worker Role Interview (WRI)

The WRI was initially developed as part of a study designed to determine
psychosocial variables influencing work success. The WRI is a 16 item scale,
which rates the clients likelihood of work success (either returning to a
specific job or employment in general).
When should it be used? Key areas of Assessment:
The WRI should be used when a client is thinking of going into the workforce
or returning to the workforce. The WRI collects data on six areas:
Personal causation
Values
Interests
Roles
Habits
Perceptions of the environment
The WRI is presented in a manual which provides the therapist with
background information, as well as detailed instructions and guidelines for
administration.
Initially, therapists administer a semi-structured interview in which they can
simultaneously conduct the OCAIRS interview.
Following this, a rating scale is completed, entering comments as appropriate.
Training required?
Training is not required to administer the WRI.
The assessment can be purchased from the MOHO website for $40.00
Time to administer:
Semi structured interview can take 30-60 minutes to administer.
Strengths/Benefits:
The WRI provides a solid foundation for planning intervention with a worker
whose impairments are interfering with their work.
The WRI identifies psychosocial factors related to work that are not
considered by most work assessments, so can reveal unique strengths and
weaknesses, which should be considered when intervention planning.
46
Evidence supporting assessment:

Haglund, Karlson, Keilhofner & Lai (1997) examined construct validity of the
Swedish version of the WRI in psychiatric patients, and found that the WRI
was a psychometrically sound assessment besides two items in the
environment content area (Perception of boss, perception of co-workers).
Inter-rater reliability for the total assessment was found to be acceptable, but
three out of six individual content areas received ratings well below the
accepted standard of .80.
Test-retest reliability displayed high reliability, which shows the assessments
ability to measure consistently over time when used by one rater.
The WRI is available through the MOHO clearing House. If you would
47
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OCCUPATIONAL

INDEPENDENT LIVING SKILLS AND FUNCTIONAL ASSESSMENT

COMMUNITY AND DOMESTIC ACTIVITES OF DAILY LIVING

INTERESTS, LEISURE AND GOAL SETTING

HABITS, ROLES AND ROUTINES

SCHOOL/ VOCATION ASSESSMENT

Occupational Performance History Interview II (OPHI II)

Firstly, the therapist conducts the semi-structured interview using the

THE MODEL OF HUMAN OCCUPATION SCREENING TOOL (MOHOST)

No training is required to conduct this assessment; however it is important to

OCCUPATIONAL CIRCUMSTANCES INTERVIEW AND RATING SCALE

AMPS (ASSESSMENT OF MOTOR PROCESS SKILLS)

Training is required to complete the AMPS

DOMESTIC AND COMMUNITY SKILLS ASSESSMENT REVISED EDITION

ORYGEN YOUTH HEALTH DOMESTIC AND COMMUNITY SKILLS

When should it be used? Key areas of the Assessment

Evidence supporting the Assessment

COOKING ASSESSMENT SUMMARY

When should it be used? Key areas of the Assessment

ADOLESCENT/ADULT SENSORY PROFILE

The Adolescent/Adult Sensory Profile is a self-report measure that is used to

No training is required; however it is helpful to have an understanding of

NORTH-WESTERN MENTAL HEALTH SENSORY SAFETY TOOL

Evaluation of social interaction (ESI)

Specific Training is required to perform the ESI; if you receive this

Assessment of Communication and Interaction skills (ACIS)

Evidence supporting assessment:

MODIFIED INTEREST CHECKLIST

ADOLESCENT LEISURE INTEREST PROFILE

Covers a wide range of activities

CANADIAN OCCUPATIONAL PERFORMANCE MEASURE (COPM)

No formal training is required to administer the COPM.

Evidence supporting the Assessment

Whether they are currently in the role.

Helps to determine what a client has been successful in and why a

Evidence supporting the Assessment

ROUTINE TASK INVENTORY - EXPANDED

The Routine Task Inventory-Expanded is an assessment of activities of daily

No training is required; however, the RTI-E should be used by professional

School Setting Interview (SSI)

allows recording of recommendations for accommodation. Recommendations

Worker Role Interview (WRI)

Evidence supporting assessment:

Boyer, G., Hachey, R., Mercier, C. (2000). Perceptions of occupational

That Collect Information Through Interviews. In G. Kielhofner (Ed).

interaction during occupational engagement. AmericanJournal of

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