Guiding Therapist Decisions for Measuring Outcomes in Occupational Therapy

The process of deciding how to measure occupational performance is challenging to occupational therapists for several reasons. First, while it is common for therapists in their educational programs to learn to administer many different assessments, it is less common for assessment to be learned as part of an overall measurement approach. Placing the use of assessments within a person, occupation, and environment measurement framework helps to organize our thinking about how we use measurement in practice. Second, therapists often have difficulty deciding what specific attribute(s) to measure. For example, a client has identified that he or she wants to be able to go shopping. What are the occupational performance attributes that are important to the occupation of shopping but are causing him or her difficulty—is it moving around a store, managing money, or selecting the groceries? Is the problem in performance related to where he or she will shop? The area of performance difficulty leads to a decision about the attribute to focus on for measurement. Finally, once a decision has been made about the attribute(s) to measure, what specific assessment tool is the best to use? Considerations of ease of use, time, psychometric characteristics, and cost are central to this decision.