Abstract
Background. Occupational therapists play a major role in identifying the assistance needs of individuals living with a traumatic brain injury. However, to obtain an accurate assessment, verbal assistance should be provided only when necessary, according to the person's needs. Purpose. This study aimed to understand (1) how verbal assistance is provided during an evaluation of Instrumental Activities of Daily Living and (2) why it is provided in this manner. Method. Interviews were conducted with three expert occupational therapists using their own videotaped evaluation and a “think-aloud” method to explore their clinical reasoning when providing verbal assistance. Data were analyzed using thematic analysis. Findings. The process of providing verbal assistance was recognized as flexible and nonlinear, and influenced by various factors including the participants’ level of understanding of the client's abilities. Implications. This information will help therapists better understand how and when to provide verbal assistance when assessing their clients.
Highlights
Living with a traumatic brain injury (TBI) can lead to major challenges with thinking through all of the decisions involved in completing complex everyday activities such as preparing meals, shopping for groceries or managing one’s finances (Bottari et al, 2011; Fortin et al, 2003; Godbout et al, 2005; Lefebvre et al, 2008)
All three occupational therapists (OTs) were previously involved in the validation of the Instrumental Activities of Daily Living (IADL) Profile (Bottari et al, 2010a), CB played a major part in this process as she was the main developer of this observation-based ecological tool
Despite the complexity of this process, this study offered a first picture of the role of verbal assistance during a dynamic assessment
Summary
Living with a traumatic brain injury (TBI) can lead to major challenges with thinking through all of the decisions involved in completing complex everyday activities such as preparing meals, shopping for groceries or managing one’s finances (Bottari et al, 2011; Fortin et al, 2003; Godbout et al, 2005; Lefebvre et al, 2008). Described as an interactive approach between the therapists and clients, this type of assessment allows therapists to explore the effect of various factors (e.g., assistance during the task, task modification, and potential interventions) on the person’s performance (Coelho et al, 2005) Through this interaction, therapists may try various types of assistance to identify the ones that should optimally be integrated into the client’s routine to improve performance and engagement in meaningful activities (Haywood & Lidz, 2006; Haywood & Miller, 2003) while allowing the client to do as much of the activity on his/her own. Assistance is provided to help the client progress in the task, allowing observation of further task components and abilities that could not be observed otherwise (Bottari et al, 2010a) To attain this objective, therapist–client interactions (whether they aim to provide assistance or not) must be in accordance with the person’s true needs only if and when necessary, without overestimating or underestimating the person’s abilities. This information will help therapists better understand how and when to provide verbal assistance when assessing their clients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
