Assessment and Measurement in Recreational Therapy (AMRT) Notes PDF

**Assessment and Measurement in Recreational Therapy (AMRT) Notes** [Why do we asses?] - Assessment is a [systematic] process of collecting, analyzing, and reporting - Assessment and documentation make an activity an intervention - Main point is to gather information, once gathered you...

**Assessment and Measurement in Recreational Therapy (AMRT) Notes** [Why do we asses?] - Assessment is a [systematic] process of collecting, analyzing, and reporting - Assessment and documentation make an activity an intervention - Main point is to gather information, once gathered you must ANALYZE and prioritize [Why is it important ?] - (client) Gain client info, baseline, progress, discharge. (program) keeps track of progress, administrative requirement in order to get reimbursed. Is used to examine & document programs effectiveness. (student) CTRS exam [When is it used ?] - Assessment and documentation make an activity an INTERVENTION - Intervention activity can be measured meanwhile a diversional activity are not measured 5 PRINCIPLES OF ASSESSMENT [Systematic] process: what info to gather, how to gather info, how to analyze results, making decision based on results. Logical [Connection] Among: Content of assessment, needs of client, content of program [Yield Dependable and Consistent Results:] From time to time, from one participant to another [Placement] Primarily Based on assessment results Provide [Baseline] info - Documentation: on going assessment of the participants health statues, a form of progress notes or medical charting procedures. - [Chapter 7 reading Notes ] CHART is a 27 item questionnaire designed to measure the level of of community participation with an individual with spinal cord injuries - Divided into 5 categories physical independence, mobility, social integration, economic self sufficiency and occupation **[History of Assessment in RT Notes:]** ***1950s** :* RT military hospitals (for veterans) "Games therapy" assessment how patients were **coping** with hospitalization. Clients were assigned "Grades" as a way of measuring. - Rt came into existence, used to assess function - **DR John Davis wrote "clinical application of recreational therapy" (1952)** - **Dr. Burnie Philips** assist the doctor to getting the patient well and make life satisfying - Dr burnie First person who was a registered as recreational therapist **!960s:** Began to look at how to train RT's, Set standards to prepare RTs, few assessment tools, Therapeutic recreational journal which focused on inclusion of individuals - First standard test in RT was developed by Mundy "Mundy inventory for the trainable mentally retarded". Mundy first to suggest assessment tied to programming **1970s:** focus on skills set RT need, develop a lot more assessment, focues on recreational and leisure rather than clinical, growth is developing new assessments **1980s:** develop a process for assessment, more idea of the need of different types of methods, used standardized assessment and non-standardized assessments, develop RT process( APIED process), improve psychometric testing. **1990s:** first collection of RT assessment Textbooks, survey and assessment of current research process, growth in commercial instruments more forced on functional outcomes. **2000-current:** screening, more interdisciplinary assessments, Valid over homemade instruments, forces on function rather than only leisure, forces on diagnosing for reimbursement purposes, FIM (focus independent measure) since then have moved to Section GG Protocols: Establishment of assessment protocols Important- procedures, material Issue remaining research, test home aid assessments **Research using RT instruments point 8.0 or above for reliability coefficient** **[Testing Issue with Rt Assessment Notes:]** Measure: the basic corer of all research, the assignment of numbers, **Exact and precision in measurement** **Good measurement = good assessment** *Conceptualization* -- challenges the norm, consistencies in literature, *Operationalization-* turn something Vague into something precise, provides more precise measurement. Example- negative social interactions **[Levels of measurements (4) ]** *Nominal (name)* -- tends to be in a category, distinct categories, demographics, Examples: race, culture, gender, material statues. *Ordinal (order)-* variables we can put in a particular order( specific order), distance is unknown between things in order *Interval ( equal intervals):* still in order but we know the distance between each order Example: age ( kid who is 3 and other kids who is 4, we know how many months are between each kids) *Ratio (\# as Ratios)* - Has a zero, starts at zero, interval + Zero. Example: Lengths, Weight Precision of measurement: More precise = Ratio interval \--\> ordinal nominal = less precise "clinical reasoning" use expert judgement on the part of the therapist, using skills and training to make a judgement. Codependency issues: health relationships provided certain decency issue **ADAPTING TESTS- should not change unless, in order to get more accurate results** Visual impairments: increasing font size, contrasting colors, central placement **[Psychometrics in RT Assessment Notes: ]** Psychometrics - is how we understand measurement and the reliability of it, how we develop and construct instruments. *Validity VS reliability* Reliability: is it dependable, is it stable, is it repeatable. Reliable Validity: does it measure what it is supposed to measure, accurate **Types of internal validity -- valid within that group** Weaker form of validity is face or content Statistical is a strong form of evidence 1. **Face validity**- appears at face value (weakest form of validity) measure what it supposed to. 2. **Content validity**- typically used for questionnaires, no statistical value, stronger than face validity 3. **Construct validity**- Main form of validity when individuals report validity, - **Convergent validity-** when you have evidence that two similar traits measure [highly correlated], measure by similar instruments. Score of.80 is great convergence validity - **Discriminant validity**- when two instruments measure dissimilar constructs have [low correlation] between them. Lower than 1.00 expresses discriminant validity 4. **Criterion validity:** has to do with prediction, the extent to which a score on a scale or test PREDICTS scores on some other measure. EXAMPLE- SAT score predicts "student success" - **Concurrent validity**- comparison of scores to an acceptable standard, "GOLD standard" (most accurate" when you compare an instrument to the gold standard of how you would measure that outcome. 5. **Responsiveness**- the ability of the instrument to detect changes over time **Reliability** Measure of reliability refers to the scores or data, NOT the instrument High reliability DOES NOT assure VALIDITY (valid) **Types of Reliability** 1. **Stability-** are results on two serrate occasions correlated, aka test-retest method, better indicator for physical fitness and motor performances. 2. **Equivalence**- looking at two versions of the same test and are they related. EXAMPLE ACT vs SAT look at equivalent score/ consistence scores are they the same. 3. **Internal consistency**- how consistent are the scores with one single test, first half vs second half, odd vs even items 4. **Objectivity-** is the score consistence when theirs more than one tester. Best used with behavior observations or ratings, less than a 50% agreement= poor, 80% agreement or more Ways to ensure your assessment are Valid & reliable 1. Change your current assessment -- adopt a valid tool 2. Evaluate your current assessment procedures 3. Test your current assessment **[ICF and Assessment Notes -- TAKEN ON ASSESS MEASURE READING NOTES WORDDOC]** ICF provides a scientific basis and determines how we define certain things. Provides a consensus outcome (common language), allows to compare data. **[How to find recreational therapy assessment ]** - Finding an assessment to fit your agency: target outcomes, match between interventions and programs, how much time to administer, expense, fit assessment to agency(staff time), administration skills required. - How to find valid assessment: rehab measure database **[STANDARD OF ASSESSMENT NOTES: ]** Standards -- minimum level of participation determined to be acceptable Regulations -- allows that are enacted, NC RT licensure act- required license, mandate APIE process Voluntary regulation- privately enforced, minimum expectation for performances. Professional organizations- professional certification lost or challenge if standards are not meet ATRA standards of practice- Standard 1 is about assessment, - 12 professional standards - Is meant to assure a systematic provision of quality recreation services - Recent change in standard is that we must have a referral and physicians order for assessment. - Agency's: more specific than standards mentioned, apply specifically to job site you're working at, they have specific polices and procedure. EXAMPLES: notations in progress notes, areas of assessment, documenting refusal of assessment. ASSESSMENT PRINCIPLES & THEORIES - Constant reassessment of client - Information about real life information Short term -- gathering a snapshot of one current status Longitudinal -- Activity analysis- breaks down the activity Task analysis- is the client's skills Knowledge is the cognitive information applied directly to the performances Skills -- Good when doing treatment: SMART -- [S]pecific, [M]easurable, [A]chievable, [R]elevant, [T]ime limited