A user's manual for the short child occupational profile (SCOPE) : (version 2.2)

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The Model of Human Occupation Clearinghouse Department of Occupational Therapy

College of Applied Health Sciences

A User's Manual for

.·.

THE SHORT CHILD OCCUPATIONAL PROFILE (SCOPE) Patricia L. Bowyer, OTR, BCN Jessica Kramer, OTR/L

(Version 2.2) Copyright 2005 Published Augusf2008

Annie Ploszaj, OTR/L Melissa Ross, OTR/L Orit Schwartz, OTR/L Gary Kielhofner, OTR/L, FAOTA Kathleen Kramer, OTR/L

OF ILLINOIS AT CHICAGO U IC UNIVERSITY

Copyright 2005 by the Model of Human Occupation Clearinghouse, Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois of Chicago, and UIC Board of Trustees. All Rights Reserved. This manual may not be reproduced, adapted, translated or otherwise modified without express permission from the MOHO Clearinghouse. Score sheets, summary sheets and other forms which are provided as perforated pages in this manual may be reproduced, but only by the single individual who purchased the manual and only for use in practice. These forms may not be reproduced for use by others. Each individual user must purchase a manual to have permission to use forms. Some forms from this manual may be available in other languages. For access to any available forms, please visit www.moho.uic.edu. Any available translated forms will be posted under Additional Resources/MOHO Related Resources/Translated MOHO Assessments and available for download. The password to access and download translated forms associated with this manual is: Sco&e45. A therapist must purchase this manual to have access to this password. Only the purchaser of this English-version manual has permission to download and use translated forms. Restrictions regarding the use of forms within this manual a.lso apply to use of downloadable, translated forms. Forms may not be available for all languages. Some full translations of this manual may be available for international sale or distribution through third parties; details on obtaining these resources may also be found at Additional Resources/MOHO Related Resources/Translated MOHO Assessments.

,w. 1IN!VERSITY OF QUEENSLAND LIBRARY

Chapter 1:

Introduction to the SCOPE ........................................................................................................... 1 Introduction ..................................................................................................................................1 The SCOPE and Pediatric Assessment in Occupational Therapy .................................................... 1 Purpose of the SCOPE ..................................................................................................................2 History and Development of the SCOPE .......................................................................................2 Using this Manual ........................................................................................................................3

Chapter 2:

The Model of Human Occupation and the SCOPE .......................................................................5 Theoretical Framework: The Model of Human Occupation ........................................................... 5 Volition ..............................................................................................................................5 H·abituation .......................................................................................................................6 Performance Capacities and Skills ...................................................................................... 6 The Environment ................................................................................................................ 6 The SCOPE Items and MOHO Concepts ....................................................................................... 7 Describing MOHO Concepts to Other Professionals and Caregivers ............................................. 9

Chapter 3:

Administering and Rating the SCOPE ......................................................................................... 11 Determining the Appropriateness of the SCOPE .......................................................................... 11 When to Administer the SCOPE .................................................................................................. 11 Time Required ................................................................................................................. 11 Gathering Information to Rate the SCOPE ................................................................................... 11 Purpose of the Ratings ................................................................................................................ 12 Using the SCOPE Forms .............................................................................................................. 12 SCOPE Summary Rating Form .......................................................................................... 12 SCOPE Ratings Total Form ................................................................................................ 12 SCOPE Multiple Assessment Summary Form .................................................................... 12 Using the SCOPE FAIR Rating Scale ............................................................................................ 12 Using the Environment Section Rating Scale .................................................................... 14 Using the SCOPE Item Definitions, Criteria Statements, and Rating Examples to Make Rating Decisions ........................................................................................................... 14 When Underlined Criteria Statements Do Not Match the Most Appropriate Rating Category ............................................................................................................... 15 When More Than One Category Has Underlined Criteria Statements That Describe the Child ........................................................................................................... 16 When There is Not a Criteria Statement that Best Describes the Child .............................. 1 7 Rating the Environment Section Items ............................................................................. .'! 7 SCOPE Administration and Rating Flowchart .............................................................................. 18 Impact of Culture and a Child's Individual Developmental Trajectory on SCOPE Ratings ............ 19

Chapter 4:

Scoring and Interpreting the SCOPE Results ..............................................................................21 Obtaining Sum Rating Totals for the SCOPE ................................................................................21 Obtaining Section Rating Totals .......................................................................................2-1 Obtaining the Overall Rating Total ...................................................................................22 Using MOHO Theory to Interpret SCOPE Ratings .......................................................................22

SCOPE v2.2

Chapter 4:

Scoring and Interpreting the SCOPE Results (continued) Reporting the Analysis of Strengths and Challenges ....................................................................23 Describing Performance on a Specific SCOPE Item .......................................................... 23 Comparing Performance on Different SCOPE Sections ..................................................... 23 Using other MOHO Based Assessments with the SCOPE ............................................................ 24

Chapter 5:

Planning Goals and Intervention Based on the SCOPE ............................................................... 29 The SCOPE Goal and Intervention Planning Chart.. ....................................................................29 SCOPE Item and Definition ..............................................................................................29 Keywords and Example Goals ..........................................................................................2 9 Strategies for lntervention ................................................................................................ .30 Theoretical Reasoning ......................................................................................................30 Family lnvolvement. .........................................................................................................30 Documenting Goals and Intervention Plans Using the SCOPE Intervention Planning Form ........ .31

Chapter 6:

Using the SCOPE to Document Outcomes .................................................................................33 Collecting Information to Document Outcomes .........................................................................33 Examining Change in Individual Item Ratings ................................................................. .33 Examining Direction of Change in Section Rating Totals .................................................. .33 Examining Direction of Change in the Overall Rating Total .............................................. 34 What to Do if the SCOPE Does Not Show Change Over Time .......................................... 34 Using Changes in the SCOPE Ratings to Identify a Child's Needs .................................... .34

Chapter 7:

Using Interviews to Gather Information for the SCOPE.. .......................................................... .35 Interviewing ...............................................................................................................................35 Asking Children Questions ..............................................................................................35 Using the SCOPE Parent and Teacher Interview Guides .............................................................. 36 Suggested Interview Questions: Extended Format... .......................................................... 36 Suggested Interview Questions: Abbreviated Format ........................................................ 37 Suggested Interview Questions: Keywords Format.. ..........................................................3 7 Suggested Interview Questions: Snapshot Questions ........................................................ 3 7

Chapter 8:

Using the SCOPE Parent Report Form ........................................................................................39

Chapter 9:

SCOPE Case Studies .................................................................................................................. .42 Ivan ............................................................................................................................................43 Alden: Author Kathleen Fafendyk, MA Ed ................................................................................... 61 Tabitha .......................................................................................................................................79

Chapter 10: Summary Flowchart: Using the SCOPE in Practice .................................................................... 85

SCOPEv2.2

ii

APPENDICES

Appendix A ...................................................................................................................................................... 87 SCOPE Expanded Item Criteria and Examples ............................................................................. 87 SCOPE Goal and Intervention Planning Chart.. ......................................................................... 113

Appendix B ....... .............................................................................................................................................12 7 SCOPE SCOPE SCOPE SCOPE SCOPE

Summary Rating Form .................................................................................................. 12 7 Rating Totals Form ........................................................................................................ 135 Multiple Assessment Summary Form ............................................................................. 136 Intervention Planning Form ........................................................................................... 13 7 Parent Report Form ....................................................................................................... 138 English ........................................................................................................................... 138 Spanish .......................................................................................................................... 140 SCOPE Info Sheet ..................................................................................................................... 142

Appendix C ....................................................................................................................................................143 SCOPE Parent Interview: Extended Format.. .............................................................................. 143 SCOPE Parent Interview: Abbreviated Format ............................................................................ 150 SCOPE Parent Interview: Keywords Format ............................................................................... 152 SCOPE Parent Interview: Snapshot Questions ........................................................................... 153 SCOPE Teacher Interview: Extended Format.. ............................................................................ 154 SCOPE Teacher Interview: Abbreviated Format ......................................................................... 161 SCOPE Teacher Interview: Keywords Format.. ........................................................................... 163 SCOPE Teacher Interview: Snapshot Questions ......................................................................... 164

Ill

SCOPE v2.2

SCOPEv2.2

iv

Introduction The Short Child Occupational Profile (SCOPE) provides a broad overview of a child's occupational participation and allows practitioners to systematically evaluate the factors that faci I itate or restrict occupational participation. The SCOPE is designed to be an occupation-focused, client-centered, and theory driven assessment that can be readily integrated into practice with children and adolescents aged birth to .21 years. The strength of the SCOPE lies in its ability to delineate clear patterns of occupational strengths and cha I lenges that can be used to plan interventions using the theory the Model of Human Occupation (MOHO) (Kielhofner, 2008). This assessment can be effectively used as an initial evaluation, and as an outcome measure to assess a child's progress in therapy. The SCOPE can be used across practice contexts and settings, with children and youth with a range of disabilities. While the assessment primarily relies on knowledge gained th rough observation, practitioners may use a variety of methods to obtain the information needed to complete the SCOPE. The SCOPE was originally developed to be used by occupational therapists, but other rehabilitation and educational practitioners have found the SCOPE to be a useful tool to inform their practice. Throughout this manual we will use the term practitioner to refer to any professional who uses the SCOPE. This manual will provide you with an overview of the SCOPE, administration directions, and resources for rating and interpreting the SCOPE.

The SCOPE and Pediatric Assessment in Occupational Therapy \Vhile occupational therapists have increasingly recognized the importance of occupationally based assessment oi children (Coster, 1998), pediatric practice continues to reh heavily on assessments that identify developmental in the motor, cognitive, and perceptual domains Rodger, Brown, & Roever, 2005; NBCOT, :::cc.;,. By using the Model of Human Occupation as its framework, the SCOPE allows practitioners :o assess the personal and environmental factors that

impact a child's occupational performance and participation. The Model of Human Occupation also provides practitioners with a set of concepts that can be used to interpret the SCOPE results and plan related interventions Few occupational therapy assessments provide such a clear, concise, and comprehensive framework for addressing the occupational participation of children and youth. The SCOPE recognizes that the developmental perspective is one of several perspectives used by occupational therapists to frame their assessment of a child's occupational performance. However, disability rights activists emphasize that too much reliance on developmental norms inevitably penalizes a child or young person with a disabi I ity. They argue that the question practitioners shou Id ask themselves is not whether a chi Id is deviating from a norm, but whether the child is able to achieve the kind of participation in life that fits with his/her desires and what his/her environment (e.g. family, school) expects. SCOPE neither excludes nor prioritizes The developmental considerations but leaves it to the professional judgment of the practitioner to assess their relative significance and applicability when rating each child (Coster, 2008). The term "individual developmental trajectory" is used throughout th is manual to conceptualize each child's unique potential as an occupational being. Rather than compare a child's performance to population-level, "normed" developmental scales, practitioners can hypothesize what capacities a child has the potential to acquire in the future given the child's age, impairment, prior life experiences, and environmental context. Practitioners should consider this individual developmental trajectory when determining the impact that a child's current developmental status should have on SCOPE ratings. The SCOPE helps practitioners consider the range of factors that impact participation beyond developmental delay. For example, a practitioner working with a child with fine motor delays and poor handwriting has several intervention options:

SCOPE v2.2

1

INTRODUCTION TO THE SCOPE •

The practitioner can decide to modify the environment (i.e., use a computer to complete written work),

•

provide more writing practice (i.e., improve the motor ski I I of manipulating task objects), or

•

remediate impairments (i.e., increase the child's intrinsic hand strength).

The SCOPE ratings along with MOHO theory help the practitioner identify the intervention option that is most feasible and that may result in the greatest improvement in occupational participation. When administering and rating the SCOPE. it is important to keep in mind that the SCOPE is neither a norm-referenced nor criterion-referenced assessment. Norm-referenced assessments typically seek to compare an individual's performance to another individual, while criterion-referenced assessments compare an individual's performance to a set of standards. Unlike these types of assessments, the SCOPE seeks to evaluate a child in comparison to his/her own individual developmental trajectory.

Purpose of the SCOPE The

SCOPE

is

designed

to

do

the

following:

•

Describe a child's occupational participation irrespective of symptoms, diagnosis, age, or the treatment setting.

•

Capture strengths as wel I as challenges by considering each child's individual developmental trajectory.

•

Assess factors that represent the MOHO concepts of skills, volition, habituation, and the environment.

•

Identify areas needing further assessment and direct the practitioner to complimentary pediatric MOHO assessments in order to gain an increased understanding of a specific challenge.

•

Be simple and quick to use.

•

Facilitate communication about the child's participation with the multidisciplinary team, caregivers, and other stakeholders.

•

Support occupation-focused intervention.

•

Assess changes in the child's occupational participation over time in order to evaluate therapy outcomes.

2

SCOPE v2.2

The SCOPE consists of 25 items organized into six sections based on the concepts of the Model of Human Occupation. Personal Factors

Volition Habituation Communication & Interaction Skills Process Skills Motor Ski I ls Environment

The first five sections (volition, habituation, communication and interaction skills, process skills, and motor skills) deal directly with the child's personal factors and their impact on participation and performance. In these sections, the child is being rated. The last section explores how the environment impacts the child's ability to participate and perform occupations. In this section, the resources, opportunities, constraints, and demands presented by the environment are rated. In the first five sections of the SCOPE, an equal number of items per section allow the practitioner to compare the chi Id's relative strengths and to focus on those areas of occupational performance requiring further assessment or intervention. In the environmental section, a range of physical and social aspects of the environment are presented, which allows the practitioner to determine the aspects that most faci Iitate or restrict a chi Id's participation. Based on this information, the practitioner may then decide to complete additional assessments. As you review the SCOPE user manual, you will learn more about how to rate and interpret the SCOPE.

History SCOPE

and

Development

of

the

Occupational therapists working at an urban hospital providing care at the neonatal intensive care, inpatient, and outpatient levels expressed a need for a pediatric assessment that would allow them to incorporate MOHO concepts and language into assessment and treatment planning. The practitioners initially tried to use the Model of Human Occupation Screening Tool (MOHOST) (Parkinson, Forsyth, & l

SCOPE Coal and Intervention Planning Chart (continued)

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SCOPE Item

z

Item Definition

Key Words

Example Goal

0

--0

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< N

Strategies for Intervention

Theoretical Reasoning

Family Involvement

X )>

Physical Space (continued)

(at home, community, school, and/ or hospital) supports the child's participation.

• Has areas to • Surrounding space is safe • Stimulates • Identifies

identify 3 spaces at home or in the community that are unsafe or difficult to navigate and identify a moclific;ition that would allow more successful and safe p;irticipation.

the home safe and accessible. • Explore different community locations (park or playground) to identify accessibility concerns; problemsolve solutions with the parents and child. • Consult with daycare or teacher lo identify acc:essihility concerns and possible modifications.

with increased opportunities for exploration and engagement • allow the child to feel a sense of efficacy and competence over his/her actions and skills.

assistance are needed. • Keep toys and objects within reach of the child in his/her play area. • Arrange furniture to create an inviting "play space." • Learn accessibility laws and policies (Americans with Disabilities Act).

Physical Resources

Availability of equipment, appropriate play/learning objects, transportation, and other resources (at home, community, school, and/or hospital) support the child's participation.

• • • • •

Has access to Transportation Resources Obtains Adaptive equipment • Appropriate materials • Safe objects • Identifies

With assistance of family and therapist, child will identify and obtain an adaptive tool that will assist child in writing activities.

• Try a variety of acfaptive tools in order to identify the best adaptive device for the child. • Advocate for the family to acquire needed equipment and resources. • Help the family to identify and obtain the best seating for the child to use during homework. • Work with the family to identify appropriate toys/activities given the child's abilities and age. • Connect the child with a "peer buddy".

The right objects, equipment, and other resources help a child meet task demands and perfonn effectively and efficiently.

• Search for and use community resources. • Collaborate with therapist to identify objects that are appropriate for the child and where to get them. • Try using adaptive equipment that increases independence and safety during the child's selfcare routines.

Social Groups

The actions and attitudes of other people, including parents, teachers, peers,

• Encourages • Supports • Provides opportunity for • Assures • Enables

Child will name 3 specific actions that his/her family can take to support his/her successful performance of a

• Work with the child and family to identify community organizations (park district) that provide leisure group activities of interest to

• The attitude and opportunities provided by the people around the child influences that child's

• Attend and be involved in therapy sessions. • Plan play groups with other children in their community.

N

0

SCOPE Goal and Intervention Planning Chart (continued) SCOPE Item

C.fl

n

0

-0

m

< N N

N Ul

Item Definition

Social Groups (continued)

caregivers, etc. support the child's occupational participation.

Occupational Demands

Activity and expectations and requirements (social and leisure activities, ADLs, IADLs, school work) match a child's abilities and interests, and promote participation.

Key Words

Example Goal

• Identifies Expectations • Understands

household chore.

•

Child will learn to Velcro his/her shoes without assistance (instead of tying laces) in order to match child's abilities with the demands of the activity.

•

• • • • •

Expectations match Skills match Time Graded Modified ldenitifies

Strategies for Intervention

the child/family. • Consult with the child's daycare, school, and/ or parents about the importance of positive and supportive attitudes when working with the child. • Consult with parents and/or teachers about varying the level of assistance provided to complete activities depending on the skills of the child. • Modify activities to be challenging yet achicvable for the child. • Modify the time, number of steps, or expectations of the activity to match the child's skills and abilities. • Work with the child and family to identify community organizations (park district) that provide accessible activities of interest to the child/ family.

Theoretical Reasoning

•

participation. Individuals provide opportunities for participation when the right level of support is provided to a child given that child's abilities.

• Tasks that match a child's abilities and interests will: o support participation o allow a child lo work on increasing skills. • When activities arc over or under demanding, a child's performance is restricted.

Family Involvement

• Share the child's goals with extended family and discuss ways that they can play a part in helping the child meet those goals.

• When possible, instead of helping the child complete an activity, provide additional time so that the chi Id can independently complete the task at his/her own pace. • Provide support as necessary for tasks, but when possible allow the child to do the first two or last two steps independently (when tying shoes let the child pull the loops to make the knot). • Modify household chore expectations to meet the child's ability; modify as abilities change (use a hand-held vacuum

)> -0 -0

m

z

0

X )>

);--

SCOPE Goal and Intervention Planning Chart (continued)

N

a,

u u

rn

(fl

n

z

SCOPE Item

Item Definition

Key Words

Example Goal

0

u rn < N

Strategies for Intervention

Theoretical Reasoning

Family Involvement

N

The child's family routine supports the child's participation in occupations.

• Matches • Is structured • Is organized • Enables • Encourages • Schedules • Provides opportunities for • Develops • Implements • Identifies

Family will identify and implement one routine that provides child with an opportunity to participate in selfcare tasks.

• Give the child an opportunity to practice engaging in routines during therapy sessions . • Advise the parents on ways that home routines can support participation. • Collaborate with the parents to identify parts of the day that are difficult for their child and ways to adapt the routine.

A child's participation is supported through structure and routines because he/she knows what to expect ,rnd what is expected of him/her.

>< );--

instead of an upright vacuum). Family Routine

0

• Try to eat dinner at the same time every day and assign responsibi Iities to each family member (the child sets the table, his/her brother pours drinks). • Establish a weekly time period to \,vork on hobbies/interests during which the television is off.

APPENDIX B: SCOPE SUMMARY RATING FORiv\

Short Child Occupational Profile (SCOPE) SCOPE Summary Rating Form Client: ID: Age: Years Months Date of Birth: _ ; _ ; _ Gender: Male - - Female - Grade: Date of referal/admission: _ ; _ ; _ Dx./Reason for referral:

Assessor: Signature: Date of Eva Iuation:

I

I

Re-evaluation _ Initial Evaluation Setting: CONTRAINDICATIONS (Allergies, etc):

Discharge_

Background Information Primary caregiver/s: Where does the client live? Who else lives in the household? School/day care information: Comments:

Facilitates Allows Inhibits Restricts

F

A I R

Facilitates participation in occupation. Allows participation in occupation. Inhibits participation in occupation. Restricts participation in occupation.

Analysis of Strengths and Challenges:

Summary of Ratings: Volition

Habituation

Communication & Interaction Skills l!l

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VOUTJON Exploration The child engages in visual, tactile, and/or oral exploration of objects, persons, and the environment. f

The child spontaneously initiates and persists in exploration of the environment.

A

The child requires occasional cues, encouragement, or support to initiate and sustain exploration of the environment.

I

The chi Id requires substantial support, cues, or encouragement to initiate and sustain exploratory behaviors.

R

The child does not respond to or interact with physical and social stimuli.

Comments:

Expression of Enjoyment The child demonstrates satisfaction with activities and/or the outcomes of actions. f

The child spontaneously expresses enjoyment during and/or following an activity.

A

The child's demonstration of satisfaction and enjoyment is somewhat limited during and/or following an activity.

I

When engaged in activities, the child mav demonstrate some enjoyment but it is usuallv, mixed with anxietv' and frustration.

R

The child consistently expresses anxiety and/or frustration when engaged in activities.

Comments:

Showing Preferences and Making Choices The child chooses or demonstrates a clear sense of likes and/or dislikes toward certain objects, events, or people. f

The child demonstrates a strong sense of preference for a varietv of objects, activities, or persons.

A

The child hesitates when given choices; requires cues and suggestions in order to indicate a preference or make a choice, but is able to make a choice with support.

I

The child often relies on others to make choices and is unsure of own preferences.

R

The child does not choose and/or does not appear to have preferences for objects, activities, or persons.

Comments:

Response to Challenge The child engages in new activities and/or accepts the opportunity to achieve more, or perform under condition of greater demand. f

The child spontaneously seeks and persists in new or more challenging activities.

A

The child spontaneously attempts new or more challenging activities, but is easily frustrated and/or needs some support in order to persist.

I

The child usually requires significant support to engage in new and more demanding activities and to overcome frustration and persist during such activities.

R

The child avoids new or more challenging activities because they elicit a high level of frustration.

Comments:

HABITUATION Daily Activities The child knows how to complete daily self care activities and is able to participate in the performance of these activities (ADLs and IADLs such as dressing1 hygiene1 meals, etc.). F

The child knows how daily self care activities are performed and is able to participate in the performance of these activities.

A

The child regularly needs directions and cues to know how to do common daily self care activities and participate in their performance.

I

The child demonstrates limited understanding of how to do daily self care activities and usually requires multiple cues and significant support in order to participate in their performance.

R

The child does not know how to do common daily self care activities and does not participate in their performance.

Comments:

Response to Transitions When asked by an adult or cued by something in the environment, the child is able to terminate one activity and begin another. F

The child is able to transition between different activities, demonstrating appropriate changes in affect and arousal level.

A

The child sometimes requires cues and/or support to terminate one activity and transition to another.

I

The child requires multiple cues and substantial assistance during transitions between activities.

R

The child is verl. upset and/or bewildered by transitions; does not demonstrate ability to modu ate arousal level and affect in response to new activity; becomes cl isorgan ized.

Comments:

Routine The child has an awareness of routines and is able to participate effectively in structured daily routines.

F

The child demonstrates an awareness of the sequence and structure of a re ular routine, and can anticipate, initiate, and/or cooperate with activities relate to these routines.

A

The child requires occasional cueing and redirection in order to cooperate with the regular sequence and structure of routines in his/her life.

I

The child is often unable to participate in the sequence and structure of regular routines.

R

The child does not demonstrate an awareness of the sequence and structure of regular routines; does not anticipate, cooperate, and/or initiate routine activities.

3

Comments:

Roles The child is aware of own roles and/or demonstrates behaviors associated with the roles 1 expectations. F

The child consistently demonstrates role related behaviors; can verbalize role related expectations or selects and performs role related activities.

A

The child is not consistent in followin~ behaviors associated with role expectations and demands, but wi II demonstrate ro e related behaviors with some support.

I

The child requires multiple cues to select activities and follow behaviors associated with role expectations and demands.

R

The chi Id does not demonstrate an awareness of role related expectations; does not select or perform activities that indicate a sense of belonging and awareness of role demands.

Comments:

C01\tt1\t\UNICATJON & INTERACTION SKILLS Non~ Verbal Communication The child demonstrates appropriate and effective non-verbal communication such as facial expressions, gestures, signs, eye contact, and affection to communicate with others in the social environment. F

The child spontaneously uses non-verbal communication skills to initiate and sustain interaction with others.

A

The child exhibits non-verbal communication but only in response to prompting by others in his/her environment.

I

The chi Id exhibits very Ii m ited and/or ineffective use of non-verbal com mun ication during interactions.

R

The child does not use non-verbal communication during his/her interactions.

Comments:

Verbal/Vocal Expression The child uses verbal/vocal expression appropriately and effectively. F

The child initiates the use of verbal/vocal expression while exhibiting appropriate tone, volume, and pace.

A

When asked and/or given prompts, the child responds using verbal/vocal expression but does not initiate such expression and/or exhibits some limitations related to tone, volume, and pace.

I

The child rarely uses verbal/vocal expression and/or demonstrates difficulty with tone, volume, and pace during such expression.

R

The child is unable or unwilling to use verbal/vocal skills to express him/herself.

Comments:

Conversation The child engages in appropriate and effective conversation with peers, teachers, parents, and therapists in order to share and exchange information, ideas, and emotions. F

The child spontaneously initiates and sustains meaningful conversation in order to convey emotions and/or share and exchange information and ideas.

A

Given cues and suggestions, the child participates in meaningful conversation with his/her social environment.

I

The child has difficulty engaging in meaningful conversation with others and may be hesitant, limited, or abrupt during social interactions.

R

The child is unable or unwilling to participate in conversations with others. The child may be entirely uncommunicative or may exhibit extremely inappropriate or disjointed conversation.

Comments:

Relationships The child maintains appropriate relationships within his/her social environment.

!

F

The child is sociable and spontaneously demonstrates cooperation, collaboration with, and awareness of others.

A

The child demonstrates some ability to maintain relationships but exhibits some limitations within these relationships.

I

The child exhibits difficulty interacting and cooperating with others in order to maintain social relationships.

R

The child cannot maintain relationships due to an unawareness of others or an unwillingness to cooperate and collaborate.

Comments:

PROCESS SKILLS Understands and Uses Objects The child is able to engage in appropriate selection, organization, and use of objects. F

The chi Id consistently demonstrates effective selection, organization, and use of objects.

A

The child can select, organize, and effectively use objects if provided with stepby-step cues, instructions, and/or demonstrations.

I

The child experiences difficulty in following cues and/or demonstrations in selection, organization, and use of objects.

R

The child's selection and use of objects is disorganized. The child does not demonstrate an orientation to object utilization.

Comments:

Orientation to Environment The child exhibits an ability to interact with and adapt to the environment.

F

The child consistently seeks information about the environment, shows an awareness and understanding, and engages in appropriate interaction with the environment.

A

The child requires cues to seek, retain, and/or understand information about the environment.

I

The child's interaction with the environment is impacted by limited ability and difficulty seeking, retaining, and/or understanding information about the environment.

R

The child is unable to seek, retain, and/or understand information about the environment.

Comments:

Plan and Make Decisions The child is able to evaluate alternatives, decide on a plan, and concentrate to follow through with the plan.

F

When given the opportunity, the child consistently decides what to do and how to perform activities, and is able to maintain concentration to follow through with the plan.

A

The child usually needs cues to evaluate and plan how to perform chosen activities, and/or needs help to maintain required concentration to follow through with the plan.

I

The child is rarelG able to make a plan and requires significant cues to follow through with a p an.

R

The child does not demonstrate an ability to plan and/or follow through with a plan.

Comments:

Problem Solving The child demonstrates an appropriate ability to identify and respond to problems when they occur. F

The child consistently anticipates problems, generates workable solutions, and evaluates these solutions to determine the best course of action.

A

The child can identify difficulties but needs step-by-step cues to generate an effective response.

I

The child rarely anticipates and adapts to difficulties; needs on-going reassurance when problems are encountered.

R

The child is unable to anticipate and adapt to difficulties; makes inappropriate decisions.

Comments:

,v\OTOR SK1LLS Posture and Mobility The child's motor skills promote posture, mobility, and overall occupational performance. F

The child exhibits a stable, upright, flexible posture and effective mobility during activities.

A

The child usually demonstrates the ability to maintain posture and mobility during activities.

I

The child often demonstrates postural instability and mobility difficulties.

R

The child is unable to maintain posture and is not mobile.

Comments:

Coordination The child exhibits effective gross and fine motor movements during activities. F

The child effectively coordinates body parts to achieve fine and gross motor movements.

A

The child exhibits uncoordinated movement during some fine and,or gross motor activities.

I

The child has difficulty coordinating fine and/or gross motor movements during most activities.

R

The child is unable to coordinate,

Comments:

and use fluid movements.

Strength The child demonstrates adequate muscle strength during fine and gross motor activities. F

The child consistently uses adequate strength while grasping, moving, and transporting objects with appropriate force/speed.

A

The child exhibits minor difficulty in motor activities requiring muscle strength to grasp, move, and transport objects.

I

The child has difficulty lifting, moving, and transporting objects with appropriate force and speed.

R

The child is unable to grasp, move, and transport objects with adequate force and speed clue to muscle weakness.

Comments:

Energy/Endurance The child is able to maintain an appropriate energy level in order to participate in occupations. F

The child consistently maintains an appropriate energy level and tempo throughout all daily occupations.

A

The child sometimes demonstrates inappropriate energy levels (too high or too low) during daily occupations.

I

The child has difficulty maintaining appropriate energy levels during daily occupations.

R

The child is unable to maintain appropriate energy levels during daily occupations.

Comments:

ENYl RONJ\I\ENT The rating should reflect how the environment affects the child (rather than the child's response to the environment) F

Facilitates

A

Allows

Envimnmental aspect allows participation in occupation. Impact of unmet needs is limited.

I

Inhibits

Environmental aspect inhibits participation in occupation. Some unmet needs identified.

R

Restricts

Environmental aspect restricts participation in occupation. Major unmet needs identified.

If

Environmental aspect facilitates participation in occupation. No unmet needs.

the child has been or will be in the hospital for an extensive period of time, the therapist may choose to assess the suitability of a hospital environment.

Physical Space The layout and arrangement of physical space (at home, community, school, and/or hospital) supports the child's participation. F

Arrangement of the physical environment is accessible and provides opportunities to enfiage in various activities; stimulates and supports occupational participation in chi d's valued roles.

A

Arrangement of the physical environment does not adequately support occuhational engagement or is somewhat accessible; poses some limitations to the c ild's participation in valued roles.

I

Arrangement of the bhysical environment affords a limited range of opportunities with limited accessi ility and support for occupational participation in child's valued roles.

R

Arrangement of the physical environment is not accessible, does not provide opportunities, and prevents participation in the child's valued roles.

Comments:

Physical Resources Availability of equipment, appropriate play/learning objects, transportation, and other resources (at home, community, school, and/or hospital) support the child's participation. F

Physical resources (objects such as toys, school utensils, mobility devices) support satisfying and safe occupational participation.

A

Physical resources (objects such as toys, school utensils, mobilt devices) meet the basic needs for safety and engagement in occupations, but o not fully support satisfying participation in valued occupations.

I

Physical resources (o~ects such as toys, school utensils, mobility devices) limit opportunities for satis ying and safe engagement in occupations.

R

Physical resources (objects such as toys, school utensi Is, mobi Iity devices) are lacking, inappropriate, and/or unsafe.

Comments:

ENVJRON1\t\ENT (continued) Social Groups The actions and attitudes of other people, including parents, teachers, peers, caregivers, etc. support the child's occupational participation. F

The social environment is able, willing, or capable of offe1·ing optimal and appropriJte Jttitucles to support the child's occupational p;:irticipation.

A

The child's social environment sometimes limits occup;:itional participation due to over or under involvement.

I

The child's social environment provides minimal support and limited opportunities for pJrticipation.

R

The child's social environment does not support occupational participation due to gross under or over involvement.

Comments:

Occupational Demands Activity expectations and requirements (social and leisure activities, ADLs, IADLs, school work) match a child's abilities and interests, and promote participation. F

Occupational demands match child's abilities, interests, energy, and available time.

A

Occupational demands may not be consistent with the child's abilities, interests, energy, and time.

I

Occupational demands often affect the child's occupational enga1ement clue to inconsistencies with the child's abilities, interest, energy, or availa le time.

R

Occupational demands do not support occupational participation-- either under or over demanding.

Comments:

Family Routine The child's family routine supports the child's participation in occupations. F

The child's family routine provides optimal support for the child to participate in occupational roles.

A

The child's family routine occasionally impacts the child's ability to perform in occupational roles.

I

The child's family routine provides limited support and opportunities for participation in occupational roles.

R

The child's family routine prevents the child from participating in occupational roles.

Comments:

Short Child Occupational Profile (SCOPE)

Rating Totals Form* Client: Date of Birth: _

!_!_

ID: Gender: Male - - Female - -

Assessor: Date of Evaluation: _ ! _ /_

Grade: - -

Type: Initial __ Re-evaluation __

Additional Comments:

Step One: Record and/or transfer your SCOPE ratings Communication & Interaction Skills

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