Prepare for the assessment

Contents

Identify the need for assessment based on organisation policy and procedure 3

Intake assessment 3

Assessment of support needs 5

Common needs 5

Challenging behaviour 5

Identify appropriate assessment tools and/or processes according to organisation policy and procedures 7

Types of assessment tools 7

Clarify purpose and scope of assessment 10

Steps in clarifying purpose and scope 10

Key questions and considerations for clarifying purpose and scope 10

Detailed assessment questions 11

Confirm validity and reliability aspects of the assessment tool 14

Validity 14

Reliability 15

More information about assessment tools 15

Confirm the nature of the assessment tool 16

Content and structure of the tool 17

Validity 18

Reliability 19

Nature of assessment tool 19


Identify assessment requirements that are outside job scope and refer to an appropriate person 21

Reasons for referring a client 21

Reasons for not referring a client 22

The role of the client 22

Other services 22

Organisational issues and policies 25

Organise appropriate time and place for the assessment with the client being assessed 25

Clarify whether client wants others present at the assessment and if an interpreter is needed 26

Obtain consent from the client where required by organisation policy and procedure 28

Identify the need for assessment based on organisation policy and procedure

Assessment involves:

·  obtaining evidence about a person’s performance

·  making judgements on that evidence against prescribed standards of performance.

Before we can begin providing any support to our client, we need to complete an assessment of our client so that we can formulate the most appropriate support for our client.

The success of any support or strategy depends largely on whether:

·  the support is appropriate to the client’s needs

·  the client has been involved in the decision regarding which strategies to use.

An assessment also helps with evaluating the strategies used to meet the person’s needs because when we re-assess, we can see whether past strategies have worked.

This would be a good time to attempt Activity 1 before moving on with the remainder of this reading.

Intake assessment

The intake assessment is usually a brief assessment conducted with the client when they arrive at a service. This assessment serves several purposes. It:

·  establishes that the client is at the right service to suit their needs

·  ensures that the client fits the agency’s eligibility criteria and can thus receive a service from the agency

·  ascertains whether the client is in crisis and needs some immediate assistance

·  allows service to gain some basic information about the client

·  investigates what type of help they are requesting

·  records the type of clients who come to the service and their requests, for statistical information and further funding requests.

Many agencies have developed standardised forms, usually known as intake forms. They help workers collect information quickly and easily and ensure that the necessary information is collected. Figure 1 is an example of a common type of intake form.

Intake form
Date of interview
Name and job role of worker
Client’s name
Address
Phone number(s)
Date of birth
Sex
Country of birth
Language spoken
Referral details (source and reason)
Mental health diagnosis
Client’s main concerns
Social situation
Comments

Figure 1: Example of a standard intake form

A more detailed or comprehensive assessment is usually carried out once an individual has become a client of a service. A comprehensive assessment takes much longer and seeks to paint a whole picture of a client’s situation. It might determine:

·  the client’s background or history, including their family history, their medical history and their disability

·  what sort of help the client is seeking and the result they want

·  whether or not the client has used other services and whether this was useful to them

·  what the client’s life is like (eg where they live, what they do, whether they have a family and/or friends, what supports they have).

Assessment of support needs

Assessment of current skill level is an important component of the development of appropriate programs to assist people to learn new skills. In contrast to assessing individuals for the presence of intellectual disability, where norm referenced tests are used, assessments for planning educational programs require the use of criterion referenced tests.

Disability support workers need to consider the consequences of the particular disabilities their clients have. Disabilities are of many different kinds, and have a wide range of different consequences on the life of clients. Support and assistance needs to be tailored not only to the individual personality of the client, but also to the anticipated effects or consequences of the disability. For example, Person A may deal effectively and even cheerfully with the consequences of a particular disability while Person B may find the consequences of the same disability very hard to cope with.

As information gatherers and disseminators (though their work extends far beyond this), support workers should be familiar with the commonly encountered consequences of various kinds of disabilities. It is helpful to break these up into certain categories.

It is important to remember to identify people’s strengths and capacities first rather than going from a model of deficiency. Therefore when assessing support needs the person’s strengths should be noted first rather than their needs.

Common needs

Click here to see Maslow’s hierarchy of needs.

Challenging behaviour

Behaviour problems among people with intellectual disabilities can include:

·  behaving aggressively towards others

·  self-injurious behaviours (eg biting, hitting, eye-poking, and eating inedible material)

·  behaviours that lead to property damage

·  inappropriate social and sexual behaviours (eg hugging strangers or public masturbation)

·  self-stimulatory behaviours (eg hand mouthing or excessive rocking)

·  extreme withdrawal

·  non-compliance.

An assessment may be required to identify possible reasons behind the behaviours. Assessment of people with an intellectual disability who demonstrate challenging behaviours is often referred to psychologists working in intellectual disability services. Behavioural intervention approaches based on the theoretical framework of applied behaviour analysis have proved particularly useful in addressing challenging behaviours in this population. This most often involves working with and through significant others in the person's life, such as family members, teachers and accommodation support staff.

Identify appropriate assessment tools and/or processes according to organisation policy and procedures

Assessment can be either formal or informal and can include tests, interviews, observations, and research of past documentation.

The assessment process involves three key processes:

·  Collecting evidence

·  Judgment

·  Recording results.

More information can be obtained from: Kit to support Assessor Training, Training Package Assessment Materials Project, ANTA, 2001.

Types of assessment tools

Each organisation will have policies and procedures regarding which assessment tools should be used and for what purpose. The tool selected will depend on the reasons for assessing the client. For example, the Comprehensive health assessment process (CHAP) may be used by an organisation to undertake an annual medical assessment for adults with intellectual disabilities. Such an assessment may potentially help doctors make better diagnoses, provide appropriate treatment and, ultimately, ensure an overall better health status.

For more information about CHAP go to: www.som.uq.edu.au/research/qcidd/files/chap.pdf

This would be a good time to attempt Activities 2 and 3 before moving on with the remainder of this reading.

Domain-based assessment

Domain-based assessments look at:

·  the person’s acquisition and use of knowledge and skills (including early language/communication) at the level expected for his or her age

·  the person’s social-emotional skills (including social relationships) at the level expected for his or her age

·  whether the person uses appropriate behaviour to meet his or her needs at the level expected for his or her age.

Domain-based assessments can measure attainment in the concepts of social standards.

Norm-based assessment

Norm-based assessment refers to the process of judging and grading a person’s achievement according to how well they have performed compared to a larger group. An IQ test is a good example of a norm-based assessment. One of the major issues of most norm-based assessment tools is the reliance on written or oral responses as they do not support alternative communication systems.

Because the decision based on the assessment is extremely important for the person concerned, psychologists are usually involved in assessing both intelligence and adaptive behaviour. It is only if the person is assessed as having an intellectual disability that a range of services will be available.

Functional assessment

Functional assessment is about measuring the performance of, or capacity to perform, a variety of activities normal for people in good health.

The Department of Ageing, Disability and Home Care (DADHC) uses a comprehensive set of endorsed assessment tools to diagnose level of disability in individuals. These tools include:

·  internationally recognised psychometric intelligence scales

·  developmental scales

·  functional assessments

·  non-verbal intelligence tests for people with more significant disabilities.

All tests used by the Department are standardised and regarded internationally as effective tools in assessing the intellectual and functional abilities of an individual.

The Department has an endorsed definition of intellectual disability that includes an individual's functioning in cognitive as well as physical domains. This is available in detail on the Department's website <www.dadhc.nsw.gov.au/DADHC.htm. The level of disability is determined through the use of recognised psychometric tests and functional assessment.

This would be a good time to attempt Activity 4 before moving on with the remainder of this reading.

Competency-based assessment

Competency-based assessment is designed to measure performance, skills and knowledge against the standards for skills and knowledge needed in the workplace.

Assessing competence is about finding out whether a person can use knowledge and skills to successfully complete activities. Activities for assessing workplace competencies need to be:

·  assessed in a range of situations and environments

·  completed according to the performance standard expected in the workplace.

Characteristics of competency-based assessment

Criterion-based assessment: The person is assessed against standard criteria or benchmarks. They are not assessed in competition with their peers.

Evidence based assessment: The person being assessed may produce or demonstrate the evidence of their competence or the assessor may gather the evidence.

Participatory assessment: The person being assessed is encouraged to be involved in the process of assessment. Both the person and the assessor have the scope to negotiate the form and range of assessment activities.

Clarify purpose and scope of assessment

Purpose: the reason the assessment is being undertaken

Scope: the areas the assessment will cover

Steps in clarifying purpose and scope

1  Clarify the purpose and scope of the assessment.

Why is the assessment being done?

What is to be achieved by conducting the assessment?

What are the specific goals and objectives of the assessment?

2 Determine how comprehensive the assessment should be.

Defining the magnitude of the assessment will assist in determining the extent of the research to be undertaken—what information will need to be collected and who should be involved

How quickly the assessment needs to be done can also be a factor in determining scope.

Key questions and considerations for clarifying purpose and scope

1 Is the assessment to provide a broad picture of the person? Or, is it to focus on specific activities such as independence in personal care (bathing, dressing, eating, toilet use etc)?

A broad assessment would look at all aspects of the person and address a wide range of opportunities and questions. How broad the assessment is to be will help determine what other services and decision makers should be involved. It will also determine what information will need to be collected.

If there are specific concerns that decision makers wish to address, then the assessment could be more focused. A focused assessment can choose a number of key opportunities and limit the questions to be addressed.

2 Is this assessment creating an initial baseline?

It is important to have a process for follow up/monitoring assessment. If this is an initial assessment and is intended to provide a baseline for future comparison, it may need to be more comprehensive in the type of data collected.

A follow-up assessment should build on previous information collected and work completed previously, to look for changes and improvements.

This would be a good time to attempt Activities 5 and 6 before moving on with the remainder of this reading.

Detailed assessment questions

Psychological status

  1. Do you have a diagnosed mental illness?
  2. Are you taking any medication? If so what are you taking?
  3. Have you ever been placed on a behaviour management program?
  4. Do you have any difficulties with sleep, appetite, weight, etc?
  5. Have you ever had thoughts about harming yourself? Have you ever tried to harm yourself?
  6. Do you have a GP? Do you have a psychiatrist?

Accommodation

  1. Where are you currently living?
  2. Do you share your accommodation with other people?
  3. Where have you lived in the past?
  4. How often do you stay over at family and friends?

Work and income

  1. What is your main source of income?
  2. Are you on a pension? If so which one?
  3. Do you work? If so where and what do you do?
  4. Do you attend some form of day placement? If so where?

Family and social relationships

  1. How often do you see your family?
  2. How many friends do you have?
  3. How often do you see your friends?
  4. What places do you go out to with your friends?
  5. What do you like to do with your friends?

Ask sensitive and appropriate questions to explore the relationships your client has with other people. For example, you could ask a client to describe their relationship with their siblings rather than asking them the more confronting, direct question, ‘How do you get on with your sister or brother?’

Keep your questions as open as possible so that the client can choose what information they want to disclose. For example: ‘Can you tell me a bit about what your life was like when you were a child?’ rather than ‘How did you get on with your parents?’