Evaluation of

Social Interaction’– a standardised,

observation based

assessment.

That addresses an important aspect required for most

occupations—social interaction. Uniquely focused on social

interaction that is included in occupational performance, the

occupational therapist observes a person as he/she engages in

real interactions at work, school, or home, or during leisure/play activities with typical social partners.

Below is an illustration of the ESI with a client,

Darrell and the occupational therapist, Lena.

Administration of the ESI follows the Occupational Therapy Intervention Process Model, OTIPM, and begins with gathering information about the person, particularly around social interaction that may be interfering with occupational performance.

Together the occupational therapist and client determine the type of social interactions to observe that are relevant for the client.

Darrell has been working in various assembly line jobs over the past four years, since he completed high school. He is currently

23 years old. He reported that his past employers have let him go because he “is not a team player.” He admitted that he has had difficulty getting along with people at work and gets irritated at them. His boss recommended that he change his behavior or he will loose this job. Darrell lives at home with his father. He would like to move into an apartment with friends but has not been able to afford the rent because of his difficulty keeping a job. During his free time Darrell bowls twice a week and plays cards with friends one evening a week. When asked about how those activities are going, he revealed that he has been on different bowling teams because he has a hard time getting along with the other guys on the team. He said that the friends he plays cards with have been his buddies for many

years. He said that they will get mad at him for saying things that he shouldn’t but they “cut him slack.” After more conversation with Darrell, Lena learned that he has more difficulty with others when he needs to explain to someone else how to do a task and also when there is not a real focus to the conversation, for example in the break room or when the bowling team goes out after a game for a snack. Together Darrell and Lena decided that she will observe Darrell at work next week at which time he will describe the process for packing boxes to a new group of employees who will be joining the assembly crew. She will also observe him in the break room when there is opportunity for casual conversation. They decide that Darrell’s boss needs to know who Lena is and why she is at the job site. Darrell

realizes that his boss would look favourably upon his getting help. Darrell stated that he does not want anyone else to know that Lena is observing him. She reassured Darrell that she would be an unobtrusive observer in both of these settings. The next step is to observe the client during two social interactions that are relevant for the client and analyse the social interaction performance. Lena observed Darrell for a total of 30 minutes: 15 minutes in each of the predetermined social interactions. She sat quietly at the side of the room in both situations and took notes. Later Lena used the ESI manual to score the observations on 27 skills using criteria to consider the appropriateness and timeliness of each skill during Darrell’s two social interactions. Scoring took Lena approximately 10 minutes per observation. Describing baseline performance, actions that support and hinder social interaction, to the person leads to collaboratively determining strategies to support social interaction. ESI skills are noted in the following baseline performance. Lena shared her results with Darrell the next afternoon. She reported that she observed some strengths: Darrell began both of these social interactions appropriately

(Approaches/Starts). He placed himself at an appropriate distance from his social partners (Places Self), turned his body and face toward the people to whom he was interacting (Turns Toward), and spoke

clearly (Produces Speech).

Lena pointed out social interaction skills that she believed most interfered with the overall

quality of the two social interactions. Darrellfrequently interrupted his social partners

(Times Response) and dominated the socialinteraction (Takes Turns), not encouragingthem to participate in the interaction

(Acknowledged/Encourages). Darrell

spoke quickly (Speaks Fluently) and usedterminology that was unfamiliar to the newemployees, and used slang in the break roomthat not everyone at the table understood(Matches Language), and did not clarifywhen the social partners expressed confusion(Clarifies).

During both interactions, Darrell spoke loudly(Regulates) with exaggerated emotions(Expresses Emotion), however theseissues were even more disruptive during

the interaction in the break room, when heinappropriately disagreed with the opinionsof co-workers (Disagrees), which resultedin the several co-workers leaving the table.Overall, Lena summarized the overall qualityof Darrell’s social interaction to be moderatelyto markedly inappropriate.Darrell said he did not realize that he was“coming across that way to others” andwanted to work on the skills that werehindering his social interaction, in hopes ofkeeping his job, as well as keeping friends.Together Lena and Darrell explored optionsto help Darrell acquire some social interactionskills. The specific observations and explicit

analysis of the social interactions gave Lena

and Darrell a direction for intervention.