The Need For A Comprehensive Functional Assessment:
A good functional assessment is an important component in the rehabilitation
and habilitation of persons with disabilities. Without adequate assessment and integrated
documentation of functional outcome, status and progress cannot be observed.
A study performed by the Standardized Assessment Committee of the American
Occupational Therapy Association in the early 1980's revealed that occupational therapists
were using a countless variety of functional assessments, many of which were
"homemade" and unpublished. Review of key professional training textbooks in
occupational therapy shows that there are over 50 published functional assessments
commonly being reported and taught to new occupational therapists. This is no surprise in
occupational therapy: therapists practice in virtually all health and educational
settings, with virtually every type of disability.
Unfortunately, the variety of assessment available only complicates
occupational therapy documentation and reporting of functional status and progress.
Occupational therapy has no standardized model for aggregating functional assessment data
into a total reporting system.
Furthermore, the need for efficient and cost-effective occupational therapy
service delivery places additional pressure on occupational therapy practice. Funding
agencies, accreditation commissions and health care administrators are requiring
therapists to quantitatively consolidate information from comprehensive occupational
therapy evaluations into simple reports which highlight individuals' skills and deficits,
resulting disabilities, and ability to function in daily living, educational, vocational,
and recreational activities.
In 1979, the American Occupational Therapy Association formally recognized the
need for a profession-wide document which would help delineate the diverse and numerous
functional areas in which occupational therapists evaluate and treat their clients. The
American Occupational Therapy Association Uniform Terminology document was the result. A
few years later, the Uniform Terminology was modified to become the Comprehensive
Evaluation Checklist to assist therapists in organizing their evaluations. In the mid
1980's, the Standardized Assessment Committee of the American Occupational Therapy
Association, in conjunction with the American Occupational Therapy Foundation, funded two
projects to develop standardized methodologies for occupational therapists to interview
individuals and to quantify functional performance. One of these projects directly led to
the development of OT FACT.
