Slagle Lecture: Assessing Assessments
Earlier tonight, Dr. Wendy Coster of Boston University delivered the Eleanor Clark Slagle Lecture to a crowded auditorium of occupational therapy practitioners. The Slagle Lecture is always dense and thought provoking, and this year was no exception. Dr. Coster's talk was titled "Embracing Ambiguity: Facing the Challenge of Measurement." Coster has worked on several assessments, including the Pediatric Evaluation of Disability Inventory (PEDI) and the School Function Assessment (SFA).
Her premise: many of the assessments available today, especially those taken from outside OT, do not always tell the full story of OT clients. One must carefully determine whether the assessment accurately reflects what it is one is trying to measure. For example, the SF-36, a gold-standard assessment of health-related quality of life, asks whether a client's health limits him from performing certain activities. A client who recently had a stroke may answer affirmatively to many of the questions, but a client with congenital cerebral palsy may not see his chronic condition as a health limitation; rather, it is just part of who he is and has been for as long as he can remember. One must look with a critical eye at assessments, whether using them in one's own practice, or considering research that makes assumptions based on assessment results.
OTs must be conscientious of the assessments they choose to use, critical of research that bases determinations of a treatment's effectiveness on assessment results, and active in developing assessments that can accurately tell a client's full story. Many things can hinge on an assessment -- a client's eligibility for services or funding, for example. OTs need to be sure that clients are not being deprived and that OT practice is not being restricted based on the results of assessments that are not appropriate for the situation at hand.
ADVANCE will feature a full analysis of Dr. Coster's Slagle Lecture later this spring. In addition, the full text of the lecture will be published in the archival issue of the American Journal of Occupational Therapy at the end of the year.