Parent/Child Evaluation

Name of Child: Alexis Smith Age: 11 Evaluator: Kayla Jensen

Parent: Christina Smith Date of Evaluation: 11/08/2017

Purpose for Evaluation

An evaluation was conducted with Alexis and her mother Christina to determine

the child’s current skills as well as any challenges she may be experiencing. By

administering the provided assessments, I am developing the skills necessary to evaluate

children in future OT practice. This assignment will prepare me for a career as an

occupational therapist as I will be using many of these same tools to determine the needs

of client’s, as well as address the barriers that may be influencing their occupational

performance.

Background Information

Alexis is 11 years old and she resides with her mother, father, and two older

brothers. She has another older brother and sister that both live outside of the home. Her

family lives in Lehi, UT where she attends 6th grade at Eagle Crest Elementary School.

Her father works outside of the home M – F and her mother stays at home. Alexis can

participate in all school tasks without difficulty. Alexis does not have any

physical/mental conditions that impact her performance and she is generally happy and

healthy.

Alexis is successful in participating in extracurricular activities including sports,

completing all academic homework, and interacting with her family. She also

demonstrates ability to move and perform gross motor tasks to participate in preferred

occupations. Alexis follows a typical daily routine that helps her remember what she

needs to do for the day. She enjoys knowing what the plans are but she does not seem to
be bothered by changes made in the family’s schedule if necessary. Barriers impacting

her performance include difficulty falling asleep, getting along with her brothers, and

sometimes wearing her glasses for sport activities. Alexis’ family values going to church,

having family dinners together, and using time for healthy recreation. Some of Alexis’

interests are jumping on the trampoline, playing piano, watching Netflix, making crafts,

playing sports including swimming and basketball, and playing with her dogs.

Assessments Used

COPM

The Child was administered the COPM which highlights one’s perception of his

or her performance as well as how satisfied he or she is with their current participation in

the occupation. It focuses on problem areas that could be addressed through occupational

therapy. A typical day for Alexis includes waking up at 7 am and completing a morning

routine. Her routine consists of getting dressed, using the bathroom, eating breakfast,

doing her hair, and brushing her teeth. She leaves her home at 7:45 am and her mom

takes her to school. She attends school from 8 am – 2:15 pm. She usually rides in a

carpool home and will eat a snack, practice piano for 20 minutes, complete homework,

work on crafts, and clean her room. She eats dinner around 6 pm with her family as they

discuss their day with one another. In the evening, activities vary depending on the day;

sometimes the family watches TV, plays with their dogs, go to sporting events, or play

other games. The evening routine consists of reading scriptures, praying, getting a bed

time story from dad, and a bed time song from mom, and Alexis usually goes to sleep by

9 pm.
 Alexis shows little to no difficulty in areas of functional mobility, community

management, paid/unpaid work, household management, school and play, quiet

recreation, and active recreation. In these areas, Alexis is motivated to engage in the

activities that support these categories. However, other areas of care are disrupted

including personal care and socialization. As mentioned previously, Alexis has difficulty

going to sleep at night and as a result is usually tired the next day. Her parents have tried

to implement music in her evening routine for calming but have noticed minimal change.

As stated by Alexis’ mother, her glasses have gotten in the way of playing sports and

participating in other activities. Alexis is not comfortable with the idea of switching to

wearing contacts. Regarding socializing, Alexis experiences teasing from her brothers

and will sometimes get upset and not want to interact with them. Alexis has a shy

demeanor and it is difficult for her to make friends at first but she is learning to overcome

this and enjoys spending time with others.

Alexis and her mother felt that the main problems of concern were difficulty

falling asleep, interacting with her brothers, and wearing glasses, listed in order from

most important to least important as shown in the chart below. Overall performance for

Alexis is a seven, with a four in satisfaction. These scores indicate that Alexis and her

mother perceive these challenges as not too difficult, however, Alexis is not satisfied with

these things and could benefit from some insight on how to make these occupations more

satisfying.

OCCUPATIONAL PERFORMANCE SATISFACTION

PERFORMANCE PRIORITIES (On a scale of 1-10; (On a scale of 1-10;
1=not performing, 1=not satisfied,
10=performing 10=highly satisfied)
independently)
Difficulty Falling Asleep 6 2
 Play/Interacting with Brothers 5 2
Wearing Glasses 10 9
TOTAL 21/7 = 3 13/3 = 4.3

Developmental Test of Visual – Motor Integration (VMI)

The VMI assesses visual motor skills and informs us if there is an issue with

vision or motor skills. Alexis demonstrated ability to draw 27/30 shapes correctly, as

defined by the standards of this assessment. Scores are indicated in the chart below. Since

Alexis enjoys drawing, she took more time and tried erasing on some of the more

complex shapes. She was given two reminders to not erase. She did not meet the criteria

for two shapes that had a similar pattern, as shown in the scoring booklet. These scores

indicate that Alexis scored 77% higher than others in her age group. Her visual – motor

skills are intact as she copied the shapes that she saw with minimal correction.

Beery VMI Scores

Raw Score 27

Standard Score 111

Scaled Score 12

Percentile 77%

BOT – 2 (Manual Coordination)

The BOT – 2 assessment consists of many subtests that evaluate gross/fine motor,

balance, coordination, and strength. The manual dexterity and upper-limb coordination

subtests were administered to Alexis. The Manual dexterity section tested her

performance using her hands through completion of various tasks. These activities

include making dots in circles, transferring pennies, placing pegs in a pegboard, sorting
 cards, and stringing blocks. There are two trials for all activities except for making dots

in circles. For each trial, Alexis was given 15 seconds to complete. She did better on each

task during the second trial, except when sorting cards. There were various patterns noted

as she completed the required tasks. She alternated her hand position using a tripod grasp

with both a thumb wrap and no thumb wrap. When sorting cards, she grabbed multiple

cards on the second trial and was reminded once to only grab one card. She also

alternated hands when stringing blocks, using her dominant hand to string a block and

then switching to use her non-dominant hand to string a block. The upper-limb

coordination looks at hand-eye coordination and gross-motor function. These activities

include dropping and catching a ball, catching a tossed ball, dribbling a ball, and

throwing a ball at a target. Most of these tasks were tested using both hands and then

using only one hand to compare the performance. Alexis completed these tasks without

any verbal prompts.

Scores are indicated in the chart below. These scores together infer that Alexis is

performing at an average skill level in her overall performance. It is unclear as to why

Alexis demonstrated below average performance in manual dexterity and further

assessment would be needed to determine possible reasons for these results.

BOT – 2 Testing Total Point Scale Standard % Age Descriptive

Score Score Score Rank Equiv. Category
Manual Dexterity 27 10 8:6 – Below Average
8:8
Upper-Limb Coordination 37 18 12:6 – Average
12:11
Overall Manual 28 47 38 Average
Coordination
 Performance Observations

Behavior During Testing

Alexis was receptive to answering questions and she was open to discussing her

daily occupations and problem areas. She was focused during the conversation and

attended to the tasks she completed. She also seemed to understand directions given to

her after only one time. During the VMI assessment, Alexis focused intensely on drawing

the shapes accurately and was bothered a little if she messed up on a section.

Hand Preference

Alexis preferred to draw and perform manual dexterity tasks with her right hand.

However, when completing the task of stringing blocks, she switched back and forth

between her right and left hand as to which one she used to hold the block. She used her

right hand for most of the upper-limb coordination tasks and majority of the activities

overall and therefore, according to observation her right hand was her dominant hand.

Posture During Writing

Alexis remained seated during the task of writing. The surface she was writing on

required her to lean forward as it was placed in front of her at a lower height. She used

her left hand to stabilize the paper as she wrote with her right hand. She also supported

herself on her elbows. She demonstrated good posture when answering questions and

during the completion of other tasks.

Pencil Manipulation

Alexis held the pencil using a tripod grasp. She would adjust her grip by using a

thumb wrap at times and lifting her thumb off the pencil at other times. She seemed to

use the thumb wrap when she was more focused on drawing the shapes that required
more detail, seeking for more support and input to her hand. Pencil manipulation was

overall appropriate for her age.

Summary

Alexis is participating in daily activities as expected of peers her age. At this age,

it is typical for a child to be involved in academic pursuits, extracurricular interests, and

engaging in family routines. Alexis is very engaged in these occupations and is utilizing

her resources and strengths to incorporate a variety of activities. I have gained insight

regarding the needs a child may have and the benefit of administering assessments.

As indicated by these assessments, it seems that Alexis may have difficulty

completing tasks that require higher level hand dexterity skills. Although this is what the

assessments tell us, Alexis can adapt and make the appropriate accommodations as

needed. These assessments have highlighted a few barriers that may be impacting Alexis’

participation. However, I understand that due to this case being a typical representation of

a child, I would see a much higher need for OT services with other individuals. At this

time, informational resources and suggestions including what to try at home will be

provided to client and family to offer support with the noted challenges. Occupational

therapy services are not recommended for this child as she is able to function in her daily

occupations without much difficulty.

Date - 11/11/2017

Kayla Jensen