Guide to OT Assessments

Most occupational therapists use a standardized assessment as a means of gathering relevant data. It not only helps them see where your child lies in comparison with their same age and sex peers, but it is also a good tool to measure baseline skills.

There are drawbacks to standardized testing as well. In order to place the child/adolescent into the norms, a rigid set of rules must of followed during testing. For example, if the test states that you may only repeat the direction once, and your child was talking or looking away when the direction was given, they may miss that entire section even though they do in fact have the ability to complete it. Or suppose that day, your child was upset by an incident in the morning and did not feel like giving their best effort, they may score lower than they would on an average day. As you can see, standardized testing is a snapshot in time and thus may not fully capture someone’s true potential. The practitioner will and should always use their clinical judgement to determine if the assessment was a valid indicator of child ability.

Take Home Message: A standardized assessment is a useful tool in measuring student skills which the practitioner takes into account when determining the need for services. Other tools are also taken into account and may be more helpful in appropriately assessing a child, such as skilled functional observations, work samples, and interviews with teachers and parents. An assessment score alone does not justify the need for, or dismissal from, occupational therapy services.

Commonly used assessments for Fine Motor and Visual Motor Skills
Beery Buktenica Test of Visual Motor Integration (Beery VMI)

This assessment consists of three subtests:

  • Visual Motor Integration - On this test, the individual is presented with increasingly complex images and is asked to replicate it in a box below the image. This helps us see how the child can translate visual images into a motor response.
  • Visual Perception - The individual is presented again with increasing complex shapes. This time, they must match the image from a choice of images. This gives us information on how well the visual system perceives small details such as angle, direction, size, etc.
  • Motor Coordination - On this test, the individual is presented with increasingly challenging shapes to trace, while remaining in a given area (tracing in a box, similar to a maze). This gives us information fine motor control.

The age range is from 2 to 100 years old. The VMI portion will take between 10-15 minutes to administer and the remaining subtests take about 5 minutes each to administer.

Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOTS-2)

Uses game-like methods such as beads, cards, ball and target to measure fine and gross motor skills, coordination, and strength and agility. A therapist assessing for only certain areas may choose to use only some subtests, but will not be able to get a composite score. The age range is 4-21 years old. Completion time is 15-20 minutes for the Short Form, and 45-60 minutes for the Complete Form

Peabody Developmental Motor Scales – Second Edition (PDMS-2)

This test is commonly used in early intervention programs. It takes an allover look at Fine and Gross Motor skills. The subtests include: Reflexes, Stationary, Locomotion, Object Manipulation, Grasping, and Visual-Motor Integration. The age range is birth to 5 years old. Administration takes 20-30 per subtest, or 45-60 minutes for complete assessment.

Developmental Test of Visual Perception – Third Edition (DVPT-3)

This test is useful if problems in visual perception is strongly suspected. This tests help isolate where a breakdown in visual perception is occurring. The five subtests include: Eyehand Coordination, Copying, Figure-ground, Visual Closure, and Form Constancy. The age range is 4 years, 0 months, to 12 years, 11 months. The testing time is about 30 minutes.

Work samples, interviews, and functional observations

Work samples, interviews and functional observations can be just as or even more informative that standardized formal testing because it takes into account everyday strengths and challenges as seen by the people who work and live with the individual the most. Functional observations may also consist of the practitioner asking the teacher or parent to modify a task so that they can see how they perform skills given a group direction in their natural environment. These methods are used to inform a comprehensive evaluation of skills.

Commonly used assessments for sensory processing:
Sensory Integration and Praxis Tests (SIPT)

To date, the SIPT is widely regarded as the most complete standardized assessment for Sensory Integration. Except in some cases, this test is not usually administered in the school setting due to the depth and time required to administer this test. Structural Skilled (Clinical) Observations, and well as functional observations are usually enough to inform a school assessment. Additional training is also necessary to administer this test. The age range is 4 years to 8 years, 11 months. Administration time is 10 minutes per test; 2 hours for the entire assessment.

Sensory Processing Measure (SPM)

This assessment is designed to capture any sensory processing difficulties that an individual may be experiencing. It is in questionnaire form and includes a Home Form, Main Classroom Form, and School Environment Form which is completed by the child’s parents or home care provider, primary school teacher, and other school personnel who work and observe the child respectively. It is designed for ages 5 to 12. There is also a Preschool Form for ages 2 to 5 years old. The administration time is 15 to 20 minutes.

Sensory Profile (SP)

This assessment is designed to look at sensory processing patterns and it’s effects on functional performance. It is in questionnaire form and is completed by caregiver and teachers. There are different form for different age ranges. The age range is from 7 months to 14 years old. It may take 15-20 minutes to complete.

Systemic (structured) Observations of Sensory Processing

These observations help a practitioner isolate and identify deficits in the sensory system. There are norms available. They include the following tasks:

  • Prone Extension - looks at vestibular-proprioceptive processing
  • Supine Flexion - somatosensory function and praxis
  • Diadokokinesis or forearm alternating movements - motor planning
  • Reciprocal Stride Jumps and Jumping Jacks - bilateral integration and sequencing praxis
  • Finger to nose test - proprioceptive processing
  • Wheelbarrow walking - vestibular processing, bilateral motor coordination
  • Shilder’s Arm Extension Test - proprioceptive processing
  • Slow Ramp Movements - Proprioceptive processing
  • Projected Action Sequences - Vestibular-proprioceptive processing and sequencing praxis
Functional Observations

Skilled observations of an individual to see how they interact with their environment, their peers, and how they respond to classroom or home direct tasks

Life Skills
Goal-Oriented Assessment of Lifeskills (GOAL)

The GOAL looks at fine motor, gross motor and coordination skills in a functional motor perspective. The activities are based on life tasks that a children are required to complete daily. These include the use of utensils, locks, organizing papers and notebooks, clothes, ball play and tray carrying. The age range is 7 to 17 years old. The administration time is 45-60 minutes.

Evaluation Tool of Children’s Handwriting (ETCH)

This test takes an in-depth look at handwriting including legibility, grasp, hand preference, manipulative skills with a writing tool and speed. It includes near and far point copying, sentence generation and dictation. It evaluates both manuscript and cursive writing. This test is for grades 1-6. The administration time is about 15-20 minutes.


How Occupational Therapy is Delivered in School
Terms Defined: In OT
Terms Defined: In the IEP