Occupational Therapy Screening: How and Why Do We Do It?
Newly practicing occupational therapists and occupational therapy students often ask, “How do we do an occupational therapy screening, and why do we do it?”
We are often asked to do an occupational therapy screening on patients that someone suspects may need occupational therapy services. So, what should be included in the OT screening? How can an OT efficiently screen in a short amount of time and gather all the information needed?
It can be a bit nerve-wracking doing a screening at first, as there is no prescribed way to go about it, so it might feel like a shot in the dark. This article will highlight what an occupational therapy screening is, why we do it, and what should be included in the screening so you will feel more comfortable doing this yourself.
What is an occupational therapy screening?
A screening is a brief process where the occupational therapist asks questions or does quick tests to determine whether a patient requires the services of an occupational therapist. It is not a complete assessment or evaluation.
It is much shorter than a full assessment, and the time it takes to do it may vary based on your setting. I try to do them in 15 minutes or less, as they are often non-billable, and if I go any longer, it more closely resembles a full assessment.
Why do we do occupational therapy screenings?
- To determine if a patient requires a formal assessment or evaluation
- It can be used as a good foundation to base your assessment/evaluation on.
- It saves time, as it allows you to identify which patients need occupational therapy and prioritize them.
- Some occupational therapists even provide screening forms or checklists to teachers, parents, or nurses to contribute to more efficient and correct occupational therapy referrals.
- It also provides an opportunity to give feedback to parents or teachers, when a child is on track developmentally, and the OT just wants to provide some tips or educate on certain topics.
What should I do in my occupational therapy screening?
Set the expectation at the beginning of the appointment so that everyone is on the same page, such as “Hi, Mrs. Smith; my name is Alexia, and I am an occupational therapist. My colleague, who is a physical therapist, requested that I see you as she feels you may benefit from occupational therapy. If it is okay with you, I would like to do a 15-minute screening with you, to see if occupational therapy can be of benefit to you. This is not a full evaluation but rather a brief ‘check in’ to see if you require my services. This will involve me asking you some questions as well as gathering some information about you from the nurses”.
By setting expectations at the beginning of your session, it helps to avoid any misunderstandings, as well as help the patient adhere to a shorter time limit.
Have a list of standard questions printed out, so that you can extract information quickly to help you determine if they require occupational therapy.
This checklist can include questions and tick boxes on their level of assistance needed, which can help you save time. Some of your questions should be about:
- Current level of independence in basic activities of daily living
- Current level of independence in instrumental activities of daily living
- How their mood, level of pain, and fatigue are.
- Are they still able to engage in their leisure interests?
- Asking whether they have noticed any changes in their cognitive skills. You can include a brief list of cognitive skills and make comments next to them.
- Their current performance at work/school/university.
- Changes in their strength, range of motion, balance, and mobility. A physical screening may also be needed here, or collecting information from other staff members.
- What the patient feels their current difficulties are and what they would like to improve in.
- A section for general notes you may have.
You can also have quick standardized assessments printed out and laminated, so you can use these informally as part of your screening. The results may also be helpful in motivating why occupational therapy is needed, such as the Barthel outcome measure. You can learn more about this quick outcome measure in our article here.
You will find that, over time, you will become faster at doing these screenings. Depending on your work setting, your screening may look very different, and the more experience you have in a specific field, the easier it is to know what questions you want answers to.
My personal experience with screenings:
When I worked in a hospital, I would often receive referrals from physical therapists, speech-language pathologists, nurses, and doctors, where they felt a patient would benefit from occupational therapy but were not entirely sure.
I would often use the time that I had right before lunch or the end of the work day to have a 5-20 minute window for screening a patient. This allowed for a quick check with the patient to see if they would benefit from OT, as opposed to dedicating a large portion of time to evaluating them, only to find out that they do not actually need occupational therapy.
Sometimes, I would also be referred a patient who needs occupational therapy, but does not have funding for it. I would therefore use my screening to gather information, and do an outcome measure to be able to motivate to the funders as to why they need OT and how it will help them.
Now that I work in an outpatient setting, my screenings look very different. Occasionally, we have a patient walk into our outpatient neurorehabilitation unit inquiring about our services and requesting a greater understanding of the different multidisciplinary team members and which discipline they or a family member might benefit from.
Therefore, the screening is more informal and consists of a 10-minute conversation with the patient or the family member’s patients, whereby I explain what occupational therapy is, what we target, and gather more information on the patient’s current difficulties. This provides a great opportunity to educate others on our profession, to begin the therapeutic relationship, and to start getting an idea of what I would like to investigate further when they come for a full OT evaluation.
I am sure you can tell from this article that there is no standardized way to screen and that it will be customized to your setting, to your country, and to the person you are screening. I do hope that this article has given you some ideas to make you more confident with completing screenings yourself.
To summarize, this article highlighted: what an occupational therapy screening is, why we do it, tips on how to be more efficient while doing it, and what should be included in the screening. We hope this article helped you to see the benefits of occupational therapy screenings, and have a greater understanding of why we do them.
Additional OT Screening Resources
Occupational Therapy Screening Form And Instructions (OT Flourish)