Evaluation question

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  • #1918
    Tamara Damini
    Participant

    Hi all,

     

    I was assessing (legal) an individual with significant post-concussion symptoms.  After 2.5 hours of interview and some assessments, the individual was becoming so symptomatic that cognitive abilities such as attention and focus were being negatively impacted.  At 3 hours we agreed to book a second appointment to finish the rest of the assessments and review the information.

     

    What are your thoughts/opinions on rebooking the person so they could go home to manage their symptoms?  Should I have made them stay to see the continued impact of the symptoms?

    #1919
    Francois Paradis
    Participant

    Hello Tami,

    Although a vocational evaluation takes place in a controlled environment, we try to emulate work-like conditions to see how the evaluee performs, their positional tolerances, attention span, ability to stay on task and to work at a productive pace (especially on work samples).  I would schedule a second session at the point when an evaluee say they cannot continue, at which point test results would have little validity. The important thing is to document everything, their behavior, performance, complaints, etc. How did they feel after the first session? How do they feel during the second session (especially if on consecutive days)? This is all important information to get a sense of their work tolerance (I.E. performing sedentary tasks in an office-like setting). If a person has difficulty doing sedentary tasks for less than 3 hours in a controlled environment, how would they perform in a competitive work setting, with typical work pressures? Hope this helps.

    #1930
    Marcus Bachmann
    Participant

    Concur with Francois’ post. Specifically, a true vocational evaluation – using criterion referenced tests and work samples – simulates work. Therefore, it is not useful (or ethical!) to have the evaluee stay and see how bad it gets; rather, if three hours of sedentary activity causes them to become so symptomatic they cannot continue “working”, it speaks to their overall work capacity. Also, as François noted, their ability to recuperate can also be assessed if they come back on a later (or consecutive) date. I will often follow-up with an evaluee to see how they felt later and how long it took to return to baseline. This has implications for their ability to sustain full-time work or work on consecutive days.

    #1931
    Tamara Damini
    Participant

    Thanks for the feedback – I agree that this is relevant feedback about work tolerances and there is no benefit in expecting the individual to “push through”.

    #1935
    Jennifer Griffiths
    Participant

    Great comments and suggestions all. I would add that it is important to get a solid picture of the person’s life at the time of the assessment and document that.  What is a typical day like, what do they do, what does a bad day look like, etc.  Then compare those reports with what you see in the testing to provide some comparison or alternatively consistency.  I agree, our job is to get the best performance out of the person, if they are struggling too much the testing is invalid.

    #1944
    Francois Paradis
    Participant

    There are a couple things I do to assess client symptoms. I ask them to give me a range for each symptoms (bad day vs good day) on a scale of 0-10. I also ask them to rate their symptoms (same scale) at the start and the end of the evaluation. This helps understand how/if their symptoms progress during the assessment. I also take note of their behaviour during the assessment and the level of accommodation they needed to complete tasks. With personal injury cases, it is common to observe an aggravation of pain and fatigue. Gathering all this data helps, along with other sources (i.e. medical reports, work and/or school experience post injury) to get a sense of the person’s level of function.

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