What to Expect at Your Child's In-Home Occupational Therapy Evaluation

What to Expect at Your Child’s In-Home Occupational Therapy Evaluation. GettyImages

You’ve communicated your concerns about your baby or toddler’s development to his or her pediatrician, you’ve connected with your local early intervention agency to set up a developmental evaluation, and you’ve prepared yourself for the upcoming in-home evaluation by reading these Do’s and Don’ts. But you’re not sure what to expect during the evaluation itself! Here are some ideas of what to expect at your child’s upcoming in-home occupational therapy evaluation.

1. The occupational therapist will likely bring in his or her own toys and assessment materials. No need to pull out every toy you own in preparation for the therapist’s visit!

2. The evaluation may take anywhere from 45 to 90 minutes. The total time will depend on a variety of factors (including how readily your child participates) but, as mentioned in my previous post on how to prepare for your child’s in-home early intervention OT evaluation, it’s always a good idea to ask beforehand how long the therapist anticipates the evaluation will take.

3. The occupational therapist will likely spend the majority of the time on the floor with your child. Unless other arrangements have been made, an early intervention occupational therapy evaluation typically involves interactions and playtime on the floor. So don’t worry about clearing off or decorating your kitchen table for us in anticipation of a formal meeting at the table!

4. The occupational therapist will want to know what your primary concerns are as it relates to your child’s development. A pediatric occupational therapist looks at the “occupations” a child may want or need to participate in throughout his or her day. Examples of early childhood “occupations” for babies and toddlers include playing (including tummy time and play activities that promote progress toward developmental milestones), participating in mealtime (including self-feeding, sucking, chewing, and swallowing), participating in self-care routines (such as bathing, dressing, toileting, brushing teeth and hair), participating in family and community events (including being able to transition from one activity or environment to another), and even sleeping.

If you have concerns about how your child’s sensory systems impact his or her ability to participate in these types of daily occupations, please tell the OT! Here is an introduction to the sensory systems and how they impact daily function if you’re not sure whether or not your child is demonstrating sensory challenges.

5. There may be some paperwork for you to fill out. Or there might not be. It just depends on what the purpose of the evaluation is, how old your child is, and whether there is any further information the therapist would like to gather.

6. The therapist won’t get upset if your child is shy, refuses to cooperate, or tantrums the whole time. Early intervention therapists work with young children for a living. They’ve weathered their fair share of tantrums and meltdowns and difficulties transitioning between one activity to the next! As an occupational therapist myself, I never want a parent to feel guilty or bad if the child acts shyly or has a hard time during the evaluation.

An early intervention OT assessment is not just based on test scores, and your child won’t “miss” his or her chance at qualifying for services by refusing or being reluctant to participate. If this happens, the therapist may need to rely more heavily on parent input as well as informal observations made when your child engages with you or engages in play activities on his or her terms. Or, if necessary, a follow-up visit might be scheduled.

7. After the in-home OT evaluation is completed, it can take several weeks before you hear back about next steps and/or receive a copy of the OT assessment report. This is just part of the process, and you are welcome to ask the therapist if he or she has any basic suggestions for what types of developmental activities or strategies you can implement with your young child while you wait for the process to be completed. Once the therapist completes the evaluation, it can be a big job to then organize all the notes, score any assessment tools or forms that were completed, write it all up into a cohesive report and, if appropriate, write up recommended therapy goals. Then, typically, that report has to be sent to the appropriate parties within the early intervention agency, at which time it will be determined whether to move forward with the authorization process needed to get therapy services started for your precious little one. In general, if it’s been more than a month and you haven’t heard anything about next steps, feel free to reach out to your appropriate contact person just to check in. But please be patient! And, in the meantime, feel free to investigate online resources to support your child’s development (as well as your own!) such as Zero to Three, Autism Speaks, or the very helpful Children and Youth page on the American Occupational Therapy Association website.

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