Can I use this tool instead of standardized tests? Yes!!! Most of the time occupational therapists don’t need numbers and standardized scores to ‘qualify’ children for services or show continued need. Deciding which children could benefit from OT is an art.  This tool allows a therapist to use critical thinking skills and clinical judgment when performing assessments. The essence of our practice is to look at the children we work with as individuals with unique skills and motivations.

Is standardized testing necessary to determine the need for treatment? No. ‘Evaluation conducted by a therapist may include standardized testing, but it isn’t required because OT and PT are related services and as such do not have eligibility criteria. Emphasis should be on evaluating the students ability to function within the educational environment.’ Quote taken from ‘Occupational Therapy and Physical Therapy in Educational Settings: A Manual for Minnesota Practitioners’

*Some districts, COOP’s or other entities may require a standardized test as part of their testing procedures.

What else do I need for testing? Items to include in your zipper pouch: 3 crayons one orange, one red and one blue, 2 pencils, one pen, a scarf or piece of tissue, colorful visual target to place on the end of a pencil, small stapler, small rubber mat for the puzzle, a letter strip for testing letter recognition and letter copy, and a small scissors.

Why don’t you include a speed of handwriting task? When students lack speed in completing handwriting tasks, it is usually due to an underlying problem such as decreased strength or decreased processing speed. Our assessment gets to the bottom of the problem and the observations allow you to assess all the important skills that support fine motor success. For example, does the student pause frequently and lean against the table when working or gaze off (postural control or attention)? Does he drop his pencil and stretch his hand several times when writing (may signify strength issues). Or, does he have to stop and think about the letters he is forming ( no automated formations)? Does it take extra time just to process the information and then get it onto paper (processing delays). It will help you sort out why problems are occurring, even if it doesn’t directly address an issue like speed of completing written work.

What do I do when teachers and parents want numbers? Give them numbers! You can give approximate age ranges for most of the skills on the tool. Parents typically understand terms such as ‘1-2 years below age level’ much better than 1.5 standard deviations below the mean or 5th %ile. We have found that approximate age ranges satisfy most recipients of our information. You can also draw the focus away from numbers and instead stress classroom function, which is really what we need to look at for any student.

Tell me more about the puzzle task? The puzzle task is one of our most innovative tasks on the tool. It can be broken down into many skill levels using visual, verbal and physical guidance. It gives you information about language processing, visual processing, cognitive skills, art project assembly skills, sequencing, parts to a whole skills and spatial orientation skills.  Information gathered from this task can be correlated with information from our psychologists and teachers. The activity can be graded to appropriately meet the skill level of the child and help the student feel successful. For example, you can have the child complete the first puzzle. If that proves too challenging, he may need a visual clue. Provide a completed picture of the puzzle so he can see the finished product. Let him try again using verbal cues when necessary, such as “Look for the edges of the puzzle. or “Where would the head go on the top or the bottom?” The therapist can gain insight into a student’s challenges, and strength areas.

More about observations of gross motor skills. As children move through the exercises you offer, you will be making some important observations about how their sensory motor systems work. These observations can give important clues about underlying difficulties that may manifest in poor performance on school tasks. When observing movement, look for fluidity, timing, sequencing, balance, effort, motivation, preferences, ability to maintain contraction of muscles, joint stability, and tone. We also want to look at differences in the right and left sides of the body, motor planning, protective reactions, use of compensation strategies, ability to move against gravity, and the amount of tactile and proprioceptive feedback a child might be receiving from his body. We are comparing skills we observe to normally functioning children.

A tool that is sometimes helpful in quantifying some of these observations is the Clinical Observations of Motor Proficiency Skills (COMPS). Another tool that might be helpful with expanding on observations is ‘Observations Based on Sensory Integration Theory by Erna Imperatore Blanche. These observations will provide information about visual-tactile-vestibular-proprioceptive processing skills. Poor performance with the above skills may indicate poor feedback and feed forward signals between the body and these systems.

Does the therapist guide help me make my observations? Yes! It provides suggestions for each activity, what to look for when doing the activities, and what may be underlying causes for problems you see. It also gives general age ranges for skill attainment, which provides a nice reference when trying to determine if a student’s skills are age appropriate.

Who is this tool for? The SFMA is a great tool for beginning occupational therapists as well as seasoned therapists. It incorporates many of the skill areas necessary to help determine need in young students. It provides the therapist with an organized method for making thorough observations in a short amount of time.

It will also prove useful to the seasoned therapist as it streamlines observations and gives jumping off points for more in-depth evaluations (For instance in the areas of visual perception or vision development). In addition, it provides a way to track a student’s progress over time. It also eases the task of making comparisons of skills between students that are not easily standardized.

The SFMA is a great tool to help organize and formalize your evaluations!

What is the upper age limit on the assessment? We purposely did not put an age cap on this assessment. Appropriateness depends on the developmental age of the child being assessed. The workbook portion is appropriate for all children through grades 4 or 5. It can also be used with older children who may be working on basic school skills such as writing, cutting, etc…. Other areas of the assessment including vision skills, gross motor and kinesthetic awareness, self care, manual muscle testing, classroom observations and general observations can be used to guide the assessment of a child of any age.

The versatility of this tool allows the therapist to use it with a majority of school-aged children. And, because the assessment is reproducible, each page can be chosen to fit the age/need of the child being evaluated.

I’m clueless, what is the difference between an optometrist and an ophthalmologist? An optometrist tests eyes for defects of vision in order to prescribe glasses. They are the first line of defense when looking for vision problems. They will refer on to an ophthalmologist if they have further concerns. An ophthalmologist tests eyes for correct anatomy, function, and disease. A developmental optometrist has further training than an optometrist and tests how the eyes and brain are working together to produce reliable information. The AOA recommends all children see an optometrist by the time they are 6 months old. When assessing children, ask parents about any visits to the optometrist. Gently recommend a visit if there has been none and strongly suggest it if you pick up any possible problems using the PFMA during the evaluation. School screenings just don’t pass the muster when a child is having difficulty in the classroom. (60% of problem learners have undetected vision problems).