Welcome to Therapy Connect conversations. My name is Megan Walker, your host. Today we’re talking with Sue Cameron and Simone Dudley, who are the Directors of Therapy Connect, about assessments and how you can use assessments to get more out of your therapy journey.

Simone, we’re going to start with you. Tell us, what is the role of assessments in the therapeutic journey?

The role of assessments is quite important. Assessments can be used in the early stages to establish functional participation and capacity across developmental areas. Sometimes assessments are important in order to establish entry into some funding schemes because they provide that evidence that’s needed to often determine or qualify somebody for funding. Assessments can also be used to inform intervention. And this is really important once you’re in on your therapy journey. Of course, assessments can be used to measure the therapy progress, or the effectiveness of therapy interventions along the way as well.

Okay, fantastic. A really vital important part of therapy then from the sounds of this. And Sue tell us, can these assessments only be done in person, or can they be done via telehealth?

Well, I’m really pleased to be able to say that that can be done by telehealth Megan, because that’s a very important part of the way we deliver our services. We can do assessments in three different ways. We can do an observation, or we can do questionnaires and interviews, or we can do a standardized assessment. So, I’ll just start with observation. We can learn a lot about watching how a child might interact with a parent or a helper online. We might be able to see whether they can sit down on a chair or the way that they attend, and we can see what their behaviors like. We can see whether they’re able to look at a toy or read a book together with another person, for example. Then we can look at their social communication, how they’re interacting with their communication partner. Whether they notice the other person in the room, for example. Or whether they are able to request things that they want to do.

We can listen to the way that they speak. And so, we can find out whether we can understand what they say, or whether they are following instructions that they might be given. So, we can watch all of that in a session. If we were wanting to look at their fine motor skills, we might watch them eating, or watch them doing a jigsaw puzzle, and we can learn a lot. We can get them to move around the room so that we can see how they mobilize as well. So that’s observation. 

The next thing is parent questionnaire or an interview. So we can send questions like, “How does your child interact with other children of the same age?” Or, “Does your child have trouble putting their shoes on?” Or you can ask specific questions to try to find out where the child is at in their development.

And then the last way is by using a standardized assessment. So, standardized assessment means that you have to present a test in the same standard way every time you use the test, so that we can compare a child’s functioning with the functioning of other children the same age. So we might have to send some pictures, and some of the stimulus for the test to the family. Or usually we would share that on screen. And the fortunate thing that’s happened with people’s understanding of telepractice now is that now that they understand more about telepractice, is that the publishers of the tests are producing more of those tests in a digital format that we can use by sharing them online with families. 

Sorry. That was a very long answer to your short question, Megan.

No, you did a fantastic job Sue. I’ve got the really full picture there that telehealth is definitely no barrier to getting assessments. Sounds like you could do absolutely everything and probably more than what you can do face to face. So, thank you for your detailed answer.  Simone, tell us, is it only at the beginning of the therapeutic process where you do assessments? Are there other opportunities throughout?

Megan I would say that most practitioners would be assessed in some form throughout the intervention process with the client. It might be to measure their progress against some goals, or it might be to help refine other strategies and other interventions that might be helpful. Certainly for goal setting, and then when it comes to reviews, assessments are really critical to look at how far have we come, and what’s left to try to achieve to map out the next service plan.

Wonderful. Keep those goals on track there. And Sue, from your perspective, what are some of the common assessments that you do with your clients in speech therapy, and also in dietetics in the other parts of Therapy Connect?

Sure. So, in speech therapy, if the child’s hard to understand, then we would do an articulation assessment. So that means we’d listened to the way that the child makes sounds in response to some pictures. So we could either send the pictures to the family or we could show them on the screen. And then we can see how the child produces each of the sounds in different positions in a word. I’ll give you an example. If we were looking at, say the ”C” sound, or “K” sound, then you would show the child a picture of a cow and bacon, where the sound is in the middle of the word and at the end of the word in something like book. And you might find that they can say “tap” instead of “cap”. Then they might say bacon all right, and they might say book the correct way.

And so, we would know that we only have to target that speech down at the start of words. That’s the only place where they make the error. With language, we’d be getting children to follow instructions and we would see whether they understand things like in, on, and under. Whether they recognize vocabulary. Whether they understood the past tense of words. Do they know that, “We drinked the water,” isn’t the correct way to say it. We have to say, “We drank the water.” And then, with social communication, we’d probably use a questionnaire for families, an interview or a questionnaire. And in dietetics, I think there’s a lot of asking parents to report on their child’s eating habits and the nutrition that they get during the day. So, we’re much more relying on interviews and questionnaires for parents in dietetics as well.

Okay, great. And Simone, in your area of expertise, OT, and tell us about what sort of assessments you use. And also, what you know of assessments that are used in psychology in Therapy Connect as well.

I think that the idea that Sue pointed out, on informal assessment and formal assessment are quite common. In the OT space, sensory assessments are really common. And they’re very helpful along the journey because you can glean a lot of information and some strategies to support families around routines that might be otherwise challenging because of differences in sensory processing abilities and differences that can be supported. Once you have that information, you can therefore make some changes to the environment or to the task that can support an increase in participation. So, sensory assessments are very common. Obviously, other assessments might include play assessments, executive functioning assessments, social skill assessments. And there would be a range of questionnaire-based assessments that can be done on digital publishing platforms, as well as informal observations, depending upon the practitioner’s sort of clinical skills. And psychology would be largely clinical observations then matched with some assessments that might be questionnaire-based as well.

And Sue, we know that knowledge is power. And who are the people who get to be empowered by the outcomes of the assessments?

Well, I think the assessments just help us to understand where the child is in their developmental journey. And so, the therapists and the families can gain a much better understanding about where they should direct there, if it’s to help the child to bridge the gap between their functioning and the functionating that they’d like to achieve.

Fantastic. And schools as well Sue, that they would benefit from the outcomes of assessments with children?

Sure. It’s very important to share the results. We need to interpret the results of our assessment data and share that information and share the appropriate strategies with other people involved in the child’s life so that they do have the power then to help the child with their development.

Wonderful. And Simone, another benefit is the funding and reporting, and knowledge that can support the NDIS journey. Would you like to explain a little bit about how assessments can help with NDIS clients?

Many clients require evidence of progress and assessments can be very helpful in looking at progress made, but also outline areas for future service delivery that could be mapped out for the following plans. So, assessments are a really vital part of that annual review process for many participants. And we’re lucky at Therapy Connect that we can provide a range of assessments via telehealth to support participants achieve what they need to with their NDRS plans.

Sue, a question for you without notice. Sorry to do this to you. But if you’ve got someone on the fence thinking,  we’ll just go ahead with the therapy journey and we’ll see what happens. Versus spending the money and making the commitment to do the assessments. If they’re trying to decide between which pathway they’ll take, what would you say to a parent or a family about the importance of the assessment process?

Megan, I think you’d need to take every case as an individual case. And I think that a lot of times there’s been an over-reliance on assessment from time to time. I think it’s really important to do an assessment, to inform you about where to go in your therapy, and then to get the therapy done. And just repeatedly assessing people every year might not make a very big difference in the long term. So, I think we have to educate families about what’s important in their own child’s situation. And if we need assessment information to get some funding, or to guide the way that we intervene with that child, or the way that we deliver our therapy, then we need to convince families of the need of that. And hopefully, they’ll agree with us then that it’s necessary.

I always love speaking with both of you because you’ve always got the client’s best interests at heart at Therapy Connect. And so, as we wind up this very interesting conversation, tell us Sue, just give us the overview of what Therapy Connect is, where you work, and how people can get in contact with you.

Therapy Connect is an online service that provides speech and occupational therapy, psychology, dietetics, and physiotherapy. All online. We work all over Australia, and our therapists are located all over Australia as well. The best way to get in touch with us is to contact our very friendly client services team on our 1300 number. So it’s 1300 757 806. Or the best way to make a referral to our service, if you just decided that this is the right place for you, is to go to our website at www.therapyconnect.com.au and register your interest by filling in a form on our contact page. And so, our client services team will respond to you very quickly after that form is received.

Thanks Sue, and thank you both so much for giving us your time today to let us know more about the role of assessments in therapy.