Compliments for special issue on critical issues in functional assessment.
چکیده
The March 1993 issue of the Amen'can journal of Occupational Therapy (AjOT) , Volume 47, Number 3, is the first issue of which I have read and devoured every article. I have received every issue since 1959. I am a therapist in private practice and involved exclusively in evaluation of residual functional capacity of persons who have completed their rehabilitation. Within a 3-to-4-hr time span, I must use my accumulated assessment and evaluation skills from my years of practice to make a prognostic statement regarding the "functional status" of my client or patient. This evaluation is usually my one and only contact with the person. My statement is incorporated with other professional evaluations and used to determine a financial reward for my client or patient. I am an expert witness, and my evaluations are requested by attorneys to use in determining fi· nancial needs or rewards. As I read [in the March 1993 issue of AjOTJ about the need for evaluation tools that accurately define needs and capabilities from the client's real-life perspective, all I could say was "Amen!" The extensive foundation of information, thought, and efforts expressed in thiS issue of AjOT have motivated me to reevaluate and record all that I learn from the tools that I currently use. I know that I see more and differently depending on who and why I am evaluating. My challenge: Are there better ways of measuring "functional status" with current tools without reinventing the wheel? For example, I use the ]ebsen-Taylor Hand Function Test extensively, along with the Kenny Test of Strength and Dexterity. Their strong points are the comparison of results to statistical data. Their weak points are in the accuracy of defining normal. The challenge is in defining the activity in functional terms and of practical importance to the client being evaluated. What is the bottom line? What does it matter how the person functions in relation to statistics? Also, what does it matter in relationship to normative data? ObViously, it matters for therapeutic goals, and it matters when money is allotted on the basis of deviations from normal. The higher and more JUSt level of attention must be focusing on a combination of both objective data and subjective concerns. I do not say it as succinctly as your authors did, but it certainly was music to my ears. Sandra Butterbaugh, anA Tempe, AZ