Bringing your young child to their first occupational therapy evaluation can be an overwhelming experience. At times, the therapist may forget to explain the details of the evaluation they are conducting, so I encourage you to ask if you have any concerns or questions. The following is a breakdown of what your therapist is doing and looking for during an evaluation using a test commonly called the Peabody.
The Peabody is designed for children ages birth to 5 years old. This evaluation is made up of six subtests- Reflexes, Stationary, Locomotion, Object Manipulation, Grasping, and Visual-Motor Integration. Occupational therapists administer only two subtests – grasping and visual-motor integration. These scores combined together create what is known as a Fine Motor Quotient, which defines how your child is performing with fine motor skills in relation to same aged peers.
During the evaluation, your therapist will often be flipping back and forth through a booklet! The Peabody requires the therapist to establish your child’s chronological age (exact age on the date of the test) and to take into account pre-maturity. This will determine where the therapist starts testing in the booklet. Skills will be tested until your child reaches what is called a “ceiling,” which means he/she was unable to complete the last 3 tasks and has reached the height of their skill set. During this portion of the testing, you may see your therapist challenge your child with tasks they have never undertaken, most commonly scissor skills or buttoning. Although you may think this is odd, as it is clearly out of your child’s abilities due to their age, it is important to conduct the assessment as instructed to maintain the integrity of the test. Next, the therapist will go in the opposite direction, lower and lower down the skill set, until your child performs 3 tasks in a row perfectly, reaching their “basal level.” This is a clear indicator of whether he/she is behind their peers or displays age appropriate skills. These tasks may seem too simple for you child, but it is important to complete each as directed by the test. Once the Peabody is complete, your therapist may be able to give you an approximation of your child’s skills, but they will still need to score the test in order to provide you with a full picture of your child’s development.
During the evaluation, it is best to allow your child to work independently with the therapist, with no or limited feedback from you as the parent. The therapist will spend ample time observing your child complete given tasks without assistance. This is typical because as therapists we have to allow your child the opportunity to demonstrate what they can do on their own in order to help them in the future. As a parent, resist the temptation to jump in and help because that could compromise the results of the test. The therapist will most likely chat with you during and/or after the assessment in order to gain a clearer image of your child. Some children may be shy and not display their true skill set during an evaluation; therefore, the therapist can take note of their reported abilities at home. Unfortunately, since they were not observed, those skills set cannot be counted as being officially achieved due to the standardization of the assessment.
Always remember, your child’s therapist is there to serve your family to the best of their abilities, and if you ever have questions or concerns in the process of an evaluation or treatment, be sure to ask and discuss.
-Samantha Kelland, Occupational Therapist