You want to use a person-centered care approach — working on meaningful goals and activities with the person you are treating — but it’s just SO. HARD. to know how to do that when all you have is a standardized score from the CLQT (see also: MOCA, WAB, RIPA, WJ-III, TEA, and on and on).
You’re not alone! It’s really hard to figure out a functional need when you’ve been focused on just getting those standardized scores. So what can we do about it? (*Practically. Realistically. We’re ALL on a time schedule here.)
Introducing: The Discovering Functional Needs Series. I’m blogging about real, practical tools so that you can feel at ease and prepared to treat with a person-centered approach from the get-go.
And this week we’re talking about: Contextual Observation
Contextual Observation: Yes, as a true SLP I found a fancy way to say that I’m observing someone doing activities in real life. Making a phone call? Finding a baseball game on TV? Paying a bill? You get the picture.
Contextual observation goes hand-in-hand with my setting-specific checklists and is also part of my latest store product: The Discovering Functional Needs Packet!
Why is contextual observation so important? Well, if someone says they are having a hard time making phone calls, we need to know more about that. By observing that skill, we can see where the problem may lie. Dialing the number? Finding the phone number? Sequencing the apps to get to the correct spot? Understanding others on the phone call? Not knowing how to repair when others don’t understand them?
The fastest way to glean all of this information is to actually OBSERVE a functional need — something the person needs to do or wants to do. On top of that, we all know that someone saying they can do something is not the same as actually seeing them do it.
So how can we fit this contextual observation in QUICKLY in our assessment? I’ve created the Discovering Functional Needs Packet as a series of checklists coupled with key prompts to help you observe an actual activity. This will help you see what needs to be done, where the problem may lie, and how an intervention may be helpful.
Do you think I’m blazing my own trail here? Not at all. Did you know that contextual observation is OK and even RECOMMENDED for TBI and aphasia and beyond? It’s part of non-standardized assessment as a best practice for all populations (See ASHA Practice Portal – Assessment). This knowledge has freed me up to let go of spending all my time doing standardized testing, and instead prioritize completing non-standardized portions of the evaluation that actually give me information so I can discover and meet functional needs from Day 1.
What are your thoughts? Have you been incorporating contextual observation into your assessment time?