Standardized Evals for O-B Hand Therapy

An academic fieldwork coordinator (AFWC) recently shared the following telephone conversation with me. The AFWC was discussing a possible Level I fieldwork placement for a student in a hand therapy clinic, including the required assignments. When the AFWC mentioned that the student would need to complete an occupation-based assessment on a client at the facility, the prospective clinical instructor said, "Oh, we don't do those here; we only use standardized assessments."

The AFWC told me that she was shocked that this otherwise experienced and knowledgeable clinician would be so misinformed about occupation-based assessments. Indeed, it is shocking. How can we distinguish ourselves as the experts that we are in occupation if we are unfamiliar with the standardized occupation-based assessments that are available to us?

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A standardized assessment is an assessment that is administered and scored with specific instructions and methods. There are actually at least four standardized occupation-based assessments that are available for use in the hand therapy setting.

• The Canadian Occupational Performance Measure (COPM). This is a well-known standardized occupation-based assessment used to identify, rate and prioritize valued areas of occupation with which the client is having difficulty (Law et al., 1998). The COPM has been widely researched in varied practice settings (including hand therapy) and recommended as a useful tool in hand therapy settings (Berro & Deshaies, 2007; Bhavnani, 2000; Jack & Estes, 2010; Killian, 2006) with excellent reliability, validity and clinical utility (Ikiugu & Anderson, 2008). You can read about the COPM at and can purchase it from the Canadian Occupational Therapy Association. A link is available on the site.

• The Occupational Performance History Interview (OPHI II). This is a standardized occupation-based assessment that uses the theoretical constructs of the Model of Human Occupation (MOHO). The tool helps the occupational therapist understand a client's life history, the effect of disability on the client, and the direction the client wishes to pursue in life (Kielhofner et al., 1998). The OPHI II consists of a semi-structured interview with criterion scales for rating the data, and a structured process for recording and analyzing narrative data (Kielhofner, Mallinson, Forsyth & Lai, 2001). The OPHI II has demonstrated good reliability, validity and responsiveness (Ikiugu & Anderson, 2008; Kielhofner, Mallinson, Forsyth & Lai, 2001). Information on this tool is available at, where it can also be purchased.

• The Disabilities of the Arm, Shoulder and Hand (DASH).

• Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH).

These questionnaires are standardized assessments that can help the occupational therapist identify common limitations in occupational performance experienced by clients with hand and upper-extremity diagnoses. The DASH and QuickDASH have demonstrated good validity, reliability and responsiveness (Beaton et al., 2011; Gummesson, Ward & Atroshi, 2006). While both the DASH and QuickDASH are faster to use than the COPM or OPHI II (and free for clinical use at, the COPM and OPHI II elicit more individualized assessments of occupational functioning.

All of these assessments are standardized and demonstrate good reliability, validity and responsiveness while addressing the client in an occupation-based manner. It is worthwhile for the profession of occupational therapy and for our clients that we become familiar with and use these valuable tools.

Donna Colaianni, PhD, OTR/L, CHT, has been an occupational therapist since 1988 and has practiced in hand therapy since 1992. She is currently an assistant professor of occupational therapy at West Virginia University.

Hands On Archives

Hi Caran,

Sorry I just saw your comment! The PRWHE (The patient rated wrist/hand evaluation) is a good assessment somewhat similar to the DASH. I tend to prefer tools that are a bit more open ended and allow the client to express what is most important to them like the COPM, but tools like the DASH and PRWHE are good when time is limited.

Donna Colaianni,  Assistant Professor and Advanc,  WVUNovember 01, 2012
Morgantown, WV

What are your thoughts on the PRWHE ? We use that one at our facility and have the ot students perform that.

Caran Gottlieb Broward health-csmcMay 25, 2012
Pompano Beach, FL


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