Posted in Assistive Technology, Eleanor Cawley, M.S., OTR/L, Occupational Therapy

How Important is the Content of a Referral When Evaluating for Occupational Therapy?

When conducting an evaluation, in my case either an occupational therapy or assistive technology evaluation, is the quality of the referral important?  In my opinion, absolutely!

Occupational therapy [and assistive technology] cover a huge array of skills in an infinite number of areas.  When conducting a school-based evaluation, it is prudent to know what the student’s difficulties are.  For example, if a student is unable to take notes, I would explore a variety of skills in detail [visual tracking, handwriting, orientation to sound, etc.].  I would need to know that the student is having difficulty in this area and this is an area that the school would like to address.  I would also need to know what the student thinks:  Is writing notes the problem or is something else.  Students need to provide feedback during an evaluation.  Their feedback provides insight to strengths and limitations that professionals might not see.

If I were evaluating a senior citizen, I would need to know what current and future living situations are being discussed and what the expectations of the patient and possibly the family might be.  For example, does the patient and or the family expect that this patient will cook or shop independently?  Although I would surely conduct a global assessment of this patient’s skills, I would definitely expand and focus on the skills that the patient is expected to be able to do.  In the case of cooking and shopping, my evaluation would focus on handling utensils, navigating the kitchen, energy conservation and safety, including fall prevention, both in the kitchen and out in the community, the patient’s ability to follow written and verbal directions, generating a shopping list, etc.

The referral asks the questions that the patient and his or her family need answers to.  Having a referral focuses the evaluation on the client, the student, the patient.  It shows the person being evaluated that his or her needs are important and valued.  This helps develop a rapport with the client that can support the therapeutic process so that the client has a vested interest in participating in therapy.

So, in addition to the diagnosis, the client needs to learn what an occupational therapist does and what he or she can assist with prior to the evaluation.  My next blog will cover “Just What Does and Occupational Therapist do?”


I am an occupational therapist with 18 years of experience in the pediatric sector, much of that time as an independent contractor. I am very passionate about my work and my writing. My degrees include a Bachelor’s of Science in Health Sciences and a Master’s of Science in Occupational Therapy from Touro College. Since graduating as a non-traditional student, I have worked in a variety of settings throughout the life span but settled in the area of school-based therapy. My interests lie in the area of using technology to support independence and I often train students to use programming not only to monitor their own goal progress but also support educational, vocational and life skills. Another area of particular interest is documentation. As an independent contractor for many years, I feel that it is important to align methods of documenting goal progress with educators for greater consistency and understanding when writing for an IEP. It is better to plan a format for documentation used in the IEP, such as for assessment and goal progress and that a rubric, in many ways, fulfills the need for consistency in documentation across all domains. Combining my interest in technology and documentation, I use Microsoft OneNote to maintain all documentation. I create a digital notebook for each student or patient with any forms required uploaded as templates which can then be completed, and saved automatically. I strongly believe in student centered approach to therapy. Students must be active participants in developing goals and documenting progress. In order to help students understand their progress, I teach my students to develop electronic portfolios and to use spreadsheet programming with graphs to collect data and view progress, whenever possible.