An open letter to an occupational therapy evaluator
Dear Evaluating Occupational Therapist,
You evaluated a preschool child who has been receiving private occupational therapy for a year. I referred the family to their local school district because I thought it would be a better option for the family to receive services this way. Your evaluation was thorough and a fair representation of how that child functions - which is always good to see because sometimes evaluating preschoolers is tough and their performance can be variable. I was a little disappointed that you didn't make any attempt to contact me and get any input on the case. I think it is important for evaluating therapists to talk to previous therapists especially when high stakes decisions are being made, like eligibility for services through a system.
The agency that you work for sent a very nice person to the CPSE meeting to represent all of the evaluations that were completed. I asked the representative person what their position and role was at your agency and I learned that this person was a representative. I asked a second time and was told that the person was a representative for CPSE and CSE meetings. I didn't want to ask a third time because it might have been embarrassing - so I am not sure if it was a janitor or the executive director from the agency. They were very nice though.
The Representative read selected portions of all the evaluations at what I would call breakneck speed and it was very difficult to process the information that was provided so rapidly. I read over all of the evaluations prior to the meeting so I would be fully prepared to discuss them and am very familiar with all of the contents. What came across in the rapid review was not fully representative of what you and some of your colleagues documented in the evaluations. It was close, but it was not really accurate. At this point in the meeting I started to worry a little.
The CPSE chairperson was also very kind and friendly. I was happy that they asked me for my input. I explained that I worked with the family for a while and encouraged them to pursue services through the CPSE. I told them my own evaluation findings which were pretty close to yours. I spent some time going over the ways that this child would have difficulty in a pre-academic context, because it really wasn't explained all that well by the Representative.
I think that the CPSE chairperson was pre-disposed to finding the child eligible because no questions were really asked - which was good, because the evaluations that were completed really did support the child's classification. You didn't put any recommendations for services in your evaluation - I know that a lot of therapists don't because they are told not to put recommendations into their assessments. I understand that the idea is that final determination of eligibility and services provided rests with the CPSE - which is fine - but I still stand quite firm in the belief that the recommendations should be made and then the committee should be responsible for accepting, rejecting, or modifying those recommendations as the full committee sees fit.
I find that committees don't like to have dissenting opinions in the room, and I think that is unfortunate because when everyone is agreeing it really undermines the collaborative planning process that is actually supposed to be occurring. It really would have been OK for you to make some recommendation - and then the whole group can decide what the best solution is in context of all the other information on the table. Something bad happens when you don't make any recommendations at all - and I think you really need to know about it.
So the good evaluation that you completed was reported a little inaccurately because you weren't at the meeting. The janitor or executive director representative really didn't understand the full nature of this child's difficulties, but it was mostly ok because I tried to fill in the gaps and thankfully the CPSE chairperson was in essential agreement anyway. Something odd happened though because there were no recommendations about frequency or duration of service from you - so the CPSE chairperson turned to the district speech pathologist who has never before met the child and said
Well you can thank this very nice speech pathologist who never met the child before because they thought the child should get OT services at least twice a week. I have absolutely no idea why the CPSE chairperson would ask the district speech pathologist this question but in this situation it worked out ok.
So I know this is a long letter, Evaluating Occupational Therapist, and you are probably really busy and perhaps being so busy made it impossible for you to represent your evaluation at a child's meeting. I just thought you might want to know that THIS TIME all the stars aligned:
It might not work out so well next time - so I thought you might just want to be aware of this story.
You evaluated a preschool child who has been receiving private occupational therapy for a year. I referred the family to their local school district because I thought it would be a better option for the family to receive services this way. Your evaluation was thorough and a fair representation of how that child functions - which is always good to see because sometimes evaluating preschoolers is tough and their performance can be variable. I was a little disappointed that you didn't make any attempt to contact me and get any input on the case. I think it is important for evaluating therapists to talk to previous therapists especially when high stakes decisions are being made, like eligibility for services through a system.
The agency that you work for sent a very nice person to the CPSE meeting to represent all of the evaluations that were completed. I asked the representative person what their position and role was at your agency and I learned that this person was a representative. I asked a second time and was told that the person was a representative for CPSE and CSE meetings. I didn't want to ask a third time because it might have been embarrassing - so I am not sure if it was a janitor or the executive director from the agency. They were very nice though.
The Representative read selected portions of all the evaluations at what I would call breakneck speed and it was very difficult to process the information that was provided so rapidly. I read over all of the evaluations prior to the meeting so I would be fully prepared to discuss them and am very familiar with all of the contents. What came across in the rapid review was not fully representative of what you and some of your colleagues documented in the evaluations. It was close, but it was not really accurate. At this point in the meeting I started to worry a little.
The CPSE chairperson was also very kind and friendly. I was happy that they asked me for my input. I explained that I worked with the family for a while and encouraged them to pursue services through the CPSE. I told them my own evaluation findings which were pretty close to yours. I spent some time going over the ways that this child would have difficulty in a pre-academic context, because it really wasn't explained all that well by the Representative.
I think that the CPSE chairperson was pre-disposed to finding the child eligible because no questions were really asked - which was good, because the evaluations that were completed really did support the child's classification. You didn't put any recommendations for services in your evaluation - I know that a lot of therapists don't because they are told not to put recommendations into their assessments. I understand that the idea is that final determination of eligibility and services provided rests with the CPSE - which is fine - but I still stand quite firm in the belief that the recommendations should be made and then the committee should be responsible for accepting, rejecting, or modifying those recommendations as the full committee sees fit.
I find that committees don't like to have dissenting opinions in the room, and I think that is unfortunate because when everyone is agreeing it really undermines the collaborative planning process that is actually supposed to be occurring. It really would have been OK for you to make some recommendation - and then the whole group can decide what the best solution is in context of all the other information on the table. Something bad happens when you don't make any recommendations at all - and I think you really need to know about it.
So the good evaluation that you completed was reported a little inaccurately because you weren't at the meeting. The janitor or executive director representative really didn't understand the full nature of this child's difficulties, but it was mostly ok because I tried to fill in the gaps and thankfully the CPSE chairperson was in essential agreement anyway. Something odd happened though because there were no recommendations about frequency or duration of service from you - so the CPSE chairperson turned to the district speech pathologist who has never before met the child and said
What do you think?? Once a week or maybe twice a week??
Well you can thank this very nice speech pathologist who never met the child before because they thought the child should get OT services at least twice a week. I have absolutely no idea why the CPSE chairperson would ask the district speech pathologist this question but in this situation it worked out ok.
So I know this is a long letter, Evaluating Occupational Therapist, and you are probably really busy and perhaps being so busy made it impossible for you to represent your evaluation at a child's meeting. I just thought you might want to know that THIS TIME all the stars aligned:
- even though you didn't contact me about the child's therapy history and performance
- even though the agency representative didn't represent your evaluation very clearly
- even though you didn't make any recommendations in your report
- even though some random speech pathologist made the determinative statement on how much OT the child should receive
It might not work out so well next time - so I thought you might just want to be aware of this story.
