Scoring a young person with ASD and intellectual impairment
Question:
The client completed 3 consecutive running stitches but didn’t identify that the stitches were not tight on either the front or back.
Response:
They don’t have to get the tension correct to score the running stitch. This equates to a score of 3.4.
Question:
When I asked him if it was like mine he said ‘yes’; I further prompted him and instead of pulling it tight he went to undo all the stitches. I prompted him to tighten them without undoing, which he did.
Response:
You do not prompt people to correct a stitch. The manual states: (I am quoting the new manual here) If the person makes errors such as a stitch over the edge of the tool, skipping a hole, going in the wrong direction using wrong lace going in and out of the same hole or completing the stitches in a different section of the tool, note behaviour and allow person time to recognise and correct errors. DO NOT PROMPT the person to recognise or correct an error.
Question:
On the whipstitch he did one correct but then changed to the running stitch. He wasn’t able to correct himself, I gave him another demonstration and he attempted it but got tangled up at the back and wasn’t able to undo it himself.
Response:
If the person can do one stitch going over the edge of the leather from front to back for back to front and cannot find errors, this equates to a score of 3.4 At 3.4 the person will often revert to doing running stitches. We are not scoring errors here of twists and crosses at the back.
Question:
Should I have finished the assessment here or moved on to the cordovan?
Response:
You should technically keep going as long as the client will tolerate. Respect a decline to continue and score at that point. Use your clinical judgement to offer to cease the assessment. I usually find that I stop at the whip stitch if the person has difficulty with the running stitch and cannot do the whip stitch. Did you do the cross-in-back and twist errors? I suspect he would not have corrected these but this is often a good place to stop. It would be reasonable to observe that he did not recognise the tangled mess at the back as an error and that he wasn’t recognising and correcting twist errors as he went. However, when you insert the errors according to the protocol, it gives you more observations to report on and to confirm your clinical judgement.
Question:
I introduced the cordovan; he was able to do the first step but then not complete the second and then passed it back to me after a few attempts. I was going between 3.4 and 3.6. Is this correct?
Response:
To score 3.6 the person needs to do at least 2 whipstitches in consecutive holes going from front to back. They should recognise errors on the front of the leather. They will not look for mistakes on the back. They should stop before filling up all the holes or using all the lace.
Question:
My hesitation came from the descriptors around function not necessarily matching his overall performance. I have all of the books, but struggling to get started. Can you guide me here please on how to accurately score him?
Response:
The screen is considered highly accurate within one Level.Mode. You need to consider scores one n=mode above and below the screen score. If the person’s occupational function reflects abilities predicted at a mode above or below, that is their VALIDATED ALLEN COGNITIVE LEVEL.MODE