Manitoba Law Reform Commission
December 7, 1998
Manitoba Law Reform Commission
12th Floor
Woodsworth Building
405 Broadway
Winnipeg, Manitoba
R3C 3L6
Attention: Clifford H.C. Edwards, Q.C.
Dear Mr. Edwards:
This submission has been prepared on behalf of the Manitoba Society of Occupational Therapists (MSOT), an organization that in part:
- promotes occupational therapy and disseminates knowledge of the profession within Manitoba.
- represents occupational therapy interests and concerns to provincial legislators and policy developers.
It is with great pleasure that the MSOT Government Affairs Committee received the document entitled Discussion Paper on Informal Assessment of Competence to review and provide feedback to the Manitoba Law Reform Commission.
MSOT is often called upon to provide the Society’s official position, or provide responses to a variety of issues affecting the practice of occupational therapy.
Occupational therapists are frequently called upon to assess a person’s ability to participate in activities of daily living, specifically self care, productivity and leisure. The assessment process takes into consideration an individual’s mental, physical,
socio-cultural and spiritual self in conjunction with environmental factors. Information gathered from these assessments is utilized to determine task specific functioning or "competency".
In response to the Discussion Paper on Informal Assessment of Competence by the Manitoba Law Reform Commission, we chose to provide feedback related to the discussion questions which were of particular interest to MSOT. MSOT has concerns that a standardized test would limit the scope of occupational therapy professional practice, therefore we agree with the Manitoba Law Reform Commission’s recommendations specific to the development of an informal assessment of competency.
Is there a need for formal education in the area of competency assessment? (Page. 44)
The need for formal education is two-fold:
1) It is essential for a person to possess the skills necessary to perform a competency assessment and,
2) understanding the complexities of the legal aspects and human rights issues are of value to the individual undergoing assessment and to the assessor. Occupational therapists would appreciate further education surrounding the ethical issues of assessing competency.
Do assessors need guidance on when they can override confidentiality in ordering a formal test of competency? (Page 44)
We believe that guidance is needed in this area. As outlined in Chapter 5 the "Legal Consequences" (pages 25 - 33) of competency assessment can greatly impact on the future of the individual. Assessors must be aware of these consequences before proceeding.
Do you currently use any test for competency? (Page 45)
Occupational therapists utilize a combination of standardized tests, functional and qualitative assessments, in order to determine task specific competency.
Standardized assessments such as the Mini Mental Status Exam (Folstein, Folstein & McHugh, 1975), the Rivermead Behavioral Memory Test (Thames Valley Test Company, Barbara Wilson, Janet Cockburn, Alan Baddely, 1985), the Neurobehavioral Cognitive Status Examination (The Northern California Neurobehavioral Group Inc. revised 11/91), The Kohlman Evaluation of Living Skills (American Occupational Therapy Association, 1992) or the Allen Cognitive Functional Levels (Allen, 1985) provide baseline information regarding memory, judgement, abstract reasoning, communication skills and attention span to name a few.
Occupation-specific/task-specific assessments such as meal preparation, management of self-care tasks and money management provide information regarding an individual’s independence in various skills.
Quantitative assessment results will assist therapists when determining a client’s capacity to make informed choices specific to the environment and his/her existing occupational performance.
At this time, do you favour setting up a form, namely a series of published Guidelines, Procedures and Protocols, for an informal assessment? (Page 45)
Yes. A series of published Guidelines, Procedures and Protocols would assist therapists in structuring the assessment process. General guidelines would be preferred over standardized protocols to ensure that the informal assessment may be utilized in a variety of settings and with numerous populations.
If legislation is favoured, should a provision be included to grant immunity to persons acting in good faith when conducting an informal assessment? (Page 45)
Yes. We agree that persons formally educated in assessing competency via specific guidelines should be granted immunity for acting in good faith.
Summary
We believe the document entitled Discussion Paper on Informal Assessment of Competence was developed utilizing a client-centered approach. It strives to preserve an individual’s autonomy, self-determination and to protect a person’s privacy, confidentiality and human rights. We found the outline of the competency assessment process to be in logical sequence, stated in precise terms and easily understood. The explanations following each of the steps of the assessment are meaningful and appropriate.
Recommendations
The following is a list of recommendations for the development of guidelines on assessment of competency:
1) Formulate guidelines to assess competency utilizing the same format as stated in Chapter 6.
2) Format informal assessment guidelines to allow generalization to a broad variety of persons and occupations.
On behalf of occupational therapists in Manitoba, MSOT wishes to thank the Manitoba Law Reform Commission for providing our Society with the opportunity to review and comment on this document.
Sincerely,
Tamara J. Hanson, Co-Chair
Government Affairs
Manitoba Society of Occupational Therapists