Description
The Telehealth Occupational Therapy Evaluation Report Template was created by a pediatric OT, Melanie Criss OTD, OTR/L, with more than 10 years experience in teletherapy.
This 29 page Microsoft Word document will be available electronically immediately following payment. YOU CAN EDIT THIS DOCUMENT. It is part of the OT Telehealth Bundle.
The Pediatric or School-Based Telehealth Occupational Therapy Evaluation Report Template is a thorough template designed to allow easy editing and modification for a school-based telehealth evaluation, but could be easily tweaked to be useful in a clinic setting as well.
Detailed descriptions, pictures, and tables are provided for both standardized measures as well as informal clinical observations in the areas of fine motor, visual motor, visual perception, sensory processing, executive function, independent living, handwriting, keyboarding, and mouse skills.
The template includes clear descriptions of developmental age and grade expectations for informal observations, in addition to charts for reporting standardized scores with drop down options to identify the interpreted level of functioning based on the standard scores.
While this document is very lengthy, sections not applicable can be easily deleted as you build your individualized custom report for each student. The template also includes multiple pages of recommendations that are optional to share with the parent depending on the student need.
In addition to several sections that detail informal observation opportunities, 9 formal assessment measures are also described including:
· Beery-Buktenica Developmental Test of Visual Motor Integration, 6th Edition (VMI)
· Motor Free Visual Perception Test (MVPT-4)
· Test of Visual Perceptual Skills (TVPS-4)
· Print Tool
· Sensory Processing Measure 2 (SPM-2)
· Sensory Profile 2
· Adolescent/Adult Sensory Profile
· Roll Evaluation of Activities of Life (REAL)
· Behavior Rating Inventory of Executive Function 2 (BRIEF-2)
Looking for more telehealth resources?
Telehealth Fine Motor Assessment – Functional Skills
Telehealth 101 – Tips for Implementing Telehealth Intervention into your Pediatric OT Practice