Biomedical Engineering Reference
In-Depth Information
• A comprehensive diagnosis needs both a values-based approach (Fulford and
Stanghellini 2008) along with an evidence-based one and an idiographic personal-
ized formulation (Mezzich 2002) together with a standardized assessment.
• When assessing a set of measurements, it would be best “to sacriice reliability for
validity” (Fulford and Stanghellini 2008, p. 12). “Those of us who have worked
for several decades to improve the reliability of our diagnostic criteria are now
searching for new approaches on understanding of aetiological and pathophysi-
ological mechanisms—an understanding that can improve the validity of our
diagnoses and the consequent power of our preventive and treatment interven-
tions” (Kupfer et al. 2002, p. xv). The reliability of diagnostic tools is an essential
issue, but it does not guarantee in itself the validity of the treatment, which is the
primary purpose of rehabilitation professionals.
• The user/client functioning evaluation should encompass objective and subjective
measures for any health or health-related domain.
• Throughout the measurement and assessment process the multidisciplinary team
should pay attention to the “power balance” in user/client-professional relation-
ships and in mutual relations between professionals.
The measurement tools that we suggest can be roughly classified into two types: objec-
tive and subjective. Although the ICF Checklist (WHO 2003), any ICF Core Set, and the
Vineland Adaptive Behavior Scales (VABS; Sparrow et al. 1984) can be considered as objec-
tive measures, the WHO-Disability Assessment Schedule II (WHODAS II; WHO 2004), the
Matching Person and Technology (MPT) model (Scherer 1998), the Canadian Occupational
Performance Measure (COPM; Law et al. 2005), and the Support Intensity Scale (SIS;
Thompson et al. 2004) facilitate evaluations of the subjective perspective of the user/client.
2.2.2
Measurement and Assessment in the ATA Process
In Figure 2.1, four orange shapes highlight the steps in the ATA process where a measure-
ment and assessment are required.
From the ATA process perspective, all of these tools can be classified according to the
assessment stage in which they are administered. After the ATA process step by step, in the
“User Data Collecting” stage (step 1), to reach a comprehensive diagnosis and assessment,
both standardized and idiographic, the user/client will provide an ICF Checklist and/
or the ICF Core Set related to their specific condition, drawn up by a physician, and
the self-administered WHODAS II and SOTU (MPT). At this stage of the ATA process
professionals have not yet met the user/client so that the psychologist plays a key role
during the ”Multidisciplinary Team Meeting” by reading and interpreting all of the data
provided (step 2) to both evaluate the individual functioning profile and to set up the
“Matching Process.” At the time of the Matching Process (step 3), the VABS, the Assistive
Technology Device Predisposition Assessment
(ATD-PA), and the SIS are administered
to the user/client. The Matching Process step is the very first time the user/client meets
the professionals of the center to evaluate his or her activity limitations, operationalized
as “capacity,” and to assess the best match with an assistive solution. Finally, in the “User
Support” and “Follow-Up” stages (step 4), the team and the user/client evaluate the partici-
pation together, operationalized as performance, and continually check the user/client's
need for adjusting the match or for a new match.
