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A-ONE: Arnadottir Occupational Therapy Neurobehavioral Evalu

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Emily Jett

on 9 April 2015

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Transcript of A-ONE: Arnadottir Occupational Therapy Neurobehavioral Evalu

A-ONE: Arnadottir Occupational Therapy ADL Neurobehavioral Evaluation
About the A-ONE
Reliability
Interrater Part 1: Good
Interrater Part 2: Good
Test-retest: Not significant

Validity
Concurrent: Excellent
Construct: Good
Content: Good
Face: No data available
Psychometric Properties
Scoring using FIS and NB Scales
Part 1
Functional Independence Scale
Neurobehavioral Impairment Scale
Neurobehavioral Specific Impairment Subscale (NSIS)
Neurobehavioral Pervasive Impairment Subscale (NPIS)
Time to administer is as long as an ADL evaluation takes
Time to score is ~25 minutes

Part 2
Converts the results from Part 1 to help therapist determine potential site of cortical dysfunction based on deficits
Parts of the A-ONE
Client's belongings: shirt, pants, socks, shoes, towel, washcloth, soap, toothbrush, toothpaste, razor, deodorant, comb, fork, knife, spoon, glass/cup, plate, and breakfast food

Client's natural environment: bed, sink
Part 1 Materials

Functional Independence Scale (FIS) (4-0)
4 → independent
3 → physically independent, requires supervision or verbal cues for safety
2 → requires verbal cues to perform task
1 → requires min to mod physical assistance, client actively participates
0 → dependent


Scoring Documents
Located in the textbook
The Brain and Behavior: Assessing Cortical Dysfunction Through Activities of Daily Living.
Book available through Barnes and Noble for $23
Costs associated with training class (not many offered in US)
Training: Administrators must be licensed occupational therapists whom have attended a 3-5 day (40 hour) training course, and should have a knowledgeable background in neuroanatomy, neurophysiology, neurology, occupational performance, activity analysis, and ADL.


Location, Cost, and Training
Therapist should score ~3 functional ADL tasks
Therapist sets up client's environment for morning ADL routine
Client is instructed to get up from bed and perform all morning grooming tasks as normal
Minimal assistance is given as needed, or by client request
Administration
Scoring Documents


Deemed valid and reliable by experts
Provides detailed infomation of neuroanatomy and neurobehavioral deficits
Lots of room for therapist interpretation and analysis using clinical reasoning
Not standardized
Therapist interpretation can vary
Initially difficult to locate and understand
Strong base to provide neurobehavioral evaluation through observation of ADLs
Can be used to track progress
Ideal for OT practice
Bottom Line
Developed by Icelandic OT Gudrun Arnadottir, MA, BMROT in 1990

Purpose
To determine clients’ level of cognitive functioning by combining neurobehavioral and occupational therapy principles through ADL tasks. Its goal is to show how cognitive deficits can impact function due to lesions or improper nerve conduction within the brain.

This information can help practitioners determine clients’ level of independence, create treatment interventions, and track progress.
NSIS (used to rate severity deficit during ADL performance)
0 → no neurobehavioral deficits
1 → Neurobehavioral deficits appear, but client can perform task without assistance
2 → Neurobehavioral deficits appear, client requires verbal assistance and can process verbal cues
3 → requires demonstration and min to mod physical assistance
4 → unable to perform task due to CNS impairment
Communication impairments scored as 0 (absent) or 1 (present)
Clinical reasoning is used to score the NSIS
Full transcript