The Short Child Occupational Profile (SCOPE)

Lauren Stevenson and Brandy White

Purpose

• Initial evaluation and/or outcome measure

• Broad overview of child’s occupational participation

• Identify occupational strengths and areas to address

• Guide occupation-based goals and interventions

Key Characteristics

• Age range: birth to 21 years

• Frame of Reference: MOHO

• Very simple and flexible• Multiple means of gathering data• Includes intervention planning ideas

Test Development

• Pediatric therapists attempted to use MOHOST, but found it did not meet the needs of pediatric evaluation.• First draft: based on team of expert pediatric occupational therapists• Four years of research and revisions based on therapist and other

professional input

• Standardization: This is not a standardized assessment.

Psychometric PropertiesType of Reliability

Statistics Used Value Rating

Observer: Practitioner Separation Index

MFRM 0.83 excellent

Internal consistency: Item Separation Index

MFRM 0.99 excellent

Client Separation Index

MFRM 0.95 excellent

Construct Validity: Confirmed by MFRM analysis

Test Length and Cost• Length: • Consists of 25 items• Experienced therapists may complete this assessment

in 10+ min depending on methods used to gather information.

• Test Cost: $40• Rating and summary forms are reproducible

Assessment Approach

• TOP-DOWN APPROACH

• Ecological

• Judgment-based

Areas of Occupation Addressed• ADLs• IADLs• Education•Work• Play• Leisure• Social Participation

Domains (Sub-domains)- Volition (exploration, expression of enjoyment, showing

preferences/making choices, response to challenge)- Habituation (daily activities, response to transitions, routines, roles)- Communication and Interaction Skills (non-verbal

communication, verbal/vocal expression, conversation, relationships)- Process Skills (Understands and uses objects, orientation to

environment, plan and make decisions, problem solving)- Motor Skills (posture and mobility, coordination, strength,

energy/endurance)- Environment (how the environment affects the child, physical

space, physical resources)

Test Most Likely Used in what Settings?

• Across practice contexts and settings • Some may include:

SchoolsAcute careClinics Home

Testing Procedures• Informal observation• Formal observation• Discussion (interview) with the child• Discussion (interview) with the parents,

teachers, multidisciplinary team • Reading case notes and medical/rehab

records• Completing other formal assessments

Rating Scale• F: Facilitates occupational

participation

• A: Allows occupational participation

• I: Inhibits occupational participation

• R: Restricts occupational participation

Example of SCOPE Items

Example of SCOPE Interview Items (Optional to gather data)

Parent Interview: HabituationDescribe your child’s typical weekday and weekend routine at

home/school/in the community. Does your child know when to do these daily routines and self-care activities? How does your child actively take part in doing these routines and self-care activities?

Teacher Interview: Volition What are some things that you think this student feels he/she does

well or that he/she is proud of doing? Does the student enjoy most things, or is he/she frequently frustrated or unhappy when doing things? How do you know when this student is proud of himself/herself?

Demonstrations

• Brandy observe Lauren (child)• Response to transitions A

• Lauren interview Brandy (parent)• Response to transitions R

SCOPE Summary Rating Form

SCOPE Ratings Totals Form

Goal Writing and Intervention Planning• Guide for creating occupation-based goals and intervention

strategies• Additional form for organizing plan of care

Measurement Concerns

• Examiner error: Rating is subjective to therapist’s judgment • Some clients may be more difficult to rate

Advantages:

Occupation-based, top-down, holisticWide range of ages, diagnoses, and settingsFacilitates family-centerednessUseful for children who cannot complete standardized assessmentResults are easy to communicate to parents

Disadvantages:

Not a widely used instrumentNot standardized

References• Bowyer, P.L., Kramer, J., Ploszaj, A., Ross, M., Schwartz, O., Kielhofner, G.,

Kramer, K. (2005). A User’s Manual for The Short Child Occupational Profile (SCOPE) (v.2.2). Chicago, IL: Model of Human Occupation Clearinghouse.• Bowyer, P., Kramer, J., Kielhofner, G., Maziero-Barbosa, V., & Girolami, G.

(2007). Measurement properties of the SCOPE. Physical & Occupational Therapy in Pediatrics, 27(4), 67-85.• Bowyer, P., Lee, J., Kramer, J., Taylor, R.R., Kielhofner, G. (2012).

Determining the clinical utility of the Short Child Occupational Profile (SCOPE). British Journal of Occupational Therapy, 75(1), 19-28.• Kramer, J., Bowyer, P., Kielhofner, G., O’Brien, J., & Maziero-Barbosa, V.

(2009). Examining rater behavior on a revised version of the Short Child Occupational Profile (SCOPE). OJTR: Occupation, Participation, and Health, 29(2), 88-96.