Development of a treatment rating in school systems: service determination through objective measurement

This paper introduces the Capital Area Treatment Rating (CATR) being developed by the occupational and physical therapists of the Capital Area Intermediate Unit in Harrisburg, Pennsylvania. This rating assists therapists in identifying children in special education who require occupational or physical therapy treatment. The CATR consists of two measurement categories - functional levels and clinical judgment factors - each of which is rated on a 4-point ordinal scale. The scores from each of these categories are then added together for a final rating score. A pilot test involving 180 children in special education indicated that the need for treatment is most consistently associated with a score of 28 points or above on the CATR. A survey of 17 pediatric occupational therapists revealed strong support for the instrument's content and resulted in a revised version. Suggestions for future research and ongoing development are discussed, as are general guidelines for use of the instrument in special education occupational therapy programs.