Contribution of occupational therapy to the assessment of competence: A case study

Many occupational therapists contribute to the assessment of competence to take care of oneself and manage one’s affairs, but few guidelines exist regarding this practice with adults who have experienced a traumatic brain injury (TBI).

This study explored the ability of the Instrumental Activities of Daily Living Profile (IADL Profile) to capture competence following a TBI.

Task performance on the IADL Profile of a 46-year-old man (ML) who was found to be incompetent following a severe TBI was compared to eight control subjects (mean age 49.3 ± 4.2 years). The IADL Profile scores, observable behaviours, and verbalizations were compared using descriptive statistics (M, SD) and qualitative analyses.

The independence level of ML was lower than that of the control subjects on seven of the eight tasks of the IADL Profile (p < .05), especially for preparing a hot meal and creating a budget. ML demonstrated difficulties that impacted his performance on many tasks, and he had difficulty critiquing his results.

The IADL Profile could be used as part of a functional assessment to document competence.