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Center for Innovative OT Solutions

Administration and Scoring

An ESI observation begins with an occupational therapy interview of the client so that the occupational therapist can determine who is the client (e.g., a person, a client constellation, or a client group), what are the client’s concerns with occupational performance, and if any of those concerns pertain to social interactions with others.

If social interactions with others are an area of concern, the occupational therapist proceeds to determine what types of social interactions are presenting a challenge to the person and are prioritized for further evaluation. As part of this process, the occupational therapist also determines who are the person’s typical social partners (e.g., degree of familiarity and what type of relationship they have with the person to be observed [for example, peer, family member, supervisor].

After relevant types of social interactions and typical social partners are identified, the occupational therapist arranges a time a location to observe the person engaged in social interactions with his or her typical social partners.

After completion of each ESI observation, the occupational therapist scores the person’s quality of social interaction on 27 social interaction items (i.e., occupational performance skills) according to the criteria in the ESI manual. Each social exchange observed is scored separately, and each item is rated using a 4-point ordinal scale.

Once the evaluation is complete, the therapist enters the raw scores for each social exchange observed into the OTAP software. The OTAP Software is used to perform many-facet Rasch analyses of the person’s ordinal raw items score and generate linear quality of social interaction measures. The software considers the person’s raw scores for two or more social exchanges, the challenge of social exchanges the person was engaged in, and the severity of the occupational therapist who scored the person’s performance.

The occupational therapist can also use the OTAP Software to generate reports that assist with analysis of a person’s quality of social interaction measures, need for occupational therapy services, intervention planning, and interpreting the significance of a change in quality of social interaction after re-evaluations.