Our Assessment Methodology
A report is only as good as the evidence behind it. This page sets out how we think about occupational therapy, how we look at a person, the method we follow, and the standard every recommendation we write has to meet.
What occupational therapy actually is
The name is the single biggest source of confusion in our profession. Most people hear “occupational” and think we help with employment. That is a small corner of the work.
In occupational therapy, an occupation is anything that occupies your time and matters to you. Getting out of bed. Showering safely. Making a cup of tea. Getting dressed without running out of energy before the day starts. Taking your medication in the right order. Getting to an appointment. Doing your job. Picking your kids up. Cooking a meal you actually want to eat. Seeing your friends. Sleeping through the night.
These are the things a life is actually made of, and they are the things that quietly stop when something changes. An occupational therapist is not primarily interested in your diagnosis. We are interested in the gap between what you need or want to do, and what you can currently do, and in what is sitting in that gap.
Once you frame it that way, the work has only three levers. Almost everything an OT recommends is one of them, or a combination.
Change the task
Do the same thing a different way. Sit to shower rather than stand. Break a meal into stages across the day. Reorder a morning routine so the hardest task happens when energy is highest.
Change the environment
Alter what surrounds the task. A rail where the hand actually reaches for the wall. A different chair height. Removing the step. Equipment that takes the load out of a transfer.
Build the capacity
Grow the underlying ability, where growth is genuinely possible. Strength, endurance, technique, confidence, routine, or the skills to manage a task independently over time.
The skill is not knowing the three levers. It is knowing which one to reach for, in what order, for this person, in this house, this year. That judgement is what an assessment is for.
How disability interrupts occupation
Difficulty is rarely one clean thing. It spreads, and it usually spreads in an order that is predictable once you have seen it enough times.
Someone comes to us because they are struggling with showering. By the time we arrive, showering is almost never the only problem, and often it is no longer the main one. Something started it, and everything downstream has been quietly rearranging itself since.
By the time somebody is referred, the original difficulty is often no longer the biggest one. An assessment that only looks at the presenting problem will find the smallest part of the picture. This is why we assess the whole pattern rather than the diagnosis.
It runs the other way too. Change one condition and the sequence can reorganise. Sleep improves, so there is more in the tank. There is more in the tank, so a real meal happens twice a week. A real meal happens, so there is enough to get to the shops. That is why the most useful place to intervene is often not the most visible one, and why we look at the whole chain before recommending anything.
How we see a person
Function is not a property of a body. It is what happens when a particular person, with a particular history, meets a particular environment on a particular day.
Two people with the same diagnosis and the same test scores can live completely different lives, because everything around the diagnosis is different. The same person can manage in one room and not in another, in the morning and not in the afternoon, with a partner present and not alone. So we assess across all of it.
Hover or tap a dimension to read more
A recommendation aimed at only one dimension usually fails, because whatever is holding the pattern in place is somewhere else.
Where the evidence for this actually comes from
This is not a house view. It is how occupational therapy has been taught and practised for decades, and our clinical reasoning is grounded in the established frameworks of the profession. We name them so you can check them.
The evidence base sits in these frameworks and in the standardised tools we use. Our method is how we bring them together in a real house, on a real day.
What actually happens, from referral to report
Nine steps. The timeframes here are the ones set out in our referral policy, not aspirations.
Referral and scope
Every referral is logged and acknowledged within 2 business days. Before anything is booked we confirm what the report is actually for, what the funder has asked for, and whether an assessment is the right answer at all. If a different report would serve you better, we say so at this point rather than after you have paid for the wrong one.
Clinical triage
A registered occupational therapist reviews every eligible referral and assigns a priority. Urgent matters, safety risk, equipment failure, hospital discharge, falls risk or a plan about to end, get contact within 2 business days. High priority within 5, routine within 10. If your circumstances change while you are waiting, the priority is reviewed.
The documents, read before we arrive
Specialist letters, hospital discharge summaries and previous allied health reports are collected and read in advance. That is deliberate. It means the time with you is spent on functional observation rather than establishing a history you have already given to three other people.
Assessment where the tasks actually happen
We watch real tasks in the environment they belong to. The bathroom you use. The step you have stopped noticing. The kitchen bench that is too high. The hallway that is too narrow for a frame. Function is contextual, and a task completed in an unfamiliar room tells you very little about a Tuesday at home.
Observation beyond the front door
Independence does not stop at the house. Where it is relevant we look at how you manage getting out: transport, the walk from the car, a shopping centre. For some people this is where the difficulty first becomes visible.
More than one point in time
Where fatigue, pain or fluctuating capacity are part of the picture, we assess at more than one time of day. Somebody independent at nine in the morning can be genuinely unsafe at four in the afternoon, and an assessment that only ever happens in appointment hours will never see it.
The people who see the rest of the week
With your consent we speak with family, carers, support workers and your treating team, separately and unhurried. They routinely describe a different week from the one the participant describes, and that difference is usually informative rather than a contradiction.
Standardised, validated tools
Where they add something, we use recognised measures administered and scored as published. Tools anchor findings to something comparable. They do not replace observation, and we do not pick a tool to produce a number we want.
One report, written to a standard
Everything is compiled into a single report in which every recommendation is traced back to the evidence behind it. Before it is released it is checked against the standard set out below: that each recommendation meets the three-part test, that the sections do not contradict each other, and that somebody without a clinical background can follow the reasoning.
Our evidence standard
Every provider in this field says their reports are rigorous, defensible and evidence-based. None of those words can be checked. So here is the actual rule our reports are written to, in plain terms, so that you can hold us to it.
Every recommendation in a Youcentric report must name the evidence it rests on, say where that evidence came from, and state what happens without the support. A recommendation that cannot meet all three does not go in the report.
This is a standard you can audit. Open any report we have written, take any recommendation in it, and check whether all three are present. If one is missing, we have not met our own standard and we would want to know.
Not all evidence is equal, and the standard requires us to say which is which
Reports that present a family member’s recollection and a directly observed transfer as though they carry identical weight are the reports that fall apart under scrutiny. That is what the second part of the rule above is for. Naming where a finding came from is what lets a reader see how much weight it carries, and this is how we weigh it.
Grading the evidence is not hedging. A delegate reading a report that distinguishes what was seen from what was described can trust the whole document more, not less.
Where sources disagree, we say so
Participants routinely understate what they need, because they have adapted and stopped noticing, or because saying it out loud is difficult. Families sometimes overstate it, because they carry the parts nobody else sees. When those accounts diverge, the report records the divergence rather than quietly resolving it in favour of whichever is more convenient.
A decision maker can work with a documented disagreement. They cannot work with a contradiction they discover for themselves halfway down page eleven.
We assess what people do, not only what they say
This is the single line that separates our reports from most of what is written in this sector. An interview produces an account. An assessment produces evidence. They are not the same document.
Asking somebody how they manage a shower is a reasonable question and we always ask it. But people are unreliable narrators of their own function, and not because they are being dishonest. They have adapted so gradually that the adaptation is invisible to them. They describe the good day because it feels more truthful than complaining. They leave out the part they find humiliating. They genuinely do not know that most people do not have to sit down halfway through getting dressed.
The left column is what most reports are built from. The right column is what a delegate needs in order to fund something, and it is what we go and get.
This is also why we return at a second time of day where fatigue or fluctuating capacity is part of the picture. Capacity is not a single number. It is a curve across a day and across a week, and the point on that curve where somebody is genuinely at risk is rarely the point at which a scheduled appointment happens.
The standardised tools we use
Chosen to fit the person and the question, administered and scored as published, and reported with their published interpretation. We do not apply a fixed battery to everybody who walks through the door.
| Tool | What it measures, and when we use it |
|---|---|
| WHODAS 2.0 | Global functioning across six domains. Our default adult measure. |
| COPM | Canadian Occupational Performance Measure. Captures the activities the person identifies as mattering, and their own rating of performance and satisfaction. |
| Lawton IADL Scale | Instrumental activities of daily living: cooking, shopping, finances, transport, medication. |
| CANS | Care and Needs Scale, for complex care contexts where the question is the level and pattern of support. |
| Life Skills Profile | Everyday functioning where psychosocial disability is central. |
| Vineland-3 | Adaptive behaviour, referenced to age norms. Our default paediatric measure. |
| ABAS-3 | Adaptive behaviour across conceptual, social and practical domains. |
| Pedi-CAT | Paediatric function across daily activities, mobility, social and cognitive domains. |
Tools anchor findings to something a reader can compare against. They do not replace clinical observation, and a score on its own has never persuaded anybody. What makes a report defensible is the reasoning that connects the score, the observation and the recommendation.
One method, different questions
This is not an assessment methodology bolted onto a therapy business. It is how we work, and the same method sits behind every report we write and every course of therapy we deliver. Only the question changes.
Functional capacity assessments
The question is what a person can and cannot do, and what that means for the support they need. The full method applies: observation across environments, more than one time of day where capacity fluctuates, collateral from the people who see the week, and standardised measures appropriate to the person.
Ongoing occupational therapy
The question is what changes, and whether it is actually changing. The same three levers apply, and the same evidence standard: goals are set against observed baselines rather than impressions, and progress is measured against those baselines rather than asserted at the end of a plan period.
Therapy is where the assessment stops being a document and starts being a difference. We work across children, working-age adults and older adults.
SIL and SDA assessments
The question is what pattern of support a person needs, and where. That means overnight needs as well as daytime, what happens when a support worker is not in the room, and what a realistic week looks like rather than a best day. Evidence grading matters here more than anywhere, because the funding consequences are large and the scrutiny is heaviest.
Home modifications
The question is whether the environment can be changed to remove the barrier, and it is the clearest case for lever two. Measurement is not optional here: widths, heights, gradients, reach and turning space, recorded properly, because a recommendation built on an estimate becomes a build that does not work.
Assistive technology
The question is whether a piece of equipment closes the gap, and whether it will still be used in six months. Trial and observation are central, because equipment that is not right gets abandoned in a hallway, and the funding is spent either way.
ILO assessments
The question is what living arrangement fits a person’s actual capacity, preferences and support network, rather than what is administratively available. Roles, routines and relationships carry as much weight as physical function.
Aged care occupational therapy
The question is usually safety and independence at home, and the method is the same. Falls risk assessed where falls happen, tasks observed rather than described, and recommendations written so a family and a provider can both act on them.
Mental health occupational therapy
The question is how psychosocial disability affects daily function, which is the area most often under-evidenced and most often refused. Routine, initiation, motivation and the gap between capability and consistency all matter, and the Life Skills Profile is frequently the right measure.
What we can’t do, and what we won’t
A methodology that only describes its strengths is marketing. These are the real limits, and we would rather you knew them before you engage us than after.
- ×We cannot guarantee a funding outcome. Nobody can, and any provider who implies otherwise is telling you something they are not in a position to know. We can make sure the evidence is properly gathered, clearly presented and honestly graded. The decision belongs to the funder.
- ×We will not write a recommendation the evidence does not support. Including when it is asked for, and including when the person asking is paying the invoice. Overstating need is not a favour. It damages credibility, invites scrutiny of everything else in the document, and makes the next request harder.
- ×We will tell you if you do not need the assessment. Sometimes the answer is a shorter report, a different report, or no report at all. We would rather spend ten minutes on the phone than write you the wrong document.
- ×We will tell you if somebody else is a better fit. If a support we do not provide is what you need, or a local provider can see you sooner, that is what we will say.
- ×Some things we can name but cannot fix. Housing that is unsuitable and cannot be modified, services that do not exist in your area, waiting lists, a carer who is exhausted and has no relief. We will document them accurately, because they are part of the functional picture, but honest therapy works within what is genuinely possible.
We also provide therapy, and here is how we handle that
Some assessment-only practices argue that any provider who also delivers supports has a conflict of interest when writing an assessment. It is a fair point and we would rather answer it than pretend it does not exist.
Yes, we provide ongoing occupational therapy as well as assessments. That means an assessment we write could, in principle, recommend a service we ourselves sell. What we do about it is set out in our referral policy and applies to every assessment: we accept and provide no financial incentives, commissions or kickbacks for referrals; referral decisions are based solely on need and clinical appropriateness; any potential conflict is declared and managed; and you are free to choose any provider and will never be pressured toward our own services.
In practice it also means we tell people when the answer is not us. If a support we do not provide is what you need, if a local provider can see you sooner, or if the assessment shows a cheaper solution than the one you came in asking for, that is what the report will say.
Our methodology: your questions
What makes your method different from other providers?
Two things. We assess by observing real tasks in the environment they happen in, rather than building a report out of an interview. And we publish the standard our reports are written to, including how we weigh the strength of each piece of evidence, so you can check whether we met it rather than take our word for it.
What is your evidence standard, in one sentence?
Every recommendation must name the evidence it rests on, say where that evidence came from, and state what happens without the support. If it cannot do all three, it does not go in the report.
How many visits does it take?
Usually one or two. Where fatigue, falls or fluctuating capacity are part of the picture we may assess at two different times of day, because that variation is often the most important thing in the report.
What standardised tools do you use?
It depends on the person and the question. Commonly the WHODAS 2.0, COPM and Lawton IADL Scale for adults, the Vineland-3, ABAS-3 or Pedi-CAT for children, the Life Skills Profile where psychosocial disability is central, and the CANS in complex care contexts. Tools are chosen to fit the person, not applied as a fixed battery.
What happens if the evidence disagrees?
We say so in the report. Where a participant’s account, our observation and a family member’s description do not line up, that is recorded rather than smoothed over. A report that quietly resolves contradictions is less useful to a decision maker than one that names them.
Do you offer telehealth?
Our method is built around observing tasks in the environment they happen in, so we assess in person wherever we can. Where distance or individual circumstances make that impractical, talk to us at referral and we will work out the best approach with you.
You also provide therapy. Is that a conflict of interest?
It is a fair question and we would rather answer it than avoid it. We do provide ongoing therapy as well as assessments. Our referral policy commits us to accepting no financial incentives or commissions for referrals, to declaring and managing any conflict, and to making clear that you are free to choose any provider and will never be pressured toward our own services. Where an assessment points to a support we do not provide, or to another provider being a better fit, we say so.
How long until I get the report?
We aim to deliver the written report within 2 to 3 weeks of the assessment, depending on complexity. If you are working to a plan review date, tell us at referral and we will plan around it.
Do you assess children as well as adults?
Yes, across the lifespan, using age-appropriate tools rather than applying an adult assessment to a child.
Does this methodology apply to therapy, or only assessments?
Both. The same three levers and the same evidence standard apply to ongoing therapy: goals are set against observed baselines, and progress is measured against those baselines rather than asserted at the end of a plan period.
Refer a participant, or ask us a question first
Send a referral or an enquiry below, or call 1300 316 664. If you are not sure which report you need, ask before you book. We would rather spend ten minutes on the phone than write you the wrong document.
Evidence gathered where it actually happens
Talk to our mobile OT team about an assessment. We come to you, across Liverpool, Western Sydney and Greater Sydney.