A dynamic assessment!

The image below is from the PEO Model by Law, M et al. (1996). It illustrates an assessment approach that I like to use regardless of the area of practice. I also use it as an education tool for clients when I provide educaion on where performance is breaking down.



The model illustrates the interaction between the person, in a given environment, completing a particular activity or occupation. The interaction between the 3 areas lead to a person's occupational performance (or functioning) in their chosen activity. Person factors include the physical, the emotional/cognition or spiritual beliefs. The environment includes things like the physical, cultural and socio-economic factors, among others. And, of course, occupation is the task or activity that the individual is engaged in.

As an assessment approach it's useful because it illustrates the dynamic nature of functioning and moves away from the cause-effect mentality. It may also help identify whether it's best to use a remediative approach or a compensatory approach* (or both). For example, a client experiences a physical injury, which means the person circle moves away from the mid line thereby reducing the likelihood of successful performance in the desired activity. Now we have a several options

- use a remediative approach to treat the MSK injury to increase performance and/or
- change the demands of the activity to make it easier and/or
- change the environment to compensate for the injury.  

The choice of strategy, of course, will be influenced by medical history, client goals/expectations, flexibility to make changes, etc.

For the same reasons above I use the PEO Model as an education tool. In my experience clients find it useful to see how the environment and the activity are potential sources to enable or constrain performance as opposed to just focusing on a remediative approach.

I hope you give it a try and find it a useful tool.

* To clarify a remediative approach would focus on fixing the underlying impairment (i.e. repairing a broken leg). A compensatory approach provides an alternative method of accomplishing a goal (i.e. change the activity).