Assessment and Intervention
What this domain tests
This domain tests the full clinical reasoning cycle: selecting assessments, interpreting results, setting goals, choosing and sequencing interventions, and evaluating outcomes. Items often present a client with several findings and ask for the next step, the most appropriate tool, or the best modification of an existing plan.
Core rules and concepts
- Assessment selection. Match the tool to the question: impairment-level measures (goniometry, dynamometry, cognitive screens), activity and participation measures (ADL indices, role checklists), and standardised versus non-standardised tools. Consider reliability, validity, responsiveness, and whether norms fit the client.
- Baseline before change. Establish a measurable baseline so outcomes can be attributed and documented.
- Goal writing. Client-centred, specific, measurable, time-bound, and occupation-based. "Increase grip strength" is an impairment goal; "button own shirt within four weeks" is a performance goal.
- Intervention logic. Remediate where recovery is plausible; compensate where it is not; maintain where decline is expected. Combine approaches when the prognosis is mixed.
- Outcome evaluation. Re-measure with the same tool, compare to baseline, and revise the plan when progress stalls.
Worked example
A client six weeks after stroke has active shoulder flexion to 90 degrees, mild spasticity, and wants to dress independently. Reasoning: baseline is the measured range and observed dressing performance. The goal should be occupational (don upper-body clothing independently within six weeks). Intervention combines task practice with the affected limb, positioning and handling to manage tone, and adaptive strategies (front-opening clothing, dressing aids) so participation is not delayed while recovery continues. Re-measure at intervals and adjust.
Traps that cost marks
- Selecting a tool because it is familiar rather than because it answers the question.
- Writing goals with no measurable criterion or timeframe.
- Jumping to intervention before establishing a baseline.
- Choosing remediation for a condition with no realistic recovery potential.
- Failing to plan for re-evaluation and revision.
Exam-ready summary
Question → tool → baseline → occupational goal → matched intervention → re-measure. Each step must be visible in your answer.