School Function Assessment (SFA)

Hillary Olivier and Beatty Kelly1Key CharacteristicsJudgment basedCompleted by teachers, school professionals in 3 parts (Participation, Task Supports, Activity Performance)Measures a students performance in functional (non-academic) tasksK-6th Grade: Ages 5-12Children with motor impairments, communication impairments, emotional or behavioral difficulties, cognitive limitationsPurpose:Determine a students eligibility for special education servicesObtain information needed to develop an individualized education program (IEP) that addresses the students specific needs

B-participation includes classroom, transportation, bathroom/toileting activities, transitions (getting in line, etc), mealtime/snack time, cleaning up, social appearance -task supports: assistance and adaptations-activity performance: physical and cognitive/behavioral 2

Domains and Sub-Domains3ProcedureTesting ProceduresUsers Manual, Rating Scale Guide, Record FormUse standardized methodsOT presents assessment to school professional(s) to complete appropriate section(s)Domains/Sub-Domains can be administered in any order

Administration ProceduresCoordinator Method-one individual acts as coordinator and is responsible for others completing the form, oversees scoring and interpretationCollaborative Effort Method SFA completed during a meeting

Single Respondent Method-Used in situations where the area of concern regarding a students functioning is isolated to a specific context or a particular task

4Test Development and StandardizationStudents with Special NeedsN=363 112 sites in 40 states in urban, suburban, and rural areas66% boys and 34% girlsMotor, communication, emotional, behavioral, or cognitive limitationsStudents in Regular Education ClassroomsN=31547% boys and 53% girlsMatched by grade level and school system to students with disabilities often from the same classEstablished criterion cut off scores by grade levels for individual scales95% or more attained at least the cut-off score or betterCriterion Referenced Test5Part 1: Participation

Rating Scale1: participation extremely limited2: participation in a few activities3: participation in all aspects with constant supervision4: participation in all aspects with occasional assistance5: modified full participation6: full participation Circle appropriate rating for each setting in the record form Sum the ratings in the 6 settings to obtain participation raw score B

Part 1: the items are arranged in decreasing order of difficulty, higher ratings as one goes down the scaleRatings should reflect the extent to which the students performance is similar to that of same age/grade peersIn the rating scale guide there are example ratings for each setting Ex. 1: Student is present but participates only passively; student watches with little or no interaction; student does not go outside with peer group 6: student participates in classroom activities to the same extent as same age/peers, maintain appropriate behavior

6Part 2: Task Supports

Assistance/Adaptation Ratings1: Extensive2: Moderate3: Minimal4: No Circle appropriate rating

Sum the ratings to obtain task support raw score B

Extensive-assistance: student moved by others most or all of the time-adaptations: student uses w/c exclusively to move about the school

7Part 3: Activity Performance Physical Tasks

Performance Ratings1: Does not perform2: Partial performance3: Inconsistent performance4: Consistent performanceCircle appropriate rating

Sum the ratings to obtain activity performance physical task raw scoreAll items are arranged in increasing order of difficultyDecreasing scores as one goes down the scale towards more difficult itemsItems where ratings deviate from this pattern should be scrutinized more, since they may identify a particular strength or weakness

8Part 3: Activity Performance Cognitive/Behavioral Tasks

Performance Ratings1: Does not perform2: Partial performance3: Inconsistent performance4: Consistent performanceCircle appropriate rating

Sum the ratings to obtain activity performance: cognitive/behavioral task raw scoreB

All items are arranged in increasing order of difficultyDecreasing scores as one goes down the scale towards more difficult itemsItems where ratings deviate from this pattern should be scrutinized more, since they may identify a particular strength or weakness

9Scoring Form

Ad10ScoringTransfer raw score for each scale to column labeled Total Raw Score on the Summary Score FormConvert each raw score total to a criterion score and standard error score using appropriate table in Appendix BRecord these score for each scale in the columns labeled Criterion Score and Standard Error on the Summary Score FormThere will be 2 criterion cut-off scores for grades K-3 and 4-6Plot the students criterion score for each scale on the profile graph and connect each point Criterion cut off scores are used to establish the need for services when it must be demonstrated that the students performance is below that expected for his or her grade

May not use cut-off score, may just use the functional profile (criterion score)-if purpose is for program planning cut-off scores may not be useful11SFA InterpretationSummary form shows whether or not the student shows limitations in participation, an increased need for support (assistance and adaptations), performance of functional activities relative to his or her peers, or a combination.Top-DownRatings from Part 1: Is participation limited? If so, in which school settings?Ratings from Part 2 and 3: determine which factors appear to be limiting the students participationCase Study:Participation in Mealtime/Snack Time setting is lowPart 2 and 3: limitations in functional skills involved in eating and drinking, limitations in behavior regulation and safety, high levels of assistance, and few or no adaptationsChild eats apart from classmates because of disruptive behavior and is closely supervised**Increase positive social interactions with peers and modifying the physical and social environment for the childNot only for OT intervention, but interpretation of SFA gives the teacher a better understand of the child and his or her needs in the classroom setting12Test ResultsResults describe the functional performance of the child in an educational setting, specifically assistance levels, adaptation levels, and performance capacitiesResults can identify one or more factors that appear to be limiting the students function as well as factors that support or enhance the students performance strengths and weaknessesResults may vary depending on which school professional is the respondentResults not only help the OT for realistic intervention planning, but can provide the teacher with a better overall understanding of the child

B13Psychometric PropertiesInternal ConsistencyReliability (Cronbachs Alpha)Test-Retest Reliability(Pearson r)Test-Retest Reliability(Intraclass correlation)ValidityParticipation.92-.93.95.95Excellent CONTENT VALIDITY throughout all domainsTask Supports.94-.96.95-.99.96-.992 studies demonstrating CONSTRUCT VALIDITYActivity Performance.93-.98.90-.99.90-.99No CRITERION VALIDITY studiesIntraclass Correlation has been recommended as a more accurate reflection of agreement, particularly on tests on which clinical decisions may be basedContent Validity: 2 studiesPerceived to be both comprehensive and relevant for the population of students with disabilities in elementary schoolsTherapist ratings of usefulness was higher than teacher ratings areas of interventionConstruct Validity: Adequate, 2 studies demonstrating confirmation of theoretical formations

14Multiple Assessment ApproachTop DownLooks at overall function of the child, can get a broad view of what the child needs to work onBottom UpLooks at specific components within a Sub-DomainClothing Management: Hats Zippers ButtonsArena Trans-disciplinary approachJudgment BasedQuestionnaireRespondent's judgmentB15Other InformationDevelopmental Frame of ReferenceLooks at multiple domains and the developmental progression of a child with disabilities compared to a typically developing child within the same age range (cut-off score)Used in School System to Develop IEPTest Length1.5-2 hours to completeCost:Manual: $140.00Score Sheets: $94.50/25 sheets

B16Areas of Occupation AddressedADLsIADLsEducationPlaySocial Participation17Measurement ConcernsPopulation of only 363 students with a wide range of disabilitiesStudies of inter-respondent agreement was not conducted (Inter-Rater Reliability)Functional behaviors might be observed differently between two professionalsNeed for Criterion-related validity evidenceStudies that compare portions of the assessment to others that are comparableMathematical Error when establishing Raw ScoresCriterion related validity is the strongest type of validity and a study was not completed18ParticipationTask Supports (Assistance/Adaptations)Activity Performance

Regular Classroom (OR)PhysicalCognitive BehavioralPhysical TasksCognitive/Behavioral Tasks

Special Education ClassroomTravelFunctional CommunicationTravelFunctional Communication

Playground/RecessMaintaining and Changing PositionsMemory and UnderstandingMaintaining and Changing PositionsMemory and Understanding

TransportationRecreational MovementFollowing Social ConventionsRecreational MovementFollowing Social Conventions

Bathroom/ToiletingManipulation with MovementCompliance with Adult Directives and School RulesManipulation with MovementCompliance with Adult Directives and School Rules

TransitionsUsing MaterialsTask Behavior/CompletionUsing MaterialsTask Behavior/Completion

Mealtime/SnacktimeSetup and CleanupPositive InteractionSetup and CleanupPositive Interaction

Eating and DrinkingBehavior RegulationEating and DrinkingBehavior Regulation

HygienePersonal Care AwarenessHygienePersonal Care Awareness

Clothing ManagementSafetyClothing ManagementSafety

Up/Down Stairs (optional)

Written Work (optional)

Computer and Equipment Use (optional)