Factors when choosing Standardised Occupational Therapy Assessments

OTs value every child as an individual.

OTs value learning at an individual’s own pace.

OTs value a child achieving their own milestones.

There is also value in comparing a child’s strengths and challenges with others or with developmental expectations. Choosing the right standardised occupational therapy assessment can be an important step in understanding a child. The best assessment is not just about picking a well-known test—it’s about matching the tool to the child, the purpose of assessment, and the context.
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Whether you are a therapist reading this, a parent or educator - this article may help to inform you through the process of why we choose certain assessments over others.  If you make it to the end of the article, I will also give you a hint about what is coming next. 

​Factors an OT considers when choosing an assessment.

1. Age and Developmental Stage
Most assessments have specific age ranges they are designed for.

• Younger children (0–5 years): Assessments may focus on developmental milestones, play skills, sensory processing, and early motor development.
• School-aged children: Assessment tools may also focus sensory processing, participation in daily activities, classroom participation, fine motor skills, visual-motor integration, handwriting, attention, executive functioning skills, social emotional development and self-care.
• Teens and adults: Assessments may continue to test the same areas as younger children and they may also focus on functional daily living skills, vocational readiness, or independent living.

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2. Reason for Testing and Reporting.
An OT assessment should be driven by the why. Some of the reasons for testing include:

• Identifying developmental delays
• Supporting diagnosis (e.g., autism spectrum disorder, developmental coordination disorder)
• Recording a baseline and tracking progress over time
• Guiding therapy goals and intervention
• Providing evidence for funding or school support plans
• Research purposes

Establishing a clear purpose ensures the assessment chosen will provide the right type of information. There should also be a clear understanding about who will receive results of the assessment reporting.  Is the audience a funding body, parent, education or medical staff? Will multiple people be reading the report information? 

3. Standardised vs Criterion-Referenced

• Standardised (Norm-Referenced): Compares a child’s performance to a large group of peers the same age. This is helpful for identifying whether skills are above, below, or on par with age expectations.
• Criterion-Referenced: Measures a child’s performance against a set standard or skill list, without comparing to peers. This is useful for tracking progress or measuring mastery of specific skills over time.

4. Skills-Based or Functional Focus
Some assessments measure underlying skills, such as:

• Fine motor control (e.g., grasp, dexterity, handwriting)
• Gross motor skills (e.g., balance, coordination)
• Visual-motor integration (how eyes and hands work together)
• Sensory Processing (eg. how a child responds to sensory input)
• Executive functioning (eg. how a child perceives, plans, recalls and performs)

Some assessments evaluate a child’s functional participation, looking at how skills are applied in daily life (e.g., dressing, feeding, school tasks).  

OTs will choose the assessment depending on whether the goal is to understand how a child performs, how well they participate or how much assistance they may need.

5. Observations from Parents, Teachers, Caregivers and Therapists
Standardised assessments provide structured information, but they don’t capture everything about a child’s everyday functioning. This is where questionnaires and interviews are invaluable.

• Parent/teacher questionnaires help understand behaviour, sensory preferences, participation, and independence in real-life settings.
• Observations can highlight differences between structured testing situations and natural environments.
• Observations between home and school can also reveal how the child is participating in these environments. 
• Observations by therapists can provide insight into functional participation, sensory processing, environmental factors, accomodations already in place, social impact, social skills, non-motor factors (eg. motivation, regulation, perseverance, attention). 

6. Practical Considerations
Sometimes the “right” assessment is influenced by practical factors:

• Time available: Some assessments take 10 minutes, others over an hour.
• Child’s attention and tolerance: The tool should suit the child’s energy, mood, and regulation levels. The option to present the assessment in small segments may be considered.
• Environment: Space, equipment, and quiet may be necessary.
• Training requirements: Some assessments require specialised training or certification.
• Access to the assessment tool: It is not feasible for every assessment to be available, and an OT may need to choose the best from what is accessible.
• Online reporting: Some assessments may now be conducted online via a link or a shared screen. Some reports may be generated online. 

​ 7. Combining Multiple Tools
No single assessment will answer every question. OTs often combine:

• A standardised motor skill test
• A criterion-referenced functional checklist
• Parent/teacher questionnaires
• Interviews
• Clinical observation in natural settings

This combination provides a richer, more accurate understanding of the child’s abilities and needs.

In choosing assessments, occupational therapists consider the whole child —developmental stage, assessment purpose, skill type, and the child’s real-world participation—before selecting the most appropriate combination of tools.

The ultimate goal? We don’t just want a score, but we are looking for meaningful insights that guide intervention and help children thrive in the activities that matter most.

If you found this article helpful, you may also like to read this application of the occupational performance model. 
 
If you made it to the end of this article, well done! You may want to save it for future reference. It may be particularly helpful if you are a new graduate or student OT.  A little teaser for next week where I do a deep dive comparing two popular assessment tools - the BOT-3 and the MABC 3. There may be some extra "sensory" content coming your way too . 

Until then,

Cindy is a registered occupational therapist practising in Sydney, Australia.  She has two growing children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete).  Cindy is the author of the Occupational Therapy blog Your Kids OT.  Read more articles from Your Kids OT at https://www.yourkidsot.com/blog

Cindy is a contributing author of the Functional Skills for Kids Therapy Team.  They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK.

​The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. ​​​
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