Do you use standardised assessments within your NDIS reports? Have you ever wondered if you were doing it ‘right’ if you did include them, or felt lost about which ones to include in the first place?

Don’t worry, I’m very sure you’re not alone! In this article I’m going to cover the “Do’s and Don’ts” of including standardised assessments in your NDIS reports, to help you feel a little more confident in the choices you make.

1.       Do include them!

There are some clinicians who think standardised assessments are over-rated and our own non-standardised observations and interview skills will provide much better data for informing our recommendations. Not going to argue with some of that reasoning, but in my opinion the benefits of including them make it worth the effort. Here’s why:

-          The NDIA planner will be expecting to see them. Did you know that the NDIA has a list of preferred standardised assessments they like clinicians to use depending on the person’s disability? If this is new info for you, check out this link which will take you to this magic list.  Not saying it is a great list, and you definitely are not obligated to complete them for your client if you don’t think they will serve a helpful purpose (see section 2), but the planner will probably be looking for them. Common ones are the WHODAS 2.0 for all participants, the LSP-16 for people with psychosocial impairment, or the Care and Needs Scale for people with an ABI.

-          The NDIS loves numbers! If we can give the NDIS some numbers or scores that they regard as objective evidence, it will often hold more weight in their eyes than the non-standardised information we provide. Outcome measures that track a person’s progress in response to capacity building, or that objectively shows how a person with a progressive condition is declining, can be helpful for illustrating our recommendations.

-          The NDIA are risk adverse, so find ones that will highlight risks in objective terms for the planner. Examples could be using the Waterlow Scale to rate a participant’s risk of sustaining a pressure injury, or using the cut-off scores in the Caregiver Burden Inventory to highlight when a carer is on the brink of burnout.

2.       Don’t include them for the sake of it

Now that I’ve just told you it is a good idea to include standardised assessments in your NDIS report, here’s the “but” – don’t include them for the sake of it! You need to have a clear purpose for each assessment you include and each one should be adding value. Here are some tips:

-          Consider what you are trying to show the planner. If you are trying to highlight that the person requires support worker assistance with community access, an assessment that highlights how they are independent with self-care isn’t going to do the job.

-          Make sure the results of your standardised assessments align with your recommendations. A good example is the Care and Needs Scale. If you are recommending someone needs assistance 24/7, but then the CANS shows them as only requiring assistance up to 11 hours each day, a savvy planner has every right to question why there is a difference.

-          There is no “right” number of standardised assessments to include, and it can vary depending on the type of report you are writing. A progress report or AT application might only need 1 or 2, while a full functional capacity assessment or SDA application may need 4 or 5. They should all offer something different though – don’t include assessments that are basically measuring the same thing. For example, the FIM and Modified Barthel Index overlap in many sections, so only including one or the other is fine.

3.       Do choose ones that are appropriate for your client!

This is “Standardised Assessments 101”, but sometimes when dealing with the complexity of an NDIS report we can forget this. Here’s some things to remember:

-          Check that the assessment is appropriate for your client based on their gender, age, and diagnosis. The technical term is, has it been validated for use with your client’s population? This will stop you from making the mistake of using an assessment developed for children with an adult, or an assessment meant for people with musculoskeletal conditions with someone with a psychosocial impairment. If you’re not sure where to find this information, the Shirley Ryan Lab and Physiopedia websites are good ones to check out.

-          Consider if it is culturally appropriate. Many of the assessments that we commonly use, including those on the NDIA ‘preferred’ list, have been developed with people from Western cultures in mind. This means that it may not be appropriate for our clients from CALD backgrounds, including First Nations participants.

-          Consider the cost to the client. This doesn’t just mean is there a financial cost to complete the assessment, but also how long will it take, and is there a risk it could cause fatigue, stress or anxiety. For neurodivergent clients, consider whether the assessment is neuro-affirming and how you will interpret the results, or whether it’s not appropriate to include at all.

4.       Don’t cut and paste whole slabs of assessment results into your report

While it can make your report seem long and impressive and full of fancy words, this isn’t the point of an NDIS report. Your focus needs to be on getting your point across clearly and succinctly using plain language. Here are some tips for how to include them in a report:

-          It’s often helpful to explain what the assessment is before introducing the results, but don’t copy the assessment instruction manual! Keep it brief and consider moving this information to an endnote so it doesn’t interrupt the flow of your report.

-          Make sure you include when the assessment was completed, how it was completed (e.g. self-report, proxy, interview) and any factors that may have impacted the person’s performance on the day.

-          It is not essential to include all the raw data from your assessment (i.e. the whole assessment form or report itself), but it is essential to include your interpretation of the results. Does it match what you observed elsewhere in your assessment? What does it tell us about the person’s functional capacity? How does it link to the recommendations you will go on to make?

-          If you do decide to include some of the assessment forms, move them to an appendix and keep the body of your report for a table with a summary of the results, and your interpretation.

5.       Do choose assessments where you know what you are doing!

Just because an assessment is on the NDIA preferred list, or you know your supervisor uses it, doesn’t mean it’s automatically a good decision for you to be using it. You should only administer assessments that you understand and that you are competent to use. Remember these things:

-          If you find a great tool online, make sure you also find the great instruction manual that will probably come with it. This will give you instructions for how to ask the questions, setup the room, and interpret the scores, so don’t skip over reading it if the assessment is new to you.

-          Check for online training modules or explanation videos – in most cases you won’t be the first person to ever use the assessment, and chances are someone may have already developed some training modules or a ‘how-to’ video you can find on YouTube. Just make sure you spend a second critiquing the quality and trustworthiness of the resource before you use it (e.g. was the resource created by the assessment tool developers, or a second year allied health student doing it for an assignment?).

-          Double-check that you don’t need to be accredited to administer the tool. The FIM and MoCA are ones where you may come across some training manuals or assessment forms within your team office, but to use these assessments you actually need to undergo formal training. If it’s an assessment you’re not likely to use again with another client, it could be that it’s not worth the time or money to do the training and chances are there is another assessment out there that will give you the data that you need anyway.

Hopefully that’s a helpful starting point for you if you are new to using standardised assessments. They can add so much value, but only if you choose wisely and share the important bits in your report. If you’ve got your own tips, please share them in the comments!

P.S. If you’d like to find out more, check out the Your OT Tutor NDIS Training tab on the website. The OT Guide to Completing a Functional Capacity Assessment has a whole module on choosing standardised assessments for adult FCAs, while the 10 Steps to NDIS Report Writing Success course will touch on why they are important to include, as well as give you lots more tips and a step-by-step process to level-up your NDIS reports (this one is appropriate for non-OTs too!).

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