Key Factors in Adequately Assessing and Evaluating Autistic People
-A Talk with Ophelia Xerri, Occupational Therapist-
About Ophelia:
Qualified Occupational Therapist and Ashtanga yoga teacher
Ophelia's Expertise:
Sensory Integration certified practitioner experienced in residential adult and child homes for learning disabilities, autism and ADHD, neuro brain injury rehab, hip and knee elective, community paediatric, brain injury rehab acute and community and acute mental health.
Each person has their own way of thinking, feeling, communicating, and interacting with the world around them. This means that assessments and evaluations need to be thoughtful, flexible, and focused on the person. By taking the time to understand a person’s strengths, challenges, and the environment they live in, OTs can provide better support that truly meets their needs. Using a range of tools and observations helps build a clear picture of how someone experiences the world, and regular reviews make sure that support continues to work as things change. At the heart of this approach is respect, understanding, and a commitment to making sure each person is seen, heard, and supported in a way that works for them.
Ophelia shares:
‘Factors for effective assessment and evaluation to support autistic people involve conducting comprehensive, individualised assessments that account for sensory processing, communication preferences and unique cognitive and behavioural characteristics. I use standardised tools like the Sensory profile, MOHOST, WeeFIM, functional assessments and observations to understand a person’s strengths, needs and barriers to occupational performance. These assessments consider the person and their environment too, such as Sensory environment checklists, SHEA assessments, and home access assessments, to make sure their environment provides space for the person’s needs.
We must use outcome measures to help track progress and ongoing evaluation to ensure any interventions remain responsive to one person’s evolving needs. I believe evidence-based practices with a person-centred approach make sure that assessments and evaluations are comprehensive and effective.’
Setting SMART Goals and Adapting Support Along the Way
Supporting autistic people in a way that truly honours who they are means stepping into each journey with openness, flexibility, and respect.
A SMART goal is only smart if it starts from the person’s own voice.
What does success look like for the people we support?
What do they want to do more of, or feel more confident about?
Where do they want their energy to go each day?
‘I use the assessment phase in our occupational therapy process to shape a person’s occupational therapy goals for interventions. A method I use for planning interventions is to create SMART goals out of our plans. “SMART” stands for specific, measurable, achievable, relevant and time-bound, which helps us to check in with the goal and evaluate it.
Effective communication is a key part of the way I monitor progress and adapt interventions for autistic people. Where appropriate, I will check in with the provider and the clinicians, the internal and wider MDT, family, and the person to help identify what is working and what we need to change about the SMART goal to make it work for the person.’
Support is not static. It should breathe, evolve, and reflect the real experiences of the person. Once goals are in place, we must also be ready to check in regularly – not just with charts or data, but through meaningful conversations.
We ask:
Is this still the right goal?
Is the way we’re working toward it helping or hindering?
Does something need to shift because the person’s needs, environment, or feelings have changed?’
Why Great OTs Are Also Great Communicators
Behind every plan, strategy, and intervention lies something even more important: communication. Great occupational therapists know that communication is the bridge that brings trust, understanding, and shared decision-making to life. It’s the difference between doing something for someone and working with someone.
But what does this really look like in practice?
‘Strong communication skills are highly crucial for occupational therapists when supporting autistic individuals and communicating with their families. I must effectively adapt my communication methods to meet the unique needs of autistic people and their families to ensure I am gathering information about them and their environment to identify needs for occupational therapy input. Clear, consistent, and flexible communication ensures that goals and progress are understood and followed by the person, their care provider teams and families.
I offer a consultancy service via telehealth whereby family and staff can book an appointment with me to access information, guidance, and support to reinforce interventions in daily life. Effective communication helps create a more inclusive, supportive environment that overall will promote better outcomes for all people we support.’
How Compassion Helps Me Meet the People I Support Where They Are
‘I understand and empathise with the unique experiences and challenges of every person I support, from the person to their family and individuals in the care team, from the provider. Building trust through transparency and genuine rapport helps me to create a supportive environment where meaningful progress, however it looks day to day, is valued and celebrated.’
Occupational therapists (OTs) do more than assess needs and deliver interventions. They walk alongside people through some of their lives’ most complex and meaningful parts. Compassion is at the heart of this work: the ability to understand, feel, and respond with care and respect. Compassion allows us to truly meet people where they are, not just in a physical or clinical sense, but emotionally, socially, and psychologically too.
For autistic people in particular, being truly seen and understood is vital. Many experience a world that misunderstands their communication, sensory needs, or ways of relating.
‘I recognise that progress day to day is unique, also and every step is valuable. Flexibility and creativity in my work make me better at adapting the occupational therapy, ensuring support is responsive to individual needs while remaining aligned with professional scope and the collaborative vision of the therapy team. I collaborate and respect the people I work with to support people on my caseload, and always focus on promoting independence, confidence and wellbeing. And how is it done? Through understanding and supporting each person and enabling their environments to provide opportunities for them to engage in the things they need, want, and have to across their meaningful occupations.’
So, OTs must reflect:
- Are we hearing what’s being said beneath the words?
- Do our goals reflect the voice of the person, or just the systems around them?
- How can we ensure that interventions evolve with the person’s changing needs and experiences?
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