Hi Roy
I have been doing FCE's for over 10 years, but have been using your protocol since the course in Toronto last fall. I particularly find the physical effort and RCR information useful in my evaluations and reports.
Question from my main referral source about something in one of my reports: I had indicated that the client cooperated fully with all aspects of the evaluation. The client however, did not give full physical effort at all times nor were her reports of pain, etc. reliable at all times. The referral source was confused that I had said she cooperated with the assessment (i.e. attendance, reasonable to work with) yet she did not provide full effort. Should I be quantifying what I mean by " cooperative during all aspects of the assessment " or is it indeed a conflict of information - should I have said that she did not cooperate because of her poor effort (she actually refused some items of the test because of her pain history and fear for aggravated symptoms which I commented on in the report). Am I wrong in saying that the client cooperated with all aspects? I wasn't sure how to answer that with my referral source. I explained that cooperation meant that she agreed to participate, she was on time for the appointment, she was reasonable to work with. It was explained to the client that she could refuse activities but that it would be recorded as such in the report and also her reasons as to why. So to me it doesn't seem like she didn't cooperate even though her effort and reports were low/unreliable at times. Hope this isn't too confusing for you! Thanks for your input. (Name Withheld)

response: Thanks for your question; it reflects today's emphasis on very carefully phrasing our reports!

Although I understand what you meant by 'cooperated' and 'cooperative', I would probably not use those terms in my report. It does paint a positive picture of the client's demeanor but could cloud the picture relative to reliability of client reports and/or physical effort for the reader who wanted to assign an expanded meaning to the words.

In reponse to your referral source I would focus on the use of 'cooperate' as being relative to the client's presentation and demeanor, not PE or RCR. At the beginning of the conversation I might say something like, 'I can see your point; 'cooperative' could be thought of as being pertinent to physical effort or reliability of client reports. In my use I am referring only to the client's outward demeanor and presentation.'

I hope this helps. Please let me know if I can be of further assistance.
Roy Matheson