Frequency of fine motor manipulation
Thu, 07/08/2010 - 3:47pm
I completed a FCE on a gentlman that has multiple non dominant hand finger amputations. He does not meet MTM using the dexterity panel and Valpar 9 panel or the Valpa202. His goal is to be re-trained at a job that requires a frequent level of fine and firm handling. Is there support to say he meets occasional level but not frequent level of handling due to his speed?
Thu, 07/08/2010 - 4:52pm
#2
A couple of thoughts...
A couple of thoughts...
Keep in mind the difference between determining true frequency ability versus trying to us an MTM to determine frequency. MTM is not a predictor of occasional, frequent or constant on its own.
One thing you can say is that he did not meet the MTM speed requirement for the type of motions needed to successfully complete the physical demands assessed by the Valpar 202 (or 9). That tells the reader that he is not face enough for those motions.
Second, yes, as a thinking evaluator you can estimate his ability in terms of occasional or frequent. His ability to complete the motions qualifies him in some portion of the occasional category. The real trick is estimating whether or not he qualifies for the frequent category. From your question I assume you have determined that he does not qualify for the frequent level.
Third, let's look at the validity of the match between the work he seeks and the test used: the Valpar 9 is a one-handed test. The 202 is a two-handed test. What is the nature of the actual work he seeks? Can it be done with one hand? What is the speed requirement of the actual job he seeks? Do they require a certain production rate that he cannot meet? Is the rate so low that he can meet it? The answers should lead you to your conclusion about his potential ability to match his sought-after type of work.
Roy makes several important points. One other point would be which hand did he use for the fine motor tasks during the Valpar 9? As I am sure we are all aware, the client is not instructed as to which hand to use-If the client elected to use his affected, non-dominant hand only, the results of that test may be very skewed (and some do this in an effort to help the evaluator "see" the disability). Effort would, of course, also play a factor. For any upper extremity diagnosis, I always estimate what percentage of the Valpar 9 tests were performed with the affected hand (20%, 50%, etc.), and sometimes document that I have deviated from the standardized protocol by instructing the client to use their hand in an alternating manner. If the work requred bilateral dexterity (assembling nuts and bolts that are loose), this may have been a better way to go. Also of benefit is looking at the score and hand used for test 3-where vision is occluded. I would also look at the scores for right vs. left on the Perdue and Minnesota for a norm based comparison. Hope this helps!