Introduction to the Evaluation of Social Interaction The Evaluation of Social Interaction (ESI) s a valid, reliable, and sensitive measure of a person's quality of social interaction

Presentation overview ESI description Overview of administration and scoring Interpretation of results In this presentation I will Describe the ESI, what it is intended to measure and with whom it is an appropriate assessment Provide an overview of the administration and scoring of the ESI Show how we interpret the results of an ESI observation

Social interaction affects all areas of occupation Why do occupational therapists need an evaluation of social interaction? Diminished social interaction can limit full participation in all areas of occupations During work/productivity, when we socially interact with co-workers or supervisors

Social interaction affects all areas of occupation During instrumental (domestic) ADL tasks when deciding what to have for dinner and/or cooking a meal together

Social interaction affects all areas of occupation During personal (basic) ADL tasks when eating a meal together or interacting with a personal assistant or aide when dressing or doing other PADLs

Social interaction affects all areas of occupation During community activities such as when Finding out about a product while shopping, or

Social interaction affects all areas of occupation Making a purchase at a store

Social interaction affects all areas of occupation During leisure/play when people socially interact with others over coffee or collaborate when playing games

Social interaction affects all areas of occupation During educational activities, such as when Young students socially interact in the classroom, or

Social interaction affects all areas of occupation College students collaborate to complete a project Nearly any occupation in which the person socially interacts with another person is appropriate for an ESI observation as long as: The social context is natural to the intended purpose of the social interaction The social interactions are not simulated nor “role play” Unlike some tests of social skills, the therapist cannot be the person’s partner — Why?

ESI items The occupational therapist cannot simultaneously Engage in the social interaction and Evaluate the 27 different social interaction skills of the ESI ESI test items: social interaction skills The test items of the ESI represent social interaction skills Social interaction skills are the small, observable actions (i.e., units of social behavior) that a person enacts when talking and interacting with another person

We can think about social interaction skills as links of a chain The person enacts each social interaction skill one after another (the links of the chain) Until he or she constructs the entire social exchange (the chain) For example, when observing someone have a meeting with a colleague during lunch, the occupational therapist can observe the person to Approach her social partner Greet her social partner by Looking at him, Shaking his hand, and Asking a question, “How are you?” Each of these actions is linked one by one while she constructs the social exchange As the social interaction continues, the occupational therapist observes the person to Turn her face and body away from her social partner Laugh inappropriately Look back at her social partner, and Abruptly say, “Goodbye”

Scoring the ESI items Competence = Appropriate, polite, respectful, well-timed 4 = Competent performance 3 = Questionable performance 2 = Ineffective performance 1 = Unacceptable performance To score the ESI items, we judge the quality of each observable action The criterion against which we judge quality of a social interaction skill is competence Competence is defined as a social interaction that is Socially appropriate Polite Respectful Well-timed Mature ESI items are scored based on the following rating scale: 4 = competent, no problem 3 = questionable 2 = ineffective; clear disruption to the social interaction 1 = severe; markedly inappropriate, risk for physical harm or to personal integrity, need for assistance

ESI standardization sample The ESI is valid for use Across cultures With men or women Across the age span (2 years through 100+ years) With people of any diagnosis or disability: Psychiatric disorders Development disabilities Neurological disorders Multiple and/or other diagnoses At risk Well people without a diagnosis or disability Note to presenter. Use the first two pages of Section 3.1 Current Standardization Sample of your ESI manual to emphasize specific diagnoses of clients your audience typically works with So that ESI results are valid, occupational therapists must administer and score the ESI in a standardized way

Standardized assessment So that ESI results are valid, occupational therapists must administer and score the ESI in a standardized way Every occupational therapist who administers the ESI follows the same standardized procedures To begin, the occupational therapist interviews the client and learns what occupations are of concern

Standardized assessment Based on what the client reports, the occupational therapist then Observes the person engage in two natural social exchanges with typical social partners and Rates the observed quality of social interaction

Standardized assessment Next, the occupational therapist uses the ESI manual and software to: Score the 27 ESI skills Enter the scores into a computer Generate ESI results reports

Computer-generated reports The ESI Results Report includes visual representations and narrative descriptions of the person’s ESI results Reports are customizable, allowing the occupational therapist to add his or her own narrative documentation of the person’s ESI results

Taking a closer look at the ESI Results Report This yellow “ruler” is the ESI scale and represents a range of quality of social interaction from a high of “competent social interaction” to a low of “markedly ineffective social interaction” A white arrow to the left of the ruler represents the person’s observed quality of social interaction [point to the white arrow] In this example, the arrow falls in the range where it is common to observe “markedly ineffective” social interaction

The report also depicts the range in quality of social interaction demonstrated by healthy, well adults In this example, the person’s white arrow falls below the “expected range” This means that the person’s quality of social interaction is lower than expected for a healthy, well person 72 years old

Improved quality of social interaction 9/12/2015 Moderately to markedly ineffective and/or immature social interaction Improved quality of social interaction Re-evaluation Important for evidence-based practice is our need to re-evaluate the client to determine the effectiveness of our interventions The ESI can be used to measure change over time In this example, the person’s quality of social interaction improved   Notes to presenter: Consider presenting a case study Present a client and why you chose to administer the ESI Show your ESI results report Discuss how you used your ESI results to guide intervention Show your ESI progress report Engage your audience in a discussion about the benefits of using the ESI, including: Communicate our occupational therapy evaluation results with the client and others Demonstrate how specific social interaction skill deficits impact the person’s overall quality of social interaction Collaborating with the client to set goals Measuring the change in quality of social interaction Building evidence that specific interventions were effective for improving quality of social interaction

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