1. 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

2. 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

3. 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

4. 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

5. 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

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

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

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

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

10. 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?

11. 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

12. 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”

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. More information and resources are available on the CIOTS website, www
More information and resources are available on the CIOTS website,