Summary of the OCAIRS

The OCAIRS is a criterion-referenced and standardised test. It is conducted as a semi-

structured interview. The OCAIRS is based on the Model of Human Occupation (MOHO) and

measures clients’ occupational participation. Teenagers, adults and elderly clients (Kielhofner

& Taylor, 2017) with psychiatric and physical disabilities are suitable for using the OCAIRS

(Forsyth et al., 2005). Also, it is a descriptive and evaluative assessment that takes 20 to 30

minutes to finish and 5 minutes for the rating (Kielhofner & Taylor, 2017). The OCAIRS is

started with a natural interview collecting the nominal and ordinal data by the following 12

items and the 4 point rating scale (Haglund & Forsyth, 2013), which are used to outline the

current situation and the changes of the clients over time. The OCAIRS has demonstrated

considerable reliability and concurrent validity (Haglund & Forsyth, 2013). The OCAIRS

requires the OTs to use advanced interviewing skills. For instance, the OTs have to customise

their approach to conduct the interview effectively for clients with different disabilities

(Forsyth et al., 2005). Therefore it has been widely used for clients in all age ranges.

Summary of MOHOST

The MOHOST is a standardised assessment that is composed of skilled observation and

criterion-referenced tests (Lee et al., 2013). The MOHOST is an assessment that can be used

with a wide range of populations including teenagers, adults, the elderly and those with verbal

or non-verbal skills (Parkinson et al., 2004). The MOHOST is useful in measuring why a client

is not engaging in self-care, productivity or leisure occupations through the MOHO (Kielhofner

& Taylor, 2017). The therapist will start collecting the nominal data with descriptive

assessment by observing and categorising the client’s occupational performance into six

subscales which are based on the MOHO concepts in a given environment (Parkinson et al.,

2004). After that, the ordinal data will be collected through the 4 point rating scale. The

MOHOST can also be used as an evaluative outcome measure since it has a high sensitivity in
measuring the change of the client (Kramer et al., 2009). Moreover, the MOHOST is flexible

in using mixed data collection methods (Parkinson et al., 2004). The result of the MOHOST is

usually combined with the proxy report which is conducted by the multidisciplinary team for

the therapists to make their therapeutical decision (Parkinson et al., 2004). It is generally agreed

that the MOHOST features high reliability and validity and it is suitable not only for clients

except children and those with verbal or mental disabilities.

Compare & Critique

Comparing the similarity of the two assessments, it is clear that they both have adequate

reliability. According to Forsyth (2011), the mean square fit statistics (MNSQ) effectively

represent interrater and interrater reliability. An MNSQ value of 1.0 indicates an ideal fit for

an item and values greater than 1.4 are judged to show a misfit (Maciver et al., 2016). None of

the MnSq for the items in the Chinese version of the MOHOST exceeded 1.4, and most of them

were very near an ideal MNSQ of 1.0. Moreover, Haglund & Forsyth (2013) indicated that

most of the items in the OCAIRS do not exceed 1.4 and are close to 1.0. Therefore, both are

consistent screening tools for therapists in real-life situations. Also, both of the tests have high

concurrent validity (Kielhofner et al., 2010) ; (Scott et al., 2017), which mean they have a great

extent to agree on the same or similar traits and behaviours (Kielhofner & Taylor, 2017). As a

result, both are highly appropriate for validating the client's occupational performance

(Parkinson et al., 2004) ; (Forsyth et al., 2005). On the other hand, the MOHOST and the

OCAIRS are client-centred assessment tools. Since they are MOHO based assessments, the

clinicians will consider the volition and habituation of the clients during the utilisation of

assessment (Kielhofner & Taylor, 2017). As a result, both are practical tools for the therapist

in considering future therapeutic goals (Cruz et al., 2019; Haglund & Forsyth, 2013). However,
both assessment tools required therapists to have a consolidating understanding of the content

and process (Parkinson et al., 2004; Forsyth et al., 2005).

Regarding the disparity between the two tests, the MOHOST is a skill observation test that can

get more objective data from the client since the comparison is possible (Forsyth et al., 2017).

There is a possibility of feedback in the MOHOST since the therapist can offer feedback after

the test. At the same time, the OCAIRS relies primarily on the client's report. In addition, there

is a stronger emphasis on the client's verbal communication since the OCAIRS is a semi-

structured interview. Considering the time taken by both assessment tools, it has been shown

that the MOHOST required less time than the OCAIRS. The MOHOST will take a minimum

of ten minutes to complete (Parkinson et al., 2004), while the OCARIS will take 25 minutes to

finish (Forsyth et al., 2005).

Scenario

In terms of the scenario, the MOHOST should be more appropriate for Bill since he has a

disability in his mentality and can only converse for a short period. Regarding the data

collection, the MOHOST is more suitable since it is a skills observation and can be used to

compare with other assessment tools which are undertaken by other professionals if

necessary, so it can collect a broad range of data with minimal intrusion to the client

(Parkinson et al., 2017). On the contrary, the OCAIRS is a semi-structured interview that

requires a consistent response from the client (Forsyth, 2017). From the scenario, Bill may

have limited verbal conservation since he is experiencing paranoid delusion (Nasrallah et al.,

2019). Therefore, the utilisation of the MOHOST may require less emphasis on Bill’s

language. Moreover, the time undertaken by the MOHOST is less than the OCAIR. Bill can

only sustain a conversation for a short time due to his mental issues. If the therapist use the

OCAIRS as the assessment tool, it would make it difficult for the therapist to collect adequate
data. Furthermore, Bill has paranoid delusions and hallucinations meaning that his response

may not be reliable or he may have insufficient insight into himself (Reckner et al., 2020), so

the therapist should use the MOHOST test to provide insight to the client (Parkinson et al.,

2017) instead of using the OCAIRS which is heavily relied on client’s self-report (Forsyth et

al., 2006).
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