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Following a period of intervention children can be assessed using the GAS scaling and be given a numeric score. This can be used not only on an individual basis but also on a larger scale to assess programs and to conduct research.
According to McDougall & King, 2007, the scale should meet the following criteria:
Have clinically equal intervals between all scale levels
The amount of change between levels should be clinically relevant
Change should be measured using just one variable keeping other variables constant
Identify a timeframe for the achievement of the goal
Here is an example:
SMART GOAL: Child will transfer from sitting in his wheelchair to standing at his desk by pushing through both hands on the armrests, having his feet hip width apart while bringing his COM forward over his BOS and sustain standing for 10 seconds in anticipation of his walker being placed behind him, 3 out of 5 trials, by (date).
GAS SCALE: The bolded words indicate the variable being measured and the amount of change.
-2
sustain standing for less than 5 seconds
-1
sustain standing for 5 – 9 seconds
0
expected
outcome
Child will transfer from sitting in his wheelchair to standing at his desk by pushing through both hands on the armrests, having his feet hip width apart while bringing his COM forward over his BOS and sustain standing for 10-14 seconds in anticipation of his walker being placed behind him, 3 out of 5 trials.
+1
sustain standing for 15-19 seconds
+2
sustain standing for at least 20 seconds
Other examples of measurable variables besides time as in the above chart, could include, but are not limited to, variables such as distance, level of assistance, number of repetitions, and percentage of accuracy. It is also possible to use developmental levels that are approximately equal in intervals.
GAS scaling provides therapists with a useful tool for documenting measurable, observable, functional change. It is simple and inexpensive, and can be used to show change in an individual child as well as show change for the purpose of research. This methodology shows promise for therapists by capturing meaningful outcomes for the children they treat thus leading therapists to best practice.
We are thrilled to announce a new course coming in early 2015 taught by Suzanne Davis with new faculty member Kate Bain:
“Making and Showing Measurable Change in Neuro-Pediatrics”
Suzanne’s other course: Contemporary NDT Treatment of the Baby and Young Child
Good luck to all those taking finals right now and CONGRATULATIONSto all recent graduates. We are sure that you will enjoy your chosen profession and enjoy the rewards that it will bring.
Education Resources would like to help you plan your future professional development and guide you through your continuing education requirements. We offer relevant dynamic continuing education courses for PT’s, PTA’s, OT’s OTA’s and SLP’s in a full range of specialties: Pediatrics, Special Education, Adult/Geriatric Rehab., Feeding, Acute Care, NICU, Home Care, and many more.
(We will be giving away three courses) Drawing will take place in June
We also encourage you to join our popular Blog and Facebook page where where we post clinical challenges and solutions, therapy nuggets from our distinguished faculty, therapy tips from colleagues, professional development and CEU issues, as well as clinical research updates.
Please feel free to post any thoughts and comments; ideas for future courses, topics, future speakers. We look forward to welcoming you to our ERI community.
GAS is similar to SMART (Subjective, Measurable, Achievable, Realistic/Relevant, and Timed) goals in that they both require repeatable, observable, specific conditions under which outcomes can be measured. However, GAS is unique in that there are at least 5 levels of outcome. The chart below demonstrates this concept:
GAS Key-2= much less than expected outcome
-1= somewhat less than expected outcome
0= expected level of outcome, most probable outcome from treatment
+1= somewhat more than expected outcome
+2= much more than expected outcome
As noted in the chart the “0” level is the expected outcome or level of attainment following intervention. Then there are two more favorable outcomes that graduate to higher achievement than expected, and two less favorable outcomes that are lower than expected. Using this scale a therapist can determine if a child has made some progress toward the goal even if the child did not fully achieve the expected outcome, and also whether or not the child has exceeded expectations and achieved a higher outcome than expected.
Using GAS scaling in combination with the International Classification of Function (ICF) model developed by the World Health Organization lends further credence to this tool. Goals can be written with components that address the various domains of the ICF model (participation, activity, impairment, etc.) GAS can also be used in family-centered practice and lends itself to collaborative goal writing and intervention.
The next blog will give more criteria to GAS goals and provide examples of GAS and SMART goals as applied to the same function.]]>
Coming later this year – a course with a new unique approach.
We are excited to announce a new lab intensive acute carecourse offered by internationally respected Cardiovascular and Pulmonary Clinical Specialist Komal Deokule, PT, MSc.PT, CCS, MCSP, MPNZ, MIAP
We would appreciate our community’s input when it comes to developing the title.
This course has a focus on respiratory complications co-morbid with acute illness. It is lab intensive focusing on approaches to safe reconditioning.What title will best describe this course?
Please send us your thoughts by May 23rd, and we will enter your name into a random drawing to be selected to receive a free spot to a course of your choosing.
Post your thoughts in the comments below or email me: mwashington@educationresourcesinc.com
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