A-ONE - The Árnadóttir OT-ADL Neurobehavioral Evaluation training course

Course Description

Within the field of occupational therapy (OT) there is a growing awareness and need to have therapists
evaluate patients with cognitive-perceptual dysfunction in a way that is unique to OT (i.e. a functional
emphasis). Traditionally, the evaluation of activities of daily living and mobility occurs separately from the
cognitive-perceptual evaluation. This is unfortunate as the “traditional” cognitive-perceptual evaluation
includes items not oriented to the discipline of OT; that is they do not focus on how or why such dysfunction
interferes with daily activities.
With this in mind, Guðrún Árnadóttir, an Icelandic occupational therapist, developed an assessment tool that
combines neurobehavioral theory with OT principles. The A-ONE directly links functional performance
(basic activities of daily living and mobility) to neurobehavioral deficits including cognitive-perceptual and
motor impairments. The A-ONE is appropriate to use for clients over the age of 16 who present with damage
to the central nervous system.
When administering the A-ONE standardized observation methods are used to evaluate task performance and
the need for assistance in the following daily living tasks: feeding, grooming & hygiene, dressing, transfers
and mobility, and functional communication. Subsequently, speculations are made through task analysis
regarding the underlying neurobehavioral impairments that limit the performance, impairments, such as,
ideational apraxia, motor apraxia, unilateral body neglect, unilateral spatial neglect, spatial relations
dysfunction, motor control, and perseveration. The resulting impairment hypotheses are based on observed
performance errors combined with operational definitions from the A-ONE conceptual framework,
therapists’ professional reasoning skills and neurological knowledge.
The A-ONE is used throughout the international OT community. To use the tool reliably a certification
course is required. In the course participants will become familiar with the concepts used in the evaluation
and learn to differentiate between them. They will further be able to relate the A-ONE concepts to other
classification systems and gain insight to psychometric qualities of the evaluation including measurement
potential based on Rasch analysis