Occupational therapists assess how people carry out everyday activities and what affects their participation. In an FCA, this means examining the activity itself, the person's abilities, their environment and the help already available.
Other qualified professionals can also provide functional evidence. The appropriate assessor depends on the question being asked. An OT assessment is particularly relevant when the question involves several parts of everyday life and how they fit together.
Looking closely at an activity
Consider getting to an appointment. Walking to the car is only one part of the task. The person may also need to remember the booking, organise transport, leave on time, understand the conversation and follow the instructions afterwards.
An OT asks which steps the person manages, where difficulty occurs and what changes when support is available. For example, a calendar reminder and a worker's assistance with travel do different jobs. Recording both helps explain why a person attends appointments successfully.
The assessment should not assume that all difficulty comes from a diagnosis. An inaccessible building, unfamiliar instructions or a change in routine may also affect what happens. Where the cause is uncertain, the report should say so.
Bringing the evidence together
The OT compares the person's account with the other information available. This might include an assessment activity, a questionnaire, a treating professional's report or observations from someone who provides support.
Different accounts do not automatically mean that one person is wrong. A task may be easier in one setting, or one observer may see only part of it. The OT needs to clarify the difference and explain any uncertainty that remains.
Questionnaire scores can add information, but they do not replace this work. A score alone does not establish the number of support hours a person needs.
Explaining a recommendation
A recommendation should identify the need it addresses and explain why the proposed response is appropriate. Depending on the findings, that response might involve assistance from another person, an environmental change, therapy, equipment advice or a more specialised assessment.
For the appointment example, a recommendation would need to explain which parts require assistance, how often appointments occur and whether the person can use an alternative arrangement. Simply writing that the person needs community support would leave important questions unanswered.
The OT is responsible for conclusions within their professional scope. They do not decide an NDIS budget or guarantee that a recommendation will be funded. When the available information cannot support a conclusion, identifying the missing assessment is part of the job.