T.R.I.P. Assessment
Transportation Route Individualized Plan Assessment
Date of Assessment: __________________
Assessor: __________________________
General Information:
Applicant’s Name: _____________________
Applicant’s Date of Birth: __________________
New Applicant Recertification
Street Address: __________________________________
City: _________ _______ State: Zip code: _________
Phone: _______________________
Background Information:
Medical History: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Medication Taken Today? Yes No
Temperature Sensitivity?
Occupational Performance Problems
Client Interview:
Want to Do ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Need to Do- _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Expected to Do- _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Current Programs or Agencies Utilized- _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Areas of Difficulty:
Functional Mobility
ABLE UNABLE
XCX
XCXTransfers:
Indoors:
Outdoors:
Other Concerns: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Community Management
ABLE UNABLE
Transportation:
Community Access:
Finances:
Other Concerns: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Transportation Steps: If marked “able” on all verbal report steps, proceed to physical performance steps.
Verbal Report
ABLE UNABLE ADDITONAL TRAINING
Plan and schedule trip:
Know destination:
Get out door on time:
Navigate to pick-up spot:
XX
XXReady and waiting arrival:
ID correct vehicle:
Physical Performance
Board vehicle:
Pay fare:
Secure seat:
Ride bus:
Negotiate pickup:
Signal Stop:
Disembark:
Negotiate transfers:
ID return stop:
Navigate to destination:
Check-in at destination:
Navigate at destination:
Get out door on time:
Navigate to return spot:
Number of trips:
Missing Steps:
Summary:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
______________________________ ___________________
Occupational Therapist Date
Administration of the T.R.I.P. Assessment-
Client Interview: This portion of the assessment was inspired from the Canadian Occupational Performance Measure to facilitate a client centered approach when assessing the IADL of community mobility. The premise is to dialogue with the client, utilizing open ended questions, to help identify the clients need and intent for accessing public transportation.
Areas of Difficulty: This portion of the assessment can be incorporated into the client interview or completed as the assessment process takes place. The assessor can mark if the client is observed as “able” or “unable” to do a specific task noted during the interview process. If the skill is not able to be observed during throughout the interview process, the assessor should use the areas as prompts for further questioning of the clients perceived abilities.
Transportation Steps: This portion of the assessment is to be utilized in a field test with the client. First, ask the client to plan and schedule a trip to and from a desired location. If the client is unable to do so, then the assessor has the right to use a pre-determined route that will prompt a thorough examination of each suggested step.
Scoring-
“Able”: When the client completes a step without the need for physical or cognitive assistance, (no notable difficulty). The client may be granted extended time to complete the step if it directly relates to cognitive processing abilities as long as the extended time does not put the client in harm’s way.
“Unable”: When the client does not complete a step with or without physical and/or cognitive assistance, (notable difficulty throughout the step). The client will not be marked “unable” if they require extended time to complete a step due to cognitive processing, unless the extended time renders the client in harm’s way.
“Additional Training”: This option maybe selected if the client is able to complete a step, per the assessment guidelines but would still benefit from training for skill advancement. This option is also deemed appropriate to select when the client is noted “unable” to complete a task, if the additional training would prove to advance the skill set and remediate process for future independence.
“Mobility/Cognitive Aid(s)”: This option maybe selected if the client currently utilizes a mobility or cognitive aid in order to maximize functional independence. The client’s performance should not be marked “unable” if they require the use of an aid, unless the aid renders the client in harm’s way.
The following assessment has components that were inspired from the Canadian Occupational Performance Measure and modified from the Activities of Community Transportation Wheel model. Permission to utilize these components were requested and granted.