P-OSIS™ Service Intensity Scale

Score five clinical factors to explore a service range to discuss with your team, in your practice setting's own calendar.

1. Practice setting

2. Clinical need (0–4 each)

Skill stage & intervention complexity

Where is the child in learning the target skills, and how much OT clinical reasoning does intervention need?

0 · Maintenance — skills established; periodic check of fit only1 · Generalization — skill present in structured settings; needs carryover to new routines2 · Emerging — inconsistent; needs graded tasks, cues and adaptation3 · Active acquisition — skill not yet established; needs licensed OT handling and grading4 · High complexity — severe barrier to participation; specialized OT techniques required

Multisystem load (Vision · Sensory · Motor · Focus)

How many performance systems are contributing to the functional concern?

0 · No functional system concern1 · One system, mild impact2 · Two systems interacting (e.g., vision undermining pencil control)3 · Three systems involved4 · All four systems co-impacting daily performance

Caregiver / team carryover capacity

Can the family or team carry out strategies without the OT present?

0 · Strategies carried out consistently and independently1 · Carries out with occasional reminders2 · Inconsistent — turnover, staffing or caregiver stress causes drop-off3 · New to strategies — needs ongoing modeling and coaching4 · High burden or safety risk if handled incorrectly — needs direct OT guidance

Developmental window & rate of change

Is this a time-sensitive period?

0 · Stable baseline; no urgent timeline1 · Gradual, expected progression2 · Approaching a milestone or routine change3 · Critical window or upcoming transition (e.g., Pre-K→K, post-surgery, new school)4 · Acute change or regression needing stabilization

Environment, safety & equipment

What adaptations, equipment or safety demands are involved?

0 · Standard environment; no adaptations1 · Low-tech supports managed independently (grip, slant board, visual schedule)2 · Moderate modification (seating, regulation space, lighting/contrast)3 · Complex equipment needing ongoing adjustment4 · High safety risk (falls, elopement, skin/positioning risk)

Scoring progress

0/5 scored

Complete all five factors before a service range is shown. A score of 0 counts as an answer.

Field-test 0.1. A decision-support tool for team discussion; final service decisions rest with the team and the treating OT's clinical judgment. Not normed. Nothing is saved.

Resources All areas

Performance Minds Learning

Browse by Performance Cascade™ step

Start with vision, then follow the chain: posture and motor, sensory regulation, attention and task behavior. A reasoning guide, not a diagnosis.

VisionStep 1 · Visual efficiency

MotorStep 2 · Posture and motor control

SensoryStep 3 · Sensory regulation

Focus / ExecutiveStep 4 · Attention and task behavior

AOTA Approved Provider

No. 0000001618

Sensory, Motor and Focused Minds courses are not yet AOTA-approved. SPA™, MPA™ and FPA™ are criterion-referenced field-test tools, not diagnostic instruments.