Vignette - I Don't Have a Deficit


The video "I Don't Have a Deficit" addresses the issue of cultural insensitivity among standardized assessments and how clients may be scored inappropriately as a result of these biases. In this video, the occupational therapist assumes that the client has an impairment hindering the activity of hair washing because the client reports not washing her hair every week. The video illustrates how assessments may not be culturally sensitive and it is important that we as practitioners do not let such biases impact quality of care.


  1. What is the problem being addressed in this video vignette?
  2. The standardized assessments that you are required to use at a facility are culturally insensitive. When administering this assessment to a client, what steps would you take to obtain a complete occupational profile?
  3. What are aspects of different cultures that have the potential to be marked as a deficit on standardized assessments?
  4. When encountered with a culturally sensitive scenario, what questions would you want to ask your client to learn more about their culture before administering the standardized assessment?
  5. When administering assessments to clients of the same cultural group, how can assumptions influence the therapeutic relationship?
  6. Give some reasons why a client would not be able to provide a rationale for how their cultural habits affect their ADL performance.
  7. If a client cannot articulate this information, how can the therapist learn about the client's culture while maintaining the therapeutic relationship?
  8. How could the setting in which you are administering the assessment impact the way in which you use culturally sensitive information?

Video Disclaimer:

These videos contain dramatized content used for educational purposes that do not represent the viewpoints or opinions of the actors, students, the Downstate Occupational Therapy Department, nor SUNY Downstate Medical Center.