Transcript Application Form

Evaluation of Social Interaction Training
Course (ESI)
With Dr. Gill Chard
Tuesday April 16-Thurs April 18 2013
St. Patrick’s University Hospital- Dublin
Organised by AMPS UK and Ireland Evaluation
of Social Interaction (ESI) training comprises of
a three-day course. It is uniquely an
Occupational Therapy Assessment:
• Focus on what the person wants and needs
to do
• Observation during occupational
performance
• Interaction within the real context of
occupation
• Observation of the person and his/her
typical social partners
The ESI is an evaluation tool used by
occupational therapists to assess a person's
social interaction performance within the
context of everyday occupations that involve
social interaction.
ESI is based on similar principles to the AMPS
and School AMPS, but the person is observed in
two tasks that involve social interaction. The
range of things you can observe are nearly
unlimited -- chatting over a meal or coffee,
playing with others, talking with sales
personnel. It all depends on the types of social
interactions that are relevant and, ideally,
identified as "problematic". It can be used with
children in schools, clients with a wide range of
disabilities, and well older adults.
The three day course will be presented by Gill
Chard
It is suitable for occupational therapists working
in all fields including children, adult physical
rehabilitation, neurology, mental health,
learning disabilities and challenging behaviours.
Find out more on the ESI website:
http://www.social-interaction.com/
At the end of the 3-day training course,
participants will:
• Have a theoretical foundation for using the
ESI to promote client-centered and
occupation-based practice
• Know the process for administering the ESI
with clients 2 years old through to adulthood
• Explain how social interaction supports
engagement in all areas of occupation and is
relevant for occupational therapy
• Administer, score, and interpret the ESI in a
reliable manner
• Use the ESI methodology to assess a
persons‘ functional ability
• Use the ESI to plan and guide occupational
therapy intervention (direct and
consultative).
Registration fees
Delegates will require a copy of the course
materials to attend the event, this will be
available when you arrive. Please note that
places are limited.
TOTAL COST €720
Please see the attached application form.
Payment MUST be made with your application
form by cheque, Laser card or credit card.
Should you require more information before
applying contact Sherrie Buckley, at
[email protected] or +353 (0)12493
426
Please note that all
applications must be
received by Monday
March 11th 2013
Evaluation of Social Interaction Training
Course (ESI), with Gill Chard
Tuesday 16th April-Thursday 18th April 2013
St. Patrick’s University Hospital
Application Form
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Please complete and return this form WITH PAYMENT for receipt by 11 March 2013 to Sherrie
Buckley, Department of Occupational Therapy, St. Patrick’s University Hospital, James’s Street,
Dublin-8 or by email [email protected]
Telephone bookings with a credit card payment will be accepted
If you wish to be invoiced please supply the full organisation name and postal address the
invoice needs to be sent to and an order number or other reference.
On receipt of your application you will be sent joining instructions and confirmation of your
place. IF YOU DO NOT RECEIVE THIS PLEASE CONTACT Sherrie
Please do not book travel until you have received written confirmation as we are
unable to issues refunds should the course not go ahead.
Booking details
Name
Job Title
Employer
Address
Fee
€720
Invoice
Receipt required
Post code
Special dietary requirements
Email address
Any other special needs
Payment details
 A cheque for the appropriate fee attached (made payable to St. Patrick’s University Hospital)
 Credit Card Details
Please charge my Visa/Mastercard/Laser account with €......... *please specify type of card
Card No:
Expiry Date ____/_____Valid From___/___ 3 digit security code_____ ___
Cardholder’s Signature Cardholder’s address
______________________________________________________________________________
______________________________________________________________________________
INFORMATION
Cancellations: Refunds will not be made without written application. Cancellations made up to six weeks prior to the event will incur a charge of
20% of the registration fee. Cancellations made subsequent to this date will incur a charge of 60% the registration fee. Refunds will not be made
after the conference has finished, but a suitable delegate may be sent – please notify the course organisers of any changes.