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Occupation-based evaluation and intervention: validity of the assessment of motor and process skills when used with persons with mental retardation
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The ability to perform everyday life occupations is a critical component in both evaluation and intervention for persons with mental retardation (MR). While the ability to perform personal and instrumental activities of daily living (ADL) has always been important for occupational therapy (OT) practice, there is an absence in OT literature and research with a focus on ADL and persons with MR. The overall aim of this thesis was to evaluate the validity of the Assessment of Motor and Process Skills (AMPS) for evaluation and intervention of ADL ability for persons with MR.

In order to evaluate the evidence of validity of the AMPS ability measures based on relation to level of MR, two groups of participants with MR were evaluated with the AMPS (,#=22; #= 39). The results indicated expected moderate relationships between ADL motor and ADL process ability measures and level of MR, despite different methods used for evaluating level of MR. The results also indicated that the results of the AMPS evaluation could be used to directly describe and measure the consequences in performance of ADL tasks for persons with different levels of MR.

The evidence of validity of the AMPS was further examined in a study including participants with different types of developmental disabilities (e.g., MR, cerebral palsy, spina bifida) (#=1724). An application of many-faceted Rasch analysis was used to examine goodness-of-fit of the responses for the tasks, skill items, and participants included in the study. All tasks and all items except one demonstrated acceptable goodness-of-fit to the model on the ADL motor and ADL process scales. An expected proportion of participants demonstrated acceptable goodness-of-fit on the ADL motor scale. On the ADL process scale, a slightly lower proportion of participants than expected demonstrated acceptable goodness-of-fit. The results indicated further that persons with more severe levels of MR and persons with more limited ADL process abilities demonstrated different response patterns across tasks and possibly items.

The evidence of validity of the internal structure of the AMPS scales was also evaluated between persons with mild and moderate MR (#=178; #=170). Group specific ADL motor and ADL process skill item hierarchies were generated using many-faceted Rasch analyses and compared. The hierarchies of ADL motor and ADL process skill items remained stable across groups, indicating evidence of validity of the AMPS scales when used to evaluate persons with MR. The results also indicated that although participants with moderate MR demonstrated overall lower mean ADL motor and ADL process ability, they did perform some specific ADL motor and ADL process skills at a similar level as persons with mild MR.

Finally, the utility of the AMPS ability measures for detecting change were examined in an intervention study including three female participants with moderate MR. The study was based on a single case design and evaluated the effectiveness of a structured occupational therapy intervention program. Improvements were found for the participants in relation to the implementation of the program, but the pattern of changes were different between the participants and across the dependent variables. ADL process ability was the only variable that improved across all participants. The results supported the ADL process abilities as sensitive measures for detecting changes in ADL ability of persons with MR.

In conclusion, the results of these studies contribute to the evidence of validity of the AMPS ability measures and scales, specifically in relation to the evaluation of persons with MR. The finding that an OT program resulted in improved ADL process ability also suggest that the results of the AMPS can be used to plan as well as evaluate outcomes of OT practice. Further research is also suggested in order to improve validity evidence and utility of the AMPS when used with persons with MR.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet , 2003. , p. 83
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 836
Keyword [en]
Mental retardation, intellectual disability, developmental disabilities, occupational therapy, activities of daily living, ADL assessment, performance skills, occupational performance, Many- faceted Rasch measurement, single case design
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:umu:diva-94111ISBN: 91-7305-438-0 (print)OAI: oai:DiVA.org:umu-94111DiVA, id: diva2:763461
Public defence
, Umeå universitet, Umeå
Supervisors
Note

Diss. (sammanfattning) Umeå : Umeå universitet, 2003

Available from: 2014-11-14 Created: 2014-10-03 Last updated: 2018-03-15Bibliographically approved
List of papers
1. IADL Ability Measured with the AMPS: relation to two Classification Systems of Mental Retardation
Open this publication in new window or tab >>IADL Ability Measured with the AMPS: relation to two Classification Systems of Mental Retardation
1995 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 2, no 3/4, p. 121-128Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to examine the relationship between the Assessment of Motor and Process Skills (AMPS) and two types of assessment of level of mental retardation. The subjects were 22 adults from the United States and 39 adults from Sweden, all diagnosed with mental retardation. The subjects in each group were divided into three subgroups according to their level of mental retardation. The level of mental retardation was determined according to established criteria used in each country. They were then assessed using the AMPS to evaluate motor and process (organizational and adaptive) skills necessary for competent IADL task performance. The results showed that different methods of determining the level of mental retardation showed patterns similar to motor and process skills. The correlations were strongest between the Swedish method of assessing level of mental retardation and the AMPS. The correlations were stronger between level of mental retardation and process skills in both the Swedish and US groups. The results indicate a relationship between level of mental retardation and IADL ability, despite differences in assessments of level of mental retardation. The study recommends the use of the AMPS as a valid and sensitive instrument of IADL ability in the development of intervention strategies in occupational therapy for persons with mental retardation. Further studies with the AMPS are suggested in order to evaluate IADL skills in this population.

Place, publisher, year, edition, pages
Scandinavian University Press, 1995
National Category
Occupational Therapy
Identifiers
urn:nbn:se:umu:diva-96265 (URN)10.3109/11038129509106804 (DOI)
Projects
digitalisering@umu
Available from: 2014-11-14 Created: 2014-11-14 Last updated: 2018-06-07Bibliographically approved
2. Validity of a performance assessment of activities of daily living for people with developmental disabilities
Open this publication in new window or tab >>Validity of a performance assessment of activities of daily living for people with developmental disabilities
2003 (English)In: Journal of Intellectual Disability Research, ISSN 0964-2633, E-ISSN 1365-2788, Vol. 47, no 8, p. 597-605Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Since clients with different types of developmental disabilities often experience difficulties in activities of daily living (ADL), it is critical that assessments of ADL are evaluated in order to ensure that one can make valid judgements based on the results of the appraisal. The purpose of the present study was to evaluate the validity of a specific performance assessment instrument, the Assessment of Motor and Process Skills (AMPS), when used by occupational therapists with clients with developmental disabilities. Unlike global ADL assessments, the AMPS is used not only to evaluate the level of ADL dependence, but also to estimate the quality of each specific action performed when a person is performing ADL tasks.

METHODS: Data were gathered from 1724 participants with different developmental disabilities, including intellectual disability (ID), cerebral palsy and spina bifida. Many-Facet Rasch (MFR) analysis was used to examine person-response validity, and task and item scale validity.

RESULTS: Goodness-of-fit statistics showed that the tasks and items had acceptable scale validity. The participants had acceptable person-response validity on the ADL motor scale, but had slightly lower than expected levels of person-response validity on the ADL process scale. The results indicate that clients with more severe forms of ID may have a higher proportion of different performance profiles in ADL than is expected by the MFR model of the AMPS. Since the proportion of participants who did not meet the criteria was only 3% lower than expected and in accordance with other studies, the difference may not be clinically meaningful. Otherwise, the results indicated that the AMPS is a valid tool when used with clients with developmental disabilities.

CONCLUSIONS: Further research is needed to evaluate the use of the AMPS in clinical assessment and intervention planning for this group of clients.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2003
Keyword
activities of daily living, performance assessment
National Category
Occupational Therapy
Identifiers
urn:nbn:se:umu:diva-81613 (URN)10.1046/j.1365-2788.2003.00475.x (DOI)14641807 (PubMedID)
Available from: 2013-10-18 Created: 2013-10-18 Last updated: 2018-06-08Bibliographically approved
3. Activities of daily living in persons with intellectual disability: Strengths and limitations in specific motor and process skills
Open this publication in new window or tab >>Activities of daily living in persons with intellectual disability: Strengths and limitations in specific motor and process skills
2003 (English)In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 50, no 4, p. 195-204Article in journal (Refereed) Published
Abstract [en]

As there is a wide range of abilities among clients with intellectual disability, occupational therapists should use assessments of activities of daily living that specify clients’ strengths and limitations to guide and target interventions. The aim of the present study was to examine if activities of daily living performance skills differ between adults with mild and moderate intellectual disability. Three hundred and forty-eight participants with either mild intellectual disability (n = 178) or moderate intellectual disability (n = 170) were assessed using the Assessment of Motor and Process Skills to examine the quality of their activities of daily living skills. The overall activities of daily living motor and activities of daily living process hierarchies of skill item difficulties remained stable between groups. Although participants with moderate intellectual disability had more difficulty overall with activities of daily living motor and activities of daily living process skills, they were able to carry out some of these activities equally as well as participants with mild intellectual disability. The findings are discussed in relation to the planning of specific interventions to improve the ability of clients with intellectual disability to carry out activities of daily living.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2003
Keyword
activities of daily living assessment, Assessment of Motor and Process Skills, intellectual disability, performance skills, Rasch analysis
National Category
Occupational Therapy
Identifiers
urn:nbn:se:umu:diva-81621 (URN)10.1111/j.1440-1630.2003.00401.x (DOI)
Available from: 2013-10-18 Created: 2013-10-18 Last updated: 2018-06-08Bibliographically approved
4. Client-Centred Occupational Therapy for Persons with Mental Retardation: Implementation of an Intervention Programme in Activities of Daily Living Tasks
Open this publication in new window or tab >>Client-Centred Occupational Therapy for Persons with Mental Retardation: Implementation of an Intervention Programme in Activities of Daily Living Tasks
2003 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 10, no 2, p. 51-60Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to implement a single-case design to evaluate the outcomes of a specified occupational therapy intervention programme. The intervention programme was based on a client-centred top-down approach and followed the Occupational Therapy Intervention Process Model. The interventions included both restorative and adaptive strategies to improve performance of the activities of daily living (ADL) tasks the participants defined as relevant and meaningful. Three women with moderate mental retardation living alone in apartments with support from professionals were included in the study. The Assessment of Motor and Process Skills was used to evaluate for changes in ADL motor and ADL process ability. The Assessment of Awareness of Disability was used to evaluate changes in the client’s awareness of disability. The results showed improvements for all participants but patterns of changes were different between the participants and the outcome variables. ADL process ability was the only outcome variable that improved in all participants. The results are discussed in relation to the design used for evaluating intervention efficacy. Future improvements in the process of evaluating occupational therapy interventions are suggested.

Place, publisher, year, edition, pages
Taylor & Francis, 2003
Keyword
evaluation, many-faceted Rasch measurement, mental retardation, occupational performance, single-case design
National Category
Occupational Therapy
Identifiers
urn:nbn:se:umu:diva-81628 (URN)10.1080/11038120310009416 (DOI)
Available from: 2013-10-18 Created: 2013-10-18 Last updated: 2018-06-08Bibliographically approved

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