FUNCTIONAL

ASSESSMENT
TOOLS
IN
PSYCHOSOCIAL
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The Canadian Occupational Performance Measure

• COPM was developed approximately 15 years ago in response to a call

from the CAOT and Health Canada.
• The intention was to explore existing outcome measures and
determine whether there was something “out there” that would assist
occupational therapists in evaluating their interventions.

• The COPM is a semi-structured interview designed to identify

problems in occupational performance as articulated by the patient in
partnership with the therapist.
• It is designed to interdigitate with the CMOP. The COPM has three
distinct sections:
• Self-care: Activities of daily living and instrumental activities of daily
living
• Productivity: Education and work
• Leisure: Play, leisure, and social participation

• Two scores are provided following completion of the interview

process:
• performance and satisfaction.
• These are both self-rated by the client. The occupational
performance problems identified in this process may also be
weighted in terms of importance to assist in establishing the
client’s priorities, thus providing information and clearer
direction for the additional components of the therapeutic
interchange of setting goals and planning interventions.
• The COPM was designed to apply equally to all clients.
• This includes all ages, developmental stages, disabilities, conditions,
and cultural backgrounds.
• In addition, the COPM can be used with clients that are not necessarily
the designated client.
• The only real requirements to using the COPM are that the client-
therapist relationship be built in a manner that supports and illustrates
the core values and expectations of client-centeredness, and that the
therapist practices in an occupation-centered manner, therefore
focusing upon the assessment of occupational performance and
satisfaction with occupation.
Dynamic Performance Analysis (DPA)
 Actual observation of occupational performance
 A method for analyzing the activity during client performance of the
activity
 Depends on performance area of concern
 Should take note of activity demands, performance skills, client factors
and context affecting performance
 Observation and therapist reflection provide opportunities to re-teach
and otherwise adapt the activity to enable more effective performance.

WHODAS 2.0 is:

 A generic assessment instrument for health and disability A tool to
produce standardized disability levels and profiles Applicable across
cultures, in all adult populations Directly linked at the level of the
concepts to the International Classification of Functioning, Disability
and Health (ICF)
 Used across all diseases, including mental, neurological and addictive
disorders
 Short, simple and easy to administer (5 to 20 minutes)
 Applicable in both clinical and general population settings
 A tool to produce standardized disability levels and profiles
 Applicable across cultures, in all adult populations
 Directly linked at the level of the concepts to the International
Classification of Functioning, Disability and Health (ICF)

WHODAS 2.0 covers 6 Domains of Functioning, including:

 Cognition – understanding & communicating
 Mobility– moving & getting around
 Self-care– hygiene, dressing, eating & staying alone
 Getting along– interacting with other people
 Life activities– domestic responsibilities, leisure, work & school
 Participation– joining in community activities

Role Checklist

- The Role Checklist is a clinical assessment tool used by occupational

therapists to help identify the occupational performance of patients
through the identification of roles and the values of those roles.
 - It was originally developed by Frances Oakley as a means to describe
and evaluate the construct of “roles” within the Model of Human
Occupation (MOHO)
-
The purpose of the Role Checklist

 to assess an individual’s occupational role performance,

indicating an individual’s role identification as well as the value
that an individual attach to his or her roles.
 It is a written inventory that is appropriate for adolescents,
adults, and older adults with physical or psychosocial dysfunction

Since it was designed to identify the occupational behavior of patients, the

roles identified on the checklist are roles that provide opportunities to fulfill
behavior within an occupational performance dimension.

The 10 roles included in the checklist are:

o student,
o worker,
o volunteer,
o caregiver,
o home maintainer,
o friend,
o family member,
o religious participant,
o hobbyist/amateur, and
o participant in organizations

Each of these roles is briefly described, with a reference to the frequency with
which the role is enacted. These frequencies are included in the definition,
since fulfilling the role should include doing something within the role rather
than merely stating a relationship to that role. For example, being a friend
establishes a relationship and, based on the feelings while doing something
with a friend at least once a week, shows enactment of occupational behavior.
There is also an “other” category on the checklist for the individual to identify
enacted occupational roles that are not listed.

- The assessment is based on self-report. Usually, it is completed as the

therapist interviews a patient; however, the assessment can be
completed independently by the patient.
- The instrument takes approximately 15 minutes to complete and
consists of two parts.
  Part One asks the patient to consider each of the 10 roles listed on the
Checklist as to whether they have performed each role in the past, are
presently fulfilling the role, or anticipate fulfilling that role in the
future.
 The “past” refers to any time up until the preceding week. The
“present” refers to the past week (7 days), including the day of the
administration of the Checklist. The “future” refers to tomorrow or any
day thereafter.
 Part Two asks the patient to indicate the value of each of the roles
delineated in the Checklist, regardless of whether they have fulfilled
the role or not. The degree to which the individual values each role is
indicated by three choices: “not at all valuable,” “some- what valuable,”
or “very valuable.”

RESEARCH AND CLINICAL USE

 If roles are deemed a component in the domain of occupational therapy,

as they are in the Framework6 under Performance Patterns, it should
be addressed by occupational therapists in our diverse settings.
 The Role Checklist can be used to identify problems with continuity of
role performance, specifically whether or not the patient is fulfilling
the same roles in the present as he or she has in the past and plans to
fulfill in the future. Other problems can also be identified. For example,
the Role Checklist can illustrate visually to an individual that he or she
is attempting to fulfill too many roles and is stressed by the demands
of each of the roles.
 Additionally, since the assessment addresses the value of roles, it can
be used to identify role loss that could be associated with problems of
self-identity and self-esteem.
 With the assessment of role value, the Checklist can compare an
individual’s role participation and role value. Individuals who
participate in roles that are not highly valued or do not participate in
roles they do value may demonstrate frustration and/or lack of
motivation.
 Contradictions between goals and current life situations or functional
status may lead to occupational dysfunction.
 Most importantly, the completion of the Role Checklist can provide a
mechanism for dialogue between therapist and patient about issues
that are often difficult to articulate and define.
 As a useful assessment tool for occupational therapists, the Role
Checklist can be used in a variety of settings and should be presented
 as an important tool for the profession. It has been translated into
several languages (eg, Spanish, Portuguese, French, Arabic, German,
and Swedish), and although it has been developed with the MOHO, it
can be used independently of the model or with other models that
include role performance. Since its development, the Role Checklist has
been used in research studies as a tool or methodological instrument
for examining role performance.

Interest Checklist (IC)

 a paper and pencil questionnaire usually used in combination with an

interview designed by Matsutsuyu to assess the patient’s interests-past,
present and future.

 includes: manual skills, physical sports, social recreation, activities of

daily living, cultural/educational interests.

Evaluation of Social Interaction (ESI)

- Documents purpose of interaction, structure, and qualities

of the social partner

- Assesses comfort level and quality of social interaction

- 4 point scale scoring 27 aspects of social interaction

Mini Mental Status Exam (MMSE)

 Scoring of zero (0) to thirty (30) on 20 areas

– Zero (0) for refusal error or can’t do

– Score of <27 indicates impaired cognitive function

– Score of 27-30 is Normal

Occupational Therapy Task Observation Scale (OTTOS)

 - developed by John Hopkins University as a quickly administered,

short, reliable means of monitoring patient progress in task
observation
 - composed of two parts, general behavior and task behavior

 - scores immediately provide feedback on whether patient has

improvements or deteriorations