This project will result in the standardization of an assessment of functional skills of older persons that will be used by occupational therapists for more accurate (1) determination of capacity for safe and independent living, (2) identification of individuals at-risk for functional decline, and (3) selection of appropriate and cost-effective interventions. The assessment, the Assessment of Motor and Process Skills (AMPS), provides an ecological appraisal of a person's motor and process (organizational/adaptive) skills as they are used during the actual performance of a familiar, chosen, and relevant activity of daily living (ADL). A total of 20 new personal and domestic ADL tasks will be calibrated on a quota sample of 1000 young and older adults that represent the well to frail elderly continuum, and with equal representation for gender and proportional representation for race (black/white). Reliability and scale validity, including the utility of the AMPS as a measure of change associated with increased safety risk and as a predictor of ability across tasks of greater of lesser difficulty, will be carefully examined. The scales also will be examined to be sure that they are free of bias associated with gender, race, ability level, or diagnosis. The AMPS skill items are conceptualized as universal taxonomies of motor and process operations that are necessary for skilled task performance. The ability to simultaneously assess component motor and process skills as the person actually performs daily living tasks that are matched to the abilities, needs, interests, and cultural background of the person tested permits direct measurement of the impact of motor and process skill deficits on independent and safe daily life task performance. The use of many-faceted Rausch analysis methods will lead to measures that adjust person ADL ability measures to account for the severity of the rater and the difficulty of the tasks the person chooses to perform. Further, the use of many-faceted Rausch analysis will lead to the definition of a hierarchy of task and skill item difficulties, along common linear scales (ADL motor and ADL process), that can be used to compare and predict performance of individuals of varying ability levels. This precise and critical information is needed to plan and measure the efficacy of intervention programs.
