Program planning: the clinical utility of three activities of daily living assessment tools

A jury of five occupational therapy experts was used to evaluate the clinical utility of three activities of daily living assessment tools that were originally designed for purposes other than individualized occupational therapy assessment or program planning. The three tools were the Index of Independence in Activities of Daily Living, PULSES Profile, and Physical Self-Maintenance Scale. Using the results from each tool, scored for a simulated patient with a right cerebrovascular accident, as well as medical information about the patient, the jury members were asked to plan a treatment program. The consensus of the jury was that the results from each tool did not provide enough information to help them identify the patient's specific performance problems or the causes of those problems. Therefore, the three tools were considered to have low clinical utility for planning individualized occupational therapy treatment. For use in planning an individualized treatment program, an activities of daily living assessment tool should provide specific information about which component of a task the patient found difficult or was unable to do and the type and level of assistance required.