Tobler, K., Sydney-Jones A., Tan C., McDonnell, E., Ranka J. (2006, July). Assessment of ‘doing’ in AIDS Dementia care.  Poster presented at the World Federation of Occupation Therapist Congress, Sydney, Australia.

Occupational therapists who work in residential and supported living contexts with clients who have AIDS Dementia Complex (ADC) face unique problems in identifying ‘doing’ goals when the potential to ‘do more’ is questionable. In particular, therapists find it difficult to identify specific task performance goals, measure progress and provide objective evidence of outcome when change is slow.

The purpose of this paper is to present an assessment method being used by occupational therapists working in Sydney with clients who have ADC, and to demonstrate how this method is being used to set goals, tailor intervention to the specific performance needs of clients and to measure program effectiveness.

The assessment method is derived from a standardized, criterion-referenced occupational therapy tool known as the Perceive, Recall, Plan & Perform System of Task Analysis (PRPP System). Stage One of this instrument is based on procedural task analysis methods whereby everyday tasks are broken down into the key procedural steps required for task completion. Clients are then observed performing identified tasks and errors noted using the protocol of the assessment. These may include errors of omission (a step is left out), errors of accuracy (a step is performed inaccurately), errors of repetition (a step is repeated too many times), or errors of timing (too much time is spent on a particular step). Percentage calculations are then carried out to determine a mastery score. Sub-scores are also calculated to determine the percentage impact of error type. Therapists use mastery scores to set specific task performance goals and measure change. Error typology scores are used to identify the aim and focus of intervention as well as specific instructional strategies required to achieve improved mastery.

A case study of a client with ADC performing the familiar everyday tasks of preparing a shopping list and shopping for food will be used to illustrate key points in this paper, and demonstrate how this assessment method contributed to the design of ongoing therapy for this client.