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A review of performance-based measures of functional living skills

Moore, D. J., Palmer, B. W., Patterson, T. L., and Jeste, D. V.
There is growing recognition of the need to consider the effect of mental health treatments on functional independence/abilities, in addition to any effects on primary symptoms. A variety of performance-based measures of functional living skills have appeared in the medical literature over the past 25 years in discipline-specific journals, but there has been little attempt to synthesize this information to guide mental health clinicians and researchers in choosing among the available measures. Thus, the goal of the present review was (1) to identify and evaluate the strengths and weaknesses of currently available performance-based assessments of functional living skills for adult populations, and (2) to make specific recommendations regarding use of currently available instruments as well as recommendations for future instrument development. Through a comprehensive search of electronic citation databases for English-language articles on performance-based instruments, as well as via cross-referenced articles in the bibliography of each initially identified article, we identified 94 relevant articles covering 31 instruments, including 20 multi-domain instrument batteries, and 11 additional domain-specific performance-based instruments. Most identified instruments provided evidence of adequate reliability, but empirical data regarding the predictive validity of each scale in terms of actual "real world functioning" was less prevalent. Several good performance-based measures have been developed for individuals with dementia, psychiatric illnesses, and older healthy individuals. Future instrument development may benefit from a focus on brevity, empirical item selection as determined by patients/caregivers, predictive validity with an emphasis on change in functioning over time, and the relationship of performance to levels of competency required for the completion of everyday tasks.
J Psychiatr Res
0022-3956 (Print)
Publication year:
Functional status:
Cognitive/mental functioning
Social functioning
Adults (18-65)
Seniors (65+)
Mental and behavioural disorders and related symptoms
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
4 - Performance-based tests
6 - Clinical rating scales
ADL Test - Activities of Daily Living Test
AST - Activities of Daily Living Situational Test
BaFPE - Bay Area Functional Performance Evaluation
BDPS - Beck Dressing Performance Scale
CPT - Cognitive Performance Test
DAFA - Direct Assessment of Functional Abilities
DAFS - Direct Assessment of Functional Status
DRUGS - Drug Regimen Unassisted Grading Scale
EFB - Everyday Functioning Battery
EPT - Everyday Problems Test
FATM - Functional Ability to Take Medications
FCI - Functional Capacity Index
FPM - Functional Performance Measure
ILS - Independent Living Scales
IVK - Immersive Virtual Kitchen
KELS - Kohlman Evaluation of Living Skills
KTA - Kitchen Task Assessment
MMAA - Medication Management Ability Assessment
MMT - Medication Management Task
OTAS - St. George Hospital Memory Disorders Clinic Occupational Therapy Assessment Scale
OTDL - Observed Tasks of Daily Living
OTEPS - Occupational Therapy Evaluation of Performance and Support,
PADL - Performance Test of Activities of Daily Living
PASS - Performance Assessment of Self-Care Skills
RADL - Refined ADL Assessment Scale
RKE-R - Rabideau Kitchen Evaluation Revised
SAILS - Structured Assessment of Independent Living Skills
T&C - Time and Change Test
TFLS - Texas Functional Living Scale
TOGSS - Test of Grocery Store Shopping
UPSA - University of California San Diego Performance-based Skills Assessment