Validity of using the Assessment of Motor and Process Skills to estimate overall home safety in persons with psychiatric conditions.

OBJECTIVE Occupational therapists often base estimates of home safety on their behavioral observations of a client performing functional activities during a hospitalization. To examine this practice, this study investigated the predictive validity of the Assessment of Motor and Process Skills (AMPS) to the overall home safety of persons with psychiatric conditions associated with cognitive impairments. METHOD Ability in activities of daily living (ADL) of 20 participants was evaluated with the AMPS before discharge from an inpatient psychiatric unit. Within approximately 2 weeks of their discharge, the participants' home safety was evaluated within their home settings using the Safety Assessment of Function and the Environment for Rehabilitation. To form a basis for comparison, a second administration of the AMPS was administered concurrently with the home safety evaluation. RESULTS Moderate positive relationships were found between ADL motor and ADL process ability and home safety in both the clinic and the home; however, analyses of the sensitivity, specificity, and overall predictive values revealed that home ADL process ability was the best predictor of home safety for participants who were categorized as less safe in the study. CONCLUSION Findings suggest that clinic ADL evaluations using the AMPS give a reasonable estimate of home safety for participants categorized as having more home safety risk. For participants categorized as having less home safety risk, clinic ADL evaluation using the AMPS produced significantly less accurate estimates than ADL evaluations conducted in the home. These results indicate that home safety estimates may be most accurate if they are based on home rather than clinic ADL process ability measures.