Author
M. Powell Lawton, PhD., Elaine M. Brody, ACSW
Year Published/Publisher
1969/APA PsycTests
Type of Assessment
Performance Measure or Questionnaire (depending on method of measure and administration)
Cost
Free
How to Access
free online
PDF https://www.cgakit.com/_files/ugd/2a1cfa_b03315d46e90435ea3b756cb708fa6a4.pdf
Population
Older adults
Appropriate Setting
Community-based, Acute, SNF
Purpose/Areas Assessed
Functional performance of instrumental activities of daily living
Administration: The clinician can either have the client or their caregiver complete this tool as a self-report questionnaire or have the client demonstrate each of the activities and determine the item description that most closely resembles the client’s highest functional level based on their observations.
User Qualifications
n/a, assessment can be carried out by oneself
Materials Required
This performance measure includes IADLs such as ability to use a telephone, go shopping, meal prep, housekeeping, laundry, using transportation, managing medications, and demonstrating ability to handle finances. Materials you may want to have on hand when observing and measuring one's performance in these areas include:
Telephone
Ingredients, technology, and tools for food preparation
Housekeeping tools
Laundry
Washer/dryer or equivalent
Car or public transportation
Current medications
Checks/budget/bills/etc.
Most of these items will vary depending on what is available and what the client prefers to use.
Scoring Procedure
The Lawton IADL scale can be scored in several ways.
The most common method is to rate each item either dichotomously (0 = less able, 1 = more able) or trichotomously (1 = unable, 2 = needs assistance, 3 = independent) and sum the eight responses. The higher the score, the greater the person's abilities. Clients are scored according to their highest level of functioning in that category. The final total score ranges from 0 (low function, dependent) to 8 (high function, independent). The final total score may be presented as a percentage of function.
For example, a total score of 6 out of 8 would represent 75% function (75% independence, 25% dependence). Sequential scoring over time provides a measure of declining or improving degree function and dependence.
Psychometric/Standardization
Few studies have been performed to test the Lawton IADL scale psychometric properties. The Lawton IADL Scale was originally tested concurrently with the Physical Self-Maintenance Scale (PSMS). Reliability was established with twelve subjects interviewed by one interviewer with the second rater present but not participating in the interview process. Inter-rater reliability was established at .85. The validity of the Lawton IADL was tested by determining the correlation of the Lawton IADL with four scales that measured domains of functional status, the Physical Classification (6-point rating of physical health), Mental Status Questionnaire (10-point test of orientation and memory), Behavior and Adjustment rating scales (4-6-point measure of intellectual, person, behavioral and social adjustment), and the PSMS (6-item ADLs). 180 research subjects participated in the study, but few received all five evaluations. All correlations were significant at the .01 or .05 level. To avoid potential gender bias at the time the instrument was developed, specific items were omitted for men. This assessment instrument is widely used both in research and in clinical practice.
Strengths
Easy to administer, only 10-15 minutes long, specific deficits can be identified to assist in safe discharge planning
Weaknesses
Self-report method of administration may lead to over-estimation or under-estimation of ability, may be sensitive to small changes in function over time
References
APA PsycNet. (n.d.). APA PsycNet. Retrieved April 29, 2024, from https://psycnet.apa.org/record/9999-06803-000?doi=1
Lawton scale : CGA Toolkit Plus. (n.d.). Cgakit. Retrieved April 29, 2024, from https://www.cgakit.com/f-1-lawton-scale
McMahon, E. (2008). Lawton –Brody Instrumental Activities of Daily Living Scale (IADL). 23.