Author(s): Rogers, J.C., Holm, M.B., Chisholm, D
Year of Publication: 2016
Publisher: University of Pittsburgh, Department of Occupational Therapy
Type of Assessment:
Standardized Performance Measure
Criterion-Based
Observation-Based
Occupation-Based
Cost: Free for Access; $ for materials
How to Access: https://www.shrs.pitt.edu/performance-assessment-self-care-skills-pass-materials
Age: Adolescent - 13-17, Adult - 18-64, Elderly Adult - 65+
Diagnoses: Arthritis + Joint Conditions, Cardiac Dysfunction, Multiple Sclerosis, Parkinson's Disease & Movement Disorders, Pulmonary Disorders Spinal Cord Injury, Stroke Recovery, Bipolar Disorder, Dementia, Depression, Macular Degeneration, Osteoarthritis, CVA, & other Mental Health Conditions
Setting: Home health, Inpatient, Outpatient
a performance-based, criterion-referenced, and client-centered observational tool to provide a holistic snapshot (person-task-environment) of the client’s ability to live independently and safely in the community by assessing performance on various ADLs and IADLs. Independence, adequacy, and safety are rated on four-point scale
Functional Mobility:
Bed Mobility, Stair Use, Toilet Mobility & Management, Bathtub & Shower Mobility, & Indoor Walking
Basic ADLs:
Oral Hygiene, Trimming Toenails, Dressing
IADLs-Physical:
Taking out Garbage & Key Use, Changing Bed Linens, Sweeping, Cleanup after Meal Preparation
IADLs-Cognition:
Shopping, Bill Paying by Check, Checkbook Balancing, Mailing Bills, Telephone Use, Medication Management, Obtaining Critical Info from the Media (Auditory & Visual), Flashlight Repair, Home Safety, Playing Bingo, Oven Use, Stovetop Use, Use of Sharp Utensils
Balance-Vestibular
Cognition
Coordination
Dexterity
Executive Functioning
Functional Mobility
Hearing
Occupational Performance
Reading Comprehension
Reasoning/Problem Solving
Seating
Strength
Upper Extremity Function
Vision & Perception
Time: 1.5-3 hours
Group/Individual: Individual
Subtests: 26 tasks within 4 domains: Functional mobility (5), Basic ADLs (3), IADLs -physical (4) & cognitive (14)
163 criterion-referenced subtasks rated for independence, safety, & adequacy on a 4-pt scale
Instructions: For each task or area of function being tested, there are instructions on the set up, materials needed, and a script for directions
E.g.: For Task C#1: FM - Bed Mobility: "I need to have you show me how you get into bed, move in bed, and get out of bed. I have placed a towel on the end of the bed, so don't worry about your shoes."
Materials: Paper, Pencil, and Varied Household Items
Bed, pillows, shoes, Stairs, toilet, shorts, water, towels, toothbrush, toothpaste, dentures, shower, safety rails around bathtub, paper towels, garbage can, toenail scissor, toenail clipper, toenail nipper and file, bathroom, chair, clothes, socks and shoes (large in case client does not have their own), table, 8 unopened cans, envelope, 5 coupons, wallet, change purse, coins, bills, paper, pen, calculator, hand help magnifier, local utility bills with envelopes, tablet, calendar, checkbook, lights, scissors, tablet, stamps, room, keys, plastic garbage sack, telephone, local consumers yellow pages, 7 day medication sheet, one prescription type bottle with child proof lid, one prescription type bottle with non-child proof lid, wall clock, chains, audiotape recorder, newspaper article about hypothermia or heat stroke, 2 good batteries, 2 bad batteries, one burned out bulb, one good bulb, and clear plastic bag. Broom, dustpan. dry cereal, rugs, medium sized knife, cooking oil, bingo card, highlighter, audio tape reading BINGO numbers, kitchen essentials (saucepans, cutting board) and ingredients to make muffins.
User Qualifications: Training including reading and review of an article/manual
How to Score: Items are rated on a predefined 4-point (0-3) ordinal scale with scores producing a mean value for a task independence, task safety, and task adequacy score
Assistive technology devices used by client are documented in top left section of the rating form
Independence: A check mark is recorded by the type & number of prompts given in the appropriate box for each subtask; if no assistance is given, an X is placed in the associated box
If 3 prompts are provided for a single subtask, this indicates a higher level of assistance needed
Safety: A single check mark is recorded for one or more safety tasks for the associated subtask
The entire task receives a single safety score, not each individual subtask
Summary score is placed in "Safety Score" box
Adequacy: Each subtask has a double underlined action verb or phrase to indicate the subtask Process, and a single underlined word describing optimal Quality outcome
If a prompt is given for the subtask process, a single check is placed in the process box
If a prompt is given for the subtask quality, a single check is placed in the quality box
Score Indications: Higher scores = greater independence, safety or adequacy
Independence score: depends on level of assistance needed and frequency of prompts determined by the mean of the independence scores for each subtask
Level 0 = No assistance
Level 1 = Verbal support - encouragement
Level 2 = Verbal non-directive cues - alert that something is not right
Level 3 = Verbal directive cues - verbal statements on what to do next
Level 4 = Gesture -tactile cues like pointing at task object
Level 5 = Task/Environment Rearrangement - break task down
Level 6 = Demonstration - demonstrate followed by return performance
Level 7 = Physical Guidance - "hands down", move body/extremity to facilitate action as needed
Level 8 = Physical Support - "hands up", supporting the body part to facilitate action
Level 9 = Total Assist - examiner does task for client to compensate for disability
Score 3: No assists given
Score 2: No Level 7-9; Occasional Level 1-6
Score 1: No Level 9; Occasional Level 7-8; Continuous Level 1-6
Score 0: Level 9, Continuous 7-8 or Inability
Safety score: Accounts for risks to the client or to the environment and is the lowest observed safety score for any subtask within that task
Score 3: Safe practices were observed
Score 2: Minor risks evident, no assistance provided
Score 1: Risks were observed & assistance given to prevent potential harm
Score 0: Severe risks to safety observed causing cessation of task
Adequacy score: Accounts for efficiency with which the task is performed and quality of the product and is the lowest observed adequacy score for any subtask within that task
Includes the process involved in and quality of subtask performance
Reliability:
Test-Retest: High
Independence scale: r=0.92-0.96
Safety scale: 90% agreement
Interrater: High
Independence: 96% agreement
Safety: 97% agreement
Validity:
Content Validity
Based on established functional assessment questionnaires, including the OARS Multidimensional Functional Assessment Questionnaire and the Functional Assessment Questionnaire
Construct Validity
Unidimensionality of Independence and Safety scales confirmed through exploratory factor analysis
Strengths:
Standardized - task administration (placement of objects & verbal instructions)
Therapist can provide assistance when needed
Clinic & Home version to increase accessibility that are nearly identical and account for use of client's materials
Flexible - therapist can only administer relevant tasks & can use the test as a template to develop new items
Free to access and materials are common household items
Weaknesses:
Length of time for administration
No certificate
Chisholm, D., Toto, P., Raina, K., Holm, M., & Rogers, J. (2014). Evaluating capacity to live independently and safely in the community: Performance assessment of self-care skills. British Journal of Occupational Therapy, 77(2), 59-63. https://doi.org/10.4276/030802214X13916969447038
Czohla, D., Gajudo, K., Manhinan, J., Ryemon, J., Stern, M., Renfro, M., & Petrovsky, J. (2019). Performance assessment of self-care skills (PASS). American Physical Therapy Association. https://www.apta.org/patient-care/evidence-based-practice-resources/test-measures/performance-assessment-of-self-care-skills-pass
Rogers, J.C., Holm, M.B., Chisholm, D. (2016). Performance assessment of self-care skills (PASS-Clinic)[Version 4.1]. University of Pittsburgh.
Rogers, J.C., Holm, M.B., Chisholm, D. (2016). Performance assessment of self-care skills: Scoring guidelines [Version 4.1]. University of Pittsburgh.
Shirley Ryan Ability Lab. (2024, January 9). Performance assessment of self-care skills. https://www.sralab.org/rehabilitation-measures/performance-assessment-self-care-skills