Using the assessment of motor and process skills to compare occupational performance between clinic and home settings.

OBJECTIVES The study described in this article examined the effect of home versus clinic settings on the instrumental activities of daily living (IADL) performance of older adults. METHOD Twenty older adults living in the community were evaluated in their homes and in an occupational therapy clinic with the Assessment of Motor and Process Skills (AMPS). The motor and process ability measures were compared between the two settings with many-faceted Rasch analysis. RESULTS The subjects' motor ability measures tended to remain stable from clinic to home settings. The process ability measures tended not to remain stable from clinic to home settings, because 10 of the 20 subjects performed significantly better in their homes. CONCLUSION These findings support the idea that process skill abilities are affected by the environment to a greater degree than are motor skills abilities and that for persons living in the community, the familiar home environment tends to support IADL performance. If an occupational therapist wants to know how a person performs IADLs, the therapist should evaluate that person's performance in the environment in which the client will be functioning.