The Assessment of Motor and Process Skills (AMPS) developed by Fisher (1999), is an outcome measure used to evaluate the quality of motor and process skills necessary for effective engagement in activity of daily living (ADL) tasks (Sellers, Fisher, & Duran, 2001). AMPS is comprised of 16 motor and 20 process ADL skills and is considered to be client centered because it is the client who chooses which tasks are to be completed from a list of over 100 standardized activities (Fioravanti, Bordignon, Pettit, Woodhouse, & Ansley, 2012). During assessment, two or more tasks, that are both familiar and relevant, are chosen through negotiation with the clinician and as the client completes those tasks, the occupational therapy practitioner assesses effort, efficiency, safety, and independence with motor and process skills needed for successful performance (Fioravanti et al., 2012). Chosen activities include but are not limited to meal preparation, home maintenance, and laundry and are conceptualized such that each activity entails the use of certain motor and process skills which may include walks, reaches, bends, and transports or initiates, chooses, and accommodates, all of which are thought to be those observable, goal-directed actions that a person uses to organize logically and adapt his or her behavior over time to complete a specified task (Sellers et al., 2001). During the assessment the clinician examines and grades the unique performance attributes of the selected activity that may also include the client’s ability to attend, choose, manipulate, or inquire (Fisher, Liu, Velozo, & Pan, 1992). Each task is then rated on a 4-point scale from severe deficit (1) to competent (4) relative to the motor and process skills needed for the activity. Scoring employs a unique algorithm whose results allow the clinician to identify skill deficits to target for intervention. AMPS software can also be used to generate a faceted Rasch analysis of the person’s ordinal scores as well as other types of observations to build an occupational profile or plan therapeutic interventions. The time to complete the assessment is 30 to 40 minutes.
Marom, Jarus, and Josman (2006) have reported high test-retest reliabilities of r = 0.91 and 0.90 among certified raters for the motor and process scales and another study also obtained good to excellent results for inter-rater reliability (r = 0.74) and test-retest reliability (r = 0.91) among a sample of adults with psychiatric disabilities performing the same chosen task; however, test-retest reliability was much lower (0.70) when subjects performed different tasks (Fisher et al., 1992). An early study of the AMPS reported that global internal consistency applied to older persons to be α = 0.9 for the process skill items (Fisher et al., 1992). Kizony and Katz (2002) found that women performed significantly higher on the process scale than men and results of their study showed that gender, visual contextual memory, and visual attention was able to explain 59% of the variance of process scale scores. Using data from 118 persons with a cognitive disorder, Bouwens et al. (2007) found that the Mini Mental State Exam and Global Deterioration Scale scores were able to explain 27% and 44% of the variance of AMPS process scores. The same study found a significant relationship between AMPS process scores and total Cambridge Cognition scores at 0.58.
There is a significant amount of research in support of AMPS for use in clinical practice and the measure has been validated among various patient populations as well. Several language variants also exist suggesting cross-cultural relevance of the measure. The AMPS International Center for Innovative OT Solutions maintains a website devoted to the measure where, along with general information, training and certification information can also be found. Also, special software is available from the website that streamlines scoring and gives the clinician the ability to generate various types of detailed scoring reports, and professional analysis, as well as the ability to chart client performance over time.
Some researchers have noted difficulties with the use of AMPS in practice due to rigid time schedules and workplace routines as the assessment can take up to 40 minutes to complete (Chard, 2006). McCluskey and Cusick (2002) found that the introduction of AMPS into the workplace required managerial and administrative support as well as the introduction and adoption of new skills by occupational therapy departments and concluded that a lack of staffing and high workloads can make the AMPS assessment challenging to implement. Also, use of AMPS necessitates the clinician to be certified which entails attendance of a 5-day training course (in person) at a current cost of $1000. The assessment must then be performed on 10 clients in the practitioner’s workplace to become certified; however, once certified the candidate will receive verification of 45 contact hours of participation that can be used for documentation of continuing education credits (Center for Innovative OT Solutions, 2013).
The clinician begins the process by conducting an occupational interview to obtain information about what daily task performances are of most concern to the individual, as well to understand the circumstances and context in which the client is presently operating. Specific ADL tasks are then identified and prioritized into a subset of approximately five from which the person chooses at least two tasks to perform. The AMPS assessment contains 110 unique standardized tasks along with descriptions, instructions, and specific guidelines for scoring. The manual also provides for flexibility if there is no exact match to the client’s chosen tasks as activities can be adapted or new ones generated. Scoring is based on the quality of performance relative to the motor and process skills needed to engage in the agreed upon tasks which are scored along a 4-point ordinal scale where (1) suggests a deficit, (2) ineffective, (3) questionable, and (4) competent. Each motor and process score has unique and particular cutoff points, also outlined in the manual, where total scores are then expressed in digits that range from –3 (less able) to +4 (more able). Scores above a certain point indicate an independent level and scores below suggest the need for assistance (Marom et al., 2006).
|BODY POSITION (MOTOR)|
|SUSTAINING PERFORMANCE (MOTOR)|
|ADAPTING PERFORMANCE (PROCESS)|
|TEMPORAL ORGANIZATION (PROCESS)|
Adapted from Fisher, A. G., & Jones, K. B. (2010). Assessment of Motor and Process Skills. Vol. 1: Development, standardization, and administration manual. (7th ed., pp. 1-5). Fort Collins, CO: Three Star Press.