The A-ONE consists of two parts: an A-ONE ADL scale and an A-ONE Neurobehavioral (NB) scale. The occupational therapist scores 22 test items based on the level of assistance needed to do ADL tasks as well as underlying neurobehavioral impairments impacting that performance.
The AMPS is comprised of 16 ADL motor skill items and 20 ADL process skill items that the occupational therapist scores across two ADL tasks (72 items in total). As a result, the AMPS is a highly sensitive measure of ADL performance. The AMPS is not designed to be used to evaluate for the presence of underlying neuromuscular, biomechanical, cognitive, or psychosocial impairments (e.g., strength, range of motion, memory), nor is it designed to be used to evaluate underlying capacities (e.g., ability to grip, ability to remember, ability to plan a course of action). Unlike impairments and underlying capacities, the ADL motor and ADL process skills of the AMPS are goal-directed actions enacted in the context of occupational performance, and are analogous to the goal-directed actions defined under the Activities and Participation domains of the International Classification of Functioning Disability and Health (World Health Organization [WHO], 2001).
Similarity between the AMPS and the A-ONE
The AMPS and the A-ONE overlap, in that the AMPS and the A-ONE ADL scale both can be used to evaluate ADL ability.
Differences between the AMPS and the A-ONE
The AMPS and the A-ONE ADL scales differ in several ways:
When would I use the AMPS versus the A-ONE?
The AMPS and the A-ONE have the potential to compliment each other in practice. If one thinks in terms of the top-down evaluation and reasoning process described in the Occupational Therapy Intervention Process Model (OTIPM), the occupational therapist begins the evaluation process with a comprehensive occupational therapy interview. If desired, the A-ONE ADL scale can then be used to verify global deficits in PADL task performance if there is need to confirm the client’s (patient and carers) self-report.
At the next phase, the occupational therapist administers the AMPS as a standardized ADL performance analysis, provided the client reported problems with ADLs. That is, the AMPS is used to assess the quality of the client's ADL motor and ADL process skills, the smallest, observable, and goal-directed units of ADL performance. This more detailed information provides the basis for establishing the client’s baseline level of AMPS performance.
After the AMPS is administered, the occupational therapist proceeds to reflecting on observed task performances to determine how environmental factors, underlying impairments, or societal factors have impacted the observed task performance. The A-One Neurobehavioral Scale can be used at this point in the evaluation process to evaluate directly the impact that neurobehavioral impairments have on the client's observed ADL task performance.
In summary, if you're working with clients who have neurological disorders and problems with PADLs, you should consider using both the AMPS and the A-ONE. The A-ONE ADL scale can be used early in the OT process to determine if the person has a problem with PADLs, as evidenced by need for assistance. This evaluation could be followed by an AMPS evaluation of PADL and/or IADL, as well as to implement a performance analysis. The AMPS performance analysis will further clarify whether or not the person indeed has a problem in PADL, but also, the performance analysis adds the important step of clarifying which clusters of ADL motor and ADL process skills are most effective and which are most ineffective.
Then, after implementing the AMPS performance analysis, the OT can use the results of the A-ONE Neurobehavioral scale to help determine why some ADL skill clusters were ineffective. In this way, the OT can intertwine the results of the AMPS and the A-ONE to (a) provide evidence of the client's need for OT services, and (b) gather information needed to plan intervention. Finally, both the AMPS and the A-ONE can be used as outcome measures, but the AMPS is likely a more sensitive measure of change than is the A-ONE.
For more information on the A-ONE, contact: