1. Assessment of Motor and Process Skills
The Assessment of Motor and Process Skills (AMPS) is a reliable, valid, and sensitive measure of a person's quality of ADL task performance, not just a test of whether "the person can get the job done.“

2. Assessment of Motor and Process Skills (AMPS)
Standardized test of ADL task performance
Occupation based and client centered
More specifically, the AMPS is a standardized test of the quality of ADL task performance that reflects the unique focus of occupational therapist which is occupational performance, the doing of meaningful tasks.
The AMPS is a standardized assessment – meaning that all persons are evaluated in a consistent manner.
The AMPS is administered while the person is engaged in the performance of meaningful and relevant everyday tasks (occupation) performed the way he or she normally does them. Thus, it is an occupation-based assessment.
The AMPS is also occupation focused because the occupational therapist uses the AMPS to evaluate quality of occupational performance (not body functions).
Finally, the AMPS is client centered – meaning that the person is observed doing tasks that the client has identified as a concern and prioritized for the evaluation.
This presentation will provide an overview of the administration of the AMPS and the results of an AMPS observation. Finally, it will include an overview of validity and reliability studies and point out where more information about the psychometrics of the AMPS can be found.

3. Standardized administration
Every occupational therapist who administers the AMPS follows the same standardized procedures. That is, the occupational therapist:
Interviews the client and learns what ADL tasks are of concern and the client wants to prioritize
Observes the person perform at least two ADL tasks that were prioritized by the client
Judges the person’s quality of ADL task performance — a the degree of occupational skill (competence) observed when the person performs each ADL task

4. Standardized administration
After observing the person perform two tasks, the occupational therapist:
Scores the quality of the observed task performance using standardized criteria in the AMPS manual
Enters the scores into the OTAP software computer program
Uses the computer program to generate reports; these reports are customizable, allowing the occupational therapist to enter his or her own narrative documentation of the person’s AMPS results

5. Interviewing the client
Let’s look more closely at the standardized procedures. The AMPS administration always begins with an occupational therapy interview. During the interview, the occupational therapist finds out from the client which everyday tasks the person does well and those that are of concern to the client. If ADL is a concern, then the client chooses two challenging and prioritized ADL tasks for the AMPS observation.

6. Task choices Brushing or combing hair Pasta with sauce and a beverage
Repotting a houseplant
Putting on socks and shoes
Repair a bicycle tube puncture
Making a bed against a wall
Eating a snack with a utensil
Washing and drying hands
Presliced meat or cheese sandwich
Cleaning a bathroom
Folding a basket of laundry
Raking leaves
Fried rice
Feeding a cat
Thin pancakes or crêpes and beverage
There are 125 ADL tasks from which the person may choose, and they include:
Personal ADLs
Simple to complex meal preparation
Light housekeeping and outdoor tasks
Caring for pets and plants
Simple vehicle maintenance (i.e., repairing a bicycle tube, vacuuming the inside of an automobile)
Scrambled or fried eggs, toast, and espresso coffee
Packing a lunch
Vacuuming the inside of an automobile
Meatballs with boiled potatoes, sauce, boiled vegetable
Loading and starting a washing machine

7. Task calibration Tasks that are usually easier
Brushing or combing hair
Eating a snack and drinking a beverage
Sweeping outside
Ironing a shirt
Some tasks are harder than others. Each AMPS task has been calibrated according to its task challenge. People who are more able are observed doing harder, more challenging tasks for their AMPS observation.
Packing a lunch
Cleaning a bathroom
Pasta with meat, sauce, and a beverage
Tasks that are usually harder

8. Task A-3. Pot of coffee or tea
Essential task
Prepare a pot of boiled or brewed coffee or tea
Pour into cups
Serve with a container of milk, cream, or hot water at a counter or table
For each AMPS observation, the occupational therapist must ensure that the tasks are performed the way the person normally does them and that the way they do them matches the specific criteria in the AMPS manual. The standardized criteria for each of the 125 AMPS tasks are designed to allow for a variety of different ways people perform the same task.
A good example is task A-3. Pot of coffee or tea. As written in the AMPS manual, the person is expected to
Prepare a pot of boiled or brewed coffee or tea
Pour the coffee or tea into cups or mugs
Serve the coffee at a counter or table with a container of either milk, cream, or hot water
There are specific things that must be done to ensure that all people are evaluated in a consistent manner. In this case, the person is expected to pour the coffee or tea into cups and serve it with a container of milk, cream, or hot water. The essential task ensures that all people who do Task A-3, Pot of coffee or tea experience the same level of task challenge.

9. Task A-3. Pot of coffee or tea
The standardized criteria also includes options that allow the person to use preferred and culturally-relevant tools and materials. For example, when performing task A-3, the person can choose:
To prepare a pot of coffee or tea
If coffee is chosen, to prepare brewed coffee or boiled coffee
If the person plans to brew coffee, he or she may use an electric coffee maker or a “French press”
If the person chooses to prepare tea, he or she may heat the water for the tea in an electric kettle, on the stove, or in a microwave
Each of the 125 AMPS tasks has been standardized in this manner to ensure all people are (a) tested in a consistent manner, yet (b) allowed to do the task the way they normally do it. Thus the AMPS is both standardized and client centered.

10. This slide is the conceptual model of occupational performance that comes from the OTIPM (the Occupational Therapy Intervention Process Model; see
It illustrates occupational performance as a transaction between person factors and body functions, task demands, and environmental demands.
When the occupational therapist uses the AMPS, he or she evaluates the quality of the task performance (the quality of the doing) — engagement in ADL task performances.. The AMPS observation is represented by the “Occupational performance” box.

11. And then, after we have scored the person’s observed quality of occupational performance and obtained our AMPS results, we can reflect back on the task performance and implement a task analysis. When we implement a task analysis, we interpret the reasons for any observed problems with occupational performance by considering how person factors and body functions, environmental demands, or task demands may have limited the person’s ability to perform ADL tasks more effectively.

12. Analysis of occupational performance
It cannot be overemphasized that we do not use the AMPS to evaluate the person factors (age, education), body functions (motivation, cognition, coordination), nor do we evaluate the task objects or the environment (beverage container, throw rugs, steps, proper lighting). We use the AMPS to evaluate the quality of a person’s ADL task performance, the quality of the “doing.”

13. Thus, in order to evaluate the quality of the “doing,” the occupational therapist uses the AMPS to focus on the quality of performance of each of the goal-directed actions (i.e., occupational performance skills) that the person uses to enact the task performance. More specifically, occupational performance skills are defined as the smallest units of observable, goal-directed action that are linked together one-by-one in the process of building a task performance. When the person’s actions are compiled together, they result in a task performance.
For example, as a woman folds a basket of laundry, she:
Reaches for a shirt, chooses the red shirt, grasps the shirt, lifts the shirt out of the basket, shakes wrinkles out of the shirt, and starts to fold the shirt.
Many more task actions occur in the context of this task performance.
She pinches a button and pushes the button through the button hole. She then folds over sides of the shirt and aligns the edges, and so on, until she ends the task performance.
Action by action she constructs a task performance. The names of the occupational performance skills (observable, goal-directed task actions) are called ADL motor skills and ADL process skills and are listed on the AMPS Score Form
Note to presenter. Direct your audience to your handout of the AMPS Score Form (AMPS Score Forms may be downloaded from the CIOTS website,

14. ADL motor skills Goal-directed task actions observed when the person
Moves around the task environment
Interacts with and moves task objects
The ADL motor skills are task actions related to moving oneself and task objects in the context of an ADL task performance. For example, while the person prepares tomato sauce for pasta, the occupational therapist may observe the person walking to a drawer, pulling the drawer open, grasping a wooden spoon, lifting the spoon, and transporting the spoon to a pot of tomato sauce on the stove. The occupational therapist may also observe the person grasping a wooden spoon with one hand and holding the pot of tomato sauce with the other hand while stirring the sauce.

15. ADL process skills Goal-directed task actions observed when the person
Selects, interacts with, and uses task tools and materials
Carries out individual actions and steps of the task in a spatial-temporally effective manner
Similarly, ADL process skills are also goal-directed actions enacted as part of an ADL task performance, and they are related to:
Selecting, interacting with, and using task tools and materials
Carrying out individual actions and steps in a spatial-temporally effective manner
For example, as the person is preparing tomato sauce for pasta, the occupational therapist can observe the person searching for, locating, and choosing the pepper grinder, gathering the pepper grinder to the workspace, supporting the pepper grinder so that it does not tilt, and then pausing before initiating the step of adding pepper to the sauce.

16. ADL process skills Goal-directed task actions observed when the person
Selects, interacts with, and uses task tools and materials
Carries out individual actions and steps of the task in a spatial-temporally effective manner
Prevents task performance problems from occurring
Adaptation is also a critical feature of the AMPS process scale. Occupational therapists value a person’s ability to adapt and modify their task performance in the face of challenges. The last four ADL process skills on the AMPS Score Form deal with “adaptation” – the person’s skill related to preventing motor or process problems from happening or recurring during the task performance

17. Performance skills are not body functions
In summary, the AMPS is used to measure the person’s quality of ADL task performance. That is, we evaluate the person’s degree of occupational skill when
Grasping the knife securely so that it does not slip in her hand (Grips)
Repositioning the knife within her hand to get the knife into position to spread (Manipulates)
Holding the bread so that it does not slip on the cutting board (Grips, Coordinates, Handles) while
Spreading the butter evenly across the entire slice of bread (Flows, Calibrates, Terminates)
The AMPS is not used to evaluate body functions such as
Grip strength
Shoulder range of motion
Visual perception
Praxis
Problem solving
Nor is it used to evaluate the environment (e.g., table height, hardness of the butter)

18. Scoring performance skills
4 = competent performance
3 = questionable performance
2 = ineffective performance
1 = unacceptable performance
Each occupational performance skill (AMPS item) is scored using a 4-category scale. Scoring is criterion-referenced (as opposed to being norm-referenced) with the criterion being competent performance. Competent ADL task performance is judged to be a performance that is
Free of increased clumsiness or physical effort
Efficient (time-space organization)
Safe and independent
On many norm referenced tests, “normal” people would get perfect scores. Because the AMPS is criterion referenced, even “normal” people will get some low scores if they are doing a task that is hard enough.
Thus,
Competent (4) = no problems observed with this skill during this task performance
Questionable (3) = the therapist questions whether or not there was a problem
Ineffective (2) = some increased effort or inefficiency noted – could be slight or more pronounced
Unacceptable (1) = an unacceptable amount of effort or inefficiency, imminent safety risk, or need for assistance was noted

19. OTAP software
Computer scoring is one aspect of the AMPS that makes it such a powerful assessment. The Occupational Therapy Assessment Package (OTAP) software adjusts the person’s AMPS measures for:
The severity of the occupational therapist – this is why each occupational therapist who administers the AMPS must be trained at an AMPS workshop and be calibrated
The challenge of the tasks that the person did – this is why the specific criteria for each task must be standardized
The difficulty of the items – all people are more likely to get lower scores on hard items

20. OTAP software
What does this mean for occupational therapists who use the AMPS?
The person may be reevaluated (tested Time 1 and Time 2) by different occupational therapists and the results can be compared because the OTAP software adjusts for the severity of each occupational therapist

21. OTAP software Tasks that are usually easier Brushing or combing hair
Eating a snack and drinking a beverage
Sweeping outside
Ironing a shirt
It also means that the person may be reevaluated (tested Time 1 and Time 2) performing different tasks because the OTAP software adjusts for the challenge of the tasks.
The OTAP software is based on many-facet Rasch measurement, which allows for this level of scoring complexity.
Packing a lunch
Cleaning a bathroom
Pasta with meat, sauce, and a beverage
Tasks that are usually harder

22. AMPS observation results
The OTAP software generates AMPS results in the form of several reports that can be used by the occupational therapist when (a) communicating the results of an AMPS observation with the client and others, (b) collaborating with the client to set goals, (c) demonstrating the effectiveness of interventions, and (d) building evidence that specific interventions were effective in improving occupational performance. I will zoom-in on this page of the report in a moment.
The AMPS Results Report includes visual representations and narrative descriptions of the person’s AMPS observation results. Before I go on, however, I want to point out that
There are two scales: an ADL motor scale and an ADL process scale
This blue “ruler” is the ADL motor scale and represents clumsiness and/or physical effort
A white arrow plotted along the ruler represents this person’s ADL motor ability (point to the white arrow) – the amount of increased clumsiness and/or physical effort observed when the person engaged in two AMPS tasks
The higher the arrow along the scale, the higher the person’s level of ADL ability
The lower the arrow, the lower the person’s ADL motor ability

23. AMPS observation results
We can compare the location of this person’s ADL motor measure on the ADL MOTOR scale (the white arrow) with the following:
The bold, black text to the right of the scale represents the overall quality of ADL task performance commonly observed by people with an ADL motor ability measure at the same level along the scale
A black, horizontal cutoff, located at 2 on the scale, represents the lower limit of competent ADL task performance In this case, the person’s ADL motor ability measure is below the lower limit of competent ADL task performance and at the location along the scale where it is common to observe a mild to moderate increase in clumsiness and/or physical effort
A vertical band and dark dot to the left of the scale illustrate the normative mean and range of healthy, well, age-matched peers In this case, the person’s ADL motor ability measure is within age expectations (in the low range of ADL motor ability measures of healthy, well people who are the same age as the person who was tested)

24. AMPS observation results
The ADL process scale on the AMPS Results Report represents the level of inefficiency (time/space disorganization) that the person demonstrated during the AMPS observation

25. AMPS observation results
This person’s ADL process ability measure is
At a level where we commonly observe “mild to moderate inefficiency/disorganization” (bold, black text to the right of the scale)
Below the lower limit of competent ADL task performance (i.e., below the dark, black cutoff of 1.0),
Below the normative range (i.e., below the vertical band to the left of the scale), indicating that she was more inefficient than we would expect of a healthy, well person the same age

26. AMPS observation results
The computer-generated report also includes a table with the person’s ADL ability measures that have been transformed into commonly used statistical terms (e.g., z scores and percentile ranks). These norm-based statistics help us to compare this person’s AMPS measures with AMPS measures of typically-developing, healthy, well people of the same age.

27. Predicting need for assistance
The AMPS can be used to support the occupational therapist’s clinical judgment about someone’s need for assistance to live in the community. For example, people with an ADL process ability measure below the cutoff (< 1.0) are more likely to need assistance to live in the community. In fact, if someone has an ADL process ability measure < 1.0 and an ADL motor ability measure < 1.5, then he or she likely (83% chance) needs assistance to live in the community.

28. Predicting need for assistance
Further, if someone has an ADL process ability measure < 0.7 and an ADL motor ability measure is also < 1.0, then he or she may even need moderate to maximal support!
Clearly, the AMPS can be a powerful tool to assist with discharge planning.
Note to presenter. The result of an AMPS observation can be used to support predictions about a person’s potential to live independently in the community. The evidence based on the AMPS observation must always be used in combination with professional judgment. If questions arise about how the results of an AMPS observation can be used to support professional judgment about a person’s potential to live independently in the community, point them to Volume 1, Chapter 10, Section 10.3, Volume 2, Table 9-3, and Merritt (2010, 2011) – the full references are found on the AMPS reference list on the CIOTS website,

29. Standardization sample
Now that we have talked about the process of administering the AMPS and looked at a computer-generated AMPS Results Report, let’s discuss the standardization sample of the AMPS.
The AMPS was standardized on an international sample of more than 190,000 people with a wide range of ages and diagnoses.
The only reason not to consider using the AMPS is if the person is under the developmental age of 2 or if the person has no desire or need to engage in ADLs.

30. Standardization sample
Rheumatoid arthritis
Right-sided hemispheric stroke (RCVA)
Traumatic brain injury
Auditory/aural disorder
Cerebral palsy
Major depression
Cardiovascular
Healthy, well people
Dementia, Alzheimer type
Schizophrenia
Autism spectrum disorder, mild severity
Well older adult
Hip fracture or replacement
Respiratory
Parkinsonism
Intellectual developmental disorder
More specifically, the AMPS can be used with people who have
No identified diagnosis or disability (people who are healthy and well)
No identified diagnosis or disability, but may be at risk (i.e., frail older adults or kids at risk for developmental delay)
Mild disabilities, or
Significant physical, cognitive, emotional, or developmental disabilities
Bipolar disorder
Visual/ocular disorder
Dementia
Down syndrome
Child at risk for developmental delay
Autism spectrum disorder, marked severity
Substance abuse/addiction
Brainstem/cerebellar stroke

31. Standardization sample
Further, the AMPS can be used with
Both men and women
People across world regions – the AMPS has been shown to be free of bias related to gender and world region
Children and adults across the age span, 2 to 100+ years

32. The ACQ-OP: A partner tool for the AMPS
The AMPS also has a new partner tool called The Assessment of Compared Qualities — Occupational Performance
The ACQ-OP is a standardized, 5–10 minute interview that enables the occupational therapist to measure the extent of the discrepancy between a person’s
Reported problems with his or her ADL task performance and
Observed problems that the occupational therapist scored on the AMPS
Any discrepancy found using the ACQ-OP must be considered when collaborating with the client to set goals and agree upon an intervention plan. Thus, the ACQ-OP can be a powerful partner tool for the AMPS when testing clients who may not be aware of their problems or lack insight
Learn more about the ACQ-OP on the CIOTS website:

33. Case study Introduce the person Present AMPS results Interpret results
Discuss goals
Link interventions to the person’s goals and AMPS results
Present and interpret the person’s AMPS Progress Report
Note to presenter. It is often very useful to include a case study in your in-service. Begin by introducing the client (client-centered performance context), the tasks that were performed, etc. Share with them some of the computer-generated reports for the client, including the aspects of the report that you composed yourself (e.g., global baseline statement, item clusters with specific baseline statements, goals, and recommendations). Use your full AMPS Results Report to paint a picture of the client’s performance. Discuss how you interpreted the results of the AMPS and how you used this information to develop goals, plan intervention, and assess progress. If applicable, consider also presenting the person’s ACQ-OP results and how they influenced goal-setting and planning intervention.

34. Discussion and questions
Leave time for questions and discussion. Remind your audience to visit the CIOTS website,
More information and resources are available at