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CANADIAN OCCUPATIONAL PERFORMANCE MEASURE Authors: ‘Mary Lav, Sue Baptiste, Anne Carswell, Mary Ann MeColl, Helene Polatajko, Nancy Pollock ‘he Canadian Occupational Performance Mecsure (COPM) is an individualized meosure designed for use by occupational therapists to detect selFperceived change in occupational performance problems over time. Client Name: ‘Age: Gender: 1De: Respondent (if not client Date of Assessment Planned Date of Date of Reassessment Reassessment: “Therapist Faeilty/Ageney: Progra: bed by CADT bcos ACE (© M Low, 5 Bop, A. Coral, MA. Mal H. Plato, N, Flick, 2000,STEP 1: DENTIFICATION OF OCCUPATIONAL PERFORMANCE ISSUES STEP 2: RATING IMPORTANCE Using the scoring card provided, ask the cent {orale, ona scale of 10 10, he importance ‘of each acy. Pace the ratings in the ‘corraspancing boxes in Steps 1A, 18, oF 1. ' identity occupational perarmance problems, concerns and esues, interview the cn, ssking about dally acs in se-care, productivity an leisure. Ask cen to ldonly laiy activities which they want to do, nad to do or are expected to do by encouraging ‘am to think about 8 typical day. Then aek he een! to ently which of these activites {fe dificult fr them to 80 now fo thelr stisiacton, Record these actly problems in eps 14,18, or 10. STEP 1A: Self-care ‘ersonal Care 29, dressing, bathing, eding, hygiene) “unetional Mobility 2. trans 1aoor outdoor) Jommunity Management 9, transportation, hopping toaneas) STEP 1B: Productivity ‘aiafUnpaid Work 2. tndinglkeeping 9b, volunteering) fousehold Management 2, cleaning, sundry, ooking) MaylSchoo! 94 play sls, semen) DOU 000000 jO00 000000)STEP 1C: Leisure ‘Quiet Recreation (6.9, hobbies, ratio, reacing) Active Recreat (ea, sport, eating, rave) Socialization (e., vsting, pone call, rates, correspondence) IMPORTANGE | | _— Co =) a) co ===] C4 STEPS 3 & 4: SCORING - INITIAL ASSESSMENT and REASSESSMENT Confirm with the client the S most important problems and record them below. Using the scoring card, sk the cet to rate each probiem on performance and satisfaction, then calculate the tolal scores, Total scares are calewated by ‘adding together tne performance or saistaction scores fora prams and diving by the numberof problems. Al Feassessmenl, he clon scores each problem again for perlarmance and salistaction. Calculate the new scores anc the change score. Initial Assessment: Reassessment: OCCUPATIONAL PERFORMANCE cnranwance1 _sangracnon PROBLEMS: ‘SCORING: PERFORMANCE | SATISFACTION ‘scone ‘Score / / “otal performance ‘ola or salstaction = Perlormanee Score 1/ CHANGE IN SATISFACTION = Satstacion Sore 2 ["""""] Satisfaction Sco 15 DDITIONAL NOTES AND BACKGROUND INFORMATION titial Assessment: veassessment:
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