BAY AREA FUNCTIONAL PERFORMANCE EVALUATION (BAFPE)

PROPONENT

Judith Bloomer and Susan Williams

• developed in 1977-1978
• developed over a 1 and ½ year period at the Langley Porter Psychiatric Institute in San Francisco.
• was designed to assess the functional performance of individuals, specifically those being treated in the psychosocial setting.
• consists of two sub-tests which are the Task-Oriented Assessment and the Social Interaction Scale. These subtests assess
the ability to participate in goal-directed activities and social behavior, which are two aspects that are important in evaluating
a client in psychosocial practice.
• The test was developed in order to obtain reliable and measurable data regarding an individual’s functional performance in
their daily occupations.
• The proponents particularly paid attention to the importance of verbal and nonverbal communication of an individual, and
its purpose and relation to one’s environment.

PURPOSE

To develop a valid and reliable tool that would appropriately assess general components of functioning needed to perform activities
of daily living (ADL). (Bloomer & Williams, 1987, as cited in Hemphill-Pearson, 2008).

BAFPE: TASK ORIENTED ASSESSMENT (TOA)

TASK ORIENTED ASSESSMENT (TOA) subtests FUNCTIONAL BEHAVIORS BEING ASSESSED

1. Sorting Shells: 10 categories of shells are sorted by size, shape, and 1. Ability to paraphrase instructions
color. 2. Ability to make productive decisions
2. Money and Marketing: The amount of money needed to purchase 3. Level of motivation
specific items is calculated, the ability to purchase the items with 4. Ability to organize time and materials
available money and a mock check is determined, and the amount of 5. Degree of mastery and self-esteem
change from the transaction is calculated. 6. Level of frustration tolerance
3. Home Drawing: A floor plan for a home is drawn, with the patient 7. Attention span
following specific instructions about what should be included. 8. Ability to abstract
4. Block Design: A block design is duplicated from memory or with the use 9. Evidence of thought or mood disorder (verbal or behavioral)
of a cue card if needed. 10. Ability to follow instructions
5. Kinetic Person Drawing: A person doing something is drawn.

In the revised BAFPE, both subtests were scored separately on different sheets per task. The Bank Deposit Slip was changed to the
Money Marketing task, and several instructions in other tasks were revised. Functional parameters being assessed in TOA were also
grouped into three components, which are the following:

COGNITIVE PERFORMANCE AFFECTIVE

● Memory for written/verbal instructions ● Task completion ● Motivation or Compliance
● Organization of Time and Materials ● Errors ● Frustration tolerance
● Attention Span ● Efficiency ● Self-confidence
● Evidence of Thought Disorder ● General affective and behavioral
● Ability to Abstract impression

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• Originally developed for inpatient or outpatient psychiatric settings, but later on it has been used to other populations and
appropriate in any situation to gather information about an individual’s task-oriented functioning.
• Assesses one’s ability to act on the environment in a goal-directed way. Evaluates an individual’s functional performance in goal-
directed activities
• Contains five tasks (sorting shells, money and marketing, home drawing, block design, and kinetic person drawing) used to provide
information about the patient’s cognitive, performance, and affective areas of functioning.

Sorting shells Shells were specifically utilized as there is no sexual bias. The aesthetic of the shells was also taken into
consideration and it appears to be intrinsically motivating for the client.
Money and marketing This task will yield information regarding the client’s orientation to his/herself and to time. It also reflects the
client’s cognitive functioning, particularly adding and subtracting numbers. It also reflects a common task
usually being performed by those that budget their expenses.
Home drawing This task allows the client to practice their decision-making skills as they choose the placement of the rooms.
It may also reflect cognitive functions such as measurement and spatial organization.
Block design This task will give information regarding the memory and the visual and spatial perception of the client.
Kinetic person drawing This is the most projective task on the TOA, yielding information regarding defenses, objects, relations, and
self-concept.

BAFPE: SOCIAL INTERACTION SCALE (SIS)

The Social Interaction Scale (SIS), which assesses an individual’s behavior during social interaction with other people. In SIS, there are
seven parameters being evaluated. They are assessed using a 5-point rating scale. Used to assess seven categories of verbal and non-
verbal social interaction behaviors, which are important to overall functioning. Intended to be done within 24 hours after the TOA

The revised SIS still used the same seven parameters and 5-point rating; however, the ratings were done after five specified social
situations rather than rating after one single observation of social interaction. This change was implemented in order to gather more
objective data.

5 SOCIAL SETTING SITUATIONS 7 PARAMETERS OF SOCIAL INTERACTION

• One on one interview: During an interview or administration of • Verbal Communication: Quantity and quality of verbal interaction
the TOA. • Psychomotor Behaviour: Motor effect of psychological processes,
• Mealtime: Group setting where several individuals eat together reflected in hypo- or hyperactivity
at the same table. • Socially Appropriate Behaviour: Quality of behaviour in relation to
• Unstructured group situation: A group setting where there is no cultural and social expectations
expectation regarding the patient’s performance. • Response to Authority Figures: Quality of interaction with and
• Structured Activity group: A planned group activity or recreational response to people who influence power or control over the
game setting where social interaction is expected by the leader. individual
• Structured Oral group: any group that focuses on discussion • Independence/Dependence: Appropriateness of self-reliance and
among members. self-direction
• Ability to Work With Others: Quantity and quality of peer
interactions in work- or task-oriented settings
• Participation in Groups or Program Activities: Ability to take part
in activities that require social interaction

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ADMINISTRATION

BAFPE: TASK ORIENTED ASSESSMENT (TOA)

The instructions given by the therapist when conducting a Task-Oriented Assessment (TOA) must be read DIRECTLY from
the BaFPE manual.

INTRODUCTION (Therapist):
• “This test involves 5 different tasks that will help us understand more about the way you function in everyday
activities.
• This should show some of the things that are easy for you to do and some of the things that are more difficult.
• The whole test should about 30-45 minutes.
• Each task will have a time limit and I will tell you when to start each one.
• For each task, I will ask you to repeat the instructions before you start.
• While you are working, I will be taking some notes. If you wish, we will have time to discuss the task after you are
finished. Unless you have questions, we will start the first task.”

IMPORTANT:
• If the client asks more about the task, therapist must respond by saying:

“Rather than discuss the task more now,I think it will be easier for you to understand them as I give you the
instructions for each one and show you the materials.”

• For clients with hearing impairment, written instructions must be provided by the examiner.

TOA 1: SORTING SHELLS

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TOA 2: MONEY AND MARKETING

TOA SUBTEST SCRIPT

Money and Marketing • “The instructions for this task are written, I would like you to read them out loud. Unless you
The client will be given an amount of have problem with reading or seeing the words, go ahead and begin. Here are your instructions.”
money and a shopping list. Client reads the instructions out loud.

First, the client will be asked to

compute the total amount of the
items in the shopping list.

Second, the client will be asked to

exchange the cash check for money.

Lastly, the client will also be asked to

compute the change from the money
that he used to buy the items on the
list and see if it is correct.

Figure 1
Retrieved from https://prezi.com/vux5uwyn_1qe/bafpe-task-oriented-assessment/.

• “Please repeat the instructions and include all the details you can remember.” Client repeats the
instructions without reading the copy.
• “Here is a worksheet, some money, and a check made out for you. You can take up 8 minutes for
this task. Go ahead and begin.” Client completes the task.
• “What skills are you using for this task?”

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TOA 3: HOME DRAWING

TOA SUBTEST SCRIPT

HOME DRAWING (HOUSE • “For this task I would like you to draw a floor plan for a home. If you are not familiar with floor plans, here
FLOOR PLAN) are some examples of different types of floor plans.” Client looks at the different types of floor plans.
The facilitators will ask
the client to draw a floor
plan of a house. The client
must draw the floor plan
according to the
facilitator’s specifications
of the house such as,
number of rooms and
people who will reside in
the house.

Figure 2 Figure 3:
Retrieved from https://online.visual-paradigm.com/diagrams/templates/floor-plan/sample-floorplan/.
• “For your plan, I would like you to draw a 5x7 inch rectangle box on a piece of paper. The box will represent
the outside walls of a one-story home. There are 4 other things for you to keep in mind when you do the
plan: the home should be for 4 people, it should include at least 4 rooms from the list I will give you, there
should be an opening in the line showing where the doors are, and each of the rooms should be labeled
before you are finished. Do you understand the instructions?”

• “Please repeat the instructions and include all the details you can remember.” Client repeats the
instructions.

• “So, here are your list of rooms, paper, pencil, and ruler. You can take up to 8 minutes for this task. I will tell
you when you have 2 minutes left to work. If you finish early, please tell me.” Client completes task.

• “Please tell me why you arranged the rooms the way you did.” Client explains the floor plan.
• “What skills are you using in doing a task like this for a home floor plan?”

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TOA 4: BLOCK DESIGN

TOA SUBTEST SCRIPT

BLOCK DESIGN • “For this task, I am going to show you some blocks design on them. I will show you them for 5 seconds
The facilitator will show the and then I am going to mix them up. I would like you rearrange them so that the same design that I
client a specific design of the showed you is showing on the top. Do you understand the instructions? Please repeat the instructions
block and keep it after the client and include all the details you can remember.” Client repeats the instructions.
has seen it. Using a set of colored
• “You can take up to 2 minutes for this task. I will tell you when you 30 seconds left to work. You can
blocks, the client will copy the
design that was shown to him. use the card that the blocks are on to work on (see figure 2 below); it has an outline to help you
Assistance and cue cards may organize the blocks. If you finish early, please tell me. I will show you the blocks now and then you can
also be used to help the client begin.” Client tries to remember the block design under 5 second
remember the design if needed.

• If the client was unable to finish the block design under 2 minutes, the therapist gives the client the
guide to help him/her finish the task correctly. “Times up, are you finished? Ok I am sorry, but it is time
to stop working now. But I can give you this cue card that you can follow and try to do it again for 1
minute.” Client corrects the block design by using the cue card.

• “What skills are you using in doing a task like arranging blocks into a pattern?”

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TOA 5: KINETIC PERSON DRAWING

TOA SUBTEST SCRIPT

KINETIC PERSON DRAWING • “For the last task I would like you to draw a picture of a person doing something. You can show the
In this task, the therapist will person doing anything you wish. This is not a test of your ability to draw, so just do the best you can.
simply ask the client to draw a However, I would like to ask you not to draw the person using stick figures. Do you understand the
person who is doing something. instructions? Please repeat the instructions and include all the details you can remember.” Client
repeats the instructions.
• “Here are the materials. You can take up to 4 minutes for this task. I will tell you when you have 1
minute left to work. If you finish early, please tell me.”
• “The time is up now. Are you finished? Can you tell me what the person in your drawing is doing?”
client explains what the person in your drawing is doing.
• “In general, this has been an act of evaluation of how you can work on different tasks. This last test
has been somewhat different what do you think can be learned about people by asking them to draw
a picture of a person doing something?” client answers the follow-up question.
• “This is the last task. Do you have any questions?” client responds.
• “Thank you.”

ADMINISTRATION

BAFPE: SOCIAL INTERACTION SCALE (SIS)

1. One-to-one Interview Observation occurs during the initial interview or an assessment (i.e. TOA)
2. Mealtime Observation takes place in a general group eating situation such as several people sharing
one table. During this situation, it must be possible for group interaction to happen
3. Unstructured Group Activity Observation takes place in an informal lounge group or informal group leisure activity where
there is no expected behavior from the client
4. Structured Group Activity Observation takes place in an organized task group such as sports or recreational activity
involving teams/partners wherein social interaction is required
5. Structured Verbal Group Observation takes place in an organized group emphasizing discussion regarding recent
events, therapy group, community meetings, etc.

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 LOCATION May vary depending on whatever is available to the therapist
Examples:
• The one-to-one interview may take place in the therapist’s center or the home of the client
as long as it is in a secluded room
• Mealtime may take place when the client can share a table while eating a meal with other
people
• The group activities may take place in a room such as a family lounge

Any room or location can be utilized for this assessment as long as the space can accommodate the
people that will participate. Noise must be minimal (lessen distractions) and the lighting must be good
and sufficient for the activities (for those with poor attention)

POSITION and • 90 degrees from the client

ROLE OF THE • Maintain eye contact and always turn to the client when interacting to make them feel like they
THERAPIST are being given attention and listened to

SCORING AND INTERPRETATION

BAFPE: SOCIAL INTERACTION SCALE (SIS)

• Clients are rated on a 5-point scale on the 7 functional parameters across 5 social situations.
• Behavioural guidelines for the ratings are provided on the rating forms. Ratings range from 1 – 5, with 1 indicating
that assessment was not possible due to the degree of dysfunction
• The ratings of 2 through 5 are used to reflect a continuum of performance from (2) markedly dysfunctional or
inappropriate to (5) almost always functional or appropriate
• Not all seven parameters are scored in each situation. The SIS is completed through direct observation by the
examiner, although corroboration by other team members is desirable. A minimum of 10 minutes of observation in
each social setting is recommended, with the SIS completed within a 1- to 2-day period.

SIS Scoring Sheet

• Parameter scores are derived by summing up the ratings for each situation and dividing this number by the number
of rated observations.
• The situation scores are derived by summing up all parameter scores for that situation.
• The total SIS score is derived by totaling the five situation scores.For interpretation of situation scores, the sum of
the parameter scores for a situation is divided by the number of parameters scored.

Interpretation
Parameter and situation scores may be examined to identify a patient’s strengths and needs in relation to the seven categories
of verbal and nonverbal interaction, and in relation to structured versus unstructured and group versus one-to-one situations

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REFERENCE

• Fortuna, J. (2019, November 6). BaFPE Social Interaction Scale [Prezi Presentation]. Retrieved from https://prezi.com/a-paznkpwg9f/bafpe-
social-interaction-scale/.

• Fortuna, J. (2019, November 6). BaFPE Task-Oriented Assessment [Prezi Presentation]. Retrieved from https://prezi.com/vux5uwyn_1qe/bafpe-
task-oriented-assessment/.

• Hemphill-Pearson, B. J. (Ed.). (2008). Assessments in occupational therapy mental health: An integrative approach. Slack Incorporated.

• Hemphill-Pearson, B. J. (Ed.). (1982). The Evaluative process in psychiatric occupational therapy. Thorofare, NJ : C.B. Slack.

• Houston, D., Williams, S. L., Bloomer, J., & Mann, W. C. (1989). The Bay Area functional performance evaluation: Development and
standardization. American Journal of Occupational Therapy, 43(3), 170-183.

• Bruce, M. A., & Borg, B. (2002). Psychosocial frames of reference: Core for occupation-based practice. Slack Incorporated.

• Managh, M. F., & Cook, J. V. (1993). The use of standardized assessment in occupational therapy: The BaFPE-R as an example. American Journal
of Occupational Therapy, 47(10), 877-884.

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