Developing Assessments That Account for the Role of the Environment: An Example Using the Test of Playfulness and Test of Environmental Supportiveness

Abstract

The authors illustrate a three-stage process for developing assessments that are consistent with occupational therapists' conceptualizations of the interactions among individuals, environments, and occupations. Existing Test of Playfulness (ToP) and Test of Environmental Supportiveness (TOES) data from 265 children aged 15 months to 12 years were used. In Phase 1, the ToP was altered by dropping the statistical adjustment for rater severity (facet). In Phase 2, raw TOES scores, collapsed into categories, were added as a measured facet; the resulting assessment was examined for evidence of validity and reliability. In Phase 3, the assessment was found to be a clinically useful tool. The authors showed that environmental supportiveness has a significant effect on observed playfulness and that it can be measured and accounted for in an assessment. The process is representative of methods that could allow therapists to predict how a client's score on a measure of occupational performance might change in a different environment.