The IADL Profile: Development, content validity, intra- and interrater agreement

Background. Occupational therapists are frequently asked to document the interplay between individuals' neuropsychological deficits and the requirements of their daily lives. Purpose. The present study was designed to develop and validate a measure of independence in everyday functioning that considers recent advances in research regarding the ecological assessment of executive functions. Method. Experts (n=8) judged the IADL Profile's content validity and the tool was pilot tested with the target population (n=8). To document the tool's reliability, 30 patients aged 16 to 65 with moderate or severe TBI were recruited. A trained examiner administered the IADL Profile, and three trained judges rated video recordings on two occasions. Results. An eight-task (29-item) test was developed. Comparing ratings of four raters, 95 percent of kappa coefficients indicated moderate to almost perfect agreement, and 94% showed almost perfect intrarater agreement. Implications. The IADL Profile provides occupational therapists with a set of measures of IADL independence with strong preliminary evidence of reliability.