Reliability and validity of the Assessment of Client's Enablement (ACE)

Abstract

Introduction Goal-setting in client-centred occupational therapy is often problematic. The Assessment of Client's Enablement was developed to measure the gap between an occupational therapist's and client's ratings of occupational performance. This study examines the reliability and convergent validity of the assessment. Method The assessment was used by 22 occupational therapists with 44 clients. Convergent validity was examined between the assessment (client, occupational therapist and gap scores), Canadian Occupational Performance Measure performance and Functional Independence Measure scores. Test–retest reliability was assessed by intraclass correlation coefficient. Forty-four clients participated in the test–retest reliability study. Findings Good-to-moderate correlation was found in the assessment scores (intraclass correlation coefficients of 0.86, 0.95 and 0.78 for client, occupational therapist and gap scores, respectively). The validation study was completed by 34 clients. The correlation between Canadian Occupational Performance Measure and Assessment of Client's Enablement scores was significant (client score, Spearman’s Rank Order Correlation (rs) = 0.47; occupational therapist score, rs = 0.45). The correlation between Functional Independence Measure and the assessment's occupational therapist scores was significant (rs = 0.43). Conclusion The study confirms the reliability and convergent validity of the Assessment of Client's Enablement. The assessment requires less time to administer than similar instruments and requires no formal training, making it feasible in rehabilitation settings.