Perceive, Recall, Plan And Perform Research Articles

Cross-sectional examination of the proficiency of year 1 and year 2 children’s alphabet-letter-writing skills

AbstractThe objective for beginning writers is to learn how to generate alphabet-letters which are recognisable and easy to read. This study investigated the accuracy of Year 1 and 2 children’s alphabet-letter-writing by evaluating their alphabet and orthographic knowledge, following evidence which identifies these skills as important for correctly representing the Latin alphabet-letters in written form. 408 typical children from the first two years of formal schooling were recruited from eight Western Australian schools and asked to write the twenty-six-lowercase alphabet-letters under three different writing conditions: from memory; the initial sounds of words; and copying. Performance was measured using the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis (Stage One). Analyses revealed the mean average number of the 26- lowercase alphabet-letters correctly written from memory was 8.17 (Year 1) and 12.76 (Year 2). Mean averages were similar across the three writing conditions. Comparative analysis showed children in Year 2 were significantly better than Year 1 children at recalling the alphabet-sequence, sound-letter-translation, and retrieving the letter-shape, letter-case, and letter-orientation. No significant difference was found in name-to-letter translation, letter-formation, or letter-placement skills. The results highlighted that many typical Year 1 and 2 children have difficulty accurately generating all 26- lowercase alphabet-letters. The findings suggested that the way early writers learn to form and place an alphabet-letter, whether it is accurate or not, is how they continue to write the alphabet-letter through their early school journey. Considerations for evaluation and instruction of alphabet-letter-writing are discussed.

Feasibility of the Perceive, Recall, Plan and Perform system of intervention for persons with brain injury in community-based rehabilitation: a pilot for a multiple-baseline design study

ObjectivesThis paper describes a pilot study investigating the feasibility of the Perceive, Recall, Plan and Perform (PRPP) system for persons with cognitive impairments after acquired brain injury in the context...

Using the Perceive, Recall, Plan and Perform Assessment of cognitive strategy use with Aboriginal and Torres Strait Islander peoples: Initial exploration of clinical utility.

Culturally safe and meaningful cognitive assessment methods for use with Aboriginal and Torres Strait Islander peoples are scarce. Concerns are raised regarding the efficacy of existing methods in cross-cultural contexts. The Perceive, Recall, Plan and Perform (PRPP) Assessment offers a person-centred alternative whereby cognitive strategy application is examined during performance of culturally relevant everyday tasks. This paper explores its use with Aboriginal and Torres Strait Islander peoples in Australia. A critical case study design was applied to examine the effectiveness and relevance of the PRPP Assessment with two Aboriginal Australian people in the Northern Territory of Australia. 'Ivan' and 'Jean' were each receiving occupational therapy through a rehabilitation service over a 6-month period following acquired brain injuries. Ivan and Jean were assessed performing everyday tasks of interest and importance to them as part of routine care. A partnership approach was adopted throughout the process, and both consented to their stories being told. The PRPP Assessment was able to measure changes in Ivan's and Jean's cognitive strategy use and its impact on performance of meaningful tasks. Ivan demonstrated a 46% increase in performance mastery and a 29% increase in cognitive strategy use with most improvements identified in his ability to sense information, initiate action, and continue performance. Jean demonstrated a 71% increase in performance mastery and a 32% increase in cognitive strategy use. Her greatest improvements were in the ability to recall schemes, self-evaluate, and initiate action. The two critical case stories shared in this study suggest that the PRPP Assessment has emerging evidence of clinical utility when used with Aboriginal people with acquired brain impairment. The information gained revealed strengths in performance; it was effective in measuring change in cognitive strategy use, was able to inform the goal setting process, and guided intervention to support cognitive strategy use during task performance.

Children with handwriting difficulties: Impact of cognitive strategy training for acquisition of accurate alphabet-letter-writing

Introduction: An occupational therapy handwriting programme integrating cognitive strategy training with alphabet-letter-writing instruction was found more effective than in-class instruction alone for early writers. This study investigated the impact of cognitive strategy training for children struggling to correctly write alphabet-letters. Method: Participants were ten children in the first 2 years of formal schooling identified with challenges in alphabet-letter-writing. A nonconcurrent A1BA2 single system research design was used. The A Phases represented within-class handwriting instruction only and B Phase represented additional handwriting intervention which included cognitive strategy training. The Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis (Stage 2) was the repeated outcome measure. Results: Results revealed all ten children demonstrated a similar pattern of change in cognitive strategy application which was concomitant with improvement and mastery in writing all 26-lowercase alphabet-letters from memory. Cognitive strategies which exhibited the greatest impact on acquiring and executing accurate alphabet-letter-writing skills were those related to planning, memory, attention and sensory perception. The least influential were those associated with generating and controlling motor actions. Conclusion: This study provides beginning support for including cognitive strategies training concurrently with alphabet-letter-writing instruction to assist children struggling to write alphabet-letters.

Perceive, Recall, Plan and Perform (PRPP)-Assessment Based on Parent-Provided Videos of Children with Mitochondrial Disorder: Action Design Research on Implementation Challenges

Aims Performing the Perceive, Recall, Plan and Perform (PRPP)-Assessment, using video material of everyday life, seems sensible to lower the patient burden, enhance ecological validity, and provide care at a distance. However, receipt of adequate video material is not self-evident and assessing videos can be challenging. Therefore, this study aims to optimize the process of gaining video material and to optimize the PRPP-Assessment based on parent-provided videos. Methods An action design research method was used, focusing on implementation of the PRPP-Assessment based on parent-provided videos within the care of children with a mitochondrial disorder or similar symptoms. Results Five cycles were conducted. To receive input, the cycles used videos of nine children performing activities, written feedback, and semi-structured interviews and focus groups comprising parents (n = 13), a teacher (n = 1), occupational therapists (n = 16), and other professionals (n = 2) . This led to successful implementation of the PRPP-Assessment. General lessons were learned on (1) instructing parents; (2) handling video material; (3) PRPP-Assessment based on parent-provided videos; and (4) PRPP-Assessment of children (with limited functional abilities). Conclusions Lessons learned should be implemented in practice and are incorporated into a manual to guide the implementation of video-based observations with PRPP-Assessment in practice.

Patterns of Social Skill Difficulties in Young Children with Reduced Social Competence: Parent and Teacher Perceptions

ABSTRACTThe purpose of this study was to explore social skills of young children with reduced social competence, from the perspective of parents and teachers. The study adopted a descriptive, quantitative design using secondary data from occupational therapy assessment information on 241 children. The data were collected using a parent and teacher questionnaire based on the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis. Factor analysis techniques were used to explore conceptual groupings amongst 24 social skill items. Social skills of children with reduced social competence were categorized into four behavioral constructs: emotion and resilience, pro-social behavior, intrapersonal capacities and friendship-making skills.

Use of Perceive, Recall, Plan, Perform Stage Two Cognitive Task Analysis for students with autism and intellectual disability: The impact of a sensory activity schedule

ABSTRACTThe aim of this study was to determine the impact of a classroom sensory activity schedule (SAS) on cognitive strategy use during task performance. This work studies a single-system AB research design with seven students with autism and intellectual disability. Repeated measures using the Perceive, Recall, Plan and Perform (PRPP) Cognitive Task Analysis were taken during Phase A (teaching) and Phase B (teaching and SAS). Improvements in PRPP total scores and planning subscores were achieved for some students after use of the SAS. SAS may contribute to improved classroom cognitive strategy use for some students with autism and intellectual disability.

The Perceive, Recall, Plan and Perform (PRPP) system for persons with Parkinson’s disease: a psychometric study

Background: The Perceive, Recall, Plan & Perform (PRPP) system of task analysis might be feasible to evaluate occupational performance and information processing strategies for persons with Parkinson’s disease (PD).Aim: To evaluate: (1) the random error between raters (inter-rater study), (2) the random error within raters (intra-rater study), and (3) the internal consistency of the PRPP.Materials and methods: (1) video-recorded performance of meaningful activities of 13 Dutch persons with PD, scored independently by 38 Dutch PRPP trained occupational therapists were included in the analysis. The random error between raters was analyzed with two-way random Intraclass Correlation Coefficients (ICC). (2) Four videos were scored twice by 30 raters (6 week time interval). The random error within raters was analyzed using one-way random ICC’s. (3) Internal consistency study: data of 190 persons with PD were analyzed using Cronbach’s alpha (α).Results: Inter-rater reliability ranged from slight to moderate (ICC= 0.06–0.43). The mean intra-rater reliability ranged from moderate to almost perfect (ICC= 0.60–0.83). Internal consistency is good (α = 0.60–0.86).Conclusion: The limited inter-rater reliability but adequate intra-rater reliability and internal consistency show the feasibility of the PRPP when used for persons with PD. Implications for reliable clinical use are discussed.

An exploration of the ecological validity of the Virtual Action Planning–Supermarket (VAP-S) with people with schizophrenia

People with schizophrenia often have functional limitations that affect their daily activities due to executive function deficits. One way to assess these deficits is through the use of virtual reality programmes that reproduce real-life instrumental activities of daily living (IADLs). One such programme is the Virtual Action Planning–Supermarket (VAP-S). This exploratory study aimed to examine the ecological validity of this programme, specifically, how task performance in both virtual and natural environments compares. Case studies were used and involved five participants with schizophrenia, who were familiar with grocery shopping. They were assessed during both the VAP-S shopping task and a real-life grocery shopping task using an observational assessment tool, the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis. The results show that when difficulties were present in the virtual task, difficulties were also observed in the real-life task. For some participants, greater difficulties were observed in the virtual task. These difficulties could be explained by the presence of perceptual deficits and problems remembering the required sequenced actions in the virtual task. In conclusion, performance on the VAP-S by these five participants was generally comparable to the performance in a natural environment.

Exploring the Validity of the Perceive, Recall, Plan and Perform System of Task Analysis: Cognitive Strategy Use in Adults with Brain Injury

Introduction:Ecologically valid assessment linking cognitive strategies to observed functional performance has been strongly advocated. This study examines the construct validity of one such assessment: the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis for the evaluation of adults with brain injury.Method:Eighteen occupational therapists observed videoed patient performance (n = 16) of personal and instrumental activities of daily living, then used the PRPP System of Task Analysis to identify task performance errors and to attribute these errors to underlying cognitive strategy deficits. Multifaceted Rasch analysis was used to generate a hierarchy of test items and to propose a linear continuum, along which the difficulty of test items, raters, patients and tasks could be measured simultaneously. The generated hierarchy was examined for congruency with theories of information processing and neurorehabilitation.Results:Test items, raters, patients and tasks demonstrated ‘fit’ with the Rasch model. Construct validity was well supported by strong parallels between the Rasch-generated hierarchy of PRPP items and conceptual models of information processing and occupational performance.Conclusion:The PRPP System of Task Analysis is a valid measure of cognitive strategy use during the occupational performance of adults with brain injury, demonstrating high levels of fit with Rasch modelling for test items, raters and patients.

Difficulties with multitasking on return to work after TBI: A critical case study

Work performance research highlights that psychometric cognitive measures and cognitive component information processing measures are strong predictors of success in multitasking work environments [14]. People with a mild to moderate traumatic brain injury (TBI) returning to a job requiring multitasking, may have difficulty succeeding despite pre-morbid equivalent cognitive scores. A critical case study is presented to begin to determine what aspects of information processing contribute to difficulties in multitasking work performance, for people with a TBI. The Perceive Recall Plan and Perform (PRPP) System of Task Analysis: Workplace Interview (i.e. PRPP@WORK) is used with the employer to obtain information processing scores. Results indicate substantial information processing deficits were perceived by the employer for the employee with a TBI. Future larger studies of people with a TBI who return to work that requires multitasking are needed to more clearly indicate: the level of multitasking they perform; what aspects of information processing hinder their work performance; the impact on performance of perceived cognitive load by the person with a TBI and the type and impact of support provided to improve their work performance.

Assessment of productivity performance in men with HIV Associated Neurocognitive Disorder (HAND)

The purpose of this paper is to review what is known about return to productivity roles for people who have HIV/AIDS and HIV Associated Neurocognitive Disorder (HAND), to highlight gaps in knowledge and practice for assisting people with HAND to engage in productivity roles, to describe an occupational therapy assessment system that overcomes some of the limitations of current research and practice, and to demonstrate the clinical utility of this instrument for use with clients who have HAND. The participant in this study is a man with HIV Associated Dementia (HAD), one sub-type of HAND. The real-world impact of HAD on productivity role participation was assessed using the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis, an ecological assessment method. Productivity tasks assessed were those associated with this man's desire to become a volunteer grocery shopper. The assessment took place under naturalistic conditions in a grocery store. The participant demonstrated 28.6% mastery of the grocery shopping task. Performance was impacted on primarily by errors of accuracy and timing. Reasons for these errors centered on the participant's difficulties in applying cognitive strategies to perceive, recall, plan and perform the task. The PRPP System of Task Analysis shows promise in being able to identify errors in task mastery and the underlying cognitive strategy application errors that impact on mastery in people with HAND.

Reliability of the Perceive, Recall, Plan and Perform System of Task Analysis: A criterion‐referenced assessment

To conduct preliminary examination of the rater and test-reliability of the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis, an ecological measure designed to assess task-embedded information processing capacity during occupational therapy assessment of confused and agitated adults following traumatic brain injury. Occupational therapists observed and scored client performance using the PRPP System of Task Analysis. Correlational analysis and measures of agreement were performed to determine interrater and intrarater reliability. Test procedures were examined for reliability and internal consistency. Interrater and test reliability considered three factors: therapists, clients and tasks. A moderate level of interrater reliability was achieved between trained therapists (intraclass correlation coefficient (ICC) = 0.60). Test procedures were highly reliable (ICC = 0.88). Across two measurement occasions, therapists showed a tendency towards harder rating on the second test occasion (-4.5%; 95% confidence interval for: -10.67% → 3.17%). The findings of this study support the use of criterion-referenced tests in the area of occupational performance measurement. Occupational therapists achieved moderate interrater reliability when measuring the performance of adults with brain injury on various activities of daily living. Test procedures were found to be highly reliable in measuring the occupational performance of adults demonstrating confusion and agitation typical to the stage of post-traumatic amnesia following head injury.

Daily Functioning and Information-Processing Skills Among Persons With Schizophrenia

This study aimed to describe the limitations in information-processing skills observed among persons with schizophrenia performing daily tasks and to explore whether subgroups of participants have similar profiles based on these functional limitations. Eighty-two participants with schizophrenia living in the community were assessed during their performance of a daily activity (meal preparation). Measures included a performance-based assessment for evaluating information-processing skills-the Perceive, Recall, Plan, and Perform System of Task Analysis-community functioning and symptom assessments, and neuropsychological tests from the Cambridge Neuropsychological Test Automated Battery. Research participants were classified as having high efficiency or low efficiency according to their score on the performance-based assessment and were compared on the functional, cognitive, and symptoms variables. Participants committed various errors, and functional limitations, namely problematic information-processing skills in the perceive, recall, and plan quadrants, were observed during the daily task performance. Participants from the high-efficiency group were more independent in their living skills and more successful in attaining residential independence compared with participants from the low-efficiency group. The only cognitive test that differentiated both groups was the visuospatial associative learning test. No differences were found in the severity of symptoms. Findings suggest that both performance in a daily task and memory-and specifically associative learning capacity-provide key information for the level of residential independence. Interventions aiming for the efficient use of information-processing skills during daily tasks among persons with schizophrenia should be carried out accordingly.

Daily Functioning and Information-Processing Skills Among Persons With Schizophrenia

Daily Functioning and Information-Processing Skills Among Persons With Schizophrenia

Use of the Perceive, Recall, Plan and Perform System of Task Analysis for persons with schizophrenia: A preliminary study

Task analysis that targets information processing skills is an essential tool to understanding difficulties encountered by people with schizophrenia in their daily activities. The purpose of this preliminary study was to explore the use of the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis for this clientele. The specific objectives were to describe information processing difficulties as measured by the PRPP and to examine preliminary evidence of construct validity and interrater reliability. In the first part of this study, 10 participants with schizophrenia living in the community were assessed using the PRPP during both a simple and a complex meal preparation task. Community functioning was measured using the Independent Living Skills Survey. In the second part, interrater reliability was appraised using three trained raters, who scored 15 participants preparing the complex meal preparation task. Analysis of performance demonstrates that people with schizophrenia have difficulties especially in the Perceive and Plan quadrants of the PRPP and are more challenged in the complex task. The PRPP total score for the complex task is strongly related to the community functioning score. Results indicate good interrater reliability for the PRPP total score and moderate interrater reliability for the quadrant scores. Despite the small sample size, results from this preliminary study support the use of the PRPP System of Task Analysis to further explore the impact cognitive deficits have on daily task performance and thus on community functioning in people with schizophrenia.

Daily activities, cognition and community functioning in persons with schizophrenia

Objective This cross-sectional study explored the relationships between daily activity performance, attention, memory, executive functions and community functioning in people with schizophrenia. More specifically, this study attempted to verify the hypothesis that functional limitations in the performance of daily activities negatively affect community functioning in people with schizophrenia. Methods Eighty-two individuals with schizophrenia living in the community were recruited for the study. The Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis was used to assess participants’ functional capacity during a meal preparation task. Visuo-spatial associative memory, spatial working memory, planning, visuo-motor coordination, and selective attention were evaluated as well. Community functioning was assessed with the Independent Living Skills Survey (ILSS) and the Multnomah Community Ability Scale (MCAS). Results Correlations revealed significant associations between functional capacity and visuo-spatial associative learning, spatial working memory, planning and negative symptoms. Planning skills during meal preparation were found to be associated with MCAS. After regression analyses, only visuo-spatial memory, negative symptoms, education and familiarity with meal preparation explained variation in functional capacity. Conclusions The findings of the current study suggest that visuo-spatial associative learning, negative symptoms, education and familiarity with task are among the important factors for functional capacity. Planning skills necessary for efficient task performance were also found to be those most determinant for community functioning. Rehabilitation interventions should consider these underlying strength and deficits when developing strategies to help people with schizophrenia build functional skills essential for community living.

Measuring information processing in a client with extreme agitation following traumatic brain injury using the Perceive, Recall, Plan and Perform System of Task Analysis

Agitation following traumatic brain injury is characterised by a heightened state of activity with disorganised information processing that interferes with learning and achieving functional goals. This study aimed to identify information processing problems during task performance of a severely agitated adult using the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis. Second, this study aimed to examine the sensitivity of the PRPP System to changes in task performance over a short period of rehabilitation, and third, to evaluate the guidance provided by the PRPP in directing intervention. A case study research design was employed. The PRPP System of Task Analysis was used to assess changes in task embedded information processing capacity during occupational therapy intervention with a severely agitated adult in a rehabilitation context. Performance is assessed on three selected tasks over a one-month period. Information processing difficulties during task performance can be clearly identified when observing a severely agitated adult following a traumatic brain injury. Processing skills involving attention, sensory processing and planning were most affected at this stage of rehabilitation. These processing difficulties are linked to established descriptions of agitated behaviour. Fluctuations in performance across three tasks of differing processing complexity were evident, leading to hypothesised relationships between task complexity, environment and novelty with information processing errors. Changes in specific information processing capacity over time were evident based on repeated measures using the PRPP System of Task Analysis. This lends preliminary support for its utility as an outcome measure, and raises hypotheses about the type of therapy required to enhance information processing in people with severe agitation. The PRPP System is sensitive to information processing changes in severely agitated adults when used to reassess performance over short intervals and can provide direct guidance to occupational therapy intervention to improve task embedded information processing by categorising errors under four stages of an information processing model: Perceive, Recall, Plan and Perform.

Effective occupational therapy intervention with adults demonstrating agitation during post-traumatic amnesia

Objective: To investigate the effectiveness of occupational therapy (OT) with adults demonstrating agitation and post-traumatic amnesia (PTA) following brain injury.Design: Single-system experimental design (ABAB) across subjects.Methods: Eight subjects were recruited during acute rehabilitation. Current OT intervention was alternated with the experimental Perceive, Recall, Plan and Perform (PRPP) System approach over 4-weeks. Therapy was conducted daily. Information processing capacity during occupational tasks was measured using the PRPP System of Task Analysis. PTA status was monitored with the Westmead PTA Scale.Experimental intervention: The PRPP System is a dynamic assessment and intervention approach that directly links results of cognitive task analysis with strategies for intervention. PRPP Intervention adopts an information processing approach that simultaneously focuses on task training, strategy training and strategy application within occupational performance.Results: Seven subjects significantly improved in their application of processing strategies during the PRPP Intervention in comparison to current OT Intervention phases. Large treatment effects favoured the PRPP Intervention. Subjects demonstrated improved information processing strategy use both prior to and following emergence from PTA.Conclusions: Occupational therapy intervention based upon the PRPP System of Task Analysis and Intervention improved subjects’ ability to apply information processing strategies during occupational performance when compared to current intervention approaches.

Using the Perceive, Recall, Plan and Perform System to assess cognitive deficits in adults with traumatic brain injury: A case study

One role of occupational therapy in the rehabilitation of people with traumatic brain injury is to determine the impact of cognitive and perceptual deficits on client performance of occupational tasks. Existing methods that can be used to assess cognitive deficits include standardised instruments and observations of everyday task performance. Few of these assessment methods are able to adequately link problems of cognition with problems with self‐maintenance, productivity and leisure tasks relative to a client's expected occupational roles. The Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis enables observation of performance of any functional task and allows therapists to identify the cognitive basis of disordered performance. The results of this assessment are then used to establish and evaluate client‐centred goals and guide subsequent intervention. This article describes the PRPP System of Task Analysis and outlines how it can be used by occupational therapists involved in the management of adults with traumatic brain injury. Specifically, an in‐depth case study illustrates how this innovative model of assessment has effectively been used to promote client learning of self‐maintenance skills.