Development of the Assessment of Awareness of Disability

Abstract

It is common for clients with stroke to lack awareness of their disabilities, which is an obstacle in the rehabilitation process. The aim of this article is to describe how Rasch measurement methods were used to develop a new Assessment of Awareness of Disability (AAD) and to present a preliminary evaluation of the instrument. Awareness of disability was defined as no discrepancy between the client's actual disability (measured by the Assessment of Motor and Process Skills, AMPS) and the client's perceived and verbally described disability in a specific ADL task. AAD consists of an interview guide that includes seven questions (items) that are asked directly after the performance of the AMPS task. The AAD was administered to a target sample of 12 clients with stroke. Four clients were each tested 10 times and 8 clients were each tested once. A Rasch measurement model was used to analyse the AAD data from 48 test sessions. The results indicated that AAD measures a single construct and that it discriminates among clients with different levels of awareness of disability. While the results of this pilot study are promising, the validity and reliability of the AAD need to be further examined on a larger and more varied group of clients.