Canadian Occupational Performance Measure (COPM)

The Canadian Occupational Performance Measure1 (COPM) is used to help people with cerebral palsy and their families identify activities that are important to them to work on in therapy. It focuses on everyday activities like self-care, attending school or work, and participating in leisure or play. The COPM is known as an individualised measure because it calls for each person to consider their own situation and develop goals that are personally meaningful.

Health professionals and people with cerebral palsy and their families complete a COPM to work out the priorities for therapy and intervention. Importantly, they will also complete a COPM afterwards, to measure how they have progressed in their chosen activities.
The COPM assessment can be used with people of any age, and with cerebral palsy of any severity. For children under eight-years-old and those with communication difficulties or intellectual disability, family members or carers may need to complete the COPM.
A health professional will use a semi-structured interview to guide the person with cerebral palsy and their family to identify up to five daily activities they need to do, want to do - or would like to do better. The health professional plays an important role in working with the person and family to ensure the activities they choose are realistic and achievable.
Completing the COPM usually takes between 20 and 40 minutes.

You can ask your health care provider about how the COPM will be included within your fees for ongoing assessment and intervention.

Check with your health care provider if you are eligible for funding to assist with the assessment and intervention fees. People with disability living in Australia may also be eligible for a health care rebate through Medicare or funding from the National Disability Insurance Scheme.

Training

The COPM is a standardised measure. Formal resources are available outlining the instructions for using and scoring the assessment.

To administer the assessment, health professionals need to complete self-paced and guided training which is available in hard-copy (includes a training DVD) or through an online training module on the comprehensive COPM website.

Cost

The assessment itself is available in paper and pen form, as a digital pdf or through the COPM Web App for tablet, computer or smartphone.

Descriptions of the assessment, training options, practical examples for using it and the evidence base for COPM can also be found on the website. Different versions, including translations, can be purchased there.

Method

The client rates the importance of the activities which are selected in the interview with the health professional and prioritises up to five to focus on during intervention. Each of the five priority areas the client has chosen to focus on are rated using 10-point scales on two domains:

  • Performance – clients and family rate how well they can complete the activity
  • Satisfaction with Performance – clients and family rate how satisfied they are with their current ability to complete the activity.

After the client has completed their therapy or intervention, the health professional will again ask them/their family to score each of the five activities. The average of the scores for both Performance and the Satisfaction domains before and after the intervention are compared to see what progress has been made and whether the intervention needs to be adjusted.

Things to note

The COPM was developed to be used by occupational therapists to guide a client-centred approach to measuring the outcomes of therapy and interventions. It has also been adopted by other health professionals and health care and rehabilitation teams to guide client-centred, individualised care.

It is one of the most commonly used measures in paediatric rehabilitation, reflecting its usefulness in clinical practice and research, and user confidence in its psychometric properties2.

Psychometric properties reviewed

Validity – the COPM has good to excellent internal consistency of both Performance and Satisfaction scales in children with cerebral palsy (i.e., Cronbach’s alpha = 0.73 to 0.88)3. This is evidence of item cohesiveness and, thus, construct validity3. Further evidence for construct validity is demonstrated by overlap of items identified on the COPM with items on the Pediatric Evaluation of Disability Inventory and quality-of-life measures4. The COPM was found to have a significant overlap with problems identified by an open-ended-question interview - which is evidence for criterion validity4.

Reliability – Inter-rater agreement has been examined by comparing numbers of items and the mean scores of items that were prioritised in both of two administrations of the COPM, one week apart4. A median of 80% of items was consistent in both administrations of the COPM; this was considered sufficient for client-centred occupational therapy. Although there are no published reports of test-retest reliability of the COPM used with children, the COPM has strong test-retest reliability when used with adult client groups5.

Responsiveness – has been established by demonstrating that the magnitude of effect in experimentally proven interventions in randomised trials is substantially larger than the effect size in the comparison, control groups(e.g.,3,6). An increase of 2 points on the scale is considered to represent a clinically important change7.

NOTE: Assessments should have strong psychometric properties. These properties refer mainly to i) validity – whether the tool measures what it is meant to measure, ii) reliability – whether the results of the tool are stable under different conditions and, for tools which measure outcome iii) responsiveness – whether the test is responsive to change.
NOTE: Assessments should have strong psychometric properties. These properties refer mainly to i) validity – whether the tool measures what it is meant to measure, ii) reliability – whether the results of the tool are stable under different conditions and, for tools which measure outcome iii) responsiveness – whether the test is responsive to change.

Date of literature searches: March 2016

  1. COPM. The Canadian Occupational Performance Measure website. Accessed on March 24 2016 at: http://www.thecopm.ca/
  2. Tam, C., Teachman, G., & Wright, V. (2008). Paediatric application of individualised client-centred outcome measures: A literature review. British Journal of Occupational Therapy, 71(7), 286-296. See abstract
  3. Cusick, A., Lannin, N. A., & Lowe, K. (2007). Adapting the Canadian Occupational Performance Measure for use in a paediatric clinical trial. Disability and Rehabilitation, 29(10), 761-766. See abstract
  4. Verkerk, G. J., Wolf, M. J., Louwers, A. M., Meester-Delver, A., & Nollet, F. (2006). The reproducibility and validity of the Canadian Occupational Performance Measure in parents of children with disabilities. Clinical Rehabilitation, 20(11), 980-988. See abstract
  5. Carswell, A., McColl, M. A., Baptiste, S., Law, M., Polatajko, H., & Pollock, N. (2004). The Canadian Occupational Performance Measure: A research and clinical literature review. Canadian Journal of Occupational Therapy, 71(4), 210-222. See abstract
  6. Wallen, M., O’Flaherty, S. J., & Waugh, M. C. (2007). Functional outcomes of intramuscular botulinum toxin type A and occupational therapy in the upper limbs of children with cerebral palsy: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 88(1), 1-10.
  7. Law, M., Baptiste, S., Carswell, A., McColl, M. A., Polatajko, H., & Pollock, N. (2005). COPM Canadian Occupational Performance Measure (Vol. 4th). Ottawa, ON: CAOT Publications ACE. Manual for COPM not available free online.
Find out about CP Check-Up™

Cerebral Palsy Alliance offers a service called CP Check-Up™ which provides ongoing surveillance of the health and well-being of our clients aged 0-18 years.
The information on this page was developed using the best research evidence combined with the expertise of clinicians and people with cerebral palsy and their families. It is provided to help people with cerebral palsy, their families and caregivers, clinicians and service providers make decisions about suitable interventions. This information is intended to support, but not replace, information exchanged, and decisions made, between people with cerebral palsy, their families and health professionals.