Individually Prioritised Problem Assessment (IPPA)

People with cerebral palsy can have everyday problems with their mobility, speech, communication, hearing and self-care. These can often be helped with equipment or assistive technology. The Individually Prioritised Problem Assessment (IPPA) measures whether a piece of equipment or assistive technology has reduced the challenges a person is facing, as intended1. Some examples of how this assessment can be used include to measure whether a person’s assistive technology has reduced repetitive strain from using a communication device, improved communication at work, or increased computer proficiency.

IPPA is known as an individualised, client-centred measure, because each person with cerebral palsy considers their own situation and identifies what is important to them.
The assessment can be used for any person with cerebral palsy - including both children and adults. People with communication difficulties, or a significant intellectual disability, and children under 16-years-old need a parent or carer to help.

The IPPA is completed by a healthcare professional with the person with cerebral palsy, along with their family and carers if needed. Before any equipment or assistive technology is selected, up to seven problems that need to be addressed may be identified. The importance and difficulty of each problem is scored by the person and/or their family. A total score is then calculated.

After the equipment or assistive technology has been used for a period of time - often two to three months - the person’s problems are then rated for a second time. Comparing these scores helps determine if the equipment or assistive technology has solved the problems.

If the IPPA identifies that the equipment or assistive technology is not helping the person with cerebral palsy as it was meant to, then new options for assistance can be explored.

It takes about 20 minutes to work out the problems and complete the ratings the first time the assessment is completed. For subsequent ratings, it can take even less time.

You can ask your health care provider about how the IPPA 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 person conducting the assessment should have adequate knowledge of assistive technologies and how different disabilities, such as cerebral palsy, can affect their use1,2. While there is no specific manual or website providing training in IPPA, users can find out more about the assessment by reading a journal article that describes its development and outlines the assessment procedures and scoring method.

Cost

There are no costs for training or purchase of materials.

Psychometric properties reviewed

Validity - although little research has been done on the validity of the IPPA, initial results suggest it has good validity in adults with disability2.

Reliability - little research has been completed on the reliability of IPPA. The combination of being an individualised measure, the subjective nature of the tool and the way that the health professional might influence problem generation means that inter-rater and test-retest reliability are low1,2. Reliability may be improved if the health professional receives consistent education in the assessment or if the same health professional completes the initial and follow up assessments1.

Responsiveness - the amount of change on the IPPA after the introduction of equipment and assistive technology has been found to be large in comparison to other measures - suggesting that the IPPA may be able to adequately measure change1-3.

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: October 2015

  1. Persson, J., Hellbom, G., Oberg, B., CMT; van Beekum, T., Oortwijn, W., Brodin, H., TNO; Lorentsen, O., Rehab-Nor; Andrich, R., Ferrario, M., SIVA; de Witte, L., Wessels, R., iRv. (2000). Efficiency of Assistive Technology and Services, Final Report, DE3101 EATS, Telematics Application Programme, Sector Disabled and Elderly, CMT, Linkoping, Sweden. Report available at: http://www.siva.it/research/eats/
  2. Wessels, R., de Witte, L., Andrich, R., Ferrario, M., Persson, J., Oberg, B., Oortwijn, W., VanBeekum, T., Lorentsen, Ø. (2000). IPPA, a user-centred approach to assess effectiveness of assistive technology provision. Technology & Disability, 13(2): p. 105-115. Abstract available at: http://content.iospress.com/articles/technology-and-disability/tad00076
  3. Jedeloo, S., De Witte, L., Schrijvers, G. (2002). A user-centred approach to assess the effectiveness of outdoor mobility devices and services. International Journal of Rehabilitation Research, 25(2): p. 137-141. Preview available at: http://journals.lww.com/intjrehabilres/Citation/2002/06000/A_user_centred_approach_to_assess_the.7.aspx
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.