The Roll Evaluation of Activities of Life(REAL)Kristen and William Roll, 2013

Melinda CooperOccupational Therapy ConsultantPearson Clinical Assessment

melinda.cooper@pearson.com

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Introducing the REAL2

What is the REAL?• Assesses children’s ability to care for

themselves at home, school and in the community

• For ages 2:0 – 18:11• Parent/caregiver questionnaire• Yields scores for

• Personal ADL• Instrumental ADL

What is the REAL?

• User guide• Rating form• Additional

questionnaires to identify caregiver concerns

• Additional functional mobility questionnaire

• Age-based parent handouts

Introducing the REAL3

Introducing the REAL4

Administering the REAL•Administration time approximately 15-20 mins

•Parent/caregiver completes rating form

according to child’s level of ability

• Unable to perform – 0%

• Seldom performs – 25%

• Occasionally performs - 50%

• Frequently performs - 75%

Introducing the REAL5

ADL Self-Care Domain• Dressing skills• Hygiene and Grooming skills• Feeding skills• Toileting skills• Functional mobility• Personal care devices e.g. use/care of

hearing aids, glasses (does not contribute to overall score)

Introducing the REAL6

Introducing the REAL7

IADL Home and Community Domain• Housework/chores e.g. cleans up, sets table,

loads dishwasher/washes dishes• Managing money and shopping e.g.

identifies value of coins, makes simple purchases

• Meal preparation e.g. makes a snack• Personal safety e.g. knows emergency

number, awareness of stranger/fire danger and responses

• Travelling e.g. travels to nearby familiar place• School-related skills e.g. brings needed

materials, completes homework on time, relays messages from parent/teacher

Introducing the REAL8

Introducing the REAL9

Interpreting the REAL

• Standard scores have a mean of 100 and standard deviation of 10 (no scaled scores)

• Compare PADL and IADL scores• User guide mentions combined composite score but this is not available in this edition of the test

Introducing the REAL10

Clinical utility of the REAL

● Screening / monitoring

● Identify strengths and weaknesses in daily living skills

● Informs top down goal setting and intervention

● Evidence-based tool for demonstrating progress

● Useful for children with developmental delays● Useful for placement decisions e.g. supported living, respite care

There’s so much more to learn

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