Perceive, Recall, Plan, Perform

(PRPP) System of Task Analysis:

Assessment

PERCEIVE RECALL

PERFORM PLAN

INSTRUMENT
DEVELOPMENT
Chapparo, C., & Ranqka, J. (2012) PRPP instrument development.
In C. Chapparo and J. Ranka, PRPP Assessment Course research
training manual. (Available from authors in training courses)

PRPP Research Development: 2013 1

INTRODUCTION Patients had varying levels of physical and
cognitive ability from severe physical
The PRPP System of Task Analysis has limitations and residual post traumatic
evolved through a process of research amnesia to independence in mobility and
consisting of small clinical studies. This oriented to time and place. All patients were
section outlines the early development of the identified by their occupational therapists as
instrument to its present form. having some difficulty with cognitive
Contemporary studies are focused on further processes that interfered with optimum
establishing reliability and validity for its performance of occupational tasks.
use among various diagnostic groups and its
application to intervention. These studies are The videotaped performances were analysed
not documented in this section. They are in using the same task analysis format
the process of publication and/or can be described above. Errors were catalogued and
found on an updated occupational subjected to content analysis. Four main
performance website: error types were identified from the analysis.
www.occupationalperformance.com
→ Errors of accuracy (steps were
Early PRPP research was carried out in four inappropriate or wrong)
phases – each is outlined below.
→ Errors of omission (steps were left
out)
PHASE ONE: Development of Stage One
of the PRPP System of Analysis → Errors of repetition (steps were
unnecessarily repeated)
25 male (15) and female (10) adults between
the ages of 18 and 64 who did not have brain → Errors of timing (the total time taken
impairment were videotaped performing to complete the task was too long, or
eating, dressing and meal preparation tasks. too rushed)
Their performances were analysed using a
routine behavioural task analysis whereby Interrater agreement and intrarater
the task performance was broken down into consistency in error identification of this
major motor steps. The task steps were then part of the analysis was above 90%.
analysed to determine how similar the steps
were among the 25 adults and to give the This initial task analysis forms Stage One of
researchers some idea about the extent to the present two stage PRPP System of
which individual differences in performance Analysis and is used to set the criterion
of routine tasks were likely to be viewed as against which performance mastery of any
errors in performance. Although there were task is determined.
individual differences in the sequence of
some tasks (e.g. sandwich making), there
were not identifiable errors.

Test-retest consistency achieved for this

analysis on each task among 6 trained testers
ranged above 92%.

20 clients with brain injury who were

inpatients in a brain injury rehabilitation unit
were videotaped performing the same tasks.
PRPP Research Development: 2013 2
 Errors of recall
Difficulties classifying objects and body
parts, remembering how to use them and
fitting objects into a functional context

Errors of planning
Difficulties in planning what to do and how
to do tasks, problem solving before and
during task performance

Errors of performance
Difficulties in initiating task performance,
knowing when to stop or continue
Figure 1: Current Stage One analysis format performance to its completion
PHASE TWO: A system of classifying This formed the central core of the current
cognitive errors in performance of tasks PRPP System of Task Analysis conceptual
(Stage Two analysis) model.
Although the Stage One analysis allowed
therapists to identify breakdown in
performance of tasks, and to identify the
types of errors causing the breakdown in
performance, more information was needed
to determine the possible reason for errors
from a cognitive perspective.

45 adults with brain impairment were

videotaped performing dressing, eating,
grooming and meal preparation tasks within
their hospital environments. Stage One
analyses were completed and errors of Figure 2: First central conceptual core of PRPP System:
Four processing errors
accuracy, omission, repetition and timing
were noted.
PHASE THREE: Development of theory
Lists of errors were made and base
microanalyses were performed on each
error. Over 4000 errors were catalogued for A literature review of the body of
analysis. Categorisation of error types knowledge of perception and cognition as it
relative to the cognitive processes related to brain injury revealed one model
associated with the error fell into four broad of information processing that was
error types. congruent with the categorisation of error
types identified in Phase Two.
Errors of perception: Romiszowski (1984) (See references in last
Difficulties with attending to the task and section), an instructional psychologist, had
perceiving all of its elements developed a model of cognitive
requirements for skilled performance of
work tasks, which he called the Skill
Wheel. He proposed that difficulties in
PRPP Research Development: 2013 3
work performance (for example, typing) These studies revealed that all error types
could be explained relative to problems in were able to be described using the
perceiving, recalling, planning or constructs within the model in Figure 3,
performing aspects of the task. He further thereby lending support for the clinical
categorised these skill areas into 12 validity of the model.
subcategories.
Therapists suggested that, although this
Using the Skill Wheel constructs, a content descriptive approach was helpful to clinical
analysis on each of the error categories was practice, they needed a more concrete
done to determine if a similar breakdown of system of behavioural analysis that:
error type was possible relative to the
performance of the 45 patients with brain → Was based on discrete, observable
impairment. behaviours
→ Could be scored
Errors were able to be divided into twelve
distinct subcategories that were similar but PHASE FOUR: Development of the
not identical to Romiszowski’s descriptor behaviours
subcategories.
Using clients from a range of diagnostic
In two subsequent studies, using the twelve categories across a number of studies (TBI,
subquadrants, therapists were asked to view Stoke, Occupational Rehabilitation, Mental
videotapes of clients with brain impairment Health and Learning Disorders), videotaped
(TBI (25) and Stroke (15)) and categorise performances were broken down into the
performance errors. They were additionally twelve subcategories described in phase 3.
asked to identify aspects of performance
that were not able to be categorised. A total of 2001 errors in performance were
catalogued across the twelve subcategories.
Transcriptions of the videotaped errors were
analysed to determine the key descriptive
words that could be used to describe errors
made in each of the subcategories.

A list of possible key words was studied

and a final choice of single or paired words,
termed ‘descriptors’ (because they
described behaviour) was chosen according
to the following five criteria:

→ They were ‘doing’ words

→ They described a cognitive event
→ They were observable
→ They were everyday words, rather
than medical or jargon words (each
word and its meaning was to be
found in an English Dictionary)
Figure 3: The original twelve subquadrants of the PRPP → Each word was judged to best reflect
System of Task Analysis
the error type according to a ‘panel of
experts’

PRPP Research Development: 2013 4

Each descriptor was then operationally 2005 Revision
defined from three perspectives. First, the
Macquarie Dictionary (Australian) was used Further changes to the central core concepts
to define the essential meaning of each and the relationships between them were
word. Second, the original videotaped made in 2005 as a result of research.
performances of adults without impairment Differences between this conceptual model
were used to develop a definition of the and the previous one depicted on page 3
descriptor word relative to the usual include the following:
behaviour one would expect to observe
during performance of any task. Third, the o Changes in the conceptualised direction
videotapes of clients with impairment were of information flow from unidirectional
used to identify examples of the types of to bidirectional. Information flow
errors made relative to each descriptor. arrows between the quadrants indicate
information flow in two directions. This
A number of subsequent studies determined more adequately reflects a contemporary
inter and intra-rater reliability of the multidirectional view of information
descriptors. A few of the original descriptors processing theory (Hoffman, Paris &
were dropped from the test and others re- Hall, 1994), rather than the older
categorised, as results of the studies and unidirectional model (Broadbent, 1958).
feedback from therapists who used the The concept of bidirectional arrows are
instrument indicated the strength or the subject of further research in the
weakness of particular descriptors. developing PRPP System Intervention.

Over a six year period, the model pictured in o Addition of an arrow between Perceive
Figure 5 emerged and remained stable for and Plan subquadrants. This arrow has
some years, and is the most familiar to been added on the basis of research
people using the PRPP System. using the PRPP System of Task
Analysis that indicated a strong
relationship between attention, sensory
perception and planning in people with
brain injury (Munkhetvit, 2005), mental
health (Still, 2005), and autism (Lohri,
2005) (See following section).

PERCEIVE RECALL

Figure 4: PRPP System of Task Analysis Conceptual PERFORM PLAN

Model, 1999 - 2004

Figure 5: Changes in the central concepts of the PRPP

System and the relationships between them (2005)

PRPP Research Development: 2013 5

CURRENT FORMAT (2013) SUMMARIES OF EARLY AND
UNPUBLISHED RESEARCH USING
Changes: PRPP MEASURES AND CONCEPTS

Further research and clinical use of the The following are summaries of some of the
PRPP in practice areas which target clients research that has contributed to the
who experience sensory over-responsivity development and validation of the PRPP as a
prompted an addition of one descriptor in measurement tool. Many of these abstracts
the “Disciminating” subquadrant of have been prepared for peer reviewed papers
Perceive. The additional descriptor is termed at health science conferences, or are
regulates, and refers to the extent to which a abstracts from research theses.
person is able to discriminate the magnitude
of a sensory image during task performance. BRAIN IMPAIRMENT
The current conceptual model is pictured in
Figure 6. Cognitive Assessment in Patients with
As a result of widespread use in Australia, Acquired Brain Injury in Thailand
and non English speaking countries such as
Canada (French speaking provinces), Munkhetvit, P. (2005). Unpublished PhD Thesis. Available
from Faculty of Health Sciences, The University of Sydney.
Sweden, Austria (German), Switzerland Australia.
(German), Germany and Thailand, we have
had the opportunity to further refine the Background
language of the system, making the words Cognitive impairment is one consequence of
clearer and more consistent as descriptors of acquired brain injury (ABI) and is reported
behaviours that need to be observed. to have a profound effect on patients’
Changes to subquadrant names and selected occupational performance. Occupational
descriptors can be found by comparing therapists, as members of rehabilitation
Figure 6 below with models on the previous teams in Thailand provide assessment and
pages. None of the central definitions of the intervention for cognitive disorders that
words have changed. The following model is impact on everyday function after brain
the one currently in use from 2012. impairment. However, they do not have a
suitable cognitive assessment method that is
considered appropriate to Thai culture. The
Perceive, Recall, Plan and Perform (PRPP)
System of Task Analysis was developed in
Australia for use by occupational therapists.
Preliminary studies have demonstrated its
acceptable reliability and validity, as well as
clinical utility on samples of Australians
with a variety of disabilities including brain
impairment. The purpose this three phase
study was to investigate the usefulness of
this instrument in Thailand, and to further
explore the reliability of a modified version
of the PRPP System that was development
specifically for use by occupational
therapists in Thailand.

Figure 6: Current descriptors including changes to The first phase of the study was a small
subquadrant names and selected descriptors
qualitative study that examined the needs of
PRPP Research Development: 2013 6
Thai therapists relative to their perceived for assessment (dressing and hygiene), with
role in rehabilitation, and in cognitive all but four significant at the 95%
assessment in particular. The findings confidence level (Times .61 (hygiene);
indicated that western assessment Recalls Steps .55; Starts .43; Coordinates .00
instruments that had been in use in the (dressing).
country were considered inappropriate to Inter-rater reliability of ten therapists
Thai culture, language and role expectations. assessing ten patients with ABI across two
At the same time, however, therapists task areas (hygiene and dressing) indicated
wanted a standardised way of measuring the acceptable inter-rater reliability based on
impact of cognitive disorder on occupational total quadrant scores, with ICCs ranging
performance as an alternative to subjective from .65 to .83. All but one subquadrant
observation. The PRPP System of Task (Control .26) demonstrated acceptable inter-
Analysis was identified as a potential rater reliability (ICC ranging from .46 - .83).
measurement tool due to its ecological focus All but four of the 33 descriptors
and its standardised format. demonstrated acceptable inter-rater
reliability (Analyses, Identifies Obstacles,
Phase two of the study piloted the use of a Recalls Steps, Times), with ICCs ranging
Thai language version of the Australian from .46 - .83.
PRPP System with Thai patients who had
sustained ABI. Statistical analysis Evaluation of its utility by Thai therapists
demonstrated the capacity of the PRPP who had received training indicated its
System to identify information processing effectiveness of use in Thailand and presents
deficits during performance of everyday evidence of its cultural adaptability.
tasks, as well as its sensitivity to
performance change. Sixteen therapists who The Impact Of HIV1 Dementia (HIV1-D)
received training in a Thai translation of the On The Performance Of Everyday Tasks
original PRPP System of Task Analysis
assessed 26 patients with ABI during Ranka, J. (2011). DHlthSc Thesis Abstract. The School of
Occupation and Leisure Sciences, The University of Sydney,
drinking, eating, and dressing tasks and re- NSW, Australia.
assessed performance after two weeks.
Results indicated that it was responsive to A common and clinically important
change and therefore potentially useful to complication of late stage human
measure change in both performance and immunodeficiency virus Type 1 (HIV-1)
processing skill. infection is HIV-associated neurocognitive
disorder (HAND). HAND encompasses
Phase three investigated the reliability and three syndromes, HIV-associated
usefulness of a simplified screening tool that asymptomatic neurocognitive impairment
modified the original 3 point scoring system (ANI), HIV-1- associated mild
to a dichotomised 2 point scoring system. neurocognitive disorder (MND), and HIV-1-
The modified version demonstrated associated dementia (HAD). It is estimated
excellent test-retest reliability, whereby the that 30-60% of all HIV-1 infected
intra class correlations (ICC) (McGraw & individuals will have at least mild
Wong, 1996) for total quadrant scores were neurocognitive impairment (MND), and 10-
.96 for Perceive and Recall, .94 for Plan and 15% of those will develop HAD. Research
.92 for Perform. Test-retest reliability for conducted outside medicine has focused on
subquadrants ranged from .72 (Controlling) identifying the type and pattern of
to .96, with all but one subquadrant above neuropsychological impairments present in
.81. Test-retest reliability for 33 descriptors people with HAND, and to correlate
ranged from .75 to .99 across two tasks used impairments identified from
PRPP Research Development: 2013 7
neuropsychological testing with scores on errors of Accuracy; they made mistakes in
laboratory-based tests of everyday task what they did.
performance.
Descriptive analysis of the PRPP Stage Two
Typically, the performance of tasks and scores revealed that these men had
routines in daily life occurs in naturalistic difficulties across all domains of information
contexts, and is orchestrated around the processing strategy application but most
achievement of personally meaningful, notably with Plan Quadrant (Mean 30.75%)
needed and/or desired performance goals. It and Perceive Quadrant (Mean 53.49%)
requires that one uses cognitive strategies to strategy application behaviours. Rasch
attend, perceive, remember, decide, plan and calibration of the ordinal PRPP Stage Two
act on intentions within real-world contexts. strategy application scores produced an
Little is known about the impact of cognitive interval-level linear hierarchy of information
information processing strategy application processing strategy application difficulties
impairments on the performance of experienced by the group. Men in the
meaningful tasks and routines carried out by sample demonstrated problems sequencing
people with HAND in contexts where complex tasks, choosing plans and actions,
performance would naturally occur. analysing problems encountered, and
monitoring sensory changes during
This research addressed this gap by performances. Problems were also identified
investigating the real-world impact of in their abilities to contextualise their
information strategy application disorder in performances to fit within time constraints
a sample of 30 men diagnosed with HAD, (Contextualises to Duration), and enact
the most severe form of HAND. The home plans in a fluid manner (Flows).
contexts of those in the sample consisted of Differences in performances between men
home, supported living and residential care. with mild dementia versus those with
moderate/severe dementia identified using a
The criterion-referenced Perceive, Recall, 2 x 4 repeated measures ANOVA carried out
Plan and Perform (PRPP) System of Task on the Rasch-calibrated PRPP Stage Two
Analysis was used to identify the level of scores revealed similarities in performance
task performance mastery demonstrated by across Perceive, Recall, Plan and Perform
men in the sample (Stage One), and the Quadrants but those with mild dementia
information processing strategy application performed better overall. Further analyses
errors that impacted on their performances revealed specific differences in performance
(Stage Two). The Clinical Staging of AIDS between those with mild versus those with
Dementia Complex (CSADC) scale was moderate/severe dementia. Most striking
used to identify the level of severity of about the findings was that men at both ends
HAD. of the dementia spectrum had relatively
good Recall Quadrant strategy application
A total of seventy one task performances capacities (Mean 75.30%). Even those with
were assessed across the sample in a variety the lowest total PRPP Stage Two scores,
of naturalistic contexts. None of the men in could recognize and use objects, and recall
the sample demonstrated mastery of task the procedures of known tasks. A
performance. The mean Mastery score was statistically significant predictive correlation
30.07%. The predominant type of error was found between Plan Quadrant disorders
made by men as they performed daily life and severity of dementia.
tasks was Timing; they spent too much time
completing tasks. This was followed by This pilot study demonstrated the utility of
the PRPP System, a criterion-referenced,
PRPP Research Development: 2013 8
occupation-embedded, ecological method of ability to relearn cognitive skills for daily
identifying task performance skill and function. These initial research findings
information processing strategy application directed subsequent research phases, in
disorders impacting on performance, for use which an information processing model was
with people living with HIV/AIDS who adopted to examine application of cognitive
have HAD. Identifying the specific impact strategies during occupational performance.
of information processing strategy
application disorders on real-world task An emerging occupational therapy
performance provides occupational assessment, The Perceive, Recall, Plan and
therapists with information necessary to Perform (PRPP) System of Task Analysis,
more specifically tailor therapy to the was selected as the primary method for
individual performance and participation evaluating how application of cognitive
needs of people with HIV-1-associated strategies during occupational performance
dementia. is affected in agitated patients.

Occupational performance and Clinical utility of this measure was

information processing in adults with established in a case study of an adult
agitation following brain injury demonstrating severely agitated behaviour
during inpatient TBI rehabilitation, followed
Nott, M. (2008). PhD Thesis Abstract. School of Occupation by examination of instrument reliability and
and Leisure Sciences, The University of Sydney, NSW.
Australia (Supervisor, C. Chapparo, R. Heard) validity with ten experienced occupational
therapists and five adults with agitated
Agitation following traumatic brain injury behaviour following brain injury. The PRPP
(TBI) is characterised by a heightened state System of Task Analysis emerged as a valid
of activity with disorganised information and reliable method for determining strategy
processing that interferes with learning and application deficits during occupational
achieving functional goals. This thesis performance of adults with agitated
outlines a series of studies across four behaviour, in acute stages of TBI
research phases, investigating how rehabilitation.
occupational performance of adults with TBI
is affected by agitated behaviour and Consistent patterns of processing deficits
information processing difficulties. were related to the Perceive and Recall
Quadrants of the PRPP System. The
Clinicians report the presence of agitation assessment tool forms part of a dynamic,
interferes with engagement in therapy and interactive assessment and intervention
achievement of rehabilitation goals. system.
Research Phase One used a retrospective
chart review of 80 adults with severe TBI to The PRPP System of Intervention was
identify a high incidence of agitated evaluated in the final research phase, using
behaviour during inpatient TBI an experimental single case design with
rehabilitation. Agitated behaviour was replication across eight adults. The
associated with lengthier rehabilitation effectiveness of PRPP Intervention was
admission, prolonged duration of post- examined in comparison to conventional
traumatic amnesia (PTA), and poor occupational therapy in an ABAB design.
cognitive functioning at discharge. The Efficacy of the PRPP Intervention was
association between agitation and poor demonstrated, with patients applying
cognition persisted for at least two years significantly more information processing
after discharge, highlighting the significant strategies to occupational performance tasks
impact of agitated behaviour on people’s during PRPP Intervention than during
PRPP Research Development: 2013 9
conventional occupational therapy sessions. Therapy frequency was consistent between
Agitated behaviour concurrently reduced study interventions.
over the period of the study. Relationships
between information processing and agitated Results: Initial findings suggest increased
behaviour are hypothesised. use of cognitive strategies during
occupational tasks following the PRPP
Cognitive strategy intervention for adults Intervention. Findings to be presented
with brain impairment in a Transitional include pre-post intervention comparisons
Living Unit between "current" occupational therapy
(control) and PRPP Intervention
Nott, M., Chapparo, C., Hummell, J., Pearse, S., & Hunt, J.
(2013). Published Abstract: Occupational Therapy Australia, (experimental). Differences in use of
25th National Conference and Exhibition, July. Australian cognitive strategies, task performance,
Occupational Therapy Journal, 60, Supplement 1, p.46.
community adaptation, supports required,
Introduction: Cognitive rehabilitation is level of independence and goal attainment
most effective when a specific treatment will be evaluated. Client engagement with
approach known as cognitive or each intervention will also be evaluated.
metacognitive strategy instruction is used.
The Perceive, Recall, Plan and Perform Conclusion: TLU outcomes may be
(PRPP) System is a dynamic assessment and enhanced by adopting a cognitive strategy
intervention system based on cognitive based intervention.
strategy application during everyday
functional tasks. To date the intervention
component of this system has received WORK
limited investigation. Chronic pain: impact on information
processing at work
Objective: To compare functional,
Chapparo, C., Innes, E., & Ranka, J. (2005). Funded by a
cognitive, and participation outcomes of a Research and Development Grant. The University of Sydney.
transitional living unit (TLU) occupational Australia.
therapy programme based on the current
intervention approach and following Chronic pain has been linked to reduction in
introduction of the PRPP System of short term memory, slow reaction times,
Intervention. poor attention, difficulties with problem
solving and poor judgment (Bootes &
Methods: Single centre, controlled Chapparo, 2002). There is little evidence of
comparison study. Projected sample of 20 the extent to which pain impacts on
adults with brain impairment (currently information processing required for work.
n=9). Changes from TLU admission to
discharge were evaluated using the PRPP This study used the Perceive, Recall, Plan
System of Task Analysis, and Perform (PRPP) System of Task
neuropsychological tests, Mayo-Portland Analysis to determine the impact of chronic
Adaptability Index, Care and Needs Scale, neck and/or back pain on the efficacy of
Functional Independence Measure, task-embedded information processing
Rehabilitation Therapy Engagement Scale, required for satisfactory job performance.
and Goal Attainment. "Current" Using a group comparison design,
occupational therapy assumed a functional information processing abilities of 10 people
approach with graded support in a semi- with chronic neck/back pain who were in
structured residential environment. The paid employment were compared with a
PRPP intervention used a cognitive strategy matched control group of people without
training approach in the same environment. chronic pain. In addition, self-report
PRPP Research Development: 2013 10
measures of processing by the employee people with an acquired brain injury on
were compared with those of an external return to work.
evaluator.
Methods: 32 people who had returned to
Findings revealed the following: (1) pain work post-ABI (20M, 12F; 28-65yrs) were
subjects rated job tasks that were made interviewed using the PRPP@WORK (Q/I),
“easy” or “difficult” based on their an interview form of the Perceive, Recall,
perceived impact of pain on information Plan and Perform System of Task Analysis
processing; (2) there were differences to determine their capacity to apply
between pain and control group measures of cognitive strategies while carrying out a
perceived information processing ability to specific job in their work environment. Data
use attention, recall and planning strategies were obtained from the person with ABI,
required for job tasks; and (3) there were and an employer or supervisor. A many
differences in the impact of chronic pain on faceted RASCH model was used to examine
job related information processing ability, as the relationship between the person with
perceived by pain subjects and their ABI and the difficulty of each cognitive
employers or an external evaluator. strategy measured by the PRPP@WORK.

The long term outcome of this study was to Results: A hierarchical ordering of easiest
establish an assessment model suitable for to hardest PRPP@WORK (Q/I) cognitive
use in the work environment that had the items conformed to conceptual models of
capacity to identify the impact of chronic information processing. Higher order
pain on processing information required for executive functions requiring problem
work. solving, multiple feedback loops, working
memory, and self-monitoring were found to
Cognitive Strategy Application: be the most difficult during work
Measuring the Impact of Acquired Brain performance.
Injury on Return to Work
Bootes, K., Chapparo, C., & Heard, R. (2013). Published Conclusion: The PRPP@WORK (Q/I) can
Abstract: Occupational Therapy Australia, 25th National be used to identify ease and difficulty in
Conference and Exhibition, July. Australian Occupational cognitive strategy use during work
Therapy Journal, 60, Supplement 1, p.107.
performance.
Introduction: Following Acquired Brain
Injury (ABI), people may experience Is there a difference between the capacity
inefficient use of cognitive strategies which to apply cognitive strategies during
impact return to work. However, few procedural and social components of job
workplace assessment tools capture the performance by people with ABI who
effect of cognitive difficulties upon work return to work?
performance in situ. The Motor Accident Bootes, K., Chapparo, C., & Heard, R. (2013). Published
Authority recommends that any testing of Abstract: Occupational Therapy Australia, 25th National
Conference and Exhibition, July. Australian Occupational
cognitive capacity of people with ABI be Therapy Journal, 60, Supplement 1, p.108.
accompanied by interview with a significant
other, and that data about performance be Introduction: Difficulty with social and
compared with the self-report from the interactive components of work is thought to
person with ABI. stem from the same disorder in cognitive
strategy application after acquired brain
Objective: To discover difficulties with injury (ABI). Few workplace assessment
cognitive strategy use that is experienced by tools capture the effect of inefficient
PRPP Research Development: 2013 11
cognitive strategy use upon both task and
social aspects of work performance in situ. MENTAL HEALTH
Measuring function:
Purpose: To determine whether people with The Perceive, Recall, Plan and Perform
ABI experience similar difficulties with System of Task Analysis
applying cognitive strategies to social and
Still, M., Beltran, R., Catts, S., & Chapparo, C. (2002).
procedural components of work Cognitive and functional assessment of patients with early
performance. r psychosis. Acta Psychiatrica Scandinavica Supplementum,
413(106), 40-41 Published abstracts from 3rd International
Conference on Early Psychosis, Copenhagen, Denmark,
Methods: 32 people who returned to work September.
post-ABI (20M, 12F; 28-65yrs) were Still, M., & Chapparo, C. (2004). Australian Society for
Psychiatric Research Conference. Queensland. Australia.
interviewed using the PRPP@WORK (Q/I),
an interview form of the Perceive, Recall,
Introduction
Plan and Perform System of Task Analysis
Despite the significance of functional
which examines the cognitive capacity to
impairments for people living with
carry out both procedural (steps) and social
schizophrenia, appropriate evaluation of
(interactions) components of the job. Two
functioning has been under researched.
separate ratings, one for task performance
Recent investigations linking functional
and one for social interaction for 34
outcomes and cognitive impairment have
cognitive strategy items were obtained from
shifted the focus to measures that tap aspects
people with ABI and employers. A many
of information processing.
faceted RASCH model was used to examine
the relationship between the person with
Method
ABI, difficulty of each cognitive strategy
23 Participants (22 M; 1F) were recruited
measured, social and procedural dimensions
from two early psychosis programs South
of work.
West Sydney and Newcastle, Australia, as
part of a larger study and rated using the
Findings: Cognitive strategies that were PRPP System. Average number of years of
most and least challenging during social formal education was 11.5 (SD = 2.0)
interaction were similar to those required for
successful task performance and included: Inclusion criteria:
recognising the meaning of interactions, Within 2 years of first episode
using body language during social 18 – 25 years of age
interaction, calibrating the proportion of Reasonable English language skills
social interaction and persisting with Absence of major co-morbidity
communication. DIP rated diagnosis:
17 paranoid schizophrenia
Conclusion: Similar cognitive strategies 4 undifferentiated schizophrenia
underpin both procedural and social work 1 schizoaffective disorder
performance. People with ABI may 1 other non-organic psychotic
experience additional difficulties with social disorder
interactions involving knowing, using and All were taking atypical neuroleptics
persisting in the use of appropriate
behaviours during work tasks PRPP Task Selection
For the purposes of the study, a common
task was chosen for PRPP Assessment.
Shopping for food was selected, as all
patients have to go or have been to the shops
PRPP Research Development: 2013 12
at some point and participants reported
problems with shopping after psychosis. The Correlational analysis among quadrants
task was chosen because it involved some indicated significant relationship between
complex steps, limiting the chance of any Plan and Perceive (r = .686, p < .001), Plan
ceiling effects. It could be easily used in and Recall (r = .666, p = .001) and Plan and
both research sites and is an example of a Perform (r = .559, p = .006) Quadrants,
task that occurs in a community suggesting that Planning is related to each
environment, allowing assessment of how aspect of task performance.
the participant managed unexpected
situations and utilized everyday Conclusion
environmental cues. It was not culturally or This exploratory data suggest that:
gender biased, as the participants were able
to select what they would normally need for o Young people who present with first
eating. onset schizophrenia are likely to
experience cognitive deficits that impact
Participants were then asked to perform the on their everyday performance.
task. Specific instructions were provided o The absence of symptoms does not
regarding retaining receipts, and entering guarantee the absence of processing
each shop only once. Once en route, errors.
participants were also asked to purchase a o Complex and open tasks are most likely
stamp. The assessment was well tolerated to show cognitive deficits.
by all participants. o Difficulties with planning accounts for
many errors in performance.
Results o The PRPP is feasible for use in
Non-parametric and descriptive statistics schizophrenia and may meaningfully
were used to investigate relationships among gauge the impact of cognition on daily
the data collected. function.

Stage One Analysis - PRPP Total scores of The relationship between dimensions
Stage One above 80% generally indicates of insight, positive and negative
performance that enables safe, independent symptoms in schizophrenia and
completion of all steps of the task. The
information processing capacity
results suggest this participant sample
performed approximately 1 SD below a safe
during an everyday shopping task.
performance level. The most common error Chapparo, C., Still, M., & Beltran, R. (2008). Abstract. OT
type in Stage One was errors of accuracy (M Australia Federal Congress, Melbourne, September.
= 6.0, S.D = 3.0), followed by errors of
timing (M = 5.6, S.D = 3.7), omission (M = Background: It has been reported that lack
4.0, S.D = 2.7) and repetition (M = 3.1, S.D of insight is significantly associated with
= 1.9). cognitive disturbance, psychopathology and
functional outcomes in schizophrenia. This
Stage Two Analysis indicated the type of exploratory study used a descriptive, cross
processing errors observed during task correlation design to examine the
performance. The PRPP Total Stage Two relationship between dimensions of insight,
performance score correlated with both the positive and negative symptoms and
Recall (rs = .879**, p < .001) and Plan (rs = information processing capacity during an
.598**, p = .003), suggesting that in this everyday shopping task.
population, total performance is made up Methods: 23 young adults with first onset
primarily of errors in planning and memory. schizophrenia, and schizoaffective disorder
PRPP Research Development: 2013 13
were rated on a functional measure of task Five stages were involved in development of
embedded cognition (the Perceive, Recall, the instrument.
Plan and Perform (PRPP) System of Task
Analysis), the Scale for the Assessment of Stage One: Literature Review and PRPP
Positive Symptoms (SAPS), the Scale for Training
the Assessment of Negative Symptoms The first stage of creating the PRPP Teacher
(SANS) and the Schedule for Assessing Questionnaire involved study of the existing
Insight-Extended (SAI-E). PRPP System of Task Analysis tools, their
Results: Deficits ranging from mild to structure and mechanics. An example of one
severe were found in all measures used. such tool that applied to this study is the
Results suggest that neurocognitive function PRPP Rating Scales (Parent and Teacher)
during task performance is significantly (Fordham, 2001). In addition, the researcher
related to clinical measures of schizophrenic completed instrument training at a graduate
psychopathology and insight in this first level in the use of the parent tool, the PRPP
episode group. This suggests that therapists System of Task Analysis and was deemed to
be aware of the need to assess cognition in have established reliable use in the terms
early onset of the disorder and develop and constructs as well as the scoring system
cognitively mediated strategies to enhance (Chapparo & Ranka, 2004).
both occupational coherence and insight
during everyday task performance. In addition to reviewing the PRPP System
and associated instruments, the general
abilities of children in a school context were
studied. Since this instrument was developed
AUTISM specifically for use with children who have
problems with learning (learning disabilities,
Development of the PRPP Teacher ASD), meetings were arranged with delected
Questionnaire for Children with Autism children with learning problems, their
parents, carers and teachers. Through these
Lohri, J. (2005). Information processing and sensory resources, information was gathered about
processing abilities of young children with ASD. Unpublished
Honours Thesis. Available from The School of Occupation the expectations of teachers, parents and
and Leisure Sciences, The University of Sydney, NSW. carers, some of the typical occupational
Australia. (Supervisor, C. Chapparo) performance abilities the children were
required to perform in class, as well as the
Occupational therapists are interested in how types of assessments that would be the most
children perform school occupations. useful for the assessment of information
Specifically, as modes of intervention processing.
become consultant and school based, rather
than clinic based for children with learning Stage Two: Creating the Questions
and developmental disorders, the opinion of
teachers is sought to assist in the assessment Once the background research was
process. The PRPP Teacher Questionnaire completed, an initial list of 80 possible
was developed to obtain data about teacher’s questions was developed by converting each
perceptions of children’s ability to process PRPP descriptor into a question that was
information relative to school tasks that are relevant to children with learning disabilities
considered important by them, their parents in primary (grade) school. Out of these 80
and their teachers. This abstract summarises initial questions, 34 were chosen for the
a pilot study that established preliminary final questionnaire. The questions that
test-retest reliability for the instrument. remained were judge by one of the
developers of the PRPP System of Task
PRPP Research Development: 2013 14
Analysis (Chapparo, 2004, personal performance was rated. This was included to
communication) to be the best examples of ensure that the questionnaire was completed
the target descriptor, based on: in the manner expected of a criterion
 The extent to which each question referenced assessment, dealing with
reflected the original PRPP descriptor particular criterion for particular contexts,
 Ease of understanding by people who rather than judgment of abilities in general.
are not trained in its use, such as
teachers Stage Five: Pilot Study
 Brevity
 Application to school context. The instrument was trialled on a small
sample population of ten teachers. The
Stage Three: Scoring objective of the pilot was to measure test-
retest reliability. This type of reliability is
Once the format of the questions was the most common indicator questionnaire
finalized, scoring criteria were developed. A reliability (Litwin, 1995). For the purpose of
five point rating scale was used to: this study, teachers from Specific School
 Increase the accuracy of the PRPP Program (SSP) classes in the Sydney area
System by providing a larger variety of completed the questionnaire two times, a
possible performance indicators fortnight apart. The target sample was
 Formulate a scoring system that children with ASD.
coincided with the five point scale
obtained on other measures commonly Results
used with the instrument (e.g. The Mean scores of the children were calculated
Sensory Profile) for Test One and Test Two. These scores
 Overcome reported difficulties in were then placed into a category of
statistical analysis of the 3/2/1 scale of ‘acceptable performance’ (31-45 Recall and
the parent tool (Bryman & Cramer, Plan; 28-40 Perceive and Perform);
1997). ‘probably difficulty’ (24-30 Recall and Plan;
The scoring of the questionnaire ranged 21-27 Perceive and Perform); and ‘definite
difficulties’ (9-23 Recall and Plan; 8-20
form a score of 1 which indicates that the
Perceive and Perform). This scale was based
child ‘very seldom’ performs the target
behaviour (e.g. concentrate without being on each descriptor question yielding a score
distracted long enough to do the task), to the of ‘1’ or ‘2’ (definite difficulty); ‘3’
(probable difficulty), or ‘4’ or ‘5’
highest score of 5, indicating that the child
(acceptable performance).
‘almost always’ performs this behaviour
when needed.
All the total quadrant scores except for
Stage Four: Instructions ‘Recall’ fell into the same category in Test
One and Test Two (See Table 1).
The final stage of development prior to Quadrants Test Test Test 1 Test 1
completing the pilot study on this 1 2 Category Category
questionnaire was to write a comprehensive Perceive 24.83 25.17 Probable Probably
difficulty difficulty
yet simple explanation of how to complete Recall 32.17 28.67 Acceptable Probable
the questionnaire. This information was difficulty
written to ensure that the questionnaires Plan 23 22.17 Definite Definite
Difficulty Difficulty
were completed in the same manner by all Perform 19.17 18.67 Definite Definite
teachers. In addition to instructions for Difficulty Difficulty
scoring, a section was created requiring
Table 1: Test Retest Quadrant Raw Scores and
teachers to list five tasks against which Categories
PRPP Research Development: 2013 15
 All but the ‘Control’ sub quadrant scores confidence intercal and the upper 95% confidence
interval for test-retest reliability
fell into the same category in Test One and
Test Two (See Table 2). Although the
Out of the four PRPP Quadrants, all were
Recall and Control scores fell into different
whoen to have significantly high ICC scores
scoring categories between tests one and
indicating the stability of the total quadrant
two, the difference was minimal, as both
score on the Teacher Questionnaire. The
mean scores were on the fringe of each
PRPP Subquadrants scores were also found
category.
to be stable, except for discriminating
Sub Test Test Test 1 Test 1
(Perceive) and initiating (Perform), as
Quadrants 1 2 Category Category shown in Table 4, which achieved moderate
Attending 8.33 9.33 Prob. Prob. reliability.
difficulty difficulty
Sensing 9.17 9.5 Prob. Prob.
difficulty difficulty SubQuadrants ICC Lower Upper
Discriminating 6.83 6.33 Def. Def. CI CI
difficulty difficulty Attending 0.84 0.31 0.98
Remember 10.67 8.83 Def. Def. Sensing 0.94 0.65 0.99
facts difficulty difficulty Discriminating 0.64 -0.23 0.94
Remember 10.67 9.5 Prob. Prob. Remember facts 0.81 0.08 0.97
scheme difficulty Difficulty
Remember 10.83 10.33 Prob. Prob.
Remember scheme 0.81 0.23 0.97
steps difficulty Difficulty Remember steps 0.91 0.56 0.99
Mapping 7.83 7.33 Def. Def. Mapping response 0.85 0.31 0.98
response difficulty difficulty Programming 0.99 0.91 0.99
Programming 8.17 8 Prob. Prob. Evaluating 0.96 0.77 0.99
difficulty Difficulty Initiating 0.74 0.08 0.96
Evaluating 7 6.83 Def. Def.
Continuing 0.96 0.77 0.99
difficulty difficulty
Initiating 4.17 4.83 Def. Def. Controlling 0.93 0.31 0.99
difficulty difficulty
Continuing 6.67 6.33 Def. Def. Table 4: Intraclass correlation coefficient (ICC), the
difficulty difficulty lower 95% confidence interval and upper 95% confidence
Controlling 8.33 7.5 Prob. Def. interval for test-retest reliability of the PRPP Teacher
difficulty difficulty Questionnaire Subquadrant scores

Table 2: Test Retest SubQuadrant Raw Scores and

Categories Summary
This article describes the process used to
Intraclass correlational techniques were used develop the PRPP Teacher Questionnaire for
to measure the relationship between Tests use with children with learning and
One and Two. Intraclass correlation was developmental difficulties such as ASD. A
considered the most reliable test to measure pilot study gathered data from 10 teachers of
the test-retest reliability for this pilot study. children with ASD who assessed their
An intraclass correlation above 0.75 primary school students two weeks apart
indicates good reliability (Portney & using the PRPP Teacher Questionnaire.
Watkins, 2000). Table 3 shows the results of Results of analysis using intraclass
this analysis for the total quadrant scores. correlation coefficient indicated the total
quadrant and subquadrant scores to be a
Quadrants ICC Lower CI Upper CI stable measure of information processing.
Perceive 0.89 0.41 0.96 Further research is required on larger
Recall 0.87 0.38 0.98 samples of teachers and children to further
Plan 0.97 0.84 0.99 confirm its reliability.
Perform 0.96 0.76 0.99

Table 3: PRPP Teacher Questionnaire Quadrant

Intraclass Correlation (ICC) showing the lower 95%

PRPP Research Development: 2013 16

 Sensory and Information Processing of Registration” and “Sensation Seeking”
Children with ASD at School behaviours) (See Figure 1).

Lohri, J., & Chapparo, C. (2005). Assessing sensory Teachers rated children with ASD relative to
processing and praxis in children with ASD. Book of
Abstracts: Skills for Kids OT Australia Paediatric their usual classroom performance on the
Conference, p.57, Melbourne, Australia. SSP items. Scores were computed for each
sensory processing domain and assigned a
Background category of “definite difference”, “probably
Autism Spectrum Disorder (ASD) is a difference” or “typical performance” when
neurobiological disorder identified by three compared to normative data.
diagnostic markers: impairment in social
interaction and communication, and a Results
restricted, stereotypic mode of behaviour  A significant majority of children was
(APA, 1994). Although poor processing and judged by their teacher as demonstrating
regulation of sensory input is a primary sensory processing that was different from
source of behavioural disturbance of young typical children in the first four domains of
children with ASD (Walting, Deitz & White, sensory processing listed in the following
2001), little is known about its impact on table and typical performance in the last
cognitive and motor abilities, except that it three.
disrupts home and classroom performance.
Underresponsive/Seeks sensation
Purpose
The purpose of this non-experimental, Taste/Smell Sensitivity
exploratory study was to examine the Auditory Filtering
sensory and information processing abilities Tactile Sensitivity
of young children with ASD within the Low Energy/Weak
context of school performance. Movement Sensitivity
Visual/Auditory Sensitivity
Participants Table 1: Teacher judgements of sensory processing
30 primary school children with formal difficulties in children with ASD across 7 sensory
diagnosis of ASD (m=25, f=4: mn age = 6.4 processing domains in rank order
years).
 Children with ASD demonstrated
Research Question 1 both underresponsivity and
What are the in-class sensory processing hyperresponsivity in different sensory
abilities of young children with ASD in systems
comparison to typical children?
Research Question 2
Instrument What are the in-class information
Short Sensory Profile (SSP) (Dunn, 1999) processing abilities of young children with
A reliable, judgement based ASD in comparison to criterion
caregiver/teacher questionnaire, rating the performance?
frequency of four behavioural response
typologies that are thought to relate to a Instrument
sensory threshold across seven sensory Perceive, Recall, Plan and Perform System
processing domains, indicating of Task Analysis (PRPP)Teacher
hypersensitivity to input (“Sensory Questionnaire (Chapparo & Ranka, 2003)
Sensitivity” and “Sensory Avoidance” A reliable criterion referenced assessment
behaviours) or hyposensitivity (“Poor whereby teachers rate the effectiveness of 34
PRPP Research Development: 2013 17
observable information processing planning and task persistence, as indicated in
behaviours during task performance across the table below. Sensory sensitivities noted
four processing domains: attention and previously were not linked to difficulties in
sensory perception; recall; planning and information processing for planning.
controlling motor performance, and twelve PRPP measures, mapping or planning
related subcategories. Scores were computed responses and attention, were linked to
as “definite difficulty”, “probable difficulty” auditory filtering on the SSP, probably
or “acceptable performance” for each indicating the need for sufficient language to
processing domain and subcategory. follow commands and focus attention in
order to plan.
Results
 A significant majority of the children
found ‘Plan’ behaviours the most difficult PRPP SSP
(see shaded subcategories in the following
table) Mapping response Underresponsive/
 Teachers judged ‘Recall’ of known (planning) seeks sensation
classroom routines (procedures and facts) as Attention (On task Underresponsive/
the most effective information processing focus) seeks sensation
abilities, except when behaviour had to be
Continuation (task Underresponsive/
contextualised in time and place (Task persistence) seeks sensation
Scheme)
Self Evaluation Underresponsive/
seeks sensation
PRPP Subcategory
Continuation (effort) Attention (task Auditory Filtering
Action Map (outcome plan) focus)
Initiation (starting/stopping)
Evaluation (self assessment) Mapping response Auditory Filtering
Tactics (planning how to do) (planning)
Task Scheme (knowing when/where/how Table 3: Relationships between subquadrants on PRPP
Teacher Quesionnaire and sections of the Short Sensory
Attention Profile.
Control (timing actions)
Image Formation (sensory perception) Summary
Task Procedures (remembering routines) A significant majority of children in this
Image Discrimination (sensory)
sample had sensory processing that was
Classification (knowing facts)
different from typical children in four
Table 2: The 12 information processing subcategories of domains of sensory processing and similar
the PRPP System in ranked order of difficulty as judged to typical performance in three. A
by teachers
significant majority of the children found
Research Question 3
‘Plan’ behaviours the most difficult
What is the relationship between
information processing during class tasks.
sensory processing and information
‘Recall’ of known classroom routines was
processing abilities in children with
the most effective information processing
ASD during classroom activities?
ability during class tasks, except when
behaviour had to be contextualised in time
Using the data generated by the SSP and the
and place. There is a stronger link between
PRPP Teacher Questionnaire,
underresponsivity to sensory input and
intercorrelations among the subsections of
selected information processing strategies,
the two measures indicated relationships
than between hypersensitivities and
between underresponsiveness to sensory
information processing.
input and difficulties with attention,
PRPP Research Development: 2013 18
 Classroom Based Sensory Diets for cognitive processing such as attention, as
Children with Autism Spectrum measured by the PRPP System of Task
Disorders (ASD): A pilot study using Analysis.
single system design
Conclusion: This study contributed to the
Mills, C., & Chapparo, C. (2013). Published Abstract:
Occupational Therapy Australia, 25th National Conference evidence base for sensory diet intervention
and Exhibition, July. Australian Occupational Therapy for children with ASD and adds to the
Journal, 60, Supplement 1, p.34-35.
practice knowledge of professionals working
in this area of practice.
Introduction: Although research indicates
the presence of sensory processing
difficulties in children with ASD, limited SOCIAL BEHAVIOUR:CHILDREN
evidence supports use of sensory based
interventions to improve school function. Information Processing and Social
Use of a sensory diet may allow children to Competence
meet their sensory needs throughout the day
and support their participation in class Wight, M., & Chapparo, C. (2005). Impact of information
processing on social competence. OT Australia: Skills for
activities. Kids Paediatric Conference Book of Abstracts, p.42.
Melbourne, October.
Objectives: The purpose of this study was Wight, M. (2005). Information processing and social
competence. Unpublished Honours Thesis. Available from
to determine whether sensory diets are School of Occupation and Leisure Sciences, The University
effective in supporting participation in of Sydney, NSW, Australia. (Supervisor C. Chapparo).
classroom task and reducing challenging
behaviours in school children with ASD. Children with learning difficulties are
reported to be vulnerable to deficits in social
competence. However, there is little data to
Method: This study used a single system
indicate which social skills are problematic
AB design involving six children with ASD
for this population (Karvale and Forness
who attended an autism specific special
1996; Gresham & Elliott, 1989). Social
school. Children with sensory processing
competence has been linked to efficiency in
difficulties which negatively affected their
information processing, but there has been
school performance were selected. A
little research exploring the nature of this
baseline was determined for each child
relationship. Although models of
before the commencement of sensory diet
occupational performance place social tasks
intervention. Data were collected using
in a position of prominence for children,
video recording and behaviour scatter plots
research exploring social competence in
to measure instances and severity of
children with learning difficulties during
challenging behaviour over multiple time
occupational performance is negligible.
points. Challenging behaviour addressed
was pre-determined by the child's teacher
and family. The Perceive, Recall, Plan, This study used the Perceive Recall Plan
Perform (PRPP) system of task analysis was Perform (PRPP) System of Task Analysis
used to measure the level of children's (Teacher Questionnaire) and a Teacher
participation during class activities. Social Skills Rating Scale to assess the
information processing abilities of 22
primary school aged children with learning
Results: Preliminary results indicated
difficulties during age expected social
sensory diets used by teachers in the
performance tasks in the school context,
classroom under the guidance of an
compared to a control group. This was a
occupational therapist supported children's
pilot study that used descriptive statistics to
task performance and task-embedded
describe children’s information processing
PRPP Research Development: 2013 19
performance on five expected social tasks as scale are given for each skill (1 = almost
measured by the PRPP Teacher never, 2 = seldom, 3 = sometimes, 4 = often,
Questionnaire. Children’s social 5 = almost always).
competence was also evaluated by the
Teacher Skillstreaming Checklist. The Results
outcome of this study is a quantitative Results of a pointbiserial analysis
description of the specific information (Tabachnick & Fidell, 1996). showed that
processing components that are closely all of the children with learning difficulties
linked to social competence for this sample. performed significantly poorer than their
The study was organised around three comparison peers. The findings indicated
research questions. that there was a strong relationship between
Participants each social competence subscale and the
A convenience sample of 22 male children type of participant ranging from 72% to
with learning difficulties and 22 comparison 85%. The significance levels and strength
children were selected for this study. of relationship for each subscale are noted in
Children with learning disabilities who the below table.
participated were aged between 5 and 11
years of age, identified as having a learning Teacher Correlation P value
difficulty by their teachers in the classroom Skillsstreaming Coefficient
and social difficulties as indicated by their Checklist Sub
respective classroom teachers. Children in Scales
Classroom 0.85 <0.001
the comparison group were matched for age,
Survival Skills
gender, lack of learning disability and school Skill Alternatives 0.79 <0.001
class placement. to Aggression
Friendship 0.79 <0.001
Research Question 1 Making Skills
Is there a difference in performance on Skills for Dealing 0.78 <0.001
measures of social competence between with Stress
children with learning difficulties and their Skills Related to 0.72 <0.001
typical peers as measured by teachers? Feelings
N.B. Significant p value is set at 0.05
Instruments
Table 1: Correlations between type of participant and
The Teacher Skillstreaming Checklist subscales on the Teacher Skillstreaming Checklist
(McGinnis & Goldstein, 1997) is part of a
social skills training approach used by Research Question 2
teachers. The theoretical roots of
Skillstreaming are entrenched in Bandura’s Is there a difference between children with
social learning theory (Bandura, 1977). It is learning difficulties and typical peers on
a 60 item checklist which assesses difficulty teacher’s measures of information
with social skill at school. The teacher rates processing ability during social tasks?
social abilities using a list of 60 skills
categorized into five sub scales: classroom Instruments
survival skills, friendship-making skills, The Perceive, Recall, Plan and Perform
skills for dealing with feelings, skill (PRPP) System of Task Analysis is an
alternatives to aggression and skills for occupation centered assessment that was
dealing with stress. Examples of classroom derived from the Occupational Performance
survival skills include ‘asking for help’, Model (Australia) (Chapparo & Ranka,
‘listening’, ‘beginning a conversation’ or 1997a). This model examines the cognitive
‘ignoring distractions’. Ratings on a 1-5 component of occupational performance of
PRPP Research Development: 2013 20
everyday routines, tasks and subtasks comparison child) ranging from 75% to
(Chapparo & Ranka, 1997b). 86%. The significance levels and strength
of relationship for each subscale are noted in
This study used The PRPP System of Task the table below.
Analysis Teacher Questionnaire, which was
developed out of the PRPP System of Task PRPP Correlation P value
Analysis as a means of allowing children’s Quadrant Coefficient
teachers to evaluate cognitive component Sub Scales
performance during everyday tasks in a Perform 0.86 <0.001
Plan 0.83 <0.001
quick and easy manner. The PRPP Teacher
Recall 0.80 <0.001
Questionnaire is a criterion-referenced
Perceive 0.75 <0.001
assessment where real-world task N.B. Significant p value is set at 0.05
performance is measured against what is
expected of children in their specific Table 2: Correlations between type of participant and
contexts. All of the questions within the subscales on the PRPP Teacher Questionnaire
PRPP Teacher Questionnaire were answered
relative to 5 specific social tasks nominated Further pointbiserial analysis was conducted
by the teachers. The tasks chosen by the to investigate the 12 sub sections within
teacher were specific social tasks that the each of the information processing
teacher expected that particular child to be quadrants. These results identified which
able to perform in the school environment. subsection was contributing most to the
For example, one teacher nominated the significant correlations between type of
social tasks important to one child as being participant and information processing
able to: quadrant performance. Results are noted in
 Actively listen for instructions for social the table below.
tasks PRPP Subquadrant Correlation P
Subscale Coefficient value
 Work as part of a group on a school
Perceive
project Attention 0.76 <0.001
 Share equipment with others Sensing 0.67 <0.001
 Maintain friendships Discriminating 0.77 <0.001
 Listen to peers and respond Recall
appropriately during conversation Remembers facts 0.76 <0.001
Errors in performance in the questionnaire Remembers scheme 0.74 <0.001
were indicated through a 1-5 rating scale of Remembers 0.81 <0.001
Procedures
performance (1 = very seldom, 2 = seldom,
Plan
3 = sometimes, 4 = usually and 5 = almost
Mapping 0.83 <0.001
always). Programming 0.83 <0.001
Evaluating 0.78 <0.001
Results Perform
A pointbiserial correlational analysis was Initiating 0.79 <0.001
used to test the difference in performance Continuing 0.85 <0.001
between the children with learning Controlling 0.84 <0.001
difficulties and their comparison peers on N.B. Significant p value is set at 0.05
the 4 information processing subscales of
Table 3: Correlations between type of participant and
the PRPP Teacher Questionnaire, and the 12 subsections within each of the quadrants within the PRPP
PRPP subquadrants. Results indicated that Teacher Questionnaire
there was a strong relationship between each
information processing subscale and the type Research Question 3
of participant (learning difficulty present or
PRPP Research Development: 2013 21
 What is the relationship between Skills
information processing and social Alternatives 0.76 <0.001 0.896 8.908
competence abilities during task to
performance at school? Aggression
The data obtained from the Skills streaming Classroom 0.74 <0.001 0.896 8.908
Checklist and PRPP Teacher Questionnaire Survival
Skills
was used for this part of the study.
Feeling 0.72 <0.001 0.896 8.908
Skills
Results Predictor: (Constant), Recall
A hierarchical multiple regression analysis
was performed to determine whether the Table 4: Regression between Recall information
information processing subscales could processing predictor and each social competence subscale
(dependent variable)
predict social competence. The four
information processing quadrant subscales
In a subsequent analysis, the type of
(Perceive, Recall, Plan and Perform) were
participant variable (whether the participant
used together in a regression equation to
has a learning difficult or not) was added
predict each of the 5 social competence
into the equation and found to significantly
dependent variables (Classroom survival
impact the predictive ability of the
skills, Friendship-making skills, Skills for
information processing variables on social
dealing with feelings, Skill alternatives to
competence scores. The following table
aggression and Skills for dealing with
summarizes the findings of each of the 5
stress). Results indicated that all four
regression equations incorporating the effect
subscales predicted social competence.
of adding the predictor of type of participant
into the Recall prediction equations:
The combination of the 4 information
processing subscales in the regression
Dependent R Square p value
equation caused multicolinearity due to the Variable value (Sig.)
high correlation between each information Classroom 0.815 <0.001
processing subscale. The highest rated Survival Skills
information processing predictor variable, Friendship 0.791 <0.001
Recall, was therefore used in the regression Making Skills
analysis to predict social competence. Feeling Skills 0.724 <0.001
Results were that Recall (which could be Alternatives to 0.786 <0.001
substituted for any of the information Aggression
processing variables) was able to accurately Stress Skills 0.805 <0.001
predict each of the social competence Predictors: (Constant), (Recall Sum) Type of
subscales including Stress Skills, Friendship Participant
Making Skills, Skills Alternatives to
Table 5: Regression indicating if type of participant
Aggression Classroom Survival Skills and predictor had any influence on Recall predictions of each
Feeling Skills. The following table social competence subscale (dependent variable)
summarizes the findings of each of the 5 Summary
regression equations listed from most to There appears to be a significant relationship
least accuracy of prediction. between information processing abilities of
children with learning difficulties and their
Dependent R p Mahal Mahal proficiency in all areas of social
Variable Square value Distance Distance performance. These findings support
value (Sig.) Min. Max. previously reported links between
Stress Skills 0.79 <0.001 0.896 8.908 information processing and social
Friendship 0.77 <0.001 0.896 8.908 competence (Crick and Dodge, 1994) where
Making
PRPP Research Development: 2013 22
specific information processing components A convenience sample of 27 (21=M:6= F)
have been more successful in predicting children was selected according to the
children’s social adjustment than global inclusion criteria set (Kumar, 1997): 6 – 8
constructs. This pilot study highlights the years; identified by their school as having a
importance of assessing children’s specific learning disability; referred to
information processing abilities when occupational therapy.
problems in social competence are present.
Implications for occupational therapy Instruments
practice are that difficulties in social The PRPP System of Task Analysis
competence may be treated more effectively (Chapparo & Ranka, 1997) was used to rate
using information processing instructional children’s videotaped performance of eight
strategies. Further study is required in this school tasks: colouring, cutting and pasting,
area. drawing, writing a story, paper folding, tying
shoelaces, catching a ball and skipping.
LEARNING DIFFICULTIES: These tasks were chosen based on the
CHILDREN reasons for referral to therapy and because
they were tasks that children of this age
Assessing information processing deficits range are commonly required to perform at
in children: The PRPP System of Task school. The eight school tasks were
Analysis administered and videotaped in a standard
format and order, and in a context using
Pulis, J., & Chapparo, C. (2002). Assessing information tools that were familiar to the children.
processing deficits in children: The PRPP and the PEEX.
Action for Health in a New Millenium, Abstract Book (CD).
13th World Congress of Occupational Therapists, Stockholm, Performance was rated by the primary
Sweden. June. researchers using standardised PRPP scoring
Pulis, J. (2002). Assessing information processing deficits in
children: The PRPP System of Task Analysis. Unpublished format (1 = definite difficulty; 2 = probable
Honours Thesis. Available from The School of Occupation difficulty; 3 = acceptable performance).
and Leisure Sciences, The University of Sydney, Australia.
(Supervisor, C. Chapparo)
The videotapes were used for scoring the
Helping children become better processors children’s performances and to check inter
of information is an important educational rater, and test retest reliability. The
and therapeutic goal (Swanson, 1987). This videotapes of 10 children were given to an
goal arises from the growing awareness of independent therapist who was experienced
information processing problems that exist in this area of practice and trained in the use
in children with learning difficulties and the of the PRPP System. To check test-retest
impact these have at school and at home. stability, scores derived by the research
There is limited research in occupational raters were compared to a second set of
therapy literature that describes the type of scores generated four weeks apart. These
information processing problems occurring scores, as well as sets of scores from the
in children with learning difficulties or how research raters and the independent rater
these problems impact on task performance. were compared using a technique based on
This pilot study aimed to describe the types graph and simple calculation along the x and
of information processing difficulties y axis (Bland & Altman, 1986). Acceptable
experienced by children with learning test-retest and inter rater reliability was
difficulties as measured by the PRPP System obtained.
of Tasks Analysis during the performance of
eight school tasks. Analysis of the data obtained was organised
around three research questions.
Participants
Research Question 1
PRPP Research Development: 2013 23
 What types of information processing
difficulties do children demonstrate during TASK ORDER OF QUADRANT
PERFORMANCE (Most
typical school tasks as measured by the disordered to Least
PRPP System of Task Analysis
Colouring Plan, Recall = Perform, Perceive
Cutting and Pasting Plan, Perform, Recall = Perceive
Results Drawing Plan, Recall – Perform, Perceive
A combined total quadrant score (Perceive, Writing a Story Plan, Recall = Perceive = Perform
Recall, Plan and Perform) for all eight tasks Folding Paper Plan, Recall – Perceive = Perform
Tying a Shoelace Plan, Perform, Recall, Perceive
was used to determine whether there was a Catching a Ball Plan, Perform, Perceive, Recall
difference in the children’s overall Skipping Plan, Recall = Perceive = Perform
performance between each of the four PRPP
Table 2: Ordering of Quadrant performance for each
quadrants. The Friedman test, followed by a school task (Most difficult to Least difficult).
series of Wilcoxon signed ranks test showed
that there was a significant difference These findings indicate that when the scores
between scores for all quadrants (p<.01) for each of the eight school tasks were
except Recall and Perceive (p>.01). When combined, Planning was the most difficult
the scores for all eight school tasks were for children in this sample. Programming,
combined, a direct ordering of the quadrants Evaluating and Remembering Procedures
was found with Plan emerging as the most were the most difficult subquadrants.
problematic quadrant, followed by Perform. Although this trend was also observed in
Similar analyses were performed on the individual school task scores, it was
PRPP Subquadrants. When the children’s apparent that different tasks posed different
scores for each of the eight school tasks processing difficulties for children.
were combined, it was found that the most
problematic PRPP subcategories were Research Question 2
Evaluation and Tactics (Plan). Table 2 Are there differences between the task
shows the rank order of problematic performance of 6,7, and 8 year old children
subquadrants from most to least. as measured by the PRPP System?

SUBQUADRANT The expected criterion for performance on

Evaluating (Plan) the PRPP descriptors for all children was
Programming (Plan) 100%. Visual analysis of the data indicated
Remembering Procedures (Recall)
that all three groups of children performed
Controlling (Perform)
lower than the expected criterion on all
Mapping (Plan)
tasks, indicating difficulties. The task of
Continuing (Perform)
Sensing (Perceive)
writing a story was the most bothersome.
Remembering Scheme (Recall)
Attending (Perceive) A one way ANOVA was used to determine
Table 1: Most problematic subcategories in rank order the difference between the three age groups
(All tasks combined) on the eight tasks. Results indicated that
there was a difference between 8 year olds
A further analysis determined whether there and 6/7 year olds on colouring and writing a
were differences in performance between the story (p<0.01), and cutting/pasting, tying a
PRPP quadrants across each of the school shoelace, and skipping (p<0.05). The limited
tasks. The results indicated a distinctive numbers of children in each group demands
ordering of the fours quadrants for each that these results are interpreted with
individual school task and that this ordering caution. However, the results do indicate
was different for each task, as shown in the support for 1) the sensitivity of the PRPP
following table. System of Task Analysis to measure age
PRPP Research Development: 2013 24
related changes, and 2) that although older the data suggests a further theoretical arrow
children’s performance on practiced tasks between Perceive and Plan, particularly for
may improve, children do not ‘grow out of’ complicated motor activity such as skipping
processing difficulties. and catching a ball. The relationship
between Perceive and Plan in these two
Research Question 3 tasks probably reflects the need for sensory
Do children demonstrate different input to program motor activity and to
information processing strengths and evaluate results of motor actions.
weaknesses on each of the eight school
tasks? Summary
The limitations of the study were associated
Using the data obtained from the PRPP, with the sample being convenience rather
non-parametric Spearman’s correlation was than random, small and containing a high
used to explore the strength of the percentage (77%) of males. Care should be
relationships between children’s taken when making generalisations from the
performance across the four PRPP quadrants study. However, the study demonstrated the
and twelve subquadrants. The following sensitivity of the PRPP System of Task
table indicates the strong relationships that Analysis to differences in age performance
were identified between the quadrants for in children with learning difficulties.
each task, and additionally shows that the Information processing difficulties were
number and type of relationships changed found in all quadrants across eight
according to the task. commonly performed school tasks in the
sample, with planning operations the most
Task Quadrant R Value vulnerable to disorder. The results indicated
Relationship that the majority of this sample had
Colouring Recall/Perform .85 difficulty with organisation, sequencing and
Cutting/pasting Recall/Plan .89 choosing performance operations, and in
Writing a story Perceive/Perform .85 evaluating their own performance. The study
Folding paper Recall/Plan .89 highlighted the importance of using a variety
Plan/Perform .86 of school tasks during assessment of
Tying Shoes Recall/Plan .89 information processing in children with
Recall/Perform .86
.85
learning disabilities. No two tasks identified
Plan/Perform
Catching Ball Perceive/Recall .87 the same pattern of processing disorder.
Perceive/Plan .86
Perceive/Perform .91 Perceive, Recall, Plan and Perform
Recall/Plan .91 (PRPP) Rating Scales (Parent and
Recall/perform .89 Teacher): Preliminary Reliability and
Plan/Perform .91 Validity
Skipping Perceive/Recall .89
Perceive/Plan .91 Fordham, M. (2001). Perceive, Recall, Plan and Perform
Perceive/Perform 1.00 (PRPP) Rating Scales (Parent and Teacher): Preliminary
Reliability and Validity. Unpublished Honours Thesis.
Recall/Plan .88 Available from the School of Occupation and Leisure
Recall/Perform .89 Sciences, The University of Sydney, NSW, Australia
Plan/Perform .91 (Supervisor, C. Chapparo).
Table 3: Strong Relationships Between Quadrants Fordham, M., Chapparo, C. (2002). Information processing
rating scales (Parent and Teacher): Reliability and validity.
Action for Health in a New Millenium, Abstract Book (CD).
This data offers preliminary empirical 13th World Congress of Occupational Therapists, Stockholm,
support for the central processing arrows in Sweden. June.
the central PRPP model which depict the
One framework for describing the cognitive
relationship between quadrants. In addition,
performance deficits of children with
PRPP Research Development: 2013 25
learning disabilities is information Sample
processing theory (Swanson, 1987). The Secondary data on 59 children that had been
PRPP System of Task Analysis is an referred to occupational therapy in the
assessment that employs task analysis Sydney area was collected from therapists in
methods to determine problems with private practice who had used the PRPP
cognitive information processing function Rating Scales (Parent and Teacher) as a
during task performance. The PRPP Rating routine part of assessment prior to
Scales (Parent and Teacher) (Lowe & intervention. The children were aged from 6
Chapparo, 2000) have been developed from to 11 years and enrolled in regular grade
this tool to allow therapists to obtain parent schools.
and teacher perceptions of cognitive aspects
of children’s performance. Parent and
teacher scales have long been used Results
occupational therapists to assess children’s A large percentage of children were
performance and to establish the need and identified by their parents as having
focus of intervention in an ecological way. difficulty with occupational performance
However, very few rating scales have well- tasks, as shown in Table 1.
established psychometric properties
(Swanson, 1991). This study aimed to Occupational Percentage of children
establish the preliminary reliability Performance Skill with difficulty
Shoelaces 43.9
parameters of the PRPP Rating Scales
Puzzles 40.5
(Parent and Teacher) through two research Colouring 56.8
questions. Drawing 56.8
Research Question 1 Cutting 54.5
What are parent’s and teacher’s perceptions Pasting 56.7
of the information processing deficits of Handwriting legibility 94.2
Handwriting speed 53.7
primary school children with learning
disabilities, as measured by the PRPP Table 1: Difficulty with occupational performance tasks
Rating Scales (Parent and Teacher)? (Parents)

Instrument Parent’s perceptions of their children’s

The PRPP Rating Scales (Parent) is a difficulty with information processing are
questionnaire consisting of 69 items listed in Table 2.
comprising seven subscales that covered
both occupational performance tasks Information Processing Percentage of
Behaviours children with
(personal care, gross motor, fine motor), and difficulty
information processing (Perceive, Recall, Perseverance with difficult 62.5
Plan, Perform). The PRPP Rating Scale tasks
(Teacher) is a 72 item version comprising Stay focussed to finish 53.7
the same subscales with additional items in Finish a task without help 52.6
Shift attention 42
the Plan and Fine Motor subscales. Both Focus regardless of 55/8
scales required parents and teachers to rate motivation
items according to a ‘3’ (no difficulty), ‘2’ Attend to detail 40.5
(questionable difficulty) or ‘1’ (definite React appropriately to 48.3
difficulty) scale. The rating scales contained distractions
Follow instructions 51
written instructions and were completed by
Think before doing 50
parents and teachers without additional Get ready 42/2
education from therapists. Use strategies to do a task 41.8
Choose the best strategy 50

PRPP Research Development: 2013 26

Prepare for the next task 46.8 Prepare for next task 52
Plan a sequence of small 54.8 Plan a sequence of small 51
steps steps
Question if there is a better 52.6 Identify obstacles to task 55.6
way Assess task performance 57.9
Complete tasks in time 75.6 Question better/different 65.7
Table 2: Difficult Information Processing Behaviours ways
(PRPP Rating Scale Parents) Complete task in time 50
Keep worksheets in order 42.9
Teachers’ rating of the children’s
occupational performance at school resulted Table 4: Difficult Information Processing Behaviours
(PRPP Rating Scale Teachers)
in a list of tasks that they considered most
bothersome based on the PRPP Rating Scale
(Teacher) (Table 3). Correspondence between teacher and parent
Occupational Percentage of children
raters
Performance Skill with difficulty
Ball skills 51.4 While there are a small number of different
Skipping 41.2 items on the Parent and Teacher Scales, the
Balance 44.8 majority of items appear on both scales.
Coordination 57.6 Scores of identical items on the scales were
Colouring 67.3 correlated to determine the degree of
Drawing 69.4
Cutting 56.5
correspondence between parent and teacher
Folding paper 41.7 raters. The results are listed below.
Handwriting legibility 56.1
Using ruler 60 PRPP Rating Scale Item ICC p value
Handwriting speed 67.9 Clothes 0.65 0.001
Copying 61.4 Shoelaces 0.64 0.000
Jumping 0.44 0.012
Table 3: Difficulty with occupational performance tasks Handwriting speed 0.38 0.004
(Teachers) Cooperation 0.40 0.001
Willingness to attempt tasks 0.61 0.001
Similarly, teachers generated a list of what Actively listen 0.32 0.020
they perceived to be the most bothersome Listen to all instruction 0.44 0.006
information processing behaviours to Stay focused to finish task 0.35 0.005
Finish task without help 0.31 0.012
children based on their observation of task Try hard: effort 0.28 0.017
performance at school. Percentages of the Shift attention when required 0.39 0.003
children who were perceived to experience Focus on important detail 0.30 0.011
difficulty and the tasks are listed in Table 4. Attend to detail 0.38 0.016
Understand goal of task 0.35 0.023
Information Processing Percentage of Plan a sequence of small steps 0.36 0.012
Behaviours children with
difficulty Table 5: Correspondence between parents and teachers
on PRPP Scale items
Persisting with difficult tasks 42.3
Staying focused 50 Of 59 similar items, there was significant
Finishing a task 48.1 agreement between parents and teachers on
Saying alert 44.2 only 16. This may have been because it is
Trying hard (effort) 40.4 difficult to achieve a high correlation
Focus on important details 49 between raters when ratings are based on a
Focus regardless of 52.1
motivation
three point scale (Polgar & Thomas, 1998),
Attend to detail 51.5 or that parents and teachers view children
Manage distractions 41.1 doing different tasks and have different
Think before doing 55.1 criteria about expected performance. Of
Get ready for tasks 46.9 more importance is that the items listed in
Choose best strategy 52.6 Table 5 may be central to occupational
PRPP Research Development: 2013 27
performance required for school and home
contexts. Subscale Chronbach Alpha
Personal care 0.722
Gross Motor 0.692
There was, however, general agreement
Fine Motor 0.727
between parent and teacher scores for each Perceive 0.861
subscale, with the exception of the subscale, Recall 0.890
‘gross motor’, indicating that in general Plan 0.874
terms, parents and teachers were in Perform 0.616
agreement with not only the problem area, TOTAL SCORE 0.914
but the severity of difficulty experienced by Table 6: Internal Consistency of PRPP Rating Scale
children (Figure 1). (Parent): Subscales and Total Score

80
70
The personal care subscale was not included
60 in the teacher ratings in this analysis because
50 most of the small number of items were
40
found to have zero variance and therefore
30
20 had to be deleted from the analysis.
10
0
Pe to r
ne o r

Pe n
e

ve

rm
al
ro car

a
ot

ec
ei

Pl
o

rf o

Subscale Chronbach Alpha

m
m

rc

R
al

Parents
ss
on

Personal care -
Fi
rs

Teachers
G
Pe

Gross Motor 0.697

Figure 1: Correspondence between parent and teacher Fine Motor 0.755
raters on the PRPP Subscales Perceive 0.826
Recall 0.904
Plan 0.922
Research Question 2
Perform 0.713
Can the PRPP Rating Scales (Parent and TOTAL SCORE 0.924
Teacher) reliably measure information
processing deficits in primary school Table 7: Internal Consistency of PRPP Rating Scale
(Teacher): Subscales and Total Score
children with learning disabilities?
Both Parent and Teacher Rating Scales
Internal Consistency:
indicate strong internal consistency.
The Cronbach Alpha measure was employed
to determine the internal consistency of the
Test-retest reliability
parent and teacher versions of the PRPP
A PRPP Rating Scale was completed on two
Rating Scales. Internal consistency is the
occasions by a total of twenty two parents
extent to which results on the different items
and 12 teachers, two weeks apart prior to the
of a test correlate with one another (Polgar
commencement of intervention. An
et al, 1999). An internal consistency result of
intraclass correlation coefficient was
0.8 or higher is considered sound. Results of
employed to analyse the test-retest reliability
this analysis should be viewed cautiously
of the data. Results were obtained for the
due to the small sample size used to obtain
subscale areas making up the PRPP Rating
internal consistency results (Parent: N = 22,
Scales (Parent and Teacher). The results are
Teacher N = 12). Internal consistency results
provided in the following Tables 8 (Parent)
for each subscale area are listed below in
and 9 (Teacher).
Tables 6 (Parent) and 7 (Teacher).

PRPP Research Development: 2013 28

PRPP Subscale ICC p value impacting on both fine and gross motor skill.
Personal care 0.68 0.000 This results offer preliminary support for
Gross motor 0.77 <0.001
using information from the PRPP System of
Fine motor 0.35 0.044
Perceive 0.75 <0.001 Task Analysis in the form of a
Recall 0.66 0.000 questionnaire, and that the data obtained is
Plan 0.53 0.004 useful for identifying difficulties from the
0.59 0.59 0.001 perspective of parents and teachers. The
Table 8: Test-retest reliability PRPP subscales (Parent)
PRPP Rating Scales (Parent and Teacher)
therefore offer an additional ecological
Based on an ICC of +0.7 or above as vehicle for obtaining relevant information to
indicative of good reliability, two of the assist intervention.
seven parent subscales achieve sound levels
of test-retest reliability, while the others While a general pattern of agreement was
achieve moderate reliability. However, obtained between parent and teachers
based on a 95% confidence interval perceptions of difficulty, the number of
(p=0.05), all subscale areas with the individual items in agreement was low. This
exception of ‘fine motor’ displayed lack of correspondence between raters on
significant levels of test-retest reliability specific behaviours may be attributed to the
(p<0.05). inexperience of parents in rating their
children on specific behaviours that are not
PRPP Subscale ICC p value usually noted. The findings of this study are
Personal care - - generally consistent with other studies
Gross motor 0.87 0.000 concerning correspondence between raters.
Fine motor 0.86 0.000 For example, Sikora and Plapinger (1997)
Perceive 0.72 0.001 found statistically significant correlations
Recall 0.87 <0.001
Plan 0.90 <0.001
between parent and teacher perceptions of
0.59 0.86 <0.001 academic performance, but failed to find
significant correlations between parent and
Table 9: Test-retest reliability PRPP subscales (Teacher) teacher perceptions of specific processing
skills underlying academic performance.
All six areas (minus personal care) of the
PRPP Rating Scale (Teacher) achieved ICC High internal consistency of the subscales
greater than +0.7 indicating sound test-retest indicates that the items making up each of
reliability. the scales are measuring the same construct.
It could be hypothesised that as the PRPP
Summary Rating Scales measures both occupational
Statistical analysis of data generated from performance skills and information
the PRPP Rating Scales (Parent and processing behaviours, that there is a strong
Teacher) yielded results about parent and relationship between the two.
teacher perceptions of the information
processing deficits experience by children The test-retest reliability of subscale areas
with learning disabilities during making up the PRPP Rating Scales indicates
occupational performance. From the greater stability of teacher perceptions over
perspective of parents, the information time. It may be that training and experience
processing behaviours involving perception of teachers makes them more attentive to the
and planning appeared to be most specific information processing behaviours
problematic, predominantly affecting fine of their students. Parents commented
motor skills performance. Similarly, informally that doing the rating the first time
teachers perceived that perception and made them more conscious of the specific
planning behaviours were bothersome,
PRPP Research Development: 2013 29
behaviours of their children, therefore ability to measure a child’s performance on
impacting on subsequent ratings. The test- the same task. The focus of the
retest reliability of the parent version of the
PRPP Rating Scales may be improved Participants
clinically through some parent education Videotapes of 19 children aged three and
before its use. four years doing two play tasks expected by
the ChIPPA (Symbolic Play using ‘junk’
Assessing Information Processing in the toys and Conventional Play using farm
Context of Pretend Play: A Study of the animals and a truck) were used as secondary
PRPP System of Task Analysis (PRPP) data for PRPP observation.
and the Child Initiated Pretend Play
Assessment (ChIPPA) 10 children (8 M; 2 F) were reported to have
difficulties with preschool and were flagged
Boland, K. (2004). Assessing Information Processing in the
Context of Pretend Play: A Study of the PRPP System of Task as children with potential learning
Analysis (PRPP) and the Child Initiated Pretend Play difficulties, as determined by the ChIPPA,
Assessment (ChIPPA. Unpublished Honours Thesis. Miller Assessment for Preschoolers,
Available from School of Occupation and Leisure Sciences,
The University of Sydney, NSW. Australia. (Supervisor, C. Leiberman’s Test of Playfulness and their
Chapparo). preschool teacher. 9 (7 M; 2 F) were
considered ‘typical’.
Increasingly, early identification of learning
disability prior to formal schooling is a goal,
The researcher and supervisor were blinded
and the preschool years are a time of
to the grouping of the children until the
increased referral to occupational therapy for
PRPP Observations had been scored.
assessment and intervention (Stagnitti,
Unsworth & Rodger, 2000). Occupational
Instruments
therapy’s unique contribution in the
The PRPP System of Task Analysis (PRPP)
assessment of children with learning
was used to rate the information processing
difficulties is to provide information about
ability during the two play tasks according
the impact of information processing deficits
to standard PRPP protocol (Chapparo &
on children’s performance of tasks that are
Ranka, 1997). A total PRPP score, Perceive
personally and contextually important
score, Recall score and Perform scores were
(Cook, 1991). One area of assessment that is
used in this study. Small sample numbers
contextually relevant to the preschool years
precluded use of subquadrant and descriptor
is play. Although errors in information
scores in this study.
processing are thought to lead to
impairments in play, there is limited
The Child Initiated Pretend Play Assessment
research to describe children’s occupational
(ChIPPA) is a standardised measure of play
performance difficulties in terms of deficits
that identifies the child’s ability to engage in
in information processing during play. This
cognitive aspects of play through a semi-
study examined children’s performance on a
structured pretend play task. Prior to the
pretend play task when assessed by the
commencement of the study, an independent
Perceive, Recall, Plan and Perform System
rater had scored the children’s performance
of Task Analysis (Chapparo & Ranka,
on the ChIPPA. Three major characteristics
1997), a measure of information processing
of pretend play are scored on the ChIPPA. 1)
ability, and the Child Initiated Pretend Play
Percentage of Elaborate Pretend Play
Assessment (ChIPPA) (Stagnitti, 2000, a
Actions (PEPA), which are functional
measure of pretend play. The PRPP and
actions that are used in a sequence, theme or
ChIPPA both purport to assess aspects of
context of constructive play (Stagnitti et al,
cognition. A further aim of this study was to
2000). 2) Number of Object Substitutions
compare the two assessments and their
PRPP Research Development: 2013 30
(NOS), which is the number of times in play indicating that motor performance is not a
that each object is deliberately substituted major factor in play.
for something else (Stagnitti et al, 2000). 3)
Numer of imitated actions (NIA), whereby Research Question 3
the child copies modelled actions of the How does children’s performance on the
examiner. PRPP differ between those children with
and without pretend plan deficits as
Research Question 1 determined by the ChIPPA?
Is there agreement between the ChIPPA and
the PRPP in the identification of children Results
with deficits in pretend play? Findings indicated a significant difference in
median performance between typical and
Results dysfunctional groups for the following:
The Kappa coefficient was used to o PRPP Total Score, Perceive
determine the agreement of grouping of Quadrant Score and Plan
children between the two independent Quadrant Score during symbolic
measures. This indicates the proportion of play tasks
agreement after chance has been excluded. o PRPP Total Score, Recall
The Kappa value of 0.789 (N=19; p=0.01)
Quadrant Score and Plan
shows that agreement between the PRPP and
the ChIPPA total scores used to identify Quadrant Score during play with
children with and without dysfunction is conventional toys
substantial.
There was no significant difference in
Research Question 2 median performance between typical and
Is the PRPP able to predict performance on dysfunctional groups on:
the ChIPPA? o PRPP Recall Quadrant Score
during symbolic play
Results o PRPP Perceive Quadrant Score
Findings indicated that the PRPP scores during play with conventional
were able to predict performance in
toys
symbolic play components of the ChIPPA.
Specifically, the Perceive Quadrant Score o PRPP Perform Quadrant Scores
during symbolic play (p=<0.001) and the during either symbolic or
PRPP Total Score during symbolic conventional play
(p=<0.001) and conventional play (p=0.002)
predicted the amount of elaborate play as In summary, this study examined the play
measured by the ChIPPA. The Plan performance of children with and without
Quadrant Score was the best predictor of pretend play deficits using the PRPP System
numbers of object substitutions (p=0.01) as of Task Analysis and the Child Initiated
measured by the ChIPPA. These findings Pretend Play Assessment. Results of the
underscore the importance of information study found that the PRPP is successful in
processing, particularly planning in pretend discriminating between children with and
play. without pretend play deficits. Findings
showed a substantial level of agreement
There was no association between the PRPP between the PRPP and the ChIPPA. Certain
Perform Quadrant Score and any of the areas of information processing, as defined
ChIPPA play component scores (, possibly by the PRPP appear to be more important
than others for pretend play, specifically
PRPP Research Development: 2013 31
Plan strategies. This study supported the of one student with a learning difficulty over
notion that planning is critical in pretend 13 years. In addition, 50 teachers and 44
play. parents were surveyed regarding
participation. Data collected from this phase
Cognitive strategies and school formed the basis of Phase Two in which a
participation for students with learning teacher and parent questionnaire was
difficulties constructed following principles of
questionnaire construction.
Lowe, S. (2010). PhD Thesis Abstract. School of Occupation
and Leisure Sciences, The University of Sydney. NSW.
Australia. (Supervisors: C. Chapparo and R. Heard). An instrument, PRPP@SCHOOL-Version
1(Teacher Questionnaire and Parent
Students with learning difficulties comprise Questionnaire), was developed which
one of the main groups of children referred reflected theoretical and empirical
for assessment to Australian occupational descriptions of cognitive strategies and
therapists. Teachers and parents typically descriptors used in an existing instrument,
express concern regarding difficulty with the Perceive, Recall, Plan, and Perform
participation during school occupations. In (PRPP) System of Task Analysis. These
particular, teachers and parents describe the questionnaires, designed to form a
cognitive aspects of participation as being a companion instrument to the PRPP System
challenge. While much research has focused of Task Analysis, were trialled on 355
on the concept of participation for students children, referred to a private occupational
with physical disabilities, little is known therapy clinic in Greater Western Sydney.
about the impact of cognitive dimensions of
a learning difficulty on school participation. Data were analysed to determine the
There are few ecological assessments which viability of the measure in Phase Three of
document difficulties with the cognitive the study which comprised reliability and
aspects of school participation relative to the validity testing on the PRPP@SCHOOL-1
expectations of task performance. (TQ & PQ). Intraclass correlations indicated
Specifically, there is a lack of standardised excellent test-retest reliability with a high
assessments which utilise the perspectives level of agreement for the PQ.
of teachers and parents.
Content validity was determined through
The initial purpose of this study was to consumer review, peer review, and an expert
explore the concept of participation panel review. Discriminant validity testing
and how students with learning difficulties confirmed that the PRPP@SCHOOL-1(TQ
used cognitive strategies to participate & PQ) was able to differentiate between
successfully in school occupations. The typically developing students and students
second purpose of the study was to develop with learning difficulties.
a teacher and parent questionnaire that might
assist in the occupational therapy assessment Construct validity was assessed. Five
of the cognitive aspects of a student’s school factorsemerged from the analysis which also
participation. A review of the literature was demonstrated that the PRPP@SCHOOL-
motivated by the need to better understand 1(TQ & PQ) was functioning as a
the construct of participation and to multidimensional measure.
determine how best to measure cognitive
strategy use as a component of school Findings indicated that for children in this
participation. The subsequent research was study, participation in school occupations
then carried out in three phases. Phase One was undermined by challenges with
explored difficulties in school participation inefficient cognitive strategy use.
using a longitudinal retrospective case study
PRPP Research Development: 2013 32
 category of the PRPP@SCHOOL and
Teachers and parents were able to observe related to social interaction. Factor Two also
and clearly identify these difficulties using consisted of Plan items targeting goal setting
the PRPP@SCHOOL-1(TQ & PQ). This and generating alternative responses,
research adds a companion instrument to evaluating and problem solving. Factor
the PRPP System of Task Analysis in the Three consisted of Perceive and Perform
form of teacher and parent questionnaires items which targeted attention, persistence
to be used with students who experience and continuation of performance. Factor
school participation difficulties. In so doing, Four consisted of Recall items which
the research contributes to the expansion of targeted understanding, remembering and
occupation-focused, criterion-referenced following steps in the task, rules and
ecological instruments recommended by the procedures. Factor Five consisted of
profession as best practice assessment. Perceive and Plan items that focused on
listening and ‘getting ready' for engagement
The PRPP@SCHOOL (Teacher and in activities with others.
Parent Questionnaire) and children with
learning difficulties: An exploration of Conclusion: Data from factor analysis
construct validity identified five factors describing the nature
of reduced cognitive strategy use in students
Chapparo, C., Lowe, S., & Heard, R. (2013). Published
Abstract: Occupational Therapy Australia, 25 th National with learning difficulties. The patterns
Conference and Exhibition, July. Australian Occupational described in these factors contribute to
Therapy Journal, 60, Supplement 1, p.60-61
understanding the concept of cognition as it
The impact of physical and sensory may apply to participation in school
difficulties on participation in school occupations.
occupations is well documented. Less is
known about the impact of cognitive The PRPP@SCHOOL (Teacher
dimensions of a learning difficulty on Questionnaire): Examination of
participation in school occupations. discriminant validity
Chapparo, C., Lowe, S., & Heard, R. (2013). Published
Aim: To identify cognitive factors within Abstract: Occupational Therapy Australia, 25 th National
Conference and Exhibition, July. Australian Occupational
the PRPP@SCHOOL (TQ & PQ) that may Therapy Journal, 60, Supplement 1, p.61
explain difficulties with participation in
school activities in children with learning (K Introduction: Participation in school
- 6) who have been referred to occupational occupations is thought to be undermined by
therapy. challenges from inefficient cognitive
strategy use in children with learning
Methods: 624 PRPP@SCHOOL (TQ & difficulties. The PRPP@SCHOOL (Teacher
PQ) were obtained for 355 children enrolled Questionnaire) was developed from a
in mainstream K-6 classes participated. cognitive strategy observation instrument,
Exploratory factor analysis was used to the Perceive, Recall, Plan and Perform
examine inter-correlations among test scores (PRPP) System of Task Analysis to identify
and resulted in extraction of a set of five cognitive difficulties which hampered
factors that conceptually represented school performance from teachers'
common cognitive difficulties experienced. perspectives.

Aim: To determine whether the

Results: Five factors emerged from the data. PRPP@SCHOOL (Teacher Questionnaire)
Factor One consisted of items from the Plan differentiated between cognitive strategy use
PRPP Research Development: 2013 33
in children with and without learning can rate children's use of cognitive strategies
difficulties. during participation in school and home
occupations. There are three versions of the
Methods: 363 students (K - Yr6) from the PRPP@School (pre-school, primary school
western suburbs of Sydney comprised two or high school) all of which summarise
independent groups. Group One (n=292) cognitive strategy use into four categories of
contained students with learning difficulties cognitive processing: attention, memory,
referred to occupational therapy for planning and doing.
problems performing school activities.
Group Two (n=71) were ‘typically Aim: To compare the pattern of children's
developing children'. There were no cognitive strategy application in the four
significant differences between the two categories of cognitive processing: attention,
groups in representation of grade, gender or memory, planning and doing as rated by
age. Scores representing four cognitive parents and teachers across school stages
processing typologies on the PRPP (pre-school, primary school, and high
instrument (Perceive, Recall, Plan and school).
Perform) were obtained as well as a Total
PRPP Score. Independent group t-tests Method: PRPP@School questionnaires
determined the level of difference between were collected for 233 children with
the two groups on PRPP@SCHOOL. learning difficulties referred to occupational
therapy in the western suburbs of Sydney. A
Results: Students without learning total of 74 children attended pre-school, 96
difficulties had higher mean scores for all attended primary school and 63 attended
four PRPP cognitive strategy category high school. Between group ANOVA and
scores, as well as for the total questionnaire post hoc analysis were used to compare the
score than students with learning difficulties pattern of performance of children from
(p=<.001), indicating that items on the each of the three school stages.
PRPP@SCHOOL (Teacher Questionnaire)
discriminated between students with Results:For teacher ratings of cognitive
learning difficulty and their typical peers in strategy use, no significant difference was
this sample. found between the school stage groups with
planning emerging as the most problematic
Conclusion: This research supports use of area for children in all school stages. Parent
the PRPP@SCHOOL (Teacher rating scales identified a significant
Questionnaire) to obtain teachers' difference for Planning (p<.001) and
perspectives about the impact of cognitive Attending (p<.05) categories with children
strategy use disorder on school occupations. attending primary school and pre-school
rating lower in these areas than children in
Using the PRPP@School (Parent and high school.
Teacher Questionnaire) to identify
patterns of cognitive strategy application Conclusion: Parents and teachers identified
in children with learning difficulties different patterns of cognitive strategy use
for children in the different school grades
Chapparo, C., Lowe, S., & Heard, R. (2013). Published
Abstract: Occupational Therapy Australia, 25 th National however, the area of planning was the area
Conference and Exhibition, July. Australian Occupational most consistently rated as a difficulty for all
Therapy Journal, 60, Supplement 1, p.42-43. children.

Introduction: The PRPP@School is a

questionnaire where parents and teachers
PRPP Research Development: 2013 34
 The effectiveness of the Perceive, Recall, Conclusion: This study contributes to
Plan Perform (PRPP) System of research regarding the effectiveness of the
Intervention on the social skills of PRPP System of Intervention in the form of
children with learning difficulties a social skills camp to address issues of
social competence in children with learning
Challita, J., Chapparo, C., Hinitt, J., & Lowe, S. (2013).
Published Abstract: Occupational Therapy Australia, 25th difficulties.
National Conference and Exhibition, July. Australian
Occupational Therapy Journal, 60, Supplement 1, p.43.

CURRENT AND ONGOING

Introduction: The Perceive Recall Plan RESEARCH
Perform (PRPP) System of Intervention is
an intervention approach based on cognitive Research continues on the PRPP System of
strategy application which can be used with Task Analysis. To date, it has been applied
children with learning difficulties who also to all areas of practice where occupational
experience difficulties with social therapists are required to examine the impact
participation. of information processing deficits on those
tasks that are important to the client.
Aim: To investigate the effectiveness of a Researchers continue to work towards
social skills camp that utilises principles of generating evidence about its effectiveness,
the PRPP System of Intervention to develop and we are indebted to their endeavours and
playground social skills for children with a contribution to instrument development for
learning difficulty. OT clinical practice.

Methods: An ABA single system research All of these projects reviewed have made a
design will be employed with six primary considerable contribution to the
school children with a learning difficulty development of the tool and the evolving
who have been referred to an occupational intervention component of the PRPP system.
therapy social skills camp. The PRPP
System of Task Analysis will be used to
measure children's cognitive strategy
application for social performance during
each of the three study phases: Phase A,
prior to camp; Phase B, during the camp;
and a second Phase A, after the camp.
Parent/Teacher questionnaires and Goal
Attainment Scaling will also be used as pre
and post measures.

Results: Findings presented will include

visual representation of the data collected at
each of the three study phases (A-B-A) to
examine change in performance as a result
of the intervention. Results from statistical
analysis conducted to compare each phase
will inform if any significant change in
performance occurred during the
intervention. These will be supported by
findings from pre and post measures.

PRPP Research Development: 2013 35