validity and reliability of the time organisation and participation … · 2019. 11. 11. ·...

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Validity and reliability ofthe Time Organisation andParticipation Scale (TOPS)Sara Rosenblum aa Department of Occupational Therapy, Faculty ofSocial Welfare & Health Studies, University of Haifa,Haifa, Israel

Available online: 20 Jan 2012

To cite this article: Sara Rosenblum (2012): Validity and reliability of the TimeOrganisation and Participation Scale (TOPS), Neuropsychological Rehabilitation, 22:1,65-84

To link to this article: http://dx.doi.org/10.1080/09602011.2011.640465

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Validity and reliability of the Time Organisation and

Participation Scale (TOPS)

Sara Rosenblum

Department of Occupational Therapy, Faculty of Social Welfare & Health

Studies, University of Haifa, Haifa, Israel

The ability to organise daily life tasks and to execute them on time constitutesan essential component of being efficient and may have consequences for anindividual’s well-being. The objective of the study was to develop a self-report scale for detecting difficulties in the organisation of daily life tasks ontime, as perceived by the individual, and to examine its validity and reliability.In order to test the scale’s content and face validity, 228 Israeli adults, 83 (36%)males and 145 (64%) females, aged 18–44 (mean age 26.49, SD ¼ 5.83), par-ticipated in the study. Internal consistencies following factor analysis, as wellas construct validity, were initiated. Results of the analysis of the Time Organ-isation and Participation Scale (TOPS) revealed three distinct factors withEigen values . 1, comprised of 32 items. These three factors explained49.68% of the total variance. The scale demonstrated good internal consistencyfor the overall score (a ¼ .92), as well as for the three factors (a ranges .87 to.92). The corrected item total correlation that was performed for each of thethree factors indicated good results, ranging from .46 to .76. Construct validitywas confirmed, while the MANOVA yielded significant age group differences.Initial results suggest that the TOPS is a valid and reliable tool for detectingdifficulties in the organisation of daily life tasks on time among adults.

Keywords: Self-report scale; Perceived; Time; Organisation; Daily tasks.

Correspondence should be addressed to Sara Rosenblum, PhD, Department of Occupational

Therapy, Faculty of Social Welfare & Health Studies, University of Haifa, Haifa 31905, Israel.

E-mail: [email protected]

NEUROPSYCHOLOGICAL REHABILITATION

2012, 22 (1), 65–84

# 2012 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business

http://www.psypress.com/neurorehab http://dx.doi.org/10.1080/09602011.2011.640465

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INTRODUCTION

The way in which people use their time is meaningful in a society where thetasks are multiple, the expectations are high, and the time is limited. Today,people are required to do things at an appropriate pace in order to be efficient.Efficacy means doing much more in less time (Robinson & Godbey, 1997).To complete a task efficiently, one must be able to plan and manage activitieswithin a specific timeframe. This means beginning a task at an appropriatetime, performing it at an appropriate tempo, finding the appropriate way toperform it, and performing it within the required amount of time in asequenced manner (Blanche & Parham, 2001; Coster & Haley, 1992;Zentall, Harper, & Stormont-Spurgin, 1993). The common principle of per-forming everyday life tasks efficiently is the ability to organise those taskswithin a given timeframe (Lavoie, 2006).

Organisational ability is a component of executive function (EF). EF isdefined as a complex cognitive process forming the basis of direct targetedreactions, while considering the features of new or complex situations. Thisprocess is activated in situations that require planning, decision-making, cor-recting mistakes, problem-solving and/or beginning new actions) Norman &Shallice, 1980). Organisation of daily activities/tasks and their execution ontime is an important key to efficient time use and is a daily expression of howan individual proceeds through the time cycle based on his/her personaltemporal abilities. These abilities are required for independent work andlong-term projects (Meltzer, 2007, p. 83). Being efficient and successfullyfunctioning under time constraints provide the individual with a sense ofcontrol, which is related to better physical health, academic achievement(Lachman & Burack, 1993), and quality of life (Farnworth & Fossey, 2003).

Although there are demonstrated associations between time, actions andhealth (Farnworth, 2003), there is a paucity of literature on the process oforganising movement into occupations, such as self-care, learning or work,and occupations into daily routine activities under the constraints of time(Blanche & Parham, 2001). Clinicians report that individuals in a verywide age range are being referred to them as a result of their deficits in organ-isation of daily activities on time (Lavoie, 2006; May-Benson, Ingolia, &Koomer, 2000). As manifested through interviews of students with suchdeficits previously described in the literature, their ability to participate invaried occupations may be affected (Blanche & Parham, 2001; Goldblatt &Rosenblum, 2007; Kirby, Edwards, Sugden, & Rosenblum, 2010; Roffman,2002; Rosenblum & Weintraub, 2007). Other factors emphasised throughthose interviews and reinforced by the literature were changes in daily rou-tines and excessive stimuli environments as influences on the ability to organ-ise time and as daily stressors (Bond & Feather, 1988; Feather & Bond, 1983).However, interviewees often indicated that they do not know what causes

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their failure and how those deficits (e.g., organising in the morning in order toget to work on time) may relate to their shortcomings in academic or workenvironments.

For example, Alex is a 25-year-old student who was recently diagnosedwith Developmental Coordination Disorder (DCD), also known as clumsiness(Polatajko, Fox, & Missiuna, 1995). Alex belongs to a group of adults whomay be defined as having Atypical Brain Development (ABD) (Kaplan,Wilson, Dewey, & Crawford, 1998). Unlike cerebral palsy or intellectual dis-abilities, this condition is invisible and does not have a clear-cut symptoma-tology. Diagnosis takes time and might not be made until the child is of schoolage or even in late adulthood, when he needs to cope with more complex dailylife tasks (Josman & Rosenblum, 2011; Roffman, 2002). When asked aboutfulfilling daily tasks expected from him, Alex responded: “It also happensthat I forget things that I have to do, and I fail in planning my time. SometimesI do more than I have to do, or I don’t understand the instruction and have todo the same thing again. When I don’t get how much time it will take me tocomplete certain things, it makes me sad, frustrated and insecure.”

As described by Alex, and reinforced by the literature, the difficulty ingetting organised on time in a way that will enable the individual toperform what s/he needs or wants to do in a satisfactory manner has second-ary emotional implications and hence harms quality of life. For those who donot succeed, a situation such as waking up in the morning and getting readyfor work on time may become stressful, daily events (Aspinwall & Taylor,1997; Gil et al., 2003). Hence, identifying deficits in this area as early as poss-ible and supplying the appropriate strategies to deal with them might preventfuture emotional complications such as frustration and feelings of incompe-tence (Rosenblum & Weintraub, 2007; Wilson, 2002).

It has previously been found that focusing on these individuals’ daily func-tioning, through interviews and sensitive standardised evaluation tools, mayshed light on their unique performance characteristics and pave the waytowards an earlier diagnosis and more focused clinical intervention (e.g.,Kirby et al., 2010; Roffman, 2002). Although there is a wide body of knowl-edge regarding time management and time use employing various question-naires and time diaries (e.g., Feather & Bond, 1983; George, Dixon,Stansal, Gelb, & Pheri, 2008), there is a need for a standardised tool focusingon the individual’s perception of his/her organisational abilities related todaily task performance. Such a questionnaire should cover the construct of“perceived ability to organise daily tasks and their execution on time” in asimilar manner to that of “perceived control of time” (Macan, Shahani,Dipboye, & Phillips, 1990). However, perceived ability of organisation oftime would be measured through individuals’ rating of their own ability toorganise their time in relation to actual concrete daily performance and notto their time control in general. Such a tool may raise individuals’

VALIDITY AND RELIABILITY OF THE TOPS 67

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self-awareness about whether or not they “feel in control” (Macan et al.,1990) over organising their time as a first step towards improving daily per-formance in time.

The Time Organisation and Participation Scale (TOPS) was developed fol-lowing interviews and a thorough review of the literature. It was based on theconcepts presented by the World Health Organization (WHO, 2001) and theperson–environment occupation model (Law et al., 1996). Analysing howpeople allocate their time to activities, places and interactions amongvaried environments is an important issue, following the International Classi-fication of Function (ICF) suggested by the WHO (2001). The ICF is focusedon the concepts of the individual’s abilities, the activities performed by theindividual, the environments in which these activities are performed, andthe level of the individual’s participation as related to well-being. Theterms “activities” and “participation” are connected, and participation is con-ceptualised within a person’s environment interaction (Hammel et al., 2008;Perenboom & Chorus, 2003). Madden (2006) defined participation as invol-vement in a life situation which includes being able to control one’s own lifeand to fulfil personal goals and societal roles.

According to the person–environment–occupation model, a conflictbetween the individual’s abilities, task demands, and the environment mayresult in less successful behaviour or function (Law et al., 1996). At the indi-vidual level, the organisation of behaviour requires perception, conceptualis-ation, and integration of multiple dimensions of time and space (Blanche &Parham, 2001). Gaps between an individuals’ abilities and environmentalrequirements will be manifested in their manner of organising activities intime and may influence their participation and success in life events.

Thus, three principles guided the tool construction. The first is that itemswill cover real daily tasks/activities relating to all areas of daily life(Cermak, Gubbay, & Larkin, 2002), such as activities of daily living(ADL), work, and leisure. The second is that judgement of the ability toorganise time is made in relation to environmental requirements. The thirdprinciple is the need to include an emotional aspect as a factor influencingan individual’s performance abilities, participation, and well-being(Almeida, Wethington, & Kessler, 2002; Roffman, 2002; Rosenblum &Weintraub, 2007).

As part of establishing the TOPS validity, differences between adults inthree age groups will be analysed. Although no literature was found on organ-isation of time abilities in different periods of adulthood, especially betweenthe ages of 18 and 40 years, evidence from other sources enables us to assumeage differences in regard to this construct. It was found that both time percep-tion (Carstensen, Isaacowitz, & Charles, 1999) and executive control, includ-ing problem solving, planning and organisation, improves among adults aged20–40 years (e.g., Cepeda, Kramer, & Gonzalez de Sather, 2001; Daigneault,

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Braun, & Whitaker, 1992). More specifically, Lachman and Burack (1993)indicated that planning abilities which are essential for organisation of timeand sense of control increase among adults until the fourth decade. All ofthe above-mentioned abilities (time perception, executive control and plan-ning) are fundamental components of the ability to organise time; hence itenables the assumption of age differences as the TOPS construct validityevidence.

The aim of the present study was to describe the TOPS developmentphases and to establish the instrument’s validity and reliability amongadults aged 18–44 years. The research hypotheses, which relate to variousaspects of the tool’s validity and reliability, were as follows: (1) Constructvalidity A: A factor analysis will establish the constructs covered by thescale, based on the theoretical background and interview contents. (2)Internal consistency: Moderate to high internal consistency will be achievedfor the TOPS questionnaire as a whole and for each of its factors, based ondata from approximately 200 participants. (3) Construct validity B: Signifi-cant differences between three age groups will be found for the factor scores.

The first of the two phases below focuses on the scale development and thesecond phase presents the results to the above described hypotheses

Phase 1: Construction of the questionnaire

Selection of questionnaire items

The construction phase began with a determination of the questionnaireitems, which was based on three resources: (1) the current literature ontime use, time management, and executive functions, with an emphasis onorganisational ability among adults; (2) structured interviews with 10 adultsabout their everyday activity performance and participation, following theirown characterisation of their performance as disorganised; and (3) previousinterviews conducted by the researcher with adolescents and adults copingwith learning difficulty (LD), attention deficit hyperactivity disorder(ADHD), and developmental coordination disorder (DCD) (Kirby et al.,2010; Rosenblum & Weintraub, 2007).

Although the main purpose of the interviews was to get a better insightabout daily performance and participation characteristics, informationraised from the interviews reinforced the clinician’s report about the impor-tance of the ability to be organised and ready on time for life satisfactionand success. Participants described activities, such as preparing variedtasks, being ready for going to work on time or getting ready for sleep, asthose which disrupt their plans to do things as expected from them by them-selves or as others expect from them. Furthermore, there was evidence that,generally, adults with DCD do not succeed in doing what they need or


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want to do and that those events influence their emotional responses and, con-sequently, their life satisfaction.

Based on those resources, 34 items, representing the main issues raised inthe literature and the interviews in relation to the construct of organisation oftime in daily life performance were established. The questionnaire waswritten in Hebrew and constructed in a way that would be suitable foradults in Israel. It was translated into English for the purposes of this manu-script. Twenty items relate to the frequency of disorganisation of time ineveryday activities, such as dressing, eating, and washing, as reflected bythe individual’s pace of doing such activities in relation to environmentalexpectations. Five items relate to the extent to which the individual succeedsin organising a whole day or a certain period of time in a satisfactory manner.Seven items relate to the frequency of emotional responses following the indi-vidual’s unsuccessful organisation of time. All of the items use clear, under-standable terminology and are rated on a five-point Likert scale, with a higherscore indicating better performance.

The following are examples of how items were scored. For the first issue(20 items: 1–20), respondents are asked: “Do you feel that you perform thefollowing activities at an appropriate pace, as expected by the environment?”(e.g., getting up in the morning, dressing, organising your bag, getting organ-ised to host friends or family, planning leisure activities). Respondents mustthen rate the frequency for each item as follows: 1 ¼ never, 2 ¼ rarely, 3 ¼sometimes, 4 ¼ usually, or 5 ¼ always.

For the second issue (5 items: 21–25), respondents were asked to rate theirperformance in time organisation over the course of the day or within acertain period of time from 1 ¼ very bad to 5 ¼ excellent. The items are:dividing your time throughout the day in a way that enables you to accomplish(1) what you want to do, (2) what you need to do, (3) organising your time soas to accomplish several tasks within a given period, (4) organising your timein preparation for studying or work, and (5) performing your everyday tasks atan appropriate pace.

The third issue (7 items: 26–32) is focused on emotional responses follow-ing unsuccessful organisation of time. Respondents are asked: “Are theretimes during the day when you react emotionally as the result of a lack ofsuccess in performing activities at the pace expected of you?” for the follow-ing emotions: (1) lack of motivation to perform, (2) sadness, (3) frustration,(4) anger, (5) crying, (6) outburst towards family members, and (7) outbursttowards friends.

Finally, two items relate to the influence of change in routines and variousstimuli on the individual’s organisation of time abilities. These two items areincluded as open questions in order to facilitate further discussion between theclinician and the individual. The two open questions were: (1) Do you havedifficulty organising your daily activities on time when a change occurs in

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a familiar routine? (2) Are you distracted by various stimuli and hence do notsucceed in finishing your tasks on time?

For both the third issue and the abovementioned two items, responderswere asked to rate the frequency for each item as follows: 5 ¼ never, 4 ¼rarely, 3 ¼ sometimes, 2 ¼ usually, or 1 ¼ always. The response for thetwo items serves as a key point for further discussion with the clinician ifthe responder marked one of the options 1–4. Although the first and thirdissues and the two items are rated on the same scale from 1–5, the frequencyrating is worded reversely for the third issue and the two open questions (e.g.,for the first issue: 1 ¼ never (perform in appropriate phase). For the thirdissue and the two open questions, 1 ¼ always (react emotionally as theresult of a lack of success).

Based on the method previously described for establishing cut off scores(e.g., Graham, Struck, Santoro, & Berninger, 2006) it was assumed that par-ticipants who score below one standard deviation of the mean score of theentire sample will be at risk for difficulties in organisation of daily lifetasks on time.

Content and face validity

The original 34-item questionnaire was reviewed by three expert consult-ants and five experienced occupational therapists in order to determine if theitems adequately reflected the prescribed objectives of the instrument. Thisprocess is consistent with the establishment of content validity and face val-idity, as described by Benson and Clark (1982). All experts established thatall of the TOPS items reflected the instrument’s objectives. The wording oftwo items (12, 23) were changed, rechecked and confirmed by two experts.

Following the content validation process, a secondary qualitative evalu-ation process was performed. Three students who described themselves asdisorganised were asked to respond to the 34 questionnaire items. Whilethey were filling out the questionnaire, they were requested to indicatewhether the wording of the items was clear enough and were encouraged tocomment on any items as they saw fit. The three students reported thatmost items were clear and that completion of the questionnaire requiredonly about 10 minutes. They also remarked that filling out the questionnaireprovided them with enhanced insight into the influence of being disorganisedand its potential effects on their everyday performance. Following their com-ments, the wording of five items was improved.

Phase 2: Examination of validity and reliability

Once the final version of the questionnaire was established, the next phase ofthe tool development process involved the preliminary determination of thequestionnaire’s validity and reliability.


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Participants

A stratified sample was established to ensure diverse participants. The datawere gathered by seven trained research assistants (RA). Each RA lived in adifferent type of location (town, village, communal settlement), and was amember of a community representing diverse population groups in Israel,varying according to nationality, socioeconomic status (low, medium andhigh), and cultural and religious backgrounds, such as: urban/rural;Jewish/Arab/Druze/Circassia; and Orthodox/traditional/secular. Withinthat context, the RAs were directed to search for healthy adults without dis-abilities, stratified by age and gender in their communities, and based on theirself-reports in a preliminary questionnaire. Further demographic details werethen gathered, demonstrating the diverse representation of the studypopulation.

Using this method, 228 adults were recruited to participate in the study, 83(36%) males and 145 (64%) females. The participants ranged in age from 18–44 years, with a mean age of 26.49 (SD ¼ 5.83). The majority (69%) of theparticipants were Jewish, 9% were Muslim, 12% were Christian, and 10%were Druze. All of the participants were able to read and speak Hebrew.The study was approved by the Institutional Review Board of the Universityof Haifa. All participants signed an informed consent form approving theirparticipation in the study.

RESULTS

Hypothesis 1: Establishing the TOPS construct validity throughfactor analysis

Factor analysis is an important procedure used to determine whether theunderlying factors of a multivariate data set also reflect the underlying con-structs of an assessment (Altman, 1991). In the current study, a principalfactor extraction with a varimax rotation was performed to assist in determin-ing the domains of the questionnaires, as demonstrated by the data.

Results of the analysis revealed three distinct factors with Eigen values . 1,comprised of 32 items (see Table 1). The first factor, daily task performance atan appropriate pace (20 items: 1–20), accounted for 25% of the variance; thesecond factor, the manner in which activities are organised throughout theday (5 items: 21–26), accounted for 12.45% of the variance; and the thirdfactor, emotional responses related to organisation in time abilities (7 items:26–32), accounted for 12.25% of the variance. Overall, the three principalfactors were consistent with the primary components on which the question-naire was initially based and were found to explain 49.68% of the totalvariance.

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TABLE 1Factor loading for each of the 32 items of the TOPS

TOPS Items

Factor I

Daily task

performance at an

appropriate pace

Factor II

The manner in which

activities are

organised throughout

the day

Factor III

Emotional responses

following

disorganisation

1 Getting out of bed in the

morning

.626

2 Using the toilet .664

3 Washing face, brushing

teeth, combing hair

.745

4 Getting dressed .756

5 Eating meals .568

6 Bathing/taking a

shower

.755

7 Organising your bag .681

8 Following instructions .599

9 Preparations before

leaving the house

.726

10 Preparing different

tasks

.652

11 Fulfilling varied roles .661

12 Completing tasks/work

that you take upon

yourself

.684

13 Arranging your room or

work space (routine)

.538

14 Finding objects in your

room or around the

house

.413

15 Getting organised for a

scheduled activity

.641

16 Getting organised to

host friends or family

.645

17 Planning leisure

activities

.583

18 Getting ready for a

group activity or a

meeting with friends

.624

19 Getting ready for sleep .582

20 Carrying out varied

activities required at

work or at school

.648

21 Dividing your day so

that you are able to do

what you wish to do

.734

(Continued)


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Table 1 provides details of the specific activities in each of the three cat-egories, together with their initial Eigen values and their internal reliabilities,presented as alpha values.

Means and standard deviations for each item, for the three factors and theTOPS final scores are presented in Table 2. The mean and SD of each factorand the final scores were computed based on those results, in order to find thecut off scores for detection of difficulties in organisation of daily life tasks ontime.

It is interesting to note that the cut off scores for Factors I and II, as well asof that of the final score, were similar, ranging from 3.16–3.21 (Factor I: 3.18;Factor II: 3.11; Final score 3.16). A score of 3 at Factor I meant “usually” notdoing a certain task in appropriate pace.

TABLE 1.Continued.

TOPS Items

Factor I

Daily task

performance at an

appropriate pace

Factor II

The manner in which

activities are

organised throughout

the day

Factor III

Emotional responses

following

disorganisation

22 Dividing your day so as

to achieve what you

need to do

.812

23 Organising your time to

accomplish several

tasks within a given

period

.678

24 Organising your time in

preparation for an

exam or work

.786

25 Performing your

everyday tasks at an

appropriate pace

.694

26 Lack of motivation .628

27 Sadness .850

28 Frustration .639

29 Anger .699

30 Crying .809

31 Outburst towards family

members

.781

32 Outburst towards

friends

.777

Eigen value 10.02 3.95 1.92

% of variance 25 12.45 12.25

Internal consistency (a) .926 .87 .87

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In Factor II, a score of 3 meant something between doing things, “1 ¼ verybad” to “5 ¼ excellent”.

However, unlike the above-mentioned scores, the cut off score for FactorIII was 2.39.

TABLE 2TOPS items, three factors and final scores

Items Mean (SD) N ¼ 228

1 Getting out of bed in the morning 3.82 (1.0)

2 Using the toilet 4.10 (0.90)

3 Washing face, brushing teeth, combing hair 4.26 (0.90)

4 Getting dressed 4.08 (0.88)

5 Eating meals 3.74 (1.07)

6 Bathing/taking a shower 3.92 (1.03)

7 Organising your bag 3.80 (1.12)

8 Following instructions 3.84 (0.92)

9 Preparations before leaving the house 3.69 (1.04)

10 Preparing different tasks 3.70 (0.96)

11 Fulfilling varied roles 3.93 (0.87)

12 Completing tasks/work that you take upon yourself 3.92 (0.96)

13 Arranging your room or work space (routine) 3.51 (1.23)

14 Finding objects in your room or around the house 3.60 (1.02)

15 Getting organised for a scheduled activity 3.94 (0.96)

16 Getting organised to host friends or family 3.88 (1.00)

17 Planning leisure activities 3.39 (0.98)

18 Getting ready for a group activity or a meeting with friends 3.73 (0.95)

19 Getting ready for sleep 3.84 (1.02)

20 Carrying out varied activities required at work or at school 3.89 (0.95)

TOPS Factor I Range: 1.54–4.95 3.87 (0.69)

21 Dividing your day so that you are able to do what you wish to do 3.91 (0.95)

22 Dividing your day so as to achieve what you need to do 4.09 (0.94)

23 Organising your time to accomplish several tasks within a given period 4.10 (0.91)

24 Organising your time in preparation for an exam or work 3.82 (1.13)

25 Performing your everyday tasks at an appropriate pace 4.16 (1.02)

TOPS Factor II Range: 1.20–5.00 4.02 (0.81)

26 Lack of motivation 3.23 (0.91)

27 Sadness 3.19 (1.16)

28 Frustration 3.13 (0.99)

29 Anger 3.07 (1.03)

30 Crying 3.57 (1.37)

31 Outburst towards family members 3.08 (1.15)

32 Outburst towards friends 3.51 (1.29)

TOPS Factor III Range: 1.43–5.00 3.25 (0.86)

Final mean score Range: 1.74–4.72 3.72 (0.56)

Question 1: Difficulty when a change occurs 3.14 (1.26)

Question 2: Being distracted by various stimuli 3.05 (1.12)


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A score of 2 at Factor III means “Usually” while a score of 3 means “some-times” the individual will “react emotionally as the result of a lack of successin performing activities at the appropriate pace”.

Based on those cut off scores, 22 participants (approximately 10% of theentire sample) were defined as being at risk for difficulties in organisationof daily life tasks on time.

In further analysis, the frequencies of the responses to the 20 items of thefirst factor were analysed in order to identify in which items more than 10% ofthe participants reported that they “never” or “rarely” succeeded in perform-ing those tasks at the pace expected from them. Results of the analysis showedthat five items were found to exceed 10%: eating (10.5%); getting ready to goto sleep (12%); finding objects in one’s room or around the house (12.4%);planning leisure activities (17%); and arranging one’s room/workplace(24%).

The means and SD of responses to the two questions are presented inTable 2. When analysing the frequencies of the first open question (difficultywhen a change occurs in a familiar routine), 24% of the participants werefound to indicate that they “usually” or “always” experienced difficulties.For the second question (being distracted by various stimuli and hence notsucceeding in finishing tasks on time), 21% of the participants indicatedthat they “usually” or “always” experienced difficulties. Moreover, althoughthe qualitative data received from the two open questions requires further anddeeper analysis it showed that these issues were very meaningful for the par-ticipants in relation to perceived organisation of time. For example, partici-pants described a situation in which something unexpected, such as aphone call, occurs while they prepare themselves to go to work. This eventcauses confusion and harms their familiar routine thus causing them toinvest more energy and time in their routine activities and sometimes alsomaking them late.

With regard to the second open question, “being disrupted”, participantsdescribed, for example, that when they try to do their shopping in a smallsupermarket with less people in it, they perform much better and with signifi-cantly less time and energy investment in comparison to shopping in abig mall.

Hypothesis 2: Establishing TOPS internal consistency

Internal consistency was determined by calculating Cronbach’s alpha coef-ficient for all 32 items and for each category, with .70 previously stipu-lated as an acceptable level. Based on the results, the alpha coefficientwas determined as .92, indicating that the scale has excellent reliability.There was no need to delete any of the items because doing so did notimprove the level of reliability. Moreover, as presented in Table 2, the

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internal consistency values of all three factors were high (ranging from.87 to .92).

The corrected item total correlations performed for each of the threefactors indicated good results. For the first factor, “daily task performanceat an appropriate pace” (20 items), the correlations ranged from .46 to .68.For the second factor, “the manner in which activities are organised through-out the day” (5 items), the correlations ranged from .64 to .74. For the thirdfactor, “emotional responses related to organisation in time abilities” (7items), the correlations ranged from .47 to .76. As required, all the valueswere above .40 (Gliem & Gliem, 2003).

Hypothesis 3: Establishing further construct validity through agegroup differences analysis

Based on the results of the factor analysis, the construct validity of the 32-item questionnaire was examined by determining its ability to distinguishbetween three age groups.

To establish construct validity, 207 adults aged 20–40 years were takenfrom the entire sample and were divided into three age groups: (1) 20–25;(2) 25.01–30; and (3) 30.01–40 years old. The gender frequencies foundin these three groups are described in Table 3.

The ANOVA yielded significant differences for the gender frequencies in eachof the three groups, F(2, 206) ¼ 6.21 p ¼ .002. Hence, gender was held constantwhile MANOVA was performed in order to analyse whether there were signifi-cant differences between the three age groups across the three TOPS factors. TheMANOVA yielded significant differences between the three age groups acrossthe three TOPS factors, F(6, 398) ¼ 6.72 p , .0001 p ¼ .092.

Post hoc analysis indicated significant differences between certain agegroups for each of the three factors of the TOPS. Means and standarderrors (SE) and the post hoc results are presented in Table 4. As a whole, itwas found that the ability of people to perform tasks at an appropriate pace(Factor I) improved significantly between the ages of 25 and 40 (groups 2,3) in comparison to that of group 1 (ages 20–25). For the two other factors

TABLE 3The frequencies of males and females among the three age groups

Group 1

20–25 years of age

n ¼ 70

Group 2

25.01–30 years of age

n ¼ 96

Group 3

30.01–40 years of age

n ¼ 39 Total

Males 22 42 5 69

Females 49 55 34 138

Total 71 97 39 207


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of organising activities throughout the day (Factor II) and emotionalresponses following disorganisation (Factor III), significant improvementwas found between the ages of 25 and 30 and 30 and 40.

DISCUSSION

Evaluating an individual’s ability to organise time in relation to daily activityperformance and participation is not an easy task (Lollar & Simeonsson,2005; Wilson, 1997). The development of the TOPS questionnaire addressesthe need arising from the literature, as well as from interviews with individ-uals with ABD, LD, ADHD, and DCD, for a standardised evaluation scale toassess perceived ability for the organisation of daily tasks on time. Such ascale may be useful in preventing later emotional distress by providingpeople with strategies and tools to deal with their difficulties (Lavoie,2006; Levine, 2005). This trend is in line with the recent perception of partici-pation as an indicator of function and health, as reflected by the ability toengage in appropriate social roles (WHO, 2001).

As a whole, the results of the current study demonstrate good validity andreliability of the TOPS. In particular, the three principal factors resulting fromthe analysis explain 50% of the total variance, and their internal reliabilityvalues are high and acceptable, with Cronbach’s alpha ranging from .87 to.92 and corrected item total correlations ranging from .46 to .76. Theresults of the factor analysis show that the three principal factors – dailytask performance at an appropriate pace (Factor I); the manner in whichactivities are organised throughout the day (Factor II); and emotionalresponses related to organisation of time abilities (Factor III) – were consist-ent with the primary components on which the questionnaire was initiallybased, and were found to explain 49.68% of the total variance.

TABLE 4Mean (SE) of the three TOPS Categories: A comparison between the three age groups

TOPS

factors

Group 1

20–25 years of

age

n ¼ 71 M (SE)

Group 2

25.01–30 years

of age

n ¼ 97 M (SE)

Group 3

30.01–40 years

of age

n ¼ 39 M (SE)

F

(2, 201) h2

Post

hoc

TOPS I 3.56 (0.08) 3.87 (0.07) 4.18 (0.11) 10.87 ∗∗ .098 1 , 2∗

1 , 3∗

TOPS II 4.00 (0.09) 3.90 (0.08) 4.34 (0.13) 4.07 ∗ .039 2 , 3∗

TOPS

III

3.23 (0.10) 3.12 (0.09) 3.55 (0.14) 3.24∗ .031 2 , 3∗

∗p , .05, ∗∗p , .01

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The uniqueness of the TOPS tool is in its focus on daily tasks as a basis fordeveloping awareness about the individual’s abilities. Previous tools focusingon the perceived control of time employed general questions, such as: “Doyou often feel that your life is aimless, with no definite purpose?”; “Do youhave a daily routine that you follow?” (Feather & Bond, 1983). In clinicalinteraction, such questions may be useful for some of those who have attaineda more advanced level, after they have already analysed and developedawareness of their actual daily performance in time using a tool such as theTOPS. Through the process, the individual becomes the expert of his/herown daily experience, a kind of “expert witness” (Atikson, 2004).

Preliminary results of possible cut off scores indicated that a mean finalscore of below 3.16, which is logical according to the meaning of thegrading scale, might be a sign of difficulties in organisation of daily lifetasks on time. Preliminary cut off points were also supplied for each of thethree factors. At this phase, the clinician may use the scale for detecting dif-ficulties in the client’s ability to be organised in time, while relating to theitems, factors and final scores. Further studies in larger samples and variedpopulations are required in order to further establish the TOPS cut offscores for identification of people with difficulties in organisation of dailylife tasks on time.

Focusing on one’s daily activities may lead to a greater personal under-standing of the changes that need to be made in order to improve one’s organ-isation of daily activities on time and thereby enhance one’s feelings ofsuccess and empowerment.

Raising individuals’ awareness may lead them to develop better organis-ational ability through self-management (e.g., Britton & Glynn, 1989) inthe temporal dimension. Developing such planning behaviour may berelated to various positive influences on the individual, such as less strain(Jex & Elacqua, 1999), somatic tension (Davis, 2000) and role ambiguity(Macan et al., 1990). Furthermore, it may enhance the individual’s successin the work environment (Claessens, Van Eerde, Rutte & Roe, 2004;George et al., 2008), job satisfaction (Adams & Jex, 1999; Davis, 2000;Macan, 1994; Macan et al., 1990) and health and well-being (Adams &Jex, 1999).

In that context, the results of the frequencies of the difficulties encounteredin achieving certain daily tasks at an appropriate pace may have implicationsfor the clinical process. For example, 12% of participants were found to havedifficulties with organisation of time when they needed to find objects in theirroom, and 24% had difficulty in arranging their room or work environment.These findings shed light on the relation between organisation in space andorganisation of time. Zental and colleagues linked the ability to plan andexecute an activity within a limited time, place objects where they can beeasily located, and plan how to execute the activity as a construct of


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organisation of time and space (Zentall et al., 1993). Other researchers haveemphasised the dimensions of time and space in relation to organisationalability (Blanche and Praham, 2001; Temple, 1997). Temple (1997), forexample, defined organisational ability as the ability to plan ahead and organ-ise behaviour across time and space in order to fulfil one’s goals andintentions.

Therefore, although the TOPS focuses on organisation of time abilities,deep analysis of the items problematic for each individual may supplyinsight into the meaning of organisation of time deficits and their relationto the individual’s own organisation in space abilities.

Based on the qualitative data collected from the two open questions and thefact that more than 20% of the typical adult participants indicated having dif-ficulties with changes in routine and distractions from too many stimuli, theseissues seem to be critical to a better understanding of individual performance.Thus, clinicians can only benefit from having a standardised assessment toolavailable for evaluating these issues. Previous studies have emphasised dailyfamily routines as a measure of the ability to organise both family membersand daily activities in a way that facilitates well-being by providing a sense ofcontrol and confidence (Fiese & Wamboldt, 2000). Routines are predictable,repetitive, and functional, and result in meaningful outcomes, hence provid-ing a supportive framework (Woods, Kashinath, & Goldstein, 2004). On theother hand, changes in daily routines may be experienced as a kind of stressorand are associated with emotional responses. Previous studies have also high-lighted the consequences of stress as a result of disorganisation on people’shealth and well-being (Almeida et al., 2002). Implementing an evaluationwith the TOPS questionnaire might prevent further emotional complicationsby exploring the presence of daily routines and changes in those routinesthrough the therapeutic process (Mahoney et al., 1999).

The option of discussion of the results of the current study regarding agedifferences is limited. To the best of our knowledge, no standardised toolexists for evaluating a perceived organisation of daily tasks in time abilityamong adults in varied age groups (Zentall al., 1993; Lifshitz & Josman,2006). Most studies on performance abilities or organisational skills in timeamong adults compared younger adults (aged 20–30 years) to older adults(aged 60–80 years). Studies of varied performance abilities of adults in theage range of 20 to 40 are scarce. Additional research is required in order todetermine the ranges of organisation of time abilities in varied age groups,with an emphasis on older adults. There is a recognised decrease in motorspeed and executive control (e.g., Treitz, Heyder, & Daum, 2007), as wellas in daily life functioning (e.g., Amieva, Phillips, & Della Salla, 2003)among this population. Information gathered with such a tool in typical popu-lations can constitute a basis for studying perceived time organisation abilityamong adults with varied pathologies in the future.

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Conclusion and future research

The development of the TOPS provides an answer to the need for a valid andreliable tool for the evaluation of organisation of daily life tasks on timejudged by the respondent him or herself. It was utilised in a diverse populationof 228 adults in Israel and was found to have good content, face and concur-rent validity, with acceptable internal consistency. Further, validity wasdemonstrated by its three domains and by its distinction between agegroups in organisation of time. The TOPS questionnaire addresses the needto use ecologically valid assessments for evaluating perceived organisationof time, which relates to executive control (Burgess et al., 2006). Executivecontrol has become a major topic of discussion in theory and research inrecent years (e.g., McCloskey, Perkins, & Van Divner, 2008).

The main limitation of the current study is that it used a stratified sample,but in a snowball method, and thus participants in each class may share thesame characteristics and not be a representative sample. Future studiesusing larger, representative samples should be performed to expand andstrengthen our preliminary findings. It is also recommended that the TOPSbe studied for test–retest reliability. Furthermore, although the instrumentwas initially examined among typical adults, future research using theTOPS should evaluate organisation of time among adults from diversepopulations with varied disabilities that may have an impact on theirparticipation.

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