Clinical Assessment and Intervention Tools

The SUS (System Usability Scale) and UTAUT-2 (Unified Theory of Acceptance and Use of Technology) had to be validated for users with autism, traumatic brain injuries, and intellectual disabilities so that they could evaluate a new training system related to their computerized workstations.

The training system includes a PowerPoint presentation on a tablet showing each adapted instruction on a slide to facilitate the assembly of an electrical resistor (written instructions, video, diagram of parts to be used), as well as a computerized workstation with numbered bins to help trainees follow the instructions.

The following co-design method was carried out with the Sustainable Health Evaluation and Innovation Network :

1. Establish a multidisciplinary advisory group (SHEN advisor, principal investigator, research coordinator)
2. Develop initial drafts of the prototype (REISD advisor)
3. Evaluate the tool by thinking aloud (REISD advisor, principal investigator, research coordinator)
4. Test the adapted tool in three workshops (ITSA, Servio, CIUSSS-CN Lapierre workshop). 12 SUS completed
5. Generate a final prototype after discussion with the research team (three researchers and master’s student)

Results:

Scale and 10 modified SUS items

Scale and 16/22 modified UTAUT-2 items

See the article accepted for publication

Cooking skills and food skills had to be adapted for users with autism so that they could assess their sense of competence in the kitchen as autistic adults when making recipes using a digital application.

The following co-design method was used:

1. Establish a multidisciplinary advisory group (master’s student, principal investigator, co-investigator)
2. Develop initial drafts of the prototype using the Autistic Self Advocacy Network. One Idea Per Line: A Guide to Making Easy Read Resources. 65pp. https://autisticadvocacy.org/wp-content/uploads/2021/07/One-Idea-Per-Line.pdf (Master’s student)
3. Evaluate the questionnaire by thinking aloud (research coordinator, master’s student, principal investigator)
4. Test the adapted questionnaire in a workshop with four young adults with autism (ITSA)
5. Generate a final prototype of the questionnaire after discussion with the research team (two researchers and master’s student)

Results

Cooking skills and food skills adapted to account for neurodiversity (questionnaire in English)
View the project poster (pending publication of the article – in French)

Objective

This questionnaire is based on the Preventive Work Behavior Model (PWBM), which describes workers’ contribution to the prevention of occupational injuries through their involvement in six types of behavior. It aims to assess the frequency with which certain behaviors are adopted in relation to prevention at work. It provides a brief definition of each of the categories, as well as a number of behaviors that can be adopted in everyday work life.

Interpretation of results

A mean score close to five indicates that the preventive behaviours in this category are frequently used by the worker. Conversely, a low average score indicates that the behaviors in this category are used infrequently. It is therefore important to consider the reasons for this low frequency of use.

This tool can be used to open discussions with the people who accompany a worker in the process of accessing, returning to or maintaining work.

For more information on this questionnaire

Lecours, A., Beaulieu, AA., Poulin, V., Nastasia, I, & St-Hilaire, F. Échelle de fréquence des comportements préventifs au travail : analyse des propriétés métrologiques. Canadian Journal of Behavioural Science. Online First. http://dx.doi.org/10.1037/cbs0000319

Lecours, A., Beaulieu, AA., Poulin, V., Nastasia, I, & St-Hilaire, F. (2021) Development of a Questionnaire Measuring Preventive Behaviors at Work. Journal of Occupational Rehabilitation, 31(3) : 570-580. doi :10.1007/s10926-02009955-2

Alexandra.Lecours@uqtr.ca

Aging at work podcast: How to preserve your health? (In French only)

The UQTR (jr) Research Chair on the Health of Aging Workers presents a podcast that focuses on the physical, mental and social aspects of the health of people aged 55 and over, and promotes their participation in the workplace after a period of disability, thereby optimizing their contribution to the functioning of organizations and the development of society.

Go to podcast

The APPrivoiser l’Aphasie Primaire Progressive (APP) program is a free information and support program for people living with APP and their loved ones. The APPrivoiser l’APP program co-construction team is made up of three main partners: the community organization ARTÈRE, the Chaire de recherche sur les aphasies primaires progressives – Fondation de la famille Lemaire (Dr. Robert Laforce & Dr. Monica Lavoie) and Université Laval/Cirris (Dr. Laura Monetta).

Program objectives:
– Inform people living with PPA and their loved ones through information sessions led by a facilitator and expert video vignettes aimed at demystifying the disease;
– Create a place for sharing and belonging.

Topics covered:
Each theme is addressed in a video capsule by an expert: neuropsychologist, speech therapist, notary, etc.

APA basics :
– PPA variants and their evolution
– Diagnosis and management
– Everyday impact of language symptoms

Facilitating communication with a person with PPA:
– Strategies for facilitating communication
– Assisting communication

Everyday impact of PPA on :
– Feeding and motor skills
– Cognition
– Autonomy
– Social participation and leisure

Caregiving issues :
– Impact of PPA on behavior
– The disease acceptance process
– Legal, placement and end-of-life issues

Format:
– Six (6) sessions
– Session length: 1h30
– A participant’s notebook is handed out at the first meeting of the program, so that participants can annotate and reread the important information covered during the program.

Contact your local association to check program availability.

For further information: info@plateformeapp.ca

Article (in French) : 
Coconstruction d’un programme psychoéducatif d’information et de soutien pour les personnes vivant avec une aphasie primaire progressive et leurs proches

A directory of mobile applications relevant to clinical practice in neuropsychology has been compiled by Éléonore Sarazin of the Neuradap laboratory of Simon Beaulieu-Bonneau, professor at Université Laval’s School of Psychology. The directory was created following responses to a survey designed to document the experience of Quebec neuropsychologists and neuropsychology students in using mobile technology as part of their clinical practice. The survey was distributed from May 9 to November 1, 2023, in collaboration with the Association québécoise des neuropsychologues (AQNP), and includes 147 respondents. The directory was built with the aim of providing Quebec neuropsychologists and neuropsychology students with a tool to facilitate the integration of the use of mobile technology into their practice. The directory includes applications of interest to clients and their various needs, but also to clinicians (organization, appointment management, stimulus presentation, etc.).

The quality and scientific validity of the applications have not been formally assessed by the research team.

Background

Clinical measures of postural control when sitting in adults are not standardized, and most are derived from in-house tools. An initial study was carried out to adapt a pediatric instrument to assess this posture in adult wheelchair users:

Adaptation of a seated postural control measure for adult wheelchair users

The Measure of Seated Postural Control in Adults (MCPAA) is a very useful tool for postural assessment. Each section assesses: 1) the ability to remain and move while seated without support (1 item); 2) static alignment of the head, trunk, pelvis and lower limbs in the three planes (22 items), and 3) variations in postural alignment caused by an activity, propulsion or locomotor aid (22 items). Test scoring is based on an ordinal scale system.

The metrological qualities of this first version of the tool were evaluated, as well as its use in a clinical context.

Aims: To assess inter-rater and test-retest fidelity.

Method: Two expert occupational therapists assessed 33 adult subjects on two occasions.

Results: The test-retest reliability of section 1 was excellent (intra-class correlation (ICC)= 0.95), while that of sections 2 and 3 was moderate (0.60 and 0.62). Inter-rater reliability was rated as good to excellent for sections 1, 2 and 3 (ICC of 0.93, 0.68 and 0.69 respectively).

Benefits: Analysis of the results has led to the development of version 2.0, which has yet to be tested. However, its use is already improving the quality and consistency of assessments carried out from one assessor to another, ensuring more rigorous follow-up of clients over time and objective verification of the achievement of intervention objectives.

Link for the article: Reliability of the seated postural control measure for adult wheelchair users

To obtain the complete French-language version of the user guide and quotation form, click here.

To obtain the clinically adapted version, click here instead.

This version 2.0 has just been culturally adapted and validated in Italian (SPCMA 2.0).

Link for the article: Cultural adaptation and validation in Italian of the Seated Postural Control Measure for Adults 2.0

Context : Labor shortages are a problem affecting all employment sectors, and the manufacturing industry is no exception. As a result, the industry is more open to recruiting people with disabilities, such as autism spectrum disorders (ASD), craniocerebral disorders (CCD) or intellectual disabilities (ID). To develop the skills of these people and enhance their employability, the Pre Vincent research team works with industrial partners to demonstrate the work carried out in the company and support familiarization with these tasks.

Objective 1 : To film employees to develop familiarization videos about working in the electronics sector for future employees of inclusive companies.

Method : A research and development specification was used to design the instructional videos.

Data collection:  An occupational therapy student and a Cirris research professional visited two industrial production companies, Festo Didactic and Gentec, located in the Quebec City area. A total of 18 employees from both companies were filmed on site.

Video editing : Educational videos lasting 3 to 8 minutes were developed. In each video, concrete text read aloud and written in black and white on a slide was inserted to reinforce understanding of the task steps observed. Attention is also drawn to the sensory stimuli present in each of the work tasks, as well as the mental functions primarily used, with the aim of informing the clienteles of the aspects they might be confronted with in this type of task.

Post-supervision questions : Four to six questions were inserted to 1) probe the person’s interest in learning to perform this type of work task, 2) probe the level of discomfort with various aspects associated with performing the task, and 3) verify understanding of the task and the safety elements essential for proper operation. To write the text, the occupational therapy student used literacy concerning vocabulary related to the microelectronics sector. She also considered the learning characteristics of people with autism spectrum disorder, mild intellectual disability and moderate to severe traumatic brain injury.

Results : 24 examples of industrial work familiarization are available in :

• Material handling (4 videos)
• Carpentry (2 videos)
• Machine operation and sub-assembly (15 videos)
• Industrial painting (1 video)
• Placement of parts in warehouse with work orders (2 videos)

Distribution : To use the educational videos, click on the links below to discover 24 examples of work in the industrial sector. These videos are particularly relevant for secondary school teachers, employment and labor services, and rehabilitation center staff. This will greatly help neuroatypical youth become familiar with different tasks in the manufacturing industry and better choose what appeals to them.

The videos (in French): 

Subassembly | Familiarization with the manufacture of a resistor | 2:39
Subassembly | Manufacture of an electronic circuit board | 7:23
Subassembly | Familiarization with the insertion of jacks (connection terminals) on one side of an electrical box | 5:01
Subassembly | Familiarization with inspecting electronic boards and through-hole assembly techniques | 5:51
Subassembly | Familiarization with manufacturing a stator (fixed part of a motor or generator) | 6:25
Subassembly | Familiarization with manufacturing an induction coil | 6:31
Subassembly | Familiarization with manufacturing an electronic board – Surface mount technology (SMT) | 6:29
Subassembly | Familiarization with the preparation of electrical wire harnesses | 5:42
Subassembly | Familiarization with the selection of electronic components and assembly of a printed circuit | 5:46
Subassembly | Preparation of through-hole parts for the assembly of electronic boards | 6:38
Handling | Hanging parts on the conveyor for painting | 3:52
Handling | Disassembly of feeder cassettes and return to inventory | 3:39
Handling | Packaging of small electronic parts for modified shipping | Duration: 3:55
Handling |Familiarization with the packaging of electronic devices for shipping | 5:00
Handling | Familiarization with the production and packaging of instruction manuals: printing, cutting, and binding | 6:24
Handling | Familiarization with unhooking, inspecting, and storing newly painted parts| 4:15
Handling | Inserting electronic components into the cells of a tape intended for the cassette | 6:43
Handling | Inserting tape into the cassette feeder of a machine that assembles electronic cards | 5:48
Machine operation | Familiarization with printing on the front or back of electronic enclosures | 4:24
Parts preparation | Execution of a work order for the collection of parts in the warehouse intended for sub-assembly | 6:49
Parts preparation | Familiarization with the collection of parts in the warehouse intended for the assembly of electronic boards | 4:16
Industrial painting | Familiarization with electrostatic spray painting of parts suspended on a conveyor belt | 5:18
Carpentry | Familiarization with the custom assembly of compartmentalized furniture for electronic modules | 7:19
Carpentry | Familiarization with the custom manufacture of industrial wooden crates for shipping | 5:30

Problem

Autism is a neurodevelopmental disorder characterized by significant deficits in sense perception, communication and social interaction, as well as restricted and repetitive behaviors and interests. The employment rate among young adults with autism spectrum disorder (ASD) is about 25%, which is about 3 times lower than among youth without disabilities. There may be a variety of reasons for this low percentage, including:

• Sensory difficulties (touch, hearing, vision, position or smell) and a lack of resources to deal with them
• A need for initial support to become familiar with the job and integrate well into the socio-professional environment (e.g., accommodation or individual support)

Solution

Studies have shown that instructional videos can be useful in promoting the recruitment and integration of autistic people into the workplace. They allow new employees to become familiar with different tasks and clearly demonstrate how to perform them. Instructional videos can also be used in schools to initiate discussions about the future of the grocery industry and then used in employment as a cheat sheet.

The educational videos developed by Dr. Claude Vincent’s research team first aim to assess the interest of future employees with ASD for different tasks to be performed in the context of a grocery store. They then make it possible to assess their understanding of the tasks and to promote their integration into the workplace. A second series of videos has also been developed to help mentors become familiar with the particularities associated with autism.

It should be noted that grocery stores are very favorable environments for autistic people, for several reasons:

• Lack of labour in the food industry predisposes employers to be more open to people with autism spectrum disorders.
• Grocery stores are present in all living environments and are already part of the daily lives of autistic people.
• Grocery stores will always need employees to perform different tasks that will be similar to a branch to the other, thus ensuring some job stability for these workers over time.

Results

11 employees of a grocery store were filmed performing various tasks in 7 separate departments. Each video includes:

• Textual information about sensory stimuli associated with tasks
• Social skills to be developed
• Safety instructions to be followed
• Hygiene instructions to be respected

A total of 21 instructional videos have been produced covering the following departments:

• Fishmonger (5)
• Fruits and vegetables (2)
• Cash register (2)
• Grocery Display (2)
• Bakery (3)
• Cheeses and cold cuts (4)
• Ready-to-eat (3)

The questionnaires associated with each video enable us to check the interest and limitations of future employees, while ensuring their understanding. Questions for mentors, meanwhile, are designed to raise their awareness of the particularities of autism. Anyone wishing to use these tools can create an account to answer the questions and then evaluate their knowledge after viewing the capsules. The data provided will be tallied.

To access the website (in French*):  Autonome Kitchen – Cuisine (app-autonome.education)Ce lien s’ouvrira dans une nouvelle fenêtre

*Please note that to access the Familiarisation à l’emploi section you must be on the French site of the application. Here’s how to change the language if you access the English version of the appCe lien s’ouvrira dans une nouvelle fenêtre.

1. Create your account
2. Click on the familiarisation à l’emploi tab
3. Choose the video to watch on Exemples de travail en épicerie

If you only wish to view the videos, you can access them via our YouTube channel: Équipe Claude Vincent, erg.

If you’d like to see the videos and questions for mentors, you can access them via our lab website (Wix). https://fredericsdumont.wixsite.com/ptsa

Problem

In 2019, the CIUSSSS de la Capitale-Nationale deplored the lack of a reliable and valid tool to assess the rehabilitation profile of autistic people in a work context in its socio-professional services. However, such a tool had already been developed ten years prior for people with intellectual disabilities. Literature searches identified only 6 validated questionnaires on the subject, but not available in French. In addition, these did not cover all dimensions of adapted work rehabilitation for autistic people.

First of all

In collaboration with 17 experts, Dr. Vincent’s research team developed, using an existing tool, a French-language observation grid specific to the reality of autistic people enrolled in a work integration pathway. Its feasibility was then tested with 3 ASD Integration workers and 5 autistic individuals (day activity center, workshops, work programs, internships)..

The original tool is the Work Rehabilitation and Adaptation Profile for adults with Intellectual Disabilities (WRAP-ID). The adapted version is called the Work Rehabilitation and Adaptation Profile for adults with Autism Spectrum Disorder (WRAP-ASD), and makes it possible to observe the rehabilitation profile in a work context of autistic people in different settings (CIUSSS, CISSS and community organizations). It also makes it possible to better document the evolution of people by identifying their strengths and needs at various points in time.

The WRAP-ASD is an observation grid in the form of an Excel compiler. It includes:

• Informative tabs (home, presentation, instructions and glossary)
• Tabs on the dimensions of rehabilitation at work for which the level of success is rated and the level of support is assessed in the comments
• Tabs used to compile results

Also, the profile of the person assessed considering 10 theoretical domains of work functioning:

1. Motivation (5 items)
2. Attendance (3 items)
3. Relationship with peers (8 items)
4. Communication skills (10 items)
5. Cognitive skills (9 items)
6. Rules and safety (3 items)
7. Independence (5 items)
8. Physical demands and endurance (7 items)
9. Handling of tools and machinery (4 items)
10. Productivity and quality (5 items)

Second of all: New version of WRAP-ASD available!

In 2023, we continued to validate the tool through observation of 41 autistic users by 19 specialized educators. In 2024, to perfect the measure, we carried out statistical analyses of its construct, internal validity and convergent validity.

The WRAP-ASD in this new version, with its 49 items instead of 59, offers added value compared with all other standardized tools, as it is the only one to track the progress of autistic ‘apprentice workers’ in socio-professional services over time. The PRACT-PTSA is also the only one to take into account as many dimensions of work as possible, and it allows the adaptations provided in the work environment to be considered thanks to the invitation to note them in the comments sections.

The WRAP-ASD refers to the different levels of support (from minimal to very important) deployed in the 4 types of socio-professional environments in Quebec, i.e. day centers, workshops, workplaces and on-the-job internships.

The changes made to the previous version concern the following elements:

– Updated Home & Questions tab
– Presentation tab updated
– Removal of 8 items (5, 16, 30, 34, 43, 47, 49 and 50)
– Merge items 2 and 3 to create new item 2
– Merging of items 7 and 8, resulting in the new item 5
– Item 29 reworked as item 25
– Item 24 reworked as item 20
– Item 52 reworked as item 42
– Item 55 has been reworked as item 45
– The title of the Handling tools/machinery section has been changed to Handling tools, appliances and machines.
– Addition of terms to the Lexicon (device, machine, simple tools, productivity)

Download the new version of WRAP-ASD (In French)

The old version is available here (In French)

Article : The ‘Work Rehabilitation and Adaptation Profile’ for Adults with Autism, a Validated French-Canadian Observation Grid

Contact the research team:
Frédéric Dumont at frederic.dumont@cirris.ulaval.ca
Claude Vincent iat Claude.Vincent@rea.ulaval.ca

One in four adults lives with chronic pain and the wait for a consultation in a specialized clinic can be counted in years. Fortunately, there are ways to alleviate pain and learn to live with it on a daily basis.

Developed by a team from Université Laval and external partners, the Agir pour moi online program was created to help people cope independently with chronic pain. The content of the program is based on an extensive review of the scientific literature on interventions that have been shown to be effective in pain management. It also takes into account the experience of people living with chronic pain, as well as the clinical experience of many health professionals.

This program is available online for free and can be completed in 8 weeks (60 to 90 minutes per week) without the support of a health professional. Developed according to the principles of patient-oriented research, it addresses the concept of pain as well as strategies for managing stress, energy, physical activity, thoughts and emotions, sleep, diet and more. Inspiring testimonial videos punctuate each lesson, in support of the theoretical content. The strategies put forward must be practiced regularly and integrated into daily routines. Participants are invited to experiment, see what strategies work for them, and adopt those that improve their quality of life.

For more information on the program, please contact Pascale Marier-Deschênes
at pascale.marier-deschenes.1@ulaval.ca

PROBLEM

There are questionnaires to assess user satisfaction with technical assistance. Clinicians can use them with their rehabilitation clients to ensure that the assistance is safe, effective, comfortable and, most importantly, that there will be no abandonment by the client of this technical aid. When users are dissatisfied, two solutions are possible: offer better training or opt for a different technical aid.

Several clinicians in the rehabilitation world as well as community organizations report that these types of questionnaires are often too general when it comes to evaluating a mobile application for wheelchair navigation in urban areas. They would like access to questionnaires specifically developed to assess the level of satisfaction of people using geospatial assistance.

Let’s take the example of a person in a wheelchair who uses the Google Map pedestrian app to walk to an unfamiliar place. Does the application take into account obstacles on sidewalks (roadworks, garbage cans, thresholds)? Are lateral elevations acceptable? Are sidewalks with an upward or downward slope marked? Are uneven surfaces reported? Is the building’s entrance wheelchair accessible?

SOLUTION

In Canada, no app yet exists for users of mobility aids. We have to go to Hungary or some cities in France to get access to apps that truly take into account all aspects of wheelchair navigation. Such applications will certainly soon be available here, and the use of the Evaluation of satisfaction with geospatial assistive technology (ESGAT 1.0) questionnaire will then make it possible to assess the level of user satisfaction with the safety and accessibility of the routes suggested by these applications.

IMPLICATIONS FOR REHABILITATION

As a clinician, you can ask your clients using a mobility device on wheels to test navigation apps by completing the questionnaire. You can inquire about their satisfaction with different aspects:

1. Informatic: ease of access, learning ability, hands-free function, ease of use, transportability and appearance
2. Geomatic: content, geographic information, effectiveness, efficiency, real-time navigation aid, security aspect.

You can download the questionnaire and use it. We welcome your feedback.