Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The goal of this poster is to provide information and foster conversation about the development, clinical use, and content validity of the Occupational Therapy Anticipatory Awareness Test (OTAAT). The OTAAT is a newly developed, performance-based assessment tool that addresses a gap in the assessment of anticipatory awareness for individuals with neurological conditions. Discussion about participation in future research and validation processes will be facilitated. Primary Author and Speaker: Danielle Mahoney Additional Authors and Speakers: Lenin Grajo, Glen Gillen

The Centennial Vision articulated by the American Occupational Therapy Association includes moving the profession to being science driven and evidence based. The American Journal of Occupational Therapy contributes to this vision by publishing high-quality research. I reviewed research in the practice area of neurological rehabilitation published between May 2010 and October 2011. In particular, I reviewed effectiveness and efficacy studies, instrument development and testing, and basic research studies. Concerns emerging from the review were (1) few studies in neurological rehabilitation; (2) many disorders not represented; (3) exclusive use of impairment-level outcomes in some studies; and (4) high preponderance of case series designs in effectiveness studies. To achieve the Centennial Vision, the field needs to improve the volume and diversity of research in neurological rehabilitation. It is also important to modify academic and clinical practice to enable occupational therapists to spend more time in producing high-quality evidence to support the crucial role they play in neurological rehabilitation.

OBJECTIVE. We sought to determine the agreement between rating of awareness based on scores on the Driving Awareness Questionnaire (DriveAware) and global judgments of awareness awarded after on-road assessment, thereby establishing the possibility of measuring drivers’ awareness. METHOD. A prospective cohort study of 60 senior drivers with neurological conditions who were referred for driving assessment. Awareness was rated as intact, partial, or absent on the basis of the discrepancy score between participants’ and clinicians’ responses to DriveAware. A second clinician (masked to these results) rated awareness on the same scale at the completion of the on-road assessment. Agreement of categorical ratings was adjusted for chance using the kappa statistic. RESULTS. Results yielded a kappa of .69 (SE = .08), indicating agreement substantially beyond chance. CONCLUSION. Results indicate that awareness of driving ability may be measured with substantial accuracy using DriveAware in senior drivers with neurological impairments. The psychometric properties of DriveAware require further research.

The ADL-focused Occupation-based Neurobehavioral Evaluation (A-ONE; Árnadóttir, 1990) can be used to evaluate both performance of activities of daily living (ADL) tasks and neurobehavioral problems that interfere with ADL task performance among clients with neurological disorders. This study examined the rating scale structure and aspects of validity and reliability of the A-ONE's ordinal ADL scale by applying Rasch analysis methods (Bond & Fox, 2001). Rasch analysis of 209 clients’ A-ONE assessments indicated that misfit of items to the ADL scale could be reduced by removing the two communication items. Threshold disordering could be corrected by combining two adjacent scoring categories (supervision and verbal assistance), thus supporting four response categories. Separation reliability for item calibrations (.98) was high and acceptable for people (.90). Finally, principal components analysis of the residuals supported unidimensionality. The study provided support for converting the ordinal ADL scale to an interval scale that has potential to be used to measure changes in ADL task performance over time.

OBJECTIVE. This study seeks to (a) compare Cognitive Behavioral Driver’s Inventory (CBDI) scores for clients who passed and failed a driving evaluation and for diagnostic groups (left cerebrovascular accident [CVA], right CVA, traumatic brain injury [TBI], and cognitive decline); (b) determine sensitivity, specificity, and positive and negative predictive values of the CBDI; (c) compare validity of the CBDI with other tools; and (d) identify factors associated with outcome. PARTICIPANTS. This historical cohort study included clients with neurological conditions who completed a driving evaluation. MEASURES. CBDI, Motor-Free Visual Perception Test (MVPT), Bells test, and driving results were extracted from the charts. RESULTS. Mean CBDI (p < 0.0001) and MVPT (p < 0.0001) scores were significantly worse for those failing compared to passing the driving evaluation. Sensitivity of the CBDI was 62%, specificity was 81%, positive predictive values were 73%, and negative predictive values were 71%. Results varied according to diagnostic group. CONCLUSIONS. The CBDI is not sufficiently predictive of outcome to replace a driving evaluation, and is predictive only for clients with R-CVA and TBI. Evaluation of driving should vary according to diagnosis.