Liliana Alvarez
University of Western Ontario
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Publication
Featured researches published by Liliana Alvarez.
Developmental Neurorehabilitation | 2012
Albert M. Cook; Kim Adams; Pedro Encarnação; Liliana Alvarez
Objective: Motor experience plays a central role in cognitive development. Assistive technologies can thus provide augmentative manipulation for children with motor disabilities. This paper explores the use of robots to this end. Method: A revision of studies conducted with typically‐developing children and children with disabilities regarding the use of robots is presented. This revision provides a description of the cognitive skills required and revealed by the child when using a robot. Opportunities for participation and exploration were identified and further research is discussed. Results: Robots provide insight into the cognitive skills of children with motor disabilities. Robots also provide means for independent exploration and participation in learning and play activities. Integration of augmentative manipulation and communication increases interest and participation of children with disabilities. Conclusion: Children with disabilities can use augmentative manipulation systems to independently explore and interact with their environment. Children can use robots as tools providing them with opportunities to reveal and further develop their cognitive skills. Alternative access methods can increase access for children with severe motor disabilities.
Otjr-occupation Participation and Health | 2017
Sherrilene Classen; Sarah Krasniuk; Liliana Alvarez; Miriam Monahan; Sarah A. Morrow; Tim Danter
Although used across North America, many on-road studies do not explicitly document the content and metrics of on-road courses and accompanying assessments. This article discusses the development of the University of Western Ontario’s on-road course, and elucidates the validity of its accompanying on-road assessment. We identified main components for developing an on-road course and used measurement theory to establish face, content, and initial construct validity. Five adult volunteer drivers and 30 drivers with multiple sclerosis participated in the study. The road course had face and content validity, representing 100% of roadway components determined through a content validity matrix and index. The known-groups method showed that debilitated drivers (vs. not debilitated), made more driving errors (W = 463.50, p = .03), and failed the on-road course, indicating preliminary construct validity of the on-road assessment. This research guides and empirically supports a process for developing a road course and its assessment.
Otjr-occupation Participation and Health | 2015
Sherrilene Classen; Jeffrey D. Holmes; Liliana Alvarez; Katherine Loew; Ashley Mulvagh; Kayla Rienas; Victoria Walton; Wenqing He
Parkinson’s disease (PD) is a neurodegenerative disorder that affects fitness to drive. Research that has examined clinical predictors of fitness to drive in PD, using the on-road assessment as the gold standard, has generally used a dichotomous pass/fail decision. However, on-road assessments may also result in one of two additional outcomes (pass with recommendations, or fail-remediable). Individuals within these subgroups may benefit from interventions to improve their fitness to drive abilities. This study investigated clinical predictors that could be indicative of the pass, pass with recommendations, or fail-remediable categories for drivers with PD (N = 99). Trails B, Left Finger to Nose Test, and contrast sensitivity measures were identified as significant predictors for the pass, and pass with recommendations subgroups. No significant predictors were identified for the fail-remediable subgroup. Results from this study provide a foundation for clinicians to identify drivers who can benefit from recommendations to preserve their driving abilities.
The Open Journal of Occupational Therapy | 2016
Sherrilene Classen; Shabnam Medhizadah; Liliana Alvarez
Background: The Fitness-to-Drive Screening Measure© (FTDS) is an online screening tool that enables proxy raters (caregivers, family members, and friends) to identify at-risk older adult drivers via 54 drivingrelated items. This study aimed to identify areas in need of improvement for the FTDS by identifying the patterns and trends of Canadian users and providing recommendations to increase the usage, reach, and potential impact of the FTDS as a health promotion tool. Methods: We used monthly Google Analytics reports to calculate descriptive statistics for web page and session specific variables. Variables were separated into Year 1 and Year 2 and were compared using the independent sample t-test. Results: Patterns were identified for session and web page specific variables; for example, users spent less than the recommended 20 min to complete the FTDS. There was only a significant decrease in the number of French speaking users (t (22) = .01, p < .05) from Year 1 to Year 2. Conclusion: Canadians across the country are able to easily access and use the FTDS for screening older adult drivers in its current format. However, implementing suggested recommendations (e.g., short form FTDS) may increase the overall usage, utility, and/or reach of the FTDS, and, as such, may yield additional benefits to potential users.
Canadian Journal of Occupational Therapy | 2016
Sherrilene Classen; Sarah Krasniuk; Melissa Knott; Liliana Alvarez; Miriam Monahan; Sarah A. Morrow; Tim Danter
Background. Little empirical support exists for interrater reliability between evaluators from different backgrounds when assessing on-road outcomes of drivers. Purpose. We quantified interrater reliability of on-road outcomes between a certified driving school instructor (DI) and an occupational therapist and certified driver rehabilitation specialist (CDRS). Method. Both raters used the Global Rating Score (GRS) with two levels (pass, fail), the GRS with four levels (pass, pass with recommendations, fail remediable, fail), and the priority error rating score (PERS; most frequently occurring on-road errors in priority order) to assess 35 drivers (age, M = 48.31 years, SD = 9.76 years; 40% male; 86% with multiple sclerosis). Findings. The DI and occupational therapist CDRS had excellent agreement on the GRS with two levels (κ = .892, p < .0001), GRS with four levels (κ = .952, p < .0001), and the PERS (κ = .847–.902, p < .0001), indicating interrater reliability. Implications. This research contributes to empirical support for the on-road assessment.
Otjr-occupation Participation and Health | 2016
Sherrilene Classen; Liliana Alvarez
Parkinson’s disease (PD) is a common neurodegenerative disease, increasing in incidence, with a known impact on fitness to drive. Although great progress has been made on evidence-based guidelines for assessing fitness to drive of persons with PD, a need remains for early identification of at-risk drivers in need of comprehensive assessment. This study investigated whether caregivers of drivers with PD could predict the driver’s on-road outcome. We also investigated whether the predictive value of their impressions differed from that of drivers themselves, their neurologist, or from information provided by standardized measures of visual and divided attention. Caregivers’ risk impressions (odds ratio [OR] = 13.76, p = .03) and Trail Making Test Part B (Trails B; OR = 0.41, p = .02) emerged as significant predictors of passing an on-road assessment. Our findings suggest that caregiver impressions, with a measure of set shifting, may be used as an efficient screen to identify drivers with PD who are potentially at risk for failing an on-road assessment.
Otjr-occupation Participation and Health | 2015
Sherrilene Classen; Liliana Alvarez
Research journals such as OTJR: Occupation, Participation, and Health are inviting more submissions of evidence-informed reviews as they play a critical role in advancing science and practice. A well-conducted and rigorously executed evidence-informed review can contribute much to synthesize the vast literature, make known the state of the science, and inform clinical practice, while providing direction for targeted and/or future inquiry. Evidence-informed reviews (e.g., systematic literature reviews [SLRs], integrative reviews, or scoping reviews) provide clinicians and scientists with a rigorous methodology to conduct research of primary studies (Cooper & Hedges, 1994). The process of conducting such research is generally described as encompassing problem formulation, literature search, data evaluation, data analysis, and presentation/dissemination stages. Although this general framework appears simple, much needs to be understood before embarking upon such reviews. Traditional reviews of the literature are different from evidence-informed reviews. Basic reviews of the relevant literature have long been emphasized as an important step in the research process. However, these traditional approaches to judging and interpreting scientific evidence are incomplete (Ottenbacher, 2011) for the purpose of advancing occupational therapy science and practice. Traditional literature review approaches may be broad in scope, not be specific in the search process, be biased in the source selection, be variable in appraisal, be subjective in synthesis, and lead to inferences that are not evidence based. Scholars and clinicians may still use traditional literature reviews to acquire a cursory understanding of a body of knowledge, but evidence-informed reviews are necessary for efficient and effective clinical decision making. With our growing body of knowledge, evolving science, and research involving diverse populations, settings, and/or conditions, evidence-informed reviews will help occupational therapy scientists and clinicians to
Archive | 2013
Liliana Alvarez; Adriana Rios; Kim Adams; Pedro Encarnação; Albert M. Cook
Motor experience plays a critical role in cognitive and social development. Developmental research has identified the major role of motor experience through manipulation and locomotion on the cognitive development of typically developing children. Children with physically disabilities cannot independently explore the environment and manipulate objects, and their motor impairments limit their opportunities for developing cognitive and social skills. Assistive technologies can provide the means for children with disabilities to independently interact with their physical and social environments. Assistive robots can provide children with disabilities with opportunities for object manipulation. This paper describes research using robots to understand and promote cognitive and social development of children with physical disabilities.
Otjr-occupation Participation and Health | 2018
Liliana Alvarez; Sherrilene Classen; Shabnam Medhizadah; Melissa Knott; Kwesi Asantey; Wenqing He; Anita Feher; Marc S. Moulin
Motor vehicle collisions are the leading cause of death among North American youth, with a high prevalence of distraction-related fatalities. Youth-focused interventions must address detecting (visual scanning) and responding (adjustment to stimuli) to critical roadway information. In this repeated measures study, we investigated the feasibility (i.e., recruitment and sample characteristics; data collection procedures; acceptability of the intervention; resources; and preliminary effects) of a DriveFocus™ app intervention on youth’s driving performance. Thirty-four youth participated in a 9-week protocol (retention rate = 89.7%; adherence rate = 100%). No participants experienced simulator sickness. A preliminary nonparametric evaluation of the results (n = 34) indicated a statistically significant decrease in the number of visual scanning, F(2, 68) = 3.769, p = .028, and adjustment to stimuli, F(2, 68) = 6.759, p = .002, errors between baseline, midpoint, and posttest. This study lays the foundation to support a targeted intervention trial to improve youth’s attention to critical road information, building on their mobile technology preferences.
Frontiers in Public Health | 2018
Liliana Alvarez; Sherrilene Classen; Shabnam Medhizadah; Melissa Knott; Wenqing He
Road traffic injuries are the leading cause of death for youth between the ages of 15 and 29 around the world. A need remains for evidence-based interventions that can improve the underlying skills of young drivers, including hazard perception and anticipation. This pilot study investigated the preliminary impact of a six session DriveFocus™ intervention on the ability of young novice drivers (mean age = 18.6, SD = 2.12) to detect (visual scanning), and respond (adjustment to stimuli) to critical roadway information. Using a CDS-200 DriveSafety™ simulator, drives were recorded and sent to a blinded evaluator (occupational therapist), who scored the recorded drives for number and type (visual scanning and adjustment to stimuli) of errors. We observed a statistically significant decline in the number of visual scanning [t(34) = 2.853, p = 0.007], adjustment to stimuli [t(34) = 3.481, p = 0.001], and total driving errors [t(34) = 3.481, p = 0.002], among baseline and post-test 2.