The development of the conversation skills assessment tool.

Background and aims: Having a conversation with someone or even more within a group of people is complex. We are never taught at school how to do it, which implies we consider having a conversation as something simple and straightforward. Instead, we just learn from observing others. Some people are great conversationalists - it comes naturally to them - while others struggle. Some people may not fully understand how the process works, how turn-taking happens, don't understand visual cues such as body language and facial expressions, and fail to comprehend that some topics may be appropriate or inappropriate. This can be the case for both neurotypical and neurodivergent people. The Conversation skills Assessment Tool has been developed in this first instance to help in assessing and examining conversation skills in an intervention with young autistic adults on a virtual platform (a virtual world). This paper will present the evolution of the new measure through the exploratory phase, the development phase and finally a detailed account of the inter-rater reliability process. Methods: The intervention associated with this study was carried out though a multiple baseline design with 3 autistic participants (in their early 20 s) and took place over 4 phases (15-17 sessions). The sessions involved semi-structured conversations in face-to-face (phases 1 and 4) and virtual (phases 2 and 3) settings and were videotaped with the participants' consent. Twelve of those were used by this study in the development process through iterative inter-rater reliability stages between two coding teams. Results: Evaluation of the Conversation skills Assessment Tool tool revealed the potential benefit of implementing interventions with measures that more objectively and concretely (e.g., by noting frequencies) assess observable behaviours that are associated with having positive conversations with others. Beyond this, it is anticipated that Conversation skills Assessment Tool can emerge as a tool capable of not only accounting for the environment an interaction takes place in (e.g., professional, casual), but also offers beneficial feedback for both autistic students and other populations (e.g., young children, English language learners). Conclusions: This measure has the potential to offer quantifiable and trackable guidance to people who have difficulties conversing. The authors do not wish to perpetuate an ableist social construct of what is a 'good' conversation, nor do they suggest that conversation skills training is useful solely for people with communication and/or socialization difficulties. Rather, they hope that Conversation skills Assessment Tool can be adopted more broadly to give both neurotypical and neurodivergent people a better understanding of how to communicate more effectively with others, while also becoming more aware and accepting of differing conversational styles. Implications: Because of its ability to track (or self-monitor) one's development of conversational skills over time, Conversation skills Assessment Tool could serve as an educative tool in early childhood education. It can be used by occupational/speech therapists and other professionals and also used to self-monitor one's development of conversational skills. Conversation skills Assessment Tool was developed to assess conversation skills on a one-to-one basis; therefore, another iteration of Conversation skills Assessment Tool would have to look at group conversations.

Enhancing pre-employment transition services: A type 1 hybrid randomized controlled trial protocol for evaluating WorkChat: A Virtual Workday among autistic transition-age youth.

Autistic transition-age youth experience high rates of unemployment and underemployment, in part due to the social challenges they may face when having conversations in the workplace. In an effort to help enhance conversational abilities in the workplace, our collaborative team partnered to develop WorkChat: A Virtual Workday. Specifically, our team of scientists, community partners, and diversity and inclusion experts participated in a community-engaged process to develop WorkChat using iterative feedback from autistic transition-age youth and their teachers. With initial development complete, this study reports on the protocol that our collaborative team developed, reviewed, and approved to conduct a randomized controlled trial (RCT) to evaluate the real-world effectiveness and initial implementation process outcomes of WorkChat when integrated into post-secondary pre-employment transition services (Pre-ETS). Our aims are to: 1) evaluate whether services-as-usual in combination with WorkChat, compared to services-as-usual with an attention control, enhances social cognition and work-based social ability (between pre- and post-test); reduces anxiety about work-based social encounters (between pre- and post-test), and increases sustained employment by 9-month follow-up; 2) evaluate whether social cognitive ability and work-based social ability mediate the effect of WorkChat on sustained employment; and 3) conduct a multilevel, mixed-method process evaluation of WorkChat implementation.

Guidelines for assessment and intervention with persons with disabilities: An executive summary.

This article provides an executive summary of the American Psychological Association's (APA's) revised Guidelines for Assessment and Intervention With Persons With Disabilities. The revision was requested by the Committee on Disability Issues in Psychology and was approved by the APA Council of Representatives in February 2022. The task force updated and expanded the guidelines' empirical bases; squarely situated the guidelines in a changing sociocultural landscape (reflected in discussions of disability models, biases and barriers, language use, intersectionality, and respectful and fair assessment and intervention); and added many concrete suggestions for conceptualizing disability and working with disabled clients and their support systems. In this executive summary, we include key points from each of the 23 guidelines. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Near-Peer Facilitation of a Soft Skills Program for Young Adults With Autism.

IMPORTANCE: Young adults with autism spectrum disorder (ASD) experience poor employment outcomes. Teaching soft skills and using peer-based interventions improve outcomes for people with ASD. OBJECTIVE: To evaluate the preliminary efficacy of a soft skills intervention and the feasibility of delivery to a group of young adults with ASD by near-peer occupational therapy master's-level students. DESIGN: Pretest-posttest single-group design. SETTING: College campus. PARTICIPANTS: Convenience sample of 14 young adults (M age = 21.57 yr) with ASD. INTERVENTION: The Assistive Soft Skills and Employment Training (ASSET) program is a 12-session, manualized, soft skills group intervention previously validated with the ASD population. Topics include communication, attitude and enthusiasm, teamwork, networking, professionalism, and stress management. OUTCOMES AND MEASURES: Social functioning, self-efficacy, and adaptive behavior were measured preintervention and immediately postintervention using standardized self-report rating scales. Participant satisfaction and experience were assessed using program-specific measures. RESULTS: Participants made statistically significant improvements, with medium to large effect sizes in social functioning, self-efficacy, and adaptive behavior. They reported high levels of satisfaction and a positive experience with the program content and delivery. CONCLUSIONS AND RELEVANCE: This study provides evidence of participant satisfaction and perceived soft skills improvement and confidence, in addition to the preliminary efficacy of master's-level students as near-peer facilitators of the ASSET program with an ASD population. What This Article Adds: The results suggest that trained and supervised master's-level students can effectively deliver a manualized intervention as near-peer facilitators, elicit positive feedback and high levels of participant satisfaction, and replicate and extend previously reported participant gains.

Psychosocial and vocational impacts of COVID-19 on people with and without disabilities.

PURPOSE/OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic led to devastating economic impacts and psychosocial changes for individuals around the world, including people with chronic illness and disabilities (CID). This study explored the impacts on employment and how it related to stress and satisfaction with life during COVID-19 between people with and without CID. RESEARCH METHOD/DESIGN: A cross-sectional study design was used with 1,380 adults from 20 countries who were employed before the COVID-19 pandemic, including 318 people with CID. Statistical methods (i.e., descriptive statistics, chi-square analyses, two-way analysis of variances) were used to analyze the time, employment, group, and interaction effects. RESULTS: There were three main findings. (1) Compared with those without CID, individuals with CID were more likely to have their employment impacted by the COVID-19 pandemic and they were more often laid off or dismissed from their job. (2) Individuals with CID reported significantly higher stress and lower life satisfaction compared with those without CID during the COVID-19 pandemic regardless of its impacts on employment. (3) Individuals whose employment was impacted reported significantly lower life satisfaction during the COVID-19 pandemic regardless of their CID status. CONCLUSION/IMPLICATIONS: Findings highlight the employment and psychosocial impacts of a global pandemic and provide implications for moving forward in regards to vocational and psychosocial intervention services and supports that will be needed, especially for those with CID. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Character Strengths Across Disabilities: An International Exploratory Study and Implications for Positive Psychiatry and Psychology.

The purpose of this study was to examine the differences in character strengths for people with disabilities by using an international dataset by the VIA Institiute on Character. Specifically, we aimed to explore (a) the top and bottom five character strengths reported by different disability groups and all people with disabilities more broadly, and (b) group differences in each character strength and total character strengths. The investigator contacted the VIA Institute on Character (http://www.viacharacter.org/) for obtaining the dataset for the current study. After data cleaning, our sample size resulted in 11,699 people with disabilities. Among most people with disabilities, the top five character strengths scores were love of learning, honesty, appreciation of beauty and excellence, kindness, and fairness. The bottom five character strengths scores were self-regulation, perseverance, zest, spirituality, and prudence. Knowing that there is heterogeneity in character strengths across groups gives us a better understanding of the areas that people with different disabilities and conditions might thrive and provides clinicians and practitioners with a more nuanced understanding for how to possibly intervene with their clients. Positive psychiatry and psychology implications are discussed.

Social support as a mediator of stress and life satisfaction for people with intellectual or developmental disabilities during the COVID-19 pandemic.

INTRODUCTION: This study examined factors that predict stress level and life satisfaction among adults with intellectual or developmental disabilities during the COVID-19 pandemic and the role of social support. METHOD: From a larger study about the experiences during the pandemic of 2028 individuals with and without disabilities, 181 adults with intellectual or developmental disabilities (or proxy) responded. RESULTS: Most respondents with intellectual or developmental disabilities (92.8%) reported negative impacts from the pandemic, with 55.2% of the 96 employed pre-pandemic reporting impacted employment, including job loss. The negative impact of the pandemic was a significant predictor of stress level; social support was related to reduced stress. Stress level and the negative impact of the pandemic were inversely related to life satisfaction; social support was positively related to life satisfaction. Social support partially mediated the association between stress level and life satisfaction. DISCUSSION: Comprehensive services and social support systems are needed to combat the impact of the pandemic.

Using the biopsychosocial model to predict sense of community for persons with serious mental illness.

BACKGROUND: Sense of community (SOC) is paramount for persons with serious mental illness (SMI) to achieve the goals of psychiatric rehabilitation (PsyR): recovery, community integration and quality of life (QOL). This study provides a thorough understanding of the predictors of SOC by using the biopsychosocial model as the conceptual framework. AIMS: The purpose of this study was to evaluate the effectiveness of the proposed biopsychosocial model of SOC among persons with SMI. METHOD: Hierarchical regression analysis was used to understand the overall prediction model of SOC, as well as the unique contribution of the biological, psychological and social factors on SOC. RESULTS: Results of the study provide empirical support for using the biopsychosocial model in understanding SOC for persons with SMI. CONCLUSIONS: This study informs PsyR professionals on how to provide effective PsyR services to improve SOC for persons with SMI, such as self-efficacy promotion and social support provision.

Health Care Transition Services and Adaptive and Social-Emotional Functioning of Youth with Autism Spectrum Disorder.

To promote health care transition services (HCTS) among youth with autism spectrum disorder (ASD), it is important to understand their access to HCTS and the association with functioning. We conducted weighted descriptive statistics and regressions. Findings suggested that HCTS were inconsistently provided to youth with ASD. Access to two or more HCTS was associated with positive social-emotional functioning. Helping youth with ASD understand health care changes and working with them to gain skills in managing health needs were found to be significant determinants of positive social-emotional functioning. The present study sheds light on HCTS that are essential for youth with ASD and highlights the necessity of health care system changes to promote service access and optimal functioning for youth with ASD.

Building Skills, Confidence, and Wellness: Psychosocial Effects of Soft Skills Training for Young Adults with Autism.

Recognizing that social functioning and mental health are linked to social participation and employment outcomes, this pilot study examined the preliminary outcomes of an eight-session, work-related social skills training program designed for young adults with high-functioning autism (HFASD). Results indicate statistically significant improvements in social cognition, social function, and social confidence. Furthermore, participants (n = 26) reported statistically significant reductions in anxiety, and a trend toward lessening depressive symptoms. These results suggest that: (1) social skills training is suitable for individuals with HFASD and clinically-significant levels of anxiety and/or depression, and (2) bolstered social functioning may have broader, cyclical impacts on social confidence, psychological wellness, and social and vocational participation in this population.

Applying the self-determination theory to develop a school-to-work peer mentoring programme to promote social inclusion.

Social inclusion of individuals with intellectual and developmental disabilities (IDD) is related to positive mental health and social outcomes; yet, individuals with IDD experience societal barriers that limit opportunities for community participation. Providing opportunities for interactions between individuals with and without IDD through peer mentoring may diminish barriers and improve community inclusion. Guided by the self-determination theory, the current report describes the development of a peer mentoring programme to promote the natural process of building intrinsic motivation and personal growth through opportunities for individuals without disabilities to socialize with individuals with IDD on a large university campus and throughout the surrounding community. The theoretical framework that informed the development of the peer mentoring programme is described, as well as the participants, the setting in which the programme is situated, the structure of the programme, the initial impacts and improvement of the programme over time, including approaches to sustainability, and implications for future research and practice.

Predictors of perceived social effectiveness of individuals with serious mental illness.

OBJECTIVE: Social effectiveness continues to play a critical role in recovery of people with serious mental illness (SMI), with greater social effectiveness predicting many positive life outcomes. Despite the abundance of literature supporting the relationship between perceptions and behavior, little is known about predictors of perceived social effectiveness of individuals with SMI. METHODS: The purpose of this study is to examine the predictors of perceived social effectiveness of individuals with SMI. Cross-sectional data of 192 participants with SMI recruited from four psychiatric rehabilitation clubhouses in 2 states in the South and Midwest regions of the United States were used for this study. Self-report data on category of psychiatric disabilities, psychiatric symptoms, cognition, insight, educational attainment, empathy, interpersonal interactions and relationships, self-stigma, disability acceptance, and perceived social effectiveness were collected and analyzed using multiple regression analysis (MRA). RESULTS: MRA yielded a regression model that accounted for 56% of the variance in perceived social effectiveness, which is considered a large effect size. Controlling for all other factors, mood disorder, educational attainment, empathy, interpersonal interactions and relationships, and disability acceptance were found to be significant predictors of perceived social effectiveness of persons with SMI. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Practitioners should consider determining points of intervention and targeting specific elements that enhance perceived social effectiveness. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Development, feasibility, and preliminary efficacy of an employment-related social skills intervention for young adults with high-functioning autism.

This article details the iterative development, feasibility, and preliminary efficacy of an 8-week work-related social skills intervention, Assistive Soft Skills and Employment Training, for young adults with high-functioning autism spectrum disorder. In this mixed-methods study, pre- and post-intervention surveys, interviews, and functional measures were used to gather information on the program's feasibility, user acceptability, practicality, and preliminary efficacy. Results indicate that Assistive Soft Skills and Employment Training graduates showed significant improvements in work-related social skills knowledge, social functioning, and social/empathy self-efficacy. Participants and group facilitators also reported high satisfaction with program activities, training modalities, frequency, and duration of the intervention. Results support expanded use of group-based, work-related, social skills interventions for young adults with high-functioning autism spectrum disorder. Moreover, these findings, though preliminary, suggest that manualized, empirically based programs like Assistive Soft Skills and Employment Training promote improved social functioning, self-confidence, engagement, and adherence to training, as well as broader impacts, including improved sense of belonging and greater employability in this traditionally underserved population.

Social-cognitive predictors of vocational outcomes in transition youth with epilepsy: Application of social cognitive career theory.

OBJECTIVE: This study examined the utility of social-cognitive career theory (SCCT; Lent, Brown, & Hackett, 1994) as a framework to investigate career self-efficacy, outcome expectations, goals, and contextual supports and barriers as predictors of choice actions among transition-age individuals with epilepsy. Moreover, these SCCT constructs are offered as an operational definition of work participation in this population. METHOD: Using a quantitative descriptive research design and hierarchical regression analysis (HRA), 90 transition-age individuals with epilepsy, age 18-25, were recruited from affiliates of the Epilepsy Foundation and invited to complete an online survey comprised of a series of self-report social-cognitive measures. RESULTS: The HRA findings indicated that self-efficacy, outcome expectations, and environmental supports were significant predictors of work participation in youth and young adults with epilepsy. The final model accounted for 58% of the variance in work participation, which is considered a large effect size. CONCLUSIONS: The research findings provide support for the use of the SCCT framework to identify predictors of work participation and to provide guidance for designing customized vocational rehabilitation services and career development interventions for individuals with epilepsy in the transition from adolescence to adulthood. (PsycINFO Database Record

Symptom severity and life satisfaction in brain injury: The mediating role of disability acceptance and social self-efficacy.

BACKGROUND: Although the negative impact of symptom severity on subjective well-being outcomes has been established among individuals with brain injury, the mediating and protective role that positive human traits might have on this relationship has not been adequately explored. OBJECTIVE: The purpose of this study was to examine the impact of social self-efficacy and disability acceptance on the relationship between symptom severity and life satisfaction among individuals with brain injury. METHODS: Hierarchical regression analysis and correlation techniques were used to test a hypothesized dual-mediation model of life satisfaction in a sample of 105 adults with acquired brain injury. RESULTS: Results indicated that social self-efficacy and disability acceptance fully mediated the relationship between symptom severity and life satisfaction, lending support for a dual-mediation model with disability acceptance being the strongest contributor. CONCLUSIONS: These findings suggest there may be considerable value for rehabilitation providers to develop strengths-based service strategies and/or specialized intervention programs that focus on capitalizing these positive human traits to promote life satisfaction and well-being for clients with brain injury. Implications for clinical practice and future research direction are also discussed.

Disclose or not? Effect of impression management tactics on hireability of persons with epilepsy.

OBJECTIVE: The purpose of this study is to determine the effect of assertive impression management (IM) tactics, such as personal storytelling and self-promotion, on job interview outcomes of people with epilepsy. Specifically, the effect of IM on interviewers' subjective impressions and evaluation of hireability of job candidates with epilepsy were examined. METHODS: Ninety-nine master's level graduate students majoring in business or human resources were randomly assigned to three experimental conditions to view one of three 15-min video clips of a job applicant interviewing for a technical computer sales position. The three experimental conditions were (1) job applicant who did not disclose any disability, (2) job applicant with epilepsy who did not use IM tactics, and (3) job applicant with epilepsy who used IM tactics. After watching the job interview video portraying the experimental conditions, participants were asked to rate the job applicant in terms of general impression and hireability for the described position. RESULTS: The use of IM was found to have a significant effect on job interview outcomes (p < 0.01). Post hoc comparisons indicated that the average rating of business/human resources students on both general impression and hireability for the job applicant with epilepsy and IM condition were significantly higher than for the job applicant with epilepsy who did not use IM condition. Furthermore, mediation analysis revealed that general impression is a mediator for the relationship between IM and interview outcomes. SIGNIFICANCE: This study demonstrates that IM has a significant and positive effect on job interview outcomes for persons with epilepsy. IM can be used as a powerful strategy for empowering people with epilepsy to combat disability stigma, and offset negative perceptions of employers about the potential of this population to be productive workers.

Brief Report: A Pilot Study of the Use of a Virtual Reality Headset in Autism Populations.

The application of virtual reality technologies (VRTs) for users with autism spectrum disorder (ASD) has been studied for decades. However, a gap remains in our understanding surrounding VRT head-mounted displays (HMDs). As newly designed HMDs have become commercially available (in this study the Oculus Rift™) the need to investigate newer devices is immediate. This study explored willingness, acceptance, sense of presence and immersion of ASD participants. Results revealed that all 29 participants (mean age = 32; 33 % with IQ < 70) were willing to wear the HMD. The majority of the participants reported an enjoyable experience, high levels of 'presence', and were likely to use HMDs again. IQ was found to be independent of the willingness to use HMDs and related VRT immersion experience.

Mediators of disability and hope for people with spinal cord injury.

PURPOSE: To test potential strength-based mediators of functional disability and hope in adults with spinal cord injury. METHOD: Two hundred and forty-two participants with spinal cord injury were recruited for this study. The mean age of participants was 44.6 years (standard deviation = 13.2), and 66.1% were men. Participants completed a survey containing a demographic questionnaire, as well as measures of functional disability, hope, self-esteem, proactive coping, perceived social support and disability acceptance. Mediation analysis was conducted using a bootstrap test for multiple mediators. RESULTS: Proactive coping, self-esteem and perceived social support significantly mediated the relationship between functional disability and hope, while disability acceptance did not. The combination of mediators resulted in functional disability no longer being a significant predictor of hope. CONCLUSIONS: The strength-based constructs of proactive coping, self-esteem and social support appear effective in predicting hope regardless of severity of spinal cord injury. Functional disability was no longer predictive of hope after controlling for these strength-based constructs. Disability acceptance did not significantly add to the mediation model. These results provide further evidence for strength-based interventions in rehabilitation. Implications for Rehabilitation Strength-based constructs of proactive coping, self-esteem and social support are important factors for addressing hope following spinal cord injury, regardless of level of severity. Rehabilitation services providers should focus efforts on supporting clients in the accurate appraisal of predictable stressors and then generate means for addressing them as a form of proactive coping. Rehabilitation services providers must be cautious when addressing self-esteem to focus on perceived competence and learning processes rather than self-esteem directly or through the accomplishment of goals that may not be achieved. Knowing that social supports are related to hope post-spinal cord injury, it is important for rehabilitation services providers to recognize potential social supports early in the rehabilitation process and involve those social supports in the rehabilitation process when possible.

Factors influencing Chinese college students' preferences for mental health professionals.

BACKGROUND: Transition from high school to college can be particularly difficult and stressful for Chinese college students because of parent expectations. AIMS: The purpose of this study was to examine therapist variables influencing Chinese college students' preferences for mental health professionals using conjoint analysis. METHOD: Two hundred fifty-eight community college students in Hong Kong were asked to rate the profile of 55 mental health professionals representing a combination of therapist characteristics (i.e., gender, age, race/ethnicity, professional background, and training institutions) from the most to least preferred therapist from whom to seek psychological counselling. FINDINGS: Results indicated that students' preference formation was based largely on professional background and training institution of the mental health professionals. Clinical psychologists and clinical social workers were preferred over educational psychologists (school psychologists), counsellors, and psychiatrists. Mental health professionals who received training from more prestigious schools were preferred over those trained at less prestigious schools. CONCLUSIONS: Understanding clients' preference formation for choosing mental health professionals could be the first step to gain insights for developing effective educational and outreach strategies to promote help seeking behavior and mental health service utilization among Chinese college students.

Gender differences in vocational rehabilitation service predictors of successful competitive employment for transition-aged individuals with autism.

As males and females with autism spectrum disorder (ASD) experience different symptomology, their needs for vocational rehabilitation (VR) are unique as they transition into adulthood. This study examined the effects of gender differences in VR service predictors on employment outcomes for transition-aged individuals with ASD. A total of 1696 individuals (857 males and 839 females) were analyzed from a sample of RSA-911 data of FY 2011. Hierarchical logistic regression analyses were conducted. Results revealed both gender-independent VR service predictors (with job placement and on-the-job supports more beneficial for both genders) and gender-specific predictors of employment (with counseling and guidance, job search assistance, and other services more beneficial for the male group). This study provides support for individualized gender-specific VR services for people with ASD.