ADL Profile

Purpose

The ADL Profile is a criterion-referenced measure of independence in everyday activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
such as self-care, household management and community activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
for individuals with a traumatic brain injury (TBI). The ADL Profile was created by Elisabeth Dutil, Carolina Bottari, Marie Vanier and Céline Gaudreault.

In-Depth Review

Purpose of the measure

The ADL Profile is a criterion-referenced measure of independence in everyday activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
in consideration of the important contribution of executive functions for individuals with a traumatic brain injury (TBI) (Canadian Association of Occupational Therapists, 2012; C. Bottari, personal communication, November 6, 2012). The ADL Profile consists of both a performance-based assessment (evaluator’s direct observation of performance) and a questionnaire administered in the form of semi-structured interviews with the person and a significant other (perceptions of person and significant other of person’s functioning). The ADL Profile assesses an individual’s ability to formulate and plan goals for personal and instrumental activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
of daily living (PADL and IADL) in interaction with the environment in which they live. Using a task-analysis framework, the individual’s independent performance of ADL tasks is quantitatively analyzed according to 4 executive function operations:

1. Formulating a goal
2. PlanningPlanning ability involves anticipating future events, formulating a goal or endpoint, and devising a sequence of steps or actions that will achieve the goal or endpoint” (Anderson, 2008, p. 17)
   
3. Carrying out the task
4. Verifying attainment of the initial goal (Bottari et al., 2010b).

The ADL Profile was originally developed for use with patients with traumatic brain injury as an assessment of independence in everyday activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
within three environments:

1. Personal (self-care dimension);
2. Home (home dimension); and
3. Community (community dimension).

An exhaustive list of variables was derived from existing ADL tools and were organized as activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
, tasks or operations under the three dimensions of personal care, home and community environments, according to Crochart’s (1987) ergonomic model. An expert group of therapists and researchers were consulted to review the refined list of variables and to ensure that all domains related to the concept of ADLs were included in the instrument. A review of the literature on components of ADL assessments also provided support for the experts’ verdict (Dutil et al., 2005).

Available versions

There are no alternate versions of the ADL Profile.

The IADL Profile is a revised version of the ADL Profile (Bottari et al., 2010b) and as such is not included in this review.

Features of the measure

Items:

The ADL Profile consists of 20 PADL and IADL tasks in two parts:

1. A non-structured, performance-based assessment that comprises observation of 17 tasks; and
2. A semi-structured interview administered to the patient and his/her significant other that documents 3 tasks (indicated below).

The 20 items relate to (a) personal care; (b) household management; and (c) community activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
: Personal care items (6 tasks):

1. Bathing/showering
2. Grooming
3. Toileting
4. Putting on clothes and shoes
5. Having a meal
6. Following his or her diet/taking his or her medication*

Household management (5 tasks):

1. Preparing a light meal
2. Preparing a hot meal
3. Doing daily housecleaning
4. Doing weekly housecleaning
5. Doing laundry

Community activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
(9 tasks):

1. Walking or moving outdoors
2. Using public transportation
3. Driving a car*
4. Running errands
5. Telephoning for information
6. Paying bill
7. Using an automatic banking machine
8. Making a budget
9. Keeping appointments*

* Three tasks are evaluated by semi-structured interview. Driving is not evaluated per se but certain information is gathered regarding this activity.

Description of tasks:

The client is asked what he/she would normally do at that time of the day and is then given the opportunity to perform the ADL task without assistance from the clinician. The non-structured evaluation enables the clinician to observe deficits relating to executive processes. Accordingly, the clinician informs the client at the onset of the test that he/she will provide limited interactions with the client throughout the examination. This enables the clinician to observe the client’s ability to manage on his/her own. It is important that the clinician provides a minimum of structure and assistance during the test, even if the client makes an error, because observing their ability to monitor and correct errors without assistance is crucial to showing their independence in consideration of executive functions. The examiner may withhold cueing for up to 10 minutes, unless a situation is judged as dangerous. If the person is clearly unable to perform a component without help the examiner may provide graded assistance (Bottari et al, 2010b).

If the client chooses a task that is not part of the ADL Profile the clinician may ask the client to consider another goal.

What to consider before beginning:

The ADL Profile is best administered in the client’s home and community environment (Bottari et al., 2010b).

Klein et al. (2008) reviewed standardized performance-based ADL measures developed for adult/geriatric populations using an action research study design with 10 occupational therapists working with adult/geriatric clients with physical dysfunction in a tertiary-care rehabilitation hospital, to identify which measures best matched principles of occupational therapy practice and intended outcomes. The ADL Profile achieved the highest rating for its ‘fit’ with the values, beliefs and principles that underpin occupational therapy practice when compared with 17 other ADL measures, including the Assessment of Motor and Process Skills, Rivermead ADL Assessment, the Functional Performance Measure, Nottingham ADL Scale, Barthel Index and Functional Independence Measure. The ADL Profile met four of five construct criteria:

• Client-centred (score enables item relevancy for client);
• Dynamic interaction (measure acknowledges dynamic interaction between the client, task and physical environment, but does not consider the financial or social environment);
• Uniqueness of the individual (measure enables assessment of physical, affective and cognitive performance components); and
• Uniqueness of performance (measure incorporates client determination of task process unless client safety is a factor).

Of the 18 tools analysed, none achieved a score for the fifth dimension, a holistic perspective (i.e. integration of the client’s roles, culture, resources, spiritual beliefs and values). While it was reported that the ADL Profile did not consider the social environment, it is important to note that the questionnaire is administered to the patient’s significant other.

Scoring and Score Interpretation:

Each task is scored according to independence in task performance (task score) and the manner in which the task is performed (operation score) with regards to the following four operations:

(i)formulate a goal
(ii)plan
(iii)carry out the task
(iv)verify attainment of the initial goal (Bottari et al., 2010b).

Tasks are scored using a four-level ordinal scale:

0	dependent
1	requires verbal assistance (1v) or physical assistance (1p) or verbal and physical assistance (1vp)
2	independent with difficulty
3	independent

Scores are not added across tasks or operations. The task score is determined by the lowest score on any of the four operations observed during performance of the task. Therefore, difficulty in any operation directly influences independence and task performance.

Time:

Time to administer the ADL Profile will depend on the client’s stage of recovery and the number of tasks the clinician needs to administer. In acute care, it may take between 30 and 60 minutes as the clinician may decide to only administer self care tasks and one or two tasks from the community or home domains. When administered in preparation for discharge from a rehabilitation hospital or to community based participants to whom all tasks may be pertinent to administer, up to 7 hours may be required.

The administration time is acceptable when only components of the tool are administered to the subjects, but the assessment is length if administered in full. However, the authors note that the wealth of information obtained from observing the person complete various activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
in her home and community environment cannot be underestimated in terms of its contribution to treatment planningPlanning ability involves anticipating future events, formulating a goal or endpoint, and devising a sequence of steps or actions that will achieve the goal or endpoint" (Anderson, 2008, p. 17)
.

Training requirements:

The ADL Profile is intended for use by occupational therapists. It is recommended that clinicians complete a three-day training course to ensure correct administration and interpretation. The course provides information regarding the measure (objectives, conceptual frameworks, variables, administration procedure, scoring and interpretation), uses video to provide instruction regarding administration, and provides opportunities to practice task analysis and scoring (Bottari et al., 2010a).

Subscales:

N/A

Equipment:

The ADL Profile does not necessitate specialized equipment but requires any objects the client typically uses in his/her daily living.

Alternative forms of the ADL

There are no other forms of the ADL Profile.

Client suitability

Can be used with:

• Patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
• Patients with TBI throughout the continuum of care: – to assist in discharge planningPlanning ability involves anticipating future events, formulating a goal or endpoint, and devising a sequence of steps or actions that will achieve the goal or endpoint” (Anderson, 2008, p. 17)
  from an acute care hospital, in rehabilitation and for community reintegration (Bottari et al., 2006; C. Bottari personal communication, November 6, 2012).
• Patients with schizophrenia (Semkovska et al., 2004).

Should not be used with:

• None reported

In what languages is the measure available?

French and English.

Summary

What does the tool measure?	The ADL Profile measures independence in everyday activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function. in consideration of executive function deficits related to goal setting, planningPlanning ability involves anticipating future events, formulating a goal or endpoint, and devising a sequence of steps or actions that will achieve the goal or endpoint” (Anderson, 2008, p. 17) and execution.
What types of clients can the tool be used for?	Clients with traumatic brain injury and strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Is this a screeningTesting for disease in people without symptoms. or assessment tool?	Assessment tool
Time to administer	Time to administer the ADL Profile will depend on the client’s stage of recovery and the number of tasks the clinician needs to administer. In acute care, it may take between 30 and 60 minutes as the clinician may decide to only administer self care tasks and one or two tasks from the community or home domains. When administered in preparation for discharge from a rehabilitation hospital or to community based participants to whom all tasks may be pertinent to administer, up to 7 hours may be required.
Versions	ADL Profile
Other Languages	French
Measurement Properties
ReliabilityReliability can be defined in a variety of ways. It is generally understood to be the extent to which a measure is stable or consistent and produces similar results when administered repeatedly. A more technical definition of reliability is that it is the proportion of “true” variation in scores derived from a particular measure. The total variation in any given score may be thought of as consisting of true variation (the variation of interest) and error variation (which includes random error as well as systematic error). True variation is that variation which actually reflects differences in the construct under study, e.g., the actual severity of neurological impairment. Random error refers to “noise” in the scores due to chance factors, e.g., a loud noise distracts a patient thus affecting his performance, which, in turn, affects the score. Systematic error refers to bias that influences scores in a specific direction in a fairly consistent way, e.g., one neurologist in a group tends to rate all patients as being more disabled than do other neurologists in the group. There are many variations on the measurement of reliability including alternate-forms, internal consistency , inter-rater agreement , intra-rater agreement , and test-retest .	Internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency.: No studies have examined the internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. of the ADL Profile when used with an adult strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. population. Test-retest: No studies have examined the test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society). of the ADL Profile when used with an adult strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. population. Intra-rater: No studies have examined the intra-rater reliabilityThis is a type of reliability assessment in which the same assessment is completed by the same rater on two or more occasions. These different ratings are then compared, generally by means of correlation. Since the same individual is completing both assessments, the rater’s subsequent ratings are contaminated by knowledge of earlier ratings. of the ADL Profile when used with an adult strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. population. Inter-rater: One study reported adequate inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept. for three tasks: preparing a hot meal; eating; obtaining information.
ValidityThe degree to which an assessment measures what it is supposed to measure.	Content: The ADL Profile was established through literature reviews and consultation with expert researchers and clinicians. Criterion: No studies have reported on the criterion validityExamines the extent to which a measure provides results that are consistent with a gold standard . It is typically divided into concurrent validity and predictive validity . of the ADL Profile when used with an adult strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. population. Construct: Convergent: One study reported significant correlations between five ADL Profile tasks related to personal care and corresponding tasks of the FIM (Standing up, Toilet transfers, Bathtub transfers, Walking, Stair climbing).
Floor/Ceiling Effects	No studies have examined ceiling effects of the ADL Profile when used with an adult strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. population.
SensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.” / SpecificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative).	No studies have examined the sensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.” /specificity of the ADL Profile when used with an adult strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. population.
Does the tool detect change in patients?	No studies have reported on responsivenessThe ability of an instrument to detect clinically important change over time. of the ADL Profile when used with an adult strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. population.
Acceptability	The administration time is acceptable when only components of the tool are administered, but administration in full may take up to seven hours over several sessions. However, the wealth of information obtained from observing the person complete various activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function. in her home and community environment cannot be underestimated in terms of its contribution to treatment planningPlanning ability involves anticipating future events, formulating a goal or endpoint, and devising a sequence of steps or actions that will achieve the goal or endpoint” (Anderson, 2008, p. 17) .
Feasibility	The ADL Profile can be administered by an occupational therapistIn charge of the “assessment of personal and domestic care activities; evaluation and treatment of functional impairments related to change in sensorimotor, cognitive and perceptual abilities; prescription of wheelchairs and bathroom appliances; home visits; patient and family education.”(Suggested by Philips et al, 2002) . It requires completion of a three-day training course.
How to obtain the tool?	Available at the Canadian Association of Occupational Therapists: www.caot.ca or Les Éditions Émersion http://www.leseditionsemersion.com/articles.php?lng=fr&pg=6.

* Initially developed for a traumatic-brain injured population, the psychometric properties of the tool with this population are described in the administration guide of the too

Psychometric Properties

Overview

A literature search was conducted to identify all relevant publications on the psychometric properties of the ADL Profile relevant to individuals with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain.. Two studies were found.

Floor/Ceiling Effects

No studies have reported ceiling effects of the ADL Profile in clients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain..

Reliability

Internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency.:
No studies have reported on the internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. of the ADL Profile in clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Test-retest:
No studies have reported on the test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
of the ADL Profile in patients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain..

Intra-rater:
No studies have reported on the intra-rater reliabilityThis is a type of reliability assessment in which the same assessment is completed by the same rater on two or more occasions. These different ratings are then compared, generally by means of correlation. Since the same individual is completing both assessments, the rater’s subsequent ratings are contaminated by knowledge of earlier ratings.
of the ADL Profile in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Inter-rater:
Dell’Aniello-Gauthier (1994) reported that the ADL Profile demonstrates adequate inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
(mean kappa = 0.58-0.68) for three ADL tasks: preparing a hot meal, eating and obtaining information.

Validity

Content:

The ADL Profile was established through literature reviews & consultation with expert researchers and clinicians (Dutil et al., 2005).

Criterion:

No studies have reported on the criterion validityExamines the extent to which a measure provides results that are consistent with a gold standard . It is typically divided into concurrent validity and predictive validity .
of the ADL Profile.

Construct:

Convergent:
Gervais (1995) found significant correlations between 5 tasks of the ADL Profile related to personal care and corresponding tasks of the Functional Independence Measure (Kendall’s tau c = 0.40-0.73; p<.001).

Responsiveness

No studies have examined the responsivenessThe ability of an instrument to detect clinically important change over time.
of the ADL Profile.

References

• Azegami M., Ohira M., Miyoshi K., Kobayashi C., Hongo M., Yanagihashi R., & Sadoyama T. (2007) Effect of single and multi-joint lower extremity muscle strength on the functional capacity and ADL/IADL status in Japanese community-dwelling older adults. Nursing & Health Sciences, 9(3), 168-176.
• Bottari, C., Dutil, C., Dassa, C., & Rainville, C. (2006) Choosing the most appropriate environment to evaluate independence in everyday activities: Home or clinic? Australian Occupational Therapy Journal, 53, 98-106.
• Bottari, C., Dassa, C., Rainville, C., & Dutil, C. (2010a). A Generalizability Study of the Instrumental Activities of Daily Living Profile. Archives of Physical Medicine and Rehabilitation, 91, 734-42
• Bottari, C., Dassa, C., Rainville, C., & Dutil, C. (2010b). The IADL Profile: Development, content validity, intra- and interrater agreement. The Canadian Journal of Occupational Therapy, 77 (2), 90-101.
• Canadian Association of Occupational Therapists. (2012). ADL Profile. Retrieved from: http://www.caot.ca/default.asp?pageid=1438
• Crochard, K. (1987). Les activités du GESCOM en 1986. Paris: Centre national d’études des telecommunications.
• Dell’Anniello-Gauthier, M. (1994). Étude métrologique du mini-profil, instrument de mesure du statut fonctionnel des personnes âgées victimes d’un accident vasculaire cérébral. Sherbrooke, Québec : Université de Sherbrooke.
• Dutil, E., Bottari, C., Vanier, M., & Gaudreault, C. (2005). ADL Profile: description of the instrument. 4th ed. Montréal: Les Éditions Émersion.
• Dutil, E., Bottari, C., Vanier, M. & Gaudreault, C. (2005). Profil des AVQ: Description de l’outil, 4th ed. Montréal: Les Éditions Émersion.
• Fougeyrollas, P. Saint-Michel, G. & Blouin, M. (1989). Propostition d’une révision du 3e niveau de la CIDIH: le handicap. [Proposition for a revision of the 3rd level of the International Classification of Handicaps: the handicap]. Réseau International CIDIH, 2 (1), 9-32.
• Gervais N. (1995). Comparaison du profil des AVQ et de la mesure d’indépendance fonctionnelle: validité de trait. Montréal: Université de Montréal.
• Kielhofner, G. (1995). A Model of Human Occupation: Theory and Application. USA: Lippincott Williams & Wilkins.
• Klein, S., Barlow, I. & Hollis, V. (2008). Evaluating ADL measures from an occupational therapy perspective. Canadian Journal of Occupational Therapy 75,: 69-81.
• Lawton, P. (1983). Environment and other determinants of well-being in older people. The Gerontologist 23, 349-357.
• Luria, A.R. (1973). The Working Brain – An Introduction to Neuropsychology. New York: Basic Books.
• Semkovska, M., Bedard, M.A., Godbout, L., Limoge, F., & Stip, E. (2004) Assessment of executive dysfunction during activities of daily living in schizophrenia. Schizophrenia Research, 69: 289-300

See the measure

How to obtain the ADL Profile:

The ADL Profile can be purchased at Les Éditions Émersion (https://www.leseditionsemersion.com).