Normalization of an ecologic organization and problem-solving test in a vocational rehabilitation setting: TEM-PRO.

OBJECTIVE: Standard neuropsychological evaluation after severe TBI (traumatic brain injury) often minimizes executive deficits, the latter are known to seriously impair return to work. Therefore, we developed an ecological organization and problem-solving test in a vocational setting called the TEM-PRO. In the present study, we aimed to normalize the TEM-PRO in a population of 40 control patients without neurological and psychiatric disorders.

MATERIAL/PATIENTS AND METHODS: The TEM-PRO is based on the multiple errands test from Shallice and Burger (1991). It has been translated into French and validated in our institution. The adaptation of the original test in a vocational setting induces the addition of 4 activities of variable complexity, research and redaction of information and demands to follow well defined rules. Skills that are solicited are planning, selective and sustained attention, prospective memory, organization, problems solving and behavior adaption over a long period of time. The control cohort included forty French-speaking patients (36 men), medium age 35±12years, mostly blue collar workers without any neurological or psychiatric history, participating in a return to work program.

RESULTS: The TEM-PRO is completed in 3 to 6h depending on the capacity of the patients and shows a good sensitivity without ceiling effect. It allows a quantitative and differentiated evaluation, a classification of various error types (interpretation and judgment failure, rule breaks, task failures and inefficiencies) and provides a qualitative behavioral analysis. Analyses from the controls patients allowed us to establish a standardized error-rating system.

DISCUSSION-CONCLUSION: The multiple errands test (TEM-PRO) is an ecological, original and sensitive test. In this study, a standardized error-rating system was obtained from a cohort of patients without neurological or psychiatric history, involved in a return to work program. Further research for the validation of the TEM-PRO on TBI patients is in progress.