bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful Voluntary Grasp and Release Using the Cookie Crusher Myoelectric Hand in 2-Year-Olds
Authors: Meredith Judy M. , Uellendahl Jack E. , Keagy Robert D.
Published: April 2012

We examined the ability of two 2-year-old children with limb deficiency to demonstrate grasp and release while using the cable-operated voluntary opening hook-hand and the externally powered single-site myoelectric Cookie Crusher system. The Cookie Crusher circuit is an electronic package that causes the prosthetic hand to open in response to muscle contraction and closes (as if crushing a cookie) when the muscle is relaxed. Both children were consistently good prosthetic wearers, beginning with their initial passive devices and progressing through their cable-operated hooks and hands. However, before they began to use the Cookie Crusher (Subject 1 at 25 months, Subject 2 at 30 months), neither had developed voluntary grasp or release in spite of 3 to 12 months’ use of cable-operated voluntary opening prehensors. Both children developed a voluntary grasp and release for the first time within minutes of starting to use the Cookie Crusher. The more adept of the two children, a girl with a traumatic above-elbow amputation, showed prehensile function with the Cookie Crusher during play. The spontaneous use of the Cookie Crusher may be related to the predominance of associated reactions in young children. As children play bimanually, associated movements of the nondominant extremity often occur and, in the case of children with limb deficiencies fitted with Cookie Crusher prehensors, these associated reactions result in successful grasp and release. We will continue to follow the choice of effective control schemes in these children as they mature.
The Depersonalization of Patients: A Profile Gleaned from Narratives
Authors: Peloquin Suzanne M.
Published: April 2012

Occupational therapists who would better understand and advocate against depersonalization in health care can find specific references in narratives to the attitudes and behaviors that seem problematic. Patients argue that helpers fail to recognize that illness and disability are events charged with personal meaning. Instead of communicating with patients, helpers establish a distance that diminishes them. They withhold information in a manner that precludes hope, they use brusque manners, and they misuse their powers. Each of these behaviors seems unreasonable and impersonal, and each discourages patients. Together these narratives might inspire therapists to value interactive reasoning as central to practice, to recommit to their consideration of persons, and to enact a climate of caring.
Exploring Multicultural Competencies of Occupational Therapists: Implications for Education and Training
Authors: Pope-Davis Donald B. , Prieto Loreto R. , Whitaker Christina M. , Pope-Davis Sara A.
Published: April 2012

The purpose of this investigation was to explore the influence of demographic and educational variables on self-reported multicultural competencies of occupational therapists. A sample of 94 occupational therapists currently working in the field participated in this investigation. Multicultural course work, seminars and workshops, percentage of minority patients worked with, and highest degree held were found to correlate significantly with self-reported multicultural competencies. Regression analyses found that highest degree held, percentage of minority patients worked with, multicultural course work, and participation in multicultural seminars and workshops accounted for about half of the variance in multicultural awareness. These findings are discussed in terms of academic courses and continued professional training and education for occupational therapists.
Prosthesis Training as a Context for Studying Occupational Forms and Motoric Adaptation
Authors: Yuen Hon Keung , Nelson David L. , Peterson Cindee Q. , Dickinson Alyce
Published: April 2012

Objectives. Occupational therapy authors frequently emphasize the importance of the use of objects in the development of motor skill. This study investigated the use of object-produced visual input in learning control of flexion and extension of an above-elbow training prosthesis.

Method. Fifty-two male college students were randomly assigned to two training procedures: (a) two 1.5-min periods in which they used a flashlight attached to the hook of the prosthesis to connect dots on paper with light, or (b) the same time periods in which they had the opportunity to practice moving an equally weighted prosthesis, but without the light or dots. To assess motoric adaptation after training under one of the two conditions, each subject traced a continuous line through a maze with a pen attached to the hook. Deviations from the line were measured reliably.

Results. Data analysis with a Mann-Whitney test revealed that subjects in the group that trained with added materials traced with significantly more skill than subjects in the other group (one-tailed U =225.5, p = .02).

Conclusion. As predicted by occupational therapy theory, the object-produced visual input enhanced the learning of a motor skill relevant to rehabilitation. Although there is a need for more study across different occupations and populations, clinicians are urged to consider the possible benefits of the use of objects in the development of motor skills, as opposed to objectless exercise. Prosthetic training provides a useful context for future research addressing theoretical issues in motor learning.
Using Research Literature to Develop a Perceptual Retraining Treatment Protocol
Authors: Neistadt Maureen E.
Published: April 2012

Objectives. Treatment protocols derived from research literature can help therapists provide more rigorous treatment and more systematic assessment of client progress.

Method. This study applied research findings about the influence of task, subject, and feedback parameters on adult performance with block designs to an occupational therapy treatment protocol for parquetry block assembly – an activity occupational therapists use to remediate constructional deficits. Task parameter research suggests that parquetry tasks can be graded according to the features of the design cards, with cards having all block boundaries drawn in being easier than those with some block boundaries omitted.

Results. Subject parameter findings suggest that clients’ lesions and initial constructional competence can influence their approaches to parquetry tasks.

Conclusion. Feedback parameter research suggests that a combination of perceptual and planning cues is most effective for parquetry tasks. Methods to help clients transfer constructional skills from parquetry to functional tasks are also discussed.
Future Time Perspective and Daily Occupations of Persons With Chronic Schizophrenia in a Board and Care Home
Authors: Suto Melinda , Frank Gelya
Published: April 2012

Objectives. An ethnographic approach was used to study the relationship between temporal perspective in persons with chronic schizophrenia and their ability to function in chosen occupations and participate in the routines of a board and care home. Components of future time perspective (extension, coherence, and density) are associated with the ability to organize and implement goal-directed activities. The study focused on how future time perspective occurs in a board and care home, with particular emphasis on how the institution influences temporality.

Methods. Participant observation and interviewing were used to gather data on 10 subjects.

Results. The pervasive influence of the facility’s institutional rules and expectations is revealed in the findings of subjects’ present time orientation and limited future time perspective.

Conclusions. An examination of the fit between the demands of available roles within one’s environment and occupations is proposed.
Medical Residents’ Education About Occupational Therapy: Implications for Referral
Authors: Deitch Cathy J. , Gutman Sharon A. , Factor Stephanie
Published: April 2012

Objective. The purpose of this study was to assess sources of physician education concerning occupational therapy and to determine whether these sources influence occupational therapy referral rates.

Method. One hundred fifteen medical residents from Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, were surveyed.

Results. Residents learn about occupational therapy through informal, direct, and interactive types of contacts (touring occupational therapy departments, having personal contact with an occupational therapist, having a family member receive occupational therapy). Perceived knowledge about occupational therapy was not significantly associated with referral rate, but it did influence a resident’s desire for further education about occupational therapy.

Conclusion. Strategies for increasing medical residents’ understanding of occupational therapy and for increasing their referrals to occupational therapy include opportunities for small group role playing, structural system changes within clinical sites, and direct marketing to consumers.
Perceived Stressors and Coping Strategies of Occupational Therapy Students
Authors: Everly Janet Stout , Poff Daniel W. , Lamport Nancy , Hamant Cel , Alvey Gayle
Published: April 2012

Objectives. Occupational therapy students often perceive their curriculum to be stressful. Anecdotal reports have described occupational therapy students’ stress and coping strategies during their academic education; this study quantifies students’ perceptions.

Method. A questionnaire was used to survey 1,095 occupational therapy students representing the major geographical regions of the United States about perceived stress and coping strategies. The data were analyzed to determine patterns and frequencies of subjects’ stress and coping strategies.

Results. At least 86% of the subjects reported their top stressors to be examinations, amount of class work, lack of free time, long hours of study, and grades. Sixty-two percent of subjects said that the stress they experienced strengthened their commitment to their professional education.

Conclusions. Academic issues and time pressures were more stressful than nonschool issues for occupational therapy students. Subjects’ strategies for coping with these stressors usually included perseverance and rarely involved drugs, sex, or alcohol.
Bridging Conflicting Ideologies: The Origins of American and British Occupational Therapy
Authors: Schemm Ruth Levine
Published: April 2012

Occupational therapy practice has bridged two contradictory value systems for more than 100 years. This article describes the origins of practice ideas in both the United States and Britain and demonstrates that founding members of the occupational therapy profession all shared a core of humanistic beliefs while embracing the emerging paradigm of scientific medicine. The result has been an intellectual tension between the biological and the psychosocial aspects of practice. For more than 75 years, occupational therapists struggled to balance the art and science of patient care; recent debates on modalities, practice domains, and research priorities indicate that the unifying core of the profession is occupation that considers a person’s mind and body.
The Use of Occupational Therapists in Independent Living Programs
Authors: Bowen Robin E.
Published: April 2012

Objectives. Occupational therapy literature describes various independent living programs developed by occupational therapists and at times documents their effectiveness, yet none of the literature reviewed examined the involvement of occupational therapists in independent living programs.

Method. Directors of independent living programs in the United States were surveyed to ascertain their use of occupational therapists, to discover which disciplines were providing traditional occupational therapy services (e.g., daily living skills, assistive device provision, etc.) in these programs, and to identify which types of independent living programs were more likely to use occupational therapy services.

Results. Less than half of the 96 responding independent living programs (46%) reported using occupational therapy services, and those programs that did provide occupational therapy services did so at a minimal rate. The programs that employed occupational therapists offered traditional occupational therapy services more often than those with no occupational therapists, but frequently, occupational therapists were not the providers of these traditional occupational therapy services. Chi-square analyses indicated that an independent living program’s use of occupational therapy services was significantly affected by the type of facility (p = 0.05), the primary funding source (p = 0.04), and the program’s practices regarding the hiring of professionals without disabilities (p = 0.04).

Conclusion. Possible reasons why occupational therapists are not employed more by independent living centers are discussed and recommendations for change are provided.
Play and Preschool Children With Autism
Authors: Restall Gayle , Magill-Evans Joyce
Published: April 2012

Objectives. This research focused on two questions. First, how does the play of children with autism differ from that of normally developing children? Second, what are the relationships between play performance and adaptive abilities?

Method. Nine children with autism and nine children without dysfunction were matched by mental age, gender, and socioeconomic status. Play performance was determined from videotapes of children playing in their homes. Parents provided information on children’s adaptive abilities.

Results. The children with autism differed from their peers on the total play score and the participation dimension of the Preschool Play Scale. Communication, as measured by the Vineland Adaptive Behavior Scales, was the adaptive ability most highly associated with play performance of the children with autism.

Conclusion. The results suggest that deficits in social development are a primary feature of autism. The findings support the use of play to evaluate and develop the interpersonal skills and habits of preschool children with this disorder.
Content for Educational Programs in School-Based Occupational Therapy From a Practice Perspective
Authors: Powell Nancy J.
Published: April 2012

Objectives. After approximately two decades of occupational therapy in the schools, updated information is needed on performance of roles, functions, and tasks for educators to use in updating content in occupational therapy professional education.

Method. A survey was sent to occupational therapists practicing in Michigan schools to gather information upon which curricular content decisions could be based. One hundred thirty-six therapists (59% of the population sampled) responded to the survey.

Results. The following intervention areas were performed most by respondents in the sample and, therefore, are needed in educational programs: sensorimotor, object manipulation, perception, biomechanics, dressing, feeding, use of adaptive and assistive devices, content related to positioning, seating, and wheelchair use, and play and leisure skills.

Conclusion. Neurophysiological approaches and assessment of students in schools were viewed by respondents as the most needed by current students in educational programs. Current needs of practitioners for continuing education focused on neurophysiological approaches; respondents reported that information about these approaches was also most needed when beginning to practice. More instruction in time management and techniques for dealing with large caseloads were noted to be important areas to address in the preparation of practitioners in schools.
Orthotic Intervention for Development of Hand Function With C-6 Quadriplegia
Authors: DiPasquale-Lehnerz Pamela
Published: April 2012

Objectives. Much has been written about the use of static orthoses to maintain proper position and prevent deformity, but there are few empirical data to determine whether static orthoses improve function, maintain range of motion, or prevent deformity in the hand.

Method. This study measured gains in hand function during a 3-month rehabilitation period in 13 persons with sixth cervical (C-6) level complete quadriplegia, 7 of whom wore a static orthosis at night (experimental group) and 6 who did not wear the orthosis (control group). Hand function, range of motion and strength were measured in all subjects 4 weeks and 8 weeks after the study commenced, and again after 12 weeks in only 69% of the subjects.

Results. No significant differences were found in hand function between control and experimental groups; hand function had improved significantly in all 13 subjects.

Conclusion. As the effects of deformity have been clinically observed, future studies should examine the effects of static orthoses with increased daily wear or wear over a longer period of time.
Functional Performance of Young Children After Traumatic Brain Injury: A 6-Month Follow-Up Study
Authors: Coster Wendy J. , Haley Stephen , Baryza Mary Jo
Published: April 2012

Objectives. A follow-up study is reported of 40 children between the ages of 1 month and 5.6 years who had sustained a brain injury either with (n = 11) or without (n = 29) additional injuries.

Method. Children and their families were assessed at both 1 and 6 months after hospital discharge with standardized measures of functional performance and family functioning, including the Child Behavior Checklist, the Pediatric Evaluation of Disability Inventory, and the Impact on Family Scale. In addition to within-group analyses, functional outcome was compared to that of a group of 17 children who had sustained non-central nervous system injuries.

Results. Mean scores for both groups of injured children were within the average range at both 1-month and 6-month follow-up testing. There was a general trend toward improved performance across the follow-up period, although only a few of these changes reached statistical significance. The effect of the injury as reported by the family was significantly associated with children’s function as reflected by number of behavior problems and increased need for caregiver assistance.

Conclusion. Results point to the need for systematic follow-up of young children after brain injury using sensitive measures to enable early identification of children whose further development may be at risk and to provide support to families whose children are displaying changes in functional behavior.
Approaches to Treating Dysphagia in Patients With Brain Injury
Authors: Avery-Smith Wendy , Dellarosa Donna M.
Published: April 2012

Dysphagia and its treatment in patients with brain injury are multifactorial. Treatment provided should address each deficit area relevant to dysphagia and should be consistent with current trends and knowledge. This article describes the subskills that compose the ability to swallow and their treatment in patients with brain injury. The available literature describing treatment and its efficacy relevant to each subskill area is reviewed. Specific areas for documenting efficacy of occupational therapy interventions are described.
Role Change After Traumatic Brain Injury in Adults
Authors: Hallett Joy Davies , Zasler Nathan D. , Maurer Patti , Cash Sandra
Published: April 2012

Objectives. The purpose of this study was to gather information regarding changes in adult life roles following severe traumatic brain injury.

Method. The Role Checklist and a semistructured interview were administered to 28 adults with traumatic brain injury who had been in the community for at least 8 months prior to the study. All 28 subjects reported role changes in their lives.

Results. The majority of the role changes were losses (71%). More than 64% percent of the subjects reported three or four role losses. The losses were in major organizing roles such as worker, hobbyist, and friend. Most role gains were seen in the roles of home maintainer, family member, and religious participant. Almost 40% of all roles were reported as changed (loss or gain), while more than 60% of roles were reported as unchanged (continuous or absent). The participants’ subjective impressions concerning the role changes and why they occurred were elicited.

Conclusion. With a better understanding of possible role change after traumatic brain injury, rehabilitation professionals can target the development of specific skills necessary for the continuation of valued roles.
Helping Factors in a Peer-Developed Support Group for Persons With Head Injury, Part 1: Participant Observer Perspective
Authors: Schwartzberg Sharan L.
Published: April 2012

Objectives. An ethnographic study of a peer-developed support group for persons with head injury was conducted to identify helping factors. These factors are the peer group experiences and processes, established theoretically and empirically, that provide support through self-help.

Method. The group comprised 13 members who regularly attended sessions for 16 months. In addition to participant observation, the data included audiotapes and videotapes of the group. The data were subjected to thematic analysis to find patterns in the participants’ experience with regard to group helping factors.

Results. Many of the positive attributes of the group seem similar to processes found in successful peer support groups. These attributes include believing and feeling part of the group because members have a common problem and can validate the effects of the injury by sharing and receiving information in a variety of ways through the group.

Conclusion. Legitimization, the acceptance of the head injury itself as real, appears to be the fundamental concept that distinguishes this group from other problem-focused self-help groups and professionally led groups.
Volitional Narratives and the Meaning of Therapy
Authors: Helfrich Christine , Kielhofner Gary
Published: April 2012

Objectives. Occupational therapy literature has long recognized meaning as central to therapy. By focusing almost exclusively on how the therapy process influences the experience of meaning, the literature has neglected to examine how the patient's experiences before therapy influence the creation of meaning in therapy.

Method. Building on a previous study of how patients discover and recount the meaning of their own lives in volitional narratives, we investigated the effect of those narratives on the experience of therapy.

Results and Conclusion. Our examination of the therapeutic experiences of two patients enrolled in a psychiatric day hospital program reveals how they assigned meaning to therapy as an episode within their larger volitional narrative.
Work Hardening: Past, Present, and Future — The Work Programs Special Interest Section National Work-Hardening Outcome Study
Authors: Niemeyer Linda O. , Jacobs Karen , Reynolds-Lynch Kathleen , Bettencourt Carl , Lang Susan
Published: April 2012

Objectives. A review of outcome research conducted between 1982 and 1992 revealed return-to-work rates for industrial rehabilitation programs that ranged from 50% to 88%. Variations in outcome statistics appeared to reflect discrepancies in factors such as type of research design, initial characteristics of the client sample, and clients excluded from the study group.

Method. A work-hardening outcome study involving 36 programs was conducted by the Work Programs Special Interest Section to address questions left unanswered by existing studies regarding (a) rates of program nonacceptance or noncompletion, (b) basic client characteristics and outcome, (c) length of disability and outcome, (d) breakdown of client disposition after program completion, and (e) program characteristics and return to work.

Results. Findings included the following: (a) 11.5% of clients were not accepted into work hardening and 24.6% did not complete the program; (b) outcome was not related to client age, gender, area of injury, or physical demand level of job before injury; (c) as duration of disability increased, return to work decreased significantly; (d) at discharge, 48.2% of clients returned to the usual and customary job and 30.5% to alternate or modified work, whereas 13.6% were referred to a vocational counselor; and (e) there was no relationship between number of visits or number of professionals seen and return to work.

Conclusion. The authors suggest a need for uniform standards in collection of outcome data to establish a basis for comparison of efficacy among programs. Recommendations include tracking comparison or control groups, grouping clients in terms of length of disability, computing success rate on the basis of number of clients who completed their program, using relevant subcategories when reporting return to work, and consistency of the postdischarge interval for follow-up.
Transition From School to Community Living
Authors: Brollier Chestina , Shepherd Jayne , Markley Kerri Flick
Published: April 2012

The transition process by which a student with moderate to severe disabilities is prepared to leave the school setting and enter into employment and community living is legally mandated and includes provisions for occupational therapy and other related services. This transition requires a team approach in which members collaborate to determine objectives with the student and his or her family in the domains of domestic, community, recreational, and vocational living. Assessment and intervention focus on functional activities that are chronologically age-appropriate and environmentally based. This focus on real life activities is a departure from the prereadiness skills and simulations used by some occupational therapists in school systems. This literature review describes the transition from school to community living, discusses methods to increase parental participation, and provides examples of functional assessments and intervention strategies pertinent to occupational therapy practice for persons with moderate to severe disabilities.
Occupational Cumulative Trauma Disorders of the Upper Extremity
Authors: Williams Renee , Westmorland Muriel
Published: April 2012

The umbrella term cumulative trauma disorders (CTDs) (also known as repetitive strain injuries, overuse syndromes, and repetitive motion disorders) covers a number of similar conditions arising from overuse of the joints or soft tissues of the upper extremity. Occupational CTDs have become a common problem in the workplace. These disorders are costly to the employer, the worker, and society in terms of time lost from work and resulting disability. Within the past decade, occupational therapists and physical therapists specializing in rehabilitation of work-related musculoskeletal injuries have seen an increase in the incidence of CTDs of the upper extremity in the workplace. Therapists are called upon not just to treat these injured workers, but also to help them regain a functional level for work reentry and to educate them to prevent reinjury. This article reviews the literature on the epidemiology, etiology, pathophysiology, and management of upper-extremity occupational CTDs. Because the ultimate goal of the workplace is to maintain the health and safety of the employee, an educational approach to hand, wrist, elbow, and shoulder use is essential to prevent, decrease, or eliminate the risk of occupational CTDs of the upper extremity.
The Neurobiology of Learning: Implications for Treatment of Adults With Brain Injury
Authors: Neistadt Maureen E.
Published: April 2012

The effectiveness of occupational therapy interventions for adults with brain injury is largely dependent on how well clients are able to learn the new strategies, techniques, and information therapists are trying to teach them. Neuroscience research in the past two decades has provided some intriguing hints about the neurological processes that may underlie that learning. Understanding this research might stimulate new occupational therapy ideas about more effective ways to facilitate recovery and learning in adults with brain injury. This review presents an overview of the physical, biochemical, and electrical changes in nerve cells that have been found to accompany learning in adults with and without brain injury. Recommendations for treatment derived from the review include teaching to clients’ levels of learning and information-processing strengths.
Using Audioteleconferencing to Link Occupational Therapy Graduate Students in the United States and Canada
Authors: Mitcham Maralynne D. , O’Shea Barbara J.
Published: April 2012

Lack of access to graduate education in the United States and Canada is a frustration for many occupational therapists who wish to further their careers. One way to overcome lack of access is to use technology to bridge the distances. The occupational therapy schools at the Medical University of South Carolina, Charleston, and Dalhousie University, Halifax, Nova Scotia, have collaborated for several years to provide graduate occupational therapy courses via audioteleconferencing. A general overview of the progress made in the project, as well as its design and unique features, is discussed. The major recommendation is that more occupational therapy schools could use distance education to collaborate when resources are few and needs are great. Such efforts benefit both faculty members and students.
The Effect of Occupational Therapy Education on Students’ Perceived Attitudes Toward Persons With Disabilities
Authors: Lee Tatia M. C. , Paterson John G. , Chan Chetwyn C. H.
Published: April 2012

Objectives. The effect of occupational therapy education on students’ perceived attitudes toward persons with disabilities was studied.

Method. The perceived attitudes of 144 occupational therapy students toward persons with disabilities were measured before (retrospective pretest) and after (posttest) the students attended formal professional education at the University of Alberta.

Results. Posttest scores were significantly higher than the retrospective pretest scores, indicating that students’ attitudes became more positive after they commenced formal professional education. The posttest scores of students at various levels of education, however, did not show any significant difference.

Conclusion. On the basis of these observations, a positive but nonlinear relationship between occupational therapy education and attitudes toward persons with disabilities was postulated.
Activities of Daily Living Capabilities and Values of Long-Term-Care Facility Residents
Authors: Atwood Shelby M. , Holm Margo B. , James Anne
Published: April 2012

Objective. The Minimum Data Set for Nursing Home Resident Assessment and Care Screening was used to compare staff-report and self-report of residents’ capabilities in eight activities of daily living (ADLs) in one long-term-care facility (LTCF).

Method. The relative values residents placed on independence in each of the eight ADLs were compared with their self-reported capabilities in those ADLs. Subjects were 30 LTCF residents ranging in age from 45 to 96 years.

Results. Residents perceived themselves to be significantly more capable than did staff members for dressing (p < .05), toileting (p < .01), locomotion (p < .05), and personal hygiene (p < .001). For five of the ADLs, residents tended to report high capability in the ADLs they valued most.

Conclusion. These findings support the need to include resident self-assessment in treatment planning, because staff members’ and residents’ perceptions of ADL capabilities may differ.
Predicting Outcome in High-Risk Newborns With a Neonatal Neurobehavioral Assessment
Authors: Majnemer Annette , Rosenblatt Bernard , Riley Patricia
Published: April 2012

Objectives. Effective medical management and rehabilitation efforts in neonates at risk depend on early identification of underlying brain injury. The aim of this study was to determine the prognostic value of the Einstein Neonatal Neurobehavioral Assessment Scale (ENNAS) in high-risk neonates, and to compare its predictive validity at two stages in development (i.e., 1 and 3 years of age).

Method. Twenty-three healthy neonates (control group) and 51 high-risk neonates (high-risk group) were assessed at term and were followed longitudinally. At 1 and 3 years, subjects in both groups were evaluated in a blind fashion by a psychologist and a pediatric neurologist.

Results. Developmental delays became more apparent as high-risk newborns matured; the percentage of subjects with an abnormal Griffiths general quotient increased from 1 year (13.7%) to 3 years (39%). Analysis revealed that a normal neonatal performance on the ENNAS in high-risk subjects accurately predicted a favorable outcome at 1 year and 3 years of age. Although an abnormal ENNAS was not consistently associated with a poor outcome, the positive predictive value improved markedly from 1 year to 3 years of age.

Conclusion. The findings indicate that a normal neonatal neurobehavioral assessment is reassuring, as most of these children are free of neurodevelopmental sequelae at 3 years of age. For many persons, the ENNAS may provide early evidence of a pattern of brain injury that is manifested only as the child is challenged by more complex skill acquisition such as language, memory, and perceptual-motor tasks. The ability of this assessment to predict behavioral and academic skills at school age remains to be determined. Early identification of developmental deficits enables occupational therapists to direct infants to appropriate early intervention programs, thus optimizing their functional potential.
The Assessment of Motor and Process Skills of Persons With Psychiatric Disorders
Authors: Pan Ay-Woan , Fisher Anne G.
Published: April 2012

Objective. The purpose of this study was to examine the discriminant validity of the Assessment of Motor and Process Skills (AMPS) when used to evaluate a heterogeneous sample of subjects with psychiatric disorders.

Method. Sixty subjects, ranging in age from 16 to 72 years, participated in this study; 30 were persons without disorders living in the community; 30 had diagnosed psychiatric disorders. Two univariate F tests were used to test the hypothesis that mean AMPS measures would differ significantly between the group with and the group without psychiatric disorders.

Results. The hypothesis was supported for both AMPS motor and process scale measures. As would be expected among a sample that includes many higher functioning persons, many subjects with psychiatric disorders did just as well as subjects in the group without psychiatric disorders.

Conclusions. Motor as well as process skill abilities of persons with psychiatric disorders should be evaluated. Because the AMPS provides more specific features than other global functional instruments, it can help clinicians plan treatment and intervention more effectively. Further examination of the motor and process skill deficits within and among diagnostic subgroups and of the effect of medication and prolonged hospitalization on AMPS motor and process abilities is indicated.
Weaving the Warp and Weft of Occupational Therapy: An Art and Science for All Times
Authors: Wood Wendy
Published: April 2012

This article employs a metaphor of weaving in order to analyze, both historically and critically, the art and science of occupational therapy. To spark reflection about where occupational therapy has been, is now, and would like to progress as the new century approaches, the article is thematically organized around the profession’s two most fundamental convictions. These convictions are termed the warp and weft of occupational therapy. The warp of occupational therapy is defined as our philosophical belief that engagement in occupation can favorably influence health. The weft of occupational therapy is defined as our humanistic value of respect for the person. Occupational therapy is, in turn, regarded as a powerful tapestry of human potential that unfolds when this belief and value are therapeutically applied. By analyzing selective clinical, educational, and research initiatives throughout this century, the article is dedicated to the continued adherence to, and development of, occupational therapy’s core principles.
Use of the Bruininks-Oseretsky Test of Motor Proficiency in Occupational Therapy
Authors: Wilson Brenda N. , Polatajko Helene J. , Kaplan Bonnie J. , Faris Peter
Published: April 2012

Objective. In addition to the need for good measurement tools in occupational therapy, there is a need for the tools to be used knowledgeably. The purpose of this article is to investigate the usefulness of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) for both descriptive (diagnostic) and evaluative (change over time) purposes.

Method. The typical profile of subtest scores for children with mild motor problems revealed that certain subtests of the BOTMP may be better indicators of motor problems for these children than others. An analysis also was performed to compare the use of raw (point) scores with standard (age-adjusted) scores in evaluating change.

Results. Four subtests that provide a greater degree of discrimination between children with and without motor problems were identified. Raw (points) scores were found to provide a more valid measure of change over time than standard (age-related) scores.

Conclusion. We recommend that, for clinical use, the BOTMP subtest standard scores be used for diagnostic purposes and that the raw scores be used for evaluative purposes.
Occupational Adaptation Model of Professional Development as Applied to Level II Fieldwork
Authors: Garrett Sharon A. , Schkade Janette K.
Published: April 2012

Objective. The purpose of this study was to test the validity of a model of professional development that was based on occupational adaptation. This model proposes that students have three classes of adaptive response behaviors available for use: primitive, transitional, and mature.

Method. Eight Level II fieldwork students were assigned to the Department of Veterans Affairs Medical Center, Dallas, Texas, for 12 weeks. Experienced fieldwork supervisors at the medical center developed a taxonomy of behavioral statements consistent with the developmental model’s three classes of adaptive response behaviors. This taxonomy was converted to a student log in which supervisors rated the frequency with which the Level II fieldwork students exhibited these behaviors.

Results. The patterns of behaviors, which were represented graphically for each of the students, generally supported the predictions of the model. Students demonstrated all three classes of behaviors. Primitive and transitional behaviors emerged when the students experienced increased or unusual demands, even when the students’ modal behaviors was mature. Students temporarily reverted to lower level behaviors when faced with situations that they perceived as too difficult or as too unfamiliar.

Conclusion. This model of professional development facilitates an understanding of students’ development during their transition from classroom to practice setting. Generalization to other settings will require validation of the student log.
Group Treatment: Goals, Tasks, and Economic Implications
Authors: Duncombe Linda W. , Howe Margot C.
Published: April 2012

Objective. In 1993, a replication of a 1983 survey of occupational therapists who used group treatment in practice was administered in order to determine whether economic and demographic changes during the 10-year period altered the use of group treatment in the delivery of occupational therapy services.

Method. The survey used in 1983 was updated with new questions regarding reimbursement and payment and was mailed to 307 practicing occupational therapists nationwide. Of the 188 respondents, who represented all areas of practice, 96 used group treatment and provided data on the 233 groups that they led.

Results. The two largest groups of occupational therapists who used group treatment worked in non-medical facilities (i.e., schools and community facilities). In general, group occupational therapy was activity oriented and small sized. Therapeutic goals included enhancing patients’ task skills, communication and socialization skills, and physical abilities. Fifty-five percent of the 75 respondents to a reimbursement question indicated that there was no difference in the rate charged for individual versus group treatment.

Conclusion. Occupational therapists continue to use group treatment in a variety of facilities and with many different groups. The differences between the 1983 and 1993 studies were largely due to demographics (e.g., the decrease in the number of therapists working in mental health settings.) Recent documentation of the cost-effectiveness of group treatment may promote its use in times of staff member shortages and restricted funds.
Involvement of Adult Rehabilitation Patients in Setting Occupational Therapy Goals
Authors: Northen Jena G. , Rust Diane M. , Nelson Craig E. , Watts Janet H.
Published: April 2012

Objective. This preliminary study was designed to determine whether occupational therapists involve patients and their families in a goal-setting process and, if so, to identify the methods used.

Method. Thirty registered occupational therapists practicing in adult physical rehabilitation settings were audiotaped during an initial evaluation. Researchers reviewed corresponding documentation and interviewed each subject. Twenty-three patient and family involvement criteria were generated from standards developed by accreditation commissions and health care professions.

Results. Data revealed that although subjects did involve patients and families in a goal-setting process, a number of criteria were not attempted, thus much potential for involvement was unrealized. Subjects with scores above and below one standard deviation from the mean were identified to determine which patient participation criteria had the highest discrepancies. Discrepancies included (a) verbal preparation of the patient and family for initial and ongoing treatment, purposes and procedures of evaluation and treatment, and potential outcomes of treatment, (b) attempts to elicit the patient’s concerns, and (c) collaboration with the patient to establish treatment goals.

Conclusion. Factors that might have influenced subjects’ use of a patient participation approach included the application of a specific theory or technique, time constraints, patient’s age, and assumptions about the patient’s cognitive status.
Comparing the Roles of Community-Living Persons and Patient Populations
Authors: Dickerson Anne E. , Oakley Frances
Published: April 2012

Objectives. This study compares the occupational role profile of a large sample of community-living persons without disabilities with the profile of a population of patients with psychosocial or physical disabilities and suggests areas of occupational therapy intervention.

Methods. The Role Checklist was used to compare the roles of 1,020 community-living persons without disabilities with the roles of 292 adults with physical or psychosocial disabilities. Specifically, community-living persons were matched to the entire patient group, a group of patients with psychosocial dysfunction, and a group of patients with physical dysfunction to compare the groups in terms of their past, present, and future role profiles and the value they assigned to those roles.

Results. There were significant differences in the types of roles identified. In general, the patients identified involvement in fewer present roles than the community-living persons. Differences between the two groups also appeared in the identification of future roles and value of those roles.

Conclusions. Roles appear to be affected by disability, whether physical or psychosocial in nature. If role participation is seen as part of the occupational functioning of the person, occupational therapy needs to address this area.
A Room Temperature Vulcanizing Silicone Rubber Sport Splint
Authors: Canelón Mario Francisco , Karus Alison joy
Published: April 2012

Athletic hand and wrist injuries may be treated by immobilizing the affected extremity in a rigid splint to protect the injury site for an extended time period. For athletes, this means a reduction in playing time, perhaps being out for an entire playing season. The use of a room temperature vulcanizing silicone rubber compound allows for a playing splint that complies with athletic regulations. Proper application of the room temperature vulcanizing silicone rubber provides an excellent, reliable protective playing splint allowing for safe, functional athletic performance for the injured player during the game. This article describes the fabrication process of a silicone rubber protective playing splint for athletic hand and wrist injuries. The effectiveness of the silicone rubber protective playing splint is illustrated via case studies.
Influence of the U.S. Military and Occupational Therapy Reconstruction Aides in World War I on the Development of Occupational Therapy
Authors: Gutman Sharon A.
Published: April 2012

The development of occupational therapy was heavily influenced by an early evolved relationship between orthopedists and reconstruction aides during the first World War. Orthopedists were largely responsible for both the presence of occupational therapy in the war and the eventual acceptance (by army personnel) of women fulfilling this military function. As a result of gender issues of that time – characterized by a dearth of employment opportunities for women and by a general resistance to women in military roles – this affiliation with orthopedists in World War I served to promote occupational therapy within the military environment. This affiliation also marked an early Willingness by occupational therapists to accept the medical model as one guide for clinical practice.
Spherical Grip Strength in Children 3 to 6 Years of Age
Authors: Link Lisa , Lukens Shirley , Bush Mary Ann
Published: April 2012

Objective. The purpose of this study was to establish normative data on spherical grip strength of children 3 to 6 years of age with the Martin Vigorimeter.

Method. Two hundred twenty-five preschoolers in the Kalamazoo, Michigan, area were tested with standardized positioning and instructions. The mean of three trials for each hand was used as the grip-strength score. A repeated measure design was used and the right and left hands were alternated during testing to allow a 20-sec rest period between trials. Hand width also was measured in inches from the head of the second metacarpal to the head of the fifth metacarpal.

Results. Hand width and grip strength were significantly correlated for both the right (p < .0001) and the left hands (p < .001). Grip strength increased linearly across all of the age groups (p < .001). The results of paired t tests did not show a significant difference in grip strength between the right and left hands or between boys and girls. A table of mean grip-strength scores and hand width measurements along with their standard deviations is presented for clinical use.

Conclusion. The vigorimeter could be used to assess the grip strength of children with rheumatic disorders without putting excessive pressure on the joints or skin of the hand.
Functional Capacity Evaluations of Persons With Chronic Fatigue Immune Dysfunction Syndrome
Authors: Barrows Diane M.
Published: April 2012

Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) is estimated to affect 2 to 5 million people in the United States. Despite its high incidence, persons with CFIDS have been neglected by the medical community mainly because there is no singular confirming diagnostic test or proven effective treatment.

The CFIDS population is incorrectly stereotyped as upper-middle-class, white, female hypochondriacs: consequently, symptoms often are belittled or ignored. In reality, CFIDS is a severe medical condition that affects women, men, and children of any race and often causes long-term or total disability.

The results of a modified functional capacity evaluation developed by the author and completed on 86 persons with CFIDS between 1988 and 1990 confirm that this population has severe physical and cognitive disabilities that affect their professional, familial, and social lives. The results of these evaluations are used to present a profile of persons with CFIDS that can serve as a basis for understanding this population and for guiding intervention.