bluuebunny/crossref_metadata_2025 huggingface dataset:
Collaborative Consultation: The Efficacy of Remedial and Compensatory Interventions in School Contexts
Authors: Kemmis Barbara L. , Dunn Winnie
Published: April 2012

Objective. This study examined the intervention success of weekly collaborative consultation between therapists and teachers.

Method. Ten therapist–teacher pairs consulted for 60 min weekly throughout the school year about students identified as having sensory integration dysfunction with learning problems. Each week, the pairs identified a specific functional classroom goal then designed either a remedial or compensatory intervention and set criteria for intervention success. At each successive weekly meeting, the pairs determined whether the goal was met. Intervention success was analyzed across 10 students (for a total of 213 goals).

Results. There was a positive effect for overall intervention success. Although remedial and compensatory interventions were equally successful across student performance areas, therapist–teacher pairs demonstrated a preference for compensatory and academic goals.

Conclusion. The overall positive effect for intervention success suggests that when occupational therapists and teachers collaborate on behalf of students, they can facilitate student success in a variety of performance areas. Therapist–teacher preference for compensatory and academic goals indicates that therapist–teacher collaboration can be useful for occupational therapists to link interventions to academic goals in school contexts.
Occupational Therapy in Full-Inclusion Classrooms: A Case Study From the Moorpark Model
Authors: Kellegrew Diane Hammon , Allen Delores
Published: April 2012

This article provides a historic review of the movement toward integrated classroom placements as well as the characteristics of full-inclusion classrooms relevant to occupational therapy school-based practice. A full-inclusion model adopted by the Moorpark Unified School District is described. This model incorporates occupational therapy as a vital and integral component of the school’s inclusive education efforts.
Supervision and Consultation Services for Pediatric Occupational Therapists
Authors: Rainville Ellen Berger , Cermak Sharon A. , Murray Elizabeth A.
Published: April 2012

Objective. Occupational therapists with advanced experience or expertise provide supervision and consultation services in a variety of settings. This pilot study examined the use of such supervision and consultation services by pediatric occupational therapists.

Method. Special education administrators and pediatric occupational therapists from Massachusetts, a state often regarded as a leader in special education, responded to surveys designed especially for this study. These surveys asked about current supervision and consultation use, satisfaction with present services, and the need for additional resources in this area. Opinions regarding practice areas that would best be addressed by supervision and consultation were also obtained.

Results. Both administrator and therapist respondents agreed that expert occupational therapy supervision and consultation are needed. Identified areas of interest were classroom supervision and consultation strategies, service delivery decisions, and evaluation methods.

Conclusion. Pediatric occupational therapists need expert supervision and consultation from occupational therapists with advanced experience or expertise in addition to traditional management, education, and training methods.
Meaningful Work in Supportive Environments: Experiences With the Recovery Process
Authors: Strong Susan
Published: April 2012

Objective. This ethnographic study examined what makes work meaningful for persons with persistent mental illness and how this meaningfulness relates to their recovery.

Method. Twelve persons between 32 and 58 years of age who had been involved an average of 19 years with a formal mental health system participated in in-depth interviews and a focus group. Thematic analysis and case studies were understood in the context of the investigator’s 15 months of participant observation of 35 persons with psychiatric disabilities working at an affirmative business.

Results. The meaning of work varied with participants ’perception of their illness and their self-concept. Changes in their self-efficacy and self-concept were driven by their participation in work activities to operate the affirmative business.

Conclusion. Findings suggest that therapists could potentially facilitate these changes in clients’ sense of self-efficacy and self-concept by helping them make connections with meaningful occupations and contributions to organizations in the community and to experience challenges and successes in the context of meaningful work.
Funding Community Practice: Stage 1
Authors: Brownson Carol A.
Published: April 2012

A broad definition of community practice has implications for how occupational therapy services are defined, delivered, and funded. The historical foundations of occupational therapy support an expansion into health promotion and prevention programming that is based in the community. Moving into these roles opens up an array of funding possibilities. It may also require developing new partnerships, new skills, and work under different job titles. This article describes two approaches to broadening occupational therapy’s role into the community and gives examples of programs and funding sources for each.
Occupation and Survival: A 25-Year Follow-Up Study of an Aging Population
Authors: Iwarsson Susanne , Isacsson Ǻke , Persson Dennis , Scherstén Bengt
Published: April 2012

Objective. In this retrospective study of an elderly population cohort living in a defined Swedish rural area, the relationship between occupation and survival as a measure of objective health was investigated. The cohort has been followed for 25 years.

Method. On the basis of the baseline socioeconomic interview from assessments performed when the participants were 67 years of age, an index of active participation in daily occupation was devised. The index was used to investigate the covariation between generic everyday occupation and long-time survival.

Results. For the female participants, Kaplan-Meier curves demonstrated differences in survival between the “less active” and “more active, ” and Cox regression survival analyses resulted in a significant covariance between occupation and survival. For the male participants, no such differences were found.

Conclusion. The significant results for the women implied support for the core assumption of occupational therapy that a relationship exists between occupation and health. The lack of differences in survival among more active and less active men demonstrates the complexity of studying occupation.
Fine Motor and Functional Performance Outcomes in Preschool Children
Authors: Case-Smith Jane , Heaphy Terri , Marr Deborah , Galvin Barrie , Koch Vera , Ellis Marcie Good , Perez Irma
Published: April 2012

Objective. Studies of the effects of occupational therapy services on hand skill development in preschool children are limited. This study examined fine motor and related functional outcomes in preschool children who received regular occupational therapy services. Differential effects that were based on the number of intervention sessions and amount of consultation were also analyzed.

Method. A sample of 44 preschoolers who received occupational therapy services and 20 preschoolers who did not receive occupational therapy services was assessed on 11 fine motor and functional measures at the beginning and end of the academic year. The occupational therapy practitioners who provided the direct services recorded the format, goals, and activities for their intervention sessions.

Results. The preschoolers who received occupational therapy services demonstrated significant improvement in all but two measures and improved more than the children without fine motor delays on five of the measures. When the preschoolers who received services, categorized by number of intervention sessions, were compared, no differences in the amount of improvement were found (other than in visuomotor skills). The preschoolers who received the most consultation improved the most in two of the measures.

Conclusion. Preschoolers who received direct occupational therapy services made significant gains in fine motor skills and related functional performance. Their gains surpassed the gains made by the children who did not receive occupational therapy services, suggesting that fine motor performance improves with intervention.
Achievement of Self-Identified Goals by Adults With Traumatic Brain Injury: Phase I
Authors: Trombly Catherine A. , Radomski Mary Vining , Davis Elin Schold
Published: April 2012

Objective. This study sought to determine whether persons with traumatic brain injury who received outpatient occupational therapy services achieved self-identified goals related to tasks of daily life.

Method. Sixteen participants completed the study. Occupational therapists used their usual treatment procedures to restore independence in home and community occupational functioning. The Canadian Occupational Performance Measure identified the five most important problems that interfered with independence in the roles the participant valued as well as the participant’s perception of performance ability and satisfaction with performance. Goal Attainment Scaling documented achievement of the five self-identified goals. The Independent Living Skills Evaluation (ILSE) and the Reintegration to Normal Living Scale(RNL) measured changes in overall instrumental activities of daily living and community reintegration.

Results. The participants significantly achieved (p < .001) their goals from admission to discharge, rated themselves as performing significantly better (p < .001), and were significantly more satisfied (p = .001) with performance after treatment than before. Additionally, they improved significantly on the ILSE (p < .001) and the RNL (p < .001) from admission to discharge. There were no significant changes in performance from discharge to followup on any of the scales.

Conclusion. Although causality cannot be inferred, it can be concluded that participants attending outpatient occupational therapy significantly improved, and improvements were sustained after discharge, but no further improvement occurred spontaneously.
Application of Structural Equation Modeling in Occupational Therapy Research
Authors: Mulligan Shelley
Published: April 2012

Structural equation modeling (SEM) is a relatively new research method for analyzing multivariate data. This article provides an introduction and overview of what SEM is and identifies some potential uses of this technique for occupational therapy researchers. The application of SEM in the areas of test construction and treatment effectiveness is highlighted, some cautionary measures related to this technique are presented, and resources that provide more detailed and advanced reading on the subject are included.
Perceptual-Motor Coupling in the Development of Grasp
Authors: Case-Smith Jane , Bigsby Rosemarie , Clutter Jill
Published: April 2012

Objective. The purpose of this study was to investigate the effect of haptic attributes of objects on infants’ grasping patterns and evaluate whether this effect is influenced by the infant’s age (i.e., phase of motor development).

Method. Grasping patterns of 180 infants who were typically developing were measured by the Posture and Fine Motor Assessment of Infants (PFMAI); the PFMAI-I was administered to infants 2 months to 6 months of age (n =60), and the PFMAI-II was administered to infants 6 months to 12 months of age (n = 120). Grasping patterns were compared for ages by month and for three objects, each with differing haptic features. The interaction between age and object was analyzed.

Results. Grasping patterns were significantly different when scores by age in months were compared. In addition, grasping patterns differed depending on the object and its haptic features and were influenced by the interaction between object held and age. Certain haptic features were associated with primitive grasp at younger ages and precision grasp at older ages. More mature skiffs were observed when the objects’ haptic features appeared to match an infant’s perceptual-motor skill.

Conclusion. The haptic features of objects influence an infant’s grasping patterns, and this influence changes with the infant’s age. These results suggest that therapists attempt to match the haptic features of objects to the infant’s perceptual-motor skiff in intervention in order to enhance grasping patterns.
Student Level II Fieldwork Failure: Strategies for Intervention
Authors: Gutman Sharon A. , McCreedy Paula , Heisler Prudence
Published: April 2012

Objective. This report describes how common student communicative and behavioral characteristics that appear to predict the existence of potential problems during Level II fieldwork were identified in order to develop and implement preventative interventions during the academic curriculum at New York University (NYU).

Record review. A record review of NYU professional Level occupational therapy students from 1986 to 1995 was completed to identify common factors among students who performed well academically but failed clinical fieldwork. Eight communicative and behavioral characteristics were identified: (a) rigidity of thinking, (b) discomfort with the ambiguity that accompanies clinical reasoning, (c) Lack of psychological insight, (d) difficulty interpreting feedback, (e) externalization of responsibility, (f) difficulty Learning from mistakes, (g) discomfort with the physical handling of patients, and (h) dependence on external measures for self-esteem.

Intervention. On the basis of the identified characteristics, five intervention strategies were adopted: (a) academic seminars that address professional behavior and interpersonal skills, (b) faculty feedback to students regarding problematic behaviors, (c) clinician and senior student counseling with identified students, (d) student remediation programs consisting of community service, and (e) student Learning contracts based on specific behavioral objectives. These strategies were administered before Level 11fieldwork to 10 students in the 1996 class who exhibited the characteristics indicative of potential fieldwork failure.

Outcome. Of the 10 students in the 1996 class, 7 passed fieldwork without further difficulty, two failed fieldwork midterm assessments but went on to achieve passing final evaluations, and one failed the final fieldwork assessment but passed an additional third fieldwork experience. The class of 1996, which was the first to receive formal intervention designed to decrease fieldwork failure, demonstrated Lower fieldwork failure rates than did all other classes in the past 10 years.
The Unpackaging of Routine in Older Women
Authors: Menks Ludwig Ferol
Published: April 2012

Objective. A qualitative research design using grounded theory procedures and techniques was used to explore how routine changed in later adulthood for seven Caucasian, college-educated, middle-class women who were not employed and who were free of major functional impairments.

Method. In-depth interviews, observations, an autobiography, and researcher-generated memos provided data. Data analysis involved concept formation, concept development, and conceptual modification and integration. Data collection and analysis were concurrent, iterative, reflective, and reflexive.

Results. Although the participants used routines to facilitate their well-being, they reported doing so to a lesser extent than when they had children living at home or when they worked. These participants unpackaged routines and molded them into increasingly flexible time-use strategies in response to age-related changes in their ecocultural niche, philosophy of life, and physical status.

Conclusion. That the participants sought less obligation and more freedom as they aged may influence the way they respond to a health care practitioner's advocating for an increase in routine. Interventions with older women must be compatible with existing routines and family themes and directly linked to well-being.
Effects of Task Goal on Movement Kinematics and Line Bisection Performance in Adults Without Disabilities
Authors: Lin Keh-chung , Wu Ching-yi , Trombly Catherine A.
Published: April 2012

Objective. This study investigated (a) whether the kinematic profile of a reaching-for-an-object movement would differ depending on the goal of the reaching task and (b) the effect of task goal on attentional carryover.

Method. Twenty-four adults without disabilities performed a horizontal line bisection task under three conditions: (a) a natural condition (pressing the ringing lever of a desk bell), (b) an impoverished condition (touching the ringing lever of a desk bell), and (c) a control condition (bisecting a line only). Only the natural and impoverished conditions used the reaching task (i.e., pressing or touching the ringing lever of the desk bell). The kinematic profile of reaching for the bell was established with the OPTOTRAK system, a quantitative kinematic analysis measure. The line bisection task was performed immediately after the reaching task, which was located adjacent to the left of the line to be bisected.

Results. The natural condition elicited better quality of reaching movement than did the impoverished condition. It produced significantly shorter movement time and higher peak velocity. A less impressive effect was found for percentage of reach where peak velocity occurs. Bisection performance under the two experimental conditions was leftward biased relative to the control condition, and the magnitude of leftward bias in the natural condition was greater than that for the impoverished condition.

Conclusion. Results supported one core assumption of occupational therapy: goal-directed and functional tasks can be used to enhance human performance. If the results hold for clinical populations, manipulations of functional goals may enhance movement performance of persons with disabilities and remediate left neglect often seen in clients who have had a stroke.
The End of Occupational Therapy
Authors: Crabtree Jeffrey L.
Published: April 2012

In this article, I propose that the unique end, or goal, of occupational therapy is to help persons with performance deficits of any kind make and express meaning through organized human performance, which I call occupation. To support this thesis, I show that, too often, philosophers, psychologists, and others who have studied meaning do not see human performance as a crucial way of making and expressing meaning. This article challenges the assumption that meaning making is only a cognitive process in which Language is its primary expression and shows that the nature of humans is to make meaning through occupation. Furthermore, this article reveals why occupational therapy should emphasize human performance and its role in meaning making. Finally, I propose that occupation is properly defined as intentional human performance organized in number and kind to meet the demands of self maintenance and identity in the family and community. I justify this definition and discuss the likely therapeutic nature of occupation and examples of the end, or goal, of occupational therapy.
How Occupational Therapists Teach Older Patients To Use Bathing and Dressing Devices in Rehabilitation
Authors: Schemm Ruth L. , Gitlin Laura N.
Published: April 2012

Objective. This article describes the methods occupational therapists use to teach bathing and dressing device use to older patients in rehabilitation programs. The relationship of three patient characteristics to five aspects of assistive device instruction was examined.

Method. The study sample included 86 patients and 19 occupational therapists who provided the assistive device training. Patients were 55 years of age or older and in rehabilitation for an orthopedic deficit, cerebrovascular accident, or Lower limb amputation. Therapists recorded information on teaching methods, perceptions of patient knowledge, and expectations for future device use after each treatment session.

Results. Patients received an average of three dressing and two bathing devices for home use. Therapists devoted an average of two and a half sessions (10 min average duration) to teach dressing device use and an average of one session (9 min average duration) to teach bathing device use. Teaching occurred mostly in the clinic setting through oral instruction and demonstration. At discharge, patients who evaluated devices positively and were evaluated as having a positive affect were perceived by the therapists as “having greater knowledge of device use. ” More time was spent teaching those patients with Lower Functional Independence Measure scores, less positive evaluations of devices, and lower affect scores. Family caregivers were involved in one or more dressing sessions for 26% of patients and one or more bathing sessions for 36% of patients.

Conclusion. Assistive device training in rehabilitation centers consists largely of simulated sessions in the occupational therapy clinic, and patients in the study described the instruction they received as “satisfactory. ” More research is needed to study the long-term effectiveness of assistive device training after patients return home.
The Sensory Profile: A Discriminant Analysis of Children With and Without Disabilities
Authors: Ermer Julie , Dunn Winnie
Published: April 2012

Objectives. The purpose of this study was to determine which factors on the Sensory Profile, a measure of children’s responses to commonly occurring sensory experiences, best discriminate among children with autism or pervasive developmental disorder (PDD), children with attention deficit hyperactivity disorder (ADHD), and children without disabilities.

Method. Data for three groups of children 3 to 15 years of age were used: 38 children with autism or PDD, 61 with ADHD, and 1,075 without disabilities. The researchers conducted a discriminate analysis on the three groups, using group membership as the dependent variable and the nine factors of the Sensory Profile as independent variables.

Results. The analysis yielded two discriminant functions: one that differentiated children with disabilities from children without disabilities and another that differentiated the two groups of children with disabilities from each other. Nearly 90% of the cases were correctly classified with these two functions.

Conclusion. The Sensory Profile is useful for discriminating certain groups of children with disabilities. Children with disabilities are accurately classified into disability categories with the factors described by previous authors. This suggests that patterns of behavior associated with certain developmental disorders are reflected in populations of children without disabilities. It may be the frequency or intensity of certain behaviors that differentiate the groups.
Occupation in Lifestyle Redesign: The Well Elderly Study Occupational Therapy Program
Authors: Jackson Jeanne , Carlson Mike , Mandel Deborah , Zemke Ruth , Clark Florence
Published: April 2012

This article describes an innovative preventive occupation-al therapy intervention for well older adults, the Well Elderly Treatment Program. In a previously reported large-scale randomized effectiveness study, this intervention was found to be highly successful in enhancing the physical and mental health, occupational functioning, and life satisfaction of multicultural, community-dwelling elders. In this article, the philosophical background, manner of development, topical content, methods of program delivery, and mechanisms underlying the program’s positive effects are discussed, along with implications for occupational therapy practice. The treatment was based on application of occupational science theory and research and emphasized the therapeutic process of lifestyle redesign in enabling the participants to actively and strategically select an individualized pattern of personally satisfying and health-promoting occupations. The wide-ranging effectiveness of the program supports the occupational therapy profession’s emphasis on occupation in affecting health and positions practitioners to extend their services to the realm of preventive interventions.
Including the Family Perspective in Sensory Integration Outcomes Research
Authors: Cohn Ellen S. , Cermak Sharon A.
Published: April 2012

Occupational therapy, along with other health and rehabilitation professions, is experiencing an increased emphasis on measurement of intervention outcomes. The results of outcomes research are being used to develop practice guidelines, set standards for reimbursement, and justify health care policy. The outcome assessments used by therapists reflect our belief systems and the assumptions about behaviors we expect to influence. Using a sensory integration perspective to illustrate key points, we present a conceptual framework that is based on the disablement framework and Coster’s occupational functioning for children model. We highlight the need to examine each of the multiple levels at which intervention may influence child and family function and the links among levels. Sensory integration theory and efficacy studies are reviewed to identify assumptions relative to how sensory integration affects the everyday occupations of children in the context of their families. Potential research methods and assessments are suggested to include the family perspective in outcome studies.
“My Secret Life”: The Emergence of One Gay Man’s Authentic Identity
Authors: Walsh Amy L. , Crepeau Elizabeth Blesedell
Published: April 2012

This qualitative study explores the Life history of Bruce, a gay man, from the perspective of homophobia. Homophobia is the fear and hatred expressed toward gay men, Lesbians, and bisexual women or men as well as persons suspected of being gay, Lesbian, and bisexual. Homophobia may become internalized, creating a form of self-hatred derived from the negative stereotypes associated with homosexuality. Bruce’s Life was shaped by the homophobia of others and his own self-hatred, Leading to isolation and a Lack of a projected authentic identity. This article focuses on the affective meanings related to significant events in Bruce’s life history and how they contributed to transformation in his Life from victimic to agentic themes. It is important for occupational therapy practitioners to recognize the influence that homophobia and internalized homophobia have on therapeutic interventions.
Neoprene Splinting: Dermatological Issues
Authors: Stern Erica B. , Callinan Nancy , Hank Mark , Lewis Eric J. , Schousboe John T. , Ytterberg Steven R.
Published: April 2012

Occupational therapists are expanding their use of custom and commercial soft splints fabricated from neoprene (poly-chloroprene), but little has been written regarding dermatological issues associated with this material. Skin contact with neoprene poses two dermatological risks: allergic contact dermatitis (ACD) and miliaria rubra (i.e., prickly heat). Allergic reaction to neoprene is generally ascribed to the accelerants used to manufacture the man-made rubber, specifically thiourea compounds and mercaptobenzothiazole (MET). Symptoms of neoprene-related ACD include itching, skin eruptions, swelling, and hemorrhages into the skin. Miliaria rubra creates small, red, elevated, inflammatory papules and a tingling, burning sensation.

Although neoprene hypersensitivity is rare, its incidence may grow as neoprene becomes a more commonly used material. It is recommended that therapists screen patients for a history of dermatological reactions to neoprene or other materials containing thiourea compounds or MBT and educate patients to discontinue splint use if dermatological symptoms develop. Therapists are also encouraged to notify splint manufacturers regarding all ACD reactions.
Elements of the Art of Practice in Mental Health
Authors: Weinstein Emily
Published: April 2012

Objective. This qualitative study explored elements of artful practice of therapists practicing in mental health treatment settings.

Method. In-depth interviews were conducted with three occupational therapists practicing in mental health who were considered exemplars of artful practice. Themes pertaining to their perspectives and approaches to practice were synthesized from interview data.

Results. The prevailing themes—therapeutic work as a vehicle for healing, collaborative guidance, and the Zen of therapy—are seen as elements forged by the therapist’s compassion and unique personal style into a dynamic therapist-client interplay that creates a space for growth and healing to occur. Results affirmed the view of the art of practice in mental health as an intricate interplay of personal traits, interpersonal skills, and skilled use of meaningful activities within the context of a client’s environment.

Conclusion. The art of practice is a fluid experiential process that takes place on a developmental continuum. The therapist’s inner awareness of the subtlety of a multi-layered healing process is an important basis of artful practice. One’s practice art can be informed by knowledge of specific elements that contribute to artful practice and can be developed through education, self-reflection, personal growth, and the maturation process.
The National Occupational Therapy Practice Analysis: Findings and Implications for Competence
Authors: Dunn Winnie , Cada Elizabeth
Published: April 2012

Objective. This article reports some of the findings from a national study of occupational therapy practice conducted by the National Board for Certification in Occupational Therapy (NBCOT) as part of its fiduciary responsibility to ensure that its entry-level certification examination is formulated on the basis of current practice.

Method. The NBCOT developed a survey with input from approximately 200 occupational therapy leaders and then used it to solicit information about current practice from 4,000 occupational therapists and 3,000 occupational therapy assistants. The sample included geographical location, experience level, and practice area distributions.

Results. Approximately 50% of the sample responded to the survey, Data indicate similarities and differences in occupational therapist and occupational therapy assistant practice (e.g., occupational therapists spend more time conducting evaluations, planning interventions, and supervising, whereas occupational therapy assistants spend more time providing interventions), an increased emphasis on population-based services (e.g., serving a business or industry rather than an individual worker), and an emphasis on occupation as a core knowledge base for practice. From a continuing competency perspective, the data can be useful to the profession; we can plan continuing education to address topics that practitioners have indicated are critical to their practice.

Conclusion. The findings will be useful for revising the entry-level certification examination and may guide thinking about the parameters of continuing competence because the responses represent a cross-section of the profession.
Accountability and Competence: Occupational Therapy Practitioner Perceptions
Authors: Fawcett Louise C. , Strickland L. Randy
Published: April 2012

Objective. Occupational therapy practitioners must meet ever-increasing accountability demands in all service delivery environments. Accountability is made possible through the ongoing development of continued competence through out a practitioner’s career. Behaviors that demonstrate accountability and reflect competence include commitment, leadership, and professional knowledge. This article discusses issues related to accountability and competence, presents findings from focus group discussions with occupational therapy practitioners regarding professional competence, and identifies actions that will bring about greater understanding of this topic.

Method. Thirty-nine randomly selected occupational therapy practitioners attended one of two focus groups. Participants responded to a structured discussion guide, including questions addressing the definition, process for sustaining, and outcomes of continued competence.

Results. Several themes emerged from these discussions. Views about what constitutes and contributes to continued competence in occupational therapy were diverse, and perceptions of occupational therapy “practice” were broad. Participants believed that the “outcomes” of a practitioner’s continued competence were best defined as autonomy in executing the occupational therapy process.

Conclusions. Findings offer potential language to articulate competence in occupational therapy and facilitate a discipline-wide conversation. The findings likewise challenge practitioners to assume new professional behaviors that require both personal and interpersonal skills. Such behaviors are critical to demonstrating accountability and competence.
Management Competencies Required of Administrative and Clinical Practitioners in the New Millennium
Authors: Boyt Schell Barbara A. , Yarett Slater Deborah
Published: April 2012

Changes in the health care environment necessitate revisiting management-related competencies for both clinical and administrative practitioners. Major changes include the shift from recruitment to reengineering, direct service to multiple service models, department to program management, professional standards to market-driven standards, and single-system to multisystem management. Important competencies include the ability to identify and implement flexible staffing, to use communication technologies to support staff members across multiple sites, to understand of the business of health care, and to create innovative service delivery models consistent with the core values of the profession.
Competence in Scientific Inquiry and Research
Authors: Abreu Beatriz C. , Peloquin Suzanne M. , Ottenbacher Kenneth
Published: April 2012

The survival and expansion of the profession of occupational therapy depends on its ability to respond to continually changing environments. One of the most current and critical factors in this adaptation is the capacity of therapists to achieve competence in scientific inquiry and research. Competence in the role of researcher is necessary because it contributes to the development of the individual therapist, the profession, and the organization within which the therapist functions. The aim of this article is to review and elaborate on the competencies associated with the role of researcher and to propose a reconceptualization of the knowledge, skills, and attitudes that shape competence in scientific inquiry.
Developing the Instructional Skills of New Faculty Members in Occupational Therapy
Authors: Mitcham Maralynne D. , Gillette Nedra P.
Published: April 2012

During the past 5 years, the American Occupational Therapy Association, American Occupational Therapy Foundation, and Medical University of South Carolina worked together to promote the instructional performance of new faculty members within the profession. This article describes the development and progression of initiatives for more than 300 new faculty members in occupational therapy and the characteristics of those who participated. On the basis of experience gained with these new faculty members, we recommend that the profession of occupational therapy adopt a more systematic approach to conceptualizing, planning, and orchestrating the range of faculty development activities needed by academicians; develop strategies to socialize and encourage prospective faculty members to develop the necessary academic qualifications sooner in their careers; and explore ways in which experienced academicians from other fields can be enticed into our own to strengthen existing faculties.
Academic Juggling Act: Beginning and Sustaining an Academic Career
Authors: Crepeau Elizabeth B. , Thibodaux Louise , Parham Diane
Published: April 2012

Rapid expansion in the number and size of occupational therapy academic programs has resulted in a crucial need for faculty recruitment and retention. To encourage occupational therapy practitioners to consider academia as a career option, and to support those who choose this option, this article reviews higher education literature related to socialization into academia, the different types of academic institutions, the tenure system, and the process of entering into and sustaining an academic career. This literature is then correlated with issues in occupational therapy education. The article closes with specific literature-based suggestions for creating and sustaining an academic career through development of teaching skills, research agendas, and support systems.
The Use of Rasch Analysis To Produce Scale-Free Measurement of Functional Ability
Authors: Velozo Craig A. , Kielhofner Gary , Lai Jin-Shei
Published: April 2012

Innovative applications of Rasch analysis can lead to solutions for traditional measurement problems and can produce new assessment applications in occupational therapy and health care practice. First, Rasch analysis is a mechanism that translates scores across similar functional ability assessments, thus enabling the comparison of functional ability outcomes measured by different instruments. This will allow for the meaningful tracking of functional ability outcomes across the continuum of care. Second, once the item–difficulty order of an instrument or item bank is established by Rasch analysis, computerized adaptive testing can be used to target items to the patient’s ability level, reducing assessment length by as much as one half. More importantly, Rasch analysis can provide the foundation for “equiprecise” measurement or the potential to have precise measurement across all levels of functional ability. The use of Rasch analysis to create scale-free measurement of functional ability demonstrates how this methodology can be used in practical applications of clinical and outcome assessment.
Occupations and Well-Being: A Study of Personal Projects
Authors: Christiansen Charles H. , Backman Catherine , Little Brian R. , Nguyen Alex
Published: April 2012

Objective. The purpose of this study was to explore the relationship between occupation and subjective well-being (SWB).

Method. A convenience sample of 120 adults completed a personal projects analysis, a method of rating their current goal-directed pursuits. They also completed measures of SWB (Affect Balance Scale, Life Satisfaction Index Form A) and personality traits (Myers-Briggs Personality Inventory). Characteristics of personal projects were correlated with SWB scores. Multiple regression analysis was used to investigate possible predictors of well-being from among the characteristics of personal projects, personality traits, and demographic variables.

Results. The stress associated with personal projects was significantly and inversely correlated with well-being, as was project difficulty. Perceived progress in completing projects was significantly positively correlated with well-being. The strongest predictors for well-being were the composite project factors of stress and efficacy. Two personality traits, sensing and extraversion, interacted with the project dimension of stress to emerge as significant predictors of well-being. Together, these four variables explained 42% of the variance in well-being scores.

Conclusion . These findings are consistent with assumptions that attributes of meaningful occupations are significantly related to people’s perceived well-being.
Outcomes of Protocol-Based and Adaptation-Based Occupational Therapy Interventions for Low-Income Elderly Persons on a Transitional Unit
Authors: Spencer Jean , Hersch Gayle , Eschenfelder Verna , Fournet Jacqueline , Murray-Gerzik Melanie
Published: April 2012

Objectives. The study objectives were to describe (a) adaptation trajectories of elderly persons treated on a transitional unit for deconditioning and tracked after their return to the community, (b) an individualized adaptation-based intervention provided to selected elderly persons in addition to protocol-based treatment for deconditioning, (c) goals and outcomes of these two interventions, and (d) contrasting perceptions of outcomes by elderly persons, their family members, and their therapists.

Method. A longitudinal qualitative design was used to track 8 participants from transitional unit to community. Data on the protocol-based intervention were obtained from chart review and therapist interviews. Data on the adaptation-based intervention were obtained from the Client-Centered Evaluation and Community Adaptive Planning Assessment, which were used for goal setting and problem solving. In the community, contrasting perspectives on outcomes were obtained from the participants, their family members, and their therapists through semistructured interviews.

Results. Participants’ adaptation trajectories revealed that half relocated to new living arrangements after discharge from the transitional unit. At the time of follow-up, 91% of the protocol-based goals and 100% of the adaptation-based goals had been met in some fashion, with modification in the goal or development of new solutions in some cases. Outcomes valued by the participants were returning to former occupations and relationships; family members valued getting quality care for the participant; and therapists valued improvement in strength, endurance, and increased independence in activities of daily living (ADL).

Conclusion. Findings support use of an individualized consultative intervention that addresses occupational performance areas and performance contexts combined with a protocol-based, hands-on intervention that addresses performance components and basic ADL for elderly persons with multiple chronic illnesses.
Managing Occupations in Everyday Life To Achieve Adaptation
Authors: Thorén Jönsson Anna-Lisa , Möller Anders , Grimby Gunnar
Published: April 2012

Objective. The aim of this qualitative study was to gain a deeper understanding of how persons with poliomyelitis sequelae manage their daily occupations in order to adapt to environmental demands. This was a study of adaptive processes and capability in everyday life.

Method. Interviews with 22 persons with poliomyelitis sequelae were content analyzed according to grounded theory.

Results. The analysis yielded 18 concepts describing adaptive strategies of participants. The strategies were arranged in six general groups: utilizing physical capability, influencing emotions, altering pattern of occupations, promoting concrete problem-solving, influencing relations, and facilitating future activities.

Conclusion. The strategies were interwoven, revealing different ways of reaching an adaptive balance in daily occupations for the present and the future.
Measurement Issues in Treatment Effectiveness Studies
Authors: Davies Patricia L. , Gavin William J.
Published: April 2012

Improved understanding of the various test scores found in clinical norm-referenced assessment instruments will enable therapists to make informed decisions about selecting the best test scores for measuring and reporting applied clinical research activities (i.e., initial evaluation, progress report, program evaluation, treatment effectiveness research). The application of norm-referenced test scores in treatment effectiveness research is discussed, with all issues applying directly to the use of individual clients’ test scores in making clinical decisions and reporting assessment results. The scientific principles of measurement used by researchers are outlined, followed by a discussion of the various test scores that can be obtained from a norm-referenced test and how each score is interpreted. Recommendations are provided for the use of the various test scores in treatment effectiveness research, specifically addressing research questions that can be answered from results obtained using the different measures available in norm-referenced tests: Did the clients improve in performance? At what rate are the skills being gained?
Motor Development of Native American Children on the Peabody Developmental Motor Scales
Authors: Crowe Terry K. , McClain Catherine , Provost Beth
Published: April 2012

Objective. Native American children have not been widely represented in the normative samples of standardized tests assessing motor development. This study investigated the cultural relevance of the Peabody Developmental Motor Scales (PDMS) in 2-year-old Native American children who are typically developing.

Method. The PDMS was administered to a sample of 44 Pueblo children who were 24 months through 35 months of age and typically developing. Each child’s family also completed a parent questionnaire addressing the child’s development and family demographics. Participant scores were compared with those of the normative sample.

Results. The sample scored significantly lower than the normative sample (p ≤ .001) on the Fine Motor Scale, and, when gender was taken into consideration, all but the older girls (30 months–35 months of age) had significantly lower scores. All but the younger girls (24 months–29 months of age) scored within the normal range on the Gross Motor Scale.

Conclusion. Our results with this small sample suggest that caution be used when comparing motor performance (especially fine motor abilities) of 2-year-old Native American children against the PDMS normative data.
Occupational Therapists in the School Setting: Working With Students With Complex Health Care Needs
Authors: Lowman Dianne Koontz , Simons Dianne F. , Shepherd Jayne T. , Fiocca Jeanne T. , Ernouf Holly S. , Hundley Becky S.
Published: April 2012

Objective. This study investigated one aspect of the role of school-based occupational therapists working with students with complex health care needs during the school day.

Method. One hundred seventy-two occupational therapists working in school systems were surveyed with regard to their involvement with children with complex health care needs, particularly specific complex health care procedures performed, knowledge of policies, training in the administration of health-related procedures, and perceived levels of competency.

Results. Sixty-eight (61%) of the therapists reported having children with complex health care needs on their caseload; of these, 65% reported involvement in seizure monitoring and 24% reported performing gastrostomy feedings. Most respondents reported an awareness of policies regarding administration of medication, gastrostomy feeding, and seizure monitoring in their school system. Respondents’ main role with this population included activities in positioning, environmental modification, and staff instruction.

Conclusion. The major role of occupational therapists working in school systems involved providing direct intervention with the student and not conducting or instructing others in health-related procedures. Therapists also served as a resource on health-related issues for school personnel.
The Village AIDS Day Treatment Program: A Model of Interdisciplinary and Interdependent Care
Authors: Murphy Nancy , Messina William , Getter Elizabeth , Gutterman Linda , Martin Thomas , Rincon Patricia , Zimmerman Jan
Published: April 2012

This article describes the Village AIDS Day Treatment Program, a program for people living with HIV/AIDS that provides health care by using a full range of interdependent services. Opened in 1988, this program was the first of its kind in the country. It has provided leadership in developing a model of care that addresses the full spectrum of health care—promotion, prevention, maintenance, and treatment. Along with describing the program and its services, this article includes the program’s history and its influencing philosophies.