bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Graded Craft Activities on Visuomotor Integration in an Inpatient Child Psychiatry Population
Authors: Kleinman Barbara L. , Stalcup Ange
Published: April 2012

The effectiveness of a graded series of craft activities on improving visuomotor skills was tested with an inpatient child psychiatry population. A standardized test of visuomotor integration served as a pretest and posttest to compare two nonconcurrent groups in the same setting. The inpatient program was the same for both groups, except that the treatment group (n = 33) participated in a graded craft sequence, while the control group (n = 24) did not. The frequency and degree of improvement were significantly greater in the treatment group. The degree of improvement in both groups was significantly related to age, IQ, and diagnosis of affective disorder, but not to sex, psychotropic medication, number of treatment sessions, or other diagnoses, including conduct disorder and attention deficit disorder. Mean age and IQ did not differ significantly between the two groups. The study tentatively supports a graded crafts program as a means for the improvement of visuomotor skills, but suggests that further research be done with matched groups.
A Problem-Solving Version of the Allen Cognitive Level Test
Authors: Josman Naomi , Katz Noomi
Published: April 2012

The purpose of this study was to construct and validate a problem-solving version of the existing Allen Cognitive Level Test (ACL) (Allen, 1985). The new problem-solving version of the ACL (ACL–PS) follows the theoretical developments of the cognitive disability theory and the information processing approach. It was constructed to provide a more accurate assessment of the problem-solving process as well as task performance, especially at the higher cognitive levels. Both tests were administered to a psychiatric adolescent group (n = 49) who were subdivided according to diagnosis and to a matched nondysfunctional control group (n = 29).

The results showed that both the ACL and the ACL–PS differentiated significantly between the patients and the control subjects and among the patient groups. At Level 6 of the ACL, none of the subjects needed any demonstration, with all scores distributed between independent performance or performance following verbal instructions only, that is, problem-solving phases that were added with the ACL–PS. The scoring of the ACL–PS is provided in addition to detailed scoring of the cognitive levels. It is suggested that the ACL–PS be implemented as a clinical evaluative tool with adolescents.
Occupational Therapy Service: Individual and Collective Understandings of the Founders, Part 1
Authors: Peloquin Suzanne M.
Published: April 2012

This inquiry aims to explore the understandings of patient, therapist, and occupation held by the founders of the National Society for the Promotion of Occupational Therapy. Influenced by contemporary historical events, the founders shared a common belief that the right occupation could help persons in need. Personal narratives found within the early occupational therapy literature illustrate each founder’s unique understanding of how occupation might address contemporary problems. Each view contributed to the development of a multifaceted therapy. Exploration of the multiple interpretations that shaped a common idea may help current therapists to better understand their heritage of caring and to compare it with current practices. The first part of this inquiry considers the personal narratives of George Edward Barton, Susan Elizabeth Tracy, and William Rush Dunton, Jr. The second part, which will appear in a later issue, will further discuss Dunton’s views, along with those of Eleanor Clarke Slagle, Herbert Hall, Susan Cox Johnson, and Thomas Bessell Kidner.
The Transition from Nonoral to Oral Feeding in Children
Authors: Dunbar Sandra Barker , Jarvis Ada H. , Breyer Marty
Published: April 2012

In this single-subject study, an evaluation was completed to determine the effect of occupational therapy intervention on the oral intake of 3 children who had their nutritional needs met by nonoral methods prior to the administration of an oral feeding program. Treatment consisted of a gradual increase of food presentation with the application of behavioral management methods and the presentation of developmentally appropriate play activities. Oral intake was measured during baseline and intervention phases to establish the effect of intervention. An analysis indicated an increase in oral intake in the intervention phase in 2 of the 3 children. The results, that occupational therapy intervention can increase the oral intake of children in transition from nonoral to oral feeding, might be strengthened through the replication of this study on larger populations.
What is Worth Knowing in Occupational Therapy?
Authors: Törnebohm Häkan
Published: April 2012

It is assumed that all professional work presupposes and is regulated by paradigms, which are owned by practitioners. Research oriented to a field of practice serves to influence the paradigms in that field and, consequently, the practices in it. Researchers in a field oriented to occupational therapy must find out what the practitioners in that field need to know. They have to explore for problems by engaging in discussions on paradigm issues together with practicing occupational therapists. This paper presents a sketch of a possible occupational therapy paradigm along with lists of queries that make use of essays written by occupational therapists.
Motor Learning Concepts Applied to Activity-Based Intervention With Adults With Hemiplegia
Authors: Sabari Joyce Shapero
Published: April 2012

This paper presents a framework for the integration of motor learning research findings with a neurodevelopmental treatment perspective. The importance of activity-based intervention is emphasized, and a strategy for activity synthesis is presented. Clinical problems seen in persons with hemiplegia are used to clarify concepts and illustrate therapeutic interventions.
From Ellis Island to Assisted Living: Meeting the Needs of Older Adults From Diverse Cultures
Authors: Barney Karen F.
Published: April 2012

Among the rapidly increasing population of older adults, the minority elderly have also been increasing in numbers and are projected to grow at a more rapid rate than the white population well into the next century (American Association of Retired Persons, 1989). This factor, together with the existence of substantial ethnic diversity among both white and minority elders, mandates that our profession examine how we address the associated needs of all older adults who receive occupational therapy services in order to promote optimal performance and quality of life. Rationales for providers to increase personal awareness of these factors as basic contextual determinants in providing services are offered. The inclusion of cultural and ethnic considerations in all interventions with older adults as critical components in the provision of quality service is given, together with suggestions for methods of implementation.
Long-Term Care of the Aged: Ethical Dilemmas and Solutions
Authors: Crabtree Jeffrey L. , Caron-Parker Laura M.
Published: April 2012

This article identifies the need to rethink beliefs and assumptions about the bioethics of long-term care of elderly people. An unconventional way of conceptualizing autonomy is explored that may help occupational therapists support and maintain the independence of older frail and dependent persons. In addition, the partnership model of bioethics is introduced – that is, an ethical framework that makes partners of family members in health care decisions affecting the older adult.
Private Practice Occupational Therapy in the Skilled Nursing Facility: Creative Alliance or Mutual Exploitation?
Authors: Faust Lawrence , Meaker Myra K.
Published: April 2012

Occupational therapy private practice appears to play a major role in the provision of rehabilitation services in skilled nursing facilities. A critical look at the meaning of private practice, however, indicates that many of today’s private practitioners lack characteristics traditionally associated with that term. Group private practices are well suited to retain the essential qualities of private practice while competing effectively in a corporate environment. They accomplish this difficult task by applying therapeutic principles of growth and change to the complex relationship between the group practice and the skilled nursing facility. Application of these principles allows the occupational therapy group private practice to behave consistently with its professional identity while addressing the competitive demands of the marketplace.
The Use of Technical Aids Among Community-Based Elderly
Authors: Parker Marti G. , Thorslund Mats
Published: April 2012

The growing elderly population will increase the need for assistive technology in the form of technical aids and housing adaptations to facilitate independence in activities of daily living. In this study, which was undertaken to facilitate a better understanding of the life-styles of the disabled elderly and the role of technical aids, 57 disabled persons over 74 years of age were studied. All of the subjects were residents of a rural Swedish community. The subjects had a total of 422 aids, an average of 7.4 per person. Seventy-five percent of the aids were being used, and 42 persons had at least one aid that granted autonomy. This finding illustrates the importance of technical aids in home care. It is recommended, therefore, that information about assistive technology be disseminated to personnel at all levels of community-based care.
Ethics Across the Occupational Therapy Curriculum
Authors: DeMars Patricia A. , Fleming John D. , Benham Patricia A.
Published: April 2012

The authors describe the development of specific teaching modules, methods, and techniques with which to raise student consciousness and generate awareness of ethical issues in occupational therapy practice as well as to develop the ethical decision-making process through the use of three ethical decision-making and thinking models. This focus on ethics has been integrated into the entire 2-year occupational therapy curriculum at a liberal arts college as part of the college’s larger institutional mission and objectives. The results obtained from informal faculty and student contacts and students’ feedback after completion of clinical fieldwork demonstrate increased student sensitivity and ability to identify and discern ethical issues as well as increased awareness of the many professional complexities involved in the determination of decisive proactive responses.
A Belly Gutter Splint for Proximal Interphalangeal Joint Flexion Contracture
Authors: Wu Shin-Han
Published: April 2012

Various splints are available for the correction of proximal interphalangeal (PIP) joint flexion contracture in patients with hand injuries. This article discusses the mechanics of several splints. The belly gutter splint, an alternative design that can be used for this contracture, is introduced.
Occupational Therapy: The Role of Ideology in the Development of a Profession for Women
Authors: Litterst Terry Anne E.
Published: April 2012

This paper uses contemporary accounts, newspaper articles, and professional literature to describe the origin and development of the profession of occupational therapy. Ideas about the organization of work, women ’s characteristics, and the historical context of World War I are included. Occupational therapy is discussed from the perspective of values that contributed to the successful establishment and maintenance of a recognized structure in the work force for women performing occupational therapy services.
The Henry B. Favill School of Occupations and Eleanor Clarke Slagle
Authors: Loomis Barbara
Published: April 2012

During the World War I era, Eleanor Clarke Slagle directed Special Courses in Curative Occupations and Recreation at the Henry B. Favill School of Occupations, in cooperation with the Chicago School of Civics and Philanthropy, in Chicago, Illinois. This paper describes this pioneer course in occupational therapy education. The influence of the settlement house setting, course descriptions from the school’s bulletin, and Slagle’s philosophy with related experiences drawn from her correspondence and curriculum vitae are presented. The program of study was short lived (1915 to 1920). There are indications that although this program was highly regarded under Slagle’s leadership, it was not continued after her resignation and departure from Chicago in 1920.
The Origin and Evolution of Activity Analysis
Authors: Creighton Cynthia
Published: April 2012

Practitioners of occupational therapy in the early 1900s selected therapeutic activities with an intuitive understanding of their characteristics and operations. The term activity analysis and the methodology for breaking down and examining tasks scientifically, however, were borrowed from industry during World War I. Methods originally used in time and motion study of jobs were applied to vocational retraining and therapeutic crafts; later, they were applied to a broader range of activities. The most systematic early use of activity analysis was in occupational therapy for physical dysfunction, particularly in military hospitals. Development of the concept was gradual until the 1970s, when the delineation of theoretical frames of reference for practice led to important changes. Today, activity analysis is viewed as a multifaceted process that involves both generic and specific components.
A Historical Review of Occupational Therapy’s Role in Preventive Health and Wellness
Authors: Reitz S. Maggie
Published: April 2012

The public is becoming increasingly cognizant of the importance of proactive health behavior and is seeking assistance from health care professionals in their pursuit of wellness. As occupational therapy strives to meet this growing consumer demand, a historical review of the profession’s involvement in proactive health activities can enhance its response. Since its inception, occupational therapy has recognized the importance of both preventive action and the promotion of wellness. In this paper, the significant historical events in this area are discussed to stimulate future research and clinical application in health promotion.
Maintaining Autonomy: The Struggle Between Occupational Therapy and Physical Medicine
Authors: Colman Wendy
Published: April 2012

In 1948, several physiatrists, representing the emerging medical specialty of physical medicine, held a meeting at which they aggressively attempted to wrest control of occupational therapy’s educational programs and national registry from the jurisdiction of the American Occupational Therapy Association. This paper offers one view of the events that led up to that meeting and the consequences of that struggle for occupational therapy autonomy. It focuses on several critical incidents in the struggle, the salient issues debated, and the strategies used by both physical medicine and occupational therapy to influence the outcome. The consequences of the confrontation as they affected occupational therapy education and practice are discussed.
Deficits of Reaching in Subjects With Left Hemiparesis: A Pilot Study
Authors: Trombly Catherine A.
Published: April 2012

Therapy to restore functional movement of stroke patients is based on assumptions about the deficits that occur in motor control as a result of stroke. Success has been limited, perhaps as a result of insufficient information concerning the characteristics of movement after stroke. In this pilot study, the Waterloo Spatial Motion Analysis Recording Technique (WATSMART™), an optoelectric motion analysis system, was used with surface electromyography to measure voluntary reaching in the impaired and unimpaired arms of 5 subjects with left hemiparesis. The ability to reach in a smooth coordinated way was significantly poorer in the impaired arms than in the unimpaired arms, for which scores were essentially normal. The patients were less able to activate the muscles of the impaired arm and, as a result, used a greater percentage of the maximum activity they could generate to complete the unresisted reaching task. The electromyographic differences between arms, however, did not reach significance.

The results corroborate previous findings and show that movement deficits of particular patients can be diagnosed precisely with kinematic analysis and electromyography. If greater precision in diagnosis were available clinically, more effective therapy might be developed.
Clinical Reasoning Process for Service Provision in the Public School
Authors: Hall Laura , Robertson Wendy , Turner Mary Ann
Published: April 2012

This paper outlines the clinical reasoning process used to guide decisions on the provision of occupational therapy services in the Wake County Public School System in North Carolina. The process is based on a theoretical framework derived from occupational therapy theory and public law. Benefits of using the clinical reasoning process include (a) increased consistency of decision making among therapists; (b) increased appropriateness of decisions regarding whether a student needs educationally based occupational therapy services, what type of occupational therapy service would meet the student’s need, and how often this service should be provided; and (c) improved ability of therapist to articulate to all those involved with a student the reasoning behind decisions to provide educationally based occupational therapy services. The schematic diagrams that depict this process provide a useful tool for therapists with varied work experiences entering school-based practice.
Continuing Education Requirements to Maintain Occupational Therapy Licensure
Authors: Garrahy Robin , Thibodaux Louise , Hickman Charlene , Caldwell Deidra
Published: April 2012

Different states use a variety of regulatory mechanisms to monitor the quality of practice in occupational therapy. The requirement for mandatory continuing education has been adopted by fewer than half of American states, but there is reason to predict that this trend will increase. This study investigates the patterns linking licensure to continuing education and recommends actions to ensure uniformity and accountability.
Gender Differences in Dementia Management Plans of Spousal Caregivers: Implications for Occupational Therapy
Authors: Corcoran Mary A.
Published: April 2012

Occupational therapists treating older people with Alzheimer disease know that they must also consider the others who are affected by the disease, the informal caregivers. Intervention is most effective when it enables both the impaired person and the primary caregiver to manage the secondary symptoms of dementia. Unfortunately, little is understood about how caregivers approach and carry out their tasks and about why male and female caregivers respond differently to their caregiving role in terms of depression, burden, stress, and substance abuse.

This paper discusses the effects of gender on dementia management plans of spousal caregivers. Husbands and wives have different approaches to caregiving; each approach has consequences. Male caregivers adopt a task-oriented approach to their duties and carry out their activities in a linear fashion; female caregivers use a parent–child approach and nest activities inside one another in a constant stream of work. Two cases are presented to illustrate gender differences in dementia management plans. Implications for occupational therapy include suggestions for supporting men and women in their caregiving role, modulating the negative consequences of caregiving, and conducting research to demonstrate the efficacy of an occupational therapy approach.
Interwoven Threads: Occupational Therapy, Feminism, and Holistic Health
Authors: Miller Rosalie J.
Published: April 2012

Occupational therapy is a predominantly female profession; 93% to 95% of occupational therapists are women. The implications and ramifications of this reality have seldom been directly addressed. In this article, beliefs about balance, activity, environment, and autonomy are explored from the perspectives of occupational therapy, feminism, holistic health, and medicine. The assertion that occupational therapy has more in common philosophically with feminism and holistic health than it does with medicine is supported. This awareness provides a new framework for examining current issues of concern to the profession, such as support for purposeful activity, existence outside the mainstream of power holders, and problems and powers inherent in being seen as a women’s profession. Recommendations are made that occupational therapists commit more money and energy to encourage, facilitate, and support female leadership; develop innovative strategies for keeping members who take time out to raise families informed; support more holistic and feminist reorganization of work settings; instill awareness of these issues in our students; and address our strengths as a women’s profession. All occupational therapists must also confront their own anti-woman prejudice.
Occupational Therapy Intervention With the Alcoholic’s Family
Authors: Moyers Penelope A.
Published: April 2012

In this paper, the role of occupational therapy in the treatment of the family affected by alcoholism is explored. Literature is reviewed to analyze occupational therapists’ current approaches for interacting with the family. A family-treatment approach, based on systems theory, is organized into three hierarchical treatment levels that accommodate the family’s maladaptive roles. Family treatment methods thought most likely to produce the desired results are delineated according to treatment level. Treatment Level 1 focuses on reduction of maladaptive role behaviors of the family that enable the person’s drinking. At Treatment Level 2, family members are taught coping skills that weaken their reliance on maladaptive roles. Emotional development is stimulated at Treatment Level 3 through confrontation of continued use of maladaptive roles.
Assistive Technology Device Use in Patients With Rheumatic Disease: A Literature Review
Authors: Rogers Joan C. , Holm Margo B.
Published: April 2012

Occupational therapists often prescribe assistive technology devices (ATDs) to assist persons with disabilities in performing daily living tasks. Estimates suggest that although most ATDs are used, a substantial proportion are never used or are discarded shortly after they are obtained. A review of the literature on ATDs was carried out to identify factors that contribute to ATD use and disuse. The review focused on persons with osteoarthritis and rheumatoid arthritis, because such persons are frequent users of ATDs. Although the literature review highlighted person-, environment-, and ATD-related factors as relevant to ATD use, it also underscored the dearth of scientific study of the prescriptions, provision, and use of ATDs. A model is proposed to guide empirical research aimed at identifying non–device users from the outset of treatment so that interventions to improve ATD use may be initiated or alternative interventions implemented. The variables comprising the model pertain to the patient, the patient’s living environment, the therapist prescribing the device, and the device itself.
Hand Splinting in Quadriplegia: Current Practice
Authors: Krajnik Sheila R. , Bridle Mary J.
Published: April 2012

A mailed survey was conducted to collect information about the application of hand splints to patients with spinal cord injuries resulting in quadriplegia at levels C-5, C-6, C-7, and C-8. Survey respondents were occupational therapists in spinal cord injury centers nationwide. Frequency and descriptive statistics were collected concerning both static and dynamic splints, the clinical reasoning behind splint selection, and methods used for the evaluation of hand function. The results of the survey indicate that hand splinting is an accepted intervention for the target population. A variety of static splint designs were used, depending on level of injury, muscle strength, and the patient’s acceptance. The dynamic splint designs were used most frequently with patients whose lesions were at C-6 and C-7. The reasons for not splinting were primarily related to the patient’s compliance and acceptance. Observation of patients’ performance of functional tasks was the preferred method of evaluation of hand function, as there are no appropriate standardized tests available for this population.
The Meaning of Activity: Day Care for Persons With Alzheimer Disease
Authors: Hasselkus Betty Risteen
Published: April 2012

The purpose of this study was to gain understanding of the meaning of the daily routines and activities at a day-care center for persons with Alzheimer disease, as experienced by the staff. With the use of the qualitative research techniques of participant observation and ethnographic interviewing, data were collected for 4 weeks at a small adult day-care center for persons with mid- to late-stage Alzheimer disease or related disorders. Analysis of the data revealed that the foremost guiding principle for all activities during the day was prevention, that is, to prevent participant behavior that would be harmful to self or to others. Secondary to this overarching guideline, other characteristics of a “good day” versus a “rough day” were also identified. The findings are discussed as they relate to activity program planning and to sources of staff satisfaction in the care of persons with Alzheimer disease.
Infant Neuromotor Assessments: A Review and Preview of Selected Instruments
Authors: Einarsson-Backes Lynn M. , Stewart Katherine B.
Published: April 2012

The advancement of medical technology has produced an increased number of surviving neonates. Occupational therapists and physical therapists working in neonatal intensive care units and follow-up clinics are faced with the challenge of providing early assessment and treatment for this relatively new population of infants. The purpose of this article is to review selected infant motor evaluation instruments used by therapists and to preview those currently being developed. An overview of the historical background of infant neuromotor testing is provided, followed by a review of the Infant Neurological International Battery (Ellison, Horn, & Browning, 1985) and the Neonatal Neurobehavioral Examination (Morgan, Koch, Lee, & Aldag, 1988). Two infant motor tests currently being developed, the Chandler Movement Assessment of Infants Screening Test and the Miller Infant and Toddler Test (both of which, at the time of this writing, are unpublished) are described. Updated information on the psychometric properties and the clinical usefulness of these new infant neuromotor tests can assist therapists in selecting reliable and valid measures in their clinical practice.
A Comparison of the Individualized Education Plan and the Individualized Family Service Plan
Authors: Decker Bonnie
Published: April 2012

The individualized education plan (IEP) and the individualized family service plan (IFSP) are mandated for children with special needs. Occupational therapists participate in the development of both the IEP and the IFSP. This paper summarizes the similarities and the differences in the mandated components. The components addressed are (a) information about the child’s status, (b) information about the family, (c) outcomes for the child and family, (d) intervention services, (e) other services, (f) dates and duration of services, (g) selection of a case manager, and (h) transition plans.
The Use of Computers in Occupational Therapy for Visual-Scanning Training
Authors: Ross Freda L.
Published: April 2012

This study examined the effect of computer-assisted remediation, with the use of specific visual-scanning software, in the retraining of a functional scanning deficit. Three subjects who displayed significant deficits in visual scanning were selected. A single-subject study was conducted, involving an ABA multiple baseline across-subjects design. Introduction of computer-based intervention with visual-scanning software occurred after 2 to 3 weeks of the gathering of baseline data. Removal of this intervention followed six to nine sessions of 15 to 30 min each over 3 weeks, and data were collected over a 2-week return-to-baseline phase. The dependent variables – speed, accuracy, and the number of re-referencing glances – were measured on functional performance of a grocery-shelf scanning task. Analysis with the two standard deviation band method did not reveal a significant change in performance on the functional task between the three phases. Visual and graphic analyses confirmed that computer intervention did not significantly affect performance on the functional task. The clinical significance of the results suggest that software-assisted remediation may not be an appropriate modality for achievement of a functional occupational therapy outcome.
Locus of Control in Nondisabled Versus Congenitally Physically Disabled Adolescents
Authors: Janelle Sylvie
Published: April 2012

Locus of control in 13 nondisabled and 8 congenitally physically disabled adolescents was examined with the use of the Nowicki-Strickland Locus of Control Scale for Children (Nowicki & Strickland, 1973a). All subjects with disabilities had IQs within normal limits, used wheelchairs, and could communicate verbally. The two groups were matched in IQ, age, sex, race, and socioeconomic status. It was hypothesized that the locus of control scores for the disabled group would evidence significantly more externality than the scores for the nondisabled group. A Mann Whitney U test was done to analyze the data gathered, and the results were found to be statistically nonsignificant (U = 58.50, p = .635). Adjunct analyses were conducted to explore the percentage of internal and external answers between the two groups. Race was the only variable correlating significantly with locus of control scores (r = .54, p = .05). The study’s results suggest that disability is not a significant predictor of externality in adolescents. Persons with an internal locus of control are more assertive and better able to cope with their environment; occupational therapists can offer many therapeutic strategies to persons with an external locus of control for improved function and quality of life.
History of Federal Legislation for Persons With Disabilities
Authors: Reed Kathlyn L.
Published: April 2012

This paper discusses federal legislation relating to persons with disabilities and it divides into 13 areas. Several areas of legislation, such as education and basic education, have a long history beginning with World War I. Laws related to other areas, such as federal support for developing technology, have been adopted only within the past 5 years. The Americans With Disabilities Act of 1990 (ADA) (Public Law 101–336), which guarantees civil rights to Americans with disabilities, has five titles, and each is summarized. Although the ADA provides for Americans with disabilities to be included in American society, it has some major limitations, including the lack of an affirmative action requirement and of provisions for the education and training of persons with disabilities so that they can qualify for employment. Several of the federal laws related to persons with disabilities have affected the field of occupational therapy either favorably or adversely. The conclusion is drawn that occupational therapists need to be alert to pending legislation to promote the role of occupational therapy in serving persons with disabilities.
The Americans With Disabilities Act of 1990 and Employees With Mental Impairments: Personal Efficacy and the Environment
Authors: Crist Patricia A. H. , Stoffel Virginia C.
Published: April 2012

The Americans With Disabilities Act of 1990 (ADA) (Public Law 101–336) provides persons with mental health problems basic rights resulting in full access to community resources, especially the rights and privileges associated with the work role. This paper discusses the law, personal self-efficacy, and four environmental aspects as they relate to the employment of persons with mental impairments: (a) employer and co-worker attitudes, (b) essential job functions, (c) reasonable accommodations, and (d) community access. Areas of intervention for occupational therapists in mental health include attitude and advocacy training, assisting employers in providing reasonable accommodations, and preparing persons with mental impairments to be successful employees. Examples in occupational therapy are reviewed to illustrate the implementation of the ADA with persons with mental health problems.
Implementing the Americans With Disabilities Act of 1990 in Higher Education
Authors: Bowman O. Jayne , Marzouk Donna K.
Published: April 2012

The purpose of this paper is to provide educators and administrators in higher education with a greater understanding of how the Americans With Disabilities Act of 1990 (ADA) (Public Law 101–336) may affect institutions of higher education and to suggest ways that occupational therapists can assist institutions of higher education to comply with the ADA. When educators attempt to comply with the ADA in systems of higher education, the complexity of universities calls for a model reflective of that complexity. The systems approach to higher education, a model based on the general systems theory, is suggested as such a model. The three essential components of the model – input (i.e., applicants to a university), throughput (i.e., enrolled university student), and output (i.e., the student being graduated) – are acted on by many subsystems of the university. Some of those likely to be affected are application procedures, transportation, housing, dining facilities, and curricula. In planning ways to comply with the ADA, educators in higher education may find that many of these subsystems are required to adapt and make reasonable accommodations for the student with a disability. The model can be used to help identify those subsystems that will be affected by the law and to facilitate planning to comply with the law.

Although occupational therapists most often work with persons to help them adapt to change in their lives, they can also work in systems of higher education and help the systems to plan and implement programs related to the ADA. The most effective programs are usually those that are well planned and designed from a holistic perspective, rather than those that are developed as a reaction to a specific situation or incident, that is, programs that are proactive rather than reactive. By using the systems approach to higher education, occupational therapists can focus on those components and subsystems within a university that may be affected by the ADA and meet the individual needs of a university.
Reasons for Choosing Occupational Therapy as a Profession: Implications for Recruitment
Authors: Cooperstein Karen R. , Schwartz Kathleen Barker
Published: April 2012

This study examines the ways in which 272 recently certified occupational therapists learned of the profession of occupational therapy and the factors that influenced their decisions to choose occupational therapy as a career. The data were analyzed according to age, sex, and geographic region to identify potential ways to improve recruitment efforts. The results indicated that therapists most often learned of the profession while working in a health care setting. First exposure to occupational therapy was usually through an acquaintance in the profession, a family member, or a friend. The primary reasons for choosing occupational therapy included a desire to help people with disabilities, the promise of challenge and variety, the opportunity to work in a health care setting, and the belief that jobs are plentiful. The factors most likely to dissuade people from the profession were the expense of an education and lack of a clear understanding of occupational therapy.
Relaxation Training: A Self-Help Approach for Children With Headaches
Authors: Engel Joyce M.
Published: April 2012

Children and adolescents frequently complain about recurrent nonmalignant headaches. Relaxation exercises are one possible treatment for these headaches. As the role of occupational therapy in pediatric pain management emerges, relaxation training is becoming one of the treatment activities. The present study investigated the efficacy of progressive relaxation exercises in reducing headache complaints, particularly those headaches of a mixed variety. Ten subjects with a mean age of 11.5 years completed the 6-week self-help program. A multiple-baseline across-subjects design was used. Baseline periods were randomly assigned and ranged from 7 to 25 days with treatment introduced in a time-staggered fashion across subjects. After completing their treatment, 8 of the 10 subjects had a mean increase of 15% in headache-free days. Specific guidelines for relaxation training are provided in the outlined treatment program.
A Cross-Cultural Test of the Validity of Occupational Therapy Assessments With Patients With Schizophrenia
Authors: Evans Juli , Salim Ahmed Awadh
Published: April 2012

The validity and use of psychosocial assessments in occupational therapy are ongoing concerns (Moyer, 1984) and were the focus of this study. Fifty African patients with schizophrenia and 10 nondysfunctional African volunteers took an an assessment battery that included the Schroeder, Block, Campbell Adult Psychiatric Sensory Integration Evaluation (SBC) (Schroeder, Block, Trottier, & Stowell, 1978), a daily activity, work, and leisure activity interview based on the Model of Human Occupation (Kielhofner, 1985), and a culture-specific test of functional performance. Data on subjects’ psychiatric histories and demographics were collected. Rationale for the assessments used, methods for devising the functional assessment, methods and procedures for data collection, and analysis are presented.

A stronger relationship was found to exist between subjects’ performances on the SBC and the functional activity test than between interviews based on the Model of Human Occupation and the functional activity test, both for patients and for the whole sample. All assessments were found to differentiate between patients and nonpatients, although the SBC was the best discriminator. Among psychiatric history variables, the strongest relationships were between measures of seriousness of illness and both the SBC and functional activity assessment. The most effective way to measure performance dysfunction and seriousness of illness in persons with schizophrenia was to measure the underlying sensorimotor impairment or to use a culture-specific test of functional performance.
Effects of Aging on Adult Hand Function
Authors: Shiffman Lori M.
Published: April 2012

The effects that normal aging have on adult hand function and functional performance are not well understood. An empirical study was conducted examining relationships between prehension pattern type and frequency, hand strength, and performance time in functional tasks. Four groups of 10 adults were selected by age and gender, ranging from 24 to 87 years. Subjects were asked to pour milk into a cup and remove money from a wallet while being videotaped. Prehension patterns were identified with a functionally based classification system. Grip and three types of pinch were measured with a dynamometer and a pinch gauge.

Prehension pattern selection did not seem to differ with age. Statistically significant differences in age were found for prehension pattern frequency, hand strength, and performance time. Nondysfunctional older subjects were observed resetting identical prehension patterns secondary to lateral pinch weakness, which contributed to increased prehension pattern frequency and performance time.

Hand function seemed to remain stable until age 65 years, after which it diminished slowly. After age 75 years, age differences in performance were most apparent.
Occupational Adaptation: Toward a Holistic Approach for Contemporary Practice, Part 1
Authors: Schkade Janette K. , Schultz Sally
Published: April 2012

A theoretical perspective designed for clinical application and based on fundamental occupational therapy principles is offered. This perspective, the occupational adaptation frame of reference, is presented as an articulation of (a) a normal developmental process leading to competence in occupational functioning;(b) the process through which the benefits of occupational therapy occur; and (c) a perspective that promotes holistic practice. The person is viewed as operating occupationally through an idiosyncratic configuration of sensorimotor, cognitive, and psychosocial systems, all of which are inevitably involved in each occupational response. This occupational functioning is described as occurring through interaction of the person with a work, play and leisure, or self-care context that has distinctive physical, social, and cultural properties (i.e., the occupational environment). Occupational adaptation is a perspective that can influence practice, education, and research.
An Occupational Therapy Perspective in the Treatment of Multiple Personality Disorder
Authors: Waid Karen M.
Published: April 2012

Adult persons with multiple personality disorder have survived a traumatic past. After diagnosis and the initiation of psychotherapy, they frequently face a long and arduous treatment process. During this time, intense emotions and memories are retrieved that can disrupt functional life skills in an already disjointed life. The stresses of life combine with therapeutic issues to perpetuate the dissociation that interrupts functional performance. The original traumas occurred when the child was functioning primarily at a sensorimotor level. Occupational therapy can identify sensorimotor activities that provide a focal point of control to reduce stress during the therapeutic process and to develop new life skills.
Career Self-Efficacy in Occupational Therapy Practice
Authors: Bush JoAnn V. , Powell Nancy J. , Herzberg Georgiana
Published: April 2012

Career expectations contribute to job satisfaction, which ultimately affects personnel retention. This paper focuses on a current trend in career literature: career self-efficacy, judgments about the efficacy of one’s career choice and adjustment. Career self-efficacy is relevant to occupational therapy in that therapists are leaving the profession because of unmet career expectations. This paper explores Bandura’s self-efficacy theory (the basis of career self-efficacy) and discusses the authors’ experience in clinical practice and education relating the application of career self-efficacy to occupational therapy. Suggested methods for enhancing career self-efficacy include the implementation of a professional development course based on Bandura’s self-efficacy theory; incorporation of self-efficacy content into the professional theory and practice courses; clinical supervision that creates realistic self-perceptions of performance during the fieldwork experience; and transitional programs for entry-level practitioners that identify and explore personal career expectations and support for the experienced practitioner.
Computer-Assisted Functional Assessment and Documentation
Authors: Smith Roger O.
Published: April 2012

Occupational therapy personnel spend considerable time on functional assessment and documentation. The rapid and error-free information processing ability of computers offers methods for data collection, clinical decision making, and reporting of functional assessment results, which may be more effective and efficient than the current paper-and-pencil methods.

Computers can provide assistance throughout the many steps of the functional assessment and reporting process. Software is available to assist in direct data collection, data reduction, and analysis, or to assess complex data systems and databases. Additionally, computers can use assessment techniques, such as dynamic question sets and expert systems, which have not been possible with paper-and-pencil methods. Furthermore, data collected on computers are readily available to be integrated in computer-assisted report writing and can be compiled into large databases for analysis. These databases can be used for program evaluation, continuous quality improvement exercises, and other research objectives. This paper provides a snapshot of these computer uses in the assessment process.
Adaptive Computer Use for a Person With Visual Impairment
Authors: Buning Mary Ellen , Hanzlik Jodie Redditi
Published: April 2012

A single-subject research design that used multiple baselines across behaviors compared traditional adaptations (e.g., the use of readers) to adapted computer technologies for typical reading activities performed by an adult with severe visual impairment. A Macintosh IIci™ equipped with software that translated information displayed on the monitor into synthesized speech was paired with a page scanner and optical character recognition software to convert scanned images of printed text into computer documents. These computer technologies were applied to three reading behaviors: proofreading of word-processed documents, reading of printed research articles, and reading of common printed materials such as letters and instruction sheets. The findings demonstrated that the use of adapted computer technology, rather than traditional methods, increased the subject’s reading efficiency and frequency. The increased functional independence that occurred as a result of the computer technology improved the subject’s patterns of adaptation in reading-related tasks and improved the quality of her life.
Occupation Embedded in a Real Life: Interweaving Occupational Science and Occupational Therapy
Authors: Clark Florence
Published: April 2012

This lecture presents an example of research in the genre of interpretive occupational science and demonstrates how occupational science can inform clinical practice. The innovative qualitative methodology used blended elements of the anthropological tradition of life history ethnography, ethnomethodology, the naturalistic methods used by Mattingly and Schön to study practice, and especially narrative analysis as described by Polkinghorne. The bulk of the paper is presented in the form of a narrative analysis that provides an account of a stroke survivor’s personal struggle for recovery, a story that emerged from transcription, coding, and analysis of transcripts from approximately 20 hours of interview time. First, this narrative analysis provides an example of how the occupational science framework can evoke a particular kind of storytelling in which childhood occupation can be related to adult character. Storytelling of this kind is later shown to be therapeutic for the stroke survivor. Next, the narrative illustrates how rehabilitation can be experienced by the survivor as a rite of passage in which a person is moved to disability status and then abandoned. Finally, a picture is given of how occupational story making and occupational storytelling embedded in real life can nurture the human spirit to act and can become the core of clinical practice.
Issues in Assessment of Psychosocial Components of Function
Authors: Bonder Bette R.
Published: April 2012

For occupational therapy to provide a holistic view of meaningful activity, we must understand the relationship between physical, psychological, and social variables, especially as they affect our psychosocial evaluations and treatment. Existing definitions of psychosocial variables are unclear and, for occupational therapy practice, must be linked to activity and occupational performance.

Occupational therapists need to become more educated about the uses and limitations of psychosocial instruments and to develop new instruments that address the central tenets of occupational therapy by focusing on whether or not a person is able to do what is necessary and fulfilling. Further, understanding what is meant by meaningful activity and what people need to accomplish it will advance our effectiveness in occupational therapy assessment and practice.