bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating Activities of Daily Living: Directions for the Future
Authors: Law Mary
Published: April 2012

Current assessments of simple activities of daily living (ADL) and more complex, instrumental activities of daily living (ADL) could be improved. These assessments are criticized because there are so many different tests for various diagnostic populations, because they rely on self-report rather than observation, because they are based on such varied conceptual frameworks, because they are often cumbersome and lengthy to administer, and because they often rely on outdated or specific cultural perspectives. Improvement of ADL and IADL assessment lies in making them more contextual and client specific, (i.e., by addressing clients’ needs in real-life contexts that consider roles, culture, varying environments, and developmental stage).
Client-Centered Assessment
Authors: Pollock Nancy
Published: April 2012

When occupational therapists assess function or occupational performance, they must consider each person’s unique needs and abilities, as well as the environmental and social factors that may be affecting the clients’ performance. Therefore, occupational therapists must use evaluation tools that are individualized and sensitive to the clients’ varying needs and situations. One approach to individualized evaluation is the use of a client-centered process of setting goals and assessing change. This paper describes the development of a methodology for a client-centered assessment currently being used in Canada, the Canadian Occupational Performance Measure (COPM). The conceptual model, administration and scoring procedures, and preliminary feedback to the COPM are described.
Sequence Comparison Methodology for the Analysis of Movement Patterns in Infants and Toddlers With and Without Motor Delays
Authors: Miller Lucy Jane , Roid Gale H.
Published: April 2012

In an attempt to quantify the theoretical construct quality of movement, a set of measurable constructs were identified by subject matter experts, and a scale (the Toddler and Infant Motor Evaluation [TIME]) incorporating those constructs was developed and pilot tested. Sequence comparison data analysis methodology was examined for its applicability to examining series of movements. The study sample consisted of randomly selected children from a pilot edition of the scale. Because research indicates that specific individual positions cannot provide an accurate indication of the normalcy or dysfunction of the motor performance of infants and toddlers, this study researched the ability of series of movement positions in each of five postures (prone, supine, sit, quadruped, and stand) to discriminate between normal and atypical molar development. It was hypothesized that children with motor delays would demonstrate different sequences of movements than children without motor delays. The findings confirmed the hypothesis, because in this sample there was a significant difference in the performance of children with developmental delays in motor abilities compared with that of children who had normal movement abilities. Children with motor delays had poorer mobility, which was characterized by fewer transitions between movement patterns than children with normal motor abilities.
Discriminative Versus Evaluative Assessment: Some Observations on Goal Attainment Scaling
Authors: Ottenbacher Kenneth J. , Cusick Anne
Published: April 2012

Goal attainment scaling has been described in the rehabilitation literature as a method of evaluation designed to monitor client progress, structure team conferences, and provide information on overall program evaluation. The appropriate use of goal attainment scaling in clinical environments depends on a clear understanding of its strengths and weaknesses. The primary strength of goal attainment scaling is the ability to evaluate individualized longitudinal change. Goal attainment scaling is not a methodology designed to assess functional status. Confusion occurs when evaluation tools designed to discriminate between persons (determine status) are used to assess change in individual patients over time. This paper describes the strengths and weaknesses of goal attainment scaling as a methodology for evaluating clinical change. The process of evaluative assessment with goal attainment scaling is compared to discriminative assessment where the purpose is to distinguish between persons or to classify persons into predefined categories.
Using a Sensory Integrative Approach to Treat Self-Injurious Behavior in an Adult With Profound Mental Retardation
Authors: Reisman Judith
Published: April 2012

The treatment of self-injurious behavior in adults with mental retardation is a major challenge. A critical review of the literature compares sensory-based treatment studies by behavioral psychologists with sensory integrative treatment studies by occupational therapist. In general, therapists have used direct intervention in concentrated daily sessions. This report includes a single subject study that (a) demonstrates the clinical reasoning involved in the assessment and treatment planning process, (b) documents the efficacy of multiple short treatment sessions spread throughout the day, and (c) presents an alternative model of service provision in which direct care staff provide sensory and adaptive activities under the supervision of an occupational therapist. The use of sensory integration with adults with profound handicaps is presented as a valid application of a theory and treatment that was originally developed from work with higher functioning children with learning disabilities.
The Effect of Life Review Reminiscence Activities on Depression and Self-Esteem in Older Adults
Authors: Stevens-Ratchford Regena G.
Published: April 2012

The purpose of the study was to investigate the effect of life review reminiscence activities on reported depression and self-esteem. The study used a pretest–posttest experimental design in which 24 well older adults living in a retirement community were randomly assigned to experimental and comparison groups. The experimental group participated in six life review sessions, after which all subjects were readministered the Beck Depression Inventory and the Rosenberg Self-Esteem Survey.

An analysis of covariance indicated that life review reminiscence activities did not significantly affect depression and self-esteem. These findings imply that participation in life review activities did not negatively affect this sample of well older adults and that life review reminiscence is a worthwhile activity for this age group.
Grip Strength of Children Aged 3 to 7 Years Using A Modified Sphygmomanometer: Comparison of Typical Children and Children With Rheumatic Disorders
Authors: Dunn Winnie
Published: April 2012

The standard methods for testing grip strength can cause pain and inhibit accuracy of results when persons have rheumatic diseases. The first purpose of this study was to gather data on grip strength of typical children 3 to 7 years of age using the modified sphygmomanometer technique. Modified grip strength testing requires the person to squeeze an inflated sphygmomanometer (blood pressure device). Gender, age, height, weight, hand preference, and grip strength of 273 children 3 to 7 years old were recorded. Results illustrate that grip strength increases steadily from younger to older children. No differences were noted related to height, weight, or grip strength between girls and boys. The second purpose of this study was to compare the grip strength of a preliminary sample of children with rheumatic disorders to the grip strength of a sample of typical children. Results indicate that grip strength of the sample of 17 children with rheumatic disorders was significantly lower. This study offers therapists some guidance about grip strength expectations for children aged 3 to 7 years that can then be applied to a variety of special populations.
Cognitive Performance in Senile Dementia of the Alzheimer’s Type: The Kitchen Task Assessment
Authors: Baum Carolyn , Edwards Dorothy F.
Published: April 2012

The Kitchen Task Assessment (KTA) is a functional measure that records the level of cognitive support required by a person with Senile Dementia of the Alzheimer’s Type (SDAT) to complete a cooking task successfully. The results allow the clinician to help caregivers understand the level of support the impaired person needs to perform daily living tasks. This paper presents the validity, and internal consistency of the KTA. Data were collected from 106 persons diagnosed with SDAT. Construct validity was established by examining the relationship between subjects’ performance on the KTA and standard neuropsychological measures.
Student Perceptions of Persons With Psychiatric and Other Disorders
Authors: Lyons Mike , Hayes Robyn
Published: April 2012

Policy shifts toward fostering community inclusion of persons with disabilities have brought community attitudes (including attitudes of professionals) into sharper focus as a cause for concern. Using a social distance scale, this study examined the attitudes of cohorts of occupational therapy and business students toward persons with psychiatric and other disorders. Contrary to expectations, occupational therapy seniors did not demonstrate significantly different attitudes from occupational therapy freshmen. Although freshman occupational therapy students expressed a desire to maintain less social distance from persons with various disabilities than did freshman business students, there was nonetheless a hierarchy of preference for persons with certain disabilities over others. This order of preference had only weak stability between cohorts, with persons with psychiatric disabilities consistently ranking among the least favored. It is proposed that occupational therapy curricula attend to students’ attitudes toward persons with psychiatric and other disabilities. To this end, certain strategies to enrich students’ education are suggested.
Restaurant Wheelchair Accessibility
Authors: McClain Linda , Beringer Debra , Kuhnert Heather , Priest Johna , Wilkes Emily , Wilkinson Sue , Wyrick Lisa
Published: April 2012

This study was designed to determine the compliance of restaurants to the wheelchair accessibility standards set forth in the Uniform Federal Accessibility Standards. The standards that were operationalized in this study are also found in Title III of the Americans with Disabilities Act of 1990. The data were collected at 120 sites in three midwestern states. For one who uses a wheelchair, parking the car is often an obstacle to eating out. Only 53% of the restaurants surveyed provide handicapped parking. Entering the building may also be a problem. Of the restaurants that required a ramp, only 66% provided them. Inside the restaurant, the key problems were accessible restrooms and the height of tables. The study provided comparisons between restaurants in rural and urban settings, as well as comparisons between conventional restaurants and fast food restaurants. No notable differences emerged for these comparisons.
A Curriculum Based on Systems Theory
Authors: Schemm Ruth Levine , Corcoran Mary , Kolodner Ellen , Schaaf Roseann
Published: April 2012

This paper describes an entry-level curriculum based on systems theory that was designed to promote integrated thinking and a shared image of practice among all of the members of an educational community that included students, faculty, and clinicians. Initiated in 1983, the program integrates occupational therapy theory, critical thinking, and knowledge about person–environmental transactions with traditional medical, biological, psychological, and sociological course work to create a unique educational experience. The curriculum model is based on a spiral learning process that encourages integrated thinking. Furthermore, all concepts are systematically tied to the occupation core, the central theme of the program. Fieldwork is used to reinforce ideas presented in the classroom and features discrete learning experiences where students demonstrate their integration of knowledge and skills.

In an evaluation of the program, responses from 78 clinician, 51 alumni, and 132 student questionnaires; feedback from 132 fieldwork supervisors; and longitudinal data from 33 alumni confirmed that graduates are critical thinkers who appreciate the diverse needs of clients while demonstrating an appreciation for the curative effect of meaningful, goal-directed activities.
Attending Behavior: A Descriptive Study of Children Aged 18 Through 23 Months
Authors: Czerniecki Janine Gaudry , Deitz Jean C. , Crowe Terry K. , Booth Cathryn L.
Published: April 2012

The purpose of this study was to provide descriptive data on the attending behavior of children aged 18 through 23 months. The method used was designed to be clinically feasible for occupational therapy practitioners. Forty-eight children between the ages of 18 and 24 months were studied through observation of a 15-min session of free play with a standard set of toys. The child’s physical contact with objects was used as a guideline for timing. Four factors were examined: total time attending, total number of activities attended to, average attending time per activity, and longest time attending to one activity.

The Mann Whitney U statistic revealed that there were no significant differences between boys and girls on any of the four factors. There were, however, statistically significant differences between children aged 18 through 20 months and children aged 21 through 23 months for all of the factors except longest time attending to one activity.

The children in this study changed activities frequently (median of 10 activities in 15 min) and attended briefly (median attending time per activity of 81 sec). They were, however, capable of attending to one activity for much longer periods of time (median of 225 sec). With minimal adult intervention, the children spent an average of 12.5 min attending to the toys during a 15-min session. These results may augment other aspects of occupational therapy assessment by offering some insight into whether or not an individual child demonstrates age-appropriate attending behavior. Additionally, this standardized method of observation may offer occupational therapists a clinically feasible means of assessing attending behavior.
Death in Very Old Age: A Personal Journey of Caregiving
Authors: Hasselkus Betty Risteen
Published: April 2012

This paper describes a personal journey of caregiving for a very old family member during dying and death. The phenomenology of caregiving reveals the inner struggle experienced by all caregivers, lay and professional, between the needs of support both the living and the dying of the terminally ill person. The lived experience unfolds in phases of caregiving that support a stage theory of development in professionals’ work with dying persons. The concept of presencing or connecting is a vital component of terminal care and bas implications for occupational therapy practice. Occupational therapists can use their knowledge and understanding of occupation to bring about connecting in the dying experience. The contributions of all participants in the dying experience – family caregivers, the dying person, and health professionals – are important as sources of mutual support in the work of dying.
A Survey of Transportation Services for Children With Disabilities
Authors: Everly Janet Stout , Bull Marilyn J. , Stroup Karen Bruner , Goldsmith Janet J. , Doll Judith P. , Russell Robert
Published: April 2012

Although many students with disabilities are transported daily in school vehicles, few state guidelines address special transportation needs. This study collected information from two states on the types of vehicles and safety restraints used, and the problems encountered by public schools, community agencies, and rehabilitation centers that transport people with disabilities from birth to 21 years of age. The information collected, together with a review of research on special needs transportation, contributed toward development of state regulations for school buses used to transport special education students.

Vehicular transportation safety is an important part of individualized education planning for the 18.6% of occupational therapists working in schools. Using this study’s questionnaires occupational therapists who are primary resources for selection of seating and transportation equipment may become informed advocates for implementing safer transportation on an individual and state level for clients with disabilities.
Grasp Pattern Variations Seen in the Scleroderma Hand
Authors: Poole Janet L.
Published: April 2012

Objectives. Therapists generally describe a person’s grasp in terms of normal prehension patterns that have been discussed in the literature. However, the grasp pattern used by a person with a hand impairment may not fit into these patterns. The purpose of this study was to describe, with qualitative classification systems, static grasp patterns used by hands impaired by scleroderma and to determine the relationship between hand impairment and variations in grasp.

Methods. Seventeen subjects with scleroderma were observed grasping a key, a coin, a glass, and a saucepan. Their grasp patterns were recorded on the basis of which fingers were used to grasp the object, the surface areas of the fingers in contact with the object, and the position of the joints of the fingers. In addition, range of motion, grip and pinch strength, skin thickening, digital ulcers, calcium deposits, and tendon friction rubs were assessed.

Results. More variations in grasp were seen with the coin, glass, and saucepan than with the key. The presence of digital sores indicated more difficulty holding a coin, whereas the presence of calcium deposits indicated more difficulty holding a coin, glass, and saucepan. The number of fingers with contractures correlated with the ability to hold all four objects.

Conclusions. Persons with scleroderma show qualitative differences in grasp as compared to normal prehension patterns. These differences are influenced by impairments in the scleroderma hand. Qualitative descriptions of grasp patterns may provide therapists with additional means to document change after surgical or therapeutic intervention.
Implications of the Americans With Disabilities Act of 1990 for Elderly Persons
Authors: Bachelder Judy McGinty , Hilton Claudia List
Published: April 2012

Because the prevalence of disability increases proportionately with age, the expanding population of older adults is potentially the largest single group to benefit from the Americans With Disabilities Act of 1990 (ADA) (Public Law 101-336). One fourth of elderly persons have functional disabilities acquired through age-related chronic and acute conditions. The ADA guarantees older adults with disabilities equality in the workplace and the community. It also enhances their opportunities to continue living independently as long as possible. Applications of the ADA for elderly persons with functional impairments include providing opportunities to continue working in a job suited to their abilities, eliminating structural or programmatic barriers to full inclusion, and providing accommodations for sensor losses. Occupational therapists also have certain responsibilities and opportunities in supporting the rights of elderly persons with functional impairments under the ADA. These responsibilities include providing rehabilitation to promote community reintegration, consulting with employers and service providers on the unique needs of the elderly, and advocating on behalf of and in association with older Americans.
An Occupational Therapy Refresher Course: A 5-Year Follow-up Report
Authors: Meyers Cheryl
Published: April 2012

Objectives. The shortage of occupational therapists prompted the faculty of the program in occupational therapy at the University of Minnesota to develop a reentry (refresher) course.

Method. A questionnaire sent to all enrolled in the 2-week refresher course during a 5-year period revealed that three intended groups of therapists have benefited: those reentering practice, those considering a change to another area of specialty, and those updating their educational background.

Results. Respondents indicated that the course increased self-confidence, theoretical knowledge base, and ability to apply theory to practice.

Conclusion. Both reentering therapists and those changing specialty areas of practice reported positive employment outcomes.
Reinjury Prevention Follow-Through for Clients With Cumulative Trauma Disorders
Authors: Furth Heidi Jane , Holm Margo B. , James Anne
Published: April 2012

Objectives. Fifteen subjects with upper extremity, work-related cumulative trauma disorders were involved in a quality improvement study to determine their self-reported degree of follow-through with reinjury prevention regimens. The effect of cuing was also studied.

Method. During occupational therapy, subjects were involved in an educational session that focused on recommendations in ergonomic equipment, therapeutic maintenance techniques, body mechanics, and work simplification techniques. Follow-through with reinjury prevention education was evaluated and rated via telephone interviews approximately 2 weeks (T1 ) and 4 weeks (T2 ) after the educational session. Subjects did not know the questions they would be asked at T1, but were cued that their progress would be checked again at T2. Dependent t tests were conducted to compare the mean number of recommendations for which complete follow-through was expected with the mean number of recommendations at T1 and T2 that were implemented completely.

Results. A significantly lower degree was found of absolute completion of recommendations at T1 and T2 than had been anticipated (p < .002). No significant difference between T1 and T2 was found, indicating that cuing at T1 had little effect on subjects’ actual follow-through rate.

Conclusion. The implications of these findings for occupational therapists support the need for further reaserch in reinjury prevention and employer education.
Change in Wheelchair Transfer Performance During Rehabilitation of Men With Cerebrovascular Accident
Authors: Khader Maha Sulieman , Tomlin George S.
Published: April 2012

Objectives. A retrospective study was conducted to investigate differences in the functional outcome between patients with left cerebrovascular accident (left CVA) and right cerebrovascular accident (right CVA) in wheelchair transfer performance. It was hypothesized that the level of improvement in left CVA and right CVA groups of patients would not be the same, due to the different constellation of neurological impairments.

Method. Data were obtained from the admission and discharge scores on the Functional Independence Measure of 100 male patients, 50 with left CVA and 50 with right CVA.

Results. Both groups demonstrated a statistically significant improvement between admission and discharge for wheelchair to bed, wheelchair to toilet, and wheelchair to tub or shower transfer (p < .001). However, there were no statistically significant differences between the two groups at admission or discharge for any of the three transfer, even after statistical removal of the effects of age, number of days from onset at stroke to rehabilitation, and number of days in rehabilitation.

Conclusion. The lack of difference between the groups at time of discharge may have obscured a difference in the rate of transfer learning during the course of rehabilitation.
Relationship Between Visuomotor and Handwriting Skills of Children in Kindergarten
Authors: Weil Marsha J. , Cunningham Amundson Susan J.
Published: April 2012

Objective. The purpose of this study was to examine the relationship between the performance of children in kindergarten on the Developmental Test of Visual–Motor Integration (VMI) and their ability to copy letters legibly.

Method. Sixty typically developing children in kindergarten aged 64 months to 75 months (30 girls and 30 boys) were administered the VMI and the scale of Children’s Readiness In PrinTing (SCRIPT). The SCRIPT requires children to copy 26 lower case letters and 8 upper case letters from a model.

Results. A significant relationship was found between subjects’ performance on the VMI and ability to copy letters legibly. In addition, as subjects’ ability to copy the forms on the VMI increased, a concomitant increase in ability to copy letters was also found. There were no gender differences in performance on the VMI or on the SCRIPT.

Conclusion. The findings of this study suggest that most children in kindergarten similar to those in this study will be ready for handwriting instruction in the latter part of the kindergarten year.
Flow and the Occupational Therapy Practitioner
Authors: Jacobs Karen
Published: April 2012

Objective. This study examined optimal f1ow experience, a form of job satisfaction in occupational therapy practitioners employed at physical rehabilitation facilities in New England.

Method. Factors associated with flow were measured over a 5-day work week with the Experience Sampling Method. Ninety-seven percent of the 90 subject’ responses were analyzed and 43% of the subjects participated in the debriefing interview.

Results. Subjects experienced flow a relatively small amount of the time – an average of 5.24 times in a 5-day work week, with a range of 1 to 12 experiences. Flow was experienced most often (23.6%) when subjects were working with a client in some type of intervention. Perceived autonomy and self-esteem were high during a flow experience. Subjects described their flow experiences as including such moods and attitudes as “alert,” “happy,” “involved,” “creative.” “excited,” “productive,” “accomplished,” “proud.” “good,” “confident,” “positive,” and “challenged,” Conversely, subjects in flow also tended to describe their mood as “tense.”

Conclusion. Retaining occupational therapy practitioners is critical to meeting and increasing the unprecedented demand for health care services. Understanding what causes occupational therapy practitioners to experience flow and how to transform an activity into a flow experience may ultimately improve job satisfaction, productivity, and the retention of practitioners.
The Caring Occupational Therapist: Scope of Professional Roles and Boundaries
Authors: Sachs Dalia , Labovitz Deborah R.
Published: April 2012

Objective. This article links two dimensions of occupational therapy within the context of professionalism: the role of caring and the implications of occupational therapy being a predominantly female profession.

Method. Seven occupational therapists representing various levels of professional experience were interviewed to determine (a) how female occupational therapists perceive caring and (b) the implications of this perception for professional role definitions.

Results. Participants’ daily professional work role was determined by three factors: the interpretation of holistic philosophy in their everyday activities as occupational therapists, the influence of their caring attitude in broadening their responsibilities beyond the occupational therapists’ role definition, and the organizational settings in which their work took place.

Conclusion. The seven participants had a broad definition of the scope of their professional responsibilities and experienced difficulty defining the limits of their role. Caring is a central part of the occupational therapists’ role; therefore, perceptions about caring are central to the role definition of occupational therapists.
Perceptual Retraining for Adults With Diffuse Brain Injury
Authors: Neistadt Maureen E.
Published: April 2012

Occupational therapy for adults with perceptual dysfunction secondary to diffuse acquired brain injury from trauma or anoxia often includes remedial retraining with treatment tasks, like construction of puzzles, to provide clients with practice in deficit perceptual skills. Therapists using this approach assume that adults with brain injury learn specific perceptual skills from retraining exercises and can transfer those skills across all activities (including self-care and community living activities) that require those skills. This review of outcome studies about remedial perceptual retraining for adults with diffuse acquired brain injury suggests that those learning assumptions hold true only for clients with localized lesions and preserved abstract reasoning who have been explicitly laught to transfer learning across a variety of treatment activities. Recommendations about ways to assess client’s learning potential and appropriateness for remedial retraining include keeping track of the number of repetitions clients need to relearn functional tasks and systematically varying functional tasks during training to see how easily clients can transfer learning across variations of the same task.
After Rehabilitation: Meeting the Long-Term Needs of Persons With Traumatic Brain Injury
Authors: Jackson Jodi D.
Published: April 2012

Many survivors of traumatic brain injury have significant needs for long-term support. The rehabilitation professions, including occupational therapy, have begun to recognize these needs more fully during the last decade. The literature describes various models of supported living that provide housing, support services, and vocational assistance: however, these programs are not widely available due to limitations in public funding and inadequate insurance coverage for long-term care. Occupational therapists can contribute a broad expertise to the provision of supported living services, and the profession is encouraged to provide leadership and advocacy with respect to the long-term care needs of survivors of traumatic brain injury.
Helping Factors in a Peer-Developed Support Group for Persons With Head Injury, Part 2: Survivor Interview Perspective
Authors: Schulz Celia H.
Published: April 2012

Objectives. A follow-up study of the support group discussed in Schwartzberg’s 1994 study was conducted to determine participants’ perceptions of helping factors in the group.

Method. Subjects were given a semistructured interview; follow-up interviews were held to ensure accuracy.

Results. Eleven helping factors were spontaneously generated from group members’ data. These factors were socializing; finding out other people’s perspectives and attitudes; expressing thoughts and feelings; receiving support; feeling something in common with other group members; gaining understanding, empathy, and acceptance through listening and sharing; getting perspective by learning about other people’s limitations and strengths; helping others; getting help with problem solving; feeling hope; and learning information about brain injury. Members ranked expressing thoughts and feelings as the most helpful factor and finding out other people’s perspectives and attitudes as the least helpful.

Conclusions. These results support Schwartzberg’s earlier findings, with some exceptions. The factor titles in this study have a broader scope than those in Schwartzberg’s study, and not all of the factors determined in this study are completely comparable to Schwartzberg’s factors. These findings may indicate that some differences in perspective exist between the participant observer and the survivors in the group studied.
Efficacy of a Sensory Integration Program on Behaviors of Inpatients With Dementia
Authors: Robichaud Line , Hébert Réjean , Desrosiers Johanne
Published: April 2012

Objectives. Dementia is the disease most frequently leading to admission in long-term care institutions, primarily because persons with this disease exhibit several behavioral problems. The objective of this study was to measure the efficacy of the sensory integration program developed by Ross and Burdick in improving the functioning of persons with dementia.

Method. Forty subjects with dementia (28 women, 12 men, mean age of 78.4 years) in three different institutional settings in Quebec City, Canada, were randomly assigned to the study (n = 22) or control (n = 18) group. Subjects in the study group participated in three 45-min sessions of a sensory integration program per week for 10 weeks. Outcomes were measured using the Revised Memory and Behavior Problems Checklist and the Psychogeriatric Scale of Basic Activities of Daily Living.

Results. The sensory integration program had no significant effect on the behaviors of the study group.

Conclusion. Before this type of program is labeled inefficacious, other studies are necessary to determine whether modifying the frequency of sessions, the number of subjects, and the measuring instruments would lead to similar results.
Prediction of Preschool Sensory and Motor Performance by 18-Month Neurologic Scores Among Children Born Prematurely
Authors: Lane Shelly J. , Attanasio Carla Soares , Huselid Rebecca Farmer
Published: April 2012

Objectives. Premature birth places a child at risk for a number of academic and behavioral deficits. The challenge currently facing interventionists is to identify at an early age those preterm children who will develop such deficits. Identified children can then be targeted for intervention to forestall deficits at school age.

Method. This study examined the use of a neurologic assessment, administered at 18 months of age, to identify children who will have difficulties at preschool age. Premature children identified as neurologically normal or neurologicaliy suspicious at the age of 18 months were tested with the Miller Assessment for Preschoolers.

Results. Although there was some variability in performance, as a group the children classified as neurologically suspicious at 18 months continued to fall into a risk category at 4 years of age.

Conclusion. Because such categorization may predict inadequate performance during the school-age years, monitoring of the child’s development is warranted.
Infant Mental Health in Occupational Therapy Practice in the Neonatal Intensive Care Unit
Authors: Olson Judith A. , Baltman Kathleen
Published: April 2012

The Work of supporting an infant’s emotional development and mental health begins in the neonatal intensive care unit (NICU). It depends on understanding the family and uses the parallel processes involved in relationship building to maximize the environment for the optimal development of the infant in the NICU. Occupational therapy service provision is discussed in light of knowledge about the developmental work of the full-term neonates and their parents and the corresponding work of infants in the NICU and their families. A brief vignette of occupational therapy services provided in the context of a relationship-focused infant mental health model is included.
Neurobehavioral Assessment of High-Risk Infants in the Neonatal Intensive Care Unit
Authors: Miller Margaret Q. , Quinn-Hurst Mary
Published: April 2012

Neurobehavioral organization describes infants’ abilities to organize themselves within their central nervous system maturation and environment. As part of infants’ environment, caregivers can structure the environment to support infants’ development. Care of the high-risk infant emphasizes support of infants’ emerging neurobehavioral organization. This article describes the theoretical rationale of neurobehavioral organization, effect on the infant and family, and assessments available to the neonatal occupational therapist for use with high-risk infants. Information gained via neurobehavioral assessment can be used to engage parents in better understanding their infant’s behaviors and interact at a level appropriate with their infant.
The Influence of Neonatal Intensive Care Unit Caregiving Practices on Motor Functioning of Preterm Infants
Authors: Mouradian Laurie E. , Als Heidelise
Published: April 2012

Objectives. Experimental design intervention studies have demonstrated that a model of individualized developmental care based on specific behavioral observation improves medical and behavioral outcome for very small preterm infants. It is proposed that infants who were not directly involved in an experimental intervention study per se, but were patients in a neonatal intensive care unit (NICU) where such studies took place and the model was adopted as the standard of care, demonstrate some of the same benefits as the infants in the experimental study.

Method. The study was a retrospective descriptive analysis of an existing data set. The functioning of two cohorts of infants, comparable medically and demographically and cared for in an NICU where developmental care research was conducted and subsequently adopted as the standard of care, was measured after discharge with the Assessment of Preterm Infants’ Behavior (APIB). Cohort I was cared for before the first study of individualized developmental care in the NICU; Cohort II was cared for after the individualized developmental care approach was adopted as the standard of care for the NICU.

Results. Cohort II infants demonstrated better scores than Cohort I infants on 8 out of 23 summary variables, 6 of which reflect improved motor functioning. They also showed significantly better scores on 7 of the 17 specific motor variables of the APIB.

Conclusion. Infants cared for in an NICU with an individualized developmental care approach showed improved motor system functioning compared to infants cared for in the same NICU before the approach was adopted. It is speculated that the individualized developmental approach to care based in the synactive theory of development contributed to the documented improvements. This finding would indicate that functioning of preterm infants, particularly in terms of their motor systems, can be influenced by modification in caregiving.
Person–Environment Assessments in Occupational Therapy
Authors: Letts Lori , Law Mary , Rigby Patty , Cooper Barbara , Stewart Debra , Strong Susan
Published: April 2012

Occupational therapists have begun to recognize the importance of considering how the environment influences occupational performance. Models of person–environment fit provide a theoretical context within which occupational therapists can consider the influence of the environment on function. The challenge for occupational therapists is to select assessments that incorporate concepts of person–environment fit. However, limited awareness of appropriate environmental assessments that have undergone psychometric testing has limited their introduction into clinical practice. This paper reviews 41 environmental assessments and considers each in terms of its purpose, environmental attribute, environmental application, clinical utility, instrument development, and psychometric testing. A case example illustrates the applicability to the practice of occupational therapy.
Somatosensory Processing Abilities of Very Low–Birth Weight Infants at School Age
Authors: DeMaio-Feldman Diane
Published: April 2012

Objective. The purpose of this study was to examine the relationship between somatosensory processing abilities of children at school age and their earlier experiences in the intensive care nursery as very low–birth weight (VLBW) infants.

Method. The subjects were 35 VLBW children at school age (20 girls, 15 boys) who were free of congenital deformity and developmentally appropriate for gestational age. The subjects were part of an ongoing longitudinal study. Birth weight, number of days supported by mechanical ventilation, and number of days in the neonatal intensive care unit were examined in relation to somatosensory functions. Somatosensory functions measured were manual form perception, kinesthesia, finger identification, graphesthesia, and localization of tactile stimuli.

Results. VLBW children were significantly different on all measures of somatosensory processing when compared with the standardization group.

Conclusion. Further research on the VLBW infant’s somatosensory functioning will add to the existing body of knowledge concerning development and guide practice. The finding that the infants in this study, who did not have therapy intervention, later presented diminished somatosensory functioning supports the need to develop measures of somatosensory development for use in assessments and treatment during all developmental phases.
Defining the Specialization of Pediatric Occupational Therapy
Authors: Case-Smith Jane
Published: April 2012

Objectives. Occupational therapists who work primarily with children were surveyed regarding their skill levels in competencies that define pediatric practice.

Method. The subjects were 90 advanced practitioners who received specially certification in pediatric occupational therapy in 1992 and 52 inexperienced practitioners with 5 or fewer years’ experience. Respondents rated themselves from needs assistance to highly skilled on 94 competencies.

Results. A principle components analysis of the 142 surveys identified six primary constructs that described related areas of skill in the respondents: child evaluation, communication and consultation, working with families, understanding service provision systems, use of assistive technology, and neonatology and feeding. Child evaluation, with emphasis on developmental framework, analysis of sensory integration, and neuromotor function, was the strongest construct; respondents rated it the highest. Communication and consultation with team and family members also received high ratings. The advanced practitioner respondents rated themselves higher than the inexperienced practitioner respondents in 73 of the 80 competencies in the factors identified. The differences were greatest in the competencies of analysis of sensory processing and integration, analysis of neuromotor components, and consultation with other professionals.

Conclusion. Findings suggest that advanced practitioners develop expertise in sensory integration and neuromotor analysis, and that evaluation and consultation are important skill areas in advanced occupational therapy practice.
Strategies for Negotiating Preemployment Agreements
Authors: Perry Robert , Crist Patricia
Published: April 2012

Student preemployment agreements are an emerging form of employee-sponsored financial support for students. Forms of financial support for students include the preemployment agreement, sign-on bonus, employment bonus, scholarship, loan, stipend, and grant. Various professional, legal, and ethical issues are involved in the student–employer negotiation of the preemployment agreements. Students may consider financial support for education, type of practice setting, or location of future employment as primary benefits of preemployment agreements. Fieldwork facilities may identify therapist recruitment as the primary goal when offering a financial incentive to a student. Academic fieldwork coordinators may list preservation of the therapist–student relationship or adherence to the fieldwork agreement reached between the academic program and the fieldwork facility as a primary goal. In this article, guidelines for the practical use of preemployment agreements are outlined for use by students and professionals in academic and practice settings.
The Fullness of Empathy: Reflections and Illustrations
Authors: Peloquin Suzanne M.
Published: April 2012

Seven core values are said to undergird the profession of occupational therapy, with empathy serving as a hallmark of one of those values – personal dignity. This inquiry explores the meaning of empathy within a practice that holds occupation at its center. The literature on empathy in both philosophy and the behavioral sciences yields cogent thoughts about the fullness of empathy and its characteristic actions. The Healing Heart, the biography of a pioneer therapist, Ora Ruggles, shows the manner in which occupational therapists can be empathic in their practice. These reflections and illustrations serve to sharpen the vision of occupational therapists as persons who reach for both the hands and the hearts of others.
Mentorship Experiences in a Group of Occupational Therapy Leaders
Authors: Schemm Ruth Levine , Bross Theodore
Published: April 2012

Objectives. The development of occupational therapy leaders is a long-held goal of many members of the American Occupational Therapy Association and of state associations. The initiation of mentor programs is a common means to accomplish this goal. These programs take time and effort, and, although occupational therapists have described how mentorship programs work in the literature, there are few articles that describe the actual mentorship experiences of occupational therapy leaders.

Method. To study the experiences of elected occupational therapy leaders, a 30-item questionnaire was distributed at the annual meeting of the Committee of State Association Presidents and completed by 53 respondents. Results were analyzed, and cross tabulations were run between selected items.

Results. Respondents were frequently exposed to role models, were assisted by sponsors, were mentored by other occupational therapists, and served as mentors themselves. There was little evidence that the respondents were mentored by high-powered individuals who helped launch their careers.

Conclusion. More than half of the respondents were mentored by other occupational therapists, and only 29% of the respondents reported that they surpassed the status and position of their mentors. Plans to initiate mentorship programs should include activities that promote powerful leaders who move beyond the status and position of their mentors, so that occupational therapists can represent the interests of the profession to others.
Health Care Concerns Related to Lifting: An Inside Look at Intervention Strategies
Authors: Laflin Krystal , Aja Diane
Published: April 2012

As members of injury prevention and injury management teams, physical therapists and occupational therapists have the opportunity to evaluate back stress associated with patient-lifting activities. In this study three mathematical formulas are presented that can be used to objectively assess health care workers’ maximum safe lifting capacity for moving patients. Recommendations to reduce the rate of back injury in health care workers include the use of lifting machines for moving patients. mandatory in-service education on body mechanics, and employee assistants programs that improve job satisfaction and worker morale.
Three Faculty-Facilitated, Community-Based Level I Fieldwork Programs
Authors: Rydeen Kay , Kautzmann Lisette , Cowan Mary K. , Benzing Penny
Published: April 2012

Finding sufficient placements for students’ Level I fieldwork experiences has become a major challenge in occupational therapy education and has led to the increased involvement of faculty members in facilitating these experiences. The conceptualization, site selection, program implementation, and outcome of three faculty-facilitated Level I fieldwork programs, designed for occupational therapy fieldwork students at Eastern Kentucky University, are presented here. The first program involved moving a faculty member and students to a small town in the mountains of Eastern Kentucky for 4 weeks and assigning the students to pediatric fieldwork at local agencies. The second, organized and developed by a faculty member and implemented by faculty members and students, provided an enrichment opportunity to adult consumers of psychosocial services. The third, also organized and developed by one faculty member and implemented by faculty members and students, provided day-care services to persons with Alzheimer’s disease. In all three programs, persons receiving services as well as the agencies, students, and faculty members benefited from the experience. The use of faculty role models is recommended to demonstrate and reinforce the application of theory to practice.