bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychosocial Issues in Older Adults’ Adjustment to Vision Loss: Findings From Qualitative Interviews and Focus Groups
Authors: Teitelman Jodi , Copolillo Al
Published: October 2011

Although more therapists are responding to the increasing need for visual rehabilitation services for older adults, little is reported in the literature about the emotional experience of vision loss, especially in the words of persons with low vision themselves. This paper reports findings from a qualitative inquiry involving focus groups and in-depth interviews with 15 older adults using or considering using low vision assistive devices (Copolillo & Teitelman, 2005). Although the study’s original intent was to focus primarily on decisions about LVAD use, psychological and social implications of vision loss emerged spontaneously as a dominant area of concern for participants. From an analysis of 154 codes derived from transcripted data, three themes related to psychosocial experience were generated: (a) Emotional Challenges, (b) Negative Emotional Outcomes, and (c) Indicators of Emotional Adaptation. In this article, individual components of the themes are described using illustrative quotes, and potential practice implications for therapists are presented.
Rethinking Disability and What To Do About It: Disability Studies and Its Implications for Occupational Therapy
Authors: Kielhofner Gary
Published: October 2011

Disability studies seeks to reframe rehabilitation’s understanding and responses to disability. Disability scholars point out that rehabilitation’s perspectives and practices are not objective, but instead reflect particular historical and ideological forces. By demonstrating how rehabilitation practitioners can unintentionally do things that are unhelpful or even harmful, disability scholars challenge the profession of occupational therapy to reconsider aspects of practice, education, and research.

In order to provide a context for a special issue devoted to disability studies, this paper examines disability studies’ major critiques of rehabilitation and considers their implications for occupational therapy. The paper identifies ways that occupational therapy can continue to respond reflectively to the themes of disability studies. It also identifies a number of questions raised by disability studies that will need to be addressed in practice, education, and research.
Habitus and the Embodiment of Disability Through Lifestyle
Authors: Thibodaux Louise R.
Published: October 2011

One aim of disability studies is to accurately portray the experience of persons who live with disabilities. Often this experience generates knowledge that challenges institutional and attitudinal stereotypes. In this study, disability is conceptualized as a measurable space and place characterized by objective differences among groups. Bourdieu’s concept of habitus is proposed as a way to understand how a social space is created and maintained by everyday life experience. Linking Bourdieu’s understanding of social space to the sociology of health lifestyles, the paper further proposes that classes of individuals enact individual and collective behavior that respond to life choice and life chance. Using measures from the Craig Handicap Assessment and Reporting Technique clustered to reveal patterns of community participation 2 years after spinal cord injury, the study offers an alternative way for modeling knowledge of disability as embodied categories of action expressed as differentiated health lifestyles.
Disability Studies at the Population Level: Issues of Health Service Utilization
Authors: McColl Mary Ann
Published: October 2011

OBJECTIVE. In this paper, I propose a population-level analysis of disability to raise issues of access and equity in terms of use of health services.

METHOD. The study was a cross-sectional analysis of the National Population Health Survey (Statistics Canada, 1998–1999). The sample consisted of 10,898 adults between 20 and 64 years of age.

FINDINGS. The study showed that adults with disabilities used significantly more of all types of health professionals and health services than nondisabled adults. Disability was a significant determinant of all types of health service use, representing a two- to threefold increase in risk of seeing health professionals. Although poor health explained a large proportion of variance attributable to use of medical and nursing services, it did not explain the use of other allied health services. The results are interpreted in terms of structural barriers to access to health services. The findings also remind us of the potential role for occupational therapists as advocates within the health care system for persons with disabilities.
Integrating Disability Studies Concepts Into Occupational Therapy Education Using Service Learning
Authors: Gitlow Lynn , Flecky Kathleen
Published: October 2011

This article describes an occupational therapy educational program’s experience with service-learning courses that has fostered student learning about service to the community and disability as a multidimensional construct. Faculty-reflective perspectives about disability and ways to enhance learning about disability as a human experience are presented as an important consideration for health care education curriculum design and course development.

Through review of educational evaluation described in research on service learning, the authors used a multi-method assessment matrix to capture students’ perspectives on their service learning. The community project investigated accessibility issues that persons with disabilities encountered in social participation at community arts venues. Results from student surveys, interviews, focus groups, and journal entries indicated that service learning contributed to occupational therapy students’ appreciation and understanding about disability as an individual, environmental, and societal construct.
Introducing Disability Studies to Occupational Therapy Students
Authors: Block Pamela , Ricafrente-Biazon Melissa , Russo Ann , Chu Ke Yun , Sud Suman , Koerner Lori , Vittoria Karen , Landgrover Alyssa , Olowu Tosin
Published: October 2011

This article is a work of collaborative ethnography about teaching and learning disability studies within the context of an occupational therapy graduate program. In spring 2004, 14 occupational therapy students were introduced to disability studies by their cultural anthropologist (nonoccupational therapist) course instructor. During the one-credit course, they were expected to complete readings, watch films, attend guest lectures, and make a site visit. The occupational therapy students were required to write a journal to record personal reactions and new insights gained from these experiences. This article focuses on a thematic analysis of the students’ journaled responses to the film “Dance Me to My Song,” and a site visit to a local Independent Living Center. Students were expected to analyze these experiences from both disability studies and occupational therapy perspectives. The article addresses philosophical and practical differences between occupational therapy and disability studies and identifies opportunities for collaboration between occupational therapists and independent living specialists.
The Olmstead Decision: Landmark Opportunity or Platform for Rhetoric? Our Collective Responsibility for Full Community Participation
Authors: Cottrell Rita P. Fleming
Published: October 2011

Occupational therapy’s core values and founding beliefs reflect a commitment to the attainment of a self-directed life that enables full community participation. The reality that this desired outcome remains unattainable for millions of persons with disabilities due to the institutional bias of current public policies cannot be ignored. The Supreme Court’s landmark Olmstead decision provides a judicial mechanism to right this fundamental injustice. The executive branch’s response to the Olmstead decision, the New Freedom Initiative (NFI), offers the potential to finally end the societal segregation of persons with disabilities. Occupational therapy practitioners share a moral collective responsibility to advocate for the major systemic changes that will be needed to fully implement the NFI and achieve the promise of the Olmstead decision. By joining with the disability rights movement, occupational therapy practitioners can become effective activists to help persons with disabilities attain full participation in life.
Pilot Study: Investigating the Effects of Kinesio Taping® in an Acute Pediatric Rehabilitation Setting
Authors: Yasukawa Audrey , Patel Payal , Sisung Charles
Published: October 2011

OBJECTIVES. The purpose of this pilot study is to describe the use of the Kinesio Taping® method for the upper extremity in enhancing functional motor skills in children admitted into an acute rehabilitation program.

METHOD. Fifteen children (10 females and 5 males; 4 to 16 years of age), who were receiving rehabilitation services at the Rehabilitation Institute of Chicago participated in this study. For 13 of the inpatients, this was the initial rehabilitation following an acquired disability, which included encephalitis, brain tumor, cerebral vascular accident, traumatic brain injury, and spinal cord injury. The Melbourne Assessment of Unilateral Upper Limb Function (Melbourne Assessment) was used to measure upper-limb functional change prior to use of Kinesio Tape®, immediately after application of the tape, and 3 days after wearing tape. Children’s upper-limb function was compared over the three assessments using analysis of variance.

RESULTS. The improvement from pre- to posttaping was statistically significant, F(1, 14) = 18.9; p < .02.

CONCLUSION. These results suggest that Kinesio Tape may be associated with improvement in upper-extremity control and function in the acute pediatric rehabilitation setting. The use of Kinesio Tape as an adjunct to treatment may assist with the goal-focused occupational therapy treatment during the child’s inpatient stay. Further study is recommended to test the effectiveness of this method and to determine the lasting effects on motor skills and functional performance once the tape is removed.
The Effects of Sensorimotor-Based Intervention Versus Therapeutic Practice on Improving Handwriting Performance in 6- to 11-Year-Old Children
Authors: Denton Peggy L. , Cope Steven , Moser Christine
Published: October 2011

OBJECTIVE. The aim of this study was to investigate the effects of two interventions (sensorimotor and therapeutic practice) on handwriting and selected sensorimotor components in elementary-age children.

METHOD. Thirty-eight children 6 to 11 years of age with handwriting dysfunction but no identified educational need were randomly assigned to one of the two intervention groups or a control group. Intervention groups met four times per week over 5 weeks. Handwriting was measured pre- and postintervention using the Test of Handwriting Skills. Visual perception (motor-reduced), visual-motor integration, proprioception, and in-hand manipulation were also measured.

RESULTS. Children receiving therapeutic practice moderately improved handwriting whereas children receiving sensorimotor intervention declined in handwriting performance. The control group did not change significantly. Sensorimotor impairment was noted at pretest in three or four components and selected sensorimotor component function improved with intervention.

CONCLUSION. Therapeutic practice was more effective than sensorimotor-based intervention at improving handwriting performance. Children who received sensorimotor intervention improved in some sensorimotor components but also experienced a clinically meaningful decline in handwriting performance.
Relationships Among Biomechanical Ergonomic Factors, Handwriting Product Quality, Handwriting Efficiency, and Computerized Handwriting Process Measures in Children With and Without Handwriting Difficulties
Authors: Rosenblum Sara , Goldstand Sarina , Parush Shula
Published: October 2011

OBJECTIVES. Handwriting is a work activity for children, hence it may be evaluated based on ergonomic factors. This study investigated whether nonproficient handwriters could be distinguished by biomechanical ergonomic factors during handwriting, as well as by measures of handwriting efficiency. Furthermore, the relationships among ergonomic factors, handwriting quality, efficiency, and measures of the handwriting process were examined.

METHODS. Fifty proficient and 50 nonproficient third-grade handwriters performed a handwriting task on an electronic tablet. Biomechanical ergonomic factors, measures of handwriting quality, and efficiency were rated using the Hebrew Handwriting Evaluation. Handwriting process measures were obtained from a computerized system.

RESULTS. Biomechanical ergonomic factors and handwriting efficiency measures significantly differentiated between the study groups. Significant correlations were found among ergonomic factors and handwriting quality, efficiency, and process measures.

CONCLUSION. Nonproficient handwriting is a work activity that is often characterized by inferior biomechanical ergonomics, handwriting quality, efficiency, and significantly different handwriting process measures. Results provide insights that can assist in planning intervention.
The Activity Setting of Homework: An Analysis of Three Cases and Implications for Occupational Therapy
Authors: Segal Ruth , Hinojosa Jim
Published: October 2011

An important goal of occupational therapy is to foster clients’ participation in daily life. The daily lives of children occur mainly within their homes and schools. Homework is an occupation whose performance affects children’s participation in both home and school. A qualitative study of parental self-reports of the strategies they use to foster their children’s successful engagement in homework was conducted.

In this paper, we examine three cases from this study using the activity setting concept from the ecocultural theory of family accommodation. The three cases were chosen based on their diversity: ethnic and religious background, socioeconomic status, presence of a stay-at-home mother, and presence of children with special needs.

The analysis of these cases illustrates that strategies used by parents to foster their children’s engagement in homework reflect their values and priorities, their expectations of their children, and their perceptions of their children’s strengths and limitations. The concept of activity setting can be useful for occupational therapists to analyze family situations when they are developing home treatment programs.
Self-Speech-Induced Facilitation of Simple Reaching Movements in Persons With Stroke
Authors: Maitra Kinsuk K. , Telage Kal M. , Rice Martin S.
Published: October 2011

OBJECTIVE. Occupational therapists are routinely involved in upper-extremity rehabilitation in persons with stroke. Recently we have reported that self-speech can be used to facilitate simple reach in young and older adults. The purpose of this study is to examine whether self-speech-induced facilitation of simple reach can be translated in persons with stroke.

METHOD. Following a counterbalanced repeated-measure design, seven persons with right brain stroke performed reaching and placing a glass on a cabinet shelf under four concurrent speech conditions of vocalizing the word “yeah” with both hemiplegic and nonhemiplegic sides. These four conditions are self-vocalization, external vocalization, imaginary vocalization, and no vocalization. Consistent with our previous study, in this study we also recorded the movement kinematics of angular movement of the upper arm.

RESULTS. Reaching velocity was significantly higher under self-vocalization conditions compared to the reaching velocity under no vocalization or other vocalization conditions (p < .05). Motor performance in terms of velocity, nonhemiparetic side was significantly better than hemiparetic side (p < .05).

CONCLUSION. The results suggest that self-speech can be used in facilitating movements in patients with stroke. When working with patients with right hemispheric stroke, therapists might explore possibilities of using patient’s self-speech to enhance the quality of movement performance.
Examination of the Perceived Efficacy and Goal Setting System (PEGS) With Children With Disabilities, Their Parents, and Teachers
Authors: Missiuna Cheryl , Pollock Nancy , Law Mary , Walter Stephen , Cavey Nina
Published: October 2011

The Perceived Efficacy and Goal Setting System (PEGS) is an instrument and a process that enables children with disabilities to reflect on their ability to perform everyday occupations and to identify goals for occupational therapy intervention. In this study, 117 children with disabilities in grades 1–3 completed the PEGS with occupational therapists who work in school settings. Children from 6–9 years of age with a variety of disabilities were able to self-report perceptions of their effectiveness performing 24 activities that would be expected of them each day. Parents and teachers, who completed a parallel questionnaire, rated their abilities lower than the children did. The School Function Assessment, a measure of the amount and type of support required for school participation, had low correlations with the Parent and Teacher PEGS questionnaires and did not correlate with the Child PEGS. No differences in perceived efficacy were found for children across grades or gender; however, differences were found across types of disabilities. Children were able to use the perceived efficacy information to identify and prioritize goals for intervention and these goals remained stable 2 weeks later. Occupational therapists can use the PEGS within a client-centered practice to help the child set goals for therapy and to incorporate explicitly the perspectives of parents and teachers.
Occupational Therapy Incorporating Animals for Children With Autism: A Pilot Investigation
Authors: Sams Mona J. , Fortney Elizabeth V. , Willenbring Stan
Published: October 2011

This investigation compared language use and social interaction in children with autism receiving two forms of occupational therapy: occupational therapy using standard techniques, and occupational therapy incorporating animals. Twenty-two children between the ages of 7 and 13 received both forms of therapy in a school-based occupational therapy program for children with autism. Results suggest that the children demonstrated significantly greater use of language and significantly greater social interaction in sessions incorporating animals when compared to sessions using exclusively standard occupational therapy techniques. Findings are discussed in the context of recent research that has highlighted the importance of enhancing the motivation of children with autism to engage actively in therapeutic and learning processes.
Occupational Therapy Practice Errors in Physical Rehabilitation and Geriatrics Settings: A National Survey Study
Authors: Mu Keli , Lohman Helene , Scheirton Linda
Published: October 2011

OBJECTIVES. The purpose of this survey study was to investigate occupational therapy practice errors in physical rehabilitation and geriatric practice settings.

METHOD. Two hundred and forty-five (245) out of 994 surveyed occupational therapists who have practiced or currently practice in physical rehabilitation or geriatrics settings responded to a self-developed questionnaire. Descriptive statistical analysis was used to describe practice errors as to the types, causes, impact on, and responses of occupational therapists and work sites. Inferential statistical analysis was used to explore the relationships among different variables of interest including: the effect of the number of years of practice experience on the perceived impact of making errors on practice; the relationship between disclosure or nondisclosure of errors; and the types of coping strategies used by occupational therapists and work site administrators’ responses to errors.

RESULTS. The vast majority of practice errors occurred during the intervention phase of the occupational therapy process. Misjudgment, lack of preparation, and lack of experience were reported as the top three causes of practice errors. Various coping strategies—such as compensating for the errors by voluntarily devoting additional time for care of the patient, making and following a corrective plan, concentrating on the next step, or not letting errors interfere with daily work—were used by the occupational therapists when errors occurred. The types of coping strategies and work site responses appeared to be associated with the disclosure or nondisclosure of errors.

CONCLUSION. Errors occur in occupational therapy practice. Making errors has considerable impact on occupational therapists as well as their future practice. However, disclosure of errors can often lead to positive outcomes.
Sexuality After Spinal Cord Injury: The Greek Male’s Perspective
Authors: Sakellariou Dikaios , Sawada Yuji
Published: October 2011

OBJECTIVE. This study explored how Greek men with spinal cord injury experience sexuality.

METHODS. Six men with spinal cord injury acted as key informants and data collection consisted of in-depth unstructured interviews, field notes, and a reflective log. The transcribed interviews were analyzed thematically.

RESULTS. The themes that emerged were: Barriers, Metamorphoses, and Enjoying. Sexuality was important in the life of the informants and they were engaged in various patterns of adaptation. Rather than impairment as such, certain social beliefs and values prevalent in Greek society were found to act upon the informants in compromising ways.

CONCLUSION. The results suggest that the process of reclaiming one’s sexuality is a process of meaning-finding. The data support a conclusion that occupational therapists should respect the cultural nature of sexuality. Moreover, the topic of sexuality should be approached in a holistic manner, perceiving it as extending in a continuum, which may be positively or negatively affected as a result of an acquired impairment.
Evaluation Options for Secondary Transition Planning
Authors: Kardos Margaret R. , White Barbara Prudhomme
Published: October 2011

This article presents a model evaluation plan conducted by occupational therapists that may be used to contribute information to the transition planning process in secondary school students with disabilities. Occupational therapists are not fully participating in transition services within secondary schools. One of the major obstacles to full participation identified in a previous research study by the authors of this article was that few occupational therapists were aware of appropriate evaluation options available for secondary transition planning. The authors in this article review the evaluation needs for secondary transition services in general, describe occupational therapy’s role in contributing to the Individualized Education Plan (IEP), and describe an evaluation method that gathers key information pertinent to the occupational therapy role. A case study is presented that illustrates how these assessment tools were applied to develop IEP goals in one student’s transition plan.
Handwriting Instruction in Elementary Schools
Authors: Asher Asha V.
Published: October 2011

OBJECTIVE. Classroom teachers teach handwriting, but when problems arise, students are referred to occupational therapy for remediation. This study, conducted by occupational therapists, reviews handwriting instruction by classroom teachers in one school district.

METHOD. Teachers from kindergarten through grade 6 were asked to complete an open-ended questionnaire regarding handwriting instruction.

RESULTS. Teachers differed in their methods of instruction, including in the programs and paper used, and practice provided. Teachers of grades 5 and 6 had to continue to review handwriting instruction, because all students could not fluently use handwriting as a tool of expression.

CONCLUSION. Elementary students need structured instruction to develop the motor skill of writing. School-based occupational therapists can support effective handwriting instruction by interpreting information from motor learning theory pertaining to instruction and practice, which supports acquisition, transfer, and retention of handwriting skills. They also need to be cognizant of prior handwriting instruction when addressing handwriting difficulties.
Sensory Processing Patterns in Persons With Angelman Syndrome
Authors: Walz Nicolay Chertkoff , Baranek Grace T.
Published: October 2011

OBJECTIVE. Research examining sensory processing patterns in persons with Angelman syndrome is nonexistent despite anecdotal evidence and clinical diagnostic criteria that may reflect these features. The goal of this study was to better characterize sensory processing patterns in persons with Angelman syndrome.

METHOD. Parents of 340 persons with Angelman syndrome between 3 and 22 years of age completed a standardized measure of sensory processing, the Sensory Experiences Questionnaire.

RESULTS. Results confirmed a high degree and variety of sensory processing abnormalities in persons with Angelman syndrome. These problems were most prominent in the areas of hypo-responsiveness to tactile and vestibular input, consistent with reports of sensory seeking behaviors in this population. Sensory processing deficits were not related to gender, seizure disorder, or genetic subtype. However, some behaviors were correlated with age.

CONCLUSION. This study provides the first systematic description of sensory processing abnormalities in a large sample of persons with Angelman syndrome. Considerations for enhancing occupational performance and social participation in this population through occupational therapy interventions are discussed.
The Use of Infant Seating Devices in Child Care Centers
Authors: Myers Christine Teeters , Yuen Hon Keung , Walker Kay F.
Published: October 2011

OBJECTIVE. The purpose of this study was to compare the duration of time that infants in child care centers were placed in infant seating devices to the duration of time spent on the floor or being held by child care providers.

METHOD. Thirty-eight infants who were typically developing (mean age = 4.5 months) from eight child care centers were observed minute-by-minute for a consecutive 120 min, targeting the amount of time each infant spent in seating devices, on the floor, or being held by child care providers.

RESULTS. The amount of time the infants spent in seating devices was significantly longer than on the floor (p = .0001) or being held by child care providers (p = .0001).

CONCLUSION. All infants spent more time in seating devices than on the floor or being held by child care providers. Future research should explore seating device use in infants identified as at-risk or as having special needs, particularly how child care routines for these infants may influence seating device use, as well as the impact of this practice on these infants’ motor development.
A Phenomenological Study Exploring the Meaning of a Seminar on Spirituality for Occupational Therapy Students
Authors: Thompson Barbara E. , MacNeil Cheryl
Published: October 2011

There are many unanswered questions about the concept of spirituality and its relationship to occupational performance. The role of occupational therapists in addressing clients’ spiritual needs is unclear, and the inclusion of spirituality as a topic in the educational curricula of occupational therapy students requires further attention. Focus groups and surveys were used in this phenomenological study to explore the lived experiences of 11 occupational therapy students participating in a 3-month graduate seminar entitled “Spirituality in Occupational Therapy Practice.” The study was designed to help occupational therapy faculty better understand how students experience the relationship between occupational therapy and spirituality, and how educational programs can better prepare students to translate theoretical frameworks into practice. Findings explored the students’ evolving belief systems, and began to reveal a diversity of beliefs and practices in the occupational therapy community related to spirituality. Implications for theory and practice are offered.
Occupational Factors and Characteristics of the Social Network in People With Persistent Mental Illness
Authors: Eklund Mona
Published: October 2011

Associations between occupational factors and characteristics of the social network in people with persistent mental illness were investigated. Participant groups (N = 103) representing three types of daily occupations— working or studying, visiting community-based activity centers, and having no regular daily occupation—were selected for the study. Participants were assessed regarding social interaction and on the occupational factors of time spent in productive occupations, activity level, satisfaction with daily occupations, and perceived occupational value. The groups based on daily occupation did not differ in social interaction. Associations were found mainly between the subjective estimations of occupation—satisfaction and perceived value—and characteristics of the social network. In conclusion, experiential aspects of occupation were more closely related to social interaction than actual circumstances, such as type of daily occupation or time spent in productive occupations. The results suggest that occupational therapists should focus their attention on the patient’s participation in a supportive social network because it may be related to valued and satisfying occupations.
The Acquisition and Integration of Evidence-Based Practice Concepts by Occupational Therapy Students
Authors: Stube Jan E. , Jedlicka Janet S.
Published: October 2011

This article describes the ways in which master's of occupational therapy students across one professional curriculum expressed their learning of evidence-based practice (EBP). Through qualitative case methodology and focus group interviews, the student participants’ perceptions of EBP were examined across varying levels of academic and clinical experiences. The present findings support the relevance of clinically based activity, particularly fieldwork experiences, along with discussion-based learning for developing a discerning viewpoint of EBP. The outcomes of this exploratory study yield an initial view of EBP through the eyes of students approaching novice practitioner status. This preliminary study provides awareness for occupational therapy education and research to further the development of EBP within occupational therapy practice.
An Examination of the Relationships Between Motor and Process Skills and Scores on the Sensory Profile
Authors: White Barbara Prudhomme , Mulligan Shelley , Merrill Kristen , Wright Janet
Published: October 2011

OBJECTIVE. This quasi-experimental study sought to determine whether children with possible sensory processing deficits, as measured by the Sensory Profile, performed less well on an occupational performance measure compared to children with typical Sensory Profile scores.

METHOD. Sixty-eight children were administered both the Assessment of Motor Process Skills (AMPS) and the Sensory Profile. After the assessments were completed, children were divided into two groups based on their Sensory Profile scores.

RESULTS. Independent t tests indicated statistically significant differences between groups on the AMPS ADL [Activities of Daily Living] Motor and ADL Process measures (p < .05), with the children with atypical Sensory Profile scores showing more functional difficulties. Correlations revealed significant relationships among the measures.

CONCLUSION. The results suggest that children identified with sensory processing deficits on the Sensory Profile are likely to experience some challenges in performing everyday occupations.
Development of the Sensory Processing Measure–School: Initial Studies of Reliability and Validity
Authors: Miller-Kuhaneck Heather , Henry Diana A. , Glennon Tara J. , Mu Keli
Published: October 2011

OBJECTIVE. The history and development of the Sensory Processing Measure–School are detailed, and findings of initial pilot studies are reported.

METHOD. Multiple reviews, focus groups, case studies, and two pilot studies were used to develop the early versions of the tool. Internal consistency and discriminatory ability were examined.

RESULTS. Internal consistency measured with Cronbach’s alphas ranged from .93 to .99 in the first pilot study and .70 to .99 in the second pilot study. Children who were typically developing were correctly classified 92.3% of the time, and children with sensory issues were correctly classified 72% of the time.

CONCLUSION. Initial results suggest that the tool is reliable and valid and discriminates children with and without sensory processing issues. Further research is under way with larger samples.
How Does Sensory Processing Dysfunction Affect Play?
Authors: Bundy Anita C. , Shia Sue , Qi Long , Miller Lucy Jane
Published: October 2011

OBJECTIVE. This study investigated sensory processing dysfunction (SPD) and playfulness and the effect of intervention on playfulness.

METHOD. Twenty children with SPD and 20 children who were typically developing took the Short Sensory Profile (SSP) and Test of Playfulness (ToP). Children with SPD took the praxis tests from the Sensory Integration and Praxis Tests (SIPT) and received 20 intervention sessions. Correlations among measures and differences between mean scores of groups and pre-intervention and post-intervention were examined.

RESULTS. Group ToP scores differed significantly; ToP did not increase post-intervention. Correlations among ToP and SSP ranged from .36 to .72; ToP and SIPT, from −0.1 to −0.46.

CONCLUSION. Modulation affects playfulness. Although intervention was not effective, both groups had high scores initially, making the finding difficult to interpret.
Fidelity in Sensory Integration Intervention Research
Authors: Parham L. Diane , Cohn Ellen S. , Spitzer Susan , Koomar Jane A. , Miller Lucy Jane , Burke Janice P. , Brett-Green Barbara , Mailloux Zoe , May-Benson Teresa A. , Roley Susanne Smith , Schaaf Roseann C. , Schoen Sarah A. , Summers Clare A.
Published: October 2011

OBJECTIVE. We sought to assess validity of sensory integration outcomes research in relation to fidelity (faithfulness of intervention to underlying therapeutic principles).

METHOD. We identified core sensory integration intervention elements through expert review and nominal group process. Elements were classified into structural (e.g., equipment used, therapist training) and therapeutic process categories. We analyzed 34 sensory integration intervention studies for consistency of intervention descriptions with these elements.

RESULTS. Most studies described structural elements related to therapeutic equipment and interveners’ profession. Of the 10 process elements, only 1 (presentation of sensory opportunities) was addressed in all studies. Most studies described fewer than half of the process elements. Intervention descriptions in 35% of the studies were inconsistent with one process element, therapist–child collaboration.

CONCLUSION. Validity of sensory integration outcomes studies is threatened by weak fidelity in regard to therapeutic process. Inferences regarding sensory integration effectiveness cannot be drawn with confidence until fidelity is adequately addressed in outcomes research.
Quality of Life in American Indian and White Women With and Without Rheumatoid Arthritis
Authors: Poole Janet L. , Chiappisi Heather , Cordova Jennifer Schukar , Sibbitt Wilmer
Published: October 2011

OBJECTIVE. The purpose of this study was to examine quality of life (QOL) in American Indian and White women with and without rheumatoid arthritis.

METHOD. This cross-sectional study included 64 women in four groups: American Indians with rheumatoid arthritis, healthy American Indians, Whites with rheumatoid arthritis, and healthy Whites. Participants received evaluations of pain, joint motion, hand function, daily task performance, community participation, and QOL.

RESULTS. There was a significant difference in QOL between the participants with rheumatoid arthritis and the healthy control groups but not between the American Indian and White groups. Current health and emotional–social function related to QOL in all groups. Dexterity also correlated with QOL in the two groups with rheumatoid arthritis. Performance of daily activities correlated with QOL in all groups except the healthy White groups. Community participation did not correlate with QOL.

CONCLUSIONS. The findings suggest that rheumatoid arthritis in American Indian and White women does affect QOL and that QOL does not seem to be influenced by ethnicity. Factors that related to QOL also were similar for both groups with rheumatoid arthritis.
Impact of Culture on Children’s Community Participation in Israel
Authors: Engel-Yeger Batya , Jarus Tal , Law Mary
Published: October 2011

OBJECTIVE. This study compared the participation in activities outside of formal school among Jewish and Druze Israeli children. It also examined the impact of gender and the interaction of culture and gender on participation.

METHODS. Participants included 30 Jewish and 30 Druze children ages 8–10 years, who completed the Children’s Assessment of Participation and Enjoyment (CAPE).

RESULTS. On most of the scales measured, the Jewish children showed a significantly higher participation level than the Druze children, and the Druze children performed more activities alone. The Jewish children demonstrated a higher enjoyment level than the Druze children on half of the scales. Some scales revealed higher participation by girls than by boys as well as a significant cultural group by gender interaction.

CONCLUSION. Culture may have an impact on children’s level of participation in the community. The CAPE was found to be a sensitive tool in elucidating differences between the Druze and Jewish children in community participation.
Effects of Caregiver–Child Interactions on Play Occupations Among Young Children Institutionalized in Eastern Europe
Authors: Daunhauer Lisa A. , Coster Wendy J. , Tickle-Degnen Linda , Cermak Sharon A.
Published: October 2011

OBJECTIVE. We investigated whether children institutionalized in an orphanage would engage in more developmentally competent play with their caregivers as opposed to playing alone and whether specific qualities of caregiver–child interactions were associated with more developmentally competent play.

METHOD. Twenty-six children, ages 10 to 38 months, participated in independent play sessions and in a play session with a caregiver. Interrater reliability for coding play performance was established using the weighted kappa statistic (M = .82). Twelve pediatric experts rated both child and caregiver behaviors for the interactive sessions (mean effective reliability with intraclass correlations = .89).

RESULTS. The children demonstrated more developmentally competent play when interacting with a caregiver than when playing alone, t (25) = −1.88, p ≤ .04, one-tailed. The effect size was moderate (d = .53). Longer periods of institutionalization were associated with less improvement in play performance from independent to interactive play sessions (r = −.51, p ≤ .01). Successful engagement for the child was associated with having a caregiver who provided more structure and assistance and who was directive and encouraging (r = .82, .75, .75, and .64, respectively).

CONCLUSION. Caregivers facilitated more developmentally competent participation in play with children residing in an orphanage, despite the fact that these interactions occurred in an environment vulnerable to many challenges not typical of an exclusive caregiver–child relationship. Findings are discussed in the context of environmental challenges and occupational therapy practice.
Perceived Control: How Is It Related to Daily Occupation in Patients With Mental Illness Living in the Community?
Authors: Eklund Mona
Published: October 2011

Perceived control is of significance in occupational therapy, as revealed in empirical research and suggested in practice models. This study investigated the relationship between perceived control and occupational performance in persons with long-term mental illness. The 177 participants were assessed regarding perceived control (locus of control and self-mastery) and occupational performance (activity level and satisfaction with daily occupations). Subgroups with respect to diagnosis and having gainful employment or not were also explored concerning the targeted association. The results indicated relationships between perceived control and occupational performance in the sample as a whole and in all subgroups except that representing people engaged in gainful employment or education. The latter was a surprising result, considering that the importance of perceived control was originally identified in the work science area. The results strongly supported that perceived control should be included in the clinical reasoning of occupational therapists working in mental health care.
Theory Use in Practice: A National Survey of Therapists Who Use the Model of Human Occupation
Authors: Lee Sun Wook , Taylor Renee , Kielhofner Gary , Fisher Gail
Published: October 2011

OBJECTIVE. This study describes how occupational therapists who reported using the Model of Human Occupation (MOHO) actually use the concepts and tools of this model in everyday practice as well as identifies supports and barriers to its use.

METHOD. A systematic random sample of 1,000 occupational therapists was surveyed as to what theories they used in their practice. Those using MOHO (430) were sent a detailed questionnaire; 259 therapists (60.2%) responded to the survey questionnaire.

RESULTS. More than 80% of respondents indicated that they used MOHO in their practice at least some of the time. Therapists reported that MOHO supports holistic, occupation-focused, client-centered, and evidence-based practice. They reported finding MOHO concepts useful for treatment planning and intervention. Most saw the major barrier to using MOHO as their own lack of knowledge.

CONCLUSION. Making resources more readily available and accessible to therapists might enhance the extent to which they use conceptual models such as MOHO.
PDAs as Cognitive Aids for People With Multiple Sclerosis
Authors: Gentry Tony
Published: October 2011

OBJECTIVE. Cognitive impairment is a common symptom for people with multiple sclerosis (MS). This study evaluated the effects of an occupational therapy training protocol using personal digital assistants (PDAs) as assistive technology for people with cognitive impairment related to MS.

METHODS. Twenty participants were trained to use PDAs by an occupational therapist. Assessments of functional performance were taken at the start of an 8-week pretreatment period, at the beginning and end of training, and 8 weeks after the conclusion of training.

RESULTS. Participants demonstrated the ability to learn how to use basic PDA functions and retain learning for at least 8 weeks. Functional performance increased significantly with PDA use, and this gain was maintained at 8-week follow-up.

CONCLUSION. This study provides evidence of an association between an intervention providing training in the use of a PDA and improvements in the everyday function of people with cognitive impairment related to MS.
Upper-Limb Kinematics of the Presumed-to-Be-Unaffected Side After Brain Injury
Authors: Nakamura Takayuki , Abreu Beatriz C. , Patterson Rita M. , Buford William L. , Ottenbacher Kenneth J.
Published: October 2011

OBJECTIVE. The purpose of this pilot study was to investigate the kinematics of the presumed-to-beunaffected upper limbs of people with brain injury (BI) compared with people without brain injury (WBI) during reaching.

METHOD. Seventeen people with BI with no apparent motor deficit and 17 people WBI were measured and compared. A six-camera motion analysis system was used to determine movement duration, average speed, and smoothness during reaching.

RESULTS. The group of people with BI was found to be significantly longer in movement duration (p < .0001), were slower in average speed (p < .0001), and had decreased smoothness (p < .0001) during reaching than the group of people WBI.

CONCLUSION. The results suggest that people with BI may have undetected motor deficit in their presumed-to-be-unaffected upper extremities. Further research is needed to explore the upper-limb motor performance and the impact on function and safety.
Impact of Participating in Volunteer Activities for Residents Living in Long-Term-Care Facilities
Authors: Yuen Hon Keung , Huang Peng , Burik Jerry K. , Smith Thomas G.
Published: October 2011

The purpose of this study was to investigate the effect of a volunteer activity on the perceived well-being of long-term-care (LTC) residents. Residents from five LTC facilities were randomly assigned into either a mentoring or a usual-care control group. Residents in the mentoring group tutored conversational skills to English-as-a-second-language students on a one-on-one basis for 1 hour twice per week for 12 weeks. Well-being, as a global outcome construct, was measured at baseline, after intervention, and at 3-month follow-up using the Geriatric Depression Scale, Life Satisfaction Index–A, and a self-rated health question. After intervention, residents who participated in the mentoring group rated their level of well-being higher (p = .047) than those in the usual-care group on the basis of a multivariate nonparametric global statistical test. The positive effect of mentoring on well-being relative to the control was sustained at 3-month follow-up assessment (p = .029). Findings provide preliminary support for engaging LTC residents in volunteer mentoring activities to improve their well-being.
Changes in Impairment Level, Functional Status, and Use of Assistive Devices by Older People With Depressive Symptoms
Authors: Mann William C. , Johnson Jessica L. , Lynch Lisa G. , Justiss Michael D. , Tomita Machiko , Wu Samuel S.
Published: October 2011

OBJECTIVE. We sought to understand how functional status, impairment level, and use of assistive devices change over 3 years for older adults with depressive symptoms. We further explored factors that predict change in severity of depressive symptoms.

METHOD. This study used data from the Rehabilitation Engineering Research Center on Aging Consumer Assessment Study, a longitudinal study of coping strategies of elders with disabilities. Seventy-three participants with depressive symptoms were interviewed at baseline and 3 years later.

RESULTS. During 3 years, participants experienced increased physical disability (p = .001), a decline in severity of depressive symptoms (p = .03), and an increase in the total number of assistive devices owned.

CONCLUSION. A significant number of older adults will experience a decrease in depressive symptoms over 3 years, despite an increase in physical disability. They also will obtain more assistive devices as they age.
Critical Review and Analysis of the Impact of the Physical Infrastructure on the Driving Ability, Performance, and Safety of Older Adults
Authors: Bohr Paula Christine
Published: October 2011

Literature on the impact of physical infrastructure on older adult safe driving performance was reviewed in 2005 as part of the American Occupational Therapy Association’s Evidence-Based Literature Review Project. Existing guidelines for driving environments, related to changes in visual, cognitive, and psychomotor abilities associated with the aging process (as published in the Highway Design Handbook for Older Drivers and Pedestrians, Federal Highway Administration, 2001), are exhaustive, but the authors made no attempt to critically assess the strength of the study design or level of evidence. In laboratory studies since 1999, the interventions lacked applicability to real-life driving environments. Further investigation of the effectiveness of best practice interventions and how the driving environment can better accommodate the needs of older drivers is needed. Occupational therapy interventions that focus on the occupation of driving and compensation and education strategies that allow older adults to drive safely as long as possible are included.