bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Occupational Therapy in the Home
Authors: Hinojosa Jim , Anderson Jill , Strauch Carrie
Published: April 2012

This article discusses the challenges and implications for pediatric practice in the home. Pediatric occupational therapists are moving the treatment setting from the clinic to the home. Working within the home environment requires occupational therapists to adapt their roles, functions, and treatment styles. Intervention frequently involves practical and relevant treatment, using activities and objects from the child’s world. Thus, functional goals may be more realistically achieved in the child’s living environment. Involvement with family members also offers opportunities to develop collaborative relationships with parents and, therefore, to integrate the intervention program into the child’s home life.
Planning Playgrounds for Children With Disabilities
Authors: Stout Janet
Published: April 2012

Occupational therapists are well qualified for involvement in playground planning. They know how to eliminate architectural barriers, adapt equipment to maximize independence and functional levels, and use play in facilitating children’s development. By participating in playground planning or adaption, the occupational therapist can present play opportunities for children with disabilities, increase public awareness of occupational therapy, and extend the use of treatment modalities. This paper makes specific suggestions for planning and building to make the idea for a playground a realistic goal. A case example illustrates the planning of a playground in a hospital setting.
Functional Skill Regression in Late-Stage Dementias
Authors: Nolen Ninette R.
Published: April 2012

One hundred fifty-two institutionalized persons with late-stage dementia were rated with a geriatric developmental screening scale that notes cognitive, language, sensorimotor, and self-care abilities. The results showed that the loss of functional abilities in late-stage dementias seems to occur in reverse order of their development in childhood. Developmental congruence was noted within these persons regardless of diagnosis. In addition, the average functional age rating correlated well with scores from the Folstein Mini Mental State examination (MMS) (Folstein, Folstein, & McHugh, 1975). The close correlation between scores indicates that the MMS is a fast and simple tool for predicting not only cognitive impairment but also the approximate stage of functional development.
Special Education and Occupational Therapy: Making the Relationship Work
Authors: Coutinho Martha J. , Hunter Dawn L.
Published: April 2012

Working as an occupational therapist in publicly funded schools requires a variety of skills. These skills include assessing the needs of children, serving as a member of the multidisciplinary team, developing individualized education program (IEP) goals and objectives in conjunction with other team members, providing services, and coordinating efforts with parents, teachers, and administrators. To fulfill these responsibilities, occupational therapists must have a comprehensive understanding of the complex federal and state laws that mandate the provision of special education and related services. Therefore, the purposes of this article are (a) to describe the legal framework within which decisions are made to provide occupational therapy to students in publicly funded school programs and (b) to highlight the knowledge and skills occupational therapists need to work effectively in schools with teachers, administrators, and parents.
The Changing Environment of Early Intervention Services: Implications for Practice
Authors: Hanft Barbara
Published: April 2012

A new plan for providing early intervention services for very young children and their families has been established with Part H of the Education of the Handicapped Act Amendments of 1986, Public Law 99-457. Each state is currently exploring how it can best develop one comprehensive system of care that combines health, education, social, and family services.

Health practitioners have traditionally provided early intervention services in medical settings such as hospitals and local health departments since the early 1900s. Educators, prompted by federal legislation, have provided early intervention services in the public schools primarily since 1975. Occupational therapy practitioners work in both medical and educational settings and must now meet the numerous challenges and opportunities in developing comprehensive, family-centered, community-based care for very young children with special needs. This paper traces the historical development of early intervention services and discusses the major practice issues associated with implementing Part H of the Education of the Handicapped Act Amendments of 1986.
Organizational Resources for the Occupational Therapist in the Public Schools
Authors: Sears Carol J.
Published: April 2012

Many organizational resources can assist the public school occupational therapist in fulfilling his or her commitment to the population being served. This paper presents four types of organizational resources that are readily available to the therapist: professional, nonprofit/volunteer, and commercial organizations, and information search and retrieval systems. Each category of resource contains examples and a brief description of each example. Descriptions of professional and nonprofit/volunteer organizations include information about their purpose, membership, and publications. The examples in each of these categories cover a variety of disciplines and disabling conditions; however, all are involved with and provide information about children with disabilities. Descriptions of commercial organizations highlight specific products that are applicable to occupational therapy in the schools. Descriptions of information search and retrieval systems state the kinds of materials each system maintains and provide information on how to gain access to each system.
The Reliability of the Motor Development Checklist
Authors: Gevelinger Marcia , Ottenbacher Kenneth J. , Tiffany Trina
Published: April 2012

A study was conducted to determine the interrater and test–retest reliability of the Motor Development Checklist (Doudlah, 1976). Thirty-six subjects with diagnosed multiple disabilities and severe and profound mental retardation were evaluated by two experienced occupational therapists. Reliability was established by means of the intraclass correlation approach, and results indicated that coefficients ranged from .93 to .99. The study results suggest that the Motor Development Checklist, when administered by experienced raters, can provide consistent information regarding the spontaneous motor performance of persons with multiple disabilities. Implications for practice and future research are briefly discussed.
Comparison of Myoelectric and Conventional Prostheses for Adolescent Amputees
Authors: Weaver Shirley A. , Lange Lawrence R. , Vogts Virginia M.
Published: April 2012

We questioned whether myoelectric prostheses were a reasonable alternative to conventional prostheses for adolescents with unilateral, congenital, below-elbow amputations in respect to fit, function, cosmesis, and cost. Ten patients were studied. Each received a physical, functional, and psychosocial evaluation prior to prosthetic fitting. The physical evaluation included myopotential, residual limb length and circumference, active range of motion, terminal device grasp force, and mechanical range. The functional evaluation consisted of a questionnaire of 38 bimanual activities. The psychosocial evaluation included an assessment of both the patient and the family. Following prosthesis fabrication, each patient received 10 days of training, a 3-month checkup, and a 6-month reevaluation. Wearing patterns, perception of cosmesis, change in physical attributes of the residual limb, and functional performance were documented. Results indicate that for these subjects myoelectric prostheses with a hand were an acceptable alternative to conventional prostheses with a hook.
The OSOT Perceptual Evaluation: A Research Perspective
Authors: Boys Marian , Fisher Pat , Holzberg Claire , Reid David W.
Published: April 2012

Although the Ontario Society of Occupational Therapists (OSOT) Perceptual Evaluation has been widely used, it has never been standardized. A study was undertaken to examine the validity of the battery for differentiating neurologically normal persons from those who have been independently diagnosed as neurologically impaired. A group of 80 brain-damaged patients was compared with a matched group of 70 neurologically normal persons. Comparison of scores for the two groups supports the validity of the instrument for differentiating the neurologically normal from the perceptually impaired person. The distribution of scores suggests that the degree of impairment can be classified as mild, moderate, or severe. Finally, the OSOT Perceptual Evaluation is found to be a reliable procedure for the assessment of perceptual dysfunction.
Intrinsic Motivation in Product-Oriented and Non-Product-Oriented Activities
Authors: Thibodeaux Carol S. , Ludwig Ferol Menks
Published: April 2012

This study investigated the hypothesis that purposeful activity is an intrinsic motivator. We hypothesized that subjects would take longer to perceive themselves to be working hard and would have a higher heart rate increase when working on a product-oriented activity than when working on a non-product-oriented activity. Fifteen subjects sanded a cutting board that they could keep and a piece of wood that they could not keep until they reached a rating of 15( hard) on the Borg Rating Scale of Perceived Exertion. No significant differences were found in the subjects’ heart rate increase or in the time it took subjects to perceive themselves as working hard. Subjects reported significantly more enjoyment in sanding the cutting board than in sanding the wood, and significance increased further upon completion of the sanding board. Ex post facto, when subjects were categorized into three groups depending upon the degree of liking for each activity, it appeared that the degree of liking may be important in predicting exercise effort. Implications for practice and further research are discussed.
Hand Splinting for Infants in the Intensive Care and Special Care Nurseries
Authors: Anderson Linda J. , Anderson J. Michael
Published: April 2012

Infants in intensive care nurseries often have hand deformities and hand dysfunction. The traditional therapeutic approaches to hand care used in the treatment of adults, young children, and older infants are not always adequate to prevent progressive deformity in preterm and neonatal infants. Medical instability, time constraints, lack of family participation in the therapeutic program, the complexity of the treatment program, and fear of harming the infant are considerations that may indicate the need for splinting as an adjunctive therapeutic intervention. A number of factors are particularly important in making splints for infants, including splint alignment and padding, strap attachment, and thermoplastic malleability.
Sexual Functioning as a Topic in Occupational Therapy Training: A Survey of Programs
Authors: Payne Mary Jane , Greer Donald L. , Corbin David E.
Published: April 2012

To investigate the current status of sex education in occupational therapy curricula, a questionnaire survey was mailed to department chairs of 67 university programs that were either accredited or in the application process. A total of 50 programs returned usable responses. The results indicate that occupational therapy may be in a transition period: A significant minority of the respondents were either undecided about or against including sexual functioning in occupational therapy, but the majority were of the opinion that the patient’s sexual functioning is an important domain of occupational therapy practice. A high percentage of programs reported that instructional time was being devoted to the basics of sexual functioning, but programs varied considerably in the amount of time allocated for this topic.
Teaching Ethical Analysis in Occupational Therapy
Authors: Haddad Amy M.
Published: April 2012

Ethical decision making is a cognitive skill requiring education in ethical principles and an understanding of specific ethical issues. It is also a psychodynamic process involving personalities, values, opinions, and perceptions. This article proposes the use of case studies and role-playing techniques in teaching ethics in occupational therapy to supplement conventional methods of presenting ethical theories and principles. These two approaches invite students to discuss and analyze crucial issues in occupational therapy from a variety of viewpoints. Methodology of developing case studies and role-playing exercises are discussed. The techniques are evaluated and their application to the teaching of ethics is examined.
Attitudes of Occupational Therapy Personnel Toward Persons With Disabilities
Authors: Benham Patricia K.
Published: April 2012

The study described in the following article investigated the attitudes of occupational therapy personnel toward persons with disabilities. The examination involved attitudes in general as measured by the Scale of Attitudes Toward Disabled Persons (SADP) (Antonak, 1981), specific attitudes toward infants with Down’s syndrome, beliefs concerning the importance of favorable attitudes toward patients, and beliefs concerning the role of the American Occupational Therapy Association (AOTA) in the development of ethical guidelines for the delivery of health care services.

The results of a survey of 619 occupational therapy personnel indicate that they hold a very favorable attitude toward persons with disabilities, and that they believe that a negative attitude would adversely affect the therapeutic relationship. The majority agree that the expression of a favorable attitude should be a criterion in student selection. The majority also agree that AOTA should develop position papers on ethical issues and take a public position on issues pertinent to the rights of the disabled person.

Occupational therapy personnel proved to be very homogeneous on the general attitudinal scale. However, the Down’s syndrome scenario uncovered significant differences among the different categories of respondents in the variables for professional level, area of practice, years of practice, and geographic location. A majority of respondents agreed that it is unethical to withhold needed surgery from a child because of disability. However, they differed on the ethics of aborting a fetus with Down’s syndrome (most thought it was unethical).
The Relationship Between Visual-Perceptual Motor Abilities and Clumsiness in Children With and Without Learning Disabilities
Authors: O’Brien Valerie , Cermak Sharon A. , Murray Elizabeth
Published: April 2012

One visual-perceptual test, four visual-motor tests, and a test of motor impairment were administered to 22 children with learning disabilities and 22 children without learning disabilities, aged 5 to 8 years. The children with learning disabilities were divided into two groups—“clumsy” and “nonclumsy”—based on their scores on the motor impairment test. It was hypothesized that the clumsy children with learning disabilities would score significantly lower on visual-perceptual and visual-motor tests than the nonclumsy children with learning disabilities who, in turn, would score significantly lower than the children without learning disabilities. It was further hypothesized that there would be a significant correlation between the degree of clumsiness and the degree of visual-perceptual and visual-motor deficit. Analysis of the data indicated that, as expected, the clumsy children with learning disabilities scored significantly lower than the children without learning disabilities (the control group). There was no significant difference between the clumsy and nonclumsy children with learning disabilities or between the nonclumsy children with learning disabilities and the control group. Degree of clumsiness significantly correlated with scores on four of five tests. Results are discussed in terms of subtypes of learning disabilities and sample size.
Tongue Movements in Normal 2- to 8-Year-Old Children: Extended Profile of an Eating Assessment
Authors: Gisel Erika G.
Published: April 2012

In this study tongue movements of 103 normal 5-, 6-, 7-, and 8-year-old children were measured and compared. The 5-year-olds were compared with children of an earlier study and data were combined for 2- to 8-year-old children.

Two different tongue positions were measured as three standard textures of food were presented: first, the position of the tongue as the food was 5 cm away from the lips, and second, the position of the tongue or other oral characteristics as the food was swallowed. For the anticipation of food a significant age–texture (p < .001) as well as an age–sex–texture interaction was noted (p < .035). For swallowing, significant age (p < .0001), texture (p < .0001), and sex–age interactions (p < .0001) were found. Although food is anticipated in a similar fashion by both sexes, age and texture differences must be taken into account when swallowing is evaluated. A preliminary developmental curve for the two eating behaviors is presented for children 2 to 8 years old.
The Effects of Chronic Otitis Media on Motor Performance in 5- and 6-Year-Old Children
Authors: Von Therese , Deitz Jean C. , McLaughlin John , DeButts Suzette , Richardson Mark
Published: April 2012

Two 16-member groups of 5- and 6-year-old children, one group with a history of chronic otitis media and one without such a history, were tested on three measures of motor performance. These were the Motor Accuracy Test–Revised, the Stott Test of Motor Impairment, and measures of duration of standing balance. These instruments assess, respectively, fine motor coordination, overall motor skills, and balance. On each of these measures, children with a history of chronic otitis media scored lower than children without such a history. However, when these scores were compared statistically, no significant differences were found between the two groups. Because the results of this study were inconclusive, routine motor performance evaluation of children with a history of chronic otitis media is not advocated at this time.
Unilateral Neglect: Suggestions for Research by Occupational Therapists
Authors: Van Deusen Julia
Published: April 2012

This paper reviews the research literature pertinent to the evaluation of and therapy for patients having unilaterial neglect. Emphasis is on areas in need of research by occupational therapists. Specific suggestions are made for studies to relate evaluation tools to functional criteria, to adapt the environment, and to investigate the effectiveness of compensatory or neurologically based treatment.
A Comparison of Motor Performance of Preschoolers Enrolled in Mental Health Programs and Non–Mental Health Programs
Authors: Kramer Lois Arms , Deitz Jean C. , Crowe Terry K.
Published: April 2012

Recognizing that the etiologies of some major mental illnesses may be in the physical domain, this study described and compared the motor performance of 27 preschool children enrolled in mental health programs with 27 children enrolled in Project Head Start, a non–mental health program. The two groups were matched for age, race, and sex. The Gross and Fine Motor scales of the Peabody Developmental Motor Scales were administered to all subjects. On both measures the children enrolled in mental health programs scored significantly lower than the children enrolled in Project Head Start. In addition their scores were more variable. The results of this study support other findings suggesting that developmental delays may be characteristic of children with emotional disturbances.
How to Read a Research Paper
Authors: Cohen Helen
Published: April 2012

A research paper includes several sections, each section having a particular purpose and containing a particular kind of information. This paper is a guide to reading a research paper. It describes the prototypical research paper and explains the purpose for each section. Issues for the astute reader to note are indicated and illustrated with examples from a research paper published in this issue of the journal.
The Scholarly Productivity of Occupational Therapy Faculty Members: Results of a Regional Study
Authors: Holcomb J. David , Christiansen Charles H. , Roush Robert E.
Published: April 2012

A study of the scholarly activities of 66 occupational therapy faculty members at selected academic health centers was conducted through a mailed survey. An analysis of the responses showed that (a) the respondents’ primary scholarly activities were reporting research findings in refereed journal articles and presenting papers at professional meetings and (b) only a small percentage of the respondents had directed extramurally funded projects. In addition, the level of scholarly productivity of the occupational therapists was significantly lower than that of their allied health colleagues. The majority of the respondents indicated that their own academic preparation was the primary factor that encouraged their scholarly pursuits and that heavy teaching responsibility was the primary discouraging factor. The respondents indicated also that faculty scholarly activities are, and will continue to be, important considerations in academic promotion decisions.
A Medical Review Approach to Medicare Outpatient Documentation
Authors: Allen Claudia , Foto Mary , Moon-Sperling Terry , Wilson Dorothy
Published: April 2012

Blue Cross of California has recognized the problem of reimbursement delays due to Medicare claims that have been returned or denied. The information in this article applies to the medical review process and suggests an interpretation of the new Medicare outpatient guidelines used by the Blue Cross of California Medicare reviewers. As a solution to the problem of delayed reimbursement, medical reviewers—who are also practicing occupational therapists—offer an explanation of the Medicare review process and suggestions for correcting technical billing errors. Methods for keeping complete and timely medical records are discussed, with the suggestion that clinicians follow these methods from the start of care. A process for documentation is presented that will clearly prove to the medical reviewer the need for the special skills of an occupational therapist. This article also proposes reasons for noncoverage because of insufficient medical necessity. It is important to note, however, that variance between fiscal intermediaries’ interpretations and requirements exists nationwide. This article, therefore, represents only one fiscal intermediary’s approach to reviewing claims and medical records.
The Bay Area Functional Performance Evaluation: Development and Standardization
Authors: Houston Dale , Williams Susan Lang , Bloomer Judith , Mann William C.
Published: April 2012

The Bay Area Functional Performance Evaluation (BaFPE) was developed in 1977–1978 to meet the need for a reliable and valid instrument for assessing the general functional performance of patients treated in psychiatric occupational therapy. It consists of two subtests, the Task-Oriented Assessment and the Social Interaction Scale. These subtests evaluate two aspects of general functional performance—task-oriented and social behavior—that are important in assessing clients with emotional, cognitive, or behavioral deficits. This article traces the instrument’s standardization over a 10-year period of development and includes a discussion of its theoretical premises, its content, and the revisions to date. Research on the reliability and validity of the BaFPE is summarized.
Occupational Therapy: A Study of Supply and Demand in Georgia
Authors: Morris Libby V.
Published: April 2012

In 1986 the University of Georgia’s Institute of Higher Education conducted a statewide needs assessment of the supply of and demand for health care professionals in over 25 health care fields. Of the 638 hospitals, nursing homes, home health agencies, and freestanding ambulatory surgical centers surveyed, 321 replied (50%). Respondents reported that occupational therapy positions have one of the highest vacancy rates and pose severe recruitment difficulties.

The occupational therapy vacancies in Georgia hospitals were 16.1% and averaged 15% in all surveyed facilities. In the hospital setting, the length of time needed to hire an occupational therapist ranged from 0 to 280 days with 3 months as average. Nevertheless, the respondents projected a 41% increase in employment of occupational therapists by 1995.

Occupational therapy employment opportunities in Georgia far exceed the supply, and this imbalance will continue until the turn of the century. Although much publicity has been focused on the severe nursing shortage nationwide, in Georgia and apparently in other states, the shortage of occupational therapists is also severe. A concerted effort is required to turn this situation around.
Bilateral Motor Coordination in 5- to 9-Year-Old Children: A Pilot Study
Authors: Magalhaes Livia C. , Koomar Jane A. , Cermak Sharon A.
Published: April 2012

The purpose of this study was to collect normative data on and to assess the clinical usefulness of scales designed to measure the quality of children’s ability to perform three bilateral motor coordination tasks: jumping jacks, symmetrical stride jumps and reciprocal stride jumps. One hundred children, aged 5 to 9 years, were tested according to the scales developed for this study. Results indicated that scores tended to increase with age and that sex differences were not significant. Jumping jacks were found to be the most reliable and the easiest of the three tasks. Reciprocal stride jumps were the most difficult. Quality of performance was assessed, and the number of jumps in a 10-sec trial was recorded for each age. The data from this study may be useful in comparing the performance of children with motor deficits to the performance of normal children of the same age.
Videotaped Versus Live Instruction in Demonstrating Evaluation Skills to Occupational Therapy Students
Authors: Bazyk Susan , Jeziorowski John
Published: April 2012

This study compared the effectiveness of videotaped and live instruction in demonstrating a developmental evaluation to occupational therapy students. Twenty-three students were randomly assigned to either the videotape or the live instruction group. While the videotape group watched a 25-minute commercially available videotape demonstrating the Milani-Comparetti Motor Development Screening Test, the live group received the same information from an instructor. A written examination that assessed student knowledge of the purpose and procedures of the evaluation tool served as the pretest and posttest. After the posttest, the students were asked to answer questions regarding their learning experience.

Results indicated no difference in test scores between the two groups. Although both groups rated the learning experience as good, all students stated a preference for live over videotaped instruction because of the opportunity to ask questions and interact with the instructor. These findings suggest that although videotaped instruction may be an effective teaching method, there may be ways to enhance student satisfaction with its use.
The Effect of Positioning on the Hand Function of Boys With Cerebral Palsy
Authors: Noronha Janette , Bundy Anita , Groll Janet
Published: April 2012

The effect of positioning (sitting and prone standing) on the hand function of 10 boys (mean age = 12.5 years, SD = 1.2 years) with spastic diplegic cerebral palsy was studied. Two groups of subjects were tested twice (Tests 1 and 2) with the Jebsen-Taylor Hand Function Test (Jebsen, Taylor, Treischmann, Trotter, & Howard, 1969; Taylor, Sand, & Jebsen, 1973) to measure rate of manipulation. In addition, a scale modified from Hohlstein (1982) was used to measure quality of grasp on each subtest of the Jebsen-Taylor test. No significant differences between the mean scores of the two groups were found on the total scores of the Jebsen-Taylor test, either between Tests 1 and 2 or between sitting and prone standing. When the data from Tests 1 and 2 were combined, it was found that on one subtest—simulated feeding—the subjects performed significantly faster while in a prone standing position. On another subtest—picking up small objects—the subjects performed significantly faster while in a sitting position. Except during the simulated feeding subtest, the quality of the subjects’ grasp was observed to be mature and tailored to the objects manipulated. This paper presents considerations for analyzing positioning in relation to upper extremity tasks.
A Critical Review of Scales of Activities of Daily Living
Authors: Law Mary , Letts Lori
Published: April 2012

Occupational therapists routinely perform activities of daily living (ADL) assessments. Although the literature contains many ADL scales, few sources summarize and review the measurement properties of such scales. In this paper, standard criteria are used to review scales of basic self-care. Each scale is critically appraised regarding its purpose, clinical utility, construction, standardization, reliability, and validity. Recommendations are made regarding the ADL scales that are most suitable for describing, predicting, or evaluating ADL function. This review is intended to help therapists in selecting the most appropriate ADL measure to use in their clinical practice.
Two Augmentative Communication Systems for Speechless Disabled Patients
Authors: Newman George C. , Sparrow Angela R. , Hospod Frank E.
Published: April 2012

Patients may be rendered speechless because of many conditions, including cancer surgery, stroke, cerebral palsy, cervical cord and head trauma, neuromuscular paralysis, and intubation for respiratory failure. These same conditions may also be associated with decreased use of the hands, so that writing and other nonverbal forms of communication are also impaired. Lack of communication can frustrate the patient, the family, and health care personnel; increase the patient’s isolation; and lead to poor patient cooperation, thus impeding progress in therapy and producing secondary psychiatric disturbances. Two communication programs that use a Commodore 64 computer are described in this paper. One communication program uses the alphabet and the other is based on the international Morse code. These programs are easy to use and inexpensive to establish, and they accommodate any switching device.
Development of the Miller Screening for Preschoolers
Authors: Miller Lucy Jane
Published: April 2012

This paper describes the development and initial validation of the Miller Screening for Preschoolers (MSP). A pilot edition of the test was administered to 174 preschool children in the state of Colorado. Of these, 39 had been previously identified as developmentally delayed. On the basis of preliminary analyses, test items were discarded if they were insensitive to differences between the at-risk group and the not-at-risk group or if they were nonsignificantly related to developmental age trends; if they were only weakly related to the domain total score; if they were redundant with other items within a domain; if they were too easy or too difficult for any given age; if they were rated low by the testers on administration and scoring issues; or if the test materials were deemed to be too expensive. This paper presents final statistics for the selected screening test items and discusses implications for the design, construction, and validation of developmental tests.
Reasons for Attrition From Occupational Therapy
Authors: Bailey Diana M.
Published: April 2012

This study examined the reasons why occupational therapists have left the field of occupational therapy. The purpose of the study was to find ways to prevent attrition and to bring back those who have left the field as a means to address the profession’s personnel shortage. Questionnaires from 696 therapists who have left the profession were analyzed. The therapists’ most common reasons for leaving were (a) childbearing and child rearing; (b) geographic relocation and subsequent inability to find a job; (c) excessive paperwork; (d) desire for increased salary and promotional opportunities; (e) high caseloads, stress, and burnout; (f) the actual practice of occupational therapy not being what was expected; (g) dissatisfaction with bureaucracy; (h) the chronicity and severity of the clients’ illnesses; and (i) an inability to find part-time work. Most therapists who left the profession did not return to practice because they felt professionally out of date and unable to compete with younger therapists.
The Relationship of Educational Level to the Development and Dissemination of Knowledge by Occupational Therapists
Authors: Storm Wendy
Published: April 2012

The purpose of this study was to investigate the qualitative and quantitative differences in productivity among occupational therapists with various educational backgrounds. Comparative analyses pertained to the respondents’ demographic data, to their productivity in the development and dissemination of knowledge, to their positions, and to their contributions to the profession. Four advanced education groups were also described in terms of their educational programs. The results of this study indicated that the most significant relationship between the type of education of occupational therapists and their productivity is found in the doctoral group. Although it was determined that time (years of experience) could account for some of the differences between the groups, no significant differences were found between the baccalaureate and entry level master’s groups. Significant differences were identified between the entry level and postprofessional master’s groups in course work and perceived benefits of education.
The Miller Assessment for Preschoolers: Clinical Use With Children With Developmental Delays
Authors: Daniels Linda E. , Bressler Sandra
Published: April 2012

In this pilot study, we investigated the clinical use of the Miller Assessment for Preschoolers (MAP) (Miller, 1982) with a sample of children with suspected or confirmed developmental delays. A retrospective chart audit was performed for 95 subjects, 30 girls and 65 boys, 34 to 68 months of age. Clinically related diagnoses were classified into six medical/developmental groups and a no-diagnosis group. When an analysis of variance was used to compare the six medical/developmental groups with the no-diagnosis group, some of the MAP score patterns differed significantly (p < .01). These score patterns provide preliminary evidence for the MAP’s effectiveness in screening children with developmental delays.
Activity Patterns and Life Changes in People With Depression
Authors: Larson Karen B.
Published: April 2012

The Activity Pattern Indicator (API) (Diller, Fordyce, Jacobs, & Brown, 1978) and the Schedule of Recent Experience (SRE) (Holmes, 1981) were used to determine activity patterns and life changes for 15 depressed patients admitted to an acute care mental health unit. Eight categories on the API were correlated with six categories on the SRE to determine the relationship between activity patterns 1 week and 1 month before hospitalization and life changes for the past year. Two correlations indicated that as the total number of life changes and home and family life changes increase, activity related to personal care decreases. Other correlations showed that as life changes related to health, work, and finance increase, such activities as passive recreation, homemaking, socializing, and personal care also increase. Because activity is the cornerstone of occupational therapy, occupational therapists, in treating patients with depression, might include facilitating close inspection of the patients’ activity patterns in relation to the changes that have occurred in their lives.
Use of the Role Checklist With the Patient With Multiple Personality Disorder
Authors: Sepiol Jane Musgrave , Froehlich Jeanette
Published: April 2012

A paucity of occupational therapy evaluation tools exists for use with patients with multiple personality disorder. The Model of Human Occupation (Kielhofner & Burke, 1980), particularly the volition and habituation subsystems within this model, proved useful for the identification of the many facets of patients with multiple personality disorder on a short-term treatment unit. The Role Checklist (Oakley, Kielhofner, Barris, & Reichler, 1986), a tool derived from the Model of Human Occupation, was adapted for use with this population and was found to be beneficial in the identification of common goals held by most of the personalities of each patient with multiple personality disorder. The use of the Role Checklist is illustrated with a case example.
Multiple Personality Disorder: An Overview
Authors: Braun Bennett G.
Published: April 2012

Multiple personality disorder is understood today as chronic dissociative psychopathology that most often develops in response to severe abuse in childhood. The dissociative component is a manifestation of a defense mechanism out of control: The person with a biopsychological capacity to dissociate flees inward from overwhelming abuse or feared abuse. When continuing abuse perpetuates dissociations and they are chained by common affective themes, the foundations of multiple personality disorder are laid. Although the disorder has its roots in childhood, most patients are not diagnosed with this condition until 20 to 50 years of age. Many have received several prior, erroneous diagnoses of mental or physical disorders or both over a period of 7 or more years. Failure of diagnosis is an indication of the multiple factors that contribute to making this a covert disorder. Diagnosis and management begin at the same place: the establishment of trust and therapeutic alliance between patient and therapist.
Adult Physical Dysfunction Content in Professional Curricula
Authors: Nelson Craig E. , Cash Sandra H. , Bauer David F.
Published: April 2012

This study examined the content of occupational therapy professional curricula as it pertains to adult physical dysfunction and the opinions and perceptions of faculty responsible for this content area. Survey results from 28 of 66 academic institutions offering professional-level education were received and analyzed. A great diversity in content and emphasis was reflected in the areas of medical conditions, general approaches to evaluation and treatment, specific evaluations, and specific treatment techniques and modalities. Most of the respondents were pleased with students’ performances in physical dysfunction Level II fieldwork, believed that course work was applicable to local clinical settings, and agreed that courses were constantly changing to reflect evolving occupational therapy theory. Approximately 30% of the respondents believed that they had inadequate time to prepare students for entry-level practice, and about half agreed that their department had the necessary equipment to teach evaluation and treatment content.
Perceived Competence Among Occupational Therapists in Mental Health
Authors: Cottrell Rita Fleming
Published: April 2012

This pilot study examined the level of perceived competence among 95 occupational therapists practicing in mental health in New York and New Jersey. Most respondents (80%) rated their ability to perform 15 professional tasks listed on the study questionnaire as good or excellent . The remaining six tasks listed on the questionnaire received lower perceived competence scores.

The findings suggest that basic, continuing, and postprofessional education programs along with a personal commitment to continued professional learning may provide therapists with the knowledge, skills, and attitudes needed to perceive themselves as competent mental health practitioners.

Because the percentage of occupational therapists practicing in mental health is declining, it is vital that we develop and support the perceived competence of our mental health practitioners.
Measuring the Effects of Neurodevelopmental Treatment on the Daily Living Skills of 2 Children With Cerebral Palsy
Authors: Lilly Lee Ann , Powell Nancy J.
Published: April 2012

This study examined the short-term effects of neurodevelopmental treatment (NDT) on the motor performance of daily living skills in 2 girls with cerebral palsy, aged 27 and 32 months. For 12 weeks, the subjects received treatment sessions consisting of NDT followed by play, or vice versa. After each treatment of play or NDT, the subjects were videotaped performing individually prescribed dressing activities. Trained raters, unaware of the type of treatment given, scored the videotapes on ordinally scaled dressing criteria. The results were not statistically significant for NDT or play for any criteria. The importance of this study is its development and exploration of refinements in single-subject research methods that show promise for use in the documentation of treatment outcomes. Such refinements include the use of functional activity as an evaluation tool and ordinal scales for the assessment of change.
Body Part Identification in 1- to 2-Year-Old Children
Authors: Witt Anita , Cermak Sharon , Coster Wendy
Published: April 2012

The purpose of this study was to examine the developmental sequence of body part identification in very young children, 11 to 25 months of age. In the first part of the study, 113 children, divided into five age groups (12-month-olds, 15-month-olds, 18-month-olds, 21-month-olds, and 24-month-olds), were asked to point to 20 body parts on a doll. The results indicated a positive correlation between number of parts correctly identified and increasing age. No sex differences or Sex × Age interactions were found.

In the second part of the study, the difference between pointing to body parts on the self and pointing to body parts on a doll was examined in two groups of 2-year-olds. The results indicated no significant difference between the ability to point to body parts on a doll and the ability to point to body parts on the self.

Factors that may contribute to the development of body part identification in 1- to 2-year-olds and the sequence in which body parts are learned are discussed. The results help provide diagnostic criteria for children with suspected delays in cognitive language, or body scheme development.
Assessing the Impact of HIV Disease
Authors: Weinstein Beth Dinah
Published: April 2012

This article presents a definition of HIV disease as a four-stage process. The Sickness Impact Profile (SIP) (Bergner, Bobbitt, Carter, & Gilson, 1981) was used to measure behavioral dysfunction in a sample of 15 persons with Stage 3 or Stage 4 (symptomatic) HIV disease.

The areas of work, leisure, cognitive behavior, and emotional behavior were found to be, on the average, most affected by HIV disease. A diagnosis of AIDS does not affect the severity of dysfunction. Functional deficits that are experienced for longer periods of time affect several behavioral categories on the SIP as well as on the overall SIP score.
Hemophilia, AIDS, and Occupational Therapy
Authors: Weinstein Beth Dinah , De Neffe Larkey Sheldon
Published: April 2012

This article describes the blood clotting disorder of hemophilia, including its transmission, incidence, and physical and psychosocial effects. The epidemiology of persons with both hemophilia and HIV are discussed, as well as HIV’s rapid spread due to contaminated blood products and the mechanisms commonly used to cope with HIV infection.

Specific suggestions on occupational therapy intervention are provided, including helping clients learn to cope with HIV by transferring skills previously learned for coping with hemophilia; teaching stress reduction, anger management, communication, and energy conservation skills; educating families and helping them set appropriate goals; designing adaptive systems for dealing with neurological deficits; and designing exercise programs.
A Day Treatment Program for Persons With AIDS
Authors: Gutterman Linda
Published: April 2012

This paper describes the Village Nursing Home’s day treatment program for persons with AIDS, with an emphasis on the role of occupational therapy and the outcomes of occupational therapy interventions. The clients’ demographics are included, and a general program philosophy of clients’ empowerment is discussed. The health promotion framework and the use of holistic modalities address the spiritual aspect of the individual and how occupational therapy and spirituality might interconnect.
The Ethics of Caring for Patients With HIV or AIDS
Authors: Hansen Ruth Ann
Published: April 2012

Health care professionals encounter many ethical issues in the care of persons who are HIV positive or who have been diagnosed as having AIDS. Such issues include the allocation of scarce resources for research and health care; the use of various methods of disease control, including mandatory testing, forced isolation, informing of sexual partners, and education; and the determination of the responsibility to treat infected patients.

These issues are presented as a stimulus to readers to examine their own attitudes regarding HIV and AIDS. The usefulness and limitations of occupational therapy’s professional code in resolving ethical dilemmas are discussed, followed by the description of a process that can be used to analyze and solve these dilemmas.
A Critical Analysis of Occupational Therapy Approaches for Perceptual Deficits in Adults With Brain Injury
Authors: Neistadt Maureen E.
Published: April 2012

Research about occupational therapy interventions for adult perceptual deficits is needed to examine the relative efficacy of different treatments and to scrutinize the theoretical assumptions underlying those treatments. The former purpose relates to providing optimal services to consumers; the latter, to advancing the knowledge base of the profession. Both of these purposes can be achieved if research questions are derived from the assumptions underlying treatments. This paper delineates those assumptions and suggests some research questions and strategies with which to test them.
A Stress Management Program: Inpatient-to-Outpatient Continuity
Authors: Courtney Cyndi , Escobedo Barbara
Published: April 2012

Stress is a factor in many modern illnesses. The development of coping skills to deal with stress is an occupational therapy goal for many patients. The program presented here uses stress management techniques to improve the situational coping skills of adult psychiatric patients. When discharged to the outpatient clinic, the patients in this program continue to learn and practice stress management techniques to increase relaxation and lessen anxiety. A case example is presented.
The Effects of Keyguard Use and Pelvic Positioning on Typing Speed and Accuracy in a Boy With Cerebral Palsy
Authors: McCormack Diane J.
Published: April 2012

The effects of keyguard use and pelvic positioning (neutral versus posterior tilt) on typing proficiency was studied in an 8-year-old boy with athetoid and spastic cerebral palsy. Speed and accuracy were measured with the Mastertype computer software program (Zweig, 1984). The results showed that the use of a keyguard increased the subject’s typing accuracy and decreased his speed. Neither neutral nor posterior pelvic positioning appeared to have a significant effect on typing speed or on accuracy.