bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of the Allen Cognitive Level Test in Assessing Cognitive Level Functioning of Emotionally Disturbed Boys
Authors: Shapiro Marsha E.
Published: April 2012

The purpose of this study was to ascertain the applicability of the Allen Cognitive Level Test (ACL) (Allen, 1982, 1985), developed for use with adult psychiatric patients, to emotionally disturbed children aged 8 to 15 years. The subjects’ performance on the ACL was compared with their performance on two other instruments that measure features of cognition: the Developmental Test of Visual-Motor Integration (VMI) (Beery & Buktenica, 1982) and the Perceptual Memory Task (McCarron, 1984). Pearson product-moment correlations were computed to study the relationships of the ACL, the Perceptual Memory Task full-scale and sub-scale scores, and the VMI raw and age-equivalent scores. The Perceptual Memory Task scores showed little or no correlation with the ACL scores. Correlations of the ACL with the VMI scores revealed moderate but significant coefficients. A relationship between age and ACL score was found. Preliminary data would indicate that the ability of emotionally disturbed children to function in the school environment depends on their mastery of task demands and that occupational therapy intervention cannot be based solely on age or level of intelligence.
Occupational Therapists in Private Practice
Authors: McClain Linda , McKinney Julie , Ralston Julie
Published: April 2012

Although increasing numbers of occupational therapists are choosing to work in private practice, little data exist describing this sector of the profession. In the present study, experienced occupational therapists were asked about their moves into private practice, including (a) their motivation, (b) their preparation, and (c) their perceptions of the move’s risks and benefits before and after the move.

A survey was sent to a national random sample of 105 occupational therapists, 74 of whom responded. According to the survey, autonomy was the most important motivating factor for occupational therapists moving into private practice. However, once they were in private practice, the occupational therapists noted that increased income was a major benefit. These occupational therapists had planned for the risks of reimbursement, referral sources, and overhead but had not anticipated problems with staffing shortages.

Incomes increased for occupational therapists who moved into private practice. The survey compared the incomes of occupational therapists before and after they entered private practice. It also compared their income and educational levels. Other comparisons included income and work experience, income and work role, and income and geographic location.

Autonomy and financial considerations appear to be the overriding issues for occupational therapists choosing careers in private practice. Almost unanimously, the survey respondents said that private practice was a good career choice.
Structuring Education: Development of the First Educational Standards in Occupational Therapy, 1917–1930
Authors: Colman Wendy
Published: April 2012

The movement to standardize educational preparation in occupational therapy grew as the profession developed following World War I. This paper explores the debates that surrounded the evolution of occupational therapy’s first sanctioned educational system. A variety of professionals involved in the formation of occupational therapy engaged in these debates. They focused their attention primarily on whether education should be regulated and, if so, how that education might be structured. Each coveted different views about how the fledgling profession might develop. These early debates signify one of the first attempts to identify a vision for the evolution of occupational therapy.
Managing Chronic Illness: An Immigrant Woman’s Acquisition and Use of Health Care Knowledge
Authors: Dyck Isabel
Published: April 2012

As occupational therapists increasingly encounter a multicultural clientele, there is growing interest in the influence of a person’s culture on his or her interactions with the environment. This paper presents a case study of a Chinese-Canadian immigrant woman with rheumatoid arthritis. The case study illustrates how the subject’s family, community networks, and workplace, coupled with the occupational therapy clinical setting, intermingled to shape the daily management of her illness. The case material focuses on the subject’s acquisition and use of different types of health care knowledge as she responds to her illness. It shows that the subject’s experiences and management decisions about her health are closely linked to the material and social conditions of her life as a working-class immigrant woman. This article suggests that attention needs to be paid to the broader systems of the environment in understanding the responses of immigrant women to occupational therapy, rather than on the cultural distinctiveness of the clients.
Internal-External Control and Temporal Orientation Among Southeast Asians and White Americans
Authors: Spadone Richard A.
Published: April 2012

This study examined ethnic group differences with the use of the Model of Human Occupation (Kielhofner, 1985b). Three groups – immigrants from Thailand, immigrants from Cambodia, and white Americans – were contrasted on two constructs – internal versus external control and temporal orientation. The study attempted to identify whether nonpatient subjects have an internal locus of control and a strong future orientation, as the Model of Human Occupation would predict. No differences were found with the use of the Internal-External Scale (Rotter, 1966). The Thai and white Americans differed significantly on the Time Reference Inventory (Roos & Albers, 1965b). The Thai selected more items referring to the past, and the white Americans chose more statements applying to the present. There were no differences for past or future time extensions between groups. All the groups had a greater past extension than future extension. It was proposed that a larger future time perspective was not a requisite for functional temporal adaptation.
Hmong Children and Their Families: Consideration of Cultural Influences in Assessment
Authors: Meyers Cheryl
Published: April 2012

Occupational therapists assessing young Hmong children with developmental problems must consider their families’ cultural beliefs as they affect the design of assessment procedures and practices. Choices that families make about health and educational services are influenced by their beliefs. Developmental status can be affected by unresolved medical problems and the child’s general health condition. Assessment components based on cultural awareness may improve the effectiveness of early identification of Hmong children with developmental delay. Appropriate use of interpreters, creation of the most beneficial assessment environment, parental report, and observation of functional skills and play provide needed information when determining the child’s eligibility for early intervention services. The author has found that trained interpreters provide the most reliable communication between family members and the therapist. Assessments in the home environment are encouraged due to the child’s age and the need for family support and interaction. Parents are an excellent source of information about the child’s current and past functional abilities. Observations of the child’s interaction with family members, with objects and toys during play, and during functional daily living activities provides the therapist with valuable information about the child’s need for intervention.
Culture, Theory, and the Practice of Occupational Therapy in New Zealand/Aotearoa
Authors: Jungersen Kaja
Published: April 2012

In the context of contemporary New Zealand, this paper discusses the need for occupational therapy to substantiate its claims of being a holistic profession with particular reference to the Maori, the indigenous people of New Zealand (referred to by the Maori as Aotearoa). In this era of accountability and consumer choice, occupational therapists need to more effectively meet the cultural needs of their clients through an understanding of both the material and nonmaterial aspects of their cultures. However, for New Zealand occupational therapists, cultural sensitivity is not enough to contribute to changing the diminished life chances of the Maori. It is proposed in this paper that the Model of Human Occupation (Kielhofner, 1985: Kielhofner & Burke, 1980), when combined with the work of radical community educators such as Freire (1972), could provide the sociopolitical dimension to New Zealand practice. The Model of Human Occupation is examined in light of current occupational therapy practice in New Zealand. It is argued that this model, when accompanied by a broader understanding of the sociopolicical processes informing monoculturalism, could be seen as a suitable framework for understanding cultural differences in New Zealand and could assist in the move toward providing culturally appropriate occupational therapy for indigenous peoples such as the Maori.
Assessment of Codependency Behavior in Two Health Student Groups
Authors: Clark Jerry , Stoffel Virginia C.
Published: April 2012

The present study examines the relationship between codependency and caregiving to determine whether codependent persons tend to be attracted to caregiving professions. The study also examined the relationship between codependency, self-esteem, and locus of control, as measured by the Friel Co-Dependency Assessment Inventory (Friel, 1985; Friel & Friel, 1987), the Tennessee Self-Concept Scale (Fitts, 1965), and the internal-External Locus of Control Scale (Rotter, 1966), respectively. Voluntary participants consisted of 15 occupational therapy students and 15 health information administration (HIA) students believed to be different from one another with respect to the caregiving aspects of their respective professions. The occupational therapy group scored significantly lower than the HIA group on the measure of codependency (m = 21.2 vs. m = 28.8, respectively) [ t(28) = 2.258, p = 05]. No other significant differences were noted between groups for the other test scores. Only codependency scores between 31 and 60, that is, moderate-to-severe and severe concerns (n = 6), had a strong correlation with self-esteem scores (r= − .974) and a moderate correlation with locus of control scores (r = .683). No student in the occupational therapy group scored within the moderate-to-severe or severe range. The results did not support a relationship between codependency and choice of a caregiving-oriented profession. Further, only moderate-to-severe and severe codependency scores were indicative of low self-esteem and high external locus of control.

Implications of this study suggest incorporation into the academic preparation of occupational therapy students information regarding codependency and self-assessment of codependency to facilitate awareness of the student’s need to nurture others. Replication of this study with registered occupational therapists and certified occupational therapy assistants to determine the extent to which these findings are applicable is suggested.
An Analysis of Computer-Related Articles in Occupational Therapy Periodicals
Authors: Angelo Jennifer , Smith Roger O.
Published: April 2012

The introduction of personal computers in the late 1970s and early 1980s has affected occupational therapy. Nine journals, three trade newspapers, and one series book published over an 11-year period by four English-speaking countries were catalogued for articles pertaining to computer use in occupational therapy. This investigation yielded 174 articles that were categorized by information type, application of computers covered, sophistication of technology, computer brand, and country of publication. Most articles provided general information, described clinical training applications, used an Apple computer, and were from an American publication. Few articles were reports of research. The percentage of computer-related articles has substantially increased in the observed 11-year period. These findings indicate increased computer use in occupational therapy.
A Hierarchical Model for Evaluation and Treatment of Visual Perceptual Dysfunction in Adult Acquired Brain Injury, Part 2
Authors: Warren Mary
Published: April 2012

A framework for evaluation and treatment of visual perceptual dysfunction in adults with acquired brain injury is presented. The framework is based on the concept of a hierarchical structure of perceptual skill levels that interact and subserve one another. Higher level skills in the structure evolve from the integration of lower level skills and are subsequently affected by disruption of the lower level skills. Oculomotor control, the visual fields, and visual acuity form the foundation skills in the framework, followed by visual attention, scanning, pattern recognition, memory, and visual cognition. The order of evaluation and treatment is dictated by the framework. Emphasis is placed on identification and remediation of deficits in the lower level skills that will cause spontaneous improvement of higher level skills. Three treatment principles and five training guidelines are presented that reflect this concept. Specific examples of treatment tasks are provided.
Effectiveness of Occupational Therapy for Reducing Restraint Use in a Psychiatric Setting
Authors: Carlson Janene M. , Holm Margo B.
Published: April 2012

Patients who received occupational therapy services (OT Group) and those who did not (NOT Group) were compared in a retrospective record review to determine the efficacy of occupational therapy in reducing the need for restraint in a state psychiatric hospital .There were 60 subjects with an Axis I diagnosis in each group who met the qualifications of a continuous 90-day minimum inpatient status during 1990. The amount of time each subject spent in restraint, seclusion, or restraint and seclusion, and free from confinement served as the dependent variables. Results showed no differences between the OT Group and the NOT Group for time spent in confinement. A major limitation in this study was the lack of specificity in the documentation of occupational therapy services.
Acquired Lymphedema: A Chart Review of Nine Women’s Responses to Intervention
Authors: Dennis Barbara
Published: April 2012

The medical records of nine women who had acquired lymphedema as a sequela to a modified radical mastectomy for breast cancer were analyzed to ascertain what factors, phenomena, or experiences in their lymphedema treatment may have influenced outcomes. The women were identified as having either successful or poor outcomes. Their conservative lymphedema treatment consisted of compression pumps, compression garments, and, in some cases, manual lymph drainage.

The qualitative analysis of records implicated the following factors in the outcome of conservative lymphedema treatment for these women: (a) the amount of delay before starting compression treatment, (b) the size of the lymphedematous arm when treatment started, (c) the availability of social and financial supports, and (d) the presence of complicating health problems. The findings of this study cannot be generalized; however, further scientific inquiry into the phenomena that lie behind treatment outcome variations could lead to more effective treatment approaches.
The Influence of Ergonomic Factors and Perceptual–Motor Abilities on Handwriting Performance
Authors: Tseng Mei Hui , Cermak Sharon A.
Published: April 2012

Difficulty with handwriting is one of the most frequent reasons that children in the public schools are referred to occupational therapy. Current research on the influence of ergonomic factors, such as pencil grip and pressure, and perceptual–motor factors traditionally believed to affect handwriting, is reviewed. Factors such as visual perception show little relationship to handwriting, whereas tactile–kinesthetic, visual–motor, and motor planning appear to be more closely related to handwriting. By better understanding the ergonomic and perceptual–motor factors that contribute to and influence handwriting, therapists will be better able to design rationally based intervention programs.
Assistive Technology and the Newly Disabled Adult: Adaptation to Wheelchair Use
Authors: Bates Pearl Sarah , Spencer Jean Cole , Young Mary Ellen , Rintala Diana Hopkins
Published: April 2012

A naturalistic, ethnographic, phenomenological study of adaptation to wheelchair use was conducted with one key informant, a 30-year-old white man with acquired paraplegia who was undergoing acute rehabilitation. Primary staff members served as additional informants. It was found that adaptation to wheelchair use had both pragmatic and emotional components. The latter appeared in alternating phases of resistance and neutrality or detente. Therapist and patient had conflicting goals relative to wheelchair use, which occasioned considerable friction. The patient’s initial attitudes regarding wheelchairs were prejudicial, which hampered his ability to see the chair as a useful tool for mobility and independence. Successful pragmatic adaptation hinged in part on emotional acceptance of the wheelchair.
Improved Productivity Through Purposeful Use of Additional Template for a Woman With Cortical Blindness
Authors: Yuen Hon Keung
Published: April 2012

A single-subject study with an ABAB design investigated an adaptation of a work activity through the purposeful use of an additional template to improve productivity for a woman with cortical blindness resulting from anoxic brain damage. The activity required the subject to outline brackets (as parts of a handi-rack woodwork project) by tracing a template on a piece of pine board. During the baseline phase of the study, the subject used one template to outline the brackets. During the intervention phase, the subject used an additional template after receiving a brief training in its use. Productivity was measured by the number of potentially usable outlined brackets. Data analysis revealed that in the intervention phases, productivity improved significantly and accuracy increased. The application of tapping the subject’s intact sensory system was valuable for determining her vocational potential. The rationale of using an additional template to improve productivity was explained by the theory of affordance.
An Abbreviated Task-Oriented Assessment (Bay Area Functional Performance Evaluation)
Authors: Mann William C. , Huselid Rebecca
Published: April 2012

The purpose of this study was to explore development of an abbreviated version of the Task-Oriented Assessment component of the Bay Area Functional Performance Evaluation (BaFPE). The BaFPE is widely used by occupational therapists practicing in mental health, but therapists have requested an instrument that could be administered and scored more quickly. Both a subjective and objective analysis support the development of an abbreviated version of the Task-Oriented Assessment.
Linking Patient and Family Stories to Caregivers’ Use of Clinical Reasoning
Authors: Kautzmann Lisette N.
Published: April 2012

Due to pressures inherent in the current health care environment, health professionals’ interactions with patients may be limited to attending to the disease process by using the scientific method of clinical reasoning. Health professionals may find it difficult to break out of this pattern of reductionistic thinking and acting to use other forms of clinical reasoning and to elicit patients’ perceptions of the illness experience. Older adults and their families are particularly susceptible to being treated in a routine, diseasefocused manner. A growing body of literature gives voice to the stories and concerns of these persons. The purposes of this paper are to discuss thinking and clinical reasoning from several perspectives and to identify selections from literature that enhance understanding of the need to pay attention to both the disease and the illness experience and to use all forms of clinical reasoning.
Work Evaluations: Critique of the State of the Art of Functional Assessment of Work
Authors: Velozo Craig A.
Published: April 2012

The area of work evaluation is fertile ground for future research and development by occupational therapists. Current evaluations of work range from standardized work evaluations associated with vocational rehabilitation to highly technical physical capacity and work capacity instrumentation and equipment often associated with sports medicine. In addition, methods used to identify pain and abnormal illness behavior add the psychosocial component of work evaluation. The limitations of most of the traditional approaches to work evaluations are their lack of focus on the actual work environments and on the meaning of work to persons. Occupational therapy can play an important and unique role in linking work evaluations to psychosocial and environmental variables and in formulating comprehensive theoretical models of work that should improve and refine present work evaluations.
Assessment of Play and Leisure: Delineation of the Problem
Authors: Bundy Anita C.
Published: April 2012

This paper discusses current perspectives on play and leisure and proposes that if play and leisure are to be accepted as viable occupations, then (a) valid and reliable measures of play must be developed, (b) interventions must be examined for inclusion of the elements of play, and (c) the promotion of play and leisure must be an explicit goal of occupational therapy intervention. Existing tools used by occupational therapists to assess clients’ play and leisure are evaluated for the aspects of play and leisure they address and the aspects they fail to address. An argument is presented for the need for an assessment of playfulness, rather than of play or leisure activities. A preliminary model for the development of such an assessment is proposed.
Role of Physical Performance Component Evaluations in Occupational Therapy Functional Assessment
Authors: Mathiowetz Virgil
Published: April 2012

In the 1970s, occupational therapy assessments tended to focus on physical performance component (PPC) evaluations such as strength and range of motion; assessment of occupational performance played a secondary role. Given changes within and outside the profession of occupational therapy, it is time for the assessment of occupation and role performance to assume a primary role, while PPC evaluation should shift to a secondary role. Although PPC evaluations may be less prominent than in the past, they will continue to play an important role in occupational therapy practice and research. Therapists need to be critical consumers of PPC measurement tools because many require further development to validate their use for occupational therapy purposes.
The Effect of Rater Severity On Person Ability Measure: A Rasch Model Analysis
Authors: Lunz Mary E. , Stahl John A.
Published: April 2012

This paper presents a method for analyzing oral examinations with an extended, many-faceted Rasch model that calibrates medical specialty candidates, protocols, and raters. Significant variance was found among protocol difficulties and rater severities. When candidates’ raw scores were compared with calibrated measures corrected for the bias caused by the particular protocols and raters encountered, variation between candidate scores and measures were observed. The data were found to fit the Rasch model well enough to be suitable for making measurement on oral examinations more objective as well as providing specific feedback to oral examination raters. In this example a medical oral examination was used; however, the techniques are applicable to any situation in which trained professionals rate candiate or patient performances. For occupational therapists, potential applications include evaluation of a student’s fieldwork performance or observation of a patient’s task performance.
Hand Function Evaluation: A Factor Analysis Study
Authors: Jarus Tal , Poremba Ruth
Published: April 2012

The purpose of this study was to investigate hand function evaluations. Factor analysis with varimax rotation was used to assess the fundamental characteristics of the items included in the Jebsen Hand Function Test and the Smith Hand Function Evaluation. The study sample consisted of 144 subjects with out disabilities and 22 subjects with Colles fracture. Results suggest a four factor solution: Factor I – pinch movement; Factor II – grasp; Factor III – target accuracy; and Factor IV – activities of daily living. These categories differentiated the subjects without Colles fracture from the subjects with Colles fracture. A hand function evaluation consisting of these four factors would be useful. Such an evaluation that can be used for current clinical purposes is provided.
Self-Feeding System for an Adult With Head Injury and Severe Ataxia
Authors: Yuen Hon Keung
Published: April 2012

This report describes a customized self-feeding system designed to increase the independence of a person with a head injury who is unable to use his arm for self-feeding. The client has spastic hemiparesis in the right upper extremity and profound ataxia in the left upper extremity. Due to the severity of these disabilities, the client required total assistance at every meal since his injury 6.5 years ago. The self-feeding system described consists of an adapted spoon, a spoon holder, a scoop dish, and a dish stand. The client scoops food from the scoop dish with the adapted spoon held in his mouth and then transfers the spoon to a magnetic holder for positioning. This adaptation allows the client to position the spoon with his chin without demanding fine motor coordination. The self-feeding system is evaluated with a BAB single case research withdrawal design. Results indicate that this self-feeding system provides a viable alternative to assisting independence in self-feeding as measured by the cost benefit ratio and nutrition intake. The client used the self-feeding system for 12 months at the rehabilitation center and has continued using the equipment at his nursing home.
Differences in Values and Goals of Occupational Therapy Students
Authors: Danka Margaret A.
Published: April 2012

This study compared professional values and goals of three levels of occupational therapy students: (a) seniors in baccalaureate programs (n = 337), (b) students in professional master’s programs (n = 95), and (c) students in postprofessional master’s programs (n = 62). Demographic characteristics including gender, age, and college background were also examined. Significant differences were identified between the baccalaureate group and the postprofessional master’s group for three professional goals: (a) making a theoretical contribution to the profession, (b) performing research in the profession, and (c) educating occupational therapy students. Significant differences were also noted for four professional values. Intellectual stimulation was more often chosen by postprofessional master’s students; exciting life and comfortable life were more often chosen by baccalaureate students, and helpfulness was more often chosen by the baccalaureate and postprofessional master’s students. It was concluded that determining the professional values and goals of occupational therapy students may generate implications for career counseling, recruitment, increased work force, decreased attrition, and future curriculum planning.
A Comparison of the Grip Strength of Children With Myelomeningocele to That of Children Without Disability
Authors: Latcha Celest M. , Freeling Miriam C. , Powell Nancy J.
Published: April 2012

The grip strengths of 108 children aged 6 to 19 years with myelomeningocele were measured and compared with previously published results for children without disability. The grip strengths of the 59 female subjects with myelomeningocele were significantly lower than those of the population without disability in all age groups except for the 12 to 15 years range. The 49 male subjects exhibited significantly lower grip strengths only up to age 12 years. Implications and recommendations for clinical treatment, effects of secondary neurological complications, limitations of the study, and topics of future research are discussed.
Content Validity of the In-Hand Manipulation Test
Authors: Exner Charlotte E.
Published: April 2012

Object manipulation skills are a rital area for client assessment in occupational therapy, but in-hand manipulation skills are not specifically included in any standardized tests of hand function for children. The In-Hand Manipulation Test (IMT) was developed for use by occupational therapists with preschool and young school-age children. Assessment of the IMT’s content validity was an important precursor to further development of the test. Twenty-four certified occupational therapists rated young children’s performance during administration of the IMT before completing a content validity survey about the test. Overall, the IMT’s content validity was supported by the feedback from the raters. A final test length of 50 items with two trials per item was considered acceptable, provided that the test takes no longer than 20 to 30 min to administer. The therapists were positive about the content and structure of the rating scale and the approach used in presenting activities to the children. Some issues related to functional validity of some skills or the proportions of in-hand manipulation skills were raised. Further development of the IMT for clinical and research use seems warranted. Revisions to the test will be made, and another pilot study will be conducted before normative data collection. Training for administering and scoring the test will incorporate the recommendations on the basis of this study’s results.
Student Coping Strategies and Perceptions of Fieldwork
Authors: Mitchell Marlys M. , Kampfe Charlene M.
Published: April 2012

A questionnaire, the revised Ways of Coping Checklist, was sent to all professional (entry-level) graduate students in the United States in one academic year during their second fieldwork level II experience to determine what coping strategies they used during their fieldwork experience. Information was also gathered regarding their perceptions of this clinical experience. Responses from 101 students showed that they used Problem-Focused and Seeks Social Support strategies more than Wishful Thinking, Blamed Self, or Avoidance strategies. More than half of the students found the experience to be stressful, and almost all agreed that it was important. Most agreed that they had control over their present circumstances in the fieldwork experience.
Therapeutic Use of Humor in Occupational Therapy
Authors: Vergeer Gwen , MacRae Anne
Published: April 2012

Interviews with five occupational therapists who use humor therapeutically in their practice were conducted and analyzed with a phenomenological method so that the lived experience of therapeutic humor use in occupational therapy could be examined. Sixteen themes were identified through data analysis: The Concept of Therapeutic Use of Humor; Spontaneous Versus Deliberate Humor; Humor, the Great Equalizer; Humor and Professionalism; Contraindications of Humor; Humor Among Co-Workers; Humor and Play; Humor and the Environment; Humor Providing Balance; The Intrinsic Quality of Humor; The Transformative Power of Humor; The Effects of Humor on the Subjects Themselves; Humor as an Evaluation and Treatment Tool; Humor as Therapeutic Use of Self; Humor as a Coping Mechanism; and Other Uses of Humor With Patients. This study revealed that the use of therapeutic humor in occupational therapy is a multifaceted phenomenon, much richer than had been previously presented in the literature.
An International Overview of Resource Centers on Disability
Authors: Hampton Mary M. K.
Published: April 2012

Facilities variously known as independent living centers, disabled living centers, disability information centers, and resource centers now exist in many parts of the world. Although occupational therapists offer valuable perspectives on quality of life, knowledge of assistive technology, and a holistic view of clients’ needs, occupational therapy is not always a part of these centers. Occupational therapists themselves may overlook these settings as venues for their services. This overview of 38 resource center organizations in 14 countries reports on their approaches to supporting persons with disabilities, professionals, and other members of the public and explorers the presence of occupational therapy and other professions in these agencies.
A Comparison of Practice Issues Among Occupational Therapists in the Rural Northwest and the Rocky Mountain Regions
Authors: Kohler Elizabeth , Mayberry Wanda
Published: April 2012

The purpose of this study was to investigate factors that affected occupational therapy practice in the rural regions of the Rocky Mountains. It compared data from the Rocky Mountain region (Wyoming, Colorado, New Mexico, Utah, and Arizona) to a previous study of the Northwest region of Alaska, Idaho, Montana, and Washington and expanded on the Northwest study. Results indicated that the two areas were similar in their demographics and problems, including need for more occupational therapists. The results also have implications regarding specialized preservice training for rural-based occupational therapists, other professions’ availability of continuing education, and other support systems. The authors provide recommendations based on the results, other literature, and conjectures, for recruitment, training, and ongoing support of rural occupational therapist through cooperative consortiums and distance learning.
Test-Retest Reliability of the Test of Visual Perceptual Skills With Children With Learning Disabilities
Authors: McFall Sheri Ambacher , Deitz Jean c. , Crowe Terry K.
Published: April 2012

This study examined the test-retest reliability of the Test of Visual Perceptual Skills (nonmotor) (TVPS). The sample consisted of 30 first-and second-grade children (aged 6years through 8 years) with identified learning disabilities. The TVPS was administered on two separate occasions that were 1 to 2 weeks apart. The intraclass correlation coefficient for the total test standard scores was .81. The intraclass correlation coefficients for the subtests ranged from .33 (Sequential Memory) to .78 (Form Constancy). The primary finding from this study is that TVPS scores on the total test show adequate test-retest reliability for use in clinical settings. The scores on the subtests, however, should he used with extreme caution, as the test-retest reliability estimates were low.
Mandatory HIV Testing and Occupational Therapists
Authors: Falk-Kessler Janet , Barnowski Cheryl , Salvant Sabrina
Published: April 2012

Objectives. As the prevalence of human immunodeficiency virus (HIV) increases, so does the prevalence of HIV-positive health care workers. This study explored what effect this will have on occupational therapy service provision. Attitudes and policies of 118 occupational therapy administrators were examined in relation to mandatory testing for HIV, attitudes on treating HIV-positive patients, working with HIV-positive staff members and students, and use of Centers for Disease Control’s guidelines on universal precautions.

Methods. A stratified sample of 200 occupational therapy administrators, drawn proportionally from all occupational therapy fieldwork centers, was sent questionnaires. The respondents (N = 118) were asked questions reflecting policy and attitude regarding HIV-positive staff members, students, and patients and mandatory testing. Descriptive statistics and chisquare analyses were computed to examine variances related to policy, ethics, and attitudes.

Results. Few occupational therapy departments have policies regarding HIV-positive health care workers or students. Those policies in place involve disability discrimination acts and using universal precautions. More than one third of the respondents support mandatory testing of all health care workers and notifying patients if their occupational therapist is HIV-positive. A large minority of respondents would either refuse to hire or train an HIV-positive therapist or student, or would restrict patient care responsibilities.

Conclusions. Although most occupational therapy administrators adhere to CDC guidelines and antidiscrimination policies, some concern and fear was expressed regarding HIV transmission through occupational therapy practice. This may result in administrative decisions regarding work and training responsibilities that are unnecessarily restrictive, such as limiting all patient care responsibilities.
Management Decisions Made by Caregiver Spouses of Persons With Alzheimer’s Disease
Authors: Corcoran Mary A.
Published: April 2012

Objectives. As the incidence of Alzheimer’s disease increases, so does the effect on families and friends who assume caregiving responsibilities. Despite the proliferation of caregiving studies reported in the literature, little is known of the day-to-day management styles and preferences of caregivers. To develop, implement, and test interventions designed to sustain caregivers in their role, more information is needed about the caregiving experience. Results of a descriptive study are presented as a first step in understanding the complex process of choosing, organizing, and implementing everyday caregiving tasks.

Method. Subjects of the study were 26 persons who provide care for a spouse with moderate impairment from Alzheimer’s disease. Interview data were analyzed with grounded theory techniques to isolate the purposes behind the management decisions of spousal caregivers.

Conclusion. Implications are presented for occupational therapy intervention to assist caregivers in gaining the knowledge and skills necessary for effective and efficient management of problem behaviors associated with Alzheimer’s disease.
The Effects of Different Treatment Activities on Functional Fine Motor Coordination in Adults With Brain Injury
Authors: Neistadt Maureen E.
Published: April 2012

Objectives. Occupational therapists frequently work to improve the fine motor coordination skills of adults who have dexterity deficits secondary to brain injury. Most therapists use a combination tabletop and functional activities to foster improved coordination in these clients. This study examined the effects of puzzle construction and kitchen activities on fine motor coordination in a group of 45 men with brain injury, as measured by pretest and posttest performance on two subtests of the Jebsen-Taylor Test of Hand Function.

Method. Subjects were randomly assigned to either a parquetry block assembly group (n = 22) or a meal preparation group(n = 23).

Results. Subjects in the functional meal preparation group showed significantly greater improvement in dominant-hand dexterity for picking up small objects than subjects in the tabletop puzzle activity group. Other coordination test results were comparable for the two treatment groups.

Conclusion. These findings suggest that functional activities may be better than tabletop activities for fine motor coordination training with this population.
The Effect of Music on Repetitive Disruptive Vocalizations of Persons With Dementia
Authors: Casby Julie A. , Holm Margo B.
Published: April 2012

Objective. This study examined the effect of classical music and favorite music on the repetitive disruptive vocalizations of long-term-care facility (LTCF) residents with dementia of the Alzheimer’s type (DAT).

Method. Three subjects diagnosed with DAT who had a history of repetitive disruptive vocalizations were selected for the study. Three single-subject withdrawal designs (ABA, ACA, and ABCA) were used to assess subjects’ repetitive disruptive vocalizations during each phase: no intervention (A); relaxing, classical music (B); and favorite music (C).

Results. Classical music and favorite music significantly decreased the number of vocalizations in two of the three subjects (p < .05).

Conclusion. These findings support a method that was effective in decreasing the disruptive vocalization pattern common in those with DAT in the least restrictive manner, as mandated by the Omnibus Budget Reconciliation Act of 1987.
Cerebrovascular Accident: Relationship of Demographic, Diagnostic, and Occupational Therapy Antecedents to Rehabilitation Outcomes
Authors: Brodie Joanne , Holm Margo B. , Tomlin George S.
Published: April 2012

Objective. This study was conducted to identify factors that were significant in predicting occupational therapy treatment choices and discharge outcomes after inpatient rehabilitation for 112 patients who had experienced a cerebrovascular accident.

Method. A retrospective descriptive study was conducted.

Results. According to discriminant function analysis, the cerebrovascular accident disability Score (i.e., level of functional disability) during the initial evaluation period was the predictor of discharge outcomes with the most clinical significance. A greater proportion of occupational therapy assessment units was the most influential occupational therapy factor associated with a positive discharge outcome. In one inpatient rehabilitation setting, a greater proportion of occupational therapy intervention for all study subjects was directed at the level of impairment compared to the level of disability.

Conclusion. Shorter inpatient stays, as well as shifts to outpatient rehabilitation, may require occupational therapists to examine whether intervention at the level of impairment or disability yields the best functional outcomes for patients who have sustained a cerebrovascular accident.
Stability and Change in Functional Assessment of Patients With Geropsychiatric Disorders
Authors: Rogers Joan c. , Holm Margo B. , Goldstein Gerald , McCue Michael , Nussbaum Paul D.
Published: April 2012

Objectives. Functional assessments of patients with geropsychiatric disorders accomplished by self-rating, informant rating, and performance test were compared.

Method. Fifty-eight inpatients with major depression or progressive dementia were evaluated on three occasions over 6 months with informant and patient versions of the Activities of Daily Living Scale of the Older Americans Resources and Services Multidimensional Functional Assessment (OARS-ADL) and with the Performance Assessment of Self-Care Skills (PASS).

Results. Patients’ scores became significantly worse (p < .01) on the informant version of the OARS-ADL and the PASS. Self-ratings with the OARS-ADL did not worsen significantly (p > .05).

Conclusion. Agreement between informant rating and performance test concerning functional status of patients with dementia was good. Elderly patients with depression may experience subtle deterioration that only becomes apparent on performance tests.
A Prediction Model of Performance in Level II Fieldwork in Physical Disabilities
Authors: Best Christopher E.
Published: April 2012

Objectives. A prediction model of performance in physical disabilities fieldwork was generated with grades received in the occupational therapy curriculum and in prerequisite courses.

Method. Grades included those from functional anatomy, neuroanatomy, physical disabilities lecture, physical disabilities clinic, and prerequisite anatomy and physiology courses. Sampling was done collectively over graduated occupational therapy classes from 1987 to 1992 at the University of Puget Sound. A multiple regression analysis was performed and prediction equations were generated far each subscale of the Fieldwork Evaluation for the Occupational Therapist. Equations for combinations of the subscale categories were also produced.

Results. Adjusted R2 values were found to be less than 10% in all equations.

Conclusion. This poor ability of grades to predict fieldwork performance suggests that future investigation be focused on variables other than grades. Such variables might include student motivation, rapport between the student and fieldwork supervisor, and hospital experience in physical disabilities.
Interrater Reliability of the Peabody Developmental Motor Scales: Fine Motor Scale
Authors: Gebhard Ann R. , Ottenbacher Kenneth J. , Lane Shelly J.
Published: April 2012

Objective. The interrater reliability of the Peabody Developmental Motor Scales (PDMS) fine motor scale was examined in 23 children with developmental disabilities who were between 2 years and 5 years of age.

Method. Three occupational therapists viewed videotapes of the children and scored each child’s performance on the fine motor section of the test. Data were analyzed with the intraclass correlation (ICC) approach; ICC values ranged from 0.90 to 0.97 for the subskills of Grasping, Hand Use, Eye–Hand Coordination, and Manual Dexterity.

Results. The ICC interrater reliability value for the total fine motor score was 0.99. Reliability values were additionally computed with the PDMS fine motor scale age-equivalent scores and Z scores. The ICC values for these methods of scoring the PDMS were 0.99 and 1.00, respectively.

Conclusion. The PDMS fine motor scale can be used consistently to evaluate fine motor delays in this population of young children.
Doing Occupational Therapy: Dimensions of Satisfaction and Dissatisfaction
Authors: Hasselkus Betty Risteen , Dickie Virginia Allen
Published: April 2012

Objectives. A phenomenological study was conducted to gain understanding of the nature of the lived experience of doing occupational therapy.

Method. One hundred and forty-eight occupational therapists nationwide were asked to describe especially satisfying and dissatisfying experiences of practice. The resulting narrative data were analyzed with dimensional analysis techniques.

Results. With the metaphor of therapy as story, three overarching dimensions of practice were derived from the narrative data: Change, Community, and Craft. The dimension of Change is strongly related to the ending or outcome of the story, Community encompasses the harmony or disharmony of the interrelationships in the shared story, and Craft includes both the skills of therapy and the broader core experience of doing therapy.

Conclusion. These findings are complementary to the three-track mind discussed in the clinical reasoning study and contribute further to our understanding of the experience of doing occupational therapy.
Moral Treatment: How a Caring Practice Lost Its Rationale
Authors: Peloquin Suzanne M.
Published: April 2012

The 19th-century practices of moral treatment and phrenology serve as historical examples of a narrowing focus in health care and reveal the manner in which theories can shape practice. The story of moral treatment, as it is told in connection with phrenology, emphasizes the push for success and right solutions. The push followed several shifts in the conceptualization of mental illness, the last of which proved moral therapy unreasonable. If practitioners in this century hope to ensure that the heart of moral treatment will withstand the effects of ever-changing theories, they must hold caring attitudes, words, and actions at the center of their practice.
Neglect in Three Dimensions
Authors: Kageyama Shigehisa , Imagase Miyuki , Okubo Mayumi , Takayama Yoshihiro
Published: April 2012

Objectives. Neglect in vertical and radial directions is rarely evaluated systematically in patients with brain damage.

Method and Results. Using the line bisection task, we confirmed that some patients with unilateral brain damage manifest vertical or radial spatial neglect. In fact, patients with severe left horizontal neglect tend to have severe vertical neglect.

Conclusion. Because vertical and radial neglect may affect the ability to perform functional daily activities, occupational therapists need to address the existence of vertical and radial neglect when evaluating and training patients with brain damage.