bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of a Skiing Experience on Adolescents With Limb Deficiencies: An Occupational Adaptation Perspective
Authors: Pasek Paula Berg , Schkade Janette K.
Published: April 2012

Objective. Effects of a 6-day snow skiing trip on 14 adolescents with limb deficiencies were explored. The purpose was to determine whether components of mastery and self-esteem could be identified.

Method. Participant observation data collection methods included videotape, interviews, daily progress notes by ski instructors, and a 1-month posttrip questionnaire. Data were analyzed for evidence of efficiency, effectiveness, and satisfaction to self and others (properties of relative mastery described in occupational adaptation.) Skier reports of positive effects were analyzed for indications of an impact on self-esteem. Three occupational therapists who have extensive experience working with adolescents also reviewed videotapes and written information.

Results. The therapists acknowledged the presence of skill mastery as an important component of skiers’ positive self-evaluation. They also commented that evidence of preexisting self-esteem and social aspects of the trip were as likely to produce positive effects as mastery of skiing.

Conclusion. Research method considerations (use of participant observation for hypothesis testing) preclude definitive interpretation of a link between skill mastery and self-esteem. Short-term positive effects of the skiing experience reported by questionnaire were present 1 month after the trip. Long-term effects should be studied.
Grip Strength and Finger Dexterity Across Five Styles of Commercial Wrist Orthoses
Authors: Stern Erica B.
Published: April 2012

Objective. Five styles of commercial static wrist extensor orthoses were compared to determine whether any style, or styles, afforded better power grip strength or finger dexterity. Because wrist extensor orthoses are intended for use during functional tasks, their influence on hand function is of great importance.

Method. Twenty-three right-hand-dominant women without upper extremity dysfunction participated in this crossover study. Dominant-hand finger dexterity and power grip strength were evaluated while wearing each of five commercial orthoses–Kendall–Futuro #33® (Futuro), AliMed Freedom Long® (AliMed Long), AliMed Freedom Short® (AliMed Short), Smith & Nephew Rolyan D-Ring® (Rolyan), and LMB Wrist Rest® (LMB) –and while using the dominant hand without an orthosis (free hand). Finger dexterity was assessed with the unimanual subtest of the Purdue Pegboard. Grip strength was assessed with a Jamar® hydraulic dynamometer.

Results. Four of the study orthoses (Futuro, AliMed Short, Rolyan, and LMB) afforded finger dexterity that did not differ significantly from that of the free hand. The AliMed Long orthosis slowed finger speed when compared with the speeds afforded by both the LMB orthosis and the free hand.

The Rolyan orthosis permitted a power grip strength that was not significantly different from the free hand. The other four commercial orthoses reduced grip strength when compared with the strength observed when wearing a Rolyan orthosis and when gripping with a free hand.

Conclusion. The five styles of commercial orthoses affect power grip and finger dexterity differently. When power grip or finger dexterity are priorities, differences among the orthoses furnish grounds for initial suggestions, although medical needs and patient preference should be the overriding factors in the final selection of an orthosis.
A Pet Therapy Intervention With Geriatric Psychiatry Inpatients
Authors: Zisselman Marc H. , Rovner Barry W. , Shmuely Yochi , Ferrie Patricia
Published: April 2012

Objective. The purpose of this study was to evaluate the effects of pet therapy on geriatric psychiatry inpatients. A demonstrable impact could lead to more Widespread or targeted use of animal companionship programs for hospitalized older persons.

Method. The study design was a randomized, parallel-group control treatment trial with pretreatment and posttreatment measures. Fifty-eight subjects with chronic age-related disabilities who were patients of the Wills Eye Hospital Geriatric Psychiatry Unit were assigned to a pet therapy intervention group or an exercise control group for 1 hr a day for 5 consecutive days. Every subject was blindly evaluated with the Multidimensional Observation Scale for Elderly Subjects (MOSES) before and after the intervention week.

Results. No Significant differences in MOSES scores were found between or within groups before and after the interventions. There was a nonsignificant tendency for subjects who received the pet intervention to have less irritable behavior after treatment. However, women with dementia who received either pet therapy or exercise intervention had improved irritable behavior scores after treatment.

Conclusion. This pilot study demonstrates the need for further research on animal-assisted interventions with hospitalized elderly persons. Differential improvement in women with dementia also requires further investigation.
Fine Motor Outcomes in Preschool Children Who Receive Occupational Therapy Services
Authors: Case-Smith Jane
Published: April 2012

Objective. This study examined preschool children’s acquisition of fine motor skills and functional performance when occupational therapy services are included as part of the educational program. It also investigated the relationships among fine motor skills and functional performance in self-care, mobility, and social function.

Method. Twenty-six preschool children who received weekly occupational therapy were studied. Measurements of their in-hand manipulation, tool use, eye–hand coordination, grasping strength, and functional performance in self-care, mobility, and social function were taken at the beginning and end of the school year.

Results. Raw and scaled scores showed significant improvements in all skill areas; standard scores showed slight improvement in eye–hand coordination and mobility function. Correlations of the motor skill tests with the functional performance scales using year-end data revealed significant correlations for in-hand manipulation, eye–hand coordination, and grasping strength with self-care function and mobility.

Conclusions. The results demonstrate the level of change that occurs in fine motor skill and self-care, mobility, and social function during the course of the school year for preschoolers with moderate fine motor delays. The relationships found in the year-end testing imply that performance in underlying fine motor skills as the focus of occupational therapy intervention is associated with self-care and mobility function.
The Resource Utilization Groups System of Nursing Home Reimbursement Policies: Influences on Occupational Therapy Practice
Authors: Thomesen Maura
Published: April 2012

Objective. This study explored the effects of federal and state reimbursement mechanisms on occupational therapy practice in the nursing home setting, specifically, the selection and scheduling of patients for treatment programs, the content of the therapy provided, and the documentation requirements.

Method. A questionnaire developed for the study was mailed to the chief occupational therapist in each of the 171 nursing homes located in New York city. Descriptive data on the research variables were collected from 83 respondents.

Results. Government regulation and reimbursement mechanisms specifically affected therapists’ treatment decisions and patient programming and scheduling in the nursing home setting. Survey results described the clinical impact of the resource utilization groups (RUGs) data collection periods. Negative effects were seen in a substantial incidence of withholding therapies from patients and the decline in the use of some traditional occupational therapy treatments. Positive effects included an increase in staff and equipment and therapists’ improved documentation skills.

Conclusion. Occupational therapy practitioners in the nursing home setting need to find ways to live with the realities of government reimbursement without compromising professionalism or clinical judgment. Documentation is the key to assuring that patients receive the therapy they need. Therapists should be aware of the regulations, document accordingly, and review those cases that were denied reimbursement to learn of documentation errors.
The Assessment of Motor and Process Skills Applied Cross-Culturally to the Japanese
Authors: Goto Sawako , Fisher Anne G. , Mayberry Wanda L.
Published: April 2012

Objectives. The purposes of this study were to examine the cross-cultural validity of the Assessment of Motor and Process Skills (AMPS) as well as the reliability of raters from different cultures.

Method. Six trained raters from diverse cultural backgrounds scored 10 Japanese subjects’ performances on familiar and culturally relevant tasks of their own choosing.

Results. Results indicated high cross-cultural validity and interrater reliability for the AMPS, as indicated by goodness of fit of subjects and raters via the many-faceted Rasch measurement model. The relative rater severity was also evaluated cross-culturally by the standardized difference (z). The Japanese rater and one of the three American raters varied significantly in severity between their scoring of Japanese subjects versus European subjects.

Conclusion. The results support the hypothesis that the AMPS can be used as a cross cultural instrumental activities of daily living assessment. Further study is needed to clarify the issue of possible cultural bias in rater severity.
Occupational Therapy Students’ Perspectives on Occupation as an Agent That Promotes Healthful Lifestyles
Authors: Dermody Jennifer L. , Volkens Patrice Power , Heater Stephen L.
Published: April 2012

Objectives. This study was conducted to determine occupational therapy students’ perspectives on occupation as an agent that promotes healthful lifestyles, what factors influence these perspectives, and the extent to which formal classroom instruction in occupation as a health-promoting agent influenced their perspective transformation.

Method. Through a precourse and postcourse survey, weekly log sheets, and audiotaped class discussions, data regarding attitudes and beliefs about health promotion were collected from 23 occupational therapy master’s students enrolled in the course Wellness Through Occupation. The data were analyzed with a priori concept coding to determine whether perspective transformation occurred as a result of formal classroom instruction.

Results. Participants indicated that family values, previous formal and informal instruction, and personal experience were the major factors that influenced their perspectives on occupation as an agent that promotes a healthful lifestyle. The results demonstrated that participants had a perspective transformation, which is the first step in the behavioral change process.

Conclusion. Formal classroom instruction can be a factor in promoting healthful lifestyles through occupation. Such instruction can be an important step in empowering people to take responsibility for their own health.
Life Histories in Occupational Therapy Clinical Practice
Authors: Frank Gelya
Published: April 2012

This article defines and compares several narrative methods used to describe and interpret patients’ lives. The biographical methods presented are case histories, life-charts, life histories, life stories, assisted autobiography, hermeneutic case reconstruction, therapeutic emplotment, volitional narratives, and occupational storytelling and story making. Emphasis is placed the clinician as a collaborator and interpreter of the patient’s life through ongoing interactions and dialogue.
Alma: Coping With Culture, Poverty, and Disability
Authors: Blanche Erna Imperatore
Published: April 2012

This article raises questions about the ways culture affects the nature of health care services. By examining the life story of Alma, a Central American woman who has a daughter with disabilities; her interactions with health care providers; and my own assumptions about cultural differences, I note the impact of cultural differences on coping and adaptation in Alma and in the health care system when working with poor, non-English–speaking clients.
Transformative Narratives: From Victimic to Agentic Life Plots
Authors: Polkinghorne Donald E.
Published: April 2012

Basic to occupational engagement is a person’s personal power to author choices. Impairment in functioning moves some clients from an agentic identity of self to a victimic identity. The change in identity causes previously self-directed clients to adopt a passive and acquiescent stance toward their lives. The recovery of occupational functioning includes the restoration of the person’s sense of agency. Recent developments in self theory emphasize the self as a process rather than a substance or thing. Narrative is the discourse mode most able to express identity as a process. Victimic identity is manifest in a self-story in which protagonists have lost power to affect change in their lives; agentic identity is manifest in self-stories of active agency. A study of clients’ rehabilitation by Cochran and Laub found that clients’ change from victimic to agentic identity moves through four phases: incompleteness, positioning, actualizing, and completion.
The Value of Studying Occupation: An Example With Primate Play
Authors: Wood Wendy
Published: April 2012

The purpose of this article is to demonstrate the value of a constraint-free study of occupation to occupational therapy. Constraint-free study refers to interdisciplinary scholarly inquiry that seeks to generate a deep understanding of how important occupations influence adaptation and health. Drawing on knowledge from animal behavior, anthropology, evolutionary biology, psychology, and primatology, primate play is discussed. Such knowledge enhances understanding of therapeutic play contexts and of play’s integrative impact on occupational performance. Moreover, a robust understanding of vital occupations, such as play, empowers practitioners, thereby reducing the profession’s vulnerability to external forces that diminish its economic and political position in the health care market. Precedents within and outside occupational therapy are described whereby control over the acquisition of basic knowledge has proven to be beneficial. It is concluded that both occupational therapy and occupational science will strongly benefit from their shared commitment to understanding the complexities of occupation.
The Use of the Edema Bar for the Treatment of Burn Patients
Authors: Rock Kim , Costigan Marguerite
Published: April 2012

The edema bar is a new device that therapists can add to their repertoire of treatment approaches for burn patients. This article looks at the challenges therapists encounter while working with burn patients and describes the edema bar’s design, its application to the burn rehabilitation process, and the multidisciplinary approach to its use.
Outcomes Research: The History, Debate, and Implications for the Field of Occupational Therapy
Authors: Ellenberg Dale B.
Published: April 2012

The field of occupational therapy, as with all facets of health care, has been profoundly affected by the changing climate of health care delivery. The combination of cost-effectiveness and quality of care has become the benchmark for and consequent drive behind the rise of managed health care delivery systems. The spawning of outcomes research is in direct response to the need for comparative databases to provide results of effectiveness in health care treatment protocols, evaluations of health-related quality of life, and cost containment measures. Outcomes management is the application of outcomes research data by all levels of health care providers. The challenges facing occupational therapists include proving our value in an economic trend of downsizing, competing within the medical profession, developing and affiliating with new payer sources, and reengineering our careers to meet the needs of the new, nontraditional health care marketplace.
Managing the Occupational Environment of Managed Care
Authors: Brayman Sara J.
Published: April 2012

The emergence of managed care has resulted in a practice environment buffeted by rapid and sweeping changes. Shifts in philosophy and approach to payment for health care affect the nature of the service and the method of its delivery. The occupational adaptation frame of reference is used to illustrate the challenges imposed by the physical, social, and cultural components of the changing occupational environment. Perceptions, observations, and concerns of middle level occupational therapy, physical therapy, social work, and nursing managers illustrate the impact of this new environment. Therapists are challenged to understand their own changing work setting and to apply the same effort to mastering its challenges as they would to examining the context of their patient’s occupational performance and to designing and implementing an appropriate clinical intervention.
Education and Training of Occupational Therapists for Neonatal Intensive Care Units
Authors: Dewire Andrea , White David , Kanny Elizabeth , Glass Robin
Published: April 2012

Objective. The neonatal intensive care unit (NICU) is an area in which occupational therapists require specialized advanced training and skills. The purpose of this study was to evaluate the nature of current practice among occupational therapists in NICU settings, their training, and their opinions regarding educational experiences necessary for NICU work.

Method. One hundred seventy-four NICU occupational therapists completed a survey questionnaire designed to elicit information about these issues.

Results. The majority of respondents were engaged in similar practice duties in NICUs, most of which had been using therapy services for less than 10 years. Most of the respondents (83%) reported that their primary source of training was on the job rather than through formal course work or training programs. Many of the respondents (40%) lacked training in the use of any infant assessments, and 50% had 2 years or less of pediatric work experience before entering practice in the NICU. The respondents indicated that mentored experience, on-the-job training, pediatric work experience, extended continuing education courses, and formal internships could prove helpful to future occupational therapists who wish to acquire the knowledge and skills to become competent in the NICU.

Conclusion. Results of the survey indicate that current training and education to work in an NICU is inadequate and needs to be addressed. Occupational therapists working in NICUs desire and express the need for specialized training to work in this practice area. A more aggressive effort toward standard NICU education and training is necessary to ensure that occupational therapists are competent members of the NICU team.
The Effects of an Occupationally Embedded Exercise on Bilaterally Assisted Supination in Persons with Hemiplegia
Authors: Nelson David L. , Konosky Kathy , Fleharty Kathleen , Webb Ruth , Newer Kristin , Hazboun Virginia P. , Fontane Cheryl , Licht Brian C.
Published: April 2012

Objectives. Occupationally embedded exercise is a central idea in the profession of occupational therapy. This experiment compared the effect of an occupationally embedded exercise involving a simple dice game with a rote exercise in persons with stroke with pronator spasticity. Both exercise conditions involved bilaterally assisted supination, consistent with the neurodevelopmental model of practice.

Methods. The sample consisted of 14 men and 12 women post-cerebrovascular accident with a mean age of 68.4 years (SD = 11.2) at six clinical sites in California, Texas, and Michigan. Subjects had pronator spasticity, full passive range for supination after a brief warm-up, and no functional supination. After random assignment for experimental condition, the subjects engaged in two sets of 10 repetitions of bilaterally assisted supination in either the occupationally embedded condition (dice game) or the rote condition (no game). A pen recorder electronically documented degrees of rotation of the handle that was grasped during the exercise.

Results. The occupationally embedded exercise resulted in significantly more handle rotation (requiring more supination) than the rote exercise, t (24) = 2.28, P (one tailed) < .05. The effect size was large.

Conclusion. This study advances the experimental analysis of therapeutic occupation in the area of occupationally embedded exercise. Clinicians are urged to consider the multidimensional nature of occupationally embedded exercise.
Art: An Occupation With Promise for Developing Empathy
Authors: Peloquin Suzanne M.
Published: April 2012

Empathy is central to the interactions of occupational therapists who value personal dignity. Persons from various sectors of the behavioral sciences and the medical humanities have proposed that engagement with the arts can develop empathy, an assumption that prompted this inquiry. The observations of artists and art philosophers suggest that the assumption that art may develop empathy is grounded in the kindred natures of the two practices and in the actions that occur when a person engages with a work of art. The assumption that art may develop empathy is grounded in the kinship of the actions common to both practices: response, emotion, and connection. Artists and art philosophers’ observations of human practices have uncovered three rules of art that may dispose one toward empathy: reliance on bodily senses, use of metaphor, and occupation by virtual worlds. Analysis of art’s potential suggests that a person who would derive empathy from art must (a) use the senses to grasp feeling, (b) stretch the imagination to see a new perspective, and (c) invite an occupation that enhances understanding. Persons who hope to develop empathy must pursue an experience that evokes the fellow feeling that inspires it. Art can offer this experience.
Analysis of the Orthopedic Content in an Occupational Therapy Curriculum From a Clinical Reasoning Perspective
Authors: Neistadt Maureen E. , Atkins Allison
Published: April 2012

Objectives. Recent studies have suggested that occupational therapists working with adults with physical disabilities do not use narrative reasoning in practice as much as they use procedural reasoning. This focus on procedural reasoning may be partially shaped by the occupational therapy educational process. The purpose of this analysis was to see whether one accredited occupational therapy curriculum was promoting narrative reasoning relative to its information on adult orthopedics.

Method. An accredited occupational therapy undergraduate and certificate curriculum was analyzed from both student and faculty perspectives to see what types of clinical reasoning were most emphasized relative to treatment of adults with orthopedic injuries. The student analysis, done by a senior as part of an independent study, looked at the clinical reasoning content of journal articles, an occupational therapy textbook, and occupational therapy lectures relative to adult orthopedic injuries. The faculty analysis, part of a curriculum revision process and independent of the student analysis, looked at the clinical reasoning content of all courses in the curriculum.

Results. The student and faculty analyses concurred that although narrative reasoning is taught in this curriculum, narrative reasoning concepts are not well integrated into the adult physical dysfunction course that deals with adult orthopedic injuries.

Conclusion. Occupational therapy educators may not be integrating narrative reasoning into more procedurally oriented physical dysfunction courses as fully as possible and may, therefore, be fostering procedurally oriented practice in physical dysfunction settings. Curricula evaluations, like the one described in this article, can be a mechanism for examining the types of clinical reasoning emphasized in a given curriculum for a given diagnostic group.
What Do We Need To Know To Practice Occupational Therapy in the Community?
Authors: McColl Mary Ann
Published: April 2012

One of the main challenges to occupational therapists in community practice is applying our existing knowledge base to support a different kind of practice in the community. This article explores the theory base in occupational therapy that informs three models of community practice: client centered, community-based rehabilitation, and independent living. It defines these three preferred models of service delivery for community practice and looks at the knowledge requirements for each. Using a taxonomy developed to classify occupational therapy theory, the article examines existing theory and gaps in the theory base for occupational therapy in community practice. Finally, the article challenges practicing therapists, educators, and researchers to examine their use of theory and their underlying assumptions for meeting the challenge of community practice.
The Community Adaptive Planning Assessment: A Clinical Tool for Documenting Future Planning With Clients
Authors: Spencer Jean Cole , Davidson Harriett A.
Published: April 2012

Objectives. The objectives of this article are to (a) identify features needed in a clinical tool in order to organize collaborative planning for the future between therapist and client; (b) describe the structure and procedures for use of the Community Adaptive Planning Assessment (CAPA), which was developed to meet these needs; (c) summarize research on the usability, trustworthiness, and clinical effectiveness of the CAPA; and (d) consider future work to further evaluate qualitative tools like the CAPA for clinical and research purposes.

Method. Initial and revised versions of the CAPA were evaluated through several studies. Usability was examined through questionnaires completed by therapists who used the CAPA in acute care, rehabilitation, home health, and community programs with a total of 105 clients who had a variety of acute and chronic disabilities. Trustworthiness was evaluated through comparison of information gathered from 21 clients with that from their family members. Clinical effectiveness was evaluated for discharge planning through content analysis of community outcomes of goals and plans established before discharge.

Results. Initial studies indicate that the CAPA has sound usability, trustworthiness, and clinical effectiveness for a variety of service delivery systems and with a variety of clients when used by experienced therapists. Findings support use of these three criteria for evaluation of tools designed to document qualitative consultation-based practice.

Conclusions. Results are related to broader issues in the profession, including a need for further study of collaborative planning for the future between clients and therapists, ways in which qualitative aspects of practice can be documented efficiently, ways in which outcomes of consultation-based practice can be evaluated, and establishment of criteria for evaluation of emerging qualitative assessments and intervention tools.
Independent Living Skills and Posttraumatic Stress Disorder in Women Who Are Homeless: Implications for Future Practice
Authors: Davis Janis , Kutter Catherine J.
Published: April 2012

Objective. Service delivery through community-based programs is the future of occupational therapy. This study examined independent living skills, traumatic experiences, and symptoms of Posttraumatic Stress Disorder (PTSD) in a sample of women residing in a supportive housing program for women and families who are homeless in order to determine the needs of this population and the possible role of occupational therapy in such a community-based program.

Method. Twenty-four women residing in a supportive housing shelter in Kansas City, Missouri, volunteered to participate in this study. The participants were evaluated for independent living skills with the Kohlman Evaluation of Living Skills. A structured interview format was used to determine whether participants experienced a trauma and whether they met diagnostic criteria for PTSD.

Results. Results indicated that women who are homeless have deficits in independent living skills, especially in the area of money management. Results also indicated that traumatic experiences and PTSD are more prevalent among women who are homeless than among women in the general population. The relationship between independent living skills and PTSD among women who are homeless was not made clear by this study.

Conclusion. The information gathered in this study underscores the importance of identifying and addressing occupational and mental health issues of women who are homeless. Results suggest that occupational therapists have a major role to play, evaluating and facilitating independent living skills, as members of multidisciplinary treatment teams in supportive housing programs for persons who are homeless.
Patterns of Sensory Integration Dysfunction: A Confirmatory Factor Analysis
Authors: Mulligan Shelley
Published: April 2012

Objective. This study evaluated a five factor model of sensory integration dysfunction on the basis of scores of children on the Sensory Integration and Praxis Tests (SIPT).The purpose of the study was to determine a plausible model for understanding sensory integration dysfunction.

Method. The hypothesized model of sensory integration dysfunction tested was derived from previous multivariate analyses and consisted of five patterns of dysfunction, including: bilateral integration and sequencing, somatosensory, somatopraxis, visuopraxis, and postural ocular motor. Confirmatory factor analysis (CFA) of the SIPT scores of 10,475 children and the scores of a subgroup of 995 children with learning disabilities were used to evaluate the model.

Results. The CFA of the hypothesized model indicated numerous weaknesses with it and, therefore, was rejected. Exploratory factor analysis (EFA) was then performed with the same data set to identify a better-fitting, more parsimonious model o/sensory integration dysfunction. A second-order, four-factor model using generalized practic dysfunction as the second-order factor and four first-order factors (dyspraxia, bilateral integration and sequencing deficit, visuoperceptual deficit, somatosensory deficit) were pro-posed. The CFA supported this model as the better-fitting model. The proposed model held true when tested with the subgroup of children with learning disabilities.

Conclusions. The modified model of sensory integration dysfunction proposed indicated that it was a good fit for the data and improved on the initial model. Clinical implications of the findings relate to the interpretation of SIPT scores and provide suggestions for test development measuring sensory integration functions. The proposed model has applications for occupational therapy intervention using sensory integration as the primary frame of reference.
Rater Reliability and Internal Scale and Person Response Validity of the School Assessment of Motor and Process Skills
Authors: Atchison Bradley T. , Fisher Anne G. , Bryze Kim
Published: April 2012

Objective. The purpose of this study was to examine the internal scale and person response validity as well as intrarater reliability of the School Assessment of Motor and Process Skills (School AMPS).

Method. Fifty-four students were assessed with the School AMPS while they performed routine school work tasks in their classrooms. The students’ ages ranged from 3 to 7 years (M = 4.0 years, SD = .7). Twenty-two students were identified as “typically developing,” and 32 were identified as having a developmental or learning disability.

Results. The School AMPS Motor and Process scale items and tasks (scale validity), the participants (person response validity), and the rater (intrarater reliability) all demonstrated acceptable goodness-of-fit to the many faceted Rasch model (MnSq < 1.4, z < 2).

Conclusion. Results supported the validity and reliability of the School AMPS. With additional research and development, the School AMPS has the potential to become the first functional, unobtrusive, reliable, and valid assessment designed by occupational therapists for use by school-based occupational therapists.
Working Well With Others: The Prediction of Students’ Clinical Performance
Authors: Tickle-Degnen Linda
Published: April 2012

Objective. The purpose of this study was to determine whether multivariate measurement at the initiation of students’ training in occupational therapy could predict clinical performance in Level II fieldwork.

Method. Forty-five students in their first semester were videotaped in pairs and completed personality and emotional communication measures related to the potential for working well with others. Two years later, the students’ clinical performance was rated by Level II fieldwork supervisors.

Results. In the physical rehabilitation fieldwork setting, students who were conventional and quietly concerned were rated higher than students who were unconventional, talkative, and less other-centered. In the pediatric rehabilitation setting, students who were autonomous and nonverbally perceptive were rated higher than students who were interdependent and less perceptive. In the psychiatric rehabilitation setting, students who were emotionally reactive to facial but not body cues of emotion were rated higher than students who had low emotional reactivity and were less perceptive to facial but not body cues.

Conclusion. The varying institutional cultures, types of patients, and roles of occupational therapy across fieldwork settings may require different sets of attributes for working well with others. Educators and supervisors should be aware of these possible differences when fashioning Level I fieldwork experiences.
Test–Retest Reliability of the Evaluation Tool of Children’s Handwriting-Manuscript
Authors: Diekema Susan M. , Deitz Jean , Amundson Susan J.
Published: April 2012

Objective. This study examined the test–retest reliability of the legibility portion of the Evaluation Tool of Children’s Handwriting-Manuscript (ETCH-M).

Method. The sample consisted of 31 first-grade and second-grade students with handwriting dysfunction. The ETCH-M was administered two times,1 week apart, to participants. The primary investigator acted as sole rater and followed standard scoring procedures.

Results. The reliability coefficients were .63 for total numeral legibility, .77 for total letter legibility, and .71 for total word legibility. Individual task reliability coefficients were generally lower and ranged from .20 (near-point copy) to.76 (alphabet uppercase).

Conclusion. Total letter, total word, and uppercase letter legibility were more stable than total numeral legibility scores and other individual tasks scores. When evaluating handwriting for a child, it is important to consider ETCH legibility scores as only one aspect of a comprehensive evaluation.
Occupational Therapy and Rehabilitation: An Awkward Alliance
Authors: Friedland Judith
Published: April 2012

This article argues that although occupational therapy and rehabilitation are often considered synonymous, the latter is but one aspect of the former. Early influences on occupational therapy are briefly reviewed, and some philosophical ideas about activity are described. The rationale for the use of occupations as treatment in the early part of this century, both in Canada and in the United States, is examined and contrasted with the development of physical medicine and rehabilitation after World War II. This discussion demonstrates that the origins of occupational therapy and rehabilitation in North America had little in common. As occupational therapy became incorporated into rehabilitation, the profession’s core values eroded, and although current definitions of rehabilitation offer a more appropriate fit for occupational therapy, rehabilitation continues to see engagement in occupations as a separate and subsequent step. The article concludes by considering future directions and the tasks that lie ahead.
Continuing Competence in the Health Professions
Authors: Grossman Judy
Published: April 2012

The health professions are confronted with external pressures to assure the public of the continuing competence of health care providers and internal pressures for self-regulation. This article describes the forces driving continuing competence, the difficulty defining the scope of professional competencies for experienced practitioners, the difficulty creating valid measures to evaluate continuing competence, and the need for shared responsibility and collaboration among regulation boards, professional associations, and specialty certification programs. The article presents findings from the Study of Professions, which was based on literature review, document review, and telephone interviews with key informants from 13 regulated health professions.
Transitional Portfolios: Orchestrating Our Professional Competence
Authors: Crist Patricia , Wilcox Bonita L. , McCarron Kelly
Published: April 2012

Reflective professional development results from thoughtful planning of goals and meeting learning objectives. With rapid changes in health care resulting in major reevaluation and even modification of the role and functions of an occupational therapy practitioner, producing a historical record of competencies in order to learn from one’s own experience and to plan for change is essential. A new use of the portfolio is presented to show that a portfolio can be more than the typical repository of completed projects. The transitional portfolio is introduced as a tool for one to self direct professional development through thoughtful engagement with artifacts created during one’s career in relationship to professional goals and desired roles. The transitional portfolio process is holistic, flexible, and reflective. It can serve as a way to document accumulated knowledge and skill acquisition as well as facilitate thoughtful, planned reflection on one’s career development in occupational therapy. This article describes the use of transitional portfolios to connect professional development learning experiences, accomplishments, and future opportunities for occupational therapy practitioners.
Cooperative Learning as an Approach to Pedagogy
Authors: Nolinske Terrie , Millis Barbara
Published: April 2012

Lecture-based pedagogical approaches cannot adequately prepare students in professional and technical occupational therapy programs. Faculty members in other disciplines are turning to a well-known and well-researched teaching approach called cooperative learning, which is more carefully structured and defined than most other forms of small group learning. Cooperative learning includes several key principles: positive interdependence, individual responsibility, appropriate grouping, group maintenance, cooperative skills, and promotive (interaction) time. This article provides ideas for managing the classroom with cooperative learning activities and describes eight of them: Three-Step Interview, Roundtable, Think–Pair–Share, Structured Problem Solving, Send/Pass-a-Problem, Generic Question Stems, Double Entry Journal, and Dyadic Essay Confrontation. Each activity is applied to content embedded in professional and technical occupational therapy curricula. A cooperative learning approach to evaluating learning is also presented.
Behavioral and Physiological Effects of Deep Pressure on Children With Autism: A Pilot Study Evaluating the Efficacy of Grandin’s Hug Machine
Authors: Edelson Stephen M. , Edelson Meredyth Goldberg , Kerr David C. R. , Grandin Temple
Published: April 2012

Objective. One symptom common to many persons with autism is a high arousal or anxiety level. This study investigated the effects of deep pressure on arousal and anxiety reduction in autism with Grandin’s Hug Machine, a device that allows self-administration of lateral body pressure.

Method. Twelve children with autism were randomly assigned to either an experimental group (receiving deep pressure) or a placebo group (no receiving deep pressure but in the disengaged Hug Machine). All children received two 20-min sessions a week over a 6-week period. Arousal was measured behaviorally with the Conners Parent Rating Scale and physiologically with galvanic skin response (GSR) readings.

Results. Behavioral results indicated a significant reduction in tension and a marginally significant reduction in anxiety for children who received the deep pressure compared with the children who did not. Additionally, children in the experimental group, whose GSR measure decreased, on average, after deep pressure, were somewhat more likely to have higher GSR arousal a priori.

Conclusion. These preliminary findings support the hypothesis that deep pressure may have a calming effect for persons with autism, especially those with high levels of arousal or anxiety.
A Meta-Analysis of Research on Sensory Integration Treatment
Authors: Vargas Sadako , Camilli Gregory
Published: April 2012

Objective. The purpose of this study was to find whether existing studies of treatment using sensory integration approaches support the efficacy of these approaches.

Method. With meta-analysis, the results of sensory integration efficacy research studies published from 1972 to the present were synthesized and analyzed. Sixteen studies were used to compare sensory integration effect with no treatment (SI/NT), and 16 were used to compare sensory integration effect with alternative treatments (SI/ALT). Overall average effect sizes, comparisons of the effect sizes for different dependent variables, and secondary factors associated with effect size variation were examined.

Results. The weighted average effect size of SI/NT studies was .29. However, there was a significant difference between the average effect sizes of the earlier studies (.60) and the more recent studies (.03). Of the outcome measures, larger effect sizes were found in the psychoeducational category (.39) and motor category (.40). Of SI/ALT studies, the average effect size was .09, not significantly different from zero.

Conclusion. Three central conclusions can be made. First, in the SI/NT comparison, a significant effect was replicated for sensory integration treatment effects in earlier studies, but more recent studies did not show overall positive effects. Second, larger effect sizes were found in psychoeducational and motor categories. Third, sensory integration treatment methods were found to be as effective as various alternative treatment methods.
Occupational Therapists’ Involvement With the Minimum Data Set in Skilled Nursing and Intermediate Care Facilities
Authors: Nelson David L. , Glass Lisa M.
Published: April 2012

Objectives. The Minimum Data Set (MDS) is a comprehensive, federally mandated assessment for all residents of long-term-care facilities who receive reimbursement from Medicare or Medicaid. This study investigated the degree to which occupational therapists contribute to the MDS 2.0 process.

Method. A 60-item survey developed for the study was mailed to 252 occupational therapists who worked in skilled nursing or intermediate care facilities throughout the United States, and 148 (59%) usable surveys were received. Test–retest reliability was assessed in a randomly selected subsample of 75, with a 73% rate of return. Fair to perfect reliability for individual items was found, with substantial overall mean reliability.

Results. Of the 148 respondents, 98% were familiar with and 90% were involved in the MDS process. Of the 22 MDS sections, the most involvement was with Section G, which includes subsections for dressing, eating, personal hygiene, toilet use, bathing, functional range of motion, functional rehabilitation potential, and change in activities of daily living function. The types of involvement varied from writing directly on the MDS to verbal or written reports to others responsible for writing on the MDS. Fewer than half of respondents reported contributions to MDS sections dealing with cognition, psychosocial well-being, mood or behavior, communication, vision, and activity pursuit patterns. Although most respondents were familiar with the Functional Independence Measure, they were more likely to be involved in the MDS process.

Conclusion. Even though the MDS is a comprehensive assessment, most respondents contributed only to the self-care parts of the MDS, with patterns of involvement lacking standardization across facilities
An Electromyography Study of Wrist Extension Orthoses and Upper-Extremity Function
Authors: Bulthaup Sharon , Cipriani Daniel J. , Thomas Julie Jepsen
Published: April 2012

Objective. This study examined the effect of commonly used long and short styles of commercially produced wrist extension orthoses on the activity of the proximal muscles of the shoulder and elbow and on wrist flexor and extensor muscle activity.

Method. While 17 women between 22 and 40 years of age (M = 26.6) performed a specified movement wearing each of the two styles of orthosis and without an orthosis, their motor unit recruitment of five proximal joint muscle groups, wrist extensors, and wrist flexors was measured by surface electromyography.

Results. Motor unit recruitment was significantly greater in both orthosis conditions for four of five proximal muscles and for wrist flexors. There were no significant differences between the short and long orthosis conditions for proximal muscle groups.

Conclusion. Wearing a wrist extension orthosis appears to place additional stress on the proximal joint musculature beyond that found without splint use. The study has implications for the prescription of wrist extension orthoses, especially for patients whose proximal joints are already compromised.
Perceptions of Occupational Therapists Regarding Postprofessional Education
Authors: Dickerson Anne E. , Wittman Peggy Prince
Published: April 2012

Objective. The purpose of this study was to determine how occupational therapists perceive postprofessional education, specifically the reasons for pursuing or not pursuing graduate education, as well as to examine the factors that seem most important.

Method. Seven hundred and fifty members of the American Occupational Therapy Association who did not have advanced degrees were surveyed. Respondents were asked why they did or did not want to pursue postprofessional education and, for those respondents interested in graduate study, what factors were most important. The important factors were examined across the levels of age, years of experience, practice areas, and regions.

Results. Surveys were returned by 314 members (a response rate of 42%), with 22% indicating interest in postprofessional education and 78% indicating no interest. For reasons not to pursue postprofessional education, respondents indicated that they were not interested in returning to intensive coursework and that a higher degree would not help in the advancement of their career. The two major reasons for pursuing graduate education included personal development and to increase skills and knowledge. As age increased, interest in graduate school decreased; interest was highest in the 3–6 years of experience range. Practice-specific programs was the area of specialization most desired; other important factors were cost of program and clinical work emphasized.

Conclusion.Results suggested that a relatively low number of occupational therapists consider pursuing postprofessional education. Thus, if graduate education is essential for the advancement of the profession, emphasis must be on clarifying the need for and value of postprofessional education.