bluuebunny/crossref_metadata_2025 huggingface dataset:
Some Implications of a Science of Adaptive Responses
Authors: Kleinman Barbara L. , Bulkley Betty L.
Published: April 2012

The concept of occupational therapy as a “science of adaptive responses,” as proposed by King in her 1978 Eleanor Clarke Slagle Lecture, is explored and expanded on in this article. The authors postulate an adaptation continuum consisting of homeostatic reactions, adaptive responses, adaptive skills, and adaptive patterns—a continuum that places the adaptive response in a sequential and interdependent relationship to other human responses that serve an adaptive function. Assuming that authentic occupational therapy practice is “eliciting adaptive responses” (1), the authors use the continuum to delineate the domain of occupational therapy as compared to the primary concerns of other health disciplines and to indicate the nature of collaboration between them in areas that overlap. Finally, they draw attention to some of the issues and questions that emerge from the analysis.
Negotiating the Environment: Achieving Quality Care in a Time of Flux
Authors: Ostrow Patricia C. , Joe Barbara E.
Published: April 2012

Productivity and quality of care are two health care issues practicing occupational therapists face daily in their work environments. The challenge of increasing productivity without sacrificing quality and of documenting the achievement of these dual goals is posed in this month’s column by Patricia C. Ostrow and Barbara E. Joe. We are informed on how to acquire the skills needed to meet these challenges in negotiating the environments in which we work.
A Prevention and Early Intervention Mental Health Program for Disadvantaged Pre-school Children
Authors: George Nan M. , Braun Bonnie A. , Walker James M.
Published: April 2012

In this study, 155 disadvantaged pre-school children, ages 3 to 6, were screened for developmental delays using the Cooperative Preschool Inventory as the primary evaluation tool. Thirty-eight children participated in the experimental group and 20 children were designated the control group. Experimental group children received developmental therapy and their regular classroom experience. In addition, intervention was provided to parents and teachers in order to affect the child’s total environment more positively. The control group received only classroom experience. Sixty-five percent of the control group passed the Cooperative Preschool Inventory pre-test compared to 50 percent of the experimental group. On the Cooperative Preschool Inventory post-test, 100 percent of the experimental group passed, compared to only 85 percent of the control group. These results suggest that for disadvantaged children early intervention of developmental therapy and classroom experience help eliminate their developmental delays and provide them with age-appropriate developmental skills.
The Development of Prehension in Normal Infants
Authors: Hohlstein Rita R.
Published: April 2012

This study investigated the longitudinal development of prehension in 10 normal infants, 4 through 12 months of age. The infants’ spontaneous prehensile responses to 2.54-centimeter (1-inch) red cubes, 1.27-centimeter (½-inch) red cubes, raisins, and plastic keys on chains were filmed with a Kodak Super 8 movie camera, transferred to videotape in slow motion, and analyzed. The 2.54-centimeter (1-inch) red cube data were compared to data gathered by Henry Halverson, noted authority in the area of prehension. Infants in both studies followed the same trend in their acquisition of prehensile skills, but the infants in the current study used most grasps at slightly earlier ages. The size and shapes of the objects presented influenced, but did not dictate, the grasps used. All grasps used by infants fall into three developmental phases: 1. using whole hands in an unspecialized manner; 2. using parts of hands as some specialization begins to develop; and 3. using the pads of distal phalanges or the tips of fingers in a specialized manner. The infants responded to the 3 presentations of like objects with the same grasp only 34 percent of the time, yet they were 65 percent consistent in using the same phase of prehensile development for the 3 presentations. Implications of these findings for developmentally disabled infants are discussed.
Terminology Quandary in Education
Authors: Rogers Joan C.
Published: April 2012

Communication about issues related to occupational therapy educational programs has been handicapped by the lack of agreement about program definitions. A conceptual framework for describing educational programs is presented. Present problems in terminology are elucidated through application of this framework. A proposal is put forth for clarifying program terms, definitions, and classification.
A Model for Activity Intervention in Disaster-Stricken Communities
Authors: Rosenfeld Mark S.
Published: April 2012

Environmental disasters cause deaths, injuries, and destruction of familiar surroundings. Social networks and routines that structure daily life are often left in disarray. To surmount subsequent crises, survivors must master painful feelings, solve problems, and accomplish important tasks, even while they are confused, bereaved, and displaced. Otherwise, coping failure leads to a vicious spiral of loss of self-esteem, distrust of the environment, and abandonment of social roles. Both crisis intervention and disaster literature advocate concrete and practical treatment measures. Activity intervention can prevent and reverse the destructive downward spiral by facilitating victims’ most effective coping responses. This paper reviews the pertinent literature and sets forth a theoretical model for occupational therapy in post-disaster settings.
Visuospatial Deficits after Right Hemisphere Stroke
Authors: Kaplan Joni , Hier Daniel B.
Published: April 2012

The influence of visuospatial deficits on functional status after right hemisphere stroke was investigated in 34 patients. Correlation coefficients between visuospatial deficits and other factors—age, sex, vocabulary, educational level, hemiparesis, hemianopia, left-sided extinction, length of stay on a rehabilitation unit, and time lapse between onset of stroke and admission to the rehabilitation unit—were also computed. Little correlation was found between the severity of the hemiparesis and the severity of the visuospatial deficits, yet both motor and visuospatial deficits proved to be important predictors of functional status at the time of discharge from the stroke rehabilitation unit. We conclude that visuospatial deficits are an important independent factor governing functional outcome and should be given as much attention as hemiparesis during discharge and rehabilitation planning for the right hemisphere stroke patient.
A Synthesis of Occupational Behavior and Sensory Integration Concepts in Theory and Practice, Part 1. Theoretical Foundations
Authors: Mack Wendy , Lindquist Jerry Ernest , Parham L. Diane
Published: April 2012

This series of two articles presents a model of play development for use in pediatric occupational therapy. Proposing to unify the theoretical approaches of sensory integration and occupational behavior, the model uses play as the unifying link between these two apparently different approaches. This first article reviews the major concepts of sensory integration and occupational behavior, in addition to discussing the differences and similarities between the two. General systems concepts are used as a framework upon which a model of play development is constructed. Three hierarchical levels of play are described—sensorimotor, constructive, and social—with each broken down into several developmental steps.
Contributions to the Development of Psychoeducational Approaches to Mental Health Service
Authors: Lillie Maxine D. , Armstrong Hubert E.
Published: April 2012

The psychoeducational approach to psychiatric care is articulated, and the contributions of occupational therapists to this model in one day treatment program are described. An evaluation device (the Task Check List) developed by occupational therapists and used in psychoeducational treatment planning is presented; its use by occupational therapists and other staff is illustrated.
Performance of Normal Older Adults on Tests Designed to Measure Parietal Lobe Functions
Authors: Farver Phyllis Fleming , Farver Thomas B.
Published: April 2012

Symptoms referrable to the parietal lobes, such as difficulty with dressing, unilateral neglect, or manual apraxia, are a frequent rehabilitation problem among stroke patients. Occupational therapists need an evaluation tool for parietal lobe functions and performance expectations for adults 40 years and older. A battery of tests designed to measure functions of the parietal lobes was given to 68 normal adults from 40 to 88 years of age. The test battery included drawings, stick designs, finger identifications, right-left identifications, arithmetic, clock settings, map localizations, block constructions, visual organization tasks, and visual discrimination tasks. Statistical analysis of the data revealed significant age-related changes on the constructional tasks, finger identifications, clock settings, visual organization tasks, and visual discrimination tasks. No significant age effect was found on right-left identifications, map localizations, or arithmetic. Implications for the evaluation and treatment of older adults in occupational therapy are discussed.
A Data Base for Occupational Therapy: Documentation Through Research
Authors: Gillette Nedra P.
Published: April 2012

The expectations for accountability are very real in today’s health arena. The Association has many resources to assist the member in addressing this most important aspect of our practice. Nedra Gillette, M. Ed., OTR, FAOTA, Research Coordinator, AOTF, has developed this issue for presentation to you.
Adaptive Equipment Used in the Rehabilitation of Hip Arthroplasty Patients
Authors: Seeger Melinda S. , Fisher Linda A.
Published: April 2012

In this paper an occupational therapy program involved in the acute rehabilitation of patients with total hip replacement and total surface replacement is described. The goal of the program is to help patients achieve independence in activities of daily living by the conclusion of their 2week hospitalization, while complying with the physical limitations imposed by the surgical protocol. The program consists of instruction in the use of selected adaptive equipment, in activities of daily living, and in environmental modifications. The findings of a retrospective patient survey are included. Specifically, the majority of the patients surveyed were found to be independent in essential activities of daily living by the time they were discharged from the hospital, and that use of the adaptive equipment was very high.
Arthritis: Preferred Learning Methods Among Arizona Therapists
Authors: Wickersham Elizabeth A. , Fike M. Laurita , Rousseau Elaine , Boyer John T. , Meredith Keith E. , Clay Catherine A.
Published: April 2012

Arizona occupational and physical therapists were surveyed about their needs for education in arthritis. Responses to statements regarding attitudes, knowledge, willingness to learn, and preferred methods of learning were subjected to chi-square analysis. The results showed that a significant number of both occupational and physical therapists are deficient in knowledge about the disease and maintain negative attitudes about patients with rheumatoid arthritis. Both groups indicated a high interest in continuing education about arthritis. The preferred method of learning was self-study guides.
Correlation of the Bruininks-Oseretsky Test of Motor Proficiency with the Southern California Sensory Integration Tests
Authors: Ziviani Jenny , Poulsen Anne , O’Brien Andrea
Published: April 2012

Correlations between the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) and the Southern California Sensory Integration Tests (SCSIT) were studied by using test results obtained from a sample of 49 learning-disabled children. It was found that those SCSIT tests with a motor component correlated significantly with the BOTMP battery composite scores. The fine motor composite scores of the BOTMP reflected the greatest percentage of significant correlation with SCSIT tests. These results suggested that the BOTMP would be useful for screening children for referral to occupational therapy by educators. In addition, the high correlation of the BOTMP with the SCSIT motor tests indicated that the BOTMP may be appropriate for use in clinical research to evaluate the effectiveness of sensory integrative procedures in relation to motor function.
Sensory Integration Therapy: Affect or Effect
Authors: Ottenbacher Kenneth
Published: April 2012

The results of studies examining the effectiveness of sensory integration therapy were reviewed, using recently developed quantitative methods that treat the literature review process as a unique type of research. Forty-nine studies were located initially. Eight of these studies met the following criteria: (a) they investigated the effect of sensory integration therapy; (b) they included dependent measures of academic achievement, motor or reflex performance, and / or language function; (c) they included a comparison between at least two groups; and (d) they reported quantitative results of the effect of sensory integration therapy. The 8 studies contained a total of 47 statistical hypothesis tests that evaluated the effectiveness of sensory integration therapy. An analysis of these tests, using quantitative reviewing methods, revealed that subjects participating in sensory integration therapy performed significantly better than members in the control groups who did not receive sensory integration therapy.

The application of sensory integration therapy to various client populations is discussed in relation to the existing empirical support revealed in the studies reviewed. The advantages of quantitative reviewing procedures are discussed, and use of the procedures with the developing occupational therapy research literature is recommended.
The Sensory History of Developmentally Delayed Children With and Without Tactile Defensiveness
Authors: Larson Karen A.
Published: April 2012

This study investigated whether sensory history questionnaires differentiated between developmentally delayed children with and without tactile defensiveness and, in addition, which individual items were most discriminative. Interviews were conducted with 20 mothers of developmentally delayed children regarding their children’s past and present behavioral responses to tactile and other sensory stimuli. The group of mothers with tactually defensive children reported a significantly greater number of positive responses to items previously determined to be indicative of tactile defensiveness than did the mothers of children without tactile defensiveness. An individual item analysis identified 11 items as discriminating most clearly between a group of children with tactile defensiveness and a group without tactile defensiveness. Some preliminary behavioral trends and implications for the use of sensory history questionnaires in parent counseling and in planning appropriate treatment programs are presented.
The Effect of Two Body Positions on Head Righting in Severely Disabled Individuals with Cerebral Palsy
Authors: O’Brien Maureen , Tsurumi Kathleen
Published: April 2012

This study examines the association between head righting and two commonly used therapeutic positions: semiprone on an inclined prone positioner and upright short-sitting in an adapted wheelchair. The subjects were 26 individuals with cerebral palsy and multiple handicaps who had difficulty maintaining active head control in a vertical orientation. Such head control is necessary for attending to learning tasks in the classroom and activities of daily living in the clinic. The frequency and duration of head righting during a feeding task was measured by means of a mercury switch system mounted on a headband and attached to an electromechanical digit counter and a clock. Measurements of duration and frequency beyond the predetermined range of functional head righting plus measurements on five control variables were analyzed by four statistical methods: t -test on the means, simple correlation, cannonical correlation, and regression analysis. The control variables were age, mobility level, degree of hypertonicity, level of seizure activity, and level of reflex maturity. Results indicate that, in this severely handicapped population, head righting while in the adapted wheelchair is no different from head righting while in the semiprone position. One control variable, level of independent mobility, was positively correlated with the length of time that subjects were able to maintain head righting in the semiprone position.
Decreasing Drooling through Techniques to Facilitate Mouth Closure
Authors: Ray Sharon A. , Bundy Anita C. , Nelson David L.
Published: April 2012

A single case ABA experimental design is presented in which techniques to facilitate mouth closure were hypothesized to decrease drooling. The subject was an 11-year-old male with mental retardation and cerebral palsy. Baseline 1 consisted of 10 half-hour sessions of play, followed by 1-hour periods during which the amount of saliva collected on an absorbent bib was measured and recorded. The subsequent treatment phase of 4 weeks was identical to the baseline except that a half-hour period of intervention was substituted for the half-hour of play. Intervention involved providing jaw control with intermittent tapping and jiggling, stroking the upper gum, and giving juice with jaw control. Baseline 2 consisted of 10 sessions identical to baseline 1. Results indicate that the amount of saliva leaving the mouth was a function of the presence or absence of intervention.
Interface Modalities of Technical Aids Used by People with Disability
Authors: Levy Ron
Published: April 2012

The objective of this paper was to present some initial thoughts and concepts on the subject of the interface “mechanisms” used between individuals with disability and their technical aids. These interface modalities are considered to be of primary importance in matching adaptive aids to the needs of these individuals. With this in mind, a number of basic premises concerning technical aids, user needs, and user environments are discussed. In addition, an initial framework is presented that describes a series of different levels of interface types. It is hoped that this framework will promote a greater insight into the inherent complexity of interface modalities and thereby stimulate further study.
Vestibular-Proprioceptive Functions in 4 Year Olds: Normative and Regression Analyses
Authors: Short Margaret A. , Watson P. J. , Ottenbacher Kenneth , Rogers Charlotte
Published: April 2012

Normative data were obtained for 156 pre-school children’s performances on measures of muscle tone, muscle co-contraction, standing balance, prone extension posture, flexion supine posture, asymmetrical tonic neck reflex, and postrotary nystagmus. Regression analysis indicated that these combined variables accounted for only 13.5 percent of the variance of postrotary nystagmus of 145 four year olds. However, if the data are examined only for children exhibiting nystagmus that is lower than 1 standard deviation below the mean, then these variables account for 50 percent of the variance of nystagmus. Prone extension posture, standing balance-eyes closed, and muscle tone account for 37 percent of the variance within this low-nystagmus population. These results are considered in light of the author’s previous studies demonstrating that, in learning-disabled children, vestibular-proprioceptive measures can be used clinically to predict which children will respond to sensory integration therapy with changes in postrotary nystagmus. These changes, according to sensory integration theory, reflect positive responses to therapy.
Respite Care for Community Elderly
Authors: Hasselkus Betty Risteen , Brown Margaret
Published: April 2012

Care of an elderly disabled relative is a responsibility that many families cannot bear on a continuous long-term basis. In this paper, the development of a respite care program is described that provides caregiver relief by offering short-term hospitalization for the elderly in the community. Associated therapeutic programming is discussed, including a pre-admission functional assessment and facilitation of normal, meaningful activity and functional skills during hospitalization. Descriptive data are provided to help define the functional status of elderly persons who request periodic respites. Respite care is a new health care option that may enable an older person to remain in the community and preclude the need for institutionalization.
Student Anxiety Toward Level II Fieldwork
Authors: Greenstein Lillian R.
Published: April 2012

The State-Trait Anxiety Inventory (STAI) purports to measure two types of anxiety: state anxiety, fluctuating and transitory; and trait anxiety, a relatively stable proneness to apprehension. As part of a battery of measures comparing a new occupational therapy curriculum with an old curriculum being discontinued, the STAI was administered to separate groups of students from each curriculum completing their programs concurrently. The primary purpose of the anxiety study was to test the hypothesis that students with an early introduction to Level I fieldwork (the new curriculum) would have significantly less state anxiety in anticipation of Level II fieldwork than students with a later introduction to Level I fieldwork (the old curriculum). Statistical analysis failed to support the hypothesis. Also discussed are: the significant reduction in anticipated anxiety when students report for fieldwork, and the validity and reliability of the STAI.
The Effect of Wrist Immobilization on Performance of the Jebsen Hand Function Test
Authors: Carlson Joan D. , Trombly Catherine Anne
Published: April 2012

Eighteen normal subjects participated in a study designed to monitor the effect of wrist motion on the time required to complete manual tasks from the Jebsen Hand Function Test. Activities were performed with the wrist free and with the wrist immobilized by a commercially available splint. The results showed a statistically significant increase in time to do the tasks during immobilization when compared to the free condition. There was great variation in patterns of motion between individuals. Treatment implications include individual consideration of position of wrist immobilization for splinting, proper length and fit of splint designed to immobilize, and the importance of practice in tasks following loss of wrist motion.
Development of a Hand Sensitivity Test for the Hypersensitive Hand
Authors: Yerxa Elizabeth J. , Barber Lois M. , Diaz Olivia , Black Wendy , Azen Stanley P.
Published: April 2012

An instrument was developed to measure the effects of a desensitization program on hand hypersensitivity. It was standardized with 40 “normal” subjects ages 20 to 40 of both sexes and two ethnic groups. Results showed reliability coefficients ranging from .74 to .82 for the three modalities employed in the test. Analyses of variance of agreement between test and retest scores revealed no significant differences in reliability due to hand used, sex, or ethnicity. It was concluded that the instrument could be used as both a clinical and research tool for the measurement of hand sensitivity.
The Treatment of the Hospice Patient: From Occupational History to Occupational Role
Authors: Tigges Kent Nelson , Sherman Lawrence Mark
Published: April 2012

The nature of hospice care, particularly from the point of view of the occupational therapist, is presented in respect to the treatment of a 26-year-old patient. This case study demonstrates the role of the occupational therapist in helping a patient deal with his feelings of isolation, in helping him cope with severe physical limitations to maintain a maximum level of independence, and in helping him to deal with relationships with his fiance, family, and friends. The reader is given a sense of the quality of communication between therapist and patient. Finally, a view of what the therapist can expect realistically when offering hospice care is considered.
Micro-Costing Analysis: A Measure of Accountability
Authors: Mansfield Margo
Published: April 2012

A description of a micro-costing analysis conducted by the Psychiatric Occupational Therapy Department at Rush-Presbyterian St. Luke’s Medical Center is reported. Analysis enabled a department manager to establish cost estimates for the services provided by the department. Included are data reflective of both costs and overhead. The analysis generates information concerning the relative amount of labor used, projected annual volumes, costs for direct and indirect labor, overtime, direct and indirect supplies, allocated cost, and cost for each identified evaluation and/or treatment. Access to cost information enables the department manager to realistically establish charges and to assess efficient use of personnel and supplies. The micro-costing analysis provides a vehicle to communicate departmental needs to the hospital administration based upon documented use of resources, and justified by a thorough cost breakdown.
Immediate Effects of Positioning Devices on the Normal and Spastic Hand Measured by Electromyography
Authors: Mathiowetz Virgil , Bolding Deborah J. , Trombly Catherine A.
Published: April 2012

There is a continuing controversy in the literature and in clinical practice about whether positioning devices are effective in decreasing spasticity and, if so, which type is most effective. In this study, the immediate effects of a volar resting splint, a finger spreader, a firm cone, and no device were compared on eight normal and four hemiplegic subjects. Electromyography (EMG) was used to measure flexor muscle activity of the tested forearm while the subjects squeezed a grasp meter with the contralateral hand and during the following relaxation period. Results showed significantly greater EMG activity for the finger spreader compared to no device in the flexor carpi radialis of normal subjects during the grasping period. Hemiplegic subjects did not show significantly less EMG activity when using positioning devices compared to no device. In fact, the volar splint appeared to increase the EMG activity while the subjects were grasping.
Postrotary Nystagmus Response in Children with Down’s Syndrome
Authors: Ling-Fong Zee-Chen Eunice , Hardman Michael L.
Published: April 2012

The purpose of this study was to investigate the nystagmus response in school-age children with Down’s syndrome. The 35 subjects were between 5 and 9 years of age and were enrolled in public school programs for the educable and trainable mentally retarded in the northern metropolitan areas of Utah. The Southern California Postrotary Nystagmus Test (SCPNT) was administered with slightly modified verbal instructions. Durations of nystagmus for the subjects with Down’s syndrome were compared with Ayres’ normative data from the SCPNT using a t-test for two independent means. Results indicated there was a significant reduction in the duration of nystagmus in the children with Down’s syndrome when compared to Ayres’ sample of normal children; however, there was no significant difference between males and females with Down’s syndrome in duration of postrotary nystagmus.
A Comparison of Play Behavior in Nonhospitalized and Hospitalized Children
Authors: Kielhofner Gary , Barris Roann , Bauer David , Shoestock Barbara , Walker Leslie
Published: April 2012

Because play is extremely sensitive to environmental conditions, extended hospitalization may have adverse effects on normal play development in young children. This study compared the playfulness, as well as the level of play development, of three 2-year-old children who had been hospitalized most of their lives for tracheostomies, and three 2-year-olds living at home. Data on the children’s play were gathered by videotaping in two standardized play settings and one free play setting. Statistically significant differences in the developmental level of play and in playfulness (i.e., the degree of liveliness and joy exhibited) were found between the two groups in all three settings, and the play age of all six children varied by setting. Quantitative data analysis was supported by qualitative findings.

Although the differences between the groups cannot be conclusively attributed to hospitalization alone, certain features of the hospital environment appear to have hampered the development of play.
Performance of Schizophrenic Patients on a Motor-Free Visual Perception Test
Authors: Eimon Marilyn C. , Eimon Perry L. , Cermak Sharon A.
Published: April 2012

The Motor-Free Visual Perception Test (MVPT) was administered to 15 chronic schizophrenic patients and 15 normal controls, ages 40 to 60, to see whether, perceptual deficits would be found on nonmotor tasks. Groups significantly affected performance on the MVPT, as did occupational status. In the schizophrenic group only, efficiency of intellectual functioning was positively related to how well they performed on the MVPT. Age, educational level, and IQ had no significant impact on functioning on this test in either group. The schizophrenic patients made more errors on the more complex operations of the MVPT, and the only significant group differences in percentage of subjects’ own errors was in figure-ground. The MVPT may be useful in screening for visual-perceptual deficits in adult schizophrenic patients.
The Miller Assessment for Preschoolers (MAP): An Introduction and Review
Authors: Banus Barbara J.
Published: April 2012

With the implementation of Public Law 94-142, the Education for All Handicapped Children Act, early childhood screening responsibilities intensified for occupational therapists. Frustrations caused by the absence of adequate testing tools increased proportionately. Lucy Jane Miller began working in 1971 on a new standardized test to predict school-related problems and published the Miller Assessment for Preschoolers (MAP) in 1982. Because the MAP is a new addition to the field of preschool testing, this review will introduce the MAP to occupational therapists and give a general overview and critique of its administration, scoring, and standardization procedures. The MAP has potential for becoming a major screening test for preschool children if it does predict school-related problems.
The Development of an Occupational Therapy Interview/Therapy Set Procedure
Authors: Peloquin Suzanne M.
Published: April 2012

Emphasis on returning patients quickly to the community requires staff in acute psychiatric settings to maximize therapeutic efforts within limited time frames. To satisfy standards for practice, therapists must constantly apply time management techniques to their therapeutic endeavors. Despite patient stays as brief as 10 days, practitioners continue to evaluate, treat, and plan for the discharge of each patient referred to their service. This led to a reassessment and restructuring of the initial occupational therapy interview in one psychiatric setting. The objectives of the interview, with particular emphasis on therapy set, are reviewed. These objectives were incorporated into a three-part procedure of interview/therapy set. The forms that structure the procedure are discussed as adaptable tools for use in similar settings.
Differentiation of Praxis among Children
Authors: Conrad Karen E. , Cermak Sharon A. , Drake Charles
Published: April 2012

This study was designed to evaluate the conceptual model proposed by Luria to identify different types of dyspraxia in learning-disabled (LD) children. The types of apraxia investigated were kinesthetic, optic-spatial, symbolic, and dynamic. In addition, the study explored differential performance on tasks of praxis in learning-disabled children as a function of their Wechsler Intelligence Scale for Children-Revised (WISC-R) IQ patterns. The subjects included 41 LD and 17 normal children ages 108 months to 153 months. They were administered The Praxis Test for Children, a compilation based on Luria’s division of types of praxis with brain-damaged adults. Results indicated that the test differentiated between the LD and normal groups on the dynamic and optic-spatial tests. Data analyzed for the LD children with a significant WISC-R discrepancy between their Verbal IQ and Performance IQ profile yielded no difference between these two IQ groups. Results were discussed in terms of the need to investigate individual patterns of performance in the differentiation of dyspraxia.
Possible Pubertal Effect on Therapeutic Gains in an Autistic Girl
Authors: Ayres A. Jean , Mailloux Zoe K.
Published: April 2012

A deaf, partially sighted, severely retarded autistic girl, 11 years, 6 months of age, received approximately 2 years of occupational therapy, where sensory integration procedures were employed to reduce self-stimulation. Videotaped time samples of the amount of stereotypies showed a consistent reduction from the time of starting therapy to an interruption for vacation and surgery for scoliosis 46 weeks later. On returning to therapy after a 9-week break, self-stimulation had greatly increased and did not return to the presurgery level during an additional 55 weeks of therapy, 30 of which followed the removal of a cast. Menarche occurred 1 week after removing the cast. Increased self-stimulation is linked to reduced inclination toward environmental interaction as well as to an interruption of intervention and possible pubertal effect. Brief reports on four other autistic adolescents who received similar therapy are consistent with the conjecture of frequent pubertal regression.
Eleanor Clarke Slagle Lectureship—1983; Clinical Reasoning: The Ethics, Science, and Art
Authors: Rogers Joan C.
Published: April 2012

As I join the roster of Eleanor Clarke Slagle lecturers, I am keenly aware of the privilege and responsibility of being so honored by my professional colleagues. Since my selection for the award was based on a recognition of a synthesis of skills in occupational therapy practice, education, and research, it seemed fitting for me to pursue a topic that would in some way enable me to reflect this synthesis. Thus, in developing the theme of clinical reasoning, I have taken a practice issue, studied it from an educational perspective, and formulated a conceptual framework for guiding the development of a clinical science of occupational therapy.
Crossing the Body Midline in Learning-Disabled and Normal Children
Authors: Cermak Sharon A. , Ayres A. Jean
Published: April 2012

The SVCU scores of 179 learning-disabled children, ages 5 to 8, were compared with the scores of 120 normal children, using both the actual Space Visualization Contralateral Use (SVCU) score, and the SVCU category of “normal, suspect, or possible deficit,” in order to evaluate whether using guidelines to interpret the SVCU as a function of age enabled differentiation between normal children and children with learning disabilities. The SVCU measure clearly differentiated between groups at the younger ages, although the difference was not as clear for the older age groups. It was suggested that the SVCU score be used in conjunction with other observations of midline crossing. Alternative interpretations of the SVCU score are discussed.
Telephone Call Aid for Problems of Visual Sequencing
Authors: Ores Louise , Parent Lillian Hoyle
Published: April 2012

People with problems of visual sequencing and impaired immediate memory have difficulty placing telephone calls independently. A Call Aid, created from an inexpensive spiral-bound pad of 3 x 5 inch cards, enabled people with visual sequencing problems to make a telephone call independently. In a pre-test, post-test study, nine of ten trainable mentally handicapped adolescents, IQ range 40-55, were able to dial successfully immediately after training and 1 week later. Construction of the Call Aid is described.
Chewing Cycles in 4- and 5-Year-Old Down’s Syndrome Children: A Comparison of Eating Efficacy with Normals
Authors: Gisel Erika G. , Lange Loren J. , Niman Carol W.
Published: April 2012

Chewing movements of Down’s syndrome children were measured and compared with those of normal preschool children. Twenty-six Down’s syndrome children were monitored: 14 were 4 (8 males, 6 females) and 12 were 5 years old (6 males, 6 females).

Chewing movements were measured by time (in seconds), number of cycles, and a time/cycle ratio. A chewing cycle was defined as an upward and downward movement of the chin. The time/cycle ratio is the total time, from the moment food was placed in the mouth until the final swallow occurred, divided by the number of cycles counted for the same period.

The childrens’ ages and gender did not affect time, cycles, or the time/cycle ratio. However, the measures were strongly affected by the type of food eaten.

Children with Down’s syndrome chew at a rate comparable to that of normal children. However, the duration of chewing is significantly prolonged per bite of food. This may be attributed to these childrens’ lack of chewing vigor or their inability, at the ages studied, to chew solid foods. Time/cycle ratios are an excellent index to document such differences. How much sensory differences or deficits contribute to these findings is not known.
An Independent Living Skills Training Program
Authors: Neistadt Maureen E. , Marques Kim
Published: April 2012

The growing rehabilitation and consumer movement toward independent community living for disabled adults has placed new demands on the health care delivery system. Programs must be developed for the disabled adult that provide direct training in adaptive community skills, such as banking, budgeting, consumer advocacy, personal health care, and attendant management. An Independent Living Skills Training Program that uses a psychoeducational model is described. To date, 17 multiply handicapped adults, whose average length of institutionalization was 11.9 years, have participated in the program. Of these 17, 58.8% returned to community living and 23.5% are waiting for openings in accessible housing units.
Motivation as a Factor of Perceived Exertion in Purposeful versus Nonpurposeful Activity
Authors: Kircher Marjorie A.
Published: April 2012

Perceived exertion during the performance of purposeful and nonpurposeful activity was studied in 26 women. The subjects acted as their own controls in the performance of both kinds of exercise. The two exercises were jumping rope, defined as a purposeful activity, and jumping in place without a rope, defined as a nonpurposeful activity. In each activity the subjects exercised to reach the subjective point of “very hard work” on the Borg Scale of Perceived Exertion. Duration and cessation of exercise were entirely controlled by the performers. Heart rate responses during and immediately after cessation of exercise, measured by electrocardiographic telemetry, and duration of exercise in seconds were compared for the two types of exercise. Results showed that heart rate increase at a given rate of perceived exertion was significantly higher (.001) for jumping rope. This raises the possibility that workload was inadvertently perceived by the performers to be greater in nonpurposeful activity and provides support for the hypothesis that purposeful activity serves as an intrinsic motivator to the performer.
Standardization of the Prone Extension Postural Test on Children Ages 4 Through 8
Authors: Gregory-Flock Janice L. , Yerxa Elizabeth J.
Published: April 2012

The prone extension postural test is a measurement of vestibular functioning that has been used by occupational therapists in assessing children suspected of having vestibular system deficits. The purpose of this study was to standardize the prone extension postural test because no standardized procedures or normative data were previously available for its administration.

Reliability and validity were estimated and normative data gathered on 242 normal children ranging in age from 4 through 8 years. Performance involving duration and score on a qualitative scale was recorded. Four and 5 year olds performed similarly and statistically, and significantly differently from 6, 7, and 8 year olds. When a small group of learning-disabled children was compared to a nondisabled group, the prone extension postural test differentiated between the two groups with the exception of the 4 year olds.
The Golgi Tendon Organ: A Review and Update
Authors: Moore Josephine C.
Published: April 2012

This article presents current information concerning (a) the structural relationships of the Golgi tendon organ (GTO) with different types of extrafusal muscle fibers; (b) the Gp.Ib reafferent or feedback fibers from the GTO; (c) the way in which these proprioceptors monitor muscle tension and function in parallel processing with other receptors and with the central control mechanisms of the nervous system; and (d) how GTO’s are involved in regulating autogenic excitation, autogenic inhibition, or co-contraction of extrafusal muscle fibers.
The Liberal Arts Connection
Authors: Pierce Edward R.
Published: April 2012

The study of liberal arts has, from the beginning of higher education in this country, prepared professionals for their practice. Liberal arts studies are essential for defining a career, making a career choice, and developing career skills. Also, liberal arts studies are necessary for occupational therapists to make the appropriate interconnections needed to develop a perspective that allows the therapist to be professionally competent. This perspective equips the therapist with the ability to move appropriately from the individual self-interest level to the occupational therapy community self-welfare level of functioning and behavior. The author believes that the conjoining of occupational theory, occupational practice, and liberal arts studies will ensure continued survival and viability of occupational therapy by preparing future responsive educated practitioners.
Reimbursement for Psychiatric Occupational Therapy Services
Authors: Peters Mary E.
Published: April 2012

It is increasingly important for mental health occupational therapists to monitor trends in reimbursement for mental health care in order to ensure adequate and equitable coverage of occupational therapy services. Federal and state funds for treatment of mental illness are being divided among an increasing number of mental health professionals. Private insurers are limiting direct coverage to those services that can supply cost and utilization information. This paper reviews present coverage for occupational therapy in mental health programs. Collection of efficacy and cost benefit data, establishment of separate billing procedures, and participation in the formation of public policies for treatment of the mentally ill should be primary activities pursued by occupational therapists to expand coverage of occupational therapy services in psychiatric settings.
Payment of Occupational Therapy by Legislative Mandate
Authors: Herden Irene L.
Published: April 2012

This article reviews the process that the Council on Government Affairs of the Connecticut Occupational Therapy Association undertook from 1979 to 1982 to obtain payment mandated by legislation for occupational therapy. The process included learning the Connecticut legislative system, marketing occupational therapy as a profession in the health arena, and coordinating, planning, and communicating all phases of activity to reach a final objective of mandated payment.
Defining a Child’s Zone of Proximal Development: Evaluation Process for Treatment Planning
Authors: Lyons Barbara Greenberg
Published: April 2012

Therapists who evaluate children in school settings often find that information provided by standardized tests is insufficient for effective treatment planning. Vygotsky’s concept of defining a child’s zone of proximal development is introduced to help therapists gain insight into why a child experiences task failure and assistance that can facilitate the child’s task success. This evaluation process and treatment planning framework may be used by both school and clinic-based therapists to differentiate children who should receive direct occupational therapy services from those who can benefit from indirect service.
A Review of Therapeutic Intervention Research on Gross and Fine Motor Progress in Young Children with Cerebral Palsy
Authors: Parette Howard P. , Hourcade Jack J.
Published: April 2012

Recently, perhaps due to increased societal demands for accountability, early intervention programming for handicapped infants and young children has been questioned. Therapeutic intervention provided through occupational and/or physical therapy has been increasingly implemented in habilitation settings for children diagnosed as having cerebral palsy, although research justifying this increase is inconclusive. This review presents a comprehensive evaluation of 18 studies that evaluated early occupational and/or physical therapy intervention for children with cerebral palsy. An analysis of these studies revealed that as research paradigms become more rigorous, support for therapeutic intervention effectiveness decreases. This finding was explained in light of the currently inadequate levels of technology relating to instrumentation and the manipulation of the many variables that have been suggested to affect therapeutic intervention effectiveness.
The Use of Aquatics with Cerebral Palsied Adolescents
Authors: Peganoff Shirley A.
Published: April 2012

This article demonstrates the use of adaptive aquatics in an occupational therapy treatment program for a physically disabled adolescent. Included are developmental issues as they relate to the handicapped adolescent population, the concept of purposeful activity in occupational therapy, the choice of swimming as an activity for treatment, activity analysis for treatment planning, and an interdisciplinary approach to treatment. A single case study was used to exemplify the use of swimming as a purposeful activity. Therapeutic implications of the program are discussed.
Occupational Therapists: Personality and Job Performance
Authors: Peacock A. C. , O’Shea B.
Published: April 2012

This study was conducted to determine the personality structure of a group of occupational therapists and to examine the relationship between specific personality variables and job performance of practicing occupational therapists. The results indicated that occupational therapists as a group are not distinguishable from people in general, in terms of personality; however, a number of personality variables were significantly related to job performance. Implications for both the field of occupational therapy and for the selection of students are discussed.
Denial: Implications of a Pilot Study on Activity Level Related to Sexual Competence in Burned Adults
Authors: Cooper-Fraps Cynthia , Yerxa Elizabeth J.
Published: April 2012

The purpose of this pilot study was to explore the effect of disfigurement on sexual competence and the relationship between self-reported activity level and sexual competence in burn-disfigured adults. Because of a small sample size and methodological limitations, findings were intended to be informative for planning further research rather than definitive. Results showed a strong positive correlation between activity level and sexual competence. Additional findings showed surprisingly high activity levels reported by subjects who were greatly disfigured. It was speculated that denial may have affected the results of this study. Based on this, the clinical implications of denial were explored, and suggestions for future research were generated.