bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensory Modulation and Affective Disorders in Children and Adolescents With Asperger’s Disorder
Authors: Pfeiffer Beth , Kinnealey Moya , Reed Carol , Herzberg Georgiana
Published: October 2011

OBJECTIVE. The purpose of the study was to determine if there were significant relationships between dysfunction in sensory modulation, symptoms of affective disorders, and adaptive behaviors in children and adolescents with Asperger’s disorder between 6 and 17 years of age.

METHOD. Parents of 50 children and adolescents between 6 and 17 years of age diagnosed with Asperger’s disorder based on the Diagnostic and Statistical Manual of Mental Disorders-IV criteria completed the (a) Sensory Profile for children 6 to 10 years of age or the Adolescent/Adult Sensory Profile for adolescents 11 to 17 years of age; (b) the Adaptive Behavior Assessment System: Parent Version; (c) Revised Children’s Manifest Anxiety Scale Adapted Parent’s Version; and (d) the Children’s Depression Inventory Adapted Parent’s Version. Descriptive statistics and the Pearson product-moment coefficient of correlation calculations were used for data analysis.

RESULTS. The results indicated that there were significantly strong positive correlations between sensory defensiveness and anxiety (r = .476, p = .000) in children and adolescents with Asperger’s disorder. There were also significant relationships between symptoms of depression and hyposensitivity in the total group (r = .214, p = .05) and the older group (r = .492, p = .027). There were no significant relationships between depression and overall adaptive behavior (r = –.243, p = .089) or anxiety and overall adaptive behavior (r = –.108, p = .455). Significantly strong inverse relationships were found between the specific adaptive behaviors of functional academics, leisure, social skills, and symptoms of depression. Functional academics were also significantly inversely related to anxiety. Specifically, sensory hyper- and hypersensitivity were significantly inversely related to community use and social skills.

CONCLUSION. The data supports positive relationships between anxiety and sensory defensiveness in all age ranges and a relationship between depression and hyposensitivity in older children. Stronger inverse relationships were apparent between specific adaptive behaviors including: (a) symptoms of depression and functional academics, leisure, social skills; (b) anxiety and functional academics; and (c) both sensory hyper- and hyposensitivity and community use and social skills. In this study, as the symptoms of affective disorders increased in children and adolescents with Asperger’s disorder, the functional performance in the adaptive behaviors of functional academics and social skills appeared to decrease. Performance in the adaptive behaviors of community use and socials skills appeared to decrease as symptoms of dysfunction in sensory modulation increase. Further research is necessary to determine the impact of treatment for dysfunction on sensory modulation on affective disorders and performance in specific adaptive behaviors.
Daily Occupations and Well-Being in Women With Limited Cutaneous Systemic Sclerosis
Authors: Sandqvist Gunnel , Åkesson Anita , Eklund Mona
Published: October 2011

OBJECTIVE. This study investigated occupational performance, well-being (operationalized as general life satisfaction, domain-specific life satisfaction, and self-rated health), and perceived symptoms in women with limited scleroderma and healthy controls.

METHODS. Interview-based and self-administered questionnaires were used with 36 women with limited scleroderma and 40 healthy women.

RESULTS. In the scleroderma group, most of occupation problems were perceived in work and household chores. The women with scleroderma were mainly satisfied with self-care and least satisfied with household chores. Regarding domain-specific life satisfaction, the women were least satisfied with physical health and leisure. General life satisfaction showed the strongest relations to performance of self-defined occupations and satisfaction with leisure, whereas the strongest association with self-rated health was found for satisfaction with work. Fatigue was perceived as a dominant problem and was significantly associated with well-being. Furthermore, the women with scleroderma felt lower satisfaction with daily occupations and well-being than the healthy women.

CONCLUSION. Loss of occupations, low satisfaction with leisure, perceived fatigue, shortness of breath, and pain indicated poorer well-being in women with scleroderma and need to be focused on in occupational therapy interventions.
Effects of Sensory Integration Intervention on Self-Stimulating and Self-Injurious Behaviors
Authors: Smith Sinclair A. , Press Bracha , Koenig Kristie P. , Kinnealey Moya
Published: October 2011

This study compared the effects of occupational therapy, using a sensory integration (SI) approach and a control intervention of tabletop activities, on the frequency of self-stimulating behaviors in seven children 8–19 years of age with pervasive developmental delay and mental retardation. Daily 15-min videotape segments of the subjects were recorded before, immediately after, and 1 hour after either SI or control interventions performed during alternating weeks for 4 weeks. Each 15-min video segment was evaluated by investigators to determine the frequency of self-stimulating behaviors. The results indicate that self-stimulating behaviors were significantly reduced by 11% one hour after SI intervention in comparison with the tabletop activity intervention (p = 0.02). There was no change immediately following SI or tabletop interventions. Daily ratings of self-stimulating behavior frequency by classroom teachers using a 5-point scale correlated significantly with the frequency counts taken by the investigators (r = 0.32, p < 0.001). These results suggest that the sensory integration approach is effective in reducing self-stimulating behaviors, which interfere with the ability to participate in more functional activities.
Resident and Staff Perceptions of Barriers to Independence and Employment in Supportive Living Settings for Persons With AIDS
Authors: Paul-Ward Amy , Kielhofner Gary , Braveman Brent , Levin Mara
Published: October 2011

The purpose of this study was to identify perceived barriers to independent community living and employment among clients and staff members in a transitional living facility for persons with AIDS. This qualitative study used focus groups to collect these perceptions from staff members (N = 21) and clients (N = 16). Whereas staff identified both systemic and personal barriers, clients only identified systemic barriers. These findings suggest that both clients and staff recognize the types of environmental barriers to participation that have been identified by disability scholars. The findings also underscore a consequential gap between clients’ exclusive emphasis on environmental barriers and staff emphasis on clients’ personal barriers that impact upon participation.
Embracing Our Ethos, Reclaiming Our Heart
Authors: Peloquin Suzanne M.
Published: October 2011

A profession’s ethos is an interlacing of sentiment, value, and thought that describes its character, conveys its genius, and manifests its spirit. The ethos endures over time, serving as touchstone against which individuals may strike their actions to know their worth. As a profession’s inner voice, the ethos inspires individuals and calls them back if they stray too far.

This discussion of the occupational therapy profession’s ethos has two discernable parts. The first invites deliberation, given its historical ground. The second is a blend of ideas and images, a clutch of reflections inviting affect and will to join in thought. My hope is to illuminate the ethos of the profession in such a way that a new perspective on current challenges is possible. I set before you this idea: To advance into the future with the ethos that has characterized occupational therapy since its inception is a reclamation of the profession’s heart.
The Meaning of Work After Acquired Brain Injury
Authors: Johansson Ulla , Tham Kerstin
Published: October 2011

PURPOSE. Research in the field of brain injury rehabilitation has tended to regard return to work as a measure of outcome. Researchers have not paid particular attention to the experiences of people living with a brain injury. The aim of the phenomenological study reported here was to identify and describe what characterizes the meaning of work to those with acquired brain injury.

METHODS. Ten participants of working age were interviewed about the meaning of work 1–5 years after being inflicted with a brain injury. Data were analyzed and interpreted using the Empirical Phenomenological Psychological method.

RESULTS. The findings revealed a meaning structure consisting of four main characteristics. Work was no longer experienced as the primary event in life and the social dimension had become more important. The perceived competence and work identity were threatened after the injury. A common theme across all interviews was the struggle to return to a state of normality, and working was considered to be evidence of success.

CONCLUSION. The findings described the altered meaning of work 1–5 years after brain injury. This knowledge should lead to an increased understanding among occupational therapists engaged in work rehabilitation after brain injury and can serve as a basis for individualized intervention strategies.
Discrepancy Between Older Clients’ Ability To Read and Comprehend and the Reading Level of Written Educational Materials Used by Occupational Therapists
Authors: Griffin Janelle , McKenna Kryss , Tooth Leigh
Published: October 2011

OBJECTIVE. The match between the reading level of occupational therapy education materials and older clients’ reading ability and comprehension was determined. The sociodemographic and literacy characteristics that influenced clients’ reading ability and comprehension were investigated.

METHOD. The reading level of 110 written education materials (handouts, brochures, and information leaflets), distributed to older clients (65 years of age and older) by occupational therapists working in Queensland hospitals, was analyzed using the Flesch formula. The reading ability of 214 older persons (mean age 77 years, 63% female) was assessed using the Rapid Estimate of Adult Literacy in Medicine. Participants’ comprehension of information of increasing reading difficulty was measured using the Cloze procedure.

RESULTS. The written materials required a mean reading level between the ninth and tenth grades. Participants’ mean reading ability was seventh to eighth grade. Therefore some materials may have been too difficult for participants to read and understand. Participants with a managerial or professional or clerical background (p = 0.001) and those who perceived they read well (p = 0.001) had a significantly higher reading ability. Older age was significantly related to poorer comprehension (p = 0.018), with participants 75 years of age and over having a mean comprehension score of 25.6 compared to 30.3 for those 65 to 74 years of age.

CONCLUSION. Occupational therapists must analyze the reading level of the written education materials they develop for and use with clients by applying readability formulas. There should be a match between the reading level of written materials and clients’ reading ability. Clients’ reading ability may be assessed informally by discussing years of education and literacy habits or formally using reading assessments. Content and design characteristics should be considered when developing written education materials for clients.
Community Participation Following Cerebrovascular Accident: Impact of the Buffering Model of Social Support
Authors: Beckley Margaret Newsham
Published: October 2011

This study examined data of older adults who had sustained a stroke and their ability to participate in the community following rehabilitation. There were 95 participants in this study to determine the interaction effect of functional limitation and social support on community participation. The findings indicate that for people who had sustained a cerebrovascular accident, community participation was more related to their ability to do for themselves, rather than the support that was available to them. The implications of these findings for future practice, programs, and research are discussed.
Coping During Inpatient Stroke Rehabilitation: An Exploratory Study
Authors: Gillen Glen
Published: October 2011

The emotional impact of surviving a stroke has not received the same attention as physical aspects. This is particularly true regarding how stroke survivors cope during inpatient rehabilitation. This study examined the coping strategies used by stroke survivors undergoing inpatient rehabilitation and the relationships between demographic or clinical variables and coping behaviors. This case series examined 16 acute stroke survivors via standardized assessments and a medical records review completed during the first week of inpatient rehabilitation.

Stroke survivors used combinations of multiple coping strategies. All stroke survivors used a higher number and frequency of adaptive rather than maladaptive strategies. Women used a higher number of adaptive strategies. Stroke survivors with depression used maladaptive coping strategies more frequently, whereas those presenting with a greater number and severity of comorbidities used adaptive coping strategies more frequently. Stroke survivors with higher levels of coping self-efficacy used the strategies of active coping and positive reframing more frequently.

Based on these results, it is recommended direct-care providers place greater emphasis on objectifying the emotional consequences of stroke. Further research is recommended regarding understanding the relationship between coping and outcomes.
Enhancing Research Utilization Capacity Through Multifaceted Professional Development
Authors: Craik Janet , Rappolt Susan
Published: October 2011

Some occupational therapists report that they do not feel adequately prepared to perform the arduous tasks involved in integrating research into their practice. To explore how research utilization can be conducted by practicing clinicians, self-reported research utilization behaviors of a sample of 11 occupational therapists practicing in adult stroke rehabilitation were analyzed. The constant comparison of the interview data revealed that participants’ clinical experiences, engagement in continuing education, involvement in research activities, and their mentoring of students contributed to their capacity to translate research evidence into practice. The results of the study suggest a model for enhancing research utilization capacity through professional development. Implications for practitioners, provider organizations, educators, and regulators of occupational therapy are discussed.
Rehabilitation Medicine Summit: Building Research Capacity: Executive Summary
Authors: Frontera Walter R. , Fuhrer Marcus J. , Jette Alan M. , Chan Leighton , Cooper Rory A. , Duncan Pamela W. , Kemp John D. , Ottenbacher Kenneth J. , Peckham P. Hunter , Roth Elliot J. , Tate Denise G.
Published: October 2011

The general objective of the “Rehabilitation Medicine Summit: Building Research Capacity” was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The five elements of research capacity that guided the discussions were: (1) researchers; (2) research culture, environment, and infrastructure; (3) funding; (4) partnerships; and (5) metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multi-organizational initiative is called to pursue the agendas outlined in this report.
The Measurement Properties and Factor Structure of the Test of Visual-Perceptual Skills–Revised: Implications for Occupational Therapy Assessment and Practice
Authors: Brown G. Ted , Gaboury Isabelle
Published: October 2011

OBJECTIVES. The aim of this study was to examine the measurement properties of the Test of Visual-Perceptual Skills–Revised (TVPS–R).

METHODS. A group of 356 typically developing children 5–11 years of age completed the TVPS–R along with three criterion measures.

RESULTS. Several of the TVPS–R items had item–total subscale correlation coefficients were lower than the 0.20 correlation criteria. Cronbach’s alpha coefficients varied between 0.74 and 0.84 for the seven subscales. The perceptual quotient (PQ) reliability coefficient for the age levels ranged between 0.79 and 0.91. The PQ total group reliability coefficient was 0.96.

Results from the principal component analysis indicated that the majority of the TVPS–R items loaded on a dominant first factor. Confirmatory factor analytic models were assessed using four different goodness-of-fit indices. Two of the fit indices supported the unidimensional assumption (RMR and CFI), while two of the fit indices did not support the TVPS–R one-factor model (chi-square and RMSEA). A unitary motor-free visual-perceptual factor was not found.

CONCLUSION. The TVPS–R PQ should not be used as an overall performance summary score. Of the seven TVPS–R subscales, five can be used with confidence (visual discrimination, visual-spatial relationships, visual-sequential memory, visual figure ground, and visual-closure) whereas the visual memory and visual-sequential memory subscales are not recommended.
Time Use of Mothers With School-Age Children: A Continuing Impact of a Child’s Disability
Authors: Crowe Terry K. , Florez Sandra I.
Published: October 2011

OBJECTIVE. The purpose of this study was to compare the time use of mothers of children with disabilities with the time use of mothers of children without disabilities.

METHOD. Sixty mothers with children 3 to 14 years of age (30 mothers with children with disabilities and 30 mothers with children without disabilities) completed time diaries over seven 24-hour days.

RESULTS. Significant differences were found between the two groups when comparing mean hours spent per week by mothers in occupations involving child-care activities and recreational activities. Mothers of children with disabilities spent significantly more time in child-care activities and significantly less time in recreational activities. In addition, mothers of children with disabilities reported fewer typical days and rated the quality of days as poorer. As children got older, the gap between the time mothers devoted to child care increased between the two groups.

CONCLUSION. The type of occupations a mother participates in varies significantly dependent upon whether a child in the family has a disability and the age of the child. Professionals need to work collaboratively with families to assist parents to meet the family’s daily needs particularly in light of the time demands of the mother.
Occupational Therapy Activities and Intervention Techniques for Clients With Stroke in Six Rehabilitation Hospitals
Authors: Latham Nancy K. , Jette Diane U. , Coster Wendy , Richards Lorie , Smout Randall J. , James Roberta A. , Gassaway Julie , Horn Susan D.
Published: October 2011

OBJECTIVE. To prospectively monitor occupational therapy activities and intervention techniques used during inpatient stroke rehabilitation in order to provide a description of current clinical practice.

METHODS. Data were collected prospectively from 954 clients with stroke receiving occupational therapy from six U.S. rehabilitation hospitals. Descriptive statistics summarized frequency, intensity, and duration of occupational therapy sessions; proportion of time spent in 16 therapeutic activities; and proportion of those activities that included any of 31 interventions.

RESULTS. Clients received on average 11.8 days (SD = 7.2) of occupational therapy, with each session lasting on average 39.4 min (SD = 16.9). Upper-extremity control (22.9% of treatment time) and dressing (14.2% of treatment time) were the most frequently provided activities. Interventions provided most frequently during upper-extremity control activities were strengthening, motor learning, and postural awareness.

CONCLUSION. Occupational therapy provided reflected an integration of treatment approaches. Upper-extremity control and basic activities of daily living were the most frequent activities. A small proportion of sessions addressed community integration.
The Use of Occupation-Based Treatment With a Person Who Has Shoulder Adhesive Capsulitis: A Case Report
Authors: Earley Donald , Shannon Marcia
Published: October 2011

This article describes a case report of the occupational therapy management of a 53-year-old woman diagnosed with primary shoulder adhesive capsulitis. The occupation-based interventions are described through the framework of occupation-as-means. Compensatory occupation, preparatory methods, and purposeful activities are demonstrated as being critical to minimizing connective tissue deformation associated with this condition. This case report indicates that occupation-based intervention should be initiated as soon as a diagnosis is identified to prevent the downward spiral of forced disuse associated with the affected upper extremity. As illustrated by the case report, occupation-based treatment that was provided in a timely manner immediately decreased pain, improved range and quality of motion, and enhanced occupational performance.
The Use of Automated Prompting to Facilitate Handwashing in Persons With Dementia
Authors: Labelle Katrinka-Lee , Mihailidis Alex
Published: October 2011

As the number of people living with dementia increases, occupational therapists are challenged with finding innovative, evidence-based ways to enable daily occupations. The use of computer technology is explored in this study as one potential intervention for this population. An automated prompting system was modified to provide both verbal and audiovisual prompts, and 8 participants with Standardized Mini-Mental State Examination (SMMSE) scores as low as 3/30 were followed over 60 trials to determine which prompting method was more effective in reducing caregiver interactions. Overall, the participants were able to complete more steps with the assistance of either automated prompt and required fewer caregiver interactions. Audiovisual prompting significantly reduced the number of caregiver interactions required. These results lend further support to the use of an automated prompting system but suggest that there are individual factors influencing the efficacy of the prompting mode, for which occupational therapists are well suited to assess and monitor.
Handwriting Difficulties in Primary School Children: A Search for Underlying Mechanisms
Authors: Volman M. J. M. , van Schendel Brecht M. , Jongmans Marian J.
Published: October 2011

OBJECTIVE. This study investigated the contribution of perceptual-motor dysfunction and cognitive planning problems to the quality or speed of handwriting in children with handwriting problems (HWP).

METHOD. Twenty-nine children with HWP and 20 classroom peers attending regular schools (grade 2 and grade 3) were tested with regard to visual perception, visual-motor integration, fine motor coordination, and cognitive planning abilities.

RESULTS. The HWP group scored significantly lower on visual perception, visual-motor integration, fine motor coordination, and cognitive planning in comparison with classroom controls. Regression analyses showed that visual-motor integration was the only significant predictor for quality of handwriting in the HWP group, whereas fine motor coordination (i.e., unimanual dexterity) was the only significant predictor of quality of handwriting in the control group.

CONCLUSIONS. Results suggest that two different mechanisms underlie the quality of handwriting in children with and without handwriting problems. Poor quality of handwriting of children with HWP seems particularly related to a deficiency in visual-motor integration.
Psychometric Properties of the Loewenstein Occupational Therapy Cognitive Assessment–Second Edition in Taiwanese Persons With Schizophrenia
Authors: Su Chwen-Yng , Chen Wan-Ling , Tsai Pei-Chun , Tsai Chia-Yin , Su Wei-Lieh
Published: October 2011

OBJECTIVE. This study sought to determine the psychometric properties for the Loewenstein Occupational Therapy Cognitive Assessment–Second Edition (LOTCA–II) in a population of persons with schizophrenia.

METHOD. Sixty-four participants with schizophrenia were administered the LOTCA–II at baseline, and 43 of these were randomly selected to undertake four more standardized measures of cognitive and instrumental activities of daily living (IADL) functions to test convergent validity. One week later, 48 randomly selected participants from the total sample were readministered the LOTCA–II to determine test–retest reliability.

RESULTS. Substantial ceiling effects existed in 96% of LOTCA–II items. Cronbach’s alpha for all six sub-tests ranged from .20 to .91; the alpha for the global scale was .90. Intraclass correlation coefficients ranged from .49 to .89 for the subtests and .95 for the full LOTCA–II. Low to moderate correlations were found between LOTCA–II total score and scores on cognitive and IADL measures. No overall significant differences in subtest scores were found across participants differing in employment status.

CONCLUSION. LOTCA–II performance is best interpreted in the context of total score. Further revision of the test items is recommended for a more reliable and valid use of the LOTCA–II in persons with schizophrenia.
A Randomized Controlled Pilot Study of the Effectiveness of Occupational Therapy for Children With Sensory Modulation Disorder
Authors: Miller Lucy Jane , Coll Joseph R. , Schoen Sarah A.
Published: October 2011

OBJECTIVE. A pilot randomized controlled trial (RCT) of the effectiveness of occupational therapy using a sensory integration approach (OT-SI) was conducted with children who had sensory modulation disorders (SMDs). This study evaluated the effectiveness of three treatment groups. In addition, sample size estimates for a large scale, multisite RCT were calculated.

METHOD. Twenty-four children with SMD were randomly assigned to one of three treatment conditions; OT-SI, Activity Protocol, and No Treatment. Pretest and posttest measures of behavior, sensory and adaptive functioning, and physiology were administered.

RESULTS. The OT-SI group, compared to the other two groups, made significant gains on goal attainment scaling and on the Attention subtest and the Cognitive/Social composite of the Leiter International Performance Scale–Revised. Compared to the control groups, OT-SI improvement trends on the Short Sensory Profile, Child Behavior Checklist, and electrodermal reactivity were in the hypothesized direction.

CONCLUSION. Findings suggest that OT-SI may be effective in ameliorating difficulties of children with SMD.
Goal Attainment Scaling as a Measure of Meaningful Outcomes for Children With Sensory Integration Disorders
Authors: Mailloux Zoe , May-Benson Teresa A. , Summers Clare A. , Miller Lucy Jane , Brett-Green Barbara , Burke Janice P. , Cohn Ellen S. , Koomar Jane A. , Parham L. Diane , Roley Susanne Smith , Schaaf Roseann C. , Schoen Sarah A.
Published: October 2011

Goal attainment scaling (GAS) is a methodology that shows promise for application to intervention effectiveness research and program evaluation in occupational therapy (Dreiling & Bundy, 2003; King et al., 1999; Lannin, 2003; Mitchell & Cusick, 1998). This article identifies the recent and current applications of GAS to occupational therapy for children with sensory integration dysfunction, as well as the process, usefulness, and problems of application of the GAS methodology to this population. The advantages and disadvantages of using GAS in single-site and multisite research with this population is explored, as well as the potential solutions and future programs that will strengthen the use of GAS as a measure of treatment effectiveness, both in current clinical practice and in much-needed larger, multisite research studies.
Gaining Insight Into Patients’ Perspectives on Participation in Home Management Activities After Traumatic Brain Injury
Authors: Powell Janet M. , Temkin Nancy R. , Machamer Joan E. , Dikmen Sureyya S.
Published: October 2011

OBJECTIVE. This study investigated performance of home management activities 1 year after traumatic brain injury (TBI), as reported on the Functional Status Examination.

METHOD. Home management performance of 164 rehabilitation inpatients (mean age 35.4 years, 77% men, 75% white) with moderate to severe TBI was examined in relation to demographics, injury severity, neuropsychological functioning, and living situation.

RESULTS. Fifty-nine percent reported more difficulty or more assistance with home management at 1 year. Nonperformance of individual activities before injury ranged from 16% to 76%. Age (p = .001), living situation after injury (p = .002), and neuropsychological function at 1 year (p = .001) were associated with more limited home management performance after injury as compared to premorbid function.

CONCLUSIONS. Home management is challenging 1 year after TBI, especially for older adults and those with greater cognitive impairments. Accurate preinjury information is needed to determine the nature and extent of subsequent losses, guide treatment planning and interventions, and characterize recovery of function.
Semantic Priming of Motor Task Performance in Young Adults: Implications for Occupational Therapy
Authors: Grossi Jennifer A. , Maitra Kinsuk K. , Rice Martin S.
Published: October 2011

OBJECTIVE. To investigate whether the performance of a multisegment motor task is influenced by reading a segment-specific action word.

METHOD. Twenty-four participants performed tasks that involved reaching for a bottle, grasping it, lifting and placing it on a shelf, and returning their hand to the starting position. At the initiation of each task, participants read either aloud or silently five randomly provided, task-related words (reach, grasp, lift, place, and return).

RESULTS. Reading task-related words significantly affected the reach and lift/place segments in the direction of the hypothesis (p < 0.05) but not the return segments. Grasp times were shorter and grasp velocities were higher when participants read aloud or silently the words grasp and place for the grasp segment (p < 0.05).

CONCLUSION. The results suggest that in young adults, motor performance may be influenced by precuing or priming the brain with performance-related words. A meaning of a motor performance can be manipulated by contextually relevant language, which can facilitate performance.
Occupational Therapy Outcomes for Clients With Traumatic Brain Injury and Stroke Using the Canadian Occupational Performance Measure
Authors: Phipps Shawn , Richardson Pamela
Published: October 2011

The purpose of this study was to determine whether 155 ethnically diverse clients with traumatic brain injury (TBI) and stroke (cerebrovascular accident; CVA) who received occupational therapy services perceived that they reached self-identified goals related to tasks of daily life as measured by the Canadian Occupational Performance Measure (COPM).

This study found that a statistically and clinically significant change in self-perceived performance and satisfaction with tasks of daily life occurred at the end of a client-centered occupational therapy program (p < .001). There were no significant differences in performance and satisfaction between the TBI and CVA groups. However, the group with right CVA reported a higher level of satisfaction with performance in daily activities than the group with left CVA (p = .03).

The COPM process can effectively assist clients with neurological impairments in identifying meaningful occupational performance goals. The occupational therapist also can use the COPM to design occupation-based and client-centered intervention programs and measure occupational therapy outcomes.
Functional Performance Characteristics Associated With Postponing Elementary School Entry Among Children With Down Syndrome
Authors: Dolva Anne-Stine , Lilja Margareta , Hemmingsson Helena
Published: October 2011

OBJECTIVES. This study investigated the relation between functional performance skills of children with Down syndrome and the age of entry into mainstream elementary education.

METHOD. In a cross-sectional study of 70% of the 7-year-old children with Down syndrome in Norway (N = 43), we measured functional performance using the Pediatric Evaluation of Disability Inventory (PEDI). The study was a follow-up of a previous study of the same children at age 5 assessed using the same instrument. Data from both studies were used in the analysis.

RESULTS. Forty percent of the sample of children with Down syndrome in Norway had entered elementary school after a 1-year postponement (i.e., at age 7). The functional performance skills of the children, as measured using the PEDI, were significantly lower at both age 5 and age 7 in self-care and social function compared with children with Down syndrome who entered elementary school at the usual time (i.e., at age 6). The main characteristics associated with postponed elementary school entry were found in communication skills and bladder and bowel management.

CONCLUSION. A certain level of development and independence seems to be required for a child with Down syndrome to be viewed as ready to enter elementary school, and perceptions of readiness for school may be culturally dependent. In addition to the well-described challenges in language and communication skills, being viewed as ready for school includes having stopped using diapers, a topic not previously mentioned as a factor in postponing elementary school entry for children with Down syndrome. Awareness of culturally influenced performance skills may give direction to parents and professionals in targeting areas in the preschool years that might help promote these children’s readiness for school.
Occupation Emerges in the Process of Therapy
Authors: Price Pollie , Miner Stephanie
Published: October 2011

OBJECTIVE. The current literature offers no cohesive definition of occupation-based practice. Current definitions emphasize intervention forms and contexts, which do not reflect the complexity of practice. This article demonstrates that the therapeutic relationship and the meanings that are created in the therapy process are central aspects of occupation-based practice. Occupation, as an idea that emerges in the therapeutic process, has aspects of both doing and becoming.

METHOD. The authors conducted observation sessions and interviews with an occupational therapist, Nancy, who used multiple therapeutic strategies with one child, Hannah, as they worked toward Hannah’s goals of going to preschool and becoming a friend.

RESULTS. Strategies include changing therapeutic conditions, using cognitive strategies, bridging the person–task–social context, pushing participation, and engaging in narrative micronegotiations.

CONCLUSION. Occupation emerged in the therapeutic processes as the occupational therapist and client co-created meaning about the client moving toward or away from who she wanted to become.
A Pilot Study on the Impact of Occupational Therapy Home Programming for Young Children With Cerebral Palsy
Authors: Novak Iona , Cusick Anne , Lowe Kevin
Published: October 2011

Occupational therapy home programs are a common approach used to provide interventions for children with cerebral palsy, but there is little evidence to demonstrate the effectiveness of such programs. This single-group pretest–posttest design pilot study evaluated the impact of an occupational therapy home program implemented with 20 children who had spastic hemiplegic cerebral palsy (ages 2–7 years, mean 3.8). We measured impact using Goal Attainment Scaling (GAS), the Pediatric Evaluation of Disability Inventory (PEDI), and the Quality of Upper Extremity Skills Test (QUEST). We measured participation amount through a parent self-report log. Significant changes following intervention occured in scores on the GAS, the PEDI Functional Skills and Caregiver Assistance Scales, and the QUEST, but has found no relationship between participation amount and outcome using the same measures. These promising results suggest that further investigation of the impact of occupational therapy home programs is warranted.
Understanding Occupational Therapy Students’ Attitudes, Intentions, and Behaviors Regarding Community Service
Authors: Hoppes Steve , Hellman Chan M.
Published: October 2011

Community-based practice has always been a central domain of occupational therapy, and evidence supporting its increasing importance is growing. Preparing occupational therapy students for community practice has received considerable attention in professional literature, but students’ voices have seldom been heard concerning this issue. This study sought to investigate attitudes, intentions, and behaviors regarding community service among occupational therapy students enrolled in one professional program using the Community Service Attitudes Survey. We present the Theory of Planned Behavior as a conceptual framework linking students’ attitudes and intentions with behaviors. Results indicate that these occupational therapy students’ attitudes and intentions regarding community service tended to be more strongly positive than those of their counterparts in other allied health disciplines; however, the community service behaviors of occupational therapy students were not significantly different from those of other allied health students, possibly because occupational therapy students perceived high costs to community service.
Behavioral Indexes of the Efficacy of Sensory Integration Therapy
Authors: Roberts Jane E. , King-Thomas Linda , Boccia Marcia L.
Published: October 2011

OBJECTIVE. The study examined behavioral treatment effects of classical sensory integration therapy.

METHOD. This study used a prospective longitudinal, single-subject ABAB design. The participant was a boy, age 3 years and 5 months, with average nonverbal intellectual skills, delayed communication skills, and sensory modulation disorder. Difficulties with modulating sensory input and delayed communication skills affected his occupational performance in preschool. Behavioral data were collected in the preschool by teachers who were blind to the type and timing of sensory integration therapy.

RESULTS. Improvement in behavior regulation was observed, including increased engagement and decreased aggression, less need for intense teacher direction, and decreased mouthing of objects.

CONCLUSION. Classical sensory integration therapy may be associated with improved self-regulatory behaviors.
Effects of Combined Robotic Therapy and Repetitive-Task Practice on Upper-Extremity Function in a Patient With Chronic Stroke
Authors: Rosenstein Libby , Ridgel Angela L. , Thota Anil , Samame Bridgette , Alberts Jay L.
Published: October 2011

OBJECTIVE. This article describes the effect of a robotic device combined with repetitive-task practice (RTP) on upper-extremity function in a patient with chronic stroke.

METHOD. The client was a 32-year-old woman, 11 months after stroke, with minimal wrist and finger movement. She received approximately 48 hr of intervention split evenly between a robotic device (Hand Mentor) and RTP during 3 weeks.

RESULTS. Favorable scores in the Wolf Motor Function Test were observed from pre-to postevaluation. Active range of motion, from pre-to postintervention, increased by 35° in the shoulder, 65° in the wrist, and 70° in the thumb. Kinetic analysis of a bimanual dexterity task indicated improved specification of grasping forces for both limbs.

CONCLUSION. Improvements in upper-extremity motor functioning and functional performance in daily tasks followed this client's engagement in distal initiation of movement during an RTP exercise regimen that was robotically reinforced.
Two Dimensions of Participation in Very Old Age and Their Relations to Home and Neighborhood Environments
Authors: Haak Maria , Fänge Agneta , Horstmann Vibeke , Iwarsson Susanne
Published: October 2011

This study aimed to capture and operationalize the concept of participation among people who are very old (age > 80) and to investigate whether and how aspects of housing and neighborhood environments relate to participation in very old age. Two dimensions of participation—performance-oriented participation and togetherness-oriented participation—emerged from an earlier qualitative study and were operationalized and validated in this study with quantitative variables. Both objective and perceived housing and neighborhood aspects were significantly related to, in particular, performance-oriented participation and, to a lesser extent, to togetherness-oriented participation. Most interventions in occupational therapy are accomplished within the home for very old people, but our results imply that there are potential interventions to accomplish on a societal level as well. In this respect, our study contributes to the knowledge in the field and has the potential to support the development of novel occupational therapy interventions targeting society at large.
Intervention Planning Facets—Four Facets of Occupational Therapy Intervention Planning: Economics, Ethics, Professional Judgment, and Evidence-Based Practice
Authors: Lopez Alexander , Vanner Elizabeth A. , Cowan Alexis M. , Samuel Anisha P. , Shepherd Dana L.
Published: October 2011

OBJECTIVE. This study determined occupational therapists’ perceptions of the following facets of intervention planning: economics, ethics, independent professional judgment, and evidence-based practice.

METHOD. A cross-sectional survey of 142 occupational therapists who provide short-term rehabilitation in five northeastern states was undertaken.

RESULTS. Most occupational therapists (n = 137, 96.5%) fell into one of four clusters, with the largest cluster (n = 86, 60.6%) having positive perceptions about ethics and independent professional judgment but negative perceptions about economic issues. Smaller clusters of occupational therapists were more positive about economic issues or less positive about ethics and independent professional judgment. Negative perceptions about the ability to implement evidence-based practice spanned all clusters.

CONCLUSION. American Occupational Therapy Association's efforts to educate occupational therapists about ethics appear to be effective. Most occupational therapists exercise independent professional judgment but perceive economic limitations when developing intervention plans. Practicing occupational therapists need additional research to support evidence-based practice and help in accessing and using research.
State of the Occupational Therapy Workforce: Results of a National Study
Authors: Powell Janet M. , Kanny Elizabeth M. , Ciol Marcia A.
Published: October 2011

OBJECTIVE. This study determined the current status of the occupational therapy workforce in the United States with a demand-based report using current job data.

METHOD. A 31-question survey was sent to rehabilitation administrators and managers from a proportional random sample of 556 facilities that hire occupational therapy practitioners in 29 states. Data were collected from November 2005 to February 2006 using structured mailing and follow-up procedures.

RESULTS. The response rate was 55%. The vacancy rate was 8.9% for occupational therapists and 7.7% for occupational therapy assistants. Forty-five percent of respondents predicted an increase in occupational therapy positions in the next 2 years, and 30% predicted an increase in occupational therapy assistant positions. Sixty-seven percent reported difficulty hiring occupational therapists, and 62% reported difficulty hiring occupational therapy assistants.

DISCUSSION. This study identifies a serious shortage of occupational therapy practitioners at a time when predictions of workforce demands continue to grow.
Background and Methodology of the Older Driver Evidence-Based Systematic Literature Review
Authors: Stav Wendy B. , Arbesman Marian , Lieberman Deborah
Published: October 2011

In response to demands of health care and community-based systems, occupational therapy practitioners are eager to provide effective services that are client centered, supported by evidence, and delivered in an efficient and cost-effective manner. Findings from the scientific literature provide a source of legitimacy and authority for informing and guiding practice in all areas, including driving and community mobility with older adults. A systematic review examined studies designed to enhance the driving ability, performance, and safety of older adults. This article presents an overview of the methodology used to develop the focused questions related to the person, vehicle, infrastructure, and policy and community mobility; conduct the literature review; and establish quality control. It includes a summary of the evidence and implications of the review for clinical practice, education, and research to ultimately identify interventions effective in supporting older adult participation and engagement in occupation.
Review of the Evidence Related to Older Adult Community Mobility and Driver Licensure Policies
Authors: Stav Wendy B.
Published: October 2011

A systematic review of literature related to the effects of drivers’ license policies and community mobility programs on older adult participation was completed as a part of the American Occupational Therapy Association’s Evidence-Based Literature Review Project. The results revealed that states can achieve a goal of reducing traffic crashes, traffic violations, and traffic-related fatalities through relicensing policies requiring in-person renewal and vision testing as well as driving restrictions. Evidence suggests that failure to consider the continued community mobility needs of older adults can result in increasing fatalities among senior citizens using other modes of community mobility. This evidence-based review is informative for occupational therapy practice; however, it does not reveal the association between policy and community mobility interventions and improved engagement and participation. There is a role for occupational therapy in policy development and community mobility programming to promote engagement in occupation to support participation.
Evidence-Based Perspective on the Effect of Automobile-Related Modifications on the Driving Ability, Performance, and Safety of Older Adults
Authors: Arbesman Marian , Pellerito Joseph M.
Published: October 2011

A systematic review of literature related to the impact of modifications made to automobiles on the driving ability, performance, and safety of older adults was completed as a part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association. This review evaluated research on high-tech options, such as advanced technology systems (Intelligent Transportation Systems) currently in active development by manufacturers and researchers and the effect of features such as the instrument panel and window tinting. Although the evidence related to Intelligent Transportation Systems is inconclusive, studies have indicated that older adults would use selected technology options. Aftermarket window tinting negatively affects older adults’ driving performance, and no evidence demonstrates that hydrophobic window treatment improves driving performance. The implications for occupational therapy practice, research, and education also are discussed.