bluuebunny/crossref_metadata_2025 huggingface dataset:
Survey of Physical Agent Modality Use
Authors: Taylor Eve , Humphry Ruth
Published: April 2012

Occupational therapists interested in physical disabilities practice (N = 629) responded to a questionnaire regarding their use of, training in, and opinions on physical agent modalities. Therapists in hand rehabilitation were the most frequent users of these modalities. Of the listed modalities, the most frequently used was hot and cold packs; the least used was ultrasound. The modalities used most frequently were typically performed without assistance, whereas those used less frequently were more likely to be performed with the assistance of a physical therapist. The most common educational experience for physical agent modality use was on-the-job training. Therapists who provided direct care were more positive about the use of these modalities in occupational therapy practice than were those who acted primarily as administrators, fieldwork educators, or supervisors. Respondents who specialized in hand therapy viewed modalities in a more positive light than did therapists in other areas of physical disabilities practice.
Clinical Reasoning in Medicine Compared With Clinical Reasoning in Occupational Therapy
Authors: Fleming Maureen Hayes
Published: April 2012

This article highlights some observations made in the American Occupational Therapy Association/American Occupational Therapy Foundation Clinical Reasoning Study, an ethnographic study of 14 occupational therapists working in a large teaching hospital. Concepts and premises that frequently appear in the clinical reasoning in medicine literature are discussed and compared and contrasted to observations and interpretations made of the practice and reasoning strategies of the occupational therapists who were participants in the Clinical Reasoning Study. It is postulated that similarities in the reasoning strategies of the members of the two professions are a result of use of the scientific model that calls for hypothetical reasoning. Differences, it is proposed, are accounted for by the difference in the particular focus, goals, and tasks of the two professions and the nature of the practice in those arenas. Five hypotheses are proposed as questions for further research in clinical reasoning in occupational therapy.
Analysis of Upper Extremity Movement in Four Sitting Positions: A Comparison of Persons With and Without Cerebral Palsy
Authors: McPherson James J. , Schild Richard , Spaulding Sandi J. , Barsamian Paula , Transon Carol , White Scott C.
Published: April 2012

The purposes of this study were to compare the arm movements of persons with and without cerebral palsy and to determine if the alteration of the seat angle of a chair affected the quality of those movements. Twelve subjects—3 men and 3 women with spastic cerebral palsy and 3 men and 3 women without any known anomalies that could affect arm movements—were studied. The number of movement elements constituting a reach was used to measure the quality of movements. The findings demonstrated significant differences in the number of movement elements used by the subjects with and without cerebral palsy regardless of position. No significant differences could be attributed to the seating positions. Implications are discussed in relation to the method used in the analysis of movements and the effect of the findings for research and treatment.
The Search for Useful Methodologies in Occupational Science
Authors: Carlson Michael E. , Clark Florence A.
Published: April 2012

Debate currently exists on the soundness of various research methodologies in the social sciences. In the present paper, this question is addressed in relation to the emerging discipline of occupational science. First, the discipline of occupational science is defined. Next, two competing methodologies – Paradigm 1, Positivistic, and Paradigm 2, Naturalistic – are contrasted. The criteria of genuineness and trustworthiness are proposed as crucial for the evaluation of the soundness of available research methodologies for the extension of occupational science. Next, exemplars of research methodologies that meet these criteria are described. In the conclusion, the role that nonscientific ways of knowing, such as art and literature, may play in the understanding of human occupation is discussed.
Mothers’ Perceptions of Home Treatment Programs for Their Preschool Children With Cerebral Palsy
Authors: Hinojosa Jim , Anderson Jill
Published: April 2012

Data from 8 mothers of preschool children with cerebral palsy were collected through intensive interviews concerning their experience with home programs. The data were analyzed with qualitative techniques. Each mother had previously participated in or attempted to use a home treatment program with her child, but none was currently doing so. The mothers’ descriptions suggest that they selected activities that were do-able and that they could integrate into their daily routines and interactions. Some important characteristics of these activities were that they were enjoyable for the child and not stressful for the child, the mother, or the family.
Barrier-Free Design: A Review and Critique of the Occupational Therapy Perspective
Authors: Cooper Barbara Acheson , Cohen Uriel , Hasselkus Betty Risteen
Published: April 2012

This review of the occupational therapy literature on barrier-free design identifies both a paucity of related occupational therapy research on the topic and a lack of a common conceptual base with which to guide the development and use of environmental assessments. Nonetheless, two fledgling themes can be extrapolated: the consistent reference to the concepts of accessibility, mobility, function, and safety and an increased awareness among occupational therapists regarding the accessibility standards developed by the American National Standards Institute (ANSI) (ANSI, 1971, 1980). A problem-solving model suggested by designers for the 1979 revision of ANSI standards that incorporates these conceptual themes is described and discussed.
A Comparison of the Cost-Effectiveness of Two Types of Occupational Therapy Services
Authors: Trahey Phyllis J.
Published: April 2012

The demand for efficient and effective health care prompted this study comparing the treatment outcomes and personnel costs of two types of occupational therapy service provision for the patient with a total hip replacement. System 1 used traditional individual treatment as the primary service provision method, with group treatment used as an adjunct. System 2 used group treatment as the primary intervention method, with individual treatment as the adjunct. Program evaluation research found the study subjects to be demographically homogeneous with no difference in treatment outcomes relative to four specific functional performance goals. Direct labor costs, however, were reduced by more than one third for the System 2 patients. The results of this study suggest that for specific rehabilitation patient populations, group treatment could be a cost-effective method of occupational therapy service provision.
An Investigation of Involvement in Leisure Activities After a Stroke
Authors: Jongbloed Lyn , Morgan Debra
Published: April 2012

The purpose of this study was to determine the efficacy of occupational therapy intervention related to the leisure activities of stroke survivors. Forty discharged stroke patients were randomly assigned to an experimental group, which received occupational therapy intervention related to leisure activities, or to a control group. An independent evaluator assessed the patients’ involvement in activities and satisfaction with that involvement on three separate occasions. The results showed no statistically significant differences between the experimental and control groups in activity involvement or satisfaction with that involvement. There are likely two reasons for these findings. First, the intervention was limited in scope (i.e., only five therapist visits), and second, many environmental factors strongly influence activity participation and satisfaction.
Leisure Activities After a Stroke: An Ethnographic Approach
Authors: Krefting Laura , Krefting Douglas
Published: April 2012

Ethnography is a qualitative research design that has relevance for clinical research in occupational therapy. The ethnographic approach is illustrated in the present paper through a description of how it could be used to investigate the effectiveness of an occupational therapy leisure intervention with stroke survivors. This paper contrasts ethnography with a randomized clinical trial design addressing the same question. Background information about ethnography, its relationship to other qualitative approaches, and its relevance to occupational therapy is addressed. Additionally, specific aspects of the research process are described, including triangulation of data-gathering strategies, sampling, and analysis. The limitations of ethnography are then described. The paper concludes with some examples of ethnographic work with persons with disabilities.
Early Object Rule Acquisition
Authors: Pierce Doris E.
Published: April 2012

The purpose of this study was to generate a grounded theory of early object rule acquisition. The grounded theory approach and computer coding were used to analyze videotaped samples of an infant’s and a toddler’s independent object play, which produced the categories descriptive of three primary types of object rules: rules of object properties, rules of object action, and rules of object affect. This occupational science theory offers potential for understanding the role of objects in human occupations, for development of instruments, and for applications in occupational therapy early intervention.
The Validity of the Constructional Subtests of the Sensory Integration and Praxis Tests
Authors: Cermak Sharon A. , Murray Elizabeth A.
Published: April 2012

This study was designed to examine the validity of the Design Copying and Constructional Praxis subtests of the Sensory Integration and Praxis Tests (SIPT) (Ayres, 1989) through an examination of convergent validity and the use of contrast groups. The subjects were 39 children aged 5 to 8 years. Of these children, 21 had learning disabilities and 18, who served as the control group, had no learning disabilities. The subjects were administered the SIPT as well as four other standardized measures of constructional abilities: the Developmental Test of Visual-Motor Integration (Beery, 1980), the Block Design subtest of the Wechsler Intelligence Scale for Children–Revised (Wechsler, 1974), the Primary Visual Motor Test (Haworth, 1970), and the Rey-Osterrieth Complex Figure Test (Waber & Holmes, 1985). The results indicated that the children with learning disabilities performed significantly more poorly than did the control subjects on both the Design Copying and Constructional Praxis subtests. These two subtests showed moderately high correlations (.46 to .71) with the other tests of constructional abilities when both groups were combined. Correlations were mostly in the moderate range for the children with learning disabilities but were generally not significant for the control sample. The results are discussed in terms of task demands and subject variability.
Comparison of Pencil-Grip Patterns in First Graders With Good and Poor Writing Skills
Authors: Schneck Colleen M.
Published: April 2012

The purpose of this study was to compare nondysfunctional children with and without handwriting difficulties for an examination of grip and hand preference. Additionally, in the group of children with handwriting difficulties, the children with decreased proprioceptive-kinesthetic finger awareness were compared with the children without such a decrease. The results suggest that children with handwriting difficulties may demonstrate a lower grip score than children without handwriting problems. In addition, among children with poor handwriting, those with decreased proprioceptive-kinesthetic finger awareness may demonstrate a lower grip score than those with good proprioceptive-kinesthetic awareness. Children with poor handwriting also show less hand preference than those with good handwriting.
Women, HIV Infection, and AIDS: Tapestries of Life, Death, and Empowerment
Authors: Pizzi Michael
Published: April 2012

Women, the minority population in the human immunodeficiency virus (HIV) pandemic, are fast becoming one of the highest subgroups to be injected and affected by the disease. In the United States, most of these women are black or Hispanic, poor and urban dwellers, and addicted to drugs. This paper discusses the physical, psychological, and social manifestations of HIV disease in women, such as diminished activity tolerance, neurologic or cognitive changes, occupational and social role imbalance, and stigma and discrimination, and describes the sociocultural aspects of women’s lives for assessment and treatment of women with HIV. Health promotion, education, and AIDS prevention and wellness programming are emphasized as strategies toward facilitation of self-empowerment for women with HIV disease. These health promotion and wellness strategies include learning of new and adaptation of current roles; learning strategies for self-care that include care for one’s physical, psychosocial, spiritual, and sexual health; and learning and developing action plans toward healthy living and self-empowerment.
Opening Feminist Histories of Occupational Therapy
Authors: Frank Gelya
Published: April 2012

This paper frames the history of occupational therapy in feminist terms. It focuses on gender segregation in occupational therapy, the influence of class and race in shaping opportunities for occupational therapists, and the place of feminism in the goals and achievements of the occupational therapy profession. Such issues have been addressed by feminist scholars in histories of women in medicine, nursing, and other helping professions. These sources help place the achievements of occupational therapy within the context of women’s historic entry and advancement in the American work force.
Comparative Effects of Bilateral Hand Splints and an Elbow Orthosis on Stereotypic Hand Movements and Toy Play in Two Children With Rett Syndrome
Authors: Sharpe Patricia A.
Published: April 2012

A single-subject rapidly alternating treatment design was used to compare the effectiveness of bilateral hand splints and an elbow orthosis in decreasing stereotypic hand behaviors and increasing toy play in 2 children with Rett syndrome. The subjects’ responses were compared across three treatment conditions: no intervention, hand splints, and elbow orthosis. The order of the treatment phases was randomly selected for each subject. Data were collected in both a free-time condition and a toy-play condition; the outcome measures were stereotypic hand movements and hand-to-toy contact. Both subjects demonstrated a decrease in stereotypic hand movements and a corresponding increase in toy contact with the use of the elbow orthosis. The bilateral hand splints had no obvious treatment effect.
The Role of Occupational Therapy in the Management of Depression
Authors: Devereaux Elizabeth , Carlson Michael
Published: April 2012

This document was prepared at the request of the Depression Panel of the Office of the Forum for Quality and Effectiveness in Health Care within the Agency for Health Care Policy and Research, an agency of the U. S. Public Health Service. The panel was charged to develop clinical practice guidelines for the management of depression to be used by general medical and family medicine practitioners in primary care settings. The form of the panel’s questions shaped the introductory portion of the document. After receiving the questions posed by the panel (which are stated later in this document), it was necessary to define the context of the use of occupation and occupational therapy to broaden the panel’s understanding of these terms.
Comparison of Three Computer Scanning Modes as an Interface Method for Persons With Cerebral Palsy
Authors: Angelo Jennifer
Published: April 2012

Occupational therapists are becoming increasingly involved with interface assessments. This involvement is improving the ability of persons with physical disabilities to interact with computers, augmentative communication aids, and other devices. The ability to use these devices facilitates participation in activities that would otherwise be much more difficult to pursue, such as communication, education, work, and recreation. The purpose of the present study was to systematically compare three basic modes of scanning – automatic, inverse, and step – with the use of a single-subject experimental design. Six subjects – 3 with spastic and 3 with athetoid cerebral palsy – from a local school volunteered for the study. Results indicated that the 3 subjects with spastic cerebral palsy had the greatest difficulty using the automatic scanning mode. The 3 subjects with athetoid cerebral palsy had the most difficulty using the step scanning mode. The results of this study suggest that clients should attempt each scanning mode and that their performance with each mode be compared to ensure the most appropriate recommendations.
Exploring Educational Boundaries: Occupational Therapy and the Multiple-Entry-Route System, 1970–1982
Authors: Colman Wendy
Published: April 2012

Since the mid-1960s, occupational therapy has maintained a multiple-entry-route educational system that provides professional preparation leading to certification for a variety of candidates. This paper focuses on the 1970s and recounts a time marked by exploration of an assortment of entry-level routes that embraced the concept of laddering and included proficiency testing and career mobility programs. The paper reviews the educational debates that occurred while occupational therapy tested the limits of innovative educational mechanisms. Although the American Occupational Therapy Association debated new options for professional preparation and temporarily instituted one additional educational avenue in those years, by 1982 its educational system returned to its mid-1960s design.
Driving After Cerebral Damage: A Model With Implications for Evaluation
Authors: Galski Thomas , Bruno Richard L. , Ehle Holly T.
Published: April 2012

Evaluation of the ability of cerebrally injured patients to return to driving is an important task for rehabilitation specialists. These evaluations require predictively valid methods of assessment based on identification of relevant skills and abilities. The present study tested a hypothetical model for driving after cerebral injury and determined its use in evaluating fitness to drive. Thirty-five patients with cerebral damage due to head injury or cerebrovascular accident participated in the study. All were administered (a) a predriver evaluation, that is, a battery of neuropsychological tests chosen a priori to test the model, (b) a simulator evaluation, and (c) a behind-the-wheel evaluation consisting of driving on a protected course and in traffic. The results showed that 93% of the driving outcome in traffic was explained cumulatively by findings from the predriver and simulator evaluations as well as from behavioral and operational measures during evaluation on the protected lot. These results supported the predictive validity of the model and are discussed in terms of methodology for evaluation of return to driving.
Perspectives on an Oral Motor Activity: The Use of Rubber Tubing as a “Chewy”
Authors: Scheerer Carol R.
Published: April 2012

Among school-aged children with learning and behavioral problems, a therapeutic tool found to be helpful is a “chewy.” A chewy is a cylindrical piece of rubber tubing, the ends of which are placed in the mouth and are chewed or sucked on. This behavior appears to have a calming, organizing, and focusing effect on the child. In addition, for some children who put nonedible items in their mouths, a chewy can provide an appropriate sensory substitute or alternative.

A literature review supporting the benefits of oral motor input is discussed. Three case studies of children using a chewy are presented. A discussion follows regarding the therapeutic benefits of the use of a chewy and the consideration of it as part of a child’s sensory diet. Important guidelines regarding the appearance, taste, length, durability, and sanitation of the chewy are reviewed.
Benefits of the Americans With Disabilities Act of 1990 for Children and Adolescents With Disabilities
Authors: Kalscheur Jean A.
Published: April 2012

The Americans With Disabilities Act of 1990 (ADA) (Public Law 101–336) is a civil rights law intended to bring men, women, and children with disabilities into the mainstream of American life. This paper discusses the relation of the law to pediatric occupational therapy practice. The spirit of the ADA is highly compatible with occupational therapy’s philosophical perspective. Occupational therapy personnel value functional independence, which requires an interactive relation between the environment and the child. Current pediatric practice models focus on deficit reduction and give limited attention to the environment, even though physical, social, and temporal environments contribute to disability, as do performance component deficits. An environment-centered model is suggested as a pediatric service provision approach compatible with the philosophical background of the ADA. This model emphasizes education and consultation to businesses and individuals for the purpose of altering environments to be accessible and accommodating to children and adolescents with disabilities. Three examples of environment-centered services are presented: (a) an evaluation of environments and reasonable accommodation recommendations for a teenager with a physical disability, (b) the mother of a child with cerebral palsy, and (c) the parents and program director of a community recreation program.
The Relationship Between Elbow Position and Grip Strength
Authors: Kuzala Elizabeth Ann , Vargo Michael Charles
Published: April 2012

Forty-six graduate students participated in a study to investigate the effect of elbow position on grip-strength measurements. Sixteen males and 30 females, aged 21 to 46 years, participated in the study. Data collection procedures followed standardized grip-strength testing guidelines established by the American Society of Hand Therapists, with the exception of elbow position. Grip-strength measurements were taken with the elbow positioned at 0°, 45°, 90°, and 135° of flexion. The results showed a significantly stronger grip-strength measurement at 0° of flexion and the weakest grip-strength measurement at 135° of flexion. This study supports the use of a standardized method for hand strength testing. The knowledge that grip-strength measurement is highest when the elbow is fully extended could affect treatment planning.
Socialization Groups: Using The Book of Questions as a Catalyst for Interaction
Authors: Wade Jay C.
Published: April 2012

This article describes the use of The Book of Questions (Stock, 1987) as a tool for assessment and as a catalyst for social interaction in an acute short-term inpatient psychiatric unit. Examples of questions and how they can be used to provide information for the evaluation of personality style and social and interpersonal skills are provided. Group objectives, membership criteria and format, and leadership techniques are discussed. Analysis of the group activity and patients’ responses to the group indicates that a group structured around The Book of Questions facilitates social interaction and is easily transferable to social activities outside of the structured therapeutic group setting and hospital environment.
Why Students Choose Occupational Therapy as a Career
Authors: Rozier Carolyn K. , Gilkeson Grace E. , Hamilton Basil L.
Published: April 2012

To recruit students to occupational therapy, we need to know what prospective students seek in careers. A survey consisting of an attitude inventory was sent to 403 current occupational therapy students with a response rate of 54%. Earlier research identified that students had primarily altruistic goals in selecting occupational therapy as a profession, and this study continued to find that students wanted to help others; however, this was not a predictor of their favoring the profession. A factor analysis of the inventory revealed that students chose occupational therapy as a career because they liked the salaries, nationwide job availability, regular hours, and prestige that is associated with the profession. Students were more positive about the profession if they had experience working in occupational therapy departments, and 40% reported that no specific persons had influenced their career decision.
“Doing Battle”: A Metaphorical Analysis of Diabetes Mellitus Among Navajo People
Authors: Huttlinger Kathleen , Krefting Laura , Drevdahl Denise , Tree Philip , Baca Elaine , Benally Anita
Published: April 2012

Effective communication with patients and their family members forms the foundation of a therapeutic relationship. This is particularly important when the occupational therapist, other health professionals, and the patient are from different cultural backgrounds. This paper describes one aspect of the findings of a ethnographic study of chronic diabetes among the Navajo people (referred to here as Dine’). It focuses on the dominant metaphorical images that were used by the informants to describe their illness experiences. The data suggest that diabetes can be considered a metaphor for larger social changes in the life-style and traditions (e.g., away from sheepherding as a means of basic subsistence to obtaining urban-centered employment) of native Americans and their effects on the Dine’. Implications of our findings include the importance of metaphorical communication for perceptions of compliance, powerlessness, and patient and therapist satisfaction with the therapeutic relationship.
Culturally Competent Occupational Therapy in a Diversely Populated Mental Health Setting
Authors: Dillard Maria , Andonian Lynne , Flores Olivia , Lai Lisa , MacRae Anne , Shakir Muhjah
Published: April 2012

Cultural sensitivity is a crucial component of health care provision, particularly in psychiatric settings. As society becomes more multicultural, it is essential for occupational therapists to continue to develop cultural competence, which is defined in this paper as an awareness of, sensitivity to, and knowledge of the meaning of culture. At San Francisco General Hospital, an innovative multicultural model consisting of special focus programs is used. The key to the success of such programs is a culturally competent professional staff.
Dementia Management: An Occupational Therapy Home-Based Intervention for Caregivers
Authors: Corcoran Mary A. , Gitlin Laura N.
Published: April 2012

This paper describes an occupational therapy intervention designed for family caregivers of persons with dementia. The intervention, based on the framework of a competence-environmental press model and the principle of collaboration, was implemented during 5 home visits. Each visit was designed to build caregiving skills through collaboration in identifying problem areas, developing and implementing environmental strategies, and modifying management approaches. A case vignette illustrates the therapeutic process and outcomes. The theoretical rationale and structure of the intervention and innovative documentation for evaluation of the theoretic process are also presented.
Level I Fieldwork: Creating a Positive Experience
Authors: Swinehart Susan , Meyers Susan K.
Published: April 2012

Qualitative research methodology was used to explore the purpose of level I fieldwork among occupational therapy students, clinical educators, and faculty respondents at one academic program. Differences in purposes among the three groups of respondents created different fieldwork expectations and outcomes. These differences underlined the importance of communication among students, clinical supervisors, and faculty in planning fieldwork to meet the needs of all three groups. Interpersonal skills, rather than academic skills, emerged as most important to student success in clinical education. Other factors that promote optimal level I fieldwork experience are understanding the purpose, level of commitment, clarity of expectations, timing, structure, and evaluation of the experience.
Comparison of Computer Interface Devices for Persons With Severe Physical Disabilities
Authors: Lau Cynthia , O’Leary Stephanie
Published: April 2012

This research employed a descriptive case study design to compare subjects’ performance using three computer input devices: the Tongue Touch Keypad, the HeadMaster, and the mouthstick. The sample consisted of four students with severe physical disabilities enrolled in an adaptive computer class at a community college. Components of performance examined were input speed, accuracy, and level of perceived exertion. Subjects’ acceptance of each of the interface devices was also examined. Results showed input speed to be the fastest with the mouthstick, followed by the HeadMaster and then the Tongue Touch Keypad. Accuracy of input did not vary significantly. Three subjects rated the Tongue Touch Keypad as requiring the lowest rate of perceived exertion, followed by the HeadMaster and then the mouthstick. Overall performance did not necessarily affect subjects’ acceptability ratings of the devices. Information from this study will assist therapists in evaluating the effectiveness and desirability of computer interface devices for patients.
Comparison of Assistive Device Use and Needs of Home-Based Older Persons With Different Impairments
Authors: Mann William C. , Hurren Dianne , Tomita Machiko
Published: April 2012

This paper examined assistive device use by noninstitutionalized older persons with visual, cognitive, and physical impairments. One hundred fifty seven persons over 60 years of age (M = 75.5 years) were interviewed in their homes for the University at Buffalo Rehabilitation Engineering Research Center Consumer Assessments Study. Subjects were assigned to one of seven groups according to types of impairment: minimal, physical, visual, visual and physical, cognitive, cognitive and physical, and cognitive and visual. Group assignments were based on scores on the Sickness Impact Profile (physical), Older Americans Resources and Services Program Multidimensional Functional Assessment Questionnaire (vision), and Mini Mental State Exam (cognitive). Overall, subjects owned a mean of 13.7 devices, used 10.8 devices (79% of the devices they own), and were satisfied with 9.8 devices (72% of the devices they own). There were significant differences among the impairment groups in numbers of devices owned and used, and in satisfaction with devices. Subjects expressed the need for more devices, especially devices for increasing mobility and assisting with balance. Results suggest a stronger role for occupational therapists in the assessment of assistive device needs of older persons, and in recommending devices and training persons in their use.
Addressing Assistive Technology Needs in Special Education
Authors: Shuster Nancy E.
Published: April 2012

Assistive technology is critical to maximize the functional skills of the person with a physical disability at home, work, and school. As assistive devices become increasingly complex and expensive and more options are available, the need for an assistive technology specialist is enhanced. Recent regulations and advances in technology are affecting the type, quality, and comprehensiveness of assistive technology service provision and need for assistive technology specialists. The occupational therapist’s role as an assistive technology specialist is illustrated in an example of an assistive technology program within a special education setting.
Self-Evaluation and Self-Concept of Adolescents With Physical Disabilities
Authors: King Gillian A. , Shultz Izabela Z. , Steel Kathleen , Gilpin Michelle , Cathers Tamzin
Published: April 2012

Fifty-three adolescents aged 14 to 18 years with diagnoses of cerebral palsy (n = 27), cleft lip or palate or both (n = 17), or spina bifida (n = 9) took part in this study examining their self-esteem, self-concept, self-acceptance, social self-efficacy, and values, as measured by standardized instruments. Comparisons were made separately for males and females with norms developed for adolescents without disabilities. Significant differences were found only on several aspects of self-concept: females with physical disabilities were lower in perceived social acceptance, athletic competence, and romantic appeal than the normative sample, and males with physical disabilities were lower in perceived scholastic competence, athletic competence, and romantic appeal. In addition, social self-efficacy was found to be a significant predictor of both independence and persistence in adolescents with disabilities, who were significantly less independent and persistent than were normative samples. The discussion focuses on the usefulness of the findings regarding social self-efficacy and the implications of the findings for occupational therapists.
A Model to Promote Activity Competence in Elders
Authors: Levine Ruth E. , Gitlin Laura N.
Published: April 2012

This paper describes an occupational therapy home-based intervention in which purposeful activities were used to promote adaptation and competence in older adults with chronic disabilities. Seven home care therapists visited 17 randomly selected, community-living elders who were chronically disabled and who volunteered to participate in the program. The number of visits ranged from 3 to 10 and occurred over a 3-month period according to clients’ needs and wishes. Therapists enhanced their ability to enter the client’s social and cultural system by using participant-observation techniques and collaboratively identified activities. Therapists documented each home visit with a structured fieldnote form. An analysis of 112 fieldnotes indicated that therapists were able to understand a client’s needs; this understanding resulted in small qualitative gains in areas identified as important by the client. Reilly’s concept of an activity continuum was a useful framework from which to work with this population. The implications for program development, treatment outcomes, and accountability with this approach promote improved future treatment planning with the elderly with chronic disability.
Generalization of Occupational Therapy Effects in Psychiatric Rehabilitation
Authors: Hayes Robyn L. , Halford W. Kim
Published: April 2012

Psychoeducation procedures dominate the treatment used by occupational therapists in psychiatric rehabilitation. The underlying assumption of skills training is that the skills taught generalize, that is, they persist beyond the treatment session and are used by the client in the community. This paper surveys occupational therapy literature to evaluate the generalization of skills taught to adult psychiatric clients by occupational therapists. Of the 77 studies reviewed, only 13 (17%) mentioned anything related to generalization. Seven of these articles statistically evaluated the outcome of skills training, but only four specifically assessed generalization of therapy. It is concluded that occupational therapists in psychiatry predominantly do not assess generalization of therapy. Discussion focuses on how four classes of generalization strategies (modifying the community environment, modifying the therapy environment, altering the style of therapy, and promoting client involvement) can enhance the effectiveness of occupational therapists in psychiatry.
Occupation and the Relevance of Primatology to Occupational Therapy
Authors: Wood Wendy
Published: April 2012

The adaptive functions of occupation during the phylogenetic history of the human species and the ontogenetic development of individual primates are examined through a review of relevant research of wild and captive nonhuman primates. This review suggests that the effectiveness of occupation as a therapeutic medium throughout life span development is fundamentally lied to humankind’s phylogenetic history. It is accordingly argued that there is considerable justification to maintain occupational therapy’s historical commitment to therapeutic occupation as the profession’s primary treatment modality. To support this commitment, questions to guide practice and research are identified that emanate from the primate literature and that are highly germane to the therapeutic process in occupational therapy. These questions address: (a) the relationship between the press of the various environments in which occupational therapists practice and subsequent opportunities availed to patients for engagement in occupation: (b) the relationship between the extent to which patients are or are not empowered to exert real control over their use of time their eventual development of disabling conditions; and (c) the therapeutic efficacy of occupation as compared with other treatment approaches that are not comparably holistic.
The Influence of an Animal on Social Interactions of Nursing Home Residents in a Group Setting
Authors: Fick Katharine M.
Published: April 2012

This study was conducted to determine the effect of the presence and absence of a dog on the frequency and types of social interactions among nursing home residents during a socialization group. Point sampling was used to evaluate the behaviors of 36 male nursing home residents at a Veterans Administration Medical Center under two conditions, Dog Present and Dog Absent. A significant difference in verbal interactions among residents occurred with the dog present, F(1,69) = 4.92, p < .05. These findings are consistent with existing literature, thus providing further evidence of the value of Animal Assisted Therapy programs as an effective medium for increasing socialization among residents in long-term care facilities. Because an increase in social interactions can improve the social climate of an institution and occupational therapists frequently incorporate group process into their treatment, the therapeutic use of animals can become a valuable adjunct to reaching treatment goals.
Family Involvement in Practice: Issues and Attitudes
Authors: Humphry Ruth , González Sharon , Taylor Eve
Published: April 2012

The family occupies an important role in the lives of persons with a physical, developmental, or mental disability; however, the extent and manner in which occupational therapists work with families is not known. A questionnaire concerning family–therapist involvement was sent to occupational therapists. Responses of 340 occupational therapists with a primary practice area of physical disabilities, developmental disabilities, or mental health were compared. Results indicated that the amount of contact with families of clients, reasons for family–therapist interactions, and attitudes about the family’s abilities and involvement were affected by the respondent’s area of practice. Respondents in all three practice areas identified scheduling difficulties as the biggest issue affecting their involvement with families of their clients. Implications discussed include the need to obtain an understanding of families’ desired level of involvement and the importance of continuing education opportunities for occupational therapists in changing attitudes about working with families. This study also suggests that the role of occupational therapists with families in mental health settings needs to be better articulated and shared with professional peers.
Graded Activity: Legacy of the Sanatorium
Authors: Creighton Cynthia
Published: April 2012

Occupational therapists in all areas or practice grade therapeutic activities to help patients progress toward their goals. It is proposed in this paper that the concept of graded activity originated in German tuberculosis sanatoria in the late 1800’s, when patients were required to walk on graded (sloped) land for exercise. British physician Marcus Paterson included work, as well as walking, in his graduated exercise program for tuberculosis patients and was honored for this innovation at the founding meeting of the National Society for the Promotion of Occupational Therapy (NSPOT). George Barton, Susan Tracy, and Herbert Hall were among the NSPOT members who contributed to the development of graded activity as a principle in occupational therapy intervention. The military rehabilitation programs established during world War I provided additional impetus, and by the mid-1920s, graded activity was recognized as central to the profession.
A Comparison of Structured Sensorimotor Therapy and Child-Centered Activity in the Treatment of Preschool Children With Sensorimotor Problems
Authors: DeGangi Georgia A. , Wietlisbach Shirley , Goodin Mary , Scheiner Nancy
Published: April 2012

This study compared the benefits of a child-centered therapy approach emphasizing child-initiated play interactions within a structured therapy environment to those of a therapist-directed, structured sensorimotor therapy approach in 12 preschool children with sensorimotor dysfunction. Each child received a pretest, 8 weeks of intervention (A or B) provided once weekly for a 1-hr session, a retest, 8 weeks of intervention (B or A) provided once weekly, and a final retest. A case study methodology was used to evaluate outcome data. Structured sensorimotor therapy was more useful than child-centered therapy in promoting gross motor skills, functional abilities (i.e., self-care), and sensory integrative functions. Child-centered therapy appeared to promote fine motor skills better. Although there were no differences in the two therapies for gains in play, attention, and behavior, variables such as temperament, attentional abilities, family stress, severity of sensorimotor delay, and whether the child had received treatment before seemed to affect which therapy was more beneficial for behavior, play, and attention. The effect of the findings on therapeutic practice is discussed.
Vestibular Rehabilitation Improves Daily Life Function
Authors: Cohen Helen
Published: April 2012

This article reviews recent research that addresses the functional outcomes of intervention for vestibular disorders. Vestibular impairments cause disequilibrium, blurred vision, disorientation, and vertigo. These sensory disturbances and motor impairments in turn cause dysfunction in many activities of daily living and in social interactions that traditional medical treatments do not address. The motor sequelae of some vestibular disorders can be treated successfully with programs of graded exercises and activities, the functional implications of which are described herein. The functional impairments caused by other vestibular disorders, which cannot be treated with graded activities, are also described. These disorders include bilateral vestibular loss caused by connective tissue disorders or by the use of ototoxic medications, tumors of the labyrinth or vestibular nerve, and Meniere’s disease. Occupational therapy intervention for these conditions may involve providing adaptive equipment, teaching alternative strategies for performing activities of daily living, and psychological intervention for depression and anxiety.
Adaptation to a Stroke: The Experience of One Couple
Authors: Jongbloed Lyn
Published: April 2012

Objective. Treatment of stroke, as described in the occupational therapy literature, focuses primarily on the person’s physical problems, and less on the way in which the family and environment influence adaptation. This article examines family and environmental influences on adaptation to stroke.

Method. The content of five interviews conducted over 2 years with a woman who experienced a stroke and her husband was analyzed with ethnographic research methods.

Results. The analysis revealed that a stroke cannot be understood as an individual phenomenon, because the life course of both this woman and her husband were profoundly affected by it. The man’s roles as family member, caregiver, home maintainer, and hobbyist required change after his wife’s stroke. The woman’s experience of her changed body, dependence, and altered homemaking role were influenced not only by her husband’s attitudes but also by societal values.

Conclusion. The findings suggest that clinicians and researchers must pay greater attention to those living with the person who experienced a stroke and to the ways in which the person’s social, cultural, and economic environments influence adaptation to disability.
Performance of Typical Children on the Sensory Profile: An Item Analysis
Authors: Dunn Winnie
Published: April 2012

Objectives. The purpose of this study was to obtain data about typical children on the 99-item Sensory Profile, a newly developed tool derived from sensory history items reported in the literature and designed to assess children’s responses of commonly occurring sensory events.

Method. Parents of 64 typical children 3 to 10 years of age completed the Sensory Profile; parents used a five-point Likert scale to report the percentage of time their children engaged in each behavior Researchers then analyzed these percentages to determine differences by age and gender.

Results. Sixty-seven of the items on the Sensory Profile were found to be uncommon for these typical children. On further analysis with a multivariate analysis of variance and appropriate follow-up procedures, one item was more common for younger children, and four items were more common for girls.

Conclusion. Two thirds of the items on the Sensory Profile were uncommon for typical children and thus may contribute useful information about children with disabilities who respond to these sensory events.
Finding Your Way in the Maze of Computer Access Technology
Authors: Anson Denis
Published: April 2012

Occupational therapists who must provide alternative computer access are faced with a daunting task. From nearly 500 types of devices, they must decide on a specific access technology that will meet clients’ needs. Without extensive clinical experience, it is difficult to select an appropriate level of intervention from the alternatives without guidance. The RoadMap to Computer Access Technology is a tool that assists clinicians in using the information obtained in an occupational therapy evaluation to select an appropriate level of intervention for a specific client. Clinicians answer a series of yes or no questions and follow the directions on the RoadMap. The RoadMap leads clinicians to a small group of devices that should meet the access needs of the client.
Comparison of Individual and Group/Consultation Treatment Methods for Preschool Children With Developmental Delays
Authors: Davies Patricia L. , Gavin William J.
Published: April 2012

Objectives. Although alternative treatment methods are becoming more widely discussed and implemented in pediatric occupational therapy, empirical data demonstrating the effectiveness of these treatment methods are lacking. The present study compares the effectiveness of an alternative treatment method (group/consultation) to traditional direct therapy.

Method. Eighteen preschool subjects classified as developmentally delayed received either individual/direct therapy or group/consultation therapy. Each child was assessed initially and again 7 months later with three standardized tests assessing fine motor and gross motor development, functional skills in the home, and nonverbal intelligence.

Results. Subjects in both treatment methods demonstrated significant increases in both fine and gross motor skills with the rate approximating that of the normal distribution of typically developing children.

Conclusion. There were no statistically significant differences between treatment methods on any of the assessments.