bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of Time Use by Adults With Spinal Cord Injuries
Authors: Yerxa Elizabeth J. , Locker Susan Baum
Published: April 2012

The self-perceived quality of time use of 15 community-based adults with spinal cord injuries was compared with that of 12 age- and sex-matched nondisabled adults through the use of the Activity Configuration Log (modified from an unpublished clinical assessment developed by Claudia Allen). Differences in how subjects classified their daily occupations were found between and within groups, especially for the categories of Work, Self-Maintenance, and Other. The results suggest that the subjects’ classifications of occupations and interpretations of their meanings are important sources of information for both the science of occupation and occupational therapy practice. The subjects with spinal cord injuries had a high rate of unemployment (67%) and much more daily free time than did their nondisabled counterparts. The affective quality of particular occupations was found to be related to the affective quality of the entire day. Occupational therapists agreed more with each other than with the subjects with disabilities when classifying occupations. Implications for practice and research are provided.
Use of an Elbow Restraint to Improve Finger-Feeding Skills in a Child With Rett Syndrome
Authors: Sharpe Patricia A. , Ottenbacher Kenneth J.
Published: April 2012

A single-subject study with an ABAB design was conducted to examine the effectiveness of an elbow restraint splint in improving the functional hand use of a child with Rett syndrome. The intervention consisted of the child’s wearing an elbow restraint on her nondominant (left) arm during snack time. Her ability to finger-feed cereal from a bowl was evaluated across four phases. An analysis of the data revealed only modest improvements in the amount of cereal consumed and in the time required to complete the eating task. Variability in the subject’s performance made visual interpretation of the data difficult. The findings, however, were in the anticipated direction and provide indications for future research.
Mastery in Clinical Occupational Therapy
Authors: DePoy Elizabeth
Published: April 2012

This study sought to describe the characteristics of mastery in occupational therapy practice. A Delphi survey (i.e., an inquiry technique used to predict and define constructs [Linstone & Turoff, 1975]) of 33 occupational therapy experts was conducted to obtain their conceptions of the characteristics of occupational therapy mastery. Three master clinicians, identified by the expert respondents, were then interviewed to validate and illustrate the concepts of mastery identified in the Delphi survey. The results suggest that mastery is a combination of selected personal traits, creative and flexible judgment, the use of occupation as the foundation for practice decisions, and a strong commitment to occupational therapy practice. Further, mastery is expressed through a personal style that is unique to each clinical master.
Shoulder Subluxation and Pain in Stroke Patients
Authors: Bohannon Richard W. , Andrews A. Williams
Published: April 2012

Twenty-four patients with stroke were studied (a) to determine the interrater reliability of a clinical measurement of shoulder subluxation, (b) to confirm the interrater reliability of the Ritchie Articular Index (Bohannon & LeFort, 1986) for measuring shoulder pain, (c) to establish the relationship between the Ritchie index Scores and shoulder lateral rotation range of motion measured at the point of pain (SROMP), and (d) to determine the relationship between shoulder subluxation and shoulder pain. The agreement between the two examiners’ (the authors) measurements of subluxation was “almost perfect” (Landis & Koch, 1977, p. 165). The agreement between the two examiners’ Ritchie index measurements was “substantial” (Landis & Koch, 1977, p. 165). The Ritchie index and SROMP measurements correlated significantly. Neither the Ritchie index nor the SROMP measurements correlated significantly with subluxation. Although the measurements used in this study were reliable, they did not support the association of shoulder subluxation with shoulder pain in stroke patients. Clinicians wishing to reduce shoulder pain in stroke patients should direct their treatment accordingly.
The Use of Tactile and Vestibular Stimulation to Reduce Stereotypic Behaviors in Two Adults With Mental Retardation
Authors: Brocklehurst-Woods Julie
Published: April 2012

In this study, two institutionalized adults with mental retardation were treated twice weekly over a 7-month period with activities that provided tactile and vestibular stimulation for the purpose of reducing stereotypic behaviors. Statistically significant treatment effects were demonstrated, but the target behaviors continued at a high and variable rate. Greater treatment frequency may be necessary for therapeutic benefit to occur in adults. Future single case studies need to be completed, with each variable manipulated systematically and with closer adherence to previous studies.
Coping Strategies Used by Occupational Therapy Students During Fieldwork: An Exploratory Study
Authors: Mitchell Marlys M. , Kampfe Charlene M.
Published: April 2012

This exploratory study examined the coping strategies and perceptions of 24 graduate students in occupational therapy who were participating in their second Level II fieldwork experience. The instruments used were the revised Ways of Coping Checklist (WCCL) (Vitaliano, Russo, Carr, Maiuro, & Becker, 1985) and a questionnaire developed by the authors. The results showed that of the five coping scales of the WCCL, the students used the Problem-Focused and Seeks Social Support strategies more than the Blamed Self, Wishful Thinking, and Avoidance strategies. Most of the students perceived the fieldwork experience as important, controllable, and stressful, but not disruptive to their lives.
An Overview of the Sensory Integration and Praxis Tests
Authors: Mailloux Zoe
Published: April 2012

This paper reviews the Sensory Integration and Praxis Tests (SIPT) (Ayres, 1989b), including its history and development, standardization, reliability, validity, and interpretation. Based on decades of theory development and earlier standardized tests, the SIPT represents a sound assessment tool for the evaluation of sensory integration and praxis in children. The SIPT’s implications for the field of occupational therapy are important and widespread. This article serves as an introduction to other papers in this issue that have used the SIPT as a research tool.
Using the Sensory Integration and Praxis Tests to Measure Change: A Pilot Study
Authors: Kimball Judith Giencke
Published: April 2012

Nineteen boys aged 6 through 8 years were pretested with the preliminary edition of the Sensory Integration and Praxis Tests (SIPT) (Ayres, 1984). They subsequently received 6 months of twice weekly occupational therapy with sensory integration intervention in a school setting and were then posttested with the preliminary edition of the SIPT. Significant improvement was seen in scores of grouped data on tests of praxis, somatovestibular functioning, and bilateral integration and sequencing. Individual improvement was visible in the Western Psychological Services ChromaGraphs of 17 of the 19 boys. Although preliminary, these findings suggest that the SIPT, unlike the Southern California Sensory Integration Tests (Ayres, 1972a), may be used to document improvement in children who have received occupational therapy with sensory integrative techniques.
The Relationship Between Form and Space Perception, Constructional Abilities, and Clumsiness in Children
Authors: Murray Elizabeth A. , Cermak Sharon A. , O’Brien Valerie
Published: April 2012

The Sensory Integration and Praxis Tests (SIPT) (Ayres, 1989) were administered to 21 children with learning disabilities and 18 children without learning disabilities, aged 5 to 8 years. The children with learning disabilities were divided into two groups, clumsy and nonclumsy, on the basis of their scores on the Test of Motor Impairment (Stott, Moyes, & Henderson, 1984). It was hypothesized that the learning-disabled children in the clumsy group would score significantly lower than the learning-disabled children in the nonclumsy group on the six SIPT subtests that measure form and space perception and visual construction and that the nonclumsy learning-disabled children, in turn, would score significantly lower than the non-learning-disabled children. It was further hypothesized that there would be a significant correlation between the degree of clumsiness and the degree of visual perceptual and constructional deficits. An analysis of the data indicated that both groups of learning-disabled children scored lower than the non-learning-disabled children on four of the six SIPT subtests. The clumsy and nonclumsy children with learning disabilities, however, differed from each other on only two subtests. The degree of clumsiness correlated significantly with three of the six subtests. The results are discussed in terms of variations in perceptual and motor skills related to subtypes of learning disabilities.
Praxis on Verbal Command and Imitation
Authors: Cermak Sharon A. , Morris Margaret L. , Koomar Jane
Published: April 2012

Nondysfunctional 4-year-old and 6-year-old children were administered the Praxis on Verbal Command subtest of the Sensory Integration and Praxis Tests (SIPT) (Ayres, 1989) under two conditions. One condition was administered in the standardized manner on verbal command; the other involved administration of the same items on imitation. An analysis of variance indicated that the variables of age and condition were significant, whereas sex was not significant. The Age X Condition interaction was also significant. Scheffé multiple comparisons revealed a significant difference between 4-year-olds and 6-year-olds on verbal command but not on imitation. Verbal-command scores were significantly lower than imitation scores for the 4-year-olds but not for the 6-year-olds.
Environmental Support and the Development of Grasp in Infants
Authors: Hirschel Amy , Pehoski Charlane , Coryell Jane
Published: April 2012

This study examines the acquisition of internal stability as it relates to the development of prehension in normal infants. Thirty-two subjects, 7 to 14 months of age, were observed grasping Cheerios from styrene surfaces that provided different amounts of support to the infants’ hands. The subjects were scored on the grasp patterns they used and on their success in securing a Cheerio without dislodging the styrene surface from a platform. Success increased with age, thus demonstrating a developmental progression in the acquisition of upper extremity internal stability. Consistency of grasp also increased with age. Whereas the youngest infants (7 to 8 months old) reverted to immature grasp patterns on the less stable surfaces, the oldest infants (13 to 14 months old) used mature pincer grasp patterns consistently. Infants 10 to 11 months old seemed to be in a transitional stage between the variability of grasp seen in the youngest infants and the consistency achieved by the oldest group.
Self-Esteem in Children: Considerations for Measurement and Intervention
Authors: Mayberry Wanda
Published: April 2012

A differentiated model of self-esteem, based on William James’s (1890), C. H. Cooley’s (1902/1968), and G. H. Mead’s (1925/1968) works and developed by Dr. Susan Harter (1983), is presented as a valuable tool for the occupational therapist to use in evaluation and intervention. Competence and social support are considered important components, and discounting is presented as a mechanism for the maintenance or improvement of self-esteem. Social comparison, social desirability, and defensiveness are discussed as important considerations, particularly regarding children with disabilities.
Developing a Variable Budget for Occupational Therapy Contract Work
Authors: Dickerson Anne
Published: April 2012

Contract occupational therapists need to develop a financial plan for improved control of their business. The variable budget allows financial planning according to actual performance volume. This paper describes a step-by-step method for the development of a variable budget through the illustration of a case example.
Preparation of Occupational Therapists to Work in Early Intervention Programs
Authors: Humphry Ruth , Link Sandra
Published: April 2012

This paper presents the results of a survey of 43 occupational therapy academic programs regarding their preparation of students to work with young children with special needs. The number of instructional hours devoted to topics related to services for infants or toddlers and their families varied greatly. Some programs plan an increase in hours but are limited by the total hours available within the curriculum.

This paper also shares the recommendations of a panel of occupational therapists with expertise in early intervention and entry-level education. The panel was concerned with the quality of preparation of therapists entering early intervention programs and encouraged the profession to review the amount of course work within each curriculum that introduces students to basic knowledge and skills related to early intervention. Some knowledge, such as the consultant’s role and working with families of persons who are physically or mentally challenged, are common to other practice areas. The panel stressed that students be taught strategies for obtaining the training necessary for postgraduate entry into a specialty area such as early intervention.
Clinical Teaching: Fieldwork Supervisors’ Attitudes and Values
Authors: Kautzmann Lisette N.
Published: April 2012

The purpose of this study was to initiate the identification of fieldwork supervisors’ educational needs by ascertaining their values and attitudes toward exemplary principles of teaching advocated by adult educators. Each principle was rephrased as an attitude or value associated with Level II fieldwork, matched with a Likert-type 5-point interval scale, and distributed to a convenience sample of 81 fieldwork supervisors. Ninety-two percent of the questionnaires were returned. The statement responses were tallied by frequency and were then summed and ranked. The range of scores indicated that the fieldwork supervisors’ values and attitudes were congruent with the identified principles of teaching. The rankings revealed that the supervisors placed the highest value on providing a thorough orientation and the lowest values on individualization of the fieldwork experience and supervisor–student collaboration. The findings indicate a need for further education about ways to individualize learning and involve students in planning, implementing, and evaluating the learning experience.
Perceptions of Role Assessment Tools in the Physical Disability Setting
Authors: Vause-Earland Tracey
Published: April 2012

Various role assessment tools in occupational therapy have been developed to help the clinician understand role performance and role adjustment and guide the structure of intervention. This study was designed to examine the clinician’s perceptions of standardized role assessment tools in physical disability settings. A random sample of 450 occupational therapists was surveyed to learn about therapists’ knowledge of four published role assessment tools. The study also examined the frequency of tool use in the acute care hospital, the rehabilitation center, and the long-term care facility.

The results from 236 questionnaires (a 52% response rate) indicated that more than half of the respondents reported that their current initial evaluation did not effectively address role performance. Additionally, most of the therapists surveyed had a poor understanding of the four standardized role assessment tools, and only 5% were using an assessment instrument in their practice. The respondents reported a desire to learn more about these instruments and how they affect treatment planning. Training implications, educational opportunities, and recommendations for future research are discussed.
Reliability of Three Clinical Measures of Muscle Tone in the Shoulders and Wrists of Poststroke Patients
Authors: Worley J. Scott , Bennett Wanda , Miller Georganna , Miller Mary , Walker Blanks , Harmon Clarissa
Published: April 2012

Muscle tone was tested at the shoulders and wrists of 49 randomly selected poststroke patients with the use of resting joint position (SJP and WJP), resistance to passive movement or stiffness (SRM and WRM), and angle of appearance of resistance (SAR and WAR). Subjects were tested while seated with their arm supported in a suspension sling adapted for free movement. Five of the first and immediately repeated measurement pairs showed strong correlations and interrater reliability (SJP, .839; WJP, .900; SRM, .886; WRM, .904; SAR, .884 [p < .05]). The sixth (WAR) showed moderate reliability (.618, p < .05). Resting joint position measurements were most reliable among subjects with higher tone. The joint first measured had a slight order effect on SRM among subjects with higher muscle tone. Its second measurements were slightly increased over the first among those subjects whose shoulders were measured first and slightly reduced when measured immediately after the wrist. Reliable means of clinical evaluation of muscle tone at the shoulder and wrist are available if the influence of level of tone and the mutual influence of muscles tested are prudently considered.
Play Deprivation in Children With Physical Disabilities: The Role of the Occupational Therapist in Preventing Secondary Disability
Authors: Missiuna Cheryl , Pollock Nancy
Published: April 2012

Self-initiated free play experiences are vital for the normal growth and development of all children. In this paper, children with physical disabilities who are deprived of normal play opportunities are viewed as having a second disability that hinders their potential for independent behavior and performance. Physical, social, personal, and environmental barriers that may limit the play experiences of children with physical disabilities are delineated. Studies of the interactions of these children during play are discussed, and a case is made for the promotion of active, free play in the home, the school, and the community. As facilitators of this process, occupational therapists must consider a variety of factors, including the unique capabilities of the child, the influence of parent–child and peer relationships, the role of other caregiving adults, the adaptation of toys and materials, and the impact of the environment and setting.
The Therapist With the Three-Track Mind
Authors: Fleming Maureen Hayes
Published: April 2012

This article reports some of the results of the American Occupational Therapy Association/American Occupational Therapy Foundation Clinical Reasoning Study. Therapists are thought to use three different types of reasoning when solving problems in day-to-day practice. Procedural reasoning guides the therapist in thinking about the patient’s physical performance problems. Interactive reasoning is used when the therapist wants to understand the patient as a person. Conditional reasoning is used to integrate the other two types of reasoning as well as to project an imagined future condition or situation for the person. Experienced occupational therapists seem to shift smoothly from one mode of thinking to another in order to analyze, interpret, and resolve various types of clinical problems.
Clinical Reasoning and New Ideas on Intelligence: Implications for Teaching and Learning
Authors: Schwartz Kathleen Barker
Published: April 2012

Some recent research efforts have been focused on the attainment of a better understanding of intelligence and reasoning. One such study is the Clinical Reasoning Study funded by the American Occupational Therapy Association and the American Occupational Therapy Foundation. Other studies have been conducted by theorists of human development. The findings of both groups reveal three common themes: the multiple aspects of intelligence, the importance of understanding the patient’s story, and the use of the caring perspective. This article examines these shared themes and discusses their implications for new directions in occupational therapy curricula.
The Narrative Nature of Clinical Reasoning
Authors: Mattingly Cheryl
Published: April 2012

Narrative reasoning is a central mode of clinical reasoning in occupational therapy. Therapists reason narratively when they are concerned with disability as an illness experience, that is, with how a physiological condition is affecting a person’s life. In this paper, narrative reasoning is contrasted with propositional reasoning, and two kinds of narrative thinking are examined. The first is the use of narrative as a mode of speech that can be contrasted with biomedical discourse, in which disability is framed as physical pathology. The second involves the creation rather than the telling of stories. Therapists try to “emplot” therapeutic encounters with patients, that is, to help create a therapeutic story that becomes a meaningful short story in the larger life story of the patient.
Meaning Ascribed to Major Professional Concepts: A Comparison of Occupational Therapy Students and Practitioners in the United States and Israel
Authors: Katz Noomi , Sachs Dalia
Published: April 2012

A number of concepts related to human performance, such as occupation, purposeful activity, function, work, doing, and play/leisure, are widely used in occupational therapy. Because these concepts are essential to the profession, we seek to understand their meaning. Many theorists in occupational therapy define and attribute different levels of importance to each of these concepts. The present study examines the professional (student vs. practitioner) and universal (American vs. Israeli) meanings of the six concepts named above. Four statistical methods were used: (a) a multivariate analysis of variance, (b) t tests and a sign test to analyze the Osgood semantic differential, and (c) Individual Differences in Multidimensional Scaling (Carroll & Chang, 1970). The results indicate that the American occupational therapists ascribed higher affective meanings than did all of the other groups to the concepts of purposeful activity, function, doing, and work. No difference was found for occupation and hobby, which rated high for all groups. Differences in the dimensions underlying the concepts between American and Israeli subjects suggest a cultural and linguistic influence on the meaning ascribed to the concepts.
Time as a Commodity: Reflections and Implications
Authors: Peloquin Suzanne M.
Published: April 2012

American society’s conceptualization of time as a commodity has supported occupational therapy practice since its inception. This article discusses numerous contemporary media messages about time both because they are pervasive and because their meaning often escapes us. Popular magazines, greeting cards, and cartoons weave themes about time into the fabric of other messages. There is remarkable coherence in the themes that cut across these three sources of time messages. Commercial images reveal the ideas that we are asked to accept about time; satirical images ask us to reflect about the ideas that we have accepted. A preponderance of images suggest that we control time and live in style. These suggestions constitute a cultural force that shapes personal values toward an end that we rarely consider. Occupational therapists need to recognize the presence and power of media images that radically challenge the meaning of living a satisfying life.
Influence of Occupational Therapy Curricula on Students’ Attitudes Toward Persons With Disabilities
Authors: Estes Joanne Phillips , Deyer Carole A. , Hansen Ruth A. , Russell J. Curtis
Published: April 2012

The influence of occupational therapy curricula on students’ attitudes toward persons with disabilities was studied. Twenty-six female students in either their first or fourth (i.e, final) semester of the occupational therapy curriculum were assessed with the Attitudes Toward Disabled Persons Scale (ATDP) (Yukor, Block, & Younng, 1966). A comparison group, 26 female students in either their first or fourth semester of the medical technology program, was also assessed with this scale. As hypothesized, the fourth-semester occupational therapy students showed significantly higher scores than did the other three groups of subjects. Also as predicted, this same group showed significantly higher scores than their first-semester counterparts and the fourth-semester medical technology students. No significant difference was found between first-semester and fourth-semester medical technology students. The occupational therapy curriculum appears to positively influence students’ attitudes towards persons with disabilities.
Job Satisfaction of Occupational Therapy Faculty
Authors: Rozier Carolyn K. , Gilkeson Grace E. , Hamilton Basil L.
Published: April 2012

What causes occupational therapy faculty to be satisfied with their teaching roles? A survey of 538 occupational therapy faculty was conducted with questions that identified demographic information and inquired about specific satisfying and dissatisfying items. Responses indicated no strong correlations between demographic information and satisfaction items but did offer some implications that warrant attention. The faculty were satisfied with teaching in general and specifically with the academic environment, the opportunity to design learning experiences, and the lack of constraints in higher education. The results of this study may help educational administrators make decisions that will foster recruitment, retention, and socialization of occupational therapy faculty.
Ethical Dilemmas in Family Caregiving for the Elderly: Implications for Occupational Therapy
Authors: Hasselkus Betty Risteen
Published: April 2012

An analysis of 60 ethnographic interviews with family caregivers for frail community-based elderly persons has suggested that ethical dilemmas are an important organizing framework for family caregiving. The present paper explores this conjecture as it relates to the practice of occupational therapy with older clients and their families. Major themes of ethical dilemmas in family caregiving, as derived from the ethnographic data, are described. Verbatim interview data are presented to illustrate the close ties between caregiving activity and the caregiver’s ethical convictions. Occupational therapists are encouraged to seek understanding of their clients’ ethical beliefs in order to maximize the potential for a therapeutic relationship built on mutual understanding and partnership.
An Ethnographic Study of Independent Living Alternatives
Authors: Spencer Jean Cole
Published: April 2012

The purpose of this ethnographic study was to compare 12 settings in which housing, attendant assistance, and transportation were shared by clusters of young adults with physical disabilities during the early years of the independent living movement. The settings that were studied were (a) a demonstration independent living program established by a medical rehabilitation facility, (b) a university dormitory, (c) four apartment clusters, and (d) six nursing homes. Data were gathered with ethnographic interviews of 109 subjects as well as by participant observation in each setting. Independent living alternatives are compared in terms of their ability to support residents’ engagement in school, work, and leisure activities and their social and cultural similarities and differences. Findings are also reported on how residents viewed their experience in clustered living arrangements and how they believe these experiences shaped their future. Implications of the findings are discussed in terms of public policy issues, including the need for community-based support services, alternative models for organizing such services, and better planning of transitions from institutions to the community.
Treatment of Lateral Epicondylitis
Authors: Fillion Peggy L.
Published: April 2012

Lateral epicondylitis associated with cumulative trauma as seen in the clinical setting has usually involved long-term care with fair results. This paper describes the structured treatment program for lateral epicondylitis developed at the Michigan Hand Rehabilitation Center in Warren, Michigan. Results of the program, as reflected in five cases, have been a decrease in treatment time and a high incidence of return to work with no symptoms or reduced symptoms.
Correlation of Perceptual Performance and Activities of Daily Living in Stroke Patients
Authors: Titus Mary Nelle D. , Gall Norman G. , Yerxa Elizabeth J. , Roberson Trish A. , Mack Wendy
Published: April 2012

Twenty-five male stroke patients were assessed with the use of a battery of perceptual tests (Gross Visual Skills [Baum, 1981], Adult Visual-Perceptual Assessment [Baylor University Medical Center, Occupational Therapy Department, 1980], Manikin and Feature Profile subtests of the Arthur Point Scale of Performance Tests [Arthur, 1943; Buros, 1974, 1978], Judgment of Line Orientation [Benton, Varney, & DeS. Hamsher, 1978], Bender Visual Motor Gestalt Test [Bender, 1946], Haptic Visual Discrimination Test [McCarron & Dial, 1976, 1979a, 1979b], Block Design and Object Assembly subtests of the Wechsler Adult Intelligence Scale–Revised [Wechsler, 1981], and Test of Three-Dimensional Constructional Praxis [Benton, 1973a; Benton & Fogel, 1962]). Also administered was the Klein–Bell ADL Scale (Klein & Bell, 1982) to measure performance of activities of daily living. The research questions were as follows: (a) To what extent did this sample of stroke patients differ from the normative samples on perceptual performance? (b) To what extent did any tests of perceptual performance correlate with performance of activities of daily living? and (c) What, if any, instruments were more useful in discriminating the perceptual performance of stroke patients from that of normative samples? The results indicated that stroke patients showed significant deficits in perceptual performance, some of which correlated with activities of daily living performance. Patients with right hemispheric lesions performed similarly to those with left hemispheric lesions except on the Haptic Visual Discrimination Test.
Resilience and Human Adaptability: Who Rises Above Adversity?
Authors: Fine Susan B.
Published: April 2012

We work in a world of traumas and triumphs. Most of the persons we serve come to us out of necessity, struggling with the sequelae of disease and illness or the aftermath of natural or manmade disasters. We bring our expertise and compassion; they bring their bodies, minds, and compromised lives. Our worlds converge around a shared task: identifying and enhancing their capacities for daily living. We pursue problems of movement, perception, cognition, affect, and social capacity within the context of their roles and aspirations. Our contacts may be extensive, but often they are brief and only partially fulfilled. Our patients move on with varying degrees of functional ability – some with determination and buoyancy, others with little confidence that life is actually worth living. We remain, frequently knowing little about the factors that have influenced the outcome of our efforts, in spite of their compelling importance to our patients, our professional viability, and the health care system.
Ethical Dilemmas in Driver Reeducation
Authors: Cook Carol A. , Semmler Caryl J.
Published: April 2012

This article illustrates ethical dilemmas faced by therapists who provide driver reeducation. The dilemmas discussed are (a) accepting a wide range of referral sources and client disabilities versus the inability to know enough to anticipate all driver performance errors, (b) the client’s safety versus the client’s right to independence, (c) financial constraints versus advantages of technology, and (d) the reporting of poor driving risk versus client confidentiality. A method for determining one’s pattern of resolving ethical dilemmas is discussed.
Addressing the Needs of the Cognitively Impaired Elderly From a Family Policy Perspective
Authors: Baum Carolyn Manville
Published: April 2012

Management of the cognitively impaired elderly person in the community is presumed to be cost-efficient and the American way. Although this is what should be done, most would agree that paying for the services that make it possible to do so is not currently within the means of the median income of the family ($25,986) or of the female head of household ($15,350) in this country. This paper reviews the changes in the family, current family policies, and practices of our businesses and government and proposes the services that could be used to support both the impaired person and the family in the management of this evolving societal issue. Strategies for development of payment mechanisms for the proposed services are presented.
Access to Computers for Older Adults: Problems and Solutions
Authors: O’Leary Stephanie , Mann Charlotte , Perkash Inder
Published: April 2012

Activity that involves a personal computer is a valuable modality for the rehabilitation of older adults. The therapist without specialized training, however, may have difficulty integrating computer use with adults with chronic health problems that impede such use. The purpose of this paper was to describe positioning, visual access, and input problems that may interfere with computer access and to identify solutions for use by the occupational therapist. Through a review of occupational therapy and adaptive computer literature, resources for adaptive computer hardware, software, and positioning devices are identified. Examples of how computer activities can be integrated into existing nursing home, day-care, and homecare programs are provided. Recommendations are made for training for the occupational therapist with limited experience with personal computers and adaptive computer technology.
Educating Entry-Level Occupational Therapy Students in Gerontology
Authors: Stone Ronald G. , Mertens Krista B.
Published: April 2012

The need for gerontic occupational therapists is increasing as the number of elders increases. The practice of including gerontologic content in occupational therapy entry-level curricula is relatively new. This article provides a rationale for including gerontologic content in entry-level occupational therapy curricula and presents the results of a brief survey conducted in November 1990 of all accredited and developing entry-level professional occupational therapy programs in the United States. Seventy-one percent of the entry-level programs responded. All of the responding programs included some gerontologic content in their curricula, and 82% of the responding programs indicated that the amount of gerontologic content in the required curriculum had increased in the past 5 years. Other gerontologic elements examined were courses offered and topics included in entry-level curricula, textbooks used, and gerontic fieldwork requirements.
The Contribution of Motor Skills and Playfulness to the Play Performance of Preschoolers
Authors: Morrison Christine Doyle , Bundy Anita C. , Fisher Anne G.
Published: April 2012

Consideration of a child’s motor proficiency, intrinsic motivation, internal locus of control, and freedom to suspend many of the constraints of objective reality were proposed to provide a more comprehensive assessment of play than would an assessment of play performance alone. For empirical validation of this conceptual model of play, 29 subjects (15 nondisabled children and 14 children with juvenile rheumatoid arthritis) between the ages of 4 years 6 months and 6 years 6 months were given four assessments: (a) the Preschool Play Scale (Bledsoe & Shepherd, 1982, Knox, 1974); (b) the Bruininks–Oseretsky Test of Motor Proficiency (Bruininks, 1978); (c) the Preschool and Primary Internal–External Locus of Control Scale (Nowicki & Duke, 1974); and (d) tests of associative fluency (Wallach & Koogan, 1965; Ward, 1968).

Multiple regression procedures revealed that, when considered together, scores on the Bruininks–Oseretsky Test of Motor Proficiency, tests of associative fluency, and the Preschool and Primary Internal–External Locus of Control Scale predicted scores on the preschool Play Scale, thereby supporting the usefulness of the proposed theoretical model. Further, there was no significant difference in the mean scores of the two groups on the Preschool Play Scale. Although this finding may be an artifact of the small sample size, it also may support the authors’ belief that children with motor impairments are able to compensate for their limitations by developing areas of relative strength that allow them to play normally. When this belief was further tested with Pearson product-moment correlations and Fisher’s Z transformations, it was found that correlations between the test scores of the nondisabled children were not significantly different from those of the children with juvenile rheumatoid arthritis. Clearly, further research is needed.
Ventilatory and Cardiometabolic Responses to Unilateral Sanding in Elderly Women With Ischemic Heart Disease: A Pilot Study
Authors: Muraki Toshiaki , Kujime Kenichi , Kaneko Tasuku , Su Michiyo , Ueba Yasuyuki
Published: April 2012

This study was undertaken to investigate how 8 elderly women with ischemic heart disease would respond to a unilateral sanding activity. Three ventilatory measures – expiratory tidal volume, respiratory rate, and expiratory volume – and four cardiometabolic measures – metabolic equivalent, systolic blood pressure, heart rate, and pressure rate product – were continuously recorded during the sanding activity. The two independent variables were angle of the sanding board and sanding velocity. The activity was graded to yield five conditions: (a) sitting at rest; (b) 0° at 15 cycles per min (cpm); (c) 0° at 30 cpm; (d) 15° at 15 cpm; and (e) 15° at 30 cpm. The findings indicated that increasing the angle of the board while holding the velocity constant did not always increase the mean values of the ventilatory and cardiometabolic measures. However, increasing the velocity while holding the angle constant always increased the mean values of the dependent variables. The data also indicated that the metabolic equivalent reached during the sanding activity was no greater than 2, which corresponds to a light activity, such as playing a musical instrument. Replication of the study with a larger sample size may further elucidate the behavior of these two functions during a graded sanding activity. In the present study, a unilateral sanding activity by elderly patients with cardiac impairment was shown to provide valuable data on ventilatory and cardiometabolic functions. The study also demonstrated that a unilateral sanding activity can be safely used as a graded activity in occupational therapy for the cardiac rehabilitation of elderly women.
The Effects of a Short Thumb Opponens Splint on Hand Function in Cerebral Palsy: A Single-Subject Study
Authors: Goodman Glenn , Bazyk Susan
Published: April 2012

An AB single-subject research design was used to assess the effectiveness of a short thumb opponens splint on hand function in a 4-year-old girl with cerebral palsy. Baseline data for active range of motion, grip and pinch strength, grasp patterns, the Box and Block Test of manual dexterity (Mathiowetz, Voland, Kashman, & Weber, 1985), and 1-in. cube stacking were collected twice a week for 4 weeks. The child was fitted with a short thumb opponens splint, which was worn 6 hr during the day and all night for 4 weeks. The twice-weekly measures of the dependent variables continued during the treatment phase. Visual and statistical analysis of the data indicate that the child showed a clinically significant improvement in palmar and radial abduction, thumb opposition, grip strength, performance on the Box and Block Test scores, cube stacking, and lateral pinch. These results suggest that for this child with cerebral palsy, the use of a short thumb opponens splint improved underlying aspects of hand function as well as hand function itself. Replication of this study with a more complex single-subject design involving more subjects is recommended to confirm these results.
Volumetric Comparison of Seated and Standing Test Postures
Authors: Stern Erica B.
Published: April 2012

Published protocols for the volumetric assessment of upper-extremity edema differ regarding patients’ posture. The present study was designed to determine the effect of posture on test–retest reliability and mean volume. Thirty women were tested in both seated and standing postures. For the dominant hand, test–retest reliabilities for the seated posture were identical to those for the standing posture. Test–retest reliability was slightly stronger for the nondominant hand in sitting than for the same hand in standing. Both postures afforded clinically acceptable test–retest reliabilities. The mean volumes in sitting were significantly lower than those in standing (p < .0001), thus suggesting that volumetric measures should be considered discontinuous if the patient’s test posture is altered. Mean volumes of the dominant hand averaged 9.3 ml more than those of the nondominant hand. It is suggested that this discrepancy be considered in the establishment of goals for edema control and in the determination of the need for continued edema treatment.
Motor Function and Activities of Daily Living Assessments: A Study of Three Tests for Persons With Hemiplegia
Authors: Filiatrault Johanne , Arsenault A. Bertrand , Dutil Elisabeth , Bourbonnais Daniel
Published: April 2012

The relationship between upper extremity motor function and independence in basic activities of daily living in subjects with hemiplegia was explored. The Barthel Index (Mahoney & Barthel, 1965) and the Fugl-Meyer Test (Fugl-Meyer, Jääskö, Leyman, Olsson, & Steglind, 1975) were selected as the standard instruments for the evaluation of activities of daily living and upper extremity motor function, respectively, because their validity and reliability have been demonstrated many times. The Functional Test for the Hemiplegic/Paretic Upper Extremity (Wilson, Baker, & Craddock, 1984a, 1984b) was also used for the evaluation of upper extremity motor function. The results obtained in 18 subjects with hemiplegia indicate that the scores on the Barthel Index are poorly correlated with both the Fugl-Meyer Test and the Functional Test for the Hemiplegic/Paretic Upper Extremity scores. It is suggested that variables other than motor function, such as the learning of compensatory techniques and perceptual–cognitive status, are responsible for this discrepancy because they can influence activities of daily living performance in persons with hemiplegia. The high correlation between the scores on the Fugl-Meyer Test and the Functional Test for the Hemiplegic/Paretic Upper Extremity indicates that either test may be used for the assessment of upper extremity motor function.
The Effects of Tactile Defensiveness and Tactile Discrimination on In-Hand Manipulation
Authors: Case-Smith Jane
Published: April 2012

The purpose of this study was to compare in-hand manipulation efficiency in children with and without tactile defensiveness and low tactile discrimination. Fifty children, aged 4 to 6 years, were tested with the use of three subtests of the Southern California Sensory Integration Tests (SCSIT) (Ayres, 1980), which measured tactile function, and three in-hand manipulation tasks. Tactile defensiveness was rated during performance of the selected SCSIT subtests. Nine of the children had mild developmental delays and 41 were without delays. Low correlations between scores on tactile defensiveness and tactile discrimination suggested that these two aspects of tactile function are separate but related phenomena. Children with both defensiveness and discrimination problems demonstrated the least efficiency on all of the in-hand manipulation tasks and had significantly higher time scores on the turn and translation in-hand manipulation tasks. Poor discrimination or tactile defensiveness alone did not relate to poor in-hand manipulation. The results suggest that a child’s tactile function should be considered in therapy to improve manipulation skill. Strategies to decrease tactile defensiveness and improve tactile discrimination may facilitate achievement of higher levels of in-hand manipulation.
A Model for Database Design
Authors: Renwick Rebecca M.
Published: April 2012

Computerized databases can facilitate several types of occupational therapy research. The value and usefulness of any database, however, is dependent on how well it has been designed. In this paper, a systematic, sequential-process model for the development of a computerized database is introduced. Each component of the model is illustrated by examples of its application to the actual design of a database for a community agency that provides occupational therapy services. The model focuses on issues related to the development of the contents of a database rather than on computer hardware and software. The issues addressed by the model include decisions about the purpose of the database, selection of the variables, and identification of the most appropriate measures with which to operationalize these variables. Content-related development issues have been given little attention in the literature, yet their neglect typically results in important limitations on the usefulness of a database. Therefore, this paper provides a set of guidelines for occupational therapists planning to establish a database for facilitating research.
The History of Work in Physical Dysfunction
Authors: Hanson Carolyn Schmidt , Walker Kay F.
Published: April 2012

Work has been at the core of occupational therapy for the last seven and a half decades. The tenets of work, which include providing a way of making a living and giving meaning to one’s existence, have remained consistent throughout occupational therapists’ use of work in the treatment of physical disabilities during three eras: World Wars I and II, the era of industrial therapy, and the work-hardening era. Although technological advances and economics have changed the scope of work, it is evident that the work-hardening programs of today have their roots in the work cure of the early 1900s.
Therefore Be It Resolved: 25 Years of Delegate Assembly/Representative Assembly Legislation
Authors: Jones Jacqueline L.
Published: April 2012

In 1965, the power to legislate the affairs of the American Occupational Therapy Association (AOTA) passed from the Board of Management to the newly created Delegate Assembly. AOTA’s progress in the 25-year period from 1965 to 1990 can be traced by studying the resolutions deliberated upon by that Assembly and its successor, the Representative Assembly. Of interest historically are not only the resolutions passed, but those defeated as well, because all indicate concern for the issues of the times in which the resolutions originated. This paper discusses certain trends that became evident, such as health care legislation concerns, strategic planning, the position of the certified occupational therapy assistant in AOTA, standards in practice and research, and advanced education. It emphasizes such issues as membership fees, continuing competency and continuing education, recruitment and personnel, and specialization.