bluuebunny/crossref_metadata_2025 huggingface dataset:
The Occupational Therapist as an Expert Witness
Authors: DeMaio-Feldman Diane
Published: April 2012

This article provides an overview of the occupational therapist’s role as an expert witness in civil litigation. It includes a description of the role and the qualifications of the occupational therapy expert witness. The material was drawn from the author’s experience.
Adult Performance on Three Tests of Equilibrium
Authors: Fisher Anne G. , Wietlisbach Shirley E. , Wilbarger Julia L.
Published: April 2012

The purpose of this investigation was twofold: (a) to determine preliminary norms for young adult males and young adult females on three clinical tests of equilibrium, Tilt Board Tip (TBT), Tilt Board Reach (TBR), and Flat Board Reach (FBR), and (b) to determine sex differences in equilibrium performance. The three equilibrium tests were administered to a sample of 25 men and 29 women between the ages of 20 and 30 years. The results revealed a significant sex difference on TBT, with men obtaining significantly higher scores than women. FBR approached significance, and no significant difference was found on the TBR. These results support earlier findings of sex differences in performance on a variety of equilibrium measures and suggest that different normative criteria should be used to evaluate the performance of males and females on some tests of equilibrium. Possible reasons for males obtaining higher scores on TBT and for lack of differences between male and female performance on FBR and TBR are discussed.
The Educational Preparation and Professional Activities of Occupational Therapists
Authors: Rogers Joan C. , Brayley Caroline R. , Cox Richard C.
Published: April 2012

The professional activities of five groups of occupational therapists with different educational backgrounds were compared to examine the influence of education on career characteristics. Analysis of covariance, using length of professional experience as the covariate, revealed statistically significant differences in the areas of education, administration and supervision, leadership, oral presentations, publications, and research but not in clinical practice, public relations, products development, or professional recognition. The greatest differences emerged between the bachelor’s, postbaccalaureate certificate, and basic master’s groups and the advanced master’s and other master’s groups, thus supporting the association between increased education and increased professional involvement. No differences were detected between the bachelor’s, certificate, and basic master’s groups or between the advanced and other master’s groups. The least involvement in professional activities occurred in the certificate group although the participation level for all groups was low. Although the findings highlight the important role of education in increasing therapists’ involvement in professional activities, educational interventions more subtle than manipulating the entry level for practice or proliferating occupational therapy graduate programs may be needed to create a cadre of occupational therapists committed to advancing the stature of occupational therapy.
Development of the Satisfaction with Performance Scaled Questionnaire (SPSQ)
Authors: Yerxa Elizabeth J. , Burnett-Beaulieu Sandra , Stocking Sarah , Azen Stanley P.
Published: April 2012

A new instrument, the Satisfaction with Performance Scaled Questionnaire (SPSQ), was developed to measure individuals’ satisfaction with their performance of independent living skills. The SPSQ was designed to be used for clinical assessment and research with community-based persons with disabilities. Split-half reliability coefficients were .97 and .93 for the two scales, Home Management and Social/Community Problem Solving, respectively. Preliminary findings provided support for construct validity. The SPSQ appears promising as a measure of the phenomenology of engagement in activities related to independent living in the community.
Men in Occupational Therapy
Authors: Rider Barbara A. , Brashear Robert M.
Published: April 2012

The purpose of this study was to identify the characteristics of male occupational therapists so that better strategies for recruiting men into the profession can be developed and the problem of retaining men in the field can be addressed. Male occupational therapists were surveyed at 3-year intervals, in 1978, 1982, and 1985. Our survey results were compared with results of the 1969 American Occupational Therapy Association (AOTA) Member Data Survey reported by Jantzen (1973), the 1982 AOTA Member Data Survey, and an unpublished study by Watson (1983).

The number of professional occupational therapists almost tripled from 1970 to 1985, whereas the increase in the proportion of men was only from 3.9% to 5%. The study showed that as a group, male occupational therapists today are younger, more likely to have advanced degrees, and less likely to be married than their 1969 counterparts. Additional data included employment data, educational data, and demographic information such as family position, education and occupation of parents, extracurricular activities in high school and college, factors influencing career choice, and goals for the future.
Historical Research Methods in Occupational Therapy
Authors: Schwartz Kathleen Barker , Colman Wendy
Published: April 2012

This article discusses the process and methods of historical research in relation to occupational therapy. The paper reviews the process of writing history, including data gathering, organization, and interpretation as well as the responsibilities of the historical researcher. The authors propose that the methods of historical research can be used by occupational therapists as a means to develop a body of knowledge about the profession’s history.
Ethical Considerations in Clinical Reasoning: The Impact of Technology and Cost Containment
Authors: Neuhaus Barbara E.
Published: April 2012

This article raises, but does not answer, the kinds of questions that need to be asked by responsible occupational therapists in the 1980s—ethical questions that deal with technological advances on the one hand and limited resources on the other. The article examines moral dilemmas that practitioners and students face when making clinical decisions in a climate where technology and cost containment may overshadow the needs of the individual patient. A review of the literature on clinical reasoning, technology, and cost containment provides the background for a discussion of specific issues of quality of life for the occupational therapist. Implications for education and practice are presented, with suggestions for further consideration.
Comparison of Tactile Preferences in Children With and Without Cerebral Palsy
Authors: Curry Jeanette , Exner Charlotte
Published: April 2012

Fifteen normal preschool children and 15 preschool children with cerebral palsy were presented with 10 pairs of objects and asked to identify their preference for one of the objects in each of the pairs. Five objects of different textures were used. The children only handled the objects; they did not view them during testing. The children with cerebral palsy chose hard objects significantly more often than they chose soft objects; the normal children had no significant choice preferences. Eleven of the children with cerebral palsy had choice patterns significantly different from those of the normal children. The apparent preference of the children with cerebral palsy for hard objects and their avoidance of soft objects suggests that they may have decreased tactile awareness and need the greater proprioceptive input that hard objects provide. The findings of this study indicate that preschool children with cerebral palsy may be at high risk for somatosensory disorders, which could markedly affect their hand function.
Development of Oral Side Preference During Chewing and Its Relation to Hand Preference in Normal 2- to 8-Year-Old Children
Authors: Gisel Erika G.
Published: April 2012

Normative data on skills of the tongue used in eating are presented. Normal children 5 to 8 years old were studied regarding their preference of placing food either on the right or left side of the mouth when starting to eat. A developmental curve spanning 2 to 8 years was generated by including data from an earlier study. Data of oral side preference were correlated with data of preferred hand use. In addition, the ability to move a small piece of food from one side of the mouth to the other was studied.

It was found that normal children undergo a transition from placing solid food predominantly on the right side at 2 years of age to placing it on the left side at 4 years of age. The left side preference persists until at least 8 years of age for both viscous and solid food textures. Oral side preference did not correlate with hand preference. The ability to move food from one side of the mouth to the other (lateralizing) was found to undergo a developmental progression: The inability to lateralize in a third of 2-year-olds gave way to rolling movements. Concomitantly, a consistent increase in slow and then smooth movements was found to occur from 2 to 8 years of age.

These data provide the clinician with a normative baseline against which eating-impaired children can be compared.
Perspectives on the Status of Sensory Integration Theory
Authors: Tickle-Degnen Linda
Published: April 2012

Sensory integration theory has generated many studies over the past decade, and individuals who are evaluating the theory and its ramifications for treatment have started to draw conclusions based upon those studies. However, the theory underlying treatment has not been fully explored through research, nor have the bulk of the treatment effectiveness studies demonstrated the methodological and statistical power necessary to adequately accept or reject effectiveness. The purpose of this article is to examine how research on sensory integration therapy relates to the underlying theory of therapy, how it is guided by the theory, and how it can be used to evaluate and develop the theory. The perspective taken in this discussion is that of a professional who does not have the experience of practicing sensory integration treatment but who is informed through the published research in the area. It is hoped that the resultant simplicity and objectivity of the discussion will provide a useful analysis of the complex issues surrounding research in this area. Suggestions are given for improving the knowledge of “outsiders” about the theory and practice of sensory integration treatment through research.
Occupational Therapy Treatment in Home Health Care
Authors: Kunstaetter Daisy
Published: April 2012

This study reviewed 96 home care records for patients seen at a home health agency during 1985. Recorded data were supplemented with information obtained from interviews with therapists who provided the care. Results of the study reveal a discrepancy between the therapists’ perception of treatment given and the treatment areas that are documented. Emphasis in documentation was found to be greater for sensorimotor components than for other treatment areas, and psychosocial skills were not included at all in the treatment plans reviewed. Therapists’ reports indicated that more emphasis is placed on the documentation of reimbursable skills than on other treatment areas. The implications of these results are presented.
Early Occupational Therapy Education in Wisconsin: Elizabeth Upham Davis and Milwaukee-Downer College
Authors: Jones Jacqueline L.
Published: April 2012

Among the early influences on the profession of occupational therapy were the founding schools and those who helped create them. The Midwest was energized by Elizabeth Upham Davis, who was instrumental in establishing the occupational therapy education program at Milwaukee-Downer College in 1918. This paper relates Mrs. Davis’s efforts on behalf of occupational therapy both in the development of the program at Milwaukee-Downer and on a national level during the early years of the profession.
Pain Management by Occupational Therapists
Authors: McCormack Guy L.
Published: April 2012

Chronic pain is common among individuals with physical disabilities. It can interfere with therapy since patients with chronic pain can become uncooperative and reluctant to move. In some cases, patients may even project their discomfort onto the therapist. This paper reviews the natural physiological mechanisms that can reduce pain perception. The occupational therapist can help facilitate the activation of these mechanisms through a combination of noninvasive modalities, functional activities, and the therapeutic use of self.
Changes in Occupational Role Performance After a Severe Burn: A Retrospective Study
Authors: Cheng Susan , Rogers Joan C.
Published: April 2012

Ten men with severe burn injuries were interviewed to examine their perceptions of the residual impact of severe burn on performance in self-care, home management, work, and leisure occupations within the year after rehabilitation. Three patterns of occupational role performance after a burn were identified: (a) a resumption of participation in all four occupational categories; (b) a return to independence in self-care with substantive impairment in home management, work, and/or leisure roles; and (c) substantive disruption in all occupational roles. Role loss or disruption was commonly associated with reduced endurance, intolerance for standing and walking, and impaired grip strength and upper extremity skill. Suggestions for rehabilitation programming and research are made.
The Meaning of Daily Activity in Family Caregiving for the Elderly
Authors: Hasselkus Betty Risteen
Published: April 2012

Sixty ethnographic interviews with 15 family caregivers for frail older people living in the community were analyzed to understand the meaning of activity in caregiving. Schön’s (1983) reflection-in-action framework was used to organize the data. Three goals of caregiving activity were derived: (a) getting things done, (b) achieving a sense of health and well-being for the care receiver, and (c) achieving a sense of health and well-being for the caregiver. The family caregiver was conceptualized as a lay practitioner involved in the clinical reasoning and ethical dilemmas integral to the provision of health care for the care receiver. The caregivers’ judgments regarding the prioritization and attainment of goals determined the forms of caregiving activities. Implications for occupational therapy practice and the relationship between the caregiver and the professional are discussed.
Early Intervention and the Influence of the Occupational Therapist on the Parent–Child Relationship
Authors: Humphry Ruth
Published: April 2012

The child’s development and the parent–child relationship reflect two interdependent processes. Several factors influence the occupational behavior of the child and the adult. In this paper, the ways in which occupational therapists can influence both the child and the parent–child relationship are identified. The parents’ occupational behavior is influenced by their knowledge of their children and their attitudes regarding the parenting role. The occupational therapist is part of the social support system and can work with the parents to enlarge their feelings of social embeddedness and support. In addition, the occupational therapist can influence the parent–child relationship by fostering the child’s development and helping the parents learn techniques to deal with their child’s undesirable characteristics, such as excessive irritability. Knowledge of the different avenues of influence helps the occupational therapist in planning and evaluating treatment in early intervention.
Criteria Mapping: A Method of Quality Assurance
Authors: Law Mary , Ryan Brenda , Townsend Elizabeth , O’Shea Barbara
Published: April 2012

Criteria mapping is a flexible and responsive method of chart audit that allows the simultaneous assessment of both the process and the outcome of care by means of health record abstraction. This method of audit is particularly suited to occupational therapy because it includes branching to reflect the sequential judgments of therapists and does not penalize the clinician for omitting unnecessary procedures. The purpose of this study was to determine the utility and reliability of the criteria mapping process in evaluating the quality of care for a self-care disability in an acute care setting. Three occupational therapists and one independent abstractor evaluated 12 charts twice. Intraobserver reliability calculated with intraclass correlation coefficients was .77 for the therapists and .65 for all observers. Interobserver reliability was .73 for the therapists and .72 for all observers. The criteria map provided comprehensive and relevant information about each chart. This paper discusses the implications of these findings for the ongoing monitoring of the quality of care in occupational therapy.
Occupational Disruption and Adaptation: A Study of House Fire Victims
Authors: Rosenfeld Mark S.
Published: April 2012

House fires are the most common disasters in our society. Disaster theorists acknowledge that complex daily living problems impede the recovery of victims. However, these problems have not been described in detail. The author conducted a qualitative study of the disruption to daily living routines caused by house fires and of the adaptation processes victims undertook to reestablish effective patterns of purposeful activity. The data-gathering methods included observation on the scenes of 15 house or tenement fires and in-depth interviews with members of 10 families displaced by fires. Disruption was found to occur in the victims’ use of time and comfort in their personal environment. A data analysis revealed a new process of occupational adaptation. The roles of tasks and activities were determined to be important in recovery.
Incidence of Upper Extremity Discomfort Among Piano Students
Authors: Revak Joan M.
Published: April 2012

The purpose of this study was to determine the incidence of upper extremity discomfort among piano majors at seven Philadelphia-area music schools. A questionnaire was distributed to 232 students, and a 31% return rate was obtained. Thirty (42%) of the 71 respondents reported experiencing discomfort that lasted more than 1 week, and 41 (58%) of the respondents reported experiencing little or no discomfort. Twenty-six (87%) of the students with discomfort suspended practice for a period of time or made adjustments at the piano. Pain/aching was the predominant discomfort reported among students. Students experienced their discomforts most frequently in the hand (49% of respondents), the forearm (19% of respondents), and the wrist (16% of respondents). The majority of students reported an impaired ability to play the piano that lasted for 6 months or less. Further research is needed to verify the scope of the problem among student pianists and to substantiate the numerous causes of discomfort that were uncovered in this study. This occupational group could benefit from the knowledge and skills of occupational therapists in the area of occupational performance and physical function.
Teaching Stress Management Techniques to a Schizophrenic Patient
Authors: Stein Franklin , Nikolic Suzanne
Published: April 2012

This paper describes a stress management training program used with a 26-year-old schizophrenic man attending an outpatient day care program. In a seven-session program the patient was taught to use various techniques in muscle relaxation and biofeedback to decrease anxiety and to cope with stress. The patient’s improvement on 7 of the 20 items of the State-Trait Anxiety Inventory demonstrated the effectiveness of even a short-term stress management program.
Specialty Choice in Occupational Therapy
Authors: Ezersky Sharon , Havazelet Leora , Scott Anne Hiller , Zettler Catherine L. B.
Published: April 2012

The shortage of occupational therapists specializing in mental health led to a survey of graduates from nine occupational therapy schools in the New York metropolitan area to determine the factors affecting their specialty choice. The variables examined were derived from a literature review of the specialty choice of psychiatry among medical students. They included personality, academic, clinical, and employment attributes. The results from 411 respondents supported the assumption that fewer occupational therapists were working in mental health than in pediatrics or physical disabilities. The primary factors affecting specialty choice were the fieldwork experience, the feelings of effectiveness in the specialty area, and the perception of employment availability. Recommendations based on a literature review and survey are included.
Feeding Efficiency of Premature Neonates
Authors: Case-Smith Jane , Cooper Patty , Scala Vicki
Published: April 2012

The purpose of this study was (a) to investigate the validity of the revised Neonatal Oral Motor Assessment Scale (NOMAS) in discriminating between efficient and inefficient feeders in a sample of high-risk premature neonates and (b) to identify significantly different oral motor behaviors in the two groups. The revised NOMAS rates normal and abnormal characteristics of nutritive and nonnutritive sucking. The 26 subjects were classified by the amount of liquid they consumed during the first 5 min of feeding.

The findings demonstrated that both nutritive and nonnutritive sucking scores were higher in the efficient feeders than in the inefficient feeders and that the revised NOMAS scores accurately classified the two groups. Characteristics that were significantly associated with inefficient feeding were lack of rhythm, disorganization in jaw and tongue movements, and pauses of more than 6 sec. Often, these responses appeared to be related to respiratory patterns.
Mouth Stick Design for the Client With Spinal Cord Injury
Authors: Smith Ruth
Published: April 2012

This paper reviews literature on mouth sticks and presents information from a survey of occupational therapists specializing in the treatment of persons with spinal cord injuries. The review discusses the standards of mouth-stick design that have been established by dentists, but the survey suggests that occupational therapy practice is widely discrepant from these standards. The author suggests increased education for occupational therapists to provide knowledge of the key elements of oral safety, and increased collaboration between occupational therapists and dentists in mouth-stick design, fabrication, and training to assure quality care for all persons who require a mouth stick.
The Biomechanics of Prehension
Authors: Spaulding Sandi J.
Published: April 2012

Occupational therapists who work with people who have physical dysfunctions are often involved in the treatment of hand injuries or disabilities. This article describes some of the mechanical principles that affect hand function, including kinematics, kinetics (force and torque), friction, stress, and strain. Practical occupational therapy examples are used to explain these principles.
Movement Laterality and Its Relationship to Hemispheric Specialization
Authors: Larkin Dawne
Published: April 2012

Hypothesized relationships between asymmetric brain processes and movement-related asymmetries are reviewed. Theories that attribute asymmetric preference and performance to hemisphere dominance have been superseded by more complex ideas: motor-specific and more global hemispheric specializations are considered to influence movement organization. Environmentally conditioned preferences and their relationship to preferential asymmetric movements are also addressed. The literature suggests that laterality may be dynamic, because task requirements have been shown to override asymmetric brain influences. This observation of the nature of laterality may result in a more flexible approach to the reeducation of preference and performance in brain-injured patients.
Occupational Therapy’s Role in Improving the Quality of Life for Persons With Cerebral Palsy
Authors: Kibele Alice
Published: April 2012

Adults with cerebral palsy need assistance to maximize their capabilities, interact with others, and achieve independence. They experience difficulty communicating their needs to successfully obtain medical/rehabilitation and independent living services, which are necessary to achieve independent living. Knowledge of the experience of such clients can help occupational therapists to better serve them. This study, which used a case study design, presents data collected during more than 80 hours of guided interviews with 5 study participants. A data analysis of the participants’ experiences showed recurring themes of the disability as the enemy, the importance of attitude, dependence versus independence, and the significance of purposeful activity. The participants’ experiences with therapists and independent living skills agencies are presented, as is an examination of the medical/rehabilitation and independent living models.
A Team Approach to Prevocational Services
Authors: Mitchell Marlys , Rourk Jane Davis , Schwarz Jennifer
Published: April 2012

This paper presents a chronology of legislative mandates for vocational rehabilitation, discusses their impact on occupational therapy, and describes relationships between special educators and vocational agencies. The Career Training Workshop, a prevocational program developed and used successfully by a North Carolina school district, is described here as an example of one effort to prepare students with disabilities for employment.
Alcohol Abuse and Perceptual-Motor Dysfunction: The Occupational Therapist’s Role
Authors: Van Deusen Julia
Published: April 2012

A review of the literature on perceptual-motor deficits in alcoholic patients is presented. Studies show that there is a relationship between perceptual-motor dysfunction and alcoholism. Because occupational therapists treat perceptual-motor deficits in other kinds of patients, they may have a role in treating these deficits in alcoholic patients as well. To assume such a role, however, occupational therapists must document a relationship between dysfunction in activities of daily living and perceptual-motor dysfunction in the alcoholic patient. Unless such a relationship is established, treatment of perceptual-motor dysfunction in alcoholic patients would not fall within the scope of occupational therapy.
Stroke Rehabilitation: Sensorimotor Integrative Treatment Versus Functional Treatment
Authors: Jongbloed Lyn , Stacey Susan , Brighton Cathy
Published: April 2012

This study compares the effectiveness of two occupational therapy approaches to treating cerebrovascular accident patients—the functional and sensorimotor integrative approaches. Subjects were 90 patients admitted to Holy Family Hospital in Vancouver, Canada, within 12 weeks after a first stroke. Consenting subjects were randomly assigned on admission to one of two occupational therapy treatment groups. All subjects received similar medical and nursing care and physical therapy.

An independent clinical evaluator assessed subjects’ function in self-care and mobility, meal preparation, and sensorimotor integration at specified times after admission. Neither the evaluator nor the subjects were aware of the treatment group to which they had been assigned.

Results showed no statistically significant differences between the two treatment groups on the three outcome measures. We therefore concluded that any differences between the effectiveness of the two approaches are small.
Internal and External Validity in Two Studies That Compared Treatment Methods
Authors: Gliner Jeffrey A.
Published: April 2012

Research comparing the effectiveness of two treatments offers both strengths and weaknesses for occupational therapy. Although it is worthwhile to determine which of two treatments works best for a particular problem, methodological problems may arise that preclude a valid conclusion. To draw valid conclusions from research, criteria for internal validity and external validity must be satisfied. The two preceding articles in this issue are examples of studies that used between-groups experimental methodology to compare the effectiveness of two different treatments. This paper evaluates the above-mentioned studies on the basis of principles of internal and external validity. One of these studies (Jongbloed, Stacey, & Brighton, 1989) was truly experimental, whereas the other study (Groves & Rider, 1989) was quasi-experimental. Results from both studies were similar because, in each study, both of the treatment groups improved, but there were no significant differences between treatments. Absence of a true control group in both studies presented limitations on the conclusion that both treatments worked equally well.
Grip Strength and Hand Dominance: Challenging the 10% Rule
Authors: Petersen Paul , Petrick Monica , Connor Heather , Conklin Deborah
Published: April 2012

The purpose of this study was to test the utility of the 10% rule in hand rehabilitation. The 10% rule states that the dominant hand possesses a 10% greater grip strength than the nondominant hand. This rule has been used for many years to assist therapists in setting strength goals for patients with injured hands. The sample for this study consisted of 310 male and female students, faculty, and staff from a small, private liberal arts college located in Pennsylvania. Grip strength was measured with a factory-calibrated Jamar dynamometer. Results showed an overall 10.74% grip strength difference between dominant and nondominant hands. This finding verified the 10% rule. However, when the data were separated into left-handed and right-handed subjects, a 12. 72% difference for right-handed subjects and a –0.08% difference for left-handed subjects was found. In conclusion, this study showed that the 10% rule is valid for right-handed persons only; for left-handed persons, grip strength should be considered equivalent in both hands.
Media Education Based on the Philosophy of Pragmatism
Authors: Breines Estelle B.
Published: April 2012

The responsibility for crafts instruction at New York University was transferred recently from the Art Department to the Department of Occupational Therapy, where a new model of media education has been developed. This change resulted from the difficulties students and faculty experienced in integrating craft activities with occupational therapy’s conceptual foundations and the realities of practice. These problems are not unique to this university but are common throughout our profession. This paper will discuss these problems and an attempt at their solution by outlining a model for media education based on historical and philosophical concepts pertinent to the profession. This model demonstrates the academic justification for the development and presentation of media education courses by occupational therapy faculty.
The Effects of a Maternal Preparation Program on Mother–Infant Pairs: A Pilot Study
Authors: Hamilton-Dodd Carol , Kawamoto Toni , Clark Florence , Burke Janice P. , Fanchiang Shan Pin
Published: April 2012

This quasi-experimental pilot study examined the association of a maternal preparation program with womens’ competence in maternal care behaviors, self-perceived adaptation to the maternal role, and satisfaction with the maternal preparation received in conjunction with obstetric and delivery care. Sixteen subjects participated in the program. A cost–benefit questionnaire was completed by the program participants to examine whether the availability of such a maternal preparation program would influence future selections of a hospital for delivery. Our Occupational Therapy Maternal Role Preparation Program was provided to the subjects in four sessions. The program included material on physiological changes in the new mother, orchestration of activities of daily living, infant development and individual differences, and the mother–infant relationship. Results were statistically significant only for the factor of the mothers’ satisfaction with their obstetric care and preparation for the maternal role, in favor of the treatment group. In addition, all 8 members of the treatment group reported that they thought the program was helpful and would recommend it to other mothers.
Moral Treatment: Contexts Considered
Authors: Peloquin Suzanne M.
Published: April 2012

Many scholars associate the 19th-century practice of moral treatment with occupational therapy practice. A more thorough understanding of moral treatment is therefore relevant for occupational therapists. This article considers moral treatment within the contexts that shaped both its characteristics and the course of its practice—the medical community and 19th-century society. This consideration may provide therapists with a broader understanding of moral treatment and enable them to address the question of a relationship between the two practices.
Guidelines for Using Both Activity and Exercise
Authors: Dutton Rebecca
Published: April 2012

The use of activity versus exercise has been a divisive topic that has separated occupational therapists into opposing factions regarding our legitimate tools. One approach to the resolution of this conflict is to use exercise as preparation and purposeful activity as application in a treatment plan. Preparation and application are not philosophically opposed concepts—They are the two ends of a continuum. The purpose of this paper is to explore how specific continua from the biomechanical and sensorimotor frames of reference can be used to generate specific guidelines about when to use activity and when to use exercise.
Formulating a Role for Occupational Therapy in Child Psychiatry: A Clinical Application
Authors: Sholle-Martin Susan , Alessi Norman E.
Published: April 2012

Occupational therapy is in need of role clarification within the specialty of child psychiatry. The literature reveals that occupational therapy is often undelineated or unrecognized by child psychiatry, has limited efficacy research, and may be at risk for losing its practice with children hospitalized for psychiatric disturbances. This paper outlines steps for the formulation of a specialized role for occupational therapy within this specialty. The Model of Human Occupation (Kielhofner, 1985) is suggested as a basis for conceptualizing this role. A clinical study focused on the evaluation of adaptive functioning with use of the Vineland Adaptive Behavior Scales (Sparrow, Balla, & Cicchetti, 1984, 1985) is presented as an example of a way in which occupational therapy can provide assessment data valuable to the interdisciplinary clinical team. The role of occupational therapy in both short-term and long-term hospitalization of children with psychiatric disturbances is described.
The Zone of Proximal Development in In-Hand Manipulation Skills of Nondysfunctional 3- and 4-Year-Old Children
Authors: Exner Charlotte E.
Published: April 2012

The purpose of this study was to assess the influence of verbal and visual cues on 28 nondysfunctional 3- and 4-year-old children’s performance of in-hand manipulation skills. During the uncued version of the test (pretest), the children were presented with play activities known to elicit in-hand manipulation skills in young children but were given no cues for specific manipulative skill use. Within 1 week of the pretest, after the children were randomly assigned to groups, a posttest was given in which the children were provided with verbal or visual cues. The results indicate that both visual and verbal cues were effective in increasing the groups’ test scores, but no significant differences were found based on the type of cue provided. Approximately 30% of the children in the study showed marked improvement on the posttest scores, whereas the others showed little change. The children who had lower pretest scores showed greater score increases on the posttest than did the children who scored somewhat higher initially. The use of an uncued test followed by a cued test may be an effective method for the identification of those children who are most likely to show improvement in these manipulation skills with intervention. This study’s findings lend tentative support to Vygotsky’s (1978) zone of proximal development theory and extends the application of his work into the domain of fine motor skills.
Descriptive Analysis of the Developmental Progression of Grip Position for Pencil and Crayon Control in Nondysfunctional Children
Authors: Schneck Colleen M. , Henderson Anne
Published: April 2012

This study was designed to investigate the developmental progression in pencil and crayon grip. The subjects were 320 nondysfunctional children aged 3.0 to 6.11 years, with 20 boys and 20 girls at each 6-month age interval. On the basis of a review of the literature, developmental pencil and crayon grips were defined for the study, and the type of grips each child used to perform a drawing task and a coloring task were recorded. Many children at each age level used mature pencil grips. A developmental progression, however, was shown by the percentage change of children at each age level who used mature grips. Forty-eight percent of the youngest group used mature grips, compared with 90% of the oldest children. Two pencil grips—dynamic and lateral tripod—appear to be common in older children. Differences in the developmental progression of pencil grip were noted between boys and girls and between a drawing task and a coloring task.
Art and Multiple Personality Disorder: An Expressive Framework for Occupational Therapy
Authors: Frye Becky
Published: April 2012

Patients with multiple personality and dissociative disorders have learned to create an alternate identity system, originally designed to protect them from experiencing the pain of inescapable, unrelieved trauma and abuse. The resulting amnesia and identity confusion cause significant dysfunction in daily living. Issues of trust and control are paramount, and occupational therapists are challenged with the task of engaging these patients in meaningful activity. Although these patients often avoid structured groups, they have generally been responsive to expressive art opportunities as an initial activity. This paper outlines an expressive framework by which occupational therapists can therapeutically manage the artwork behaviors of the patient with dissociative or multiple personality disorder. The material presented is based on clinical observation of more than a dozen patients with multiple personality disorder in various stages of recovery and of many persons with dissociative trauma who may have multiple personality disorder. These observations took place within an acute care, inpatient occupational therapy setting. Guidelines for the creation of a positive working alliance and therapeutic climate for self-expression are outlined, and a progressive model for the viewing of patients’ art products is described.
Occupational Therapy With Patients With Multiple Personality Disorder: Personal Reflections
Authors: Skinner Sarah T.
Published: April 2012

Patients with multiple personality disorder are being admitted to acute care psychiatric units with increasing frequency. Occupational therapists have been confronted with setting treatment goals and designing interventions for this population with little information available in the occupational therapy literature. This paper describes how one therapist, the author, reviewed psychiatric and psychological literature on multiple personality disorder to delineate a role for occupational therapists who are working with this special population on an acute care psychiatric unit within the context of existing programs.
Clinical Manifestations in Persons With Multiple Personality Disorder
Authors: Fike M. Laurita
Published: April 2012

Occupational therapists are becoming more involved in the treatment of persons with multiple personality disorder. Occupational therapy literature concerning treatment of this group of patients, however, is sparse. Clinical manifestations of multiple personality disorder include common alter personalities with distinct roles and functions, age-related behavioral patterns, and physiological differences. By recognizing and understanding these differences and characteristics and their relationship to treatment goals, occupational therapists can better use their background in life roles and occupations to increase the functional daily living skills of patients with multiple personality disorder.
Occupational Therapy Personnel and AIDS: Attitudes, Knowledge, and Fears
Authors: Atchison Ben J. , Beard Betty J. , Lester Lula B.
Published: April 2012

This study explored the attitudes, knowledge, and fears of occupational therapists and certified occupational therapy assistants regarding AIDS and HIV. The 119 respondents’ scores related to knowledge and fear revealed that many had significant fears about AIDS, which in turn may inhibit their willingness to care for persons with AIDS. The respondents also indicated a need for specific information about the condition, including current research data and information on infection control.
A Legal Perspective on AIDS
Authors: Cornblatt Marc S. , Ayres Marguerite J. , Kolodner Ellen L.
Published: April 2012

AIDS presents difficult and unprecedented legal problems. Because modern law requires that persons with disabilities or illnesses be integrated into the mainstream of society, past responses to those with communicable diseases are no longer acceptable. Laws dealing with AIDS patients will have to evolve gradually and build upon commonsense solutions to problems.
Coping With Grief in Response to Caring for Persons With AIDS
Authors: Piemme Joan A. , Bolle Jacques L.
Published: April 2012

AIDS has or will affect virtually every professional health care provider. Occupational therapists are in a key position to identify and intervene with the social and occupational changes and losses commonly experienced by this patient population. Suggestions are provided to assist occupational therapists in helping patients with AIDS maintain meaning in their lives. Strategies to help occupational therapists prevent burnout resulting from the emotional stress related to caring for patients with AIDS are suggested as well.
The Effect of Body Mechanics Instruction on Work Performance Among Young Workers
Authors: McCauley Maureen
Published: April 2012

Thirty young workers (aged 14 to 19 years) employed as groundskeepers and custodians were randomly assigned to two groups; one group received body mechanics instruction and the other did not. The instruction focused on proper spinal alignment in the work environment. Instruction on low back pain began with one classroom session before the subjects’ first day of work and continued during employment with two on-site sessions. The effect of instruction was evaluated through the observation of body mechanics during actual work performance. The results of the study indicate that the group that received instruction performed significantly better than the control group. This paper also discusses the occupational therapist’s role in providing job-specific body mechanics instruction in the work environment as a primary method of preventing low back pain.
Adding Meaning to a Design Copy Task Through Representational Stimuli
Authors: Licht Brian C. , Nelson David L.
Published: April 2012

Occupational therapists frequently use their knowledge of occupation to add meaning and purpose to therapeutic tasks. This study investigated the effects of an attempt to add meaning to a particular occupational situation—a design copy task. Added meaning was given to the design copy task through the use of stimulus figures that were representational of familiar objects—an arrow, a house, and a face. The control condition consisted of three nonrepresentational figures composed of the same geometric shapes, in the same locations on the paper as the representational figures, but combined differently. The order of presentation was controlled for. The study used 30 elderly subjects (22 women and 8 men) from six nursing homes. The accuracy of the drawings was measured by a blind rater using graph overlays and predetermined rules of scoring. A two-way analysis of variance with one repeated measure (Order × Type of Figure) indicated significant differences at the .01 level between the representational and nonrepresentational figures. This study demonstrates how added meaning can enhance performance on a visuomotor task in a vulnerable population.
Protocol for the Use of Videofluoroscopy in Pediatric Swallowing Dysfunction
Authors: Zerilli Karen S. , Stefans Vikki A. , DiPietro Michael A.
Published: April 2012

A clinical and research protocol was developed to compare the sensitivity and clinical value of videofluoroscopy with the traditional bedside clinical evaluation in the evaluation of children’s swallowing dysfunction. The bedside and videofluoroscopic evaluations of 33 children were reviewed retrospectively. Our findings indicated that recommendations for feeding changed for 14 of the children as a result of the information gained from the videofluoroscopic evaluation. The results suggest that videofluoroscopy provides therapists with more objective evidence than a bedside evaluation for determining the etiology of swallowing dysfunction and directing the management or treatment of this dysfunction.
The Relationship of the Allen Cognitive Level Test to Cognitive Abilities and Psychopathology
Authors: David Sandra K. , Riley William T.
Published: April 2012

The cognitive factors measured by the Allen Cognitive Level Test (ACL) (Allen, 1982) as well as the test’s relationship to level of psychopathology were examined through a retrospective study of 71 patients from a general hospital psychiatry unit. Pearson correlations, computed for the ACL score with the Shipley Institute of Living Scale (Shipley, 1940), a general measure of intellectual functioning, were significant. A strong correlation was found between the ACL and the Symbol-Digit Modalities Test (Smith, 1982), a measure of motor speed and concentration often used as a neurological screening instrument. This suggests the potential usefulness of the ACL to screen for cognitive dysfunctions associated with organicity. Contrary to hypothesis, there was no significant correlation between the ACL and measures of psychopathology such as the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) and the Minnesota Multiphasic Personality Inventory (Hathaway & McKinley, 1940). The relationship of the ACL to other recognized measures of cognitive functioning increases its usefulness as a valid measure of day-to-day limitations in the functioning of psychiatric patients. Effective communication of the implications of these cognitive levels to a multidisciplinary treatment team is enhanced by knowledge of the relationship of the ACL to measures of cognitive functioning and psychopathology used by other disciplines.
The Effect of Rhizotomy on Movement in Patients With Cerebral Palsy
Authors: Berman Barbara , Vaughan Christopher L. , Peacock Warwick J.
Published: April 2012

Selective posterior lumbar rhizotomy has recently become an alternative method for relieving spasticity in patients with spastic cerebral palsy. This procedure involves the selective sectioning of the lumbosacral posterior nerve rootlets. Because the whole nerve root is not cut, tactile and proprioceptive sensation remain intact. The present study measured the changes that occurred in 29 patients with spastic cerebral palsy 2 days before surgery and from 4 to 14 months after surgery. Each patient was used as his or her own control. In addition to the clinical evaluation of function, gait was analyzed on appropriate patients with a simple digital camera and microcomputer. The results indicated positive gains after rhizotomy. These gains were, however, dependent on the patients’ abilities before surgery. The most significant improvement occurred in thigh and knee ranges of movement. This somewhat controversial new method of treating spasticity shows promise in improving the quality of life of patients with spastic cerebral palsy and in facilitating their treatment.