bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensory Processing in Children With and Without Autism: A Comparative Study Using the Short Sensory Profile
Authors: Tomchek Scott D. , Dunn Winnie
Published: October 2011

OBJECTIVE. The purpose of this study is to investigate differences in sensory processing among age-matched children between ages 3 and 6 years with autism spectrum disorders (ASD) and those who are typically developing.

METHOD. Reported sensory processing abilities of 281 children with ASD were compared to age-matched peers who were typically developing, using the Short Sensory Profile (SSP).

RESULTS. Ninety-five percent of the sample of children with ASD demonstrated some degree of sensory processing dysfunction on the SSP Total Score, with the greatest differences reported on the Underresponsive/ Seeks Sensation, Auditory Filtering, and Tactile Sensitivity sections. The ASD group also performed significantly differently (p < .001) on 92% of the items, total score, and all sections of the SSP.

CONCLUSION. These findings, considered with similar published studies, begin to confirm the prevalence and types of sensory processing impairments in autism. Further research is needed to more clearly define patterns of sensory processing in people with ASD.
Sensory Processing Disorders in a Nonhuman Primate Model: Evidence for Occupational Therapy Practice
Authors: Schneider Mary L. , Moore Colleen F. , Gajewski Lisa L. , Laughlin Nellie K. , Larson Julie A. , Gay Cynthia L. , Roberts Andrew D. , Converse Alexander K. , DeJesus Onofre T.
Published: October 2011

Evaluation of sensory processing function serves as a critical component of treatment planning and implementation of intervention in pediatric occupational therapy practice. We developed a Sensory Processing Scale for Monkeys (SPS–M), based on human tests, that measures behavioral responses to a series of tactile stimuli. This assessment has been used to assess sensory processing in adult rhesus monkeys exposed to prenatal alcohol, stress, or postnatal lead. Control monkeys from undisturbed pregnancies showed a habituation pattern, prenatally stressed monkeys showed sensitization, and prenatal alcohol–exposed monkeys showed relatively high responsiveness without habituation across trials. Lead-exposed monkeys showed sensitization compared to nonlead-exposed controls, and chelation reduced the sensitization in lead-exposed animals. Aversive responsiveness was associated with up-regulated striatal dopamine receptor binding measured with positron emission tomography.
Mental Practice as a Gateway to Modified Constraint-Induced Movement Therapy: A Promising Combination to Improve Function
Authors: Page Stephen J. , Levine Peter , Hill Valerie
Published: October 2011

Modified constraint-induced movement therapy (mCIMT) is a reimbursable regimen that improves the use and function of more-affected arms in patients who have had a stroke. To participate in this regimen, however, patients must exhibit active extension of the more-affected wrists and fingers, which renders many people ineligible. This study determined the efficacy of a mental practice program that preceded mCIMT in improving more-affected arm function in 4 patients with a stroke. Patients received therapy emphasizing activities of daily living (ADLs), followed by sessions of mental practice of the ADL. One week after completing mental practice, patients participated in mCIMT. After mental practice, patients exhibited marked changes on assessments and increased active wrist and finger extension, which qualified them for mCIMT. After mCIMT, participants exhibited additional functional gains, sustained 3 months later. Data suggest that mental practice provides a pathway whereby patients can participate in mCIMT, realize additional gains, and again perform valued ADLs.
Training Needs of Pediatric Occupational Therapists in Assistive Technology
Authors: Long Toby M. , Woolverton Maria , Perry Deborah F. , Thomas M. Janet
Published: October 2011

The training of providers working with children who need assistive technology devices or services has not kept pace with the explosion of new, more sophisticated assistive technology devices now available. This article reports on a national survey of 272 pediatric occupational therapists, who responded to questions about their training needs in the area of assistive technology and delivering assistive technology services. A sizable percentage of these therapists reported less-than-adequate training in policies governing assistive technology services and the organization and function of the service system. The therapists would like training that is accessible and affordable in the areas of funding of technology and services; collaborating with families and other service providers; and accessing reliable, knowledgeable vendors. These findings underscore the need to develop pre-service and in-service training in assistive technology for providers who work with children who have disabilities.
Using Social Judgment Theory to Study Occupational Therapists’ Use of Information When Making Driver Licensing Recommendations for Older and Functionally Impaired Adults
Authors: Unsworth Carolyn A.
Published: October 2011

OBJECTIVE. This study sought to identify the informational cues that driver-assessor-trained occupational therapists (DATOTs) consider when making driver licensing recommendations for older and functionally impaired clients. Relatively little research supports these complex decisions.

METHOD. A survey using a social judgment theory framework was mailed to all practicing registered DATOTs in Victoria, Australia.

RESULTS. Cue mean rank order, as calculated across the 56 responses (return rate, 78%), revealed that the four most important cues were driving instructor interventions, driver behavior, cognitive and perceptual skills, and vehicle handling skills. Substantial individual variations in cue ranks were not attributable to respondents’ years of experience.

CONCLUSION. Because driver licensing recommendations may have a major impact on clients’ lives, debate and further study concerning information use are needed to assist DATOTs in making consistent and optimal licensing recommendations to ensure the safety of all road users and avoid when possible the negative consequences of license loss.
Agreement Between Occupational Therapy Practice Framework Classifications and Occupational Therapists’ Classifications
Authors: Butts Denea S. , Nelson David L.
Published: October 2011

The American Occupational Therapy Association (AOTA) developed the Occupational Therapy Practice Framework: Domain and Process (the Framework) to categorize and organize concepts in the field of occupational therapy in a manner that would be understandable to practitioners within the field as well as to external readers. The current study investigates the degree to which occupational therapists’ classification of terminology agrees with the Framework’s classification of terminology. Through mail survey format, 200 randomly selected AOTA occupational therapist members were asked to classify 30 randomly selected terms from the Framework into the 6 domain categories of the Framework. Based on the responses of 94 completed surveys, low levels of agreement were found between therapists’ and the Framework’s categorizations. Overall, practicing therapists did not categorize terms in a manner consistent with the categorization of the Framework. We recommend that AOTA refrain from developing systems of categorization, at least until a consensus develops in the field concerning terminology.
A Controlled Study of Services to Enhance Productive Participation Among People With HIV/AIDS
Authors: Kielhofner Gary , Braveman Brent , Fogg Louis , Levin Mara
Published: October 2011

OBJECTIVE. This study assessed the effectiveness of a model program designed to increase productive participation among people living with HIV/AIDS within supportive-living facilities.

METHODS. Using a nonrandomized, two-group design, 65 study participants were assigned to either the model program or standard care. Data on productive participation were collected at 3, 6, and 9 months after completion of the model or standard program. Outcomes were compared at each time point.

RESULTS. Forty-six participants completed the study. Participants in the two programs did not differ significantly on baseline demographic variables. Model program participants showed significantly higher levels of productive participation at all three time points (p < .05). Odds ratios were all > 3, reflecting that participants attending the model program were at least twice as likely to be productively engaged at all three time points.

CONCLUSION. Results support the effectiveness of the model program in achieving sustained productive participation in persons living with HIV/AIDS.
Evidence-Based and Occupational Perspective of Effective Interventions for Older Clients That Remediate or Support Improved Driving Performance
Authors: Hunt Linda A. , Arbesman Marian
Published: October 2011

To assess the effectiveness of person-related interventions on driving ability in older adults, this literature review was completed as a part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association. Nineteen articles were incorporated into the systematic review and include interventions in the following areas: visual, cognitive, and motor; educational; passengers; and medical. The results provide inconclusive evidence for the use of interventions such as the Useful Field of View training, home exercise programs, and passenger interactions. Conclusive evidence shows that older adults respond positively to programs stressing self-awareness of driving skills and that some medical interventions affect the ability to drive. Despite limitations, the studies reviewed provide useful information that deserves further exploration. Reading the literature provides therapists with knowledge that might improve client care. Learning about cutting-edge interventions and educating peers and students about evidence-based interventions may lead to safer community mobility for older adults
Occupational Therapy Students’ Metaphors for Helping
Authors: Davis Janis
Published: October 2011

Metaphors are powerful devices for eliciting images of practice. Exploring the metaphors of occupational therapy students provides educators with insight into students’ prior knowledge and the constraints their ideas may present in practice. Metaphorical images of helping held by newly enrolled and Level II fieldwork students were examined. Responses to a structured, open-format questionnaire revealed that the two groups were in agreement about conceptualizations of helping. The findings suggest two overarching themes: (1) the importance of client-centered practice and (2) the inevitability of client autonomy and responsibility. These results imply that educators must prepare students to face the realities of practice: working with unmotivated clients and engaging them in meaningful occupations. Thus, a continued emphasis on client-centered practice and the requisite listening skills for a therapeutic alliance are needed. Research should build on the insufficient knowledge of what happens to identity development in the transition from curricula to practice.
Evolving Identities: Thomas Bessell Kidner and Occupational Therapy in the United States
Authors: Friedland Judith , Silva Jennifer
Published: October 2011

A founder of the National Society for the Promotion of Occupational Therapy, Thomas Bessell Kidner (1866–1932) played a prominent role in the early development of occupational therapy in Canada and the United States. We describe Kidner’s early life and how his work using occupations evolved. We then examine ideas and assumptions about occupations as treatment and trace Kidner’s involvement through to his leadership role within the American Occupational Therapy Association. Through our analysis of primary and secondary source materials, we have extracted recurring themes and related them across and within the materials to discern Kidner’s influence on the profession. From among his many contributions, three areas emerge as particularly relevant to current practice: occupational therapy’s role in return to work, relationships with medicine, and the profession’s image. Kidner’s story gives us a window on our history and an opportunity to see how the profession has evolved.
Establishing Validity of a Modified Melbourne Assessment for Children Ages 2 to 4 Years
Authors: Randall Melinda , Imms Christine , Carey Leeanne
Published: October 2011

BACKGROUND. The Melbourne Assessment of Unilateral Upper Limb Function is a valid tool for measuring quality of upper-limb movement in children ages 5 to 15 with cerebral palsy. This study presents the first phase in establishing the validity of a modified version of the assessment for children ages 2 to 4.

OBJECTIVE. We sought to determine whether children without neurological impairment scored within the top 5% on the modified assessment, to investigate compliance with test demands, and to investigate the relationship between the modified tool and the Quality of Upper Extremity Skills Test.

METHOD. The test was modified and administered to 32 children without neurological impairment ages 2 to 4.

RESULTS. All children ages 2.5 to 4 scored as expected and were compliant with test demands.

CONCLUSION. The Modified Melbourne Assessment may be used with children ages 2.5 to 4 without neurological impairment. Investigation with children with neurological impairment is now indicated.
Reliability and Validity of the Test of In-Hand Manipulation in Children Ages 5 to 6 Years
Authors: Pont Karina , Wallen Margaret , Bundy Anita , Case-Smith Jane
Published: October 2011

The Test of In-Hand Manipulation (TIHM; Case-Smith, 2000) is a five-task test that uses a 9-hole pegboard to examine 2 key components of in-hand manipulation: rotation and translation with stabilization. The authors used Rasch modeling to examine the TIHM’s construct validity, interrater reliability, and test–retest reliability in 45 typically developing children ages 5.5 years to 6.5 years. A version of the test, revised using Rasch modeling, was found to have evidence for adequate construct validity and excellent interrater reliability. However, test–retest reliability over a 2-week retest period was not supported. The TIHM demonstrates potential as a clinically useful assessment of in-hand manipulation. The test does not examine all aspects of in-hand manipulation, however, and it may have limited sensitivity to the performance of finger-to-palm and palm-to-finger translation. Further validation of the test is needed before the TIHM can confidently be used in occupational therapy practice.
Modified Constraint-Induced Movement Therapy for a 12-Month-Old Child With Hemiplegia: A Case Report
Authors: Cope Steven M. , Forst Heather C. , Bibis Denise , Liu Xue-Cheng
Published: October 2011

OBJECTIVE. This case report describes the use of modified constraint-induced movement therapy (CIMT) to improve upper-limb function in a 12-month-old child with right hemiplegia. It also describes parent concerns about CIMT and documents the short- and long-term effects of modified CIMT.

METHOD. The participant was assessed 5 times over a 7.5-month period using the Peabody Developmental Motor Scales–2, Pediatric Motor Activity Log, Toddler Amount of Use Test, and Knox Parent Questionnaire. CIMT included a nonremovable cast worn on the unaffected arm and approximately 8 hr per week of occupational and physical therapy for 2 weeks.

RESULTS. Benefits of improved upper-limb function measured immediately after CIMT were sustained at 6 months’ follow-up. No adverse events related to cast use were reported.

DISCUSSION. The findings from this case report suggest that CIMT was a safe intervention associated with improving upper-limb function for this young child with hemiplegia.
Effect of Wearing a Static Wrist Orthosis on Shoulder Movement During Feeding
Authors: May-Lisowski Terri L. , King Phyllis M.
Published: October 2011

OBJECTIVE. This study compares the effect of wrist immobilization with non-immobilization on shoulder abduction, shoulder flexion, and shoulder rotation during feeding.

METHOD. Twenty right-hand-dominant participants with no upper-extremity dysfunction performed a controlled feeding activity under 2 separate wrist conditions: (1) while wearing a static wrist orthosis and (2) with the wrist not immobilized (free wrist). A Motion Monitor system using small magnetic sensors was used to measure range of motion. Data analysis included paired t tests to compare the 2 conditions.

RESULTS. Statistically significant results were found for shoulder flexion and shoulder abduction, indicating increased movement at the shoulder while feeding when the wrist was immobilized. No significant difference was found in shoulder internal rotation.

CONCLUSIONS. Wearing a wrist orthosis while feeding may alter normal movement patterns at the shoulder. Future research should examine the effects of wrist splinting on shoulder movement.
Outcomes of a Pilot Training Program in a Qigong Massage Intervention for Young Children With Autism
Authors: Silva Louisa M. T. , Ayres Robert , Schalock Mark
Published: October 2011

Sensory impairment is a common and significant feature of children on the autism spectrum. In 2005, a qigong massage intervention based on Chinese medicine and delivered by a doctor of Chinese medicine was shown to improve sensory impairment and adaptive behavior in a small controlled study of young children with autism. In 2006, the Qigong Sensory Training (QST) program was developed to train early intervention professionals to provide the QST intervention. This article describes the preliminary evaluation of the QST program as piloted with 15 professionals and 26 children and outcomes testing using standardized tests of sensory impairment and adaptive behavior. Results of outcomes comparing delivery by QST-trained therapists with delivery by a doctor of Chinese medicine showed that both groups improved and that there was no difference in outcome between the two groups. The intervention and training program are described, and implications for future research are discussed.
You Can Know Me Now If You Listen: Sensory, Motor, and Communication Issues in a Nonverbal Person With Autism
Authors: Shoener Rachel Freret , Kinnealey Moya , Koenig Kristie P.
Published: October 2011

This case report describes an intensive approach to treating autism and provides an intersection between a first-person narrative paired with intervention and outcomes. In-depth conversations between a person with autism and an occupational therapist provide insight into understanding differences and difficulties in sensory processing and regulation, praxis, and communication. Individuals with autism may be intellectually and emotionally intact but hampered by deficits that interfere with the ability to move the body efficiently. These sensorimotor deficits underlie the ability to communicate with others and to develop relationships. This article illustrates the benefits of an intensive therapeutic program designed to address sensory and motor differences underlying communication, as well as the vital role the occupational therapist plays in addressing these underlying differences to improve functional communication and social participation.
Sensory Processing and Classroom Emotional, Behavioral, and Educational Outcomes in Children With Autism Spectrum Disorder
Authors: Ashburner Jill , Ziviani Jenny , Rodger Sylvia
Published: October 2011

OBJECTIVE. We explored the associations between sensory processing and classroom emotional, behavioral, and educational outcomes of children with autism spectrum disorder (ASD).

METHOD. Twenty-eight children with ASD (with average-range IQ) were compared with 51 age- and gender-matched typically developing peers on sensory processing and educational outcomes.

RESULTS. For children with ASD, the Short Sensory Profile scores Underresponsive/Seeks Sensation and Auditory Filtering explained 47% of the variance in academic performance, yet estimated intelligence was not a significant predictor of academic performance. Significant negative correlations were found between (1) auditory filtering and inattention to cognitive tasks, (2) tactile hypersensitivity and hyperactivity and inattention, and (3) movement sensitivity and oppositional behavior.

CONCLUSION. A pattern of auditory filtering difficulties, sensory underresponsiveness, and sensory seeking was associated with academic underachievement in the children with ASD. Children who have difficulty processing verbal instructions in noisy environments and who often focus on sensory-seeking behaviors appear more likely to underachieve academically.
Embracing Ambiguity: Facing the Challenge of Measurement
Authors: Coster Wendy J.
Published: October 2011

Assigning numbers to variations in the behaviors, experiences, or beliefs of individuals and groups is a firmly established tradition in Western culture. In many areas of occupational therapy practice, quantitative measures are required to document need for services and, increasingly, quantitative measures are required to document the value of these services in terms of the outcomes achieved. In order to meet these expectations, occupational therapy frequently has adopted both methods and instruments from other disciplines including psychology, medicine, and education. However, the assumptions and modes of thinking about people that accompany these methods are not always compatible with the values and practice of occupational therapy. This paper explores tensions inherent in the assessment process in a profession that is holistic and humanistic in its orientation. I propose that in order for assessment to serve our goal of supporting health and participation through engagement in occupation we must accept the uncertainty and be vigilant about the biases in thinking that are inherent in our measures.
Health Disparities: Examination of Evidence Relevant for Occupational Therapy
Authors: Bass-Haugen Julie D.
Published: October 2011

Healthy People 2010 identified elimination of health disparities as a national priority. Few studies in the occupational therapy literature document health disparities. The purpose of this study was to examine the evidence on U.S. health disparities with specific relevance to occupational therapy and by racial/ethnic groups and income levels. National survey data were used to identify variables related to occupational performance or occupational therapy services that showed evidence of disparities. Data on U.S. citizens included health and behavioral characteristics, activity profiles, home and work environments, experiences in health systems, and outcomes of health care services. On many variables, the nature of differences for non-White groups and lower income–level groups provide evidence of health disparities. The findings support the National Healthcare Disparities Reports, which concluded that health disparities are still prevalent in the United States, and opportunities remain in health professions, like occupational therapy, to improve the health of all citizens.
Pet Ownership as a Meaningful Community Occupation for People With Serious Mental Illness
Authors: Zimolag Ulrike (Uli) , Krupa Terry
Published: October 2011

OBJECTIVE. We determined the proportion of pet owners and non–pet owners with serious mental illness, compared their characteristics and their motivations for owning or not owning a pet, and examined the relationship between pet ownership and engagement in meaningful activity and three dimensions of community integration.

METHOD. Three Assertive Community Treatment (ACT) teams reported on the pet ownership of all service recipients (N = 204). Of these recipients, 60 completed a survey. Nonparametric tests were selected for data analysis.

RESULTS. Of 204 ACT clients, 38 (18.6%) were pet owners. Twenty-four (63.2%) of 38 responding non–pet owners desired to live with a pet. There were significant differences between groups on diagnosis, gender, a global measure of function, meaningful activity, and psychological integration.

CONCLUSION. The key finding supports the hypothesis that pet owners with serious mental illness living in the community demonstrate higher social community integration. Implications for future research and practice are discussed.
Awareness of Driving Ability in Senior Drivers With Neurological Conditions
Authors: Kay Lynnette G. , Bundy Anita C. , Clemson Lindy
Published: October 2011

OBJECTIVE. We sought to determine the agreement between rating of awareness based on scores on the Driving Awareness Questionnaire (DriveAware) and global judgments of awareness awarded after on-road assessment, thereby establishing the possibility of measuring drivers’ awareness.

METHOD. A prospective cohort study of 60 senior drivers with neurological conditions who were referred for driving assessment. Awareness was rated as intact, partial, or absent on the basis of the discrepancy score between participants’ and clinicians’ responses to DriveAware. A second clinician (masked to these results) rated awareness on the same scale at the completion of the on-road assessment. Agreement of categorical ratings was adjusted for chance using the kappa statistic.

RESULTS. Results yielded a kappa of .69 (SE = .08), indicating agreement substantially beyond chance.

CONCLUSION. Results indicate that awareness of driving ability may be measured with substantial accuracy using DriveAware in senior drivers with neurological impairments. The psychometric properties of DriveAware require further research.
Sensory-Processing Disorder in Children With Cochlear Implants
Authors: Bharadwaj Sneha V. , Daniel Linda L. , Matzke Patricia L.
Published: October 2011

We examined sensory-processing disorder (SPD) in children with cochlear implants and explored the relationship between SPD and duration of hearing loss or duration of cochlear implant use. Caregivers of 30 children completed the Sensory Profile Questionnaire (SPQ). Seventy percent of the children showed “at-risk” or “different” behaviors in one or more of five categories of the SPQ: auditory, visual, vestibular, tactile, and oral processing. No noteworthy relationships surfaced between duration of deafness or duration of cochlear implant use and the atypical behaviors identified. To validate these findings further, postrotary nystagmus (PRN) testing and Miller's Assessment for Preschoolers (MAP) were administered to a subset of children. PRN was atypical in all 6 children tested. MAP findings revealed atypical sensory processing in 4 of the 6 children. Findings suggested that children with cochlear implants may be at risk for SPD. The findings are discussed in light of clinician and teacher referral for occupational therapy evaluations.
Case Report of Integrated Supported Employment for a Person With Severe Mental Illness
Authors: Chan Ashley S. M. , Tsang Hector W. H. , Li Sally M. Y.
Published: October 2011

OBJECTIVE. We illustrate the implementation of an integrated supported employment (ISE) program that augments the individual placement and support model with social skills training in helping people with severe mental illness (SMI) achieve and maintain employment.

METHOD. A case illustration demonstrates how ISE helped a 41-year-old woman with SMI to get and keep a job with support from an employment specialist. An independent, blinded assessor conducted data collection of employment information, including self-efficacy and quality of life, at pretreatment and at 3-month, 7-month, 11-month, and 15-month follow-up assessments.

RESULTS. The participant eventually stayed in a job for 8 months and reported improved self-efficacy and quality of life.

CONCLUSION. The case report suggests that ISE could improve the employment outcomes of people with SMI. Moreover, changes in the participant’s self-efficacy and quality of life were shown to be driven by the successful employment experience.
Supported Education for Adults With Psychiatric Disabilities: Effectiveness of an Occupational Therapy Program
Authors: Gutman Sharon A. , Kerner Robin , Zombek Irene , Dulek Jennifer , Ramsey C. Andrew
Published: October 2011

OBJECTIVE. This study assessed the effectiveness of a supported education program for adults with psychiatric disabilities.

METHOD. Thirty-eight adults with psychiatric disabilities were randomly assigned to an experimental group (n = 21) that received supported education services or to a control group (n = 17) that received treatment as usual.

RESULTS. We found a statistically significant difference between experimental and control group participant scores on the five instruments used to measure the program's effectiveness. Sixteen of the 21 experimental group participants (76%) completed the program. At 6-month follow-up, 10 (63%) had enrolled in an educational program, had obtained employment, or were applying to a specific program. Only 1 of the control group participants was enrolled in an educational program.

CONCLUSION. The results support the effectiveness of the supported education program. A significant number of participants were able to improve their basic academic skills, enhance professional behaviors and social skills, and return to the school or work environment.
Consequences of Poststroke Falls: Activity Limitation, Increased Dependence, and the Development of Fear of Falling
Authors: Schmid Arlene A. , Rittman Maude
Published: October 2011

OBJECTIVES. We used qualitative data to explore the perceived consequences of poststroke falls during the first 6 months after discharge from the hospital.

METHOD. We interviewed 132 male stroke survivors 1 and 6 months after discharge to describe stroke recovery trajectories. Interviews of participants who discussed falling after stroke as one of their major concerns were analyzed to explore the consequences of poststroke falls.

RESULTS. During the first 6 months after stroke, 42 (32%) participants discussed poststroke falls. The results of the qualitative analysis indicate three important emergent themes related to the consequences of poststroke falls: (1) limiting activity and participation, (2) increasing dependence, and (3) developing a fear of falling.

CONCLUSION. Falls after discharge home were common in this group of stroke survivors. Future research is needed to better understand the impact of fall-related consequences and to explore strategies for fall prevention.
Rasch Analysis of the School Function Assessment Provides Additional Evidence for the Internal Validity of the Activity Performance Scales
Authors: Hwang Jeng-Liang , Davies Patricia L.
Published: October 2011

OBJECTIVE. The internal construct validity of the School Function Assessment (SFA) was determined by examining its unidimensionality and hierarchical structure.

METHOD. The SFA was completed for 64 elementary school children (35 with disabilities, 29 without disabilities). Data were examined through Rasch analysis.

RESULTS. The majority of test items (252 of 266) within the Activity Performance Scales met the criterion set for Rasch goodness-of-fit statistics. All but three scales were found to be unidimensional, measuring a single construct. Item difficulty analysis yielded a hierarchical structure of the scales similar to the existing item layout of the SFA.

CONCLUSION. Internal validity was supported for 15 of the 18 Activity Performance scales. Each scale is psychometrically sound in measuring a specific functional task. The reliable hierarchical pattern of the assessment helps anticipate and document the student's progress in functional performance from easier to more difficult school tasks.
Potentially Problematic Postures During Work Site Keyboard Use
Authors: Baker Nancy A. , Redfern Mark
Published: October 2011

OBJECTIVE. We described the frequency and distribution of keyboard users’ potentially risky postural behaviors.

METHOD. Forty-three participants’ keyboard postural behaviors were rated with the Keyboard–Personal Computer Style instrument (Baker & Redfern, 2005). The frequency and distribution of keyboard postural behaviors and the associations and differences between the right and left sides were assessed.

RESULTS. Generally, each static posture had one criterion that occurred frequently, whereas dynamic postures were distributed throughout the criteria. The right and left sides were significantly associated for shoulder flexion, elbow flexion, hand displacement, wrist extension, forearm rotation, isolated fifth digit, metacarpophalangeal hyperextension, and wrist support use and significantly different for hand displacement, isolated thumb, number of digits, and metacarpophalangeal hyperextension.

CONCLUSION. Potentially problematic postural behaviors are common among keyboard users. Our results suggest that occupational therapists must systematically assess postures on both the right and the left sides to develop the most effective intervention strategies.
Prospective Study of the Effect of Sensory Integration, Neurodevelopmental Treatment, and Perceptual–Motor Therapy on the Sensorimotor Performance in Children With Mild Mental Retardation
Authors: Wuang Yee-Pay , Wang Chih-Chung , Huang Mao-Hsiung , Su Chwen-Yng
Published: October 2011

OBJECTIVE. This quasi-experimental study compared the effect of sensory integrative (SI) therapy, neurodevelopmental treatment (NDT), and perceptual–motor (PM) approach on children with mild mental retardation.

METHOD. Children (N = 120) were randomly assigned to intervention with SI, NDT, or PM; another 40 children served as control participants. All children were assessed with measures of sensorimotor function.

RESULTS. After intervention, the treatment groups significantly outperformed the control group on almost all measures. The SI group demonstrated a greater pretest–posttest change on fine motor, upper-limb coordination, and SI functioning. The PM group showed significant gains in gross motor skills, whereas the NDT group had the smallest change in most measures.

CONCLUSION. SI, NDT, and PM improved sensorimotor function among children with mild mental retardation. The choice of sensorimotor approaches should be determined on the basis of the child's particular needs because each approach may have an advantage in certain aspects of sensorimotor function.
Use of Assistive Technology Devices in Mainstream Schools: Students’ Perspective
Authors: Hemmingsson Helena , Lidström Helene , Nygård Louise
Published: October 2011

OBJECTIVE. The use and nonuse of assistive technology devices in school by students with physical disabilities was investigated, and the students’ experiences in using these devices is described.

METHOD. We used a mixed-methods approach with predominantly qualitative methods to collect and analyze data, which included observations of and interviews with 20 students with physical disabilities and the number and type of assistive technology devices provided.

RESULTS. It is vital that devices be integrated into educational practice and that students experience immediate benefits for their function in everyday school activities without detrimental effects on their social participation. The latter was often more important than being able to perform activities independently.

CONCLUSION. The students adopted both a functional and a psychosocial perspective of their devices, and providers should neglect neither. Children and youth need both verbal information and practical experience using devices to be able to make informed decisions.
Influence of a Misleading Context on a Design-Copying Task With Children With and Without Learning Disabilities
Authors: Coté Carol A.
Published: October 2011

OBJECTIVE. I investigated developmental and ability differences on a visual–motor task that requires inhibition of misleading information.

METHOD. Children, including those with and without learning disabilities, and adults copied simple line or dot figures inside a tilted frame with instructions to make the figures straight. Two response methods were used: drawing (motor) and placement of bars or washers (motor reduced).

RESULTS. All participants were influenced by the misleading frame, making figures that deviated from true vertical in both motor and motor-reduced formats. Adults were less influenced than children, and children with learning disabilities were more influenced than their peers. Production of more complex figures resulted in increased influence of the misleading frame.

CONCLUSION. The ability to inhibit misleading contextual information and find an appropriate frame of reference may be an important developmental process in visual–motor skill development. Implications for assessment and task analysis are discussed.
Dynamic Assessment and Prediction of Learning Potential in Clients With Unilateral Neglect
Authors: Toglia Joan , Cermak Sharon A.
Published: October 2011

OBJECTIVE. We investigated the application of dynamic assessment in examining learning potential for adults with right hemisphere stroke and unilateral neglect.

METHODS. Forty adults with right cerebrovascular accident were randomly assigned to a control or dynamic group. Both groups were administered standard pretests and posttests of unilateral neglect. The dynamic group received cues, strategy training, and feedback during an object search task.

RESULTS. Multivariate analysis of covariance indicated significant differences between groups on the object search task, with reduced unilateral neglect in the dynamic group. Greater initiation of left-sided search, strategy use, and near and intermediate transfer of learning were observed in the dynamic group.

CONCLUSIONS. The brief dynamic assessment, developed for this study, provided an opportunity to observe the client's ability to incorporate strategy training and feedback across visual search tasks. This assessment approach has the potential to characterize learning profiles and to guide intervention decisions.
Traumatic Brain Injury and Driving Assessment: An Evidence-Based Literature Review
Authors: Classen Sherrilene , Levy Charles , McCarthy Dennis , Mann William C. , Lanford Desiree , Waid-Ebbs J. Kay
Published: October 2011

OBJECTIVE. We conducted a literature review of assessment tools predicting driving performance for people with traumatic brain injury (TBI).

METHOD. Data sources were Web of Science, EBSCOhost, PubMed, and recently published literature from experts and team members not yet catalogued in the databases. We used the American Academy of Neurology's classification criteria to extract data from 13 studies, and we assigned a class (I–IV, with I being the highest level of evidence) to each study. We grouped primary studies into categories of driving assessment (neuropsychological; simulator; off-road; self-report, other report, and postinjury disability status; and comprehensive driving evaluation) and synthesized the predictability of these tools as it relates to driving performance for people with TBI.

CONCLUSIONS. To assist clinicians and researchers in making decisions regarding testing the driving performance of people with TBI, we provide recommendations for neuropsychological tests; off-road tests; self-report, other report, and postinjury disability status; and comprehensive driving evaluation.
Kettle Test—A Brief Measure of Cognitive Functional Performance: Reliability and Validity in Stroke Rehabilitation
Authors: Hartman-Maeir Adina , Harel Hagit , Katz Noomi
Published: October 2011

OBJECTIVES. We examined the reliability and validity of the Kettle Test, a brief performance measure based on a complex everyday task designed to tap into basic and higher level cognitive processes.

METHOD. Participants included 21 people attending stroke rehabilitation and 4 occupational therapists for the reliability analysis, 36 people at discharge from stroke rehabilitation, and 36 age-matched healthy control participants for the validity analyses. Instruments included a battery of conventional cognitive measures and functional outcomes.

RESULTS. Interrater reliability was found to be high. Stroke survivors at discharge from rehabilitation were found to require significantly more assistance on the Kettle Test than control participants (p < .000); their scores on the Kettle Test were significantly and moderately correlated with the conventional cognitive and functional outcome measures.

CONCLUSIONS. The results support the reliability and validity of the Kettle Test as a top-down measure of cognition-in-function in people at discharge from stroke rehabilitation.
Pilot Study on Activities of Daily Living Limitations in Adults With Hemianopsia
Authors: Warren Mary
Published: October 2011

OBJECTIVE. I sought to obtain a general understanding of the limitations in activities of daily living (ADLs) experienced by adults with hemianopsia and quandrantanopsia from acquired brain injury.

METHOD. A semistructured interview addressing the perception of difficulty completing ADLs because of vision loss and a reading performance test were administered to 46 participants referred to a low vision rehabilitation program.

RESULTS. Participants reported difficulty completing two basic ADLs, personal hygiene–grooming and feeding, and several instrumental ADLs, including driving, shopping, financial management, telephone usage, and meal preparation. ADL limitations appear to be related to the amount of visual search needed to complete the ADL and disruption of the performance skills of reading, writing, and mobility.

CONCLUSION. People with hemianopsia experience limitations in specific ADLs as a direct result of the disruption of the visual field. Further investigation is needed to confirm these findings and explore interventions to improve ADL performance.
Occupational Therapy for Service Members With Mild Traumatic Brain Injury
Authors: Radomski Mary Vining , Davidson Leslie , Voydetich Deborah , Erickson Mary W.
Published: October 2011

More occupational therapists are needed to provide client-centered, evidence-based rehabilitation to the large numbers of service members who sustained mild traumatic brain injury (mTBI) while deployed in Afghanistan and Iraq. The Proponency for Rehabilitation and Reintegration tasked a team of occupational and physical therapists to assemble evidence-based best practices specific to mTBI. Despite the fact that evidence-based reviews, guidelines, and research regarding occupational therapy for mTBI are sparse, the team developed the Clinical Practice Guidance: Occupational Therapy and Physical Therapy for Mild Traumatic Brain Injury. Occupational therapy practice recommendations specific to client education, vision, cognition, resumption of roles, and emotional well-being are summarized for civilians and characterized as practice standards or practice options. By using evidence-informed and holistic services, occupational therapists have the potential to lead rehabilitation and reintegration efforts for service members with mTBI and advance changes in the profession itself.
Development and Standardization of a “Do–Eat” Activity of Daily Living Performance Test for Children
Authors: Josman Naomi , Goffer Ayelet , Rosenblum Sara
Published: October 2011

BACKGROUND. The Do–Eat was developed to evaluate daily task performance abilities among children with developmental coordination disorder (DCD). This study investigated the tool’s reliability and validity.

METHOD. Participants were 59 children ages 5 to 6.5 years; 30 children diagnosed with DCD according to the DSM–IV–TR; and a control group of 29 children, who were matched for age, gender, and sociodemographic background.

RESULTS. Both the Do–Eat and the accompanying Parent Questionnaire yielded high internal consistency (αs = .89–.93). Construct validity was demonstrated by significant between-group differences on the Do-Eat (t[57] = 14.09, p < .001) and the Parent Questionnaire (t[57] = 3.64, p < .001). Significant correlations between children’s scores on the sensory–motor component of the Do–Eat and the Movement Assessment Battery for Children final score confirmed concurrent validity (r = −.86, p < .001).

CONCLUSIONS. Results suggest that the Do–Eat is a reliable, valid tool for identifying children at risk for DCD.
Documenting Progress: Hand Therapy Treatment Shift From Biomechanical to Occupational Adaptation
Authors: Jack Jada , Estes Rebecca I.
Published: October 2011

The investment of time and self to develop therapeutic relationships with clients appears incongruent with today’s time-constrained health care system, yet bridging the gap of these incongruencies is the challenge therapists face to provide high-quality, client-centered, occupation-based treatment. This case report illustrates a shift in approach from biomechanical to occupational adaptation (OA) in an orthopedic outpatient clinic. The progress of a client with lupus-related arthritis who was 6 days postsurgery is documented. The intervention initially used a biomechanical frame of reference, but when little progress had been made at 10 weeks after surgery, a shift was made to the more client-centered OA approach. The Canadian Occupational Performance Measure was administered, and an OA approach was initiated. On reassessment, clinically important improvements were documented in all functional tasks addressed. An OA approach provides the bridge between the application of clinical expertise, client-centered, occupation-based therapy and the time constraints placed by payer sources.
Northern Hemisphere temperature patterns in the last 12 centuries
Authors: Ljungqvist F. C. , Krusic P. J. , Brattström G. , Sundqvist H. S.
Published: October 2011

Abstract. We analyze the spatio-temporal patterns of temperature variability over Northern Hemisphere land areas, on centennial time-scales, for the last 12 centuries using an unprecedentedly large network of temperature-sensitive proxy records. Geographically widespread positive temperature anomalies are observed from the 9th to 11th centuries, similar in extent and magnitude to the 20th century mean. A dominance of widespread negative anomalies is observed from the 16th to 18th centuries. Though we find the amplitude and spatial extent of the 20th century warming is within the range of natural variability over the last 12 centuries, we also find that the rate of warming from the 19th to the 20th century is unprecedented. The positive Northern Hemisphere temperature change from the 19th to the 20th century is clearly the largest between any two consecutive centuries in the past 12 centuries.
Nonlinear earthquake behaviour of highway tunnels
Authors: Sevim B.
Published: October 2011

Abstract. This paper describes the Arhavi Highway Tunnel which has two tubes, its geometrical properties, finite element model, and the nonlinear earthquake behaviour under a huge ground motion considering soil-structure interaction. The Arhavi Highway Tunnel is one of the tallest tunnels constructed in the Black Sea region of Turkey as part of the Coast Road Project. The tunnel has two tubes and each of them is about 1000 m tall. In the study, the modal analyses of the tunnel considering soil-structure interaction are performed and natural frequencies and mode shapes are obtained. Then, nonlinear transient analysis of the tunnel using Drucker-Prager criteria is performed applying acceleration components of 1992 Erzincan, Turkey earthquake's ground motion. In the time history analyses, Rayleigh damping coefficients are calculated using main natural frequency obtained from modal analysis. Element matrices are computed using the Gauss numerical integration technique. The Newmark method is used in the solution of the equation of motion. Because too much memory for the analyses is required, the first 7.5 s of the ground motions, which is the most effective duration, is taken into account in calculations. The displacement and stress results are observed to be the allowable level of the concrete material.