bluuebunny/crossref_metadata_2025 huggingface dataset:
Checklist for the Prescription of Slings for the Hemiplegic Patient
Authors: Smith Roger O. , Okamoto Gary A.
Published: April 2012

The wide variety of hemiplegicsling designs, the lack of a uniform approach to sling selection, and the paucity of research data in this area have tended to make prescribing a sling a subjective process. Based on clinical experience and a comprehensive literature review, the authors propose a checklist for examining hemiplegic slings. The Checklist, which includes 19 desirable and 4 undesirable characteristics of slings, provides a more objective basis for comparing sling designs, warns of potential hazards, and facilitates the thorough examination of hemiplegic slings. The uses and limitations of the Checklist are discussed.
Incidence of Sensory Integrative Dysfunction among Children with Orofacial Cleft
Authors: Chapparo Christine J. , Yerxa Elizabeth J. , Nelson Judith Gick , Wilson Libby
Published: April 2012

Occupational therapists working with children with clefts observed that those children demonstrated subtle developmental delays, including learning, language, and behavioral problems that appeared related to sensory integrative dysfunction as identified by Ayres in children with learning disabilities. This study explored the possible existence of sensory integrative dysfunction in children with clefts when compared to normative data published by Ayres. The Southern California Sensory Integration Tests and the Southern California Postrotary Nystagmus Tests were administered to 70 four- to nineyear old children with clefts, who had been selected from four different hospital settings.

Comparisons of the mean subtest scores of the sample children and the norms showed that significant levels (p < .05) of difference existed. The subjects with clefts exhibited dysfunction related to vestibular and tactile processing and bilateral integration. No relationship was found between sensory integrative dysfunction and the child’s cleft type, sex, or hospital setting.
A Developmental Prehension Assessment for Handicapped Children
Authors: Erhardt Rhoda Priest , Beatty Patricia Ann , Hertsgaard Doris Massey
Published: April 2012

A study consisting of three components is reported. During Phase One an extensive literature search led to a compiled set of norms for reflexive and voluntary prehensile development. Phase Two included the clinical use and revision of the resultant Erhardt Developmental Prehension Assessment (EDPA©). Phase Three involved the testing of the EDPA for interrater reliability, which resulted in highly significant intraclass correlations. Single test item correlations were also analyzed to identify items needing clarification or alteration in preparation for final revision of the instrument. A sample application in the clinical field is illustrated by segments of an EDPA used to develop an Individualized Educational Plan, required by Federal Law 94-142 (Education of All Handicapped Children).
An Occupational Therapy Program for Chronic Back Pain
Authors: Flower Adelaide , Naxon Elya , Jones Richard E. , Mooney Vert
Published: April 2012

This paper describes a multidisciplinary approach to the evaluation and treatment of the patient with chronic spinal pain with particular emphasis on the cooperative roles of the physical disabilities occupational therapist and the psychosocial occupational therapist. The goal of the total program is to help patients progress from a sick role of dependent, painful behavior to a less pain-centered, more productive role–one in which they have begun to assume control over the way they feel and function. The success of the program is measured by the patient’s increased activity level and improved ability to cope with the demands of home and job. A review of patient records after one year of operation showed that only 4 of 54 patients who completed both phases of the program were returning to the orthopedic back clinic as outpatients.
Measurement of Ocular Pursuits in Normal Children
Authors: Gilligan Mary Beth , Mayberry Wanda , Stewart Linda , Kenyon Pat , Gaebler Chris
Published: April 2012

Ocular pursuits have been evaluated by occupational therapists (OTRs) in many settings, but normative information has been lacking. In this study, a standardized method of testing and recording ocular pursuits was developed and pilot tested on both normal and handicapped children. Normative data were then collected by using a cooperative research method in which 28 OTRs in the state of Colorado were trained, in a one-day workshop, to administer and score the test, achieving .98 inter-rater reliability for total test score. Each qualified tester evaluated approximately 15 normal children between 3 and 11 years of age. The total sample was 489 subjects.

There were some age-related trends, and most behaviors demonstrated a ceiling effect, particularly with older children. The results imply that many normal children have some immaturity in ocular pursuit skills until 6 or 7 years of age.
The Delineation of the Role of Entry-Level Occupational Therapy Personnel
Authors: Shapiro Diane , Brown Dale
Published: April 2012

The role assumed by occupational therapists and occupational therapy assistants during the first year of practice was delineated as part of an examination development project. The methods used to collect and analyze data obtained from several hundred therapists, assistants, and supervisors are described. A section of the results is presented to illustrate the differences and similarities found between the two levels of personnel.
Relationship of the Southern California Sensory Integration Tests, the Southern California Postrotary Nystagmus Test, and Clinical Observations Accompanying Them to Evaluations in Otolaryngology, Ophthalmology, and Audiology: Two Descriptive Case Studies
Authors: Royeen Charlotte Brasic , Lesinski George , Ciani Sharon , Schneider David
Published: April 2012

A preliminary investigation was conducted into the relationship of the Southern California Sensory Integration Tests (SCSIT), the Southern California Postrotary Nystagmus Test (SCPNT), and clinical observations accompanying these tests to evaluations in otolaryngology, ophthalmology, and audiology. The subjects were two children with vestibularly based sensory integrative dysfunction. The results revealed that there was no agreement between the results of the SCPNT and the otolaryngological evaluation. There was some agreement between the ophthalmology evaluation and the clinical observations accompanying the SCSIT. Both subjects scored poorly in two areas of auditory processing. Possible reasons for these results are discussed as well as implications for occupational therapy research and practice.
The Effects of Auditorally Augmented Feedback on the Eye-Hand Coordination of Students with Cerebral Palsy
Authors: Talbot Michael L. , Junkala John
Published: April 2012

To explore the question of whether auditorally augmented feedback can improve the eye-hand coordination of individuals with cerebral palsy, 59 (cerebral-palsied) students (mean chronological age 14 years, 3 months) were pretested with the Southern California Motor Accuracy Test and then randomly assigned to three groups. Group 1 performed training exercises—tracing line drawings—while simultaneously receiving auditorally augmented feedback about their efforts. Group 2 performed the same training exercises without the augmented feedback. Group 3 served as controls. All subjects were post-tested with the Southern California Motor Accuracy Test, followed by a second post-test after a 3-month interval. At the first post-test, the performance of the feedback group was significantly superior to that of the other groups. At the second post-test, the performance patterns among the groups were essentially the same as at the time of the first post-test, but between-group differences were no longer significant. The results of this study are discussed in both empirical and theoretical terms.
Order and Disorder in Medicine and Occupational Therapy
Authors: Rogers Joan C.
Published: April 2012

Professional practice is based on knowledge of order, disorder, and change. The meaning of these concepts in medicine and in occupational therapy is compared to clarify the differences in orientation between the two disciplines. The negative influence of the biomedical model on occupational therapy theory and practice is illustrated. The development of a taxonomy of levels of performance in occupation to serve as a basis for referral to occupational therapy and for theory building is suggested.
Changing Trends in Practice
Authors: Bair Jeanette
Published: April 2012

Occupational therapists are involved in delivering their services within a very complex health care environment and it is essential to understand the implications of the health care system in planning and implementing occupational therapy services. This month’s column gives the occupational therapist a perspective on the health system and should be a guide for all clinicians and educators in looking at the role occupational therapy plays in delivering health services to the American public.
Independence Through Activity: The Practice of Occupational Therapy (Psychiatry)
Authors: Allen Claudia Kay
Published: April 2012

An outline for an emerging theory to guide occupational therapy practice with mental disorders is provided. A hierarchy of cognitive levels with an accompanying task analysis describes functional distinctions in the severity of disorder, as reflected in routine task behavior. Recent advances in the neurosciences are examined for their potential impact on knowledge development and program objectives.
A Guide for Instrument Development and Validation
Authors: Benson Jeri , Clark Florence
Published: April 2012

As occupational therapists become increasingly concerned with accountability, the paucity of adequate instrumentation available for documenting therapeutic effectiveness surfaces as a major problem. Therapists will need to construct new or refine existing instruments to satisfy the requirements of third-party payment. The purpose of this paper is to illustrate how a new instrument is planned, developed, and validated. A sequential step-by-step process is illustrated with a flowchart and applied in the hypothetical construction of an attitude scale to assess school administrators’ valuing of the role of occupational therapists in the schools. This example is provided to show how general psychometric principles are applied within an occupational therapy context.
The Effect of Choreoathetoid Movements on the Quick Neurological Screening Test
Authors: Ingolia Peg , Cermak Sharon A. , Nelson David
Published: April 2012

The effect of choreoathetoid movements and learning disabilities on children’s performances on the Quick Neurological Screening Test was assessed in 43 6-to 8-year-old boys. The subjects were selected based on the presence or absence of choreoathetoid movements and on the presence or absence of learning disabilities. The Quick Neurological Screening Test, a 15-item test designed to identify children with learning problems, was administered. Items from the test were divided into two parts—six items thought to be influenced by the presence of choreoathetoid movements, and nine items not thought to be influenced by such movements.

The results indicated that the learning-disabled boys performed less well than nonlearning-disabled subjects on the six items thought to be affected by choreoathetoid movements. The presence of choreoathetoid movements was not a significant factor. Neither the presence of a learning disability nor the presence of choreoathetoid movements was found to be a significant factor in performance on the remaining nine items.
The Implementation of Occupational Therapy Services in Rural School Systems
Authors: Regan Nancy N.
Published: April 2012

Factors influencing the integration of occupational therapy services in rural school systems are reviewed in this paper. Differences between urban and rural populations are defined and methods of successfully developing new allied health programs in public schools are discussed. A thorough understanding of the rural educational system and local community is necessary for occupational therapists to provide optimal service delivery.
Preventive Activities and Services for the Well Elderly
Authors: Kirchman Margaret M. , Reichenbach Velma , Giambalvo Barbara
Published: April 2012

A demonstration project, including interviews conducted before and after a period of occupational therapy intervention, with a group of well elderly citizens attending a nutrition site showed significant, positive improvements in Indexes of Social Resources, Life Satisfaction, and General Affect. The results appeared to validate the provision of a support system through intervention aimed at helping to keep the elderly in the community.
Occupational Role History: A Screening Tool for Psychiatric Occupational Therapy
Authors: Florey Linda L. , Michelman Shirley M.
Published: April 2012

Psychiatric hospitalization has become telescoped, thus focusing on short-term acute care. Since discharge plans are needed on admission, occupational therapists must evaluate the patient quickly and succinctly. A screening tool was developed as a preliminary device to identify critical information in two major areas: patterns of skills and achievement or patterns of dysfunction in past and current occupational role; and the degree of balance or imbalance between leisure activities and those activities associated with occupational role. The screening tool, the Occupational Role History, was used in a pilot study on 20 adult inpatients at the UCLA Neuropsychiatric Institute. The results of the pilot study suggest that this tool is useful in establishing treatment priorities from an occupational therapy perspective.
Mini-Councils: A Solution to Fieldwork Supervision
Authors: Still Jean R.
Published: April 2012

In 1977, the Occupational Therapy faculty at San Jose State University, with support from a Special Improvement Grant, embarked on a 3-year curriculum revision. One issue of particular concern was the need to devise a system for involving the clinical faculty in the revision process regardless of geographic relationship to the university. The system that evolved became known as Mini-Councils, regional groups consisting of students and clinical and academic faculty who participate in fieldwork experience at the University.

Mini-Councils replaced the on-site visit system and shifted the emphasis from supervision of individual students to discussion groups focusing on general educational issues of mutual concern to faculty and students. The Mini-Councils have also strengthened the relationship between academic and clinical educators by providing a practical, efficient means of maintaining contact with students in fieldwork, and by helping integrate academic and clinical education.
Use of Taxonomies to Sequence Clinical Objectives
Authors: Sparling Joyce W. , Mitchell Marlys M.
Published: April 2012

This paper describes the use of four educational taxonomies in establishing a task grid for guiding and determining sequential learning opportunities and activities for the developmentally delayed child and for treatment planning for team members working with the child. It describes a three-dimensional grid that includes learners, areas of learning, and levels of learning. To clarify the use of this model, the grid has been applied to feeding intervention with the delayed child. Use of the task grid suggests three factors are needed in intervention with the developmentally delayed child: 1. objectives should be stated for all domains of learning since learning occurs concurrently in different areas; 2. activities should be sequenced not only for the child but also for all those directly involved with the child, since all are involved in the learning process; and 3. analytical behavior should be stimulated in the therapist so that theory-based practice can be realized.
A Synthesis of Occupational Behavior and Sensory Integration Concepts in Theory and Practice, Part 2: Clinical Applications
Authors: Lindquist Jerry Ernest , Mack Wendy , Parham L. Diane
Published: April 2012

This is the second of two papers addressing the occupational behavior and sensory integration approaches to occupational therapy for children. In the previous paper, basic concepts from these two approaches were discussed as presenting different, yet complementary, perspectives. The use of play was identified as central to occupational therapy practice from either perspective. Concepts from both approaches were integrated into a general systems model of play development in infancy and early childhood. This paper discusses play and sensory integration as interdependent developmental phenomena that are a function of interactions between the environment (input) and the child’s internal processing (throughput). When input-throughput interactions do not permit the growth of competence, dysfunction occurs. Consideration of possible input and throughput deficits are suggested for assessment of individual children, and treatment guidelines are drawn from both the sensory integration and occupational behavior literature.
Effectiveness of Recruitment and Information Techniques in Occupational Therapy
Authors: Townsend Kim R. , Mitchell Marlys M.
Published: April 2012

A national survey was conducted to determine how occupational therapists became interested in the field. Results from the study demonstrated that personal contact was the most effective technique for creating an interest in occupational therapy. However, books, magazines, aide and volunteer jobs, guidance counselors, and career days were adjuncts to the recruitment process. This study provides data concerning previous productive means that have been used in recruitment and suggests specific actions for future recruitment.
Future Impact on Occupational Therapy from Current Changes in Higher Education
Authors: Teske Yvonne R. , Spelbring Lyla M.
Published: April 2012

The positive and negative consequences of four dimensions of change affecting higher education are examined to consider some strategies to ensure quality of the preparation and practice of future occupational therapists. Experts from several disciplines view the decades of the 1980s and 1990s as a period of intense political, social, and economic change. Forecasting the effects of change on occupational therapy education and practice could result in strengthening the profession since decisions made now will have a direct bearing on the nature of occupational therapy practice in the future. The four changes discussed are enrollment patterns, student characteristics, fiscal resources, and institutional issues.
Reliability of the Southern California Postrotary Nystagmus Test with Learning-Disabled Children
Authors: Morrison Delmont , Sublett Jean
Published: April 2012

The Southern California Postrotary Nystagmus Test (SCPNT) provides an objective assessment of nystagmus. Although depressed nystagmus duration as measured by the SCPNT is considered a major sign of vestibular dysfunction in learning-disabled children, the reliability of the SCPNT with this population has not been established. To study reliability of nystagmus duration in this population, 89 learning-disabled children were evaluated with the SCPNT. The results demonstrated that this sample had significantly depressed scores and more variability in scores than normal children. Intrascorer and test-retest reliabilities, although statistically significant, were lower than those established with normal children. A test-retest study of the reliability of placing a child in a deviant duration range over time significantly reduced reliability estimates. Clinicians using nystagmus duration scores in the evaluation of vestibular dysfunction in learning-disabled children should be sensitive to the variation in this measure in this population.
Assessment and Training of Brain-Damaged Drivers
Authors: Jones Richard , Giddens Helen , Croft Dinah
Published: April 2012

This paper describes a driving assessment and training program that is primarily for patients discharged from the hospital and who may be experiencing residual impairment from some form of brain damage. Assessment is carried out by an occupational therapist and consists of several off-road tests (vision, reaction timing, computerized preview tracking test, general medical psychological appraisal), and an on-road test. More than 300 patients have been seen since the program’s inception in 1977, and trends indicated by their assessment results are: twice as many male as female referrals; a low fail rate among nonbrain-involved patients; diagnosis as a poor predictor of outcome; no significant difference between fail rates of right and left stroke patients; significant difference in average tracking task performance between the Pass, Borderline, and Fail assessment groups. Off-road testing complements, rather than replaces, on-road testing. Thirty-eight of the 300 patients were given special training, and 15 of these were unable to reach an acceptable level. This reflects a difficulty in predicting the outcome of unlicensed patients with severe disabilities.
Factors Affecting Return to Work After Hand Injury
Authors: Bear-Lehman Jane
Published: April 2012

The study of 61 hand-injured subjects suggested that it is more than surgical and technical excellence that facilitates the return-to-work status among the hand-injured wage earners. Financial need, level of activities of daily living, and participation in occupational therapy were found to be directly related to return-to-work status. Additional findings indicated no difference between the rate of return to work for those whose injuries affected their dominant hand over those who had nondominant hand injures. The amount of medical care needed and whether it was delivered as an outpatient or an inpatient were not associated with the return to work.

The hand-injured subjects’ relevant medical history, participation in occupational therapy, capacity in activities of daily living, desire and ability to return to work, and financial support were quantified through chart audit and interview. Occupational development was measured by using the Moorhead Occupational Work History.
The Effects of Exercise on Finger Extension of CVA Patients
Authors: Trombly Catherine Anne , Quintana Lee A.
Published: April 2012

The choice of activity to improve finger extension of post-CVA patients is based on untested assumptions and hypotheses. In this study, using electromyography of the extrinsic finger muscles and electrogoniometry of wrist and finger joints, the effects of five types of exercise on the finger extension of post-CVA patients were documented.

Results indicated that resisted and rapid exercises recruited high percentages of output of all three muscles. Slow, unresisted extension exercises preferentially recruited the extensor digitorum. No exercise caused significant immediate changes in range of motion (ROM), flexor/extensor balance, time required to open the hand, or level of activity of the extensor digitorum during opening of the hand. Resisted grasp did not limit the patients’ ability to extend the fingers. Variability in percent of motor output among the subjects of this study indicates the need to monitor each patient during therapy.
Technology in the Education of Multiply-Handicapped Children
Authors: Trefler Elaine , Nickey Jeryl , Hobson Douglas A.
Published: April 2012

The number of technical aids now available has allowed severely multiply-handicapped children to better participate in their education. Project TEACH (Technical-Educational Aids for Children with Handicaps), a 3-year early childhood demonstration project of the Federal Office of Education, provided ten children with seating systems, mobility aids, feeding devices, and augmentative communication aids. The children’s performance of academic, motor, daily living, and communication skills as they relate to their educational program is reported as well as the model used to deliver technical services in an educational environment.
Application of Humanistic Learning Theory in an Associate Degree Program for Occupational Therapy Assistants
Authors: Bloss-Brown Suzanne Lins , Schoening Maxine R.
Published: April 2012

A humanistic education model was implemented in a 2-year associate degree curriculum for occupational therapy assistants. The goal of this model was to help students to become responsible and successful with their own lives. This prepares students with higher levels of ability to cope effectively with clients in crises. The curriculum presented here supports the framework of The American Occupational Therapy Association role delineation document (Entry-Level Role Delineation for OTRs and COTAs, approved by the Representative Assembly, AOTA, March 1981).
Toward a Methodology of the Short-Term Effects of Neurodevelopmental Treatment
Authors: DeGangi Georgia A. , Hurley Linda , Linscheid Thomas R.
Published: April 2012

Neurodevelopmental treatment (NDT) is a technique widely used by physical and occupational therapists in the treatment of neuromuscular disorders; however, quantitative evidence supporting its use has yet to be provided. Several studies have attempted to examine the effects of NDT, but because of poor research methodology, conclusions drawn to support the use of NDT are not based on reliable or well-documented evidence. The purpose of this study was to develop a reliable method of measuring short-term, objective changes in children with cerebral palsy and to measure the immediate effects of NDT and play interventions. A single subject design was replicated with four subjects receiving NDT and nonspecific play over a 5-week time period. Pre- and post-test items were designed to reflect qualitative changes in movement, postural tone, and reflex activity, and were videotaped and coded using interval and time-sampling techniques. The results of this study are equivocal; they neither validate nor invalidate NDT. This study provides a methodology for the investigation of the short-term effects of NDT.
Occupational Behavior and Life Satisfaction among Retirees
Authors: Gregory Mark D.
Published: April 2012

Kielhofner’s A Model of Human Occupation was used to guide a study on the effect of occupational behavior (defined as the type, amount, and meaningfulness of one’s activities) on life satisfaction in retirees. Seventy-nine volunteers from a variety of settings for the elderly completed a questionnaire about the amount and types of their activities, the meaningfulness of their activities (i.e., enjoyability, autonomy, and competency), and life satisfaction. The results demonstrated that occupational behavior plays a significant role in affecting life satisfaction among retirees.
Activity Group Counseling for Learning-Disabled Children with Behavior Problems
Authors: McKibbin Elsie , King Judy
Published: April 2012

One of the most difficult problems confronting occupational therapists, teachers, and parents in dealing with latency-age learning-disabled children is handling oppositional behavior. Pre-adolescent boys, in particular, frequently have difficulty working cooperatively in a group, relating to peers, staying with a task, and seeing the consequences of their actions.

This paper provides a rationale for treatment of children in groups and describes the development and early results of an activity group approach to counseling learning-disabled children with behavior problems using Gazda’s developmental model. Group members showed improved ability to relate with siblings and peers; more mature and cooperative behavior; greater independence and impulse control; and increased verbal expression of anger. Parent and teacher feedback on behavior changes was positive.
Tongue Movements in 4- and 5-Year-Old Down’s Syndrome Children During Eating: A Comparison with Normal Children
Authors: Gisel Erika G. , Lange Loren J. , Niman Carol W.
Published: April 2012

This study describes tongue movements of 4- and 5-year-old Down’s syndrome children during eating and then compares the movements to those of age-matched normal children. The study is the second in a long-term project to develop a standardized eating assessment for children.

Tongue movements were monitored in 26 children: 14 were 4 years ± 2 months (8 males, 6 females) and 12 were 5 years ± 2 months (6 males, 6 females). Two different tongue positions were quantified: 1) as food was presented to the child when the food was 5 cm from the lips; and 2) as food was swallowed. The childrens’ ages and gender along with the type of food affected tongue position on food presentation; however, only the childrens’ ages and gender affected tongue position on swallowing. In general, most tongue positions of Down’s syndrome children were characterized by 1) a forward placement of the tongue in the mouth, and 2) the absence of the maturational changes in normal children of the same age.
Occupational Therapy in a Medicare-Approved Home Health Agency
Authors: MacRae Anne
Published: April 2012

The clinical and professional considerations of the occupational therapist in a Medicare-approved home health agency are discussed. These considerations include the effect of Medicare regulations on occupational therapy screening, evaluation, treatment, and discharge.

An occupational therapy chart review was conducted to determine the diagnoses of patients, the duration of treatment, and the outcome of interventions. The results show that the majority of patients referred to an occupational therapist have more than one treatable diagnosis. The average duration of treatment is 7.25 visits per patient. The outcome of intervention shows that 79% of patients treated by occupational therapy were able to remain safely at home either independently or with assistance.
Technology and Occupational Therapy in the Rehabilitation of the Bedridden Quadriplegic
Authors: Seplowitz Carol
Published: April 2012

In recent years, home health care services have been expanded considerably. These services, combined with current technological advances, allow severely disabled, even bedbound, people to remain at home. This report demonstrates how one individual, although bedridden and quadriplegic, has successfully adapted his home environment. His functional independence has been markedly improved through computers, environmental control units, innovative carpentry, and adaptations by the occupational therapist. His need for attendant care has been reduced and his quality of life significantly enhanced through increased control of his surroundings. This paper suggests innovative and technological solutions to environmental problems at home. These ideas may aid the home health care occupational therapist in treating individuals who are bedbound.
Construct Validation of Occupational Therapy Measures Used in CVA Evaluation: A Beginning
Authors: Van Deusen Fox Julia , Harlowe Diane
Published: April 2012

A factor analysis was conducted that involved 33 variables from data on 100 acute cerebral vascular accident patients evaluated by occupational therapists at the St. Marys Hospital Medical Center, Madison, Wisconsin. Variables included the Brunnstrom arm and hand recovery stages, bilateral grasp and pinch measures, bilateral tests of coordination, a number of perceptual tests, and five measures of self-care. From interpretation of the rotated factor patterns, five factors were defined: self-care, left function, recovery stage, perception, and strength. The results provide evidence for the construct validity of the St. Marys CVA battery, although corroborative studies are needed.
Differential Laterality of Hand Function in Right-Handed and Left-Handed Boys
Authors: Mandell Roberta J. , Nelson David L. , Cermak Sharon A.
Published: April 2012

This study was designed to investigate differences in the degree of manual lateralization between right-handed and left-handed normal boys. Sixty-three 5, 7, and 9 year olds were tested on the Minnesota Rate of Manipulation Test (displacing subtest and turning subtest), the Finger Tapping Test, the Purdue Pegboard (placing subtest and assembly subtest), and the Southern California Motor Accuracy Test—Revised. Significant differences between right- and left-handed subjects were obtained on two of the six measures, and a third measure approached significance, with less lateralization among the left handers than among the right handers. Subsequent analyses indicated that differences in lateralization were significant or near-significant in the 5 and 7 year olds. By 9 years of age, right- and left-handed subjects no longer differed in the degree of laterality. Differences in degree of laterality, or the lack of such differences, between young right- and left-handed boys might be a function of the nature of the fine motor task or a function of the child’s previous experience with the task.
Tongue Movements in Normal Preschool Children During Eating
Authors: Schwartz Jeannette L. , Niman Carol W. , Gisel Erika G.
Published: April 2012

This study describes tongue movements of normal preschool children during eating, and is the first phase in a long-term project to develop a standardized eating assessment for children. It is hoped eventually to fill the need for an objective measurement tool in pediatric occupational therapy practice. The movements were monitored in 40 children; 20 were 4 years ± 1 month, and 20 were 5 years ± 1 month. Each group consisted of 10 boys and 10 girls.

Two different tongue positions were quantified: First, as food was presented to the child when the food was 5 cm from the lips; and second, as food was swallowed. Tongue position upon food presentation and upon swallowing was affected by age, sex, and type of food. Both responses showed maturational changes from 4 to 5 years. It is proposed that important maturational changes take place between 4 and 5 years of age, but that adult patterns of swallowing are attained later in development.
Chewing Cycles in 4- and 5-Year-Old Normal Children: An Index of Eating Efficacy
Authors: Schwartz Jeannette L. , Niman Carol W. , Gisel Erika G.
Published: April 2012

Eating movements in the preschool child undergo change between the ages of 2 and 5 years. There is a lack of objective clinical data from normal children against which eating movements of feeding-impaired children can be compared. In this study, chewing movements were measured to complement tongue movements described in an earlier study. The movements were monitored in 40 children: 20 were four years old and 20 were five years old. Each group had ten boys and ten girls.

Chewing movements were measured by time (sec), number of cycles, and a time/cycle ratio. A chewing cycle was defined as an upward and downward movement of the chin. Total time from the moment food was placed in the mouth until the final swallow occurred was divided by the number of cycles counted for the same period.

Age and sex did not affect time, cycles, or the time/cycle ratio. However, the measures were strongly affected by the type of food eaten. These findings suggest that the texture of food strongly influences both the number of chewing cycles performed and the time used for chewing.

The occupational therapist administering eating evaluations to children should carefully choose the foods offered for initial evaluations and use the same food consistently during reevaluations.
Dichotic Listening Performance in Normal Children and Adults
Authors: Bissell Julie Crites , Clark Florence
Published: April 2012

The purpose of this study was to investigate normative expectations on the dichotic listening test in order to determine the influence of sex and development on dichotic listening performance. Thirty 5-to-6 year olds, thirty 11-to-12 year olds, and 30 adults, 15 males and 15 females in each group, were tested by using consonant-vowel dichotic stimuli. There were no significant differences between males and females except for the 11- to 12-year-old females who were significantly more accurate than the males. Degree of ear asymmetry did not differ among the three age groups; however, the adults and 11-to-12 year olds were significantly more accurate than the 5-to-6 year olds. Guidelines are suggested for the interpretation of dichotic listening test data.
Choice Making in Group and Individual Activity
Authors: Henry Alexis D. , Nelson David L. , Duncombe Linda W.
Published: April 2012

A guiding premise of occupational therapy practice is that it is beneficial to allow clients freedom of choice in selecting and participating in activities. This study examined subjects’ affective responses to having or lacking freedom of choice in completing an activity and explored how those responses might differ when subjects did the activity in individual as opposed to group settings. Forty female undergraduate and graduate students participated in an origami activity under four different experimental conditions: a) individual–choice; b) individual–no choice; c) group–choice; and d) group–no choice. Afterward, each subject rated how she felt about herself while participating in the activity by using Osgood’s semantic differential designed to elicit responses in terms of three affective factors: evaluation, power, and activity. Data analysis revealed an interaction between the two independent variables on the power factor such that subjects who were not permitted choice responded significantly differently from those who were permitted choice only in the group setting. Implications of this finding for occupational therapy practice are discussed.
Electromyographic Study of the Upper Extremity During Bilateral Sanding: Unresisted and Resisted Conditions
Authors: Spaulding S. J. , Robinson K. L.
Published: April 2012

Electromyographic information was obtained from seven right shoulder complex muscles in nine subjects (three normal, three paraplegic, and three quadriplegic) during the occupational therapy activity of bilateral sanding on an incline board, an activity that has been recommended as a treatment modality to strengthen the triceps brachii. Electromyography revealed that the anterior and middle portions of the deltoid were the muscles most responsible for the subjects’ arm movements during both resisted and unresisted bilateral sanding. Triceps lateralis and medialis were also active during the up phase, but not as consistently as the deltoid. Pectoralis major and biceps brachii were not extensively active in most subjects. The small size and heterogeneity of the subject sample limits the generalizations of our findings. However, graded resisted bilateral sanding does appear to be an appropriate activity for strengthening the shoulder muscle group, especially the deltoid and triceps brachii, in the tested patient populations.
Reimbursement in Private Practice
Authors: Hershman A. Gloria
Published: April 2012

Occupational therapists in private practice must develop sound business policies and procedures to help ensure third party reimbursement for their services. Carefully delineated protocols and proper documentation in treatment are of utmost importance. Fee schedules are established within the framework of local government regulations, using one or a combination of the following methods: unit value system, modalities and procedures, cost-plus or overhead, and state relative value system or maximum allowable fees. Blue Cross/Blue Shield or other private third party payers, Medicare or Medicaid, and workers’ compensation insurers are the usual parties billed for services rendered. Therapists must use good public relations methods to educate their present and future reimbursers and act as advocates for private practitioners in occupational therapy.
Funding Health Services for Children
Authors: Rourk Jane Davis
Published: April 2012

This paper reviews major federal laws that have helped raise a consciousness in this country for increasing availability of health care services for handicapped and chronically ill children, and have authorized financial assistance for these services. This review is intended to provide a basic understanding of these key statutes so that they can be used to expand available occupational therapy services. Private health insurance is also reviewed since approximately one-third of all health care costs for children is reimbursed by this source.
The Medicare Prospective Payment System
Authors: Scott Susan J.
Published: April 2012

In 1983 Congress adopted the most significant change in the Medicare program since its inception in 1965. Along with measures to ensure the solvency of the Social Security System into the next century, Congress approved a system of prospective payment for hospital inpatient services, whereby hospitals are paid a fixed sum per case according to a schedule of diagnosis related groups (DRGs). The program will be phased in over a four-year period that began October 1, 1983. Several types of hospitals and distinct part units of general hospitals are excluded from the system until 1985, when Congress will receive a report on a method of paying them prospectively. Information used to calculate the DRG rates was published September 1, 1983, as part of the interim final regulations. Other third party payers, such as state Medicaid systems and insurance companies, are considering converting to this method of payment, and several have adopted it. The implications for occupational therapy include a greater emphasis on reducing hospital length of stay, expanding outpatient care, increasing productivity, and a trend toward documentation and accounting consistent with computer technology.
Hand Strength and Prone Extension in Right-Dominant, 6 to 9 Year Olds
Authors: Bowman O. Jayne , Katz Barry
Published: April 2012

A stratified random sample of 153 right-dominant children (6 to 9 years of age) with normal or above intelligence was selected to study the development of hand strength, and the quality and duration of prone extension as a function of age, sex, height, and weight of the child. The Jamar hand dynamometer was used to measure hand strength, and a new scale for rating the quality of prone extension was presented. Both right- and left-hand strength increased monotonically with age, with the right being significantly higher than the left. Duration of prone extension increased monotonically with age, but quality of prone extension did not correlate with age. Sex differences were found only on the variable left-hand strength (males greater than females). Hand strength demonstrated weak correlation with duration of prone extension. Both height and weight exhibited strong positive correlations with hand strength, weaker positive correlations with duration of prone extension, and no correlation with quality of prone extension. The results suggest hand strength can be an index of normal development, and children ages 6 to 9 can attain the prone extension position; however, the meaning of duration greater than 30 seconds needs to be researched further.
Crisis Intervention: The Nuclear Task Approach
Authors: Rosenfeld Mark S.
Published: April 2012

Failure to perform certain life tasks adequately contributes to crisis development. Occupational therapists frequently treat individuals in crisis. The state of crisis disrupts normal activity patterns, adding to the individual’s sense of helplessness and disequilibrium. Activities may play a crucial role in the process of recovery. “Nuclear tasks” are activities that promote adaptive resolution of crisis elements and spur active problem solving on the part of crisis patients.
Developmental Coaching of the Down Syndrome Infant
Authors: Esenther Shirley E.
Published: April 2012

Proprioceptive input appropriate to the developmental level of the Down Syndrome infant, and kinesthetic and proprioceptive leading of the infant enhance joint stability and prompt the infant to participate in a fuller repertoire of exploratory movement at a relatively early developmental age. Comparison of performances of the Down Syndrome population at the Ray Graham—Fairwood School with that of other Down Syndrome infants in the literature suggested that our intervention program, developmental coaching, had made a difference. A retrospective study was undertaken to document the progress made. Of the 40 infants studied, 95 percent achieved certain hand skills criteria by 10 months of age; 92.5 percent achieved prewalking mobility by 10 months of age; and 40 percent achieved free walking by 18 months of age.
Parents and Therapists in a Professional Partnership
Authors: Anderson Jill , Hinojosa Jim
Published: April 2012

Based on a review of the literature, occupational therapy intervention with parents of handicapped children is presented. Normal conflicts in raising a child, parent responses to the diagnosis of disability, and stage-related parent reactions are examined to help understand the issues of parenting a developmentally or learning disabled child. The development of a collaborative relationship between the occupational therapist and parents is stressed. Selected methods of evaluation and strategies for occupational therapy intervention are described with a focus on the use of activities with parents.
The Southern California Postrotary Nystagmus Test and Electronystagmography Under Different Conditions of Visual Input
Authors: Nelson David L. , Weidensaul Nancy K. , Shih Louisa Shing-Ru , Anderson Virginia G.
Published: April 2012

This study assessed the Southern California Postrotary Nystagmus Test (SCPNT)-stimulated nystagmus under three conditions of indoor illumination (bright, dim, and dark), and it studied the concurrent validity of SCPNT and electronystagmographic (ENG) measures of nystagmus duration and excursion. Eighteen adult subjects received three sets of rotations to the left under different lighting conditions in a counterbalanced order. The duration and excursion of the SCPNT were monitored under the bright and dim conditions, and ENG-recorded duration, excursion, frequency, slow-phase velocity, and average intersaccadic interval were measured under all three lighting conditions. No significant differences were found between nystagmus duration or excursion under the bright and dim conditions, but highly significant differences were found between the dark condition and the other two conditions. The correlation between ENG-recorded duration and SCPNT visually monitored duration across bright and dim conditions was .73, and the correlation for excursion was .24. These results suggest that occupational therapy researchers and clinicians need not question the validity of SCPNT procedures under different indoor lighting conditions, and suggest that the concurrent validity of ENG recordings and SCPNT measures requires more study.
Allied Health Team Management of Rheumatoid Arthritis Patients
Authors: Feinberg Judy R. , Brandt Kenneth D.
Published: April 2012

The use of a coordinated team of allied health professionals (AHPs) to treat patients with rheumatoid arthritis assigned to experimental groups (EG) and comparison groups (CG) was assessed. The EG patients were evaluated regularly by each AHP team member, whereas CG patients were seen by AHPs only upon referral. Of the 10 EG and 13 CG patients who remained in the study for 2 years, the EG patients initially exhibited somewhat greater disease activity than CG (as reflected by erythrocyte sedimentation rate and duration of morning stiffness). After 2 years, EG patients demonstrated less disease activity than at the outset, whereas CG patients either showed little change in these parameters or deteriorated during the study. Grip strength, which was initially similar in the two groups, improved in EG patients but decreased in CG patients, so that after 2 years a significant difference was noted between the two groups (p < .05). Tendency to lose hand range of motion was also greater in CG than in EG patients. Some EG patients showed improvement in finger flexion deformities during the study. Furthermore, EG patients showed a greater tendency to acquire positive attitudes regarding themselves and family relationships. These results suggest that ongoing “team care” may be more efficacious than episodic use of AHPs in management of patients with mild rheumatoid arthritis.