Showing papers in "American Journal of Occupational Therapy in 1982"
TL;DR: 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.
Abstract: 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.
379 citations
TL;DR: The results of studies examining the effectiveness of sensory integration therapy were reviewed, using recently developed quantitative methods that treat the literature review process as a unique type of research, and revealed that subjects participating in sensory Integration therapy performed significantly better than members in the control groups who did not receive sensory integration Therapy.
Abstract: The results of studies examining the effectiveness of sensory integration therapy were reviewed, using recently developed quantitative methods that treat the literature review process as a unique type of research. Forty-nine studies were located initially. Eight of these studies met the following criteria: (a) they investigated the effect of sensory integration therapy; (b) they included dependent measures of academic achievement, motor or reflex performance, and/or language function; (c) they included a comparison between at least two groups; and (d) they reported quantitative results of the effect of sensory integration therapy. The 8 studies contained a total of 47 statistical hypothesis tests that evaluated the effectiveness of sensory integration therapy. An analysis of these tests, using quantitative reviewing methods, revealed that subjects participating in sensory integration therapy performed significantly better than members in the control groups who did not receive sensory integration therapy. The application of sensory integration therapy to various client populations is discussed in relation to the existing empirical support revealed in the studies reviewed. The advantages of quantitative reviewing procedures are discussed, and use of the procedures with the developing occupational therapy research literature is recommended.
105 citations
TL;DR: It is concluded that visuospatial deficits are an important independent factor governing functional outcome and should be given as much attention as hemiparesis during discharge and rehabilitation planning for the right hemisphere stroke patient.
Abstract: The influence of visuospatial deficits on functional status after right hemisphere stroke was investigated in 34 patients. Correlation coefficients between visuospatial deficits and other factors--age, sex, vocabulary, educational level, hemiparesis, hemianopia, left-sided extinction, length of stay on a rehabilitation unit, and time lapse between onset of stroke and admission to the rehabilitation unit--were also computed. Little correlation was found between the severity of the hemiparesis and the severity of the visuospatial deficits, yet both motor and visuospatial deficits proved to be important predictors of functional status at the time of discharge from the stroke rehabilitation unit. We conclude that visuospatial deficits are an important independent factor governing functional outcome and should be given as much attention as hemiparesis during discharge and rehabilitation planning for the right hemisphere stroke patient.
99 citations
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63 citations
TL;DR: In this paper, the Preschool Play Scale was used to measure the play behavior of normal preschool children when administered by trained observers. But it was not shown to yield stable, stable, and valid measurements of play for normal children.
Abstract: Lunzer's Scale of Organzzatzon of Play Behavior, and Parten's Socwl Play Hierarchy. Data were ana lyzed usmg bwariate correlat ion coefficients. Significant res u Its suggest that the Preschool Play Scale will yield ob/ectlVe, stable, and valid measurements of play for normal preschool children when administered bv trained observers. Recummendations for further study of the Preschool Play Scale are given.
61 citations
TL;DR: The meaning of these concepts in medicine and in occupational therapy is compared to clarify the differences in orientation between the two disciplines and the development of a taxonomy of levels of performance in occupation is suggested.
Abstract: 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.
61 citations
TL;DR: A model of social evolution is proposed to extend the model of biological evolution and to demonstrate the central role of play in the social-evolutionary process and a set of principles is derived from the evolutionary-developmental characteristics of play.
Abstract: In this paper human play is examined from the perspectIve of its role in evolution. A model of social evolutzan is proposed to extend the model of biological evolution and to demonstrate the central role of play in the soclal evolutionary process. Since in evo lution play is a mechanzsm for its process, it demands species members who are playful. Thus, man IS a player by virtue of species membership and the evolutionary pathway of the species. The impli cations of this deep-seated charac teristic of playfulness are dIscussed in terms of human development. Finally, a set of principles IS derived from the evolutionary developmental characteristICS of play. Application of these przncl pies in clinical practice is demon strated and discussed.
53 citations
TL;DR: It is necessary to reflect on the beliefs that comprise occupational therapy philosophy in regard to functional independence to explore their implications for practice.
Abstract: Making sense of our daily experience is a significantly human pastime. We try to understand and structure our experiences so that we can come to grips with the messiness and confusion of everyday life and by so doing give meaning and direction to our actions. Philosophy is one method that we use for explaining our experiences. A philosophy is a collection of beliefs. A belief is a conviction in the truth of something. Our beliefs are based on our values, experiences, and knowledge. Once we have organized our beliefs into a philosophy, that philosophy provides a powerful, generally nonconscious, guide for our actions (I). It is because of the nonconscious way in which a philosophy influences our actions that it is a ppropriate to reflect on the beliefs that comprise occupational therapy philosophy in regard to functional independence. Functional independence is not just a core concept of occupational therapy theory, it is the goal of the occupational therapy process. Once our beliefs about functional independence have been articulated, we can explore their implications for practice.
53 citations
TL;DR: The group of mothers with tactually defensive children reported a significantly greater number of positive responses to items previously determined to be indicative of tactile defensiveness than did the mothers of children without tactiledefensiveness.
Abstract: This study investigated whether sensory history questionnaires differentiated between developmentally delayed children with and without tactile defensiveness and, in addition, which individual items were most discriminative. Interviews were conducted with 20 mothers of developmentally delayed children regarding their children's past and present behavioral responses to tactile and other sensory stimuli. The group of mothers with tactually defensive children reported a significantly greater number of positive responses to items previously determined to be indicative of tactile defensiveness than did the mothers of children without tactile defensiveness. An individual item analysis identified 11 items as discriminating most clearly between a group of children with tactile defensiveness and a group without tactile defensiveness. Some preliminary behavioral trends and implications for the use of sensory history questionnaires in parent counseling and in planning appropriate treatment programs are presented.
TL;DR: Ten adults with hypertonic wrist flexors volunteered as subjects in an experiment comparing the effectiveness of dorsal and volar resting hand splints in the reduction of abnormal muscle tone, finding no significant differences between the volar and dorsal splint design in reducing hypertonus.
Abstract: Ten adults with hypertonic wrist flexors volunteered as subjects in an experiment comparing the effectiveness of dorsal and volar resting hand splints in the reduction of abnormal muscle tone. Subjects were randomly assigned to two groups of five each. Individuals in one group were fitted with dorsal splints, and individuals in a second group with volar splints. Measurements by spring-weighted scales were taken to assess the efficiency of each splint design in the reduction of hypertonus. Results demonstrated no significant differences between the volar and dorsal splints in reducing hypertonus. However, the age of the subjects was found to be an intervening variable: The older subjects of both groups demonstrated a gradual but not significant decline in hypertonus, whereas the younger adults demonstrated a significant decline in hypertonus over a 6-week period.
TL;DR: Plaster splinting was used to decrease severe elbow flexor spasticity in a patient with an upper motor neuron lesion, and the patient has voluntary, functional range in the impaired extremity.
Abstract: Plaster splinting was used to decrease severe elbow flexor spasticity in a patient with an upper motor neuron lesion. A series of plaster splints were applied over a period of several weeks that allowed elbow extension yet controlled the amount of flexion. The design of the splint was effective in reducing the spasticity, which was probably a result of the input from the golgi tendon organs in the spastic flexors. Initially, the splints were worn 24 hours a day. Later in the treatment process the wearing time was reduced to 12 hours at night only. Currently, the patient has voluntary, functional range in the impaired extremity.
TL;DR: A conceptual model for occupational therapy: the ecological systems model, where the developing individual is viewed as an open system interacting with the environment, and states of health and illness can be seen as reflections of ecological adaptation.
Abstract: This article presents a conceptual model for occupational therapy: the ecological systems model. The developing individual is viewed as an open system interacting with the environment. Both humans and their environment are interconnected, joined in shaping each other. States of health and illness can be seen as reflections of ecological adaptation. Function or dysfunction is evaluated in terms of persons' effectiveness in achieving their own goals, for their own quality of life, in their interactions in the ecosystem. If performance of necessary tasks ane roles is effective in achieving those goals and in harmony with the needs and goals of the external systems, then behavior is functional.
TL;DR: Three facets of person-environment interactions are considered: environmental properties that influence the volition subsystem and the person's decision to enter a setting; the influence of the setting's demands for performance on the development of roles, habits, and skills; and factors affecting the individual's engagement in an expanding range of occupational settings.
Abstract: Although occupational therapists historically acknowledged contributions of the environment to the maintenance of productive behavior, their literature has only recently begun to illustrate the interrelationships between persons and settings. Incorporating environmental themes into the model of occupation broadens an examination of the concept of occupational performance and helps establish the clinic as a therapeutic milieu. This paper considers three facets of person-environment interactions: environmental properties that influence the volition subsystem and the person's decision to enter a setting; the influence of the setting's demands for performance on the development of roles, habits, and skills; and factors affecting the individual's engagement in an expanding range of occupational settings.
TL;DR: An outline for an emerging theory to occupational therapy practice with mental disorders is provided, which describes functional distinctions in the severity of disorder, as reflected in routine task behavior.
Abstract: An outline for an emerging theory to guzde 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 neuros6ences are examined for their potential impact on knowledge development and program obJect ives. O ccupational therapy practice began by delivering services to psychiatric patients at a time when the empirical study of the human brain was a relatively new idea. At that time many academIcians thought that objective study was impossible because the brain is so complex. The brain is complex, and the history of our profession has been influenced by the neuroscience approaches to studying its structure and function. Early in this century a decision was
TL;DR: An occupational therapy program involved in the acute rehabilitation of patients with total hip replacement and total surface replacement is described, finding that the majority of the patients surveyed were found to be independent in essential activities of daily living by the time they were discharged from the hospital.
Abstract: In this paper an occupational therapy program involved in the acute rehabilitation of patients with total hip replacement and total surface replacement is described. The goal of the program is to help patients achieve independence in activities of daily living by the conclusion of their 2-week hospitalization, while complying with the physical limitations imposed by the surgical protocol. The program consists of instruction in the use of selected adaptive equipment, in activities of daily living, and in environmental modifications. The findings of a retrospective patient survey are included. Specifically, the majority of the patients surveyed were found to be independent in essential activities of daily living by the time they were discharged from the hospital, and that use of the adaptive equipment was very high.
TL;DR: This study hypothesized that different activities would elicit different kinds of affective meanings in their participants, and results indicated that the four activities elicited significantly different responses on all three factors.
Abstract: The premise that activities have inherent meanings is basic to the theory and practice of occupational therapy. In this study the investigators hypothesized that different activities would elicit different kinds of affective meanings in their participants. The subjects in this study were 59 students beginning their training in occupational therapy. On their first day in an activities class, and before instruction in activity analysis, the subjects were presented with four selected activities. Immediately after performing each activity, the students were requested to rate the activity according to Osgood's 12-scale short-form semantic differential. The data generated were reduced subsequently to Osgood's three factors of affective meaning: "evaluation," power," and "activity" (in this study called action). Results indicated that the four activities elicited significantly different responses on all three factors. Specific results and implications of this study's methodology for future occupational therapy research are discussed.
TL;DR: Physical problems, which posed a greater handicap to self-feeding than mental problems, were of four types: improper positioning, dysphagia, upper extremity dysfunctions, and blindness.
Abstract: Data obtained from observing the residents of three long-term care facilities showed that the majority required some assistance in feeding. The facilities differed in the percentage of residents needing help and in the physical and attitudinal support given for self-feeding. Regardless of level of independence in feeding, most residents received adequate food intake. Physical problems, which posed a greater handicap to self-feeding than mental problems, were of four types: improper positioning, dysphagia, upper extremity dysfunctions, and blindness.
TL;DR: A battery of tests designed to measure functions of the parietal lobes was given to 68 normal adults, finding significant age-related changes on the constructional tasks, finger identifications, clock settings, visual organization tasks, and visual discrimination tasks.
Abstract: Symptoms referrable to the parietal lobes, such as difficulty with dressing, unilateral neglect, or manual apraxia, are a frequent rehabilitation problem among stroke patients. Occupational therapists need an evaluation tool for parietal lobe functions and performance expectations for adults 40 years and older. A battery of tests designed to measure functions of the parietal lobes was given to 68 normal adults from 40 to 88 years of age. The test battery included drawings, stick designs, finger identifications, right-left identifications, arithmetic, clock settings, map localizations, block constructions, visual organization tasks, and visual discrimination tasks. Statistical analysis of the data revealed significant age-related changes on the constructional tasks, finger identifications, clock settings, visual organization tasks, and visual discrimination tasks. No significant age effect was found on right-left identifications, map localizations, or arithmetic. Implications for the evaluation and treatment of older adults in occupational therapy are discussed.
TL;DR: The adoption of sponsorship as a leadership development strategy for occupational therapy is recommended, and illustrations of initiating and using sponsorship are given.
Abstract: Professional sponsorship is a helping relationship aimed at a career advancement. It includes the hierarchical association between the mentor and protege, and the collegial associations between peer mentors, among "peer pals," and in support networks. Sponsors serve as advocates, emotional supporters, and information-givers for those they sponsor. The adoption of sponsorship as a leadership development strategy for occupational therapy is recommended, and illustrations of initiating and using sponsorship are given.
TL;DR: In this article, a model of play development for use in pediatric occupational therapy is presented, which unifies the theoretical approaches of sensory integration and occupational behavior, using play as the unifying link between these two apparently different approaches.
Abstract: This series of two articles presents a model of play development for use in pediatric occupational therapy. Proposing to unify the theoretical approaches of sensory integration and occupational behavior, the model uses play as the unifying link between these two apparently different approaches. This first article reviews the major concepts of sensory integration and occupational behavior, in addition to discussing the differences and similarities between the two. General systems concepts are used as a framework upon which a model of play development is constructed. Three hierarchical levels of play are described--sensorimotor, constructive, and social--with each broken down into several developmental steps.
TL;DR: It is proposed that, through a mutual understanding and cooperative effort on the part of all professionals, the two models may be combined to provide comprehensive services to the developmentally disabled.
Abstract: Because of the evolving nature of the professions involved in providing services to the developmentally disabled as mandated by PL 94-142, the potential of theoretical and programmatic conflict exists. Some of the philosophical differences and similarities between occupational therapy and special education are reviewed. Two conceptual approaches to therapy and education are identified. The first approach is based on the medical model, which emphasized diagnostic evaluation to determine the cause of a disorder and the prescription of remedial activities to alleviate the dysfunction. The second approach is the task analysis model, which emphasized task content and behaviorally based teaching strategies and objectives. It is proposed that, through a mutual understanding and cooperative effort on the part of all professionals, the two models may be combined to provide comprehensive services to the developmentally disabled.