Showing papers in "American Journal of Occupational Therapy in 2006"
TL;DR: Poor quality of handwriting of children with HWP seems particularly related to a deficiency in visual-motor integration, which suggests that two different mechanisms underlie thequality of handwriting in children with and without handwriting problems.
Abstract: OBJECTIVE. This study investigated the contribution of perceptual-motor dysfunction and cognitive planning problems to the quality or speed of handwriting in children with handwriting problems (HWP). METHOD. Twenty-nine children with HWP and 20 classroom peers attending regular schools (grade 2 and grade 3) were tested with regard to visual perception, visual-motor integration, fine motor coordination, and cognitive planning abilities. RESULTS. The HWP group scored significantly lower on visual perception, visual-motor integration, fine motor coordination, and cognitive planning in comparison with classroom controls. Regression analyses showed that visual-motor integration was the only significant predictor for quality of handwriting in the HWP group, whereas fine motor coordination (i.e., unimanual dexterity) was the only significant predictor of quality of handwriting in the control group. CONCLUSIONS. Results suggest that two different mechanisms underlie the quality of handwriting in children with and without handwriting problems. Poor quality of handwriting of children with HWP seems particularly related to a deficiency in visual-motor integration.
250 citations
TL;DR: Kinesio Tape may be associated with improvement in upper-extremity control and function in the acute pediatric rehabilitation setting and may assist with the goal-focused occupational therapy treatment during the child's inpatient stay.
Abstract: OBJECTIVES. The purpose of this pilot study is to describe the use of the Kinesio Taping ® method for the upper extremity in enhancing functional motor skills in children admitted into an acute rehabilitation program. METHOD. Fifteen children (10 females and 5 males; 4 to 16 years of age), who were receiving rehabilitation services at the Rehabilitation Institute of Chicago participated in this study. For 13 of the inpatients, this was the initial rehabilitation following an acquired disability, which included encephalitis, brain tumor, cerebral vascular accident, traumatic brain injury, and spinal cord injury. The Melbourne Assessment of Unilateral Upper Limb Function (Melbourne Assessment) was used to measure upper-limb functional change prior to use of Kinesio Tape ® , immediately after application of the tape, and 3 days after wearing tape. Children’s upper-limb function was compared over the three assessments using analysis of variance. RESULTS. The improvement from pre- to posttaping was statistically significant, F(1, 14) = 18.9; p < .02. CONCLUSION. These results suggest that Kinesio Tape may be associated with improvement in upperextremity control and function in the acute pediatric rehabilitation setting. The use of Kinesio Tape as an adjunct to treatment may assist with the goal-focused occupational therapy treatment during the child’s inpatient stay. Further study is recommended to test the effectiveness of this method and to determine the lasting effects on motor skills and functional performance once the tape is removed.
216 citations
TL;DR: This investigation compared language use and social interaction in children with autism receiving two forms of occupational therapy: occupational therapy using standard techniques, and occupational therapy incorporating animals.
Abstract: This investigation compared language use and social interaction in children with autism receiving two forms of occupational therapy: occupational therapy using standard techniques, and occupational therapy incorporating animals. Twenty-two children between the ages of 7 and 13 received both forms of therapy in a school-based occupational therapy program for children with autism. Results suggest that the children demonstrated significantly greater use of language and significantly greater social interaction in sessions incorporating animals when compared to sessions using exclusively standard occupational therapy techniques. Findings are discussed in the context of recent research that has highlighted the importance of enhancing the motivation of children with autism to engage actively in therapeutic and learning processes.
193 citations
TL;DR: The type of occupations a mother participates in varies significantly dependent upon whether a child in the family has a disability and the age of the child, particularly in light of the time demands of the mother.
Abstract: Objective The purpose of this study was to compare the time use of mothers of children with disabilities with the time use of mothers of children without disabilities. Method Sixty mothers with children 3 to 14 years of age (30 mothers with children with disabilities and 30 mothers with children without disabilities) completed time diaries over seven 24-hour days. Results Significant differences were found between the two groups when comparing mean hours spent per week by mothers in occupations involving child-care activities and recreational activities. Mothers of children with disabilities spent significantly more time in child-care activities and significantly less time in recreational activities. In addition, mothers of children with disabilities reported fewer typical days and rated the quality of days as poorer. As children got older, the gap between the time mothers devoted to child care increased between the two groups. Conclusion The type of occupations a mother participates in varies significantly dependent upon whether a child in the family has a disability and the age of the child. Professionals need to work collaboratively with families to assist parents to meet the family's daily needs particularly in light of the time demands of the mother.
118 citations
TL;DR: Development of a systematic strategy by occupational therapists to elicit the roles that their clients desire to play in the therapeutic process may be an effective intervention to ensure that occupational therapists and their clients are able to fulfill their roles in client-centered practice.
Abstract: Objective The purpose of this study was to comparatively analyze the perceptions of clients and occupational therapists regarding their involvement in the process of client-centered practice. Method Participants (11 occupational therapists, 30 clients) in adult/geriatric health care facilities were each engaged in a semistructured interview to determine their perceptions of client-centered practice, specifically in the goal-setting process. Descriptive statistics were used to analyze the item data. In addition, one-way analysis of variance was computed to identify the differences of opinions in clients and occupational therapists on the process of client-centered practice in four facilities: long-term-care or rehabilitation, hospital outpatient, hospital inpatient, and nursing homes. Results The occupational therapists in this study indicated use of the principles of client-centered practice in their delivery of occupational therapy services. Their clients, however, displayed mixed perceptions about their role as active participants in client-centered practice and all responded in the negative when asked if they were aware of the approach. Perceptual differences existed between the occupational therapists and their clients in relation to the use of client-centered practice, because their responses to similar questions varied. Last, type of facility significantly influenced clients' knowledge of certain aspects of their treatment processes in the following four areas: (a) treatment goal selection, (b) encouragement provided in setting clients' goals, (c) clients' perception of the importance in the goal-setting process, and (d) education of clients about their participatory role in the goal-setting process. Conclusion Results suggest that a perceptual gap exists between occupational therapists and their clients in relation to their stated use of and participation in client-centered practice. In light of the results, development of a systematic strategy by occupational therapists to elicit the roles that their clients desire to play in the therapeutic process may be an effective intervention to ensure that occupational therapists and their clients are able to fulfill their roles in client-centered practice.
118 citations
TL;DR: The authors conducted a study to evaluate handwriting instruction by classroom teachers in one school district and found that teachers differed in their methods of instruction, including in the programs and paper used, and practice provided.
Abstract: OBJECTIVE. Classroom teachers teach handwriting, but when problems arise, students are referred to occupational therapy for remediation. This study, conducted by occupational therapists, reviews handwriting instruction by classroom teachers in one school district.
METHOD. Teachers from kindergarten through grade 6 were asked to complete an open-ended questionnaire regarding handwriting instruction.
RESULTS. Teachers differed in their methods of instruction, including in the programs and paper used, and practice provided. Teachers of grades 5 and 6 had to continue to review handwriting instruction, because all students could not fluently use handwriting as a tool of expression.
CONCLUSION. Elementary students need structured instruction to develop the motor skill of writing. School-based occupational therapists can support effective handwriting instruction by interpreting information from motor learning theory pertaining to instruction and practice, which supports acquisition, transfer, and retention of handwriting skills. They also need to be cognizant of prior handwriting instruction when addressing handwriting difficulties
115 citations
TL;DR: Therapeutic practice was more effective than sensorimotor-based intervention at improving handwriting performance and children who received Sensorimotor intervention improved in some sensorim motor components but also experienced a clinically meaningful decline in handwriting performance.
Abstract: OBJECTIVE. The aim of this study was to investigate the effects of two interventions (sensorimotor and therapeutic practice) on handwriting and selected sensorimotor components in elementary-age children. METHOD. Thirty-eight children 6 to 11 years of age with handwriting dysfunction but no identified educational need were randomly assigned to one of the two intervention groups or a control group. Intervention groups met four times per week over 5 weeks. Handwriting was measured pre- and postintervention using the Test of Handwriting Skills. Visual perception (motor-reduced), visual-motor integration, proprioception, and in-hand manipulation were also measured. RESULTS. Children receiving therapeutic practice moderately improved handwriting whereas children receiving sensorimotor intervention declined in handwriting performance. The control group did not change significantly. Sensorimotor impairment was noted at pretest in three or four components and selected sensorimotor component function improved with intervention.
112 citations
TL;DR: To determine off-road and on-road driving evaluation practices of clinicians in the United States and Canada who assess individuals with disabilities for fitness to drive, a self-administered questionnaire was elicited.
Abstract: OBJECTIVE To determine off-road and on-road driving evaluation practices of clinicians in the United States and Canada who assess individuals with disabilities for fitness to drive PARTICIPANTS Participants were 114 clinician attendees at the 2003 annual Association of Driver Educators for the Disabled with driving assessment experience ranging from 1 month to 25 years MEASURES Information was elicited regarding the clinician, clientele, referral practices, and off-road and on-road driving evaluation practices and retraining practices using a self-administered questionnaire RESULTS Participants were largely occupational therapists (68%) who worked in 42 different states and provinces The most prevalent clientele were persons with traumatic brain injury (97%) and stroke (96%) Testing times greater than 60 min were common for both the off-road (61%) and on-road (49%) evaluations Commonly performed off-road assessments included the Brake Reaction Timer; Trail Making Test, Parts A and B; and the Motor Free Visual Perception Test, used by 73%, 72%, and 66%, respectively; comprehensive computer-based driving evaluation was rare Sixty-one percent indicated that all clients underwent on-road evaluation regardless of the off-road results Finally, 78% used a standard driving route, whereas 24% used a scoring system to evaluate on-road driving CONCLUSION Driving assessment in Canada and the United States is multidimensional and time-intensive Although the domains being assessed are similar across clincians, specific off-road and on-road assessment practices vary greatly The majority use nonstandardized on-road assessments
109 citations
TL;DR: The purpose of this Slagle lecture is to raise awareness of the complexity and “delicate layerings” of Everyday occupation, its theoretical and conceptual underpinnings, the consequences of severe occupational constraints to health and well-being, and the essential relevance of everyday occupation to occupational therapy and occupational science.
Abstract: Betty Risteen Hasselkus Everyday occupation is a primary means by which we organize the worlds in which we live. The phenomenological experiences of day-to-day life build meaning and community in our lives; yet everyday occupation is often “seen but unnoticed.” Cultural tendencies and invisible social forces contribute to the obscurity of the everyday and, in severe situations, to occupational deprivation. The purpose of this Slagle lecture is to raise awareness of the complexity and “delicate layerings” of everyday occupation, its theoretical and conceptual underpinnings, the consequences of severe occupational constraints to health and well-being, and the essential relevance of everyday occupation to occupational therapy and occupational science. Everyday occupation related to food is probed in depth to illustrate the richness of day-to-day living. Occupational therapy personnel are encouraged to gain deeper understandings of the importance and meaning of everyday occupation in the lives of clients and the general public, thereby helping people find value in their everyday practices.
107 citations
TL;DR: Children with disabilities in grades 1-3 completed the Perceived Efficacy and Goal Setting System with occupational therapists who work in school settings and differences were found across types of disabilities.
Abstract: The Perceived Efficacy and Goal Setting System (PEGS) is an instrument and a process that enables children with disabilities to reflect on their ability to perform everyday occupations and to identify goals for occupational therapy intervention In this study, 117 children with disabilities in grades 1-3 completed the PEGS with occupational therapists who work in school settings Children from 6-9 years of age with a variety of disabilities were able to self-report perceptions of their effectiveness performing 24 activities that would be expected of them each day Parents and teachers, who completed a parallel questionnaire, rated their abilities lower than the children did The School Function Assessment, a measure of the amount and type of support required for school participation, had low correlations with the Parent and Teacher PEGS questionnaires and did not correlate with the Child PEGS No differences in perceived efficacy were found for children across grades or gender; however, differences were found across types of disabilities Children were able to use the perceived efficacy information to identify and prioritize goals for intervention and these goals remained stable 2 weeks later Occupational therapists can use the PEGS within a client-centered practice to help the child set goals for therapy and to incorporate explicitly the perspectives of parents and teachers
92 citations
TL;DR: Observation of occupational therapy activities and intervention techniques used during inpatient stroke rehabilitation in order to provide a description of current clinical practice reflected an integration of treatment approaches.
Abstract: OBJECTIVE. To prospectively monitor occupational therapy activities and intervention techniques used during inpatient stroke rehabilitation in order to provide a description of current clinical practice.
METHODS. Data were collected prospectively from 954 clients with stroke receiving occupational therapy from six U.S. rehabilitation hospitals. Descriptive statistics summarized frequency, intensity, and duration of occupational therapy sessions; proportion of time spent in 16 therapeutic activities; and proportion of those activities that included any of 31 interventions.
RESULTS. Clients received on average 11.8 days (SD = 7.2) of occupational therapy, with each session lasting on average 39.4 min (SD = 16.9). Upper-extremity control (22.9% of treatment time) and dressing (14.2% of treatment time) were the most frequently provided activities. Interventions provided most frequently during upper-extremity control activities were strengthening, motor learning, and postural awareness.
CONCLUSION. Occupational therapy provided reflected an integration of treatment approaches. Upper-extremity control and basic activities of daily living were the most frequent activities. A small proportion of sessions addressed community integration.
TL;DR: This study investigated whether nonproficient handwriters could be distinguished by biomechanical ergonomic factors during handwriting, as well as by measures of handwriting efficiency, to provide insights that can assist in planning intervention.
Abstract: OBJECTIVES. Handwriting is a work activity for children, hence it may be evaluated based on ergonomic factors. This study investigated whether nonproficient handwriters could be distinguished by biomechanical ergonomic factors during handwriting, as well as by measures of handwriting efficiency. Furthermore, the relationships among ergonomic factors, handwriting quality, efficiency, and measures of the handwriting process were examined. METHODS. Fifty proficient and 50 nonproficient third-grade handwriters performed a handwriting task on an electronic tablet. Biomechanical ergonomic factors, measures of handwriting quality, and efficiency were rated using the Hebrew Handwriting Evaluation. Handwriting process measures were obtained from a computerized system. RESULTS. Biomechanical ergonomic factors and handwriting efficiency measures significantly differentiated between the study groups. Significant correlations were found among ergonomic factors and handwriting quality, efficiency, and process measures. CONCLUSION. Nonproficient handwriting is a work activity that is often characterized by inferior biomechanical ergonomics, handwriting quality, efficiency, and significantly different handwriting process measures. Results provide insights that can assist in planning intervention.
TL;DR: Knowing what characterizes the meaning of work to those with acquired brain injury should lead to an increased understanding among occupational therapists engaged in work rehabilitation after brain injury and can serve as a basis for individualized intervention strategies.
Abstract: PURPOSE: Research in the field of brain injury rehabilitation has tended to regard return to work as a measure of outcome. Researchers have not paid particular attention to the experiences of peo ...
TL;DR: The strong majority of reported occupational therapy services contrasted with emerging views of best practice, but were consistent with the Colorado Department of Education's guidelines for "motor specialists" that address occupational therapy, physical therapy, and adaptive physical educators working in schools.
Abstract: Objective This purpose of this study was to describe school-based occupational therapy practice for kindergarten through twelfth-grade students in Colorado and to examine occupational therapy practice in light of current education policy and published views of best practice. Method Study data were provided by 105 occupational therapists and occupational therapy assistants who completed a 24-item questionnaire. Results Occupational therapists carried an average caseload of 43.68 students; most frequently served kindergarten through third-grade students with perceptual or communicative disabilities; and delivered services most often in pullout treatment areas. Practitioners spent most of their work week providing direct services. Remedial or developmental approaches were used 62% of the time and compensatory and educational approaches 37% of the time. Individualized education program goals addressed by occupational therapists were most frequently developed by the occupational therapist and targeted students' sensory or motor impairments. Workshops on autism and sensorimotor intervention techniques were reported as the primary and preferred forms of professional development. Conclusion The strong majority of reported occupational therapy services contrasted with emerging views of best practice. They were, however, consistent with the Colorado Department of Education's guidelines for "motor specialists" that address occupational therapy, physical therapy, and adaptive physical educators working in schools. Study findings are discussed.
TL;DR: The findings indicate that for people who had sustained a cerebrovascular accident, community participation was more related to their ability to do for themselves, rather than the support that was available to them.
Abstract: This study examined data of older adults who had sustained a stroke and their ability to participate in the community following rehabilitation. There were 95 participants in this study to determine the interaction effect of functional limitation and social support on community participation. The findings indicate that for people who had sustained a cerebrovascular accident, community participation was more related to their ability to do for themselves, rather than the support that was available to them. The implications of these findings for future practice, programs, and research are discussed.
TL;DR: Results lend further support to the use of an automated prompting system but suggest that there are individual factors influencing the efficacy of the prompting mode, for which occupational therapists are well suited to assess and monitor.
Abstract: As the number of people living with dementia increases, occupational therapists are challenged with finding innovative, evidence-based ways to enable daily occupations. The use of computer technology is explored in this study as one potential intervention for this population. An automated prompting system was modified to provide both verbal and audiovisual prompts, and 8 participants with Standardized Mini-Mental State Examination (SMMSE) scores as low as 3/30 were followed over 60 trials to determine which prompting method was more effective in reducing caregiver interactions. Overall, the participants were able to complete more steps with the assistance of either automated prompt and required fewer caregiver interactions. Audiovisual prompting significantly reduced the number of caregiver interactions required. These results lend further support to the use of an automated prompting system but suggest that there are individual factors influencing the efficacy of the prompting mode, for which occupational therapists are well suited to assess and monitor.
TL;DR: The philosophy of contextualism is introduced and a potential body of knowledge about a change process that is occupation centered is outlined, which leads to occupation-centered practice that uses multiple strategies and supports a child's occupation with social participation with peers.
Abstract: Children's learning to do everyday activities seems so obvious that the mechanisms bringing about the development of occupations remain essentially unstudied. Therefore, occupational therapy uses developmental models from other disciplines as foundation for practice. We specialists in childhood occupations need a theory-based and empirically tested body of knowledge about the processes leading to change to inform practice and guide interventions during efficacy studies. One body of knowledge about developmental mechanisms views change as originating from within the child and informs practice centered on changing the child. Given the inseparable nature of children and their social environments and daily activities, we introduce the philosophy of contextualism and outline a potential body of knowledge about a change process that is occupation centered. An intervention arising from a contextual perspective illustrates how this way of thinking leads to occupation-centered practice that uses multiple strategies and supports a child's occupation with social participation with peers.
TL;DR: Self-reported research utilization behaviors revealed that participants' clinical experiences, engagement in continuing education, involvement in research activities, and their mentoring of students contributed to their capacity to translate research evidence into practice.
Abstract: Some occupational therapists report that they do not feel adequately prepared to perform the arduous tasks involved in integrating research into their practice. To explore how research utilization can be conducted by practicing clinicians, self-reported research utilization behaviors of a sample of 11 occupational therapists practicing in adult stroke rehabilitation were analyzed. The constant comparison of the interview data revealed that participants' clinical experiences, engagement in continuing education, involvement in research activities, and their mentoring of students contributed to their capacity to translate research evidence into practice. The results of the study suggest a model for enhancing research utilization capacity through professional development. Implications for practitioners, provider organizations, educators, and regulators of occupational therapy are discussed.
TL;DR: Occupational therapists must analyze the reading level of the written education materials they develop for and use with clients by applying readability formulas because there should be a match between theReading level of written materials and clients' reading ability.
Abstract: OBJECTIVE. The match between the reading level of occupational therapy education materials and older clients' reading ability and comprehension was determined. The sociodemographic and literacy characteristics that influenced clients' reading ability and comprehension were investigated. METHOD. The reading level of 110 written education materials (handouts, brochures, and information leaflets), distributed to older clients (65 years of age and older) by occupational therapists working in Queensland hospitals, was analyzed using the Flesch formula. The reading ability of 214 older persons (mean age 77 years, 63% female) was assessed using the Rapid Estimate of Adult Literacy in Medicine. Participants' comprehension of information of increasing reading difficulty was measured using the Cloze procedure. RESULTS. The written materials required a mean reading level between the ninth and tenth grades. Participants' mean reading ability was seventh to eighth grade. Therefore some materials may have been too difficult for participants to read and understand. Participants with a managerial or professional or clerical background (p = 0.001) and those who perceived they read well (p = 0.001) had a significantly higher reading ability, Older age was significantly related to poorer comprehension (p = 0.018), with participants 75 years of age and over having a mean comprehension score of 25.6 compared to 30.3 for those 65 to 74 years of age. CONCLUSION. Occupational therapists must analyze the reading level of the written education materials they develop for and use with clients by applying readability formulas. There should be a match between the reading level of written materials and clients' reading ability. Clients' reading ability may be assessed informally by discussing years of education and literacy habits or formally using reading assessments. Content and design characteristics should be considered when developing written education materials for clients.
TL;DR: A new service delivery model for handwriting instruction has the potential to benefit students and occupational therapists should consider offering handwriting training to students in the summer especially if deterioration of performance is anticipated.
Abstract: OBJECTIVE. The purpose of this study was to examine the benefits of a summer handwriting instruction course offered to community elementary-age students. METHODS. Twenty-six students participated in the study and attended instruction for 1 hour per day for 2 weeks. Pre- and posttesting with the Evaluation Tool of Children’s Handwriting (ETCH) were conducted. Parents were also asked to rate their child’s handwriting at pretest, posttest, and 3 months posttest. RESULTS. Participants made significant improvement in two subtests of the ETCH and in parent ratings between pretest and posttest. Parent ratings remained significantly improved 3 months posttesting. Additional results suggest that children who received special education during the previous school year improved their handwriting scores on the ETCH to a greater degree than those who did not receive special education. CONCLUSION. A new service delivery model for handwriting instruction has the potential to benefit students. Occupational therapists should consider offering handwriting training to students in the summer especially if deterioration of performance is anticipated. Marr, D., & Dimeo, S. B. (2006). Outcomes associated with a summer handwriting course for elementary students. American
TL;DR: This case study elucidated occupation-centered teaching practices and suggested that "linking opportunities" in the classroom constitute an essential feature that demarcates a program as occupation- centered.
Abstract: Although occupation-centered curricula are highly promoted, the teaching processes that convey such designs remain unclear. This case study elucidated occupation-centered teaching practices. Interview and observational data were collected over 8 weeks, and analysis involved coding transcriptions, data matrices, concept maps, journaling, and writing. Participants augmented active learning strategies with strategies that linked course topics to the subject of occupation. The use of linking strategies suggested that: (a) course content was treated as two-tiered; (b) neither content nor instructional processes were inherently occupation-centered; and (c) subject-centered education strengthens social learning theories. Although curricula may appear occupation-centered based on a curriculum description and course content, ultimately "linking opportunities" in the classroom constitute an essential feature that demarcates a program as occupation-centered.
TL;DR: Specialized Knowledge and Skills for Occupational Therapy Practice in the Neonatal Intensive Care Unit Elsie Vergara;Marie Anzalone;Rosemarie Bigsby;Delia Gorga;Elise Holloway;Jan Hunter; Ginny Laadt; Susan Strzyzewski;Susanne Roley; American Journal of Occupational therapy.
Abstract: Specialized Knowledge and Skills for Occupational Therapy Practice in the Neonatal Intensive Care Unit Elsie Vergara;Marie Anzalone;Rosemarie Bigsby;Delia Gorga;Elise Holloway;Jan Hunter;Ginny Laadt;Susan Strzyzewski;Susanne Roley; American Journal of Occupational Therapy
TL;DR: A high degree and variety of sensory processing abnormalities in persons with Angelman syndrome were confirmed, most prominent in the areas of hypo-responsiveness to tactile and tactile input.
Abstract: OBJECTIVE. Research examining sensory processing patterns in persons with Angelman syndrome is nonexistent despite anecdotal evidence and clinical diagnostic criteria that may reflect these features. The goal of this study was to better characterize sensory processing patterns in persons with Angelman syndrome.
METHOD. Parents of 340 persons with Angelman syndrome between 3 and 22 years of age completed a standardized measure of sensory processing, the Sensory Experiences Questionnaire.
RESULTS. Results confirmed a high degree and variety of sensory processing abnormalities in persons with Angelman syndrome. These problems were most prominent in the areas of hypo-responsiveness to tactile and vestibular input, consistent with reports of sensory seeking behaviors in this population. Sensory processing deficits were not related to gender, seizure disorder, or genetic subtype. However, some behaviors were correlated with age.
CONCLUSION. This study provides the first systematic description of sensory processing abnormalities in a large sample of persons with Angelman syndrome. Considerations for enhancing occupational performance and social participation in this population through occupational therapy interventions are discussed
TL;DR: The CBDI is not sufficiently predictive of outcome to replace a driving evaluation, and is predictive only for clients with R-CVA and TBI.
Abstract: OBJECTIVE. This study seeks to (a) compare Cognitive Behavioral Driver�s Inventory (CBDI) scores for clients who passed and failed a driving evaluation and for diagnostic groups (left cerebrovascular accident [CVA], right CVA, traumatic brain injury [TBI], and cognitive decline); (b) determine sensitivity, specificity, and positive and negative predictive values of the CBDI; (c) compare validity of the CBDI with other tools; and (d) identify factors associated with outcome.
PARTICIPANTS. This historical cohort study included clients with neurological conditions who completed a driving evaluation.
MEASURES. CBDI, Motor-Free Visual Perception Test (MVPT), Bells test, and driving results were extracted from the charts.
RESULTS. Mean CBDI (p < 0.0001) and MVPT (p < 0.0001) scores were significantly worse for those failing compared to passing the driving evaluation. Sensitivity of the CBDI was 62%, specificity was 81%, positive predictive values were 73%, and negative predictive values were 71%. Results varied according to diagnostic group.
CONCLUSIONS. The CBDI is not sufficiently predictive of outcome to replace a driving evaluation, and is predictive only for clients with R-CVA and TBI. Evaluation of driving should vary according to diagnosis.
TL;DR: This case report indicates that occupation-based intervention should be initiated as soon as a diagnosis is identified to prevent the downward spiral of forced disuse associated with the affected upper extremity.
Abstract: This article describes a case report of the occupational therapy management of a 53-year-old woman diagnosed with primary shoulder adhesive capsulitis. The occupation-based interventions are described through the framework of occupation-as-means. Compensatory occupation, preparatory methods, and purposeful activities are demonstrated as being critical to minimizing connective tissue deformation associated with this condition. This case report indicates that occupation-based intervention should be initiated as soon as a diagnosis is identified to prevent the downward spiral of forced disuse associated with the affected upper extremity. As illustrated by the case report, occupation-based treatment that was provided in a timely manner immediately decreased pain, improved range and quality of motion, and enhanced occupational performance.
TL;DR: A qualitative exploratory study with six parents and eight occupational therapists who used the brushing and compression technique (Wilbarger Protocol) was conducted, exploring parental adherence to home treatment programs.
Abstract: The purpose of this article is to describe parental adherence to home treatment programs. A qualitative exploratory study with six parents and eight occupational therapists who used the brushing and compression technique (Wilbarger Protocol) was conducted. Participants were interviewed one or two times, exploring their experiences in adhering to the protocol. Data analysis focused on facilitators and hindrances to parental adherence and on occupational therapists' strategies used to encourage it. Parents identified their children's responses to brushing, its perceived efficacy, and interaction of the protocol with family daily schedules, as factors influencing their adherence. Occupational therapists identified only family daily schedules as influencing parental adherence. The findings are discussed in the context of the ecocultural theory of family accommodations.
TL;DR: The results suggest that the process of reclaiming one's sexuality is a process of meaning-finding, and the data support a conclusion that occupational therapists should respect the cultural nature of sexuality.
Abstract: OBJECTIVE. This study explored how Greek men with spinal cord injury experience sexuality. METHODS. Six men with spinal cord injury acted as key informants and data collection consisted of in-depth unstructured interviews, field notes, and a reflective log. The transcribed interviews were analyzed thematically. RESULTS. The themes that emerged were: Barriers, Metamorphoses, and Enjoying. Sexuality was important in the life of the informants and they were engaged in various patterns of adaptation. Rather than impairment as such, certain social beliefs and values prevalent in Greek society were found to act upon the informants in compromising ways. CONCLUSION. The results suggest that the process of reclaiming one’s sexuality is a process of meaningfinding. The data support a conclusion that occupational therapists should respect the cultural nature of sexuality. Moreover, the topic of sexuality should be approached in a holistic manner, perceiving it as extending in a continuum, which may be positively or negatively affected as a result of an acquired impairment.
TL;DR: This phenomenological study explored the lived experiences of occupational therapy students participating in a 3-month graduate seminar entitled "Spirituality in Occupational Therapy Practice", and began to reveal a diversity of beliefs and practices in the occupational therapy community related to spirituality.
Abstract: There are many unanswered questions about the concept of spirituality and its relationship to occupational performance. The role of occupational therapists in addressing clients' spiritual needs is unclear, and the inclusion of spirituality as a topic in the educational curricula of occupational therapy students requires further attention. Focus groups and surveys were used in this phenomenological study to explore the lived experiences of 11 occupational therapy students participating in a 3-month graduate seminar entitled "Spirituality in Occupational Therapy Practice." The study was designed to help occupational therapy faculty better understand how students experience the relationship between occupational therapy and spirituality, and how educational programs can better prepare students to translate theoretical frameworks into practice. Findings explored the students' evolving belief systems, and began to reveal a diversity of beliefs and practices in the occupational therapy community related to spirituality. Implications for theory and practice are offered.