The Open Journal of Occupational Therapy

Expressing eMotions Through Participation in Painting

Molly Bathje MS, OTR/L — Thu, 28 Feb 2013 08:05:44 PST

The cover of the Winter 2013 Open Journal of Occupational Therapy, titled Miles eMOTION, was created by Miles Scharfenberg, an 18-year-old young man with multiple developmental impairments. Miles’ story and his artwork provide a reflection on the ways in which creativity and art can enhance the lives of people with disabilities and their families. Miles’ art exists because of his drive toward engagement and participation in life, but also essential is his mother’s commitment to providing opportunities for him to be creative. The Miles eMOTION series of paintings can inspire occupational therapists, families, caregivers, and people with disabilities to incorporate art making as a part of their occupational profile.

Online Learning of Safe Patient Transfers in Occupational Therapy Education

Cynthia L. Hayden D. H. Ed., OTR/L, CHT — Thu, 28 Feb 2013 08:05:40 PST

Online higher education is steadily increasing. For programs in allied health to be offered effectively in an e-learning format, clinical psychomotor skills need to be addressed. The aim of this research was to design, implement, and evaluate an online safe patient transfers module for occupational therapy assistant (OTA) students. The efficacy of teaching safe patient transfers in an e-learning environment was appraised using both quantitative and qualitative analysis. The applied research project was completed at a Tennessee community college. A convenience sample of eighteen students participated in the pilot study. Twenty-five students participated in the subsequent study. The instructional design of the course was based on Mager’s Criterion Referenced Instruction model. Streaming video was used as the delivery method for course material. A pretest/posttest evaluated the students’ cognitive knowledge of safe patient transfers. A behavioral transfers competency checklist was used to rate videotapes of students’ performance of assisted stand pivot and dependent sliding board transfers. Research findings indicated students were able to learn this psychomotor clinical skill online with beginning proficiency. A paired t-test showed marked improvement of cognitive knowledge. A student learning survey revealed the majority of students preferred at least one hands-on classroom session where instructor feedback and interaction with classmates confirmed safe and effective clinical technique.

The Training and Use of Service Dogs in Occupational Therapy Education

Mary Isaacson ATP, Ed.D., OTR/L — Thu, 28 Feb 2013 08:05:35 PST

The purpose of this study is to describe the role of occupational therapy fieldwork students in the training of service dogs. Ethnography is an approach that strives to explore and describe the point of view of people. Ethnographers view the researcher as an instrument to gain insight into the subject. This researcher utilized her own experiences as an occupational therapist, an occupational therapy educator, and as a volunteer dog trainer of service dogs. She then validated the process through interviews with key informants. The results indicate that occupational therapists and occupational therapy students are capable of playing a significant role in the training and placement of service dogs. During a level I experience, occupational therapy students experienced the importance that a dog can play in a person’s life as a tool of adaptation. They also learned advocacy and professionalism and applied the Person-Environment-Occupation model of practice. In addition, students recognized that barriers exist in the use of service dogs.

International Occupational Therapists Continuing Education Needs and Opportunities: A survey

Husny Amerih Ph.D., OTR, ATP — Thu, 28 Feb 2013 08:05:34 PST

Occupational therapists (OTs) are expected to maintain up-to-date knowledge and clinical competence by engaging in continuing professional education (CPE). The objective of this research was to obtain information on CPE needs and opportunities in developed and developing countries. A survey was created and emailed to 520 OTs in various countries, asking questions about CPE requirements, opportunities, and the avenues of CPE available to OTs. One hundred-nineteen OTs from 17 different countries responded. Of the 119 OTs, 28 practice in developing countries and 91 practice in developed countries. Thirty-nine percent of the OTs in developing countries stated that they have certain requirements for CPE. In developed countries 73% of the OTs indicated such requirement were necessary to practice. In developed countries 67% of OTs reported that CPE was easily available, whereas in developing countries only 25% of OTs reported that CPE was easily available. Therapists in developed countries are more likely to participate in CPE activities, whereas their counterparts in developing countries are not. International OT stakeholders need to explore avenues to make CPE more available to OTs in developing countries and remote areas.

An Evaluation of the Potential Effectiveness of a Tai Chi Program for Health Promotion Among People with Severe Mental Illness

Ann M. Chapleau D.H.S., OTR/L et al. — Thu, 28 Feb 2013 08:05:33 PST

In response to the significant health disparities among persons with severe mental illness (SMI), this pilot study was developed to evaluate the potential effectiveness of a Tai Chi program provided to adults who are members of a psychosocial clubhouse program. A non-randomized, controlled pretest-posttest design was used, and qualitative data from a program evaluation survey is shared to provide insight into the strengths and limitations of this explorative study. A simplified, beginner-level Tai Chi program was provided twice a week for 12 weeks. Changes in cardiac and pulmonary function and perceived quality of health were measured. Results support the potential for Tai Chi to promote health among this population. Challenges to conducting this type of research are discussed, as well as implications for future, larger studies of health promotion interventions.

Functional Improvement in Older Adults after a Falls Prevention Pilot Study

Pei-Fen J. Chang Ph.D., OTR et al. — Thu, 28 Feb 2013 08:05:32 PST

Falls are a costly, disabling, and life-threatening risk in the elderly. Improvements in physical function, balance, lower extremity strength, and health-related quality of life are hypothesized to help mitigate fall risk. In this pilot study, six women and men with an average age of 81 years participated in a 6-week exercise and education program created to reduce risk of falls. Evaluations were made at baseline and at 6 weeks on four tests: the Functional Status Questionnaire, the Berg Balance Scale (BBS), the Six-minute Walk Test, and the World Health Organization Quality of Life–BREF 26-question test. Scores indicated significant improvement in functional physical status (activities of daily living), balance, distance walked in 6 min, and quality of life in the physical health domain. The size of this study limits the generalizability of its findings, but its evidence warrants undertaking a larger trial.

A Survey to Determine the Reliability of Dynamometer and Pinch Gauge Dial Readings Among Certified Hand Therapists

Theodore I. King II, Ph.D, L.Ac. — Thu, 28 Feb 2013 08:05:30 PST

Using a cross-sectional descriptive study design, surveys were mailed to 200 randomly selected certified hand therapists of the American Society of Hand Therapists (ASHT) to determine how they document analog dynamometer and pinch gauge dial readings. Three different needle settings for the dynamometer and pinch gauge were presented in picture format. For each instrument, one needle setting was just above a gauge marker, one was just below a gauge marker, and one was set exactly between two gauge markers. A total of 126 out of 200 surveys were returned for a participation rate of 63%. For the dynamometer readings, therapists estimated the exact strength reading between the two gauge markers 78.3% of the time. For the pinch gauge readings, therapists rounded to the nearest dial marker 76.5% of the time when the needle was just above or just below a dial marker and 61.9% of the time they estimated the reading when the needle was placed exactly between two dial markers.

Letter from the Editor: The Importance of Frames of Reference

Diane Powers Dirette Ph.D., OTL — Thu, 28 Feb 2013 08:05:29 PST

Art in Occupational Therapy: An Introduction to Occupation and the Artist

Molly Bathje MS, OTR/L — Wed, 21 Nov 2012 10:10:26 PST

Diagnostic Statistical Manual 5 Changes to the Autism Diagnostic Criteria: A Critical Moment for Occupational Therapists

Rondalyn Varney Whitney Ph.D., OT/L et al. — Wed, 21 Nov 2012 10:10:25 PST

Changes in the soon to be released Diagnostic Statistical Manual (DSM) – 5 (American Psychiatric Association, 2012) bring new opportunities for occupational therapy, but the profession must prepare for the impact these changes forecast. While well positioned to capitalize on newly defined specifications of Autism Spectrum Disorders (ASD) and the elevation of sensory processing difficulties to a core feature of the disorder, the profession must be alert to the potential downside of the pending changes. The more stringent diagnostic rubric will likely exclude a significant number of individuals currently eligible for therapeutic and academic services. Autism will be defined as a neurodevelopmental disorder that must be identifiable before early childhood (age 5), even if it is not detected until later as a result of environmental factors (minimal social demands, support from caretakers, etc.). The new diagnostic criteria will add the explicit recognition of sensory behaviors within a subdomain of stereotyped motor, verbal, and sensory-based behaviors and researchers suggest only 60% of those who currently meet the threshold for an autism spectrum diagnosis will continue to meet criteria under the new categorization. The proposed changes will likely encourage researchers to use greater specificity when recruiting sample populations and, as a result, help to determine interventions that are most advantageous for specific subtypes. Addressing sensory processing in the diagnostic criteria may authorize interventions aimed specifically towards reduction of sensory-related disabilities through remediation, environmental support, or parent education while simultaneously calling upon us to deliver evidence for Ayres’ sensory integration^®(ASI) approaches. The change also presents an urgent call to our profession to promote the unique scientific contributions occupational therapy makes for individuals with ASD, their families, and their educational contexts both including and in addition to the use of ASI approaches. These changes to the manual used by the psychological community for diagnosis offer occupational therapists an opportunity to emerge as the recognized leaders in the diagnosis and intervention of sensory processing disorders/dyspraxia. The issue is, then, how can the profession of occupational therapy clearly articulate our role and our knowledge to stakeholders and team members so occupational therapists are recognized as scientists and clinical experts, both key players in the diagnosis of sensory processing difficulties and the treatment of ASD?

OT-PEP: Development of a Professional Education Paradigm for Occupational Therapy

Christine E. Wright Ph.D., OTR/L — Wed, 21 Nov 2012 10:10:24 PST

This study aims to determine the fundamental tenets that define the occupational therapy education process, and to develop a professional education paradigm that corresponds to those principles. Interpretive phenomenology with Heideggerian hermeneutic philosophy was used to explicate the paradigmatic themes embedded in the occupational therapy body of knowledge. The results yielded the Occupational Therapy Professional Education Paradigm (OT-PEP), which is organized around three core concepts: Adaptive thinking, reflection, and creation of meaning. The OT-PEP is important to occupational therapy because it addresses the elements of the education process that are reflective of the philosophical underpinnings of the profession and brings together these understandings as a unified whole. Interpretive phenomenology asserts that analysis of data is influenced by the phenomenologist’s repertoire of experience. Therefore, the OT-PEP presented in the article can be considered a single offering from the author that has the potential to morph with additional analyses. The author is hopeful that occupational therapy education programs will discuss and debate the OT-PEP constructs and determine which elements are most valuable. In addition, novice educators could use the OT-PEP as a faculty development tool to assist with transitioning from clinical practice to academia.

Examining the Sensory Profiles of At-Risk Youth Participating in a Pre-employment Program

Chi-Kwan Shea Ph.D., OTR/L et al. — Wed, 21 Nov 2012 10:10:22 PST

The purpose of this study is to use Dunn’s model of sensory processing to investigate the sensory profiles of youth participating in a community-based occupational therapy pre-employment program. The youth participants had been involved in the juvenile justice system and were placed on probation. The study analyzed data from the Adolescent/Adult Sensory Profile (AASP) questionnaires (Brown & Dunn, 2002) completed by 79 youth participants. Analysis of the participants’ scores on the AASP showed statistically significant differences from the norm in two quadrants; the delinquent youth scored lower in Sensation Seeking and higher in Sensation Avoiding. The delinquent youth participants demonstrated a high prevalence of atypical sensory processing patterns. Implications for further investigation and practice are discussed.

Enhancing Social Skills in Adolescents with High Functioning Autism using Motor-based Role-play Intervention

Sharon A. Gutman PhD, OTR, FAOTA et al. — Wed, 21 Nov 2012 10:10:20 PST

The purpose of this pilot study was to collect pilot data evaluating whether a motor-based role-play intervention using a canine animal assistant can enhance social skill use in two adolescents with HFA. A single subject ABA design across two participants was used. The intervention consisted of four 1-hour sessions over 4 weeks. The quality of social interaction was measured by the Evaluation of Social Interaction (ESI) administered at baseline and the 3-month probe. Frequency of targeted social skill use was measured during baseline, intervention, and probe phases. Participant 1 experienced statistically significant increases in both ESI scores (p = .012, t = -5.488) from baseline to the 3-month probe. Participant 2 also experienced a statistically significant increase in ESI scores from baseline to probe (p = .002, t = -10.167), but he was unable to fully maintain these gains at the 3-month probe. This pilot study’s findings suggest that the intervention produced positive effects in both participants and warrant further investigation.

The Effects of a Summer Camp Experience on Factors of Resilience in At-Risk Youth

MaryBeth Merryman Ph.D., OTR/L et al. — Wed, 21 Nov 2012 10:10:18 PST

This pilot study addressed the impact of a summer camp experience on at-risk middle school youth by exploring self-reported growth in skill development and resilience. Campers who attended a five-week summer day camp were compared to a control group who maintained typical activities throughout the summer. Results showed statistically significant differences in the campers’ belief of a good future for themselves (U = 179.40, P = 0.05). Campers reported sustained or positive growth in domains of social skills and positive values from the baseline to a six-month follow up. Three significant themes emerged from individual in-depth interviews including: (a) engagement influences skill competence, (b) the camp environment expands positive choice and availability of positive occupations, and (c) males developed skills and resilience from informal physical activity while no equivalent existed for females. Middle school aged at-risk youth can benefit from occupation-based summer camp programs that promote active engagement in an enriched environment and sustain gains once they return to high-risk environments. This research contributes to a growing understanding of the potential contribution of occupational therapy in the design and delivery of effective summer camp experiences for at-risk youth.

Associations of Physiological Factors, Age, and Sensory Over-Responsivity with Food Selectivity in Children with Autism Spectrum Disorders

Michelle A. Suarez Ph.D., OTR/L et al. — Wed, 21 Nov 2012 10:10:11 PST

PURPOSE: The aim of this study was to investigate the relationship among physiological factors, age, sensory over-responsivity (SOR) and food selectivity in children with autism spectrum disorders (ASD).

METHODS: One hundred forty-one parents of children with ASD were recruited through a national autism organization, Autism Speaks, to fill out a survey regarding their child’s mealtime behavior. Survey contained items to measure the severity of food selectivity behavior, the presence of physiological factors (i.e., reflux, constipation, food allergies and the need for a specialized diet) and sensory over-responsivity (SOR). Results were analyzed using Chi Square, ANOVA and logistic regression.

RESULTS: No relationship between physiological factors and level of food selectivity was found. Older children in the 3-9 year old range did not have more foods in their diet repertoire than younger children. Finally, children with fewer than 10 and those with 11-20 foods in their diet (i.e., severe food selectivity and moderate food selectivity respectively) were found to have significantly higher scores on a measure of SOR when compared to children with 21+ foods (typical selectivity).

CONCLUSIONS: When addressing food selectivity in children with ASD, consideration of the possibility that the child may not outgrow restricted diets is warranted. Also, treatment for food selectivity may be more effective if SOR is included in protocol.

Letter from the Editor: Welcome to OJOT!

Diane Dirette Ph.D., OT — Wed, 21 Nov 2012 10:10:09 PST