Determinants of functional mobility in children with cerebral palsy in three different environments: A registry-based study.

BACKGROUND: Functional mobility in children with cerebral palsy (CP) varies widely and is affected by many factors related to the child and environment. Understanding this variability in child's natural environments: home, school, and community; and its determinants are important for effective child management. METHODS: This cross-sectional study aims to investigate the functional mobility of children with CP within home, school, and community, and explore its determinants. Participants were 107 children with CP (aged 6.4 ± 2.9 years). Functional Mobility Scale was the outcome variable. Potential determinants included child-associated impairments and interventions. Three ordinal logistic regression analyses were conducted. RESULTS: Children in Gross Motor Functional Classification System-Expanded and Revised level I walked without assistive devices in all environments, while children in levels II/III used different mobility methods in different environments. Children in levels IV/V used a wheelchair or had no form of functional mobility in all environments. Determinants of mobility varied across different environments but included impairments (visual impairments, scoliosis) and interventions (Botox, medications for spasticity, orthoses). CONCLUSIONS: Child impairments and interventions received should be considered when exploring mobility options for children with CP in different environments. Further research is needed to examine other environmental and personal factors affecting mobility.

Determinants of Manual Abilities of Children with Cerebral Palsy: A National Registry-Based Study.

PURPOSE: This cross-sectional study aimed to identify determinants of manual abilities of children with cerebral palsy (CP), as measured by the Manual Ability Classification System (MACS), in terms of intrinsic (child-related) and extrinsic (service-related) variables. METHODS: The participants were 106 children with a confirmed diagnosis of CP (aged 4-16 years). Two ordinal logistic regression models were conducted to identify intrinsic and extrinsic determinants of manual abilities. RESULTS: Four child-related (intrinsic) variables were found to be significant determinants of manual abilities: bimanual ability, ability to maintain and assume chair sitting, presence of seizures, and gross motor function, and only one service-related (extrinsic) significant variable was identified, which was receiving spasticity medications. DISCUSSION: The results highlight several determinants that should be considered when assessing and intervening to improve manual abilities of children with CP. The findings are discussed in relation to the intervention approach, contextual modification, and assistive device prescription.

Participation patterns and determinants of participation of young children with cerebral palsy.

INTRODUCTION: Understanding participation patterns of young children with cerebral palsy (CP) will enable occupational therapists to tailor family- and child-centred services. This study compares participation patterns and participation barriers of young children with CP with those of typically developing (TD) children. In addition, effect of age and gender on participation were examined as well as child-related determinants of participation for young children with CP. METHODS: Participants were a convenience sample of 110 young children with CP and 150 TD children, aged 36-72 months. Children with CP represented different levels of the Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). The Arabic Preschool Activity Card Sort was used to measure participation level as well as barriers of participation. T-tests, ANOVA, and exploratory regressions were employed. Significance was set at p < .05. RESULTS: Young children with CP showed significant decreased overall and domain-specific participation compared to TD children (p < .001). Perceived barriers of participation were mostly related to child-factors for young children with CP compared to greater variability in barriers in TD children. Gender had no significant effect on participation regardless of diagnosis; however, pattern of the effect of age was different among the two groups. MACS was found to be the only significant predictor of participation for children with CP (p = .001). CONCLUSION: Occupational therapists should focus on enhancing participation for young children with CP and consider participation barriers when designing their interventions. Several factors need to be considered when aiming to enhance participation of children with CP. The use of the MACS could contribute to better intervention planning.

Sensory processing disorders in children with hearing impairment: Implications for multidisciplinary approach and early intervention.

OBJECTIVE: To explore the differences in sensory processing between children with hearing impairments and children with normal hearing and the variables that influence sensory processing disorder (SPD). METHODS: The sensory processing abilities of 90 children were compared in three age-matched groups of 30, with cochlear implants (CIs), hearing aids (HAs), and normal hearing (NH). The Arabic Sensory Profile (Arabic_SP) was used. RESULTS: Findings were presented in the Arabic_SP section and factor levels. Sections: The NH group performed better (p < .05) than the CI group in 57% of the sections and better than the HA group in 14%. The CI group exhibited more signs of SPD than the HA group with vestibular processing, multisensory processing, and emotional-social responses. FACTORS: The NH group differed from the CI group on all the factors that showed significance and from the HA group with inattention/distractibility and poor registration. There were great differences between the CI and the HA groups on all the factors except with poor registration and fine motor/perceptual. Hearing loss variables that most affected results in the Arabic_SP were the age at receiving a hearing device and type of hearing loss onset. CONCLUSION: Along with speech and language problems, children with hearing impairment are especially vulnerable to SPD. Children with CIs and HAs are increasingly susceptible to auditory processing disorders. Higher risks of balance, multisensory processing, social-emotional, and fine motor problems are in children with CIs. Increased SPD risks came with a higher age at implantation. Findings indicate the importance of a multidisciplinary approach for early detection and intervention for children with hearing impairment, especially those with CIs.

The Psychometric Properties of the Arabic Preschool Activity Card Sort.

BACKGROUND: The Preschool Activity Card Sort (PACS) is an interview-based assessment tool to measure participation of preschool children with age range from 3 to 6 years. OBJECTIVE OF STUDY: The purpose of this study was to establish the psychometric properties of the recently translated Arabic PACS (A-PACS). METHODS: One hundred fifty-one Jordanian parents participated in the study representing different geographical areas. Children were almost equally distributed between males and females and into three age groups. Construct and concurrent validity were examined as well as the internal consistency of the scale and the test-retest reliability. FINDINGS: The A-PACS was able to differentiate between the participation level of young and old children in the domains of education, community mobility, and low demand leisure of the A-PACS giving evidence to its construct validity and it significantly correlated with some aspects of the Vineland Adaptive Behavior Scale (VABS) giving evidence to its concurrent validity. The A-PACS showed excellent overall internal consistency (α = .859) for all domains and good test-retest reliability (r = .976, p < .001). CONCLUSION: The A-PACS can be considered as a valid and reliable tool to measure participation of preschool children with normal development from Arabic cultures. Future studies should focus on the validity of the A-PACS for use with children with disabilities.

The validity and reliability of the Arabic Infant/Toddler Sensory Profile.

In this study, we report the translation process, validity, and reliability of the Arabic Infant/Toddler Sensory Profile (IT_SP). A multistep approach was implemented to ensure the accuracy and equivalency of the Arabic and original English IT_SP. Factor analysis indicated that item loadings for over 50% of the items on the Arabic version were identical to the English version; all but three items had logical loadings. Intraclass correlation coefficients (ICC) between scores on the Arabic and English versions reported by parents who were bilingual were >.90 supporting bilingual validity. Alpha coefficients for each section varied from .40 to .74, which was within the range of the English version (.17 to .86), and were thus similar. ICCs between scores for repeated assessments varied from .81 to .99 supporting test-retest reliability. The results support the validity and reliability of the Arabic IT_SP.

Motor and tactile-perceptual skill differences between individuals with high-functioning autism and typically developing individuals ages 5-21.

We examined motor and tactile-perceptual skills in individuals with high-functioning autism (IHFA) and matched typically developing individuals (TDI) ages 5-21 years. Grip strength, motor speed and coordination were impaired in IHFA compared to matched TDI, and the differences between groups varied with age. Although tactile-perceptual skills of IHFA were impaired compared to TDI on several measures, impairments were significant only for stereognosis. Motor and tactile-perceptual skills should be assessed in children with IHFA and intervention should begin early because these skills are essential to school performance. Impairments in coordination and stereognosis suggest a broad though selective under-development of the circuitry for higher order abilities regardless of domain that is important in the search for the underlying disturbances in neurological development.

Factors influencing job satisfaction among Jordanian occupational therapists: a qualitative study.

PURPOSE: The main purpose of this study was to explore factors influencing job satisfaction and dissatisfaction among Jordanian occupational therapists. METHODS: Ours was an explorative qualitative study involving the use of structured open-ended written questions. Participants were asked to answer in narrative their perception about the factors behind their job satisfaction and dissatisfaction. In addition, they were asked to express their suggestions, ideas, or solutions for increasing job satisfaction. RESULTS: Ninety-three occupational therapists responded to the survey. For job satisfaction questions, four themes emerged: a humanistic profession; professional issues; work benefits; and work environment. Participant's comments at the end of the survey revealed one general theme for improving job satisfaction, 'a call for improvement'. DISCUSSION: This qualitative study revealed that the humanistic nature of occupational therapist was counterbalanced by several dissatisfying factors for occupational therapy practitioners in Jordan. The need for better supported working conditions in terms of financial rewards, recognition, awareness and resources as well as public and professional recognition of occupational therapists are needed to enhance the occupational therapy profile in Jordan. A comprehensive collaboration is highly needed between the individual practitioners, representatives of the profession, government and hospital administrators.

Working conditions of occupational therapists in Jordan.

The purpose of this study was to investigate the working conditions and factors related to job satisfaction among Jordanian occupational therapists. A self-administered survey consisting of several questions about the participants' jobs was developed for this study. The inclusion criteria included occupational therapists who worked in the field of occupational therapy (OT) in Jordan and who had at least six months of experience. The survey was distributed to 120 occupational therapists in different OT settings. One hundred and one occupational therapists from different hospitals, centres, schools and universities responded to the survey. Salaries of the participants were low in comparison with the salaries of the rest of healthcare practitioners in Jordan. Chi-square analysis revealed significant relationship between participants' perceived job satisfaction and the administration of the setting, and between the choice of studying OT and the salary that the participant makes. Most occupational therapists in Jordan are young, have modest experience and work in general OT services in government-owned facilities or paediatric centres. A sense of dissatisfaction was obvious among the participants. Further studies are needed to explore reasons of work satisfaction and dissatisfaction among occupational therapists in Jordan.