School quality of life: Cross-national comparison of students' perspectives.

BACKGROUND: Cross-national comparisons of students' school quality of life (QoL) can support our understanding of factors that may affect students' health and well-being at school. OBJECTIVE: To compare Canadian and Israeli students' perception of their school QoL. METHODS: The Quality of Life at School Questionnaire (QoLS) was administered to 1231 students in 4th to 6th grades from Canada (n = 629) and Israel (n = 602), measuring: Physical Environment, Positive Attitudes, Student-Teacher Relationship, and Psychosocial. RESULTS: The Canadian students scored significantly higher than the Israeli students on all domains. The two-way ANOVA did not show a statistically significant interaction between country and gender nor age. However, within each country, girls and 4th grade students reported higher overall QoLS. CONCLUSIONS: This study lends support for the universal aspects of perceived QoL at school. This information may serve clinicians and educators in setting goals and developing programs to enhance students' school QOL.

Quality of life: A universal or a disability specific concept?

BACKGROUND.: Quality of life (QoL) is an important outcome of occupational therapy practice. Autism spectrum disorder (ASD) is a neurodevelopmental disorder that impacts the individual throughout their lifespan and may substantially affect QoL. Measuring QoL of people with ASD presents a challenge and a debate whether to use general versus disability-specific adapted measures. PURPOSE.: This paper aims to (a) revisit the construct of QoL and discuss specific dilemmas pertaining to its measurement, and (b) discuss implications to the assessment of QoL in individuals with ASD while highlighting the potential contribution of occupational therapy to the development of measures. KEY ISSUES.: We suggest adding the domain of accessibility into QoL assessments, including, physical, sensory, social, and cognitive aspects, and to use disability-specific QoL measures. IMPLICATIONS.: The paper presents a call for occupational therapists to be involved in developing specific ASD disability-oriented measures that consider the unique characteristics of the disorder and environmental supports.

Integration in the Vocational World: How Does It Affect Quality of Life and Subjective Well-Being of Young Adults with ASD.

This study aimed to assess whether the perception of quality of life (QOL) and subjective well-being (SWB) of young adults with autism spectrum disorders (ASD) is affected by participation in a comprehensive program. Participants included 25 young adults with ASD who participated in the "Roim Rachok Program" (RRP), where they were trained to become aerial photography interpreters. Following the training period, they served in a designated army unit where they practiced their newly acquired profession. The participants filled out two questionnaires, (a) Quality of Life (QOL-Q) and (b) Personal Well-being Index (PWI), at three points of the intervention: (a) before the course, (b) at the end of the course, and (c) six months after integrating in the designated army unit. Wilcoxon signed ranks tests were used to assess the differences between the reported QOL and SWB at the three points of time. The results suggest that there were no significant differences at the end of the course, compared to its beginning. However, there were significantly improved perception of QOL and SWB during the period between the end of the course and six months after starting work. The results of this study highlight the importance of tailored vocational programs that are adapted to the unique needs and strengths of individuals with ASD.

Will environmental interventions affect the level of mastery motivation among children with disabilities? A preliminary study.

Children with developmental disabilities tend to demonstrate lower levels of mastery motivation in comparison with typically developing children. The goal of this study was to investigate the effect of physical and social environmental interventions on the mastery motivation of children with disabilities. Participants included 19 children (from two classes) with disabilities between the ages of 2-4 years from an educational rehabilitation centre. The Individualized Assessment of Mastery Motivation was used to assess the level of mastery motivation; the Early Childhood Environment Rating Scale - Revised and the Teacher-Child Interaction Observation were used to assess the physical and social environments. A counterbalance study design was used such that the children from the two classes received two phases of intervention, social and physical environmental interventions. The study's results point to the advantage of the social intervention, over the physical one, in improving the child's mastery motivation. However, the results lend support for the efficacy of using both aspects of environmental changes to the overall persistent score. The study findings, although preliminary, demonstrate the efficacy of providing both social and physical environmental interventions to improve mastery motivation.

Neurofunctional treatment targeting participation among chronic stroke survivors: a pilot randomised controlled study.

Long-term disabilities are common among stroke survivors and are associated with reduced quality of life (QoL). Research on occupation-based intervention for chronic stroke survivors is sparse. The objective of this study was to examine the effectiveness of neurofunctional treatment (NFT), an occupation-based client-centred treatment approach, for attaining individualised goals in chronic stroke survivors. A pilot randomised control study with a crossover design was employed. The participants were randomly allocated to treatment or control groups, with the intervention replicated for the control group after three months. Twenty three community dwelling stroke survivors, at least one year post-stroke attending a community day centre participated in this study. The 12-week intervention included NFT with individualised occupational goal setting. The treatment methods included task-specific training, environmental or task adaptation, assistive devices, motivation recruitment, and advocacy. Significant differences between the groups were found on occupational performance measures, but not on QoL. These findings were replicated after crossover for the control group. The results support the efficacy of NFT for attaining occupational goals in individuals in the chronic stage after stroke, yet further research is needed to validate these findings in additional treatment settings and over time.

Executive functioning, awareness, and participation in daily life after mild traumatic brain injury: a preliminary study.

OBJECTIVE: We investigated the relationship of executive functioning and self-awareness to participation in daily life of people after mild traumatic brain injury (mTBI) referred to occupational therapy in the postacute phase. METHOD: Thirteen participants who sustained mTBI (average time since injury = 4.7 months, mean age = 43.4 years) were evaluated with the Behavioral Assessment of the Dysexecutive Syndrome, the Dysexecutive Questionnaire, the Self-Awareness of Deficits Interview, and the Participation Index (PI) of the Mayo-Portland Adaptability Inventory. RESULTS: Analysis revealed high frequencies of deficits in executive functions such as planning and shifting. However, self-awareness of the executive deficits was intact. A significant percentage (62%-85%) of participants experienced restrictions in everyday life activities, and PI scores were significantly correlated with measures of executive functioning. CONCLUSIONS: After mTBI, people may be at significant risk for persistent executive deficits and restrictions in participation that warrant occupational therapy intervention.

Assessment of spatial neglect using computerised feature and conjunction visual search tasks.

The purpose of this study was to assess the diagnostic sensitivity of tasks employing feature and conjunction visual searches in stroke patients with unilateral spatial neglect (USN). Seventy-two stroke patients (right/left hemispheric damage with/without USN) and 39 healthy controls participated in the study. Hit rate and reaction time measures of feature and conjunction searches were tested using a newly developed computerised programme for the assessment of visual spatial attention (VISSTA). In addition, subjects received a set of diagnostic paper-and-pencil tests, and were also assessed for the impact of neglect on activities of daily living. Results indicated that the computerised test clearly differentiated between stroke patients and healthy controls, and between the different patient groups. USN patients showed significant contralesional disadvantage in both feature and conjunction visual search tasks. It is proposed that computerised assessment of visual search capacity is a useful and sensitive adjunct to standard paper-and-pencil tests of USN, with the advantage of testing responses based on attention shifts under a time constraint. The learning effects that limit the usefulness of paper-and-pencil tests in longitudinal studies are less likely to affect a computerised test, making it more suitable for monitoring treatment-induced or natural recovery by way of repeated testing.

The validity of the Color Trail Test in the pre-driver assessment of individuals with acquired brain injury.

PRIMARY OBJECTIVE: To examine the validity of the Color Trails Test (CTT), a culture- fair analogue of the Trails Test, in the pre-driver assessment of individuals with acquired brain injury (ABI). RESEARCH DESIGN: Retrospective study. METHODS AND PROCEDURES: 30 participants with ABI completed the CTT and Useful Field of View (UFOV) in a driving rehabilitation clinic. Within the same week an on-road evaluation was conducted by a driving rehabilitation specialist, and a driving instructor. RESULTS: 50% of the participants passed the on-road evaluation and 50% failed. Individuals who passed the on-road test performed the CTT1 and CTT2 faster than those who failed, however the difference between the pass/fail groups was significant only for the CTT1. A correlation analysis between the CTT subtests (CTT1 and CTT2) and the UFOV subtests revealed significant, moderate correlations between these measures. CONCLUSIONS: The CTT1 may contribute to the pre-driving screening by rapidly identifying those individuals who are most at risk for unsafe driving behaviors. Further studies are required with a larger representative sample.