Supporting students with disabilities to achieve high potential through occupational therapy services during transition periods / Apoiando estudantes com deficiência durante períodos de transição para atingirem um elevado potencial por meio de serviços de terapia ocupacional

Abstract Introduction Transition periods are integral parts of a person's life span, characterized by phases of life and shifts in activity before adapting to new situations. Objectives This study aims to understand the high potential characteristics of students with disabilities and evaluate the roles of school-based occupational therapists (SBOT) in assisting these students during transition periods. Method This study comprised 196 students and five SBOT. Research instruments included a characteristic checklist for potential learners and an in-depth interview methodology. The checklist, developed from related literature, consisted of three domains: physical and socio-emotional health, self-determination, and communication and academic performance. Students' performance levels were rated by teachers, with high potential characteristics being defined as achieving an average total score ≥2.0, without obtaining a zero in any checklist item. Results Most participants achieved full scores for high potential characteristics in the physical and socio-emotional health domain. Most SBOT provided direct, indirect, and integrated services using various service delivery models that were tailored to different types of disabilities. Conclusion This study provides fundamental information for SBOT and school professionals to foster high-potential characteristics in students with disabilities during transition periods. Suitable services in the domains of physical and socio-emotional health, self-determination, and communication and academic performance can enhance these high-potential characteristics.

Resumo Introdução O período de transição é parte natural da vida de uma pessoa. Pode ser classificado por fases da vida e mudança de atividade antes de entrar em novas situações. Objetivos Explorar características de alto potencial de alunos com deficiência e investigar os serviços de terapeutas ocupacionais escolares (SBOTs) para esses alunos durante os períodos de transição. Método Participaram 196 alunos e 5 SBOTs. Os instrumentos de pesquisa compreenderam o checklist característico dos potenciais aprendizes e uma entrevista em profundidade. A lista de verificação foi desenvolvida pela literatura relacionada e consistia em três domínios, incluindo saúde física e socioemocional, autodeterminação e comunicação e desempenho acadêmico. A pontuação do nível de desempenho dos alunos foi avaliada pelos professores. As características de alto potencial dos estudantes deste estudo significaram a obtenção de pontuação total média igual ou superior a 2,0, não tendo tido nenhum zero em qualquer item avaliado pelo checklist. Resultados A maioria dos participantes atingiu a pontuação completa das características de alto potencial no domínio saúde física e socioemocional. A maioria das SBOTs prestava serviços diretos, indiretos e integrados com base em diversos modelos de prestação de serviços diferenciados para cada tipo de deficiência. Conclusão Este estudo fornece informações fundamentais para SBOTs e profissionais escolares a fim de estimular características de alto potencial em alunos com deficiência em períodos de transição. Serviços adequados nas áreas de saúde física e socioemocional, autodeterminação e comunicação e desempenho acadêmico podem aprimorar características de alto potencial para esses estudantes.

Training Program to Modify Manual Wheelchairs to Simplified Power Wheelchairs for Community Dwelling Elderly People and Caregivers.

Mobility aids, particularly power wheelchairs, are necessary for elderly individuals who have health problems and disabilities. However, there is a limitation in providing power wheelchairs for such people in the community. The objectives of this study were to develop a prototype for a simplified power wheelchair and develop and evaluate a training program that has the potential to encourage evaluation and modification of the wheelchair for the elderly and their caregivers in the community. Twenty-four participants consist of elderly people and caregivers who were interested in the training program that comprised two sessions: theory and fieldwork experience. Results showed that the elderly people and caregivers, who had no knowledge or experience of wheelchair modification, were able to learn and provide suggestions for wheelchair users in their community. Two themes emerged from evaluating the training program, which included "benefits from the training program" and "improvement of the training program in the future." Key concepts were elicited and considered in six categories: sufficient knowledge and practical learning to build confidence, values of fieldwork experiences, team support, organizational support, expansion of various contexts, and system of continued connection and services after training.

Time use in elderly people at the low active aging level: a qualitative study / Uso do tempo em idosos em baixo nível de envelhecimento ativo: estudo qualitativo

Abstract Introduction Thailand's population is aging rapidly. Thus, it is necessary to enable elderly people to be independent and actively participate in daily occupations. Objective To describe the time used by elderly people at the low active aging level in a suburban village, in Chiang Mai, northern Thailand. Method The study was qualitative research, using the narrative interview method. Three case studies on the low level of active aging were collected by following an interview-based guideline. The data were analyzed using qualitative content analysis. Results The results showed that elderly people at the low active aging level spent their time in varied activities, depending on personal factors and their contexts. Elderly people participate in different occupations of everyday life, which consist of activities of daily living and self-care, the instrumental activities of daily living, leisure, and work. Conclusion It was found that elderly people spent their time in four main categories: Activities of daily living, Instrumental ADL, leisure, and work. Enabling elderly people to increase active aging by continuing engagement in social participation and education is still challenging.

Resumo Introdução A população da Tailândia está envelhecendo rapidamente. Assim, é necessário que os idosos sejam independentes e participem ativamente das suas ocupações diárias. Objetivo Descrever o tempo utilizado por idosos com baixo nível de envelhecimento ativo. Método Utilizando o método de entrevista narrativa, três estudos de caso foram coletados seguindo uma diretriz baseada em entrevista. Resultados O resultado mostrou que os idosos com baixo nível de envelhecimento ativo despendiam seu tempo em atividades variadas, dependendo de fatores pessoais e de seus contextos. Os idosos participam de diferentes ocupações da vida cotidiana, que consistem em atividade de vida diária e autocuidado, atividade instrumental de vida diária, lazer e trabalho. Conclusão Um equilíbrio das ocupações diárias pode ser destacado para possibilitar o envelhecimento ativo dos idosos.

Development of Learning Media for the Elderly to Promote Child Health in the Community.

The purpose of this study was to develop learning media for the elderly to promote child health. The participants consisted of 172 elderly people aged 60 years and older in a suburban village of northern Thailand. This study consisted of a survey questionnaire and focus group discussions and was divided in to two phases: (1) exploring the needs of the elderly in the knowledge of child health and (2) developing learning media, so that the elderly can learn how to promote child health and evaluate its efficiency in the trial process. Results showed that the participants mostly preferred the topic of activities of daily living (ADL) in children. The learning media contributes two major contents: (a) knowledge of child development in five types of ADL performance, brushing, eating, dressing, bathing, and toileting, and (b) methods in teaching ADL skills in children. The digital contents in the learning media were proposed to experts for professional approval. Efficiency of the learning media was evaluated after the trial, when the participants expressed their opinion, and the users perceived that the learning media was effective, motivating, easy to use, and simple in the terms used, as well as appropriate in the sequence of contents and pictures and font, size, and color of the text.

Development and Usability Testing of an Emergency Alert Device for Elderly People and People with Disabilities.

The objectives of this study were to develop and evaluate the effectiveness of an emergency alert device for elderly people and people with disabilities by usability testing. There were two phases in this study: (1) development of a prototype for an emergency alert device and (2) usability testing of the device. Results presented development of the prototype, which comprised parts for sending and receiving signals. There were two kinds of alarms for emergency calls known as conscious and unconscious alerts. Participants in the usability testing phase included 12 specialists and 161 users that comprised 146 elderly people or people with disabilities and 15 caregivers or community health volunteers. The instruments used were a rating scale, usability checklist, and individual interviews regarding the usability, general appearance, and use of the device. The users agreed with the overall aspects regarding usability of the device, its general appearance, and use ( X ¯ ± SD = 4.24 ± 0.88, 4.11 ± 0.90, and 4.37 ± 0.83, respectively). Most of the participants, both specialists and users, gave their perspectives on improving the size, color of the letters displayed, type of wristband, and method for sending signals.

Active Ageing Level and Time Use of Elderly Persons in a Thai Suburban Community.

Elderly populations are growing rapidly worldwide, thus enhancing an increasing need for their independent health care, productivity, and most importantly, balance of occupations. This research is aimed at investigating the active ageing levels and time use patterns of an elderly population attending the Community Elderly School in a suburban village of northern Thailand. These participants comprised 140 persons aged 60 years and older and were without cognitive deficits, based on the Mini-Mental State Examination. Active ageing levels and time use patterns were collected by following an interview-based questionnaire. The results showed that the level of active ageing was moderate (mean active ageing index (AAI) was 0.79). All of the participants used their time in varied activities, including the seven categories: basic activities of daily living, instrumental activities of daily living, rest and sleep, education, work, leisure, and social participation. Furthermore, they spent most of their time resting and sleeping.

Information Management for the Assistive Technology Provision in Community: Perspectives of Local Policymakers and Health Service Providers.

BACKGROUND: Assistive technology (AT) is a way to enhance the performance of daily activities in people with disabilities and help them live more independently. However, an important problem in providing AT lies in the effectiveness of information management. Local policymakers and health service providers have become aware of this problem and their perspectives are the key to solving it. METHODS: This study explored the types of AT provided for people with disabilities in the community and the perspectives on information management of local policymakers and health service providers. A survey checklist and semistructured in-depth interview were the instruments of this study. The key informants in this study included administrators, nurses, and physical therapists from four community areas in Chiang Mai, Thailand. RESULTS: The medical records showed that the types of AT provided were mostly second-hand (57.24%) and borrowed devices (57.73%). All of them were low-tech devices (crutch, cane, walker, wheelchair, and adaptive tricycle). In addition, the results indicated three perspective aspects related to information management: (1) problems in the database recording system, (2) different policies and processes of information management, and (3) improvement of the AT provision system. CONCLUSION: The perspectives of local policymakers and health service providers indicated related problems, impacts of policies, and ways to improve the AT provision system by applying information technology.

Facilitators and Barriers of Assistive Technology and Learning Environment for Children with Special Needs.

The purpose of this research was to study the facilitators and barriers of assistive technology (AT) and the learning environment for children with special needs in special education schools in Chiang Mai, Thailand. The informants were one hundred and sixteen children with special needs, who studied in nursery to Grade 12, or with their caregivers. The instrument was a questionnaire applied by the International Classification of Functioning, Disability and Health (ICF) and examined for content validity by five specialists. The results in terms of AT showed that a majority of children with physical disability needed it for mobility and use of school buildings and those with hearing disability for communication. However, most of the children did not need to use AT for culture, recreation, or sports, while many considered it as a facilitator for education. In terms of the learning environment, most characteristics of the physical environment were facilitators for children with special needs, as were those of the social environment for all groups of such children. The results of this study were useful in providing information for AT and design of a learning environment relating to the varied characteristics of children with special needs in special education schools.

Home Features and Assistive Technology for the Home-Bound Elderly in a Thai Suburban Community by Applying the International Classification of Functioning, Disability, and Health.

The ageing population is having an impact worldwide and has created a serious challenge in Thailand's healthcare systems, whereby healthcare practitioners play a major role in promoting independent interaction of their client's abilities, as well as environmental factors. The purpose of this study was to survey features of the home and assistive technology (AT) for the home-bound elderly in the community of Chiang Mai, Thailand. Home evaluation included features inside and outside the home, and AT was based on the International Classification of Functioning, Disability, and Health (ICF) concept. Methods included observation and an interview that were used by the researcher for evaluation. The study found that every home had at least one hazardous home feature such as inappropriate width of the door, high door threshold, tall stair steps, no bedside rail, and inappropriate height of the toilet pan. AT was found in houses as general products and technology for personal use in daily living and for personal indoor and outdoor mobility as well as transportation. Therefore, home features and AT can afford the home-bound elderly independent living within the community. Perspective AT according to the ICF concept could provide a common language for ageing in place benefits.

Development and Reliability of the Basic Skill Assessment Tool for Adolescents with Autism Spectrum Disorder.

The purpose of this study was to improve upon the first version of the basic work skills assessment tool for adolescents with autism spectrum disorder (ASD) and examine interrater and intrarater reliability using Intraclass Correlation Coefficient (ICC). The modified tool includes 2 components: (1) three tasks measuring work abilities and work attitudes and (2) a form to record the number of verbal and nonverbal prompts. 26 participants were selected by purposive sampling and divided into 3 groups-group 1 (10 subjects, aged 11-13 years), group 2 (10, aged 14-16 years), and group 3 (6, aged 17-19 years). The results show that interrater reliabilities of work abilities and work attitudes were high in all groups except that the work attitude in group 1 was moderate. Intrarater reliabilities of work abilities in group 1 and group 2 were high. Group 3 was moderate. Intrarater reliabilities of work attitudes in group 1 and group 3 were high but not in group 2 in which they were moderate. Nevertheless, interrater and intrarater reliabilities in the total scores of all groups were high, which implies that this tool is applicable for adolescents aged 11-19 years with consideration of relevance for each group.

Model of Providing Assistive Technologies in Special Education Schools.

Most students diagnosed with disabilities in Thai special education schools received assistive technologies, but this did not guarantee the greatest benefits. The purpose of this study was to survey the provision, use and needs of assistive technologies, as well as the perspectives of key informants regarding a model of providing them in special education schools. The participants were selected by the purposive sampling method, and they comprised 120 students with visual, physical, hearing or intellectual disabilities from four special education schools in Chiang Mai, Thailand; and 24 key informants such as parents or caregivers, teachers, school principals and school therapists. The instruments consisted of an assistive technology checklist and a semi-structured interview. Results showed that a category of assistive technologies was provided for students with disabilities, with the highest being "services", followed by "media" and then "facilities". Furthermore, mostly students with physical disabilities were provided with assistive technologies, but those with visual disabilities needed it more. Finally, the model of providing assistive technologies was composed of 5 components: Collaboration; Holistic perspective; Independent management of schools; Learning systems and a production manual for users; and Development of an assistive technology center, driven by 3 major sources such as Government and Private organizations, and Schools.