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1.
Am J Occup Ther ; 78(4)2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38899950

ABSTRACT

IMPORTANCE: Play has been viewed as a critical occupation supporting health since the founding of occupational therapy, but the complexity of play presents challenges to scholars who study adults. Researchers in occupational science and occupational therapy often address experiential qualities of occupations, including those considered to be play. However, the literature lacks clear descriptions of what constitutes adult play as well as the experiences of adults during preferred activities. OBJECTIVE: To contribute to the body of knowledge on the wide range of preferred activities adults in the United States pursue and may perceive as play experiences. We refer to these activities as adult play because they contain experiential qualities of play described in key play literature. DESIGN: Cross-sectional survey study. SETTING: A 31-item survey, the Daily Occupational Experience Survey-revised (DOESr), was uploaded to Qualtrics for data collection using snowball sampling. The online survey link was distributed to participants aged 18-64 years. PARTICIPANTS: The survey was completed by 491 participants. Exploratory factor analysis was used to extract the most prevalent patterns of play experiences reported. Internal consistency and content validity were also examined. RESULTS: The factor analysis yielded an optimal solution of five factors representing distinct patterns of adult play experiences: Creativity-Adventure, Restoration, Deep Engagement, Ludos, and Mastery. CONCLUSIONS AND RELEVANCE: The five factors identified by the DOESr represent distinct patterns of adult play experiences. The DOESr demonstrated acceptable internal consistency for three of the five factors as well as for the overall tool. Plain-Language Summary: Previous research on adult occupations has not addressed the array of experiences that adults seek or enjoy while engaging in play. This study identified five patterns of adult play experiences. Understanding these patterns may assist occupational therapy practitioners when tailoring clients' play experiences to promote optimal health and well-being.


Subject(s)
Play and Playthings , Humans , Adult , Cross-Sectional Studies , Male , Female , Middle Aged , Young Adult , Adolescent , Occupational Therapy , Surveys and Questionnaires , Factor Analysis, Statistical , United States , Creativity
2.
Am J Occup Ther ; 77(4)2023 Jul 01.
Article in English | MEDLINE | ID: mdl-37589659

ABSTRACT

IMPORTANCE: Assessment of praxis using valid and reliable measures is important for understanding factors affecting occupational participation. OBJECTIVE: To evaluate evidence of construct validity and internal reliability of data gathered with four newly developed praxis tests. DESIGN: Comparative descriptive design. SETTING: Homes, schools, and therapy practices across the United States. PARTICIPANTS: A control group consisting of 163 children without any concerns or diagnoses and a case group of 145 children with sensory integration difficulties, ages 3 to 12 yr. OUTCOMES AND MEASURES: Rasch analyses to evaluate construct validity, and Student's t tests to evaluate group differences. RESULTS: Total test scores and most item scores conformed to Rasch model expectations. Group differences were significant; the control group scored higher. Internal reliability was strong. CONCLUSIONS AND RELEVANCE: Findings support the validity and internal reliability of the four praxis tests. What This Article Adds: This study adds to the growing body of evidence for validity and reliability of the Evaluation in Ayres Sensory Integration® tests.


Subject(s)
Occupational Therapy , Child , Humans , Reproducibility of Results , Schools
3.
Am J Occup Ther ; 77(1)2023 Jan 01.
Article in English | MEDLINE | ID: mdl-36779979

ABSTRACT

IMPORTANCE: Assessment of tactile perception is foundational for addressing aspects of occupational performance. OBJECTIVE: To evaluate the construct validity and internal reliability of four new tactile perception tests. DESIGN: Causal comparative groups design. SETTINGS: Homes, schools, and therapy practices across the United States. PARTICIPANTS: Children ages 3 to 12 yr: typically developing (n = 174) and those with sensory integration concerns (n = 153). OUTCOMES AND MEASURES: Rasch analyses to evaluate construct validity; analysis of covariance to evaluate group differences. RESULTS: The Rasch model confirmed evidence of construct validity for each of the four tests. The typically developing group scored significantly higher than the clinical group on all tests (η2p = .040-.105, p < .001). Person reliability indices and strata indicated moderate to strong internal reliability (Rasch person reliability indices = .69-.87; strata = 2.33-3.82). CONCLUSIONS AND RELEVANCE: The Evaluation in Ayres Sensory Integration® (EASI) Tactile Perception Tests are reliable and valid measures for assessing tactile perception in children ages 3 to 12 yr. Findings suggest that these tests are likely to be clinically useful and appropriate for children in this age range and may provide critical information regarding underlying sensory functions necessary for optimal occupational performance. What This Article Adds: This article provides data supporting the reliability and validity of the EASI Tactile Perception Tests in a U.S. SAMPLE: These assessments can be used by therapists trained in their administration to assess tactile functions that may affect participation in activities, tasks, and occupations.


Subject(s)
Occupational Therapy , Touch Perception , Child , Humans , Child, Preschool , Reproducibility of Results , Touch
5.
Am J Occup Ther ; 76(2)2022 Mar 01.
Article in English | MEDLINE | ID: mdl-35226062

ABSTRACT

IMPORTANCE: Ayres Sensory Integration® is an evidence-based practice that requires a comprehensive assessment before intervention. The Evaluation in Ayres Sensory Integration (EASI) is intended for this purpose, and psychometric data are needed to determine its validity and reliability. OBJECTIVE: To evaluate the internal consistency of four EASI Praxis tests and their validity as developmental measures. DESIGN: Cross-sectional developmental design. SETTING: Participants' homes. PARTICIPANTS: Typically developing children and young adolescents, ages 6 to 12 yr (N = 234). Outcomes and Measures: We analyzed four EASI Praxis tests using Cronbach's α, Pearson correlation coefficients, and one-way analysis of variance to explore internal consistency and developmental trends. RESULTS: The findings indicate moderate to high internal consistency for all tests. Significant correlations between age and praxis scores indicate that the EASI Praxis tests are sensitive to developmental changes. CONCLUSIONS AND RELEVANCE: Occupational therapists can have confidence in the internal consistency and sensitivity to developmental changes of these praxis scores through early adolescence. What This Article Adds: Occupational therapists administering EASI Praxis tests can have confidence that they consistently measure praxis ability and are sensitive to developmental changes across ages 6 to 12 yr. The results suggest that praxis continues to develop into early adolescence, and adolescents may benefit from assessment and intervention targeting praxis ability.


Subject(s)
Occupational Therapy , Adolescent , Child , Cross-Sectional Studies , Humans , Occupational Therapists , Psychometrics , Reproducibility of Results , Surveys and Questionnaires
6.
Am J Occup Ther ; 75(6)2021 Nov 01.
Article in English | MEDLINE | ID: mdl-34792540

ABSTRACT

IMPORTANCE: Vestibular and proprioceptive functions play a critical role in occupational performance and participation. Assessment of these functions in a reliable and valid manner is part of a comprehensive assessment in the Ayres Sensory Integration® frame of reference, commonly applied in pediatric occupational therapy. OBJECTIVE: To report on reliability and validity of six tests of vestibular and proprioceptive functions of the Evaluation in Ayres Sensory Integration (EASI). DESIGN: We used Rasch analyses to examine and modify the number of items and scoring categories on the six tests and known-groups analysis to examine group differences. We evaluated internal consistency using Cronbach's α and Rasch person reliability. PARTICIPANTS: The sample contained typically developing children (n = 150) and children with sensory integration concerns (n = 84); all participated voluntarily. Outcomes and Measures: The EASI is used to measure sensory and motor functions in children ages 3 to 12 yr. The six tests of vestibular and proprioceptive functions were analyzed in this study. RESULTS: Data from >96% of items conformed to the expectations of the model. We found statistically significant group differences (ps < .001-.128; ds = 0.20-1.31), with the typically developing children group scoring significantly higher on all but one test, and moderate to strong evidence of internal consistency (Rasch person-reliability indices ≥ 0.80; strata > 3) for five of six tests. CONCLUSIONS AND RELEVANCE: The EASI vestibular and proprioceptive tests have strong construct validity and internal reliability, indicating that they are psychometrically sound clinical measures. What This Article Adds: The development of occupational therapy assessments with strong psychometric properties, such as the EASI tests of vestibular and proprioceptive functions, enhances clinical practice and research by elucidating the factors affecting participation in accurate and dependable ways so that occupational therapy interventions can be focused and effective.


Subject(s)
Occupational Therapy , Child , Child, Preschool , Humans , Proprioception , Psychometrics , Reproducibility of Results , Surveys and Questionnaires
7.
Am J Occup Ther ; 75(5)2021 Sep 01.
Article in English | MEDLINE | ID: mdl-34780641

ABSTRACT

IMPORTANCE: Spanish-speaking populations represent a significant percentage of occupational therapy clientele globally. Culturally appropriate Spanish translations of assessments are therefore imperative. This study describes the process of a culturally adapted translation of a set of tests for use with Spanish-speaking pediatric populations. OBJECTIVE: To produce a culturally adapted Spanish translation of the Evaluation in Ayres Sensory Integration® (EASI) for international use. METHOD: We used cultural adaptation methodology that included direct and back translations of the EASI by bilingual translators and interviews with pediatric occupational therapists and children ages 3-6 yr from Spain. Linguistic experts helped revise the translations, and pediatric occupational therapy leaders in five Spanish-speaking North and South American countries reviewed the translations for comprehensibility and cultural appropriateness. RESULTS: Back translations demonstrated equivalence with the original EASI tests except for a few test instructions and scoring criteria. Interviews with occupational therapists and children in Spain revealed some comprehension difficulties for several tests, which were revised in consultation with a linguistic expert. Additional adaptations were made on the basis of recommendations to address cultural differences by occupational therapy leaders from five North and South American countries. Most changes in wording were made in one EASI test (Praxis: Following Directions) that is heavily dependent on language comprehension. CONCLUSIONS AND RELEVANCE: We used currently recommended methodologies to develop and adapt a Spanish translation of the EASI for use across diverse cultures. What This Article Adds: A Spanish translation of the EASI has been developed for use in culturally diverse Spanish-speaking countries around the world.


Subject(s)
Occupational Therapy , Child , Child, Preschool , Cross-Cultural Comparison , Humans , Language , Surveys and Questionnaires , Translations
8.
Brain Sci ; 9(7)2019 Jun 28.
Article in English | MEDLINE | ID: mdl-31261689

ABSTRACT

Sensory integration, now trademarked as Ayres Sensory Integration® or ASI, is based on principles of neuroscience and provides a framework for understanding the contributions of the sensory and motor foundations of human behavior. The theory and practice of ASI continues to evolve as greater understanding of the neurobiology of human behavior emerges. In this paper we examine core constructs of ASI identified in the seminal work of Dr. Jean Ayres, and present current neuroscience research that underlies the main patterns of sensory integration function and dysfunction. We consider how current research verifies and clarifies Ayres' propositions by describing functions of the vestibular, proprioceptive, and tactile sensory systems, and exploring their relationships to ocular, postural, bilateral integration, praxis, and sensory modulation. We close by proposing neuroplasticity as the mechanisms underlying change as a result of ASI intervention.

10.
Am J Occup Ther ; 73(3): 7303390010p1-7303390010p8, 2019.
Article in English | MEDLINE | ID: mdl-31120849

ABSTRACT

Evidence Connection articles provide case examples of how practice decisions may be informed by findings of systematic reviews sponsored by the American Occupational Therapy Association Evidence-Based Practice Project. This Evidence Connection article is the second article in a two-part series. The first article described a case report of occupational therapy provided to a child with a diagnosis of autism spectrum disorder and challenges in sensory integration in a clinic setting (Parham et al., 2019). This article describes the same child's occupational therapy service delivery by the occupational therapist working in the school setting.


Subject(s)
Autism Spectrum Disorder/therapy , Cognition/physiology , Occupational Therapy , Sensation/physiology , Adolescent , Child , Evidence-Based Practice , Humans
11.
Am J Occup Ther ; 73(1): 7301395010p1-7301395010p9, 2019.
Article in English | MEDLINE | ID: mdl-30839273

ABSTRACT

Evidence Connection articles provide case examples of how practice decisions may be informed by findings of systematic reviews sponsored by the American Occupational Therapy Association (AOTA) Evidence-Based Practice (EBP) Project. This Evidence Connection article describes a case report of a child with a diagnosis of autism spectrum disorder who has difficulties in function and participation related to challenges in sensory integration. This article is the first in a two-part series, and it focuses on occupational therapy provided to the child by a clinic-based therapist in collaboration with the child's school-based occupational therapist. Part 2 in this series will describe the same child's intervention by the school-based therapist. Intervention decisions are informed by findings of systematic reviews of intervention effectiveness that were part of an AOTA EBP Project addressing occupational therapy interventions for children and youth with challenges in sensory integration and sensory processing.


Subject(s)
Autism Spectrum Disorder/therapy , Occupational Therapy/methods , Adolescent , Autism Spectrum Disorder/diagnosis , Child , Cognition , Evidence-Based Practice , Humans , Perceptual Disorders/therapy , Sensation , Sensation Disorders/therapy
12.
Early Interv Psychiatry ; 13(2): 264-271, 2019 Apr.
Article in English | MEDLINE | ID: mdl-28840977

ABSTRACT

AIM: To identify and compare the sensory characteristics of young people at clinical high risk (CHR) for psychosis to those of peers at clinical low risk (CLR), and to national normative data. CHR and CLR participants were recruited from 6 US regions. METHOD: A descriptive cohort design was used to analyse baseline data collected as part of the Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP). Raw scores on the Adolescent/Adult Sensory Profile (AASP) were analysed for 205 young people with CHR and 87 with CLR in 2 age groups: 12 to 17 years (N = 203) and 18 to 25 years (N = 89). ANOVA procedures were used to determine whether differences in AASP scores existed across CLR, CHR, and normative groups by age group. RESULTS: CHR participants differed significantly from the normative group for all 4 AASP quadrant scores (Low Registration, Sensory Seeking, Sensory Sensitivity and Sensory Avoiding) in both age groups. CLR participants were similar to norms, except for Sensory Seeking scores that were significantly lower than norms in both age ranges. CONCLUSION: Young people with CHR demonstrate active avoidance, heightened sensitivity, reduced seeking, and reduced registration of sensations in everyday life compared to typical peers. This pattern of differences may be a valuable marker for identifying individuals who are at high risk for developing a psychotic illness, and may also inform interventions designed to prevent or minimize the illness process and accompanying dysfunction.


Subject(s)
Delusions/diagnosis , Perceptual Disorders/diagnosis , Prodromal Symptoms , Psychotic Disorders/diagnosis , Adolescent , Adult , Delusions/psychology , Disease Progression , Female , Humans , Male , Perceptual Disorders/psychology , Psychotic Disorders/psychology , Risk Assessment , Young Adult
13.
Early Hum Dev ; 120: 10-16, 2018 05.
Article in English | MEDLINE | ID: mdl-29604485

ABSTRACT

BACKGROUND: Children born preterm are prone to motor problems. Research on their motor performance has, however, rarely been integrated with sensory processing. AIM: To examine sensory-motor performance in children born extremely preterm (EPT). METHOD: In a longitudinal prospective cohort study, 49 EPT (born <28 gestational weeks; 32 boys and 17 girls) and 33 term-born (16 boys and 17 girls) children were assessed with six individual subtests from the Sensory Integration and Praxis Tests at the age of 7.0 to 7.3 years. RESULTS: The rate of test z-scores indicating dysfunction [from -2 standard deviations (SD) to < -1 SD for mild and < -2 SD for moderate-to-severe] was significantly higher in EPT children than in term-born children in all the subtests. When comparing mean performance adjusted for gender and mother's education, EPT children performed worse than term-born children in Design Copying (z-score difference - 0.83; 95% confidence interval -1.32 to -0.34), Motor Accuracy (-0.82; -1.26 to -0.38), Postural Praxis (-0.95; -1.45 to -0.45), Manual Form Perception (-0.59; -1.12 to -0.06), and Finger Identification (-0.88; -1.45 to -0.31). Additional adjustment for Full-Scale Intelligence Quotient rendered difference in Manual Form Perception non-significant. CONCLUSION: Seven-year-old EPT children perform worse than their term-born peers in tests for visual-motor, somatosensory, and motor planning performance.


Subject(s)
Infant, Extremely Premature , Psychomotor Performance , Case-Control Studies , Child , Cohort Studies , Developmental Disabilities , Female , Humans , Infant, Newborn , Longitudinal Studies , Male , Neuropsychological Tests
14.
Am J Occup Ther ; 72(1): 7201190040p1-7201190040p11, 2018.
Article in English | MEDLINE | ID: mdl-29280714

ABSTRACT

This systematic review examined the effectiveness of specific sensory techniques and sensory environmental modifications to improve participation of children with sensory integration (SI) difficulties. Abstracts of 11,436 articles published between January 2007 and May 2015 were examined. Studies were included if designs reflected high levels of evidence, participants demonstrated SI difficulties, and outcome measures addressed function or participation. Eight studies met inclusion criteria. Seven studies evaluated effects of specific sensory techniques for children with autism spectrum disorder (ASD) or attention deficit hyperactivity disorder: Qigong massage, weighted vests, slow swinging, and incorporation of multisensory activities into preschool routines. One study of sensory environmental modifications examined adaptations to a dental clinic for children with ASD. Strong evidence supported Qigong massage, moderate evidence supported sensory modifications to the dental care environment, and limited evidence supported weighted vests. The evidence is insufficient to draw conclusions regarding slow linear swinging and incorporation of multisensory activities into preschool settings.


Subject(s)
Autism Spectrum Disorder/rehabilitation , Occupational Therapy , Adolescent , Child , Child Health Services , Humans , Psychomotor Performance , Young Adult
15.
Am J Occup Ther ; 72(1): 7201195030p1-7201195030p7, 2018.
Article in English | MEDLINE | ID: mdl-29280717

ABSTRACT

Comprehensive, reliable, and valid assessment is essential for individually tailored, appropriate, and effective intervention planning and implementation. Research, education, and practice using an Ayres Sensory Integration® (ASI) approach have a long history of prioritizing comprehensive assessment. To meet the need for a set of tests that will fully evaluate the constructs of ASI with psychometrically strong, internationally appropriate, and easily accessible measurement tools, the development of the Evaluation in Ayres Sensory Integration® (EASI) has been initiated. This article introduces the EASI, describes the overarching plan for its development, and reports the results of promising preliminary analyses of discriminative validity data.


Subject(s)
Occupational Therapy/methods , Psychometrics , Psychomotor Performance , Child , Child, Preschool , Female , Humans , Male , Reproducibility of Results
16.
Am J Occup Ther ; 69(6): 6906360010p1-7, 2015.
Article in English | MEDLINE | ID: mdl-26565107

ABSTRACT

This article builds on the work of Case-Smith and colleagues and proposes a roadmap to guide future research in occupational therapy. To foster best practice in the application of principles and practices of sensory integration (SI), the pillars of practice, advocacy, and education are identified as elements that provide the foundation for research. Each pillar ensures that SI research is conducted in a rigorous and relevant manner. To this end, achievements to date are discussed, with proposed goals presented for each pillar. Finally, the roadmap builds on the pillars and outlines implications for occupational therapy with the overarching theme that a wide array of scientists, educators, therapists, and service recipients will be needed to ensure that those who may benefit most have access to intervention that is evidence based, theory driven, and provided within the highest standards of service delivery.


Subject(s)
Biomedical Research/trends , Evidence-Based Practice , Occupational Therapy/trends , Sensation Disorders/rehabilitation , Humans
17.
Am J Occup Ther ; 69(1): 6901220010, 2015.
Article in English | MEDLINE | ID: mdl-25553746

ABSTRACT

OBJECTIVE: We sought to characterize sensory integration (SI) and praxis patterns of children with autism spectrum disorder (ASD) and discern whether these patterns relate to social participation. METHOD: We extracted Sensory Integration and Praxis Tests (SIPT) and Sensory Processing Measure (SPM) scores from clinical records of children with ASD ages 4-11 yr (N=89) and used SIPT and SPM standard scores to describe SI and praxis patterns. Correlation coefficients were generated to discern relationships among SI and praxis scores and these scores' associations with SPM Social Participation scores. RESULTS: Children with ASD showed relative strengths in visual praxis. Marked difficulties were evident in imitation praxis, vestibular bilateral integration, somatosensory perception, and sensory reactivity. SPM Social Participation scores were inversely associated with areas of deficit on SIPT measures. CONCLUSION: Children with ASD characteristically display strengths in visuopraxis and difficulties with somatopraxis and vestibular functions, which appear to greatly affect participation.

18.
Am J Occup Ther ; 68(5): 506-13, 2014.
Article in English | MEDLINE | ID: mdl-25184462

ABSTRACT

This study examined the reliability and validity of the structural section of the Ayres Sensory Integration® Fidelity Measure© (ASIFM), which provides a method for monitoring the extent to which an intervention was implemented as conceptualized in studies of occupational therapy using sensory integration intervention methods (OT-SI). We examined the structural elements of the measure, including content of assessment reports, availability of specific equipment and adequate space, safety monitoring, and integration of communication with parents and other team members, such as collaborative goal setting with parents or family and teacher education, into the intervention program. Analysis of self-report ratings by 259 occupational therapists from 185 different facilities indicated that the structural section of the ASIFM has acceptable interrater reliability (r ≥ .82) and significantly differentiates between settings in which therapists reportedly do and do not practice OT-SI (p < .001).


Subject(s)
Health Services Research/standards , Occupational Therapy/methods , Sensation Disorders/rehabilitation , Humans , Process Assessment, Health Care
19.
Am J Occup Ther ; 68(5): 546-54, 2014.
Article in English | MEDLINE | ID: mdl-25184467

ABSTRACT

This study investigated the validity of sensory systems as distinct measurable constructs as part of a larger project examining Ayres's theory of sensory integration. Confirmatory factor analysis (CFA) was conducted to test whether sensory questionnaire items represent distinct sensory system constructs. Data were obtained from clinical records of two age groups, 2- to 5-yr-olds (n = 231) and 6- to 10-yr-olds (n = 223). With each group, we tested several CFA models for goodness of fit with the data. The accepted model was identical for each group and indicated that tactile, vestibular-proprioceptive, visual, and auditory systems form distinct, valid factors that are not age dependent. In contrast, alternative models that grouped items according to sensory processing problems (e.g., over- or underresponsiveness within or across sensory systems) did not yield valid factors. Results indicate that distinct sensory system constructs can be measured validly using questionnaire data.


Subject(s)
Perception/physiology , Sensation , Auditory Perception , Child , Factor Analysis, Statistical , Humans , Infant , Mental Processes , Proprioception , Sensation/physiology , Touch , Vestibule, Labyrinth , Visual Perception
20.
Am J Occup Ther ; 68(5): e149-53, 2014.
Article in English | MEDLINE | ID: mdl-25184475

ABSTRACT

This article presents the current state of measurement in the area of sensory integration within the field of occupational therapy in three areas: (1) phenotypic characterization, (2) intervention adherence and dosage, and (3) outcome measurement. The need for additional measurement tools in all three areas is addressed. In regard to outcome measurement of occupational therapy using sensory integration, the use of both qualitative and quantitative methods to obtain outcome data is recommended. Further, a strategy is recommended for obtaining outcome data from direct report from the child or other stakeholder.

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