Exploring Participant Perceptions of a Community-Based Program for People With Brain Injury.

An acquired brain injury presents complex challenges to survivors returning to the community, and as more individuals survive, the need for programs that support optimal quality of life increases. To explore participant perceptions of a community-based program. To accomplish objectives, 10 individuals living with chronic brain injury who were attendees of the community program were interviewed. Applying qualitative study procedures, all narrative data were transcribed and analyzed. All participants expressed that the program positively impacted several personal life satisfaction factors as well as their participation within their respective communities. Themes included (1) Acceptance, (2) Sense of Community, (3) Sense of Purpose, (4) Autonomy, and (5) Personal Development. Discussion includes analysis of program elements that help explain participant responses. Description of the occupational therapy grounded program offers a guide to others wishing to develop similar programs for individuals living with brain injury.

An examination of occupation-based, client-centered, evidence-based occupational therapy practices in New Hampshire.

This study surveyed occupational therapy practitioners to gain a better understanding of the nature of occupational therapy practices in the State of New Hampshire. A questionnaire was developed and distributed to a sample of practitioners working in New Hampshire to gather information regarding the extent to which occupation-based, client-centered, evidence-based services were being provided. Results suggested that practitioners highly value these service delivery attributes. However, day-to-day practice decisions regarding evaluation methods, where to conduct intervention sessions, goal writing, and choices of intervention activities suggest a stronger emphasis on the evaluation and remediation of specific performance skill and body function deficits, rather than on client performance of desired occupations. In light of the findings, the discrepancy between practitioner values and daily clinical practices is discussed, along with the challenges inherent in providing authentic, evidence-based occupational therapy.

Sensory and motor behaviors of infant siblings of children with and without autism.

We compared the sensory and motor behaviors of typically developing infants with those of infant siblings of children with autism spectrum disorders (ASD), who are considered high risk for the disorder, to explore potential sensory and motor markers for use in early diagnosis of ASD. We compared frequencies of sensory and motor behaviors during 10-min, videotaped, infant-mother play sessions and during 5 min of spoon-feeding between groups of 12-mo-old infants. Data from standardized measures of development, sensory processing, and behaviors commonly associated with ASD were also analyzed descriptively for the high-risk group. The results indicated that high-risk infants demonstrated fewer movement transitions (t [23] = -2.4, p = .03) and less object manipulation (t [23] = -2.4, p = .03) than low-risk infants. The sensory and motor differences found between typical and high-risk infants suggest that early screenings for ASD should include the examination of sensory and motor behaviors.

An examination of the relationships between motor and process skills and scores on the sensory profile.

OBJECTIVE: This quasi-experimental study sought to determine whether children with possible sensory processing deficits, as measured by the Sensory Profile, performed less well on an occupational performance measure compared to children with typical Sensory Profile scores. METHOD: Sixty-eight children were administered both the Assessment of Motor Process Skills (AMPS) and the Sensory Profile. After the assessments were completed, children were divided into two groups based on their Sensory Profile scores. RESULTS: Independent t tests indicated statistically significant differences between groups on the AMPS ADL [Activities of Daily Living] Motor and ADL Process measures (p < .05), with the children with atypical Sensory Profile scores showing more functional difficulties. Correlations revealed significant relationships among the measures. CONCLUSION: The results suggest that children identified with sensory processing deficits on the Sensory Profile are likely to experience some challenges in performing everyday occupations.

Evaluation options for secondary transition planning.

This article presents a model evaluation plan conducted by occupational therapists that may be used to contribute information to the transition planning process in secondary school students with disabilities. Occupational therapists are not fully participating in transition services within secondary schools. One of the major obstacles to full participation identified in a previous research study by the authors of this article was that few occupational therapists were aware of appropriate evaluation options available for secondary transition planning. The authors in this article review the evaluation needs for secondary transition services in general, describe occupational therapy's role in contributing to the Individualized Education Plan (IEP), and describe an evaluation method that gathers key information pertinent to the occupational therapy role. A case study is presented that illustrates how these assessment tools were applied to develop IEP goals in one student's transition plan.

Stimulant medication use, misuse, and abuse in an undergraduate and graduate student sample.

In this study, the authors investigated the characteristics of use, misuse, and abuse of stimulant medication (primarily methylphenidate and variants) among students at a northeastern US university. Researchers sent an invitation to take an Internet survey to student e-mail addresses and passed 150 paper surveys in undergraduate classes, analyzing 1,025 (975 electronically) returned surveys. Sixteen percent of respondents reported abusing or misusing stimulant medication. Ninety-six percent of respondents who specified a medication preferred to abuse or misuse Ritalin. Men and women reported similar use patterns. Most respondents who abused or misused stimulant medication swallowed pills; 40% used intranasally. Reasons for abusing or misusing stimulant medication included improving attention, partying, reducing hyperactivity, and improving grades. Consistent with previous studies, results suggest that abuse of stimulant medication is a concern on college campuses. The results point to various reasons for and methods of abusing and misusing stimulant medication that may direct future research, prevention, and intervention.

Behavioral and physiologic response measures of occupational task performance: a preliminary comparison between typical children and children with attention disorder.

OBJECTIVE: To compare performance on the Assessment of Motor and Process Skills (AMPS), a measure of functional task performance and physiological responses (salivary cortisol levels) during AMPS administration, between typically developing children and children diagnosed with attention deficit hyperactivity disorder (ADHD). METHOD: In this quasi-experimental study, independent t tests, and mixed, repeated measures analysis of variance were conducted to compare a group of typically developing children (n = 21) with a group of children with ADHD (n = 12) on two dependent measures: (a) the AMPS and (b) salivary cortisol. Salivary cortisol, a stress hormone, was taken at three time points, baseline, mid-way through AMPS administration, and 20 min following AMPS administration. RESULTS: Significant differences were found on the activities of daily living (ADL) process ability measure of the AMPS (p = .001) and the ADL motor ability measure (p = .04), with the ADHD group performing more poorly than typical children. There was no significant group (ADHD vs. control) by time period interaction effect on cortisol levels. Overall, the cortisol levels of the ADHD group were higher than the levels of those in the control group (p = .02). Cortisol levels tended to drop significantly over time (p = .01) for both groups, however the patterns differed somewhat between groups. Cortisol levels of the typical children dropped at the final time period (20 min post-AMPS administration) whereas the levels of the children in the ADHD remained higher during this time period. This interaction effect approached, but did not reach, statistical significance (p = .15). CONCLUSION: The results of this investigation suggest that the AMPS is sensitive to detecting functional performance concerns, and both motor and process skill deficits, associated with ADHD, and therefore may be a useful assessment tool with this population. Data also suggests that cortisol expression to a well-known ADL task may be lower if the task is not overly challenging for the individual, and provides support for further study of the role of cortisol with disorders of attention.

The role of the school-based occupational therapist in secondary education transition planning: a pilot survey study.

OBJECTIVE: The purpose of this study was to investigate school-based occupational therapists' knowledge of transition planning, their degree of participation in assessment and intervention of students requiring transition services, and to identify potential barriers limiting therapists' participation in transition services. METHOD: Using survey methods, a questionnaire was mailed to a random sample of therapists listed as members of the School System Special Interest Section of the American Occupational Therapy Association. Eighty therapists from all geographical regions within the continental United States and who identified themselves as working with students 13-21 years of age in an educational setting, participated in the study. The response rate was 20%. RESULTS: The majority of participants reported that they understood the terminology associated with the Individuals with Disabilities Education Act (IDEA) of 1990 and the 1997 IDEA amendments definitions of transition planning at the secondary level, but were less likely to apply that knowledge to the transition planning process. The majority of therapists reported minimal participation in secondary education transition planning assessment and intervention for students with disabilities. Most respondents believed that they were not contributing to the transition planning process in a manner that maximized their skills, and identified several barriers that they believed hindered greater participation. CONCLUSION: This pilot study suggests that occupational therapists may not be participating in transition services to their fullest potential. While the low response rate in this study precludes generalization, this information is important to guide further study as well as to shape efforts to increase occupational therapy's role in this important service area within school-based practice.

Therapists' perceptions about making a difference in parent-child relationships in early intervention occupational therapy services.

OBJECTIVE: The purpose of this study was to better understand occupational therapists' experiences of making a difference in parent-child relationships. METHOD: In this qualitative, instrumental case study, occupational therapists working in early intervention were asked to reflect on and describe occasions in which they believed that they made a real difference in parent-child relationships. The primary investigator interviewed nine experienced pediatric occupational therapists. RESULTS: All nine therapists highly valued the parent-child relationship and focused on these relationships in therapy. Eight themes emerged that described the therapists' practice insights and methods by which the therapists facilitated the parent-child relationship. CONCLUSION: The occupational therapists in this study reflected insights that resonate with the literature regarding the role of the parent-child relationship in the development of children. The authors raise the question about the adequacy of instruction at the pre-service level that prepares therapists to both assess and facilitate the parent-child relationship in early intervention.