Occupational Therapy Practice: Time From Stroke Onset to Outpatient Upper Limb Rehabilitation.

Upper limb stroke rehabilitation has been understudied in usual occupational therapy. The study's purpose was to describe the timing and amount of usual occupational therapy in the stroke population for hospital-based outpatient upper limb rehabilitation. A multi-site study of timing and amount of occupational therapy was calculated for mild and moderate upper limb stroke impairments using the Fugl-Meyer Assessment-Upper Extremity (FMA-UE). Mild stroke participants (n = 58) had a mean of 164.25 days, and the moderate stroke participants (n = 64) had a mean of 106.75 days from the date of stroke onset to first treatment which was significantly different (p = .047). There were no significant differences in the amount of therapy between mild or moderate stroke patients. Mild stroke patients experience a longer delay in receiving outpatient occupational therapy compared with moderate impairments which may be attributed to the subtlety of the impairments that impact participation in daily activities.

Mobile device accessibility with 3D printed devices for individuals with physical disabilities.

PURPOSE: Disparities may disproportionately exist for those with disabilities when using mobile devices, which are critical for independence in activities such as socialization and leisure. Prior 3D printing studies in rehabilitation have not focused on mobile device access to everyday preferred activities. METHODS: This study examined user satisfaction, self-rated performance and satisfaction with daily activities while using the mobile device, and the feasibility of customized 3D printed assistive devices. The design was a one-group, quantitative pre-test to post-test study of individuals (n = 10) residing in long-term care with a physical disability due to a neurological condition. RESULTS: Satisfaction with the 3D printed device, as compared to the previously used assistive device, was significantly higher (p = 0.005), as well as improvements in self-rated daily activity performance (p = 0.016) and satisfaction (p = 0.037), with acceptability and satisfaction of the intervention. CONCLUSIONS: Findings suggest that 3D printing is feasible with a potential increase in user satisfaction through a customization process that is client centred.

Recommendations for settings interested in providing customized 3D printed assistive devices, and for future studies, include client centred integration and educational support on mobile device usage during activities, familiarity with common customization and modification requests, and adjusting timelines to the facility's service delivery capacity.

Acoustic and Kinematic Methods of Indexing Spatiotemporal Stability in Children With Developmental Language Disorder.

PURPOSE: The spatiotemporal index (STI) is a standard metric for quantifying the stability and patterning of speech movements. The STI has often been applied to individual speech articulators, but an STI derived from the acoustic signal offers a composite and easily obtained measure that incorporates multiple components of the speech production complex. In this work, we examine the relationship between kinematic and acoustic STIs in children with and without developmental language disorder (DLD), with the aim of determining whether the acoustic and kinematic STIs reflect similar degrees of production variability. METHOD: A total of 85 children with DLD and with typical language development (or typically developing [TD] children), aged 4-8 years, were studied. In this methodological article, two experiments were conducted: one deliberately selected because group differences were observed in the kinematic STI (i.e., sentence production) and one in which there were no group differences in the kinematic STI (i.e., nonword production). These two experiments are representative of speech stability studies. The aim was to determine whether the acoustic STI (i.e., amplitude envelope) results aligned with those obtained via the kinematic STI (i.e., lip motion). RESULTS: In sentence production, most group differences aligned across kinematic and acoustic STI measures. The acoustic, but not the kinematic, STI showed higher variability in children with DLD compared with the 6-year-old TD group. In nonword production, neither the kinematic STI nor the acoustic STI differentiated children with DLD from TD children. In each experiment, the kinematic and acoustic STIs showed a moderate-to-strong correlation. CONCLUSIONS: The kinematic and acoustic STIs assess different components of speech movement patterning. However, the relationship between acoustic and kinematic spatiotemporal stability is strong in two tasks of varying linguistic complexity in children with and without DLD. These findings are promising for future experimental work in this area.

A Mindfulness Program Addressing Sleep Quality and Stress: Transition to a Telehealth Format for Higher Education Students During COVID-19.

Many higher education students report sleep problems, further exemplified along with stress at the onset of the COVID-19 pandemic. Promising evidence supports the use of mindfulness programming, although synchronous telehealth sessions have not been adequately examined. This exploratory eight-session telehealth mindfulness program utilized a pretest-posttest quantitative design to examine changes in sleep quality and perceived stress for 16 higher education students enrolled at a health professions-focused university. Sleep quality changes were measured using the Pittsburgh Sleep Quality Index (Z=-3.234, p=0.0012, d=-0.808) and perceived stress with the Perceived Stress Scale (Z=-3.102, p=0.0019, d=-0.776), both of which were significant. The results suggest that synchronous mindfulness programming delivered via telehealth has the potential to improve sleep quality and perceived stress in students, however, future studies should consider the use of objective measurements of sleep duration and quality, and a control group.

A longitudinal study of the phonological organisation of novel word forms in children with developmental language disorder.

Purpose: Deficits in the production of novel words, such as in nonword repetition tasks, are one of the early hallmarks of developmental language disorder (DLD). In children with DLD, the production of novel nonwords is characterised by speech sound inaccuracy. The focus of the present study is on the stable organisation of phonological sequences. Specifically, we aimed to identify the persistence of deficits in accuracy and in variability in sound sequencing in novel word production from pre-school to the early school years.Method: Children with and without DLD produced a set of six nonwords 12 times each, initially collected when children were 4- to 5-years old. Children repeated this task over the course of two years. Analyses included phonetic accuracy as well as network science indices of sound sequence organisation.Result: Children with DLD were less accurate than their peers with typical language at each timepoint, and their productions were markedly variable, as revealed by network science metrics; these children never converged with their peers with typical language.Conclusion: The findings suggest a unique deficit in phonological sequence production that persists beyond the pre-school years. These results offer new theoretical and clinical insights into mechanisms that underlie deficits in novel word form learning.

Comparative population genetics of Amblyomma maculatum and Amblyomma americanum in the mid-Atlantic United States.

The Gulf Coast tick, Amblyomma maculatum, is undergoing a northward expansion along the United States East Coast, most recently establishing populations in Virginia, Maryland, and Delaware. This expansion has human health implications, as A. maculatum is the primary natural vector of the bacterium Rickettsia parkeri, which causes a spotted fever-type rickettsiosis. Newly established populations of A. maculatum in Virginia tend to have high prevalence of R. parkeri, compared to lower infection rates in the historical range. The factors contributing to high R. parkeri prevalence in Virginia are not known. Investigating connectivity between sites colonized with A. maculatum can help determine whether sites with higher prevalence are isolated or well-connected through migration, thus serving as a source of infected individuals. We characterized 16S rRNA haplotypes of A. maculatum and, for comparison, the congeneric Amblyomma americanum collected from sites where these species co-occur. We then explored connectivity and genetic structure among Virginia populations using pairwise ΦST and AMOVA analyses. Our study identified one recently restored native grassland site with low A. maculatum haplotype diversity and strong evidence of a founder effect, whereas most sites are haplotypically diverse but with no clear genetic structure or connectivity between sites. These findings contrast with high connectivity and a slight mainland/island structure among A. americanum populations. Our results suggest that A. maculatum populations occasionally arise following long-distance drop-offs of few individual ticks in suitable habitat, but no clear migration patterns were observed. The distinct population genetic patterns between species might result from differences in host utilization.

Lexical-Semantic Cues Induce Sound Pattern Stability in Children With Developmental Language Disorder.

Purpose When learning novel word forms, preschoolers with developmental language disorder (DLD; also known as specific language impairment) produce speech targets inaccurately and with a high degree of intraword variability. The aim of the current study is to specify whether and how layering lexical-semantic information onto novel phonological strings would induce increased organization of sound production patterns. Method Twenty-one preschoolers with DLD and 21 peers with typical language (ranging in age from 4;1 to 5;11 [years;months]) imitated multiple renditions of novel words, half with (i.e., words) and half without (i.e., nonwords) a linked visual referent. Methods from network science were used to assess the stability and patterning of syllable sequences. Sound accuracy was also measured. Results Children with DLD were less accurate and more variable than their typical peers. However, once word forms were associated with a visual referent, network stability, but not accuracy, improved for children with DLD. Conclusions Children with DLD showed significant word form deficits as they acquired novel words and nonwords. The inclusion of a meaningful referent resulted in increased sound sequence stability, suggesting that lexical-semantic information provides a bootstrap for phonological organization in children with DLD.

Student Technology Acceptance of 3D Printing in Occupational Therapy Education.

IMPORTANCE: Reports on the integration of 3D printing in occupational therapy education and changes in student acceptance of technology over time are lacking. OBJECTIVE: 3D printing technology applications may offer effective solutions to increase client participation in occupations. However, the use of these applications in occupational therapy practice requires attention to occupational therapy students' perception of the technology's usefulness and ease of use. Students' perception of technology potentially influences their perceptions of technology use in future practice. DESIGN: This was an exploratory one-group, pretest-posttest, repeated-measures study over 12 wk to examine whether an assignment that integrated 3D printing improved students' perceptions of technology acceptance. The study used a modified questionnaire based on the Technology Acceptance Model (TAM). SETTING: Academic educational institution. PARTICIPANTS: Second-year entry-level occupational therapy students (N = 58). RESULTS: Paired t tests showed significant differences for all categories of the TAM questionnaire, including perceived usefulness (p = .001), perceived ease of use (p < .001), attitude toward using (p = .014), and intention to use (p < .001). CONCLUSION: The experiential learning assignment increased students' acceptance of 3D printing technology; however, future studies should include an exploration of clients' acceptance and perception of technology. WHAT THIS ARTICLE ADDS: This study provides evidence for the use of instructional strategies for "maker" technologies by educators when integrating experiential and interactive approaches.

Immersive Virtual Reality for the Management of Pain in Community-Dwelling Older Adults.

Immersive virtual reality (VR) can provide a high level of engagement and distraction analgesia to address pain. However, community-based applications of this technology for older adults have not been studied. The objective of this study was to examine the applicability and effectiveness of an immersive VR intervention for pain, depression, and quality of life (QOL) in older adults. This pretest-posttest, mixed-methods design included senior center members ( n = 12) with pain that interfered with daily functioning. The outcomes included the Numeric Pain Rating Scale, Patient-Reported Outcomes Measurement Information System (PROMIS®) depression scale, World Health Organization Quality of Life Scale Brief Version (WHO QOL-BREF), and open-ended questions. The VR intervention (15- to 45-min sessions, 12 sessions over 6 weeks) was well accepted with no dropouts. There was a significant decrease in pain ( p = .002, d = -1.54) with no effect on depression and QOL. There were no adverse effects, and positive perceptions of VR were reported. The 6-week immersive VR intervention was applicable and effective in reducing pain intensity for community-dwelling older adults.

An Application of Network Science to Phonological Sequence Learning in Children With Developmental Language Disorder.

Purpose: Network science has been a valuable tool in language research for investigating relationships between complex linguistic elements but has not yet been applied to sound sequencing in production. In the present work, we used standard error-based accuracy and articulatory kinematic approaches as well as novel measures from network science to evaluate variability and sequencing errors in speech production in children with developmental language disorder (DLD; aka specific language impairment). Method: Twelve preschoolers with DLD and 12 age-matched controls participated in a 3-day novel word learning study. Transcription and articulatory movement data were collected to measure accuracy and variability of productions, and networks of speech productions were generated to analyze syllable co-occurrence patterns. Results: Results indicated that children with DLD were less accurate than children with typical language at the segmental level. Crucially, these findings did not align with performance at the articulatory level, where there were no differences in movement variability between children with DLD and those with typical language. Network analyses revealed characteristics that were not captured by standard measures of phonetic accuracy, including a larger inventory of syllable forms, more connections between the forms, and less consistent production patterns. Conclusions: Network science provides significant insights into phonological learning trajectories in children with DLD and their typically developing peers. Importantly, errors in word production by children with DLD do not surface as a result of weakness in articulatory control. Instead, results suggest that speech errors in DLD may relate to deficits in sound sequencing.

Exploration of the Effects of Telerehabilitation in a School-Based Setting for At-Risk Youth.

This study explored the efficacy and feasibility of a motion-capture program that may be utilized for telerehabilitation purposes. Two children attending a school for at-risk children received 20 sessions of Timocco, with sessions lasting for 30 minutes, under the guidance of research assistants. The researchers employed a mixed methods design to analyze quantitative data and qualitative interviews. Both children improved their fine and gross motor coordination, as measured on the Bruininks-Oseretsky Test of Motor Proficiency Short Form. To explore feasibly, qualitative verbal reports of the child participants and research assistants were obtained. The children and research assistants reported positive experiences with the utilization of this platform. A collaborative, consultative telerehabilitation model may be a promising delivery mode of services for improving motor skills in children, with frequent input from the child, aide or teacher, and clinician. Further exploration is needed for telerehabilitative service delivery for at-risk children.