Medicine and Health Sciences Commons^™

Notes From An Epicenter: Navigating Behavioral Clinical Trials On Autism Spectrum Disorder Amid The Covid-19 Pandemic In The Bronx, Alaina S Berruti, Roseann C Schaaf, Emily A Jones, Elizabeth Ridgway, Rachel L. Dumont, Benjamin E Leiby, Catherine Sancimino, Misung Yi, Sophie Molholm

Department of Occupational Therapy Faculty Papers

Background: The COVID-19 pandemic impacted nearly all facets of our daily lives, and clinical research was no exception. Here, we discuss the impact of the pandemic on our ongoing, three-arm randomized controlled trial (RCT) Sensory Integration Therapy (SIT) in Autism: Mechanisms and Effectiveness (NCT02536365), which investigates the immediate and sustained utility of SIT to strengthen functional daily-living skills and minimize the presence of maladaptive sensory behaviors in autistic children.

Main text: In this text, we detail how we navigated the unique challenges that the pandemic brought forth between the years 2020 and 2021, including the need to rapidly …

Choosing Performance-Based Outcome Measures Of Daily Living Skills And Socialization For Clinical Trials In Autistic Children, Roseann C Schaaf, Amy Carroll, Elizabeth Conte Waskie, Rachel L Dumont, Elizabeth Ridgway

Department of Occupational Therapy Faculty Papers

IMPORTANCE: Robust and psychometrically sound performance-based outcome measures are needed for clinical trials of occupational therapy interventions for children with autism.

OBJECTIVE: To demonstrate a systematic approach for choosing psychometrically sound performance-based outcome measures of daily living skills and socialization for use in clinical trials of occupational therapy interventions for children with autism.

DESIGN: Rapid literature review to identify appropriate measures for studies with this population followed by quality indicator ratings and a nominal group process.

SETTING: University.

PARTICIPANTS: Four experts in autism and pediatric outcome measurement. Outcomes and Measures: Twenty-one outcome measures of daily living skills and socialization were …

Looking For Consistency In An Uncertain World: Test-Retest Reliability Of Neurophysiological And Behavioral Readouts In Autism., Shlomit Beker, John J Foxe, John Venticinque, Juliana Bates, Elizabeth M Ridgeway, Roseann C Schaaf, Sophie Molholm

Department of Occupational Therapy Faculty Papers

BACKGROUND: Autism spectrum disorders (ASD) are associated with altered sensory processing and perception. Scalp recordings of electrical brain activity time-locked to sensory events (event-related potentials; ERPs) provide precise information on the time-course of related altered neural activity, and can be used to model the cortical loci of the underlying neural networks. Establishing the test-retest reliability of these sensory brain responses in ASD is critical to their use as biomarkers of neural dysfunction in this population.

METHODS: EEG and behavioral data were acquired from 33 children diagnosed with ASD aged 6-9.4 years old, while they performed a child-friendly task at two …

Differential Item Functioning In The Patient Reported Outcomes Measurement Information System Pediatric Short Forms In A Sample Of Children And Adolescents With Cerebral Palsy., Wendy J. Coster, Pengsheng Ni, Mary D. Slavin, Pamela A. Kisala, Ratna Nandakumar, Mary Jane Mulcahey, David S. Tulsky, Alan M. Jette

Department of Occupational Therapy Faculty Papers

AIM: The present study examined the Patient Reported Outcomes Measurement Information System (PROMIS) Mobility, Fatigue, and Pain Interference Short Forms (SFs) in children and adolescents with cerebral palsy (CP) for the presence of differential item functioning (DIF) relative to the original calibration sample.

METHOD: Using the Graded Response Model we compared item parameter estimates generated from a sample of 303 children and adolescents with CP (175 males, 128 females; mean age 15y 5mo) to parameter estimates from the PROMIS calibration sample, which served as the reference group. DIF was assessed in a two-step process using the item response theory-likelihood ratio-differential …

Computerized Adaptive Tests Detect Change Following Orthopaedic Surgery In Youth With Cerebral Palsy., M J Mulcahey, Mary D Slavin, Pengsheng Ni, Lawrence C Vogel, Scott H Kozin, Stephen M Haley, Alan M Jette

Department of Occupational Therapy Faculty Papers

BACKGROUND: The Cerebral Palsy Computerized Adaptive Test (CP-CAT) is a parent-reported outcomes instrument for measuring lower and upper-extremity function, activity, and global health across impairment levels and a broad age range of children with cerebral palsy (CP). This study was performed to examine whether the Lower Extremity/Mobility (LE) CP-CAT detects change in mobility following orthopaedic surgery in children with CP.

METHODS: This multicenter, longitudinal study involved administration of the LE CP-CAT, the Pediatric Outcomes Data Collection Instrument (PODCI) Transfer/Mobility and Sports/Physical Functioning domains, and the Timed "Up & Go" test (TUG) before and after elective orthopaedic surgery in a convenience …

Cross-Cultural Comparison Of Sensory Behaviors In Children With Autism., Kristina G Caron, Roseann C Schaaf, Teal W. Benevides, Eynat Gal

Department of Occupational Therapy Faculty Papers

Parents of children with autism frequently report that their children exhibit unusual responses to sensory experiences. Little research is available, however, describing how parents' and children's culture and environment might influence parents' reports of their children's behaviors. This study compared the frequency of parent-reported responses to sensory experiences in children from two countries-Israel and the United States. We administered the Short Sensory Profile to primary caregivers of children with autism spectrum disorders (ASD) and typically developing peers. Results indicate that Israeli parents reported unusual responses to sensory experiences less frequently than U.S. parents for both ASD and typically developing children. …

Emerging As Leaders In Autism Research And Practice: Using The Data-Driven Intervention Process., Roseann C Schaaf, Erna Imperatore Blanche

Department of Occupational Therapy Faculty Papers

No abstract provided.

Identifying Strategies Early Intervention Occupational Therapists Use To Teach Caregivers., Jessica L. Colyvas, L Brook Sawyer, Philippa H. Campbell

Department of Occupational Therapy Faculty Papers

This study investigated early intervention occupational therapists' use of strategies to teach caregivers. A sample of 40 videotapes made by early intervention occupational therapists was randomly selected from an archival videotape data set of provider home visits. The sample included 20 videotapes illustrating traditional services and 20 videotapes illustrating therapists providing participation-based services. Videotapes were rated using the Teaching Caregivers Scale, which rates three variables on 30-s intervals: (1) routine, (2) provider role, and (3) strategies used to teach caregivers during early intervention home visits. Regardless of the model of service, explicit teaching strategies were rarely used during home visits.

Examining The Neuroscience Evidence For Sensory-Driven Neuroplasticity: Implications For Sensory-Based Occupational Therapy For Children And Adolescents., Shelly J. Lane, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

When Ayres first presented the theory of sensory integration (SI), she grounded it in the neuroscience literature. Neuroplasticity was then, and is today, considered to be at the heart of this theory. This evidence-based review sought to critically examine the basic science literature to specifically identify evidence for the assumptions and tenets of Ayres' theory of SI. We reviewed literature between 1964 and 2005, within psychological, physiological, and biomedical areas, addressing neuroplasticity. The review focused on sensorimotor-based neuroplasticity; explored the data that addressed the links among sensory input, brain function, and behavior; and evaluated its relevance in terms of supporting …

Evolution Of The Sensory Integration Frame Of Reference., Roseann C. Schaaf, Patricia L. Davies

Department of Occupational Therapy Faculty Papers

No abstract provided.

Occupational Therapy Using A Sensory Integrative Approach: A Case Study Of Effectiveness., Roseann C. Schaaf, Kathleen Mckeon Nightlinger

Department of Occupational Therapy Faculty Papers

OBJECTIVE: This article presents a case report of a child with poor sensory processing and describes the disorders impact on the child's occupational behavior and the changes in occupational performance during 10 months of occupational therapy using a sensory integrative approach (OT-SI).

METHOD: Retrospective chart review of assessment data and analysis of parent interview data are reviewed. Progress toward goals and objectives is measured using goal attainment scaling. Themes from parent interview regarding past and present occupational challenges are presented.

RESULTS: Notable improvements in occupational performance are noted on goal attainment scales, and these are consistent with improvements in behavior. …

Lessons Learned: A Pilot Study On Occupational Therapy Effectiveness For Children With Sensory Modulation Disorder., Lucy Jane Miller, Sarah A. Schoen, Katherine James, Roseann C Schaaf

Department of Occupational Therapy Faculty Papers

OBJECTIVE: The purpose of this pilot study was to prepare for a randomized controlled study of the effectiveness of occupational therapy using a sensory integration approach (OT-SI) with children who have sensory processing disorders (SPD).

METHOD: A one-group pretest, posttest design with 30 children was completed with a subset of children with SPD, those with sensory modulation disorder.

RESULTS: Lessons learned relate to (a) identifying a homogeneous sample with quantifiable inclusion criteria, (b) developing an intervention manual for study replication and a fidelity to treatment measure, (c) determining which outcomes are sensitive to change and relate to parents' priorities, and …

Goal Attainment Scaling As A Measure Of Meaningful Outcomes For Children With Sensory Integration Disorders., Zoe Mailloux, Teresa A. May-Benson, Clare A. Summers, Lucy Jane Miller, Barbara Brett-Green, Janice P. Burke, Ellen S. Cohn, Jane A. Koomar, L Diane Parham, Susanne Smith Roley, Roseann C. Schaaf, Sarah A. Schoen

Department of Occupational Therapy Faculty Papers

Goal attainment scaling (GAS) is a methodology that shows promise for application to intervention effectiveness research and program evaluation in occupational therapy (Dreiling & Bundy, 2003; King et al., 1999; Lannin, 2003; Mitchell & Cusick, 1998). This article identifies the recent and current applications of GAS to occupational therapy for children with sensory integration dysfunction, as well as the process, usefulness, and problems of application of the GAS methodology to this population. The advantages and disadvantages of using GAS in single-site and multisite research with this population is explored, as well as the potential solutions and future programs that will …

Children With Disturbances In Sensory Processing: A Pilot Study Examining The Role Of The Parasympathetic Nervous System., Roseann C. Schaaf, Lucy Jane Miller, Duncan Seawell, Shannon O'Keefe

Department of Occupational Therapy Faculty Papers

This study was a preliminary investigation of parasympathetic nervous system (PNS) functioning in children with disturbances in sensory processing. The specific aims of this study were to (1) provide preliminary data about group differences in parasympathetic functions, as measured by the vagal tone index, between children with disturbances in sensory processing and those without; (2) determine effect size and power needed for future studies; and (3) to lay the foundation for further examination of the relations of parasympathetic functioning and functional behavior in children with disturbances in sensory processing. Participants were 15 children, nine with disturbances in sensory processing and …

Play Behavior And Occupational Therapy., Roseann C Schaaf

Department of Occupational Therapy Faculty Papers

The effectiveness of treatment methods on a person's ability to carry out occupational roles competently is of interest to occupational therapists. This case study demonstrated how play, as an occupational role of childhood and as a measure of competence, can be used to evaluate the effectiveness of occupational therapy that uses a sensory integrative approach. The positive changes in C.C.'s play behavior support the basic philosophy of sensory integration, which states that an increase in sensory integrative functions will improve competence (in this study, competence is defined as play), that is, that a person will have the ability to carry …

Occupational Therapy In Early Intervention: A Family-Centered Approach., Roseann C. Schaaf, L L. Mulrooney

Department of Occupational Therapy Faculty Papers

This article describes a framework for occupational therapy service provision in early intervention settings and presents pilot data aimed at examining the framework's effectiveness. The Family-Centered Framework for Early Intervention is a synthesis of concepts from the Model of Human Occupation (Kielhofner & Burke, 1980) and from the literature on play. It encompasses a systematic, holistic approach that considers the child and the family within the context of their life environments. In this framework, play is used both as an evaluative tool and as an intervention modality that addresses the volition, habituation, and performance of the child and family as …

The Frequency Of Vestibular Disorders In Developmentally Delayed Preschoolers With Otitis Media., Roseann C Schaaf

Department of Occupational Therapy Faculty Papers

This study investigated the frequency of vestibular disorders in developmentally disabled preschoolers who did and who did not have a history of otitis media. Fifteen children with a history of otitis media and fifteen children with no history of otitis media were given two tests for vestibular functioning: the Southern California Postrotary Nystagmus Test (SCPNT) and the Lateral Labyrinthine Righting Reaction (LLRR), acting on the head. The scores on these tests were dichotomized, and a correlation between these two tests as measures of vestibular function was obtained. Because this correlation did not reach a satisfactory level, two a satisfactory level, …