Rehabilitation and Therapy Commons^™

Occupational Therapy Students’ Perceptions Of Their Experience In A Role-Emerging Level Ii Fieldwork Within Higher Education Student Services, Marie-Christine Potvin, Alexis Morales, Erin West, Mika Kalimi, Jeanne M Coviello

Department of Occupational Therapy Faculty Papers

BACKGROUND: Role-emerging settings - those where occupational therapy (OT) services have not traditionally been provided - are common sites for practice placements of entry-level occupational therapy students. A growing body of literature has attempted to determine the value and drawbacks of such practice placements on the professional preparedness of OT students with mixed findings. Benefits have been identified, including increased cultural understanding, advocacy, creativity, initiative, and problem-solving skills. However, OT students have been reported to perceive such placement as limiting their professional growth and preparedness to practice compared to traditional placements.

METHODS: A phenomenological study was conducted seeking the perceptions …

Examining The Latent Structure And Correlates Of Sensory Reactivity In Autism: A Multi-Site Integrative Data Analysis By The Autism Sensory Research Consortium, Zachary J. Williams, Roseann Schaaf, Karla K. Ausderau, Grace T. Baranek, D. Jonah Barrett, Carissa J. Cascio, Rachel L. Dumont, Ekomobong E. Eyoh, Michelle D. Failla, Jacob I. Feldman, Jennifer H. Foss-Feig, Heather L. Green, Shulamite A. Green, Jason L. He, Elizabeth A. Kaplan-Kahn, Bahar Keçeli-Kaysılı, Keren Maclennan, Zoe Mailloux, Elysa J. Marco, Lisa E. Mash, Elizabeth P. Mckernan, Sophie Molholm, Stewart H. Mostofsky, Nicolaas A.J. Puts, Caroline E. Robertson, Natalie Russo, Nicole Shea, John Sideris, James S. Sutcliffe, Teresa Tavassoli, Mark T. Wallace, Ericka L. Wodka, Tiffany G. Woynaroski

Department of Occupational Therapy Faculty Papers

BACKGROUND: Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these "supra-modal" traits in the autistic population.

METHODS: Leveraging a combined sample of 3868 autistic youth drawn from 12 distinct data sources (ages 3-18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to …

Evaluating Non-Pharmacological Approaches To Nursing Home Dementia Care: A Protocol, Natalie E Leland, Victoria Shier, Catherine V. Piersol, Cara Lekovitch, Jenny Martínez, Yuna H Bae-Shaaw, Neeraj Sood, Claire Day, Paul Cass, Dominique Como, Carin Wong, Felicia Chew

Department of Occupational Therapy Faculty Papers

BACKGROUND: The COVID-19 pandemic has underscored the daily challenges nursing home (NH) staff face caring for the residents living with Alzheimer's Disease and Related Dementias (

METHODS: This clustered randomized trial will compare

CONCLUSION: This trial will be the first-ever evaluation of team- and problem-based approaches to ADRD care across multiple NHs and geographic regions. Results can provide health system leaders and policymakers with evidence on how to optimize ADRD training for staff in an effort to enhance ADRD care delivery.

A Working Taxonomy For Describing The Sensory Differences Of Autism, Jason L He, Zachary J Williams, Ashley Harris, Helen Powell, Roseann C. Schaaf, Teresa Tavassoli, Nicolaas A J Puts

Department of Occupational Therapy Faculty Papers

Background: Individuals on the autism spectrum have been long described to process sensory information differently than neurotypical individuals. While much effort has been leveraged towards characterizing and investigating the neurobiology underlying the sensory differences of autism, there has been a notable lack of consistency in the terms being used to describe the nature of those differences.

Main body: We argue that inconsistent and interchangeable terminology-use when describing the sensory differences of autism has become problematic beyond mere pedantry and inconvenience. We begin by highlighting popular terms that are currently being used to describe the sensory differences of autism (e.g. "sensitivity", …

Coaching In Context Model (Version 4), Marie-Christine Potvin, Maryjane Mulcahey, Nicole Gerhardt

Department of Occupational Therapy Faculty Papers

Coaching in Context (CinC) is a conversation-based approach intended to foster clients’ goal attainment through coach-facilitated self-discovery of insights and solutions. Anchored in positive psychology, CinC situates clients as resourceful experts, and builds upon clients’ strengths to promote awareness and insights about factors that potentially impact their goals, and to strengthen problem-solving skills. CinC conversations are contextualized within lived environments including tasks demands and life roles. CinC intends to operationalize and organize professional coaching competencies into a model that health, rehabilitation, education, and human service professionals can embed into their practice.

The CinC model was developed and published in four …

Cost-Benefit Analysis Of The Cope Program For Persons Living With Dementia: Toward A Payment Model, Laura T Pizzi, Eric Jutkowitz, Katherine M Prioli, Ember Yiwei Lu, Zachary Babcock, Heather Mcabee-Sevick, Dorothy B Wakefield, Julie Robison, Sheila Molony, Catherine V. Piersol, Laura N Gitlin, Richard H Fortinsky

Department of Occupational Therapy Faculty Papers

Background and objectives: There is a critical need for effective interventions to support quality of life for persons living with dementia and their caregivers. Growing evidence supports nonpharmacologic programs that provide care management, disease education, skills training, and support. This cost-benefit analysis examined whether the Care of Persons with Dementia in their Environments (COPE) program achieves cost savings when incorporated into Connecticut's home- and community-based services (HCBS), which are state- and Medicaid-funded.

Research design and methods: Findings are based on a pragmatic trial where persons living with dementia and their caregiver dyads were randomly assigned to COPE with HCBS, or …

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 …

Bilateral Upper Extremity Motor Priming (Bump) Plus Task-Specific Training For Severe, Chronic Upper Limb Hemiparesis: Study Protocol For A Randomized Clinical Trial, Mary Ellen Stoykov, Olivia M Biller, Alexandra Wax, Erin King, Jacob M Schauer, Louis F Fogg, Daniel M Corcos

Department of Occupational Therapy Faculty Papers

BACKGROUND: Various priming techniques to enhance neuroplasticity have been examined in stroke rehabilitation research. Most priming techniques are costly and approved only for research. Here, we describe a priming technique that is cost-effective and has potential to significantly change clinical practice. Bilateral motor priming uses the Exsurgo priming device (Exsurgo Rehabilitation, Auckland, NZ) so that the less affected limb drives the more affected limb in bilateral symmetrical wrist flexion and extension. The aim of this study is to determine the effects of a 5-week protocol of bilateral motor priming in combination with task-specific training on motor impairment of the affected …

Response: Commentary: Evaluating Sensory Integration/Sensory Processing Treatment: Issues And Analysis, Sarah A Schoen, Roseann C. Schaaf, Zoe Mailloux, Anita Bundy, Shelly Lane, Teresa A May-Benson, L Diane Parham, Susanne Smith Roley

Department of Occupational Therapy Faculty Papers

No abstract provided.

Faculty Perspectives On Interprofessional Collaborations Between Occupational Therapy And Industrial Design: A Qualitative Ethnographic Inquiry, Kimberly S. Mollo, Madalyn Peterson, Rebecca Brown

Department of Occupational Therapy Faculty Papers

Incorporating a user-centred approach to universal design solutions improves functionality and access for a more diverse group of individuals to engage with end products within everyday environments successfully. Interprofessional collaborations between industrial design and occupational therapy are one approach that integrates a user-centred universal design perspective throughout the design process, as occupational therapists have unique expertise in understanding how individuals participate in activities and engage with everyday products and environments. This qualitative ethnographic inquiry explored faculty perspectives (n=5) involved in interprofessional academic collaborations between design and occupational therapy at the university level in the Northeastern United States. Five themes emerged: …

Robotic Table And Serious Games For Integrative Rehabilitation In The Early Poststroke Phase: Two Case Reports, Grigore Burdea, Nam Kim, Kevin Polistico, Ashwin Kadaru, Namrata Grampurohit, Jasdeep Hundal, Simcha Pollack

Department of Occupational Therapy Faculty Papers

Background: BrightArm Compact is a new rehabilitation system for the upper extremities. It provides bimanual training with gradated gravity loading and mediates interactions with cognitively challenging serious games.

Objective: The aim of this study is to design and test a robotic rehabilitation table-based virtual rehabilitation system for functional impact of the integrative training in the early poststroke phase.

Methods: A new robotic rehabilitation table, controllers, and adaptive games were developed. The 2 participants underwent 12 experimental sessions in addition to the standard of care. Standardized measures of upper extremity function (primary outcome), depression, and cognition were administered before and after …

Development, Preliminary Validation, And Reliability Of The Notetaking Abilities And Strategies Of University Students (Nasus) Questionnaire, Monique Chabot, Marie-Christine Potvin, Richard Hass, Abigail Garrity, Anne Bower

Department of Occupational Therapy Faculty Papers

With the increased use of technology in the classroom, notetaking methods have expanded. Current notetaking assessments for university students no longer reflect the options available or do not provide a comprehensive measurement of student preferences, skills, and perceptions of usefulness of notes. The Notetaking Abilities and Strategies of University Students (NASUS) questionnaire was created to address this gap in notetaking assessments while also examining university student preferences, perception of skills, desire to improve notetaking skills and methods of taking notes in class. The purpose of this study was to examine the psychometric properties of the NASUS questionnaire, specifically, content validity, …

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 …

Effects Of The Tailored Activity Program (Tap) On Dementia-Related Symptoms, Health Events And Caregiver Wellbeing: A Randomized Controlled Trial, Laura N Gitlin, Katherine Marx, Catherine V. Piersol, Nancy A Hodgson, Jin Huang, David L Roth, Constantine Lyketsos

Department of Occupational Therapy Faculty Papers

BACKGROUND: People living with dementia (PLWD) and caregivers are adversely impacted by lack of meaningful activity leading to worse symptoms and impaired quality-of-life. There is a critical need to develop effective and well-tolerated treatments that mitigate clinical symptoms, engage PLWD and support caregiver wellbeing. We tested whether, compared to attention control, the Tailored Activity Program (TAP) reduced clinical symptoms and health-related events, and improved caregiver wellbeing, and if TAP activities were well-tolerated.

METHODS: We conducted a single-blind randomized controlled trial among 250 dyads recruited from Baltimore-Washington DC (2012-2016) with a dementia diagnosis and clinically significant agitation/aggression. Dyads were randomized to …

Coaching In Context, M.-C. Potvin, M. J. Mulcahey, N. Gerhardt

Department of Occupational Therapy Faculty Papers

Coaching in Context (CinC) is a conversation-based approach intended to foster clients’ goal attainment through coach-facilitated self-discovery of insights and solutions. Anchored in positive psychology, Coaching in Context situates clients as resourceful experts, and builds upon clients’ strengths to promote awareness and insights about factors that potentially impact their goals, and to strengthen problem-solving skills that are solution-focused. CinC conversations are contextualized by lived environments and requirements for competent and satisfying life roles.

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 …

Down Syndrome And Dementia:: A Patient And Care-Giver Centered Approach, Mary M. Stephens, E. Adel Herge, Charmaine Wright

Department of Occupational Therapy Faculty Papers

No abstract provided.

Insights From An Inaugural Eight-Month Interprofessional Collaborative Co-Design Educational Experience Between Occupational Therapy And Industrial Design, Rebecca Brown, Kimberly S. Mollo, Madalyn Peterson, Mikael Avery, Eric Schneider, Tod Corlett

Department of Occupational Therapy Faculty Papers

The design of the built environment greatly impacts how all types of individuals and populations actively participate in their daily lives. Lack of access in the built environment for disabled populations remains a daily reality, negatively impacting engagement and life satisfaction, leading to isolation, loneliness, and depression. A university in the Northeastern United States sought to expand current constructs of the end-user and environment within a universal design (UD) perspective. On an eight-month inaugural interprofessional collaborative co-design experience, third-year occupational therapy doctoral (OTD) students were embedded in a first-year masters of industrial design (MSID) curriculum, which ran the course of …

Highlighting Gaps In Spinal Cord Injury Research In Activity-Based Interventions For The Upper Extremity: A Scoping Review., Namrata Grampurohit, Alison Bell, Susan Duff, M. J. Mulcahey, Christina Calhoun Thielen, Gary Kaplan, Ralph J. Marino

Department of Occupational Therapy Faculty Papers

BACKGROUND: Upper extremity activity-based therapy for neurologic disorders employs high-intensity, high repetition functional training to exploit neuroplasticity and improve function. Research focused on high-intensity upper extremity activity-based therapy for persons with spinal cord injury (SCI) is limited.

OBJECTIVE: To summarize high-intensity activity-based interventions used in neurological disorders for their current or potential application to SCI.

METHODS: The scoping review included articles from MEDLINE, CINAHL, Cochrane CENTRAL, and OTseeker with the criteria: non-invasive activity-based interventions delivered atleast three times/week for two weeks, upper extremity functional outcomes, 13 years or older, English language, and neurological disorders three months post onset/injury.

RESULTS: The …

Self-Efficacy Of Professionalism: Online Modules To Improve Implementation On Level Ii Fieldwork, Leigh Leonard, Otd, Ms, Otr/L

Department of Occupational Therapy Faculty Papers

Professionalism is a fundamental component of occupational therapy. The American Occupational Therapy Association (AOTA) has many official documents that reference professionalism including the Occupational Therapy Code of Ethics, Standards for Continuing Competence, Standards of Practice for Occupational Therapy, and the Occupational Therapy Practice Framework: Domain and Process, 4th ed. There are high professional expectations of occupational therapy students, however, the definition of professional behaviors varies among fieldwork educators, faculty, and occupational therapy students. The literature revealed four themes of professionalism that were consistent across all stakeholders. Online education has increasingly become the norm for many programs and there is strong …

Experience Of Stigma Post Incarceration: A Qualitative Study, Rebecca Sinko, Tina M. Deangelis, Bernadette Alpajora, Josephine Beker, Ilyse Kramer

Department of Occupational Therapy Faculty Papers

Background: Minimal attention has been given to the perspectives and experiences of individuals post incarceration regarding stigma and its impact on reintegration and occupational engagement. This research aimed to understand how stigma is experienced among individuals who were formerly incarcerated and its influence on occupational engagement, specifically social participation, work, and school occupations. This research also examined the role of occupational therapy as an intervention in addressing stigma from the perspectives of individuals who were formerly incarcerated to inform practice and mitigate the influence of stigma. Method: Interviews were conducted with 10 participants of a work rehabilitation program for people …

Sensory Based Interventions In The School Setting: P Entions In The School Setting: Perspectives Of Paraeducators, Lyn Kaiser, Marie-Christine Potvin, Caitlin Beach

Department of Occupational Therapy Faculty Papers

Background: The purpose of this study was to explore paraeducators’ perceptions of sensory-based interventions (SBIs). Paraeducators are frequently responsible for implementing SBIs to enhance a student’s ability to learn in school. Previous studies have explored the perceptions of teachers and occupational therapists, but as of yet, there are no published studies exploring the perceptions of paraeducators regarding the efficacy of SBIs.

Methods: An ethnographic study was conducted with paraeducators (n = 11) working with students diagnosed with autism spectrum disorder or emotional disturbance in a center-based special education program. These paraeducators participated in a focus group or an interview that …

A Randomized Feasibility Trial Of A Novel, Integrative, And Intensive Virtual Rehabilitation Program For Service Members Post-Acquired Brain Injury., Kiara H Buccellato, Michelle Nordstrom, Justin M Murphy, Grigore C Burdea, Kevin Polistico, Gregory House, Nam Kim, Namrata Grampurohit, Jeff Sorensen, Brad M Isaacson, Paul F Pasquina

Department of Occupational Therapy Faculty Papers

INTRODUCTION: Acquired Brain Injury, whether resulting from Traumatic brain injury (TBI) or Cerebral Vascular Accident (CVA), represent major health concerns for the Department of Defense and the nation. TBI has been referred to as the "signature" injury of recent U.S. military conflicts in Iraq and Afghanistan - affecting approximately 380,000 service members from 2000 to 2017; whereas CVA has been estimated to effect 795,000 individuals each year in the United States. TBI and CVA often present with similar motor, cognitive, and emotional deficits; therefore the treatment interventions for both often overlap. The Defense Health Agency and Veterans Health Administration would …

Appendix 10: Neurotechnology Descriptions, Namrata Grampurohit, Phd, Otr/L

Department of Occupational Therapy Faculty Papers

Neurotechnologies Covered:

• Electrical stimulation over the surface of the arm or hand
• Electrical stimulation over the surface of the spine
• Electrical stimulation over the surface of the head
• Magnetic stimulation over the surface of the head
• Braces that are powered to amplify movements
• Brain computer interface with a cap
• Baclofen pump

Effect Of Verbal Directions On Grip Strength Evaluated Using The Handheld Dynamometer, Laura Walsh, Otd, Otr/L, Cht, Marie-Christine Potvin, Phd, Otr/L

Department of Occupational Therapy Faculty Papers

Background: Grip strength measurement using the handheld dynamometer is a key aspect of the evaluation of an upper extremity injury. The handheld dynamometer manufacturer has established research-based guidelines outlining body positioning during grip strength measurement. However, verbal direction guidelines, while provided, have not yet been shown to be most effective through research. This study seeks to determine whether the use of one of two types of verbal directions, with and without encouragements, resulted in greater grip strength as measured by the handheld dynamometer.

Method: The grip strength of healthy females (n = 60) was compared using two sets of prerecorded …

Neural Foundations Of Ayres Sensory Integration, Shelly J. Lane, Zoe Mailloux, Sarah Schoen, Anita Bundy, Teresa A. May-Benson, L. Diane Parham, Susanne Smith Roley, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

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 …

Occupational Therapy Programming Facilitates Goal Attainment In A Community Work Rehabilitation Setting, Tina M. Deangelis, Kimberly Mollo, Carolyn Giordano, Michaela Scotten, Brianna Fecondo

Department of Occupational Therapy Faculty Papers

An occupational therapy program for participants with mental health challenges, a history of serious mental illness, recovering from substance use disorders, on parole/probation, and/or experiencing homelessness was implemented in a community work rehabilitation setting. The impact of occupational therapy interventions focused on stress and anger management, sleep hygiene, anxiety and depression management, relapse prevention for addiction, vocational and academic skill building, money management, healthy eating, and relationship and leisure skill development. Participant satisfaction and performance scores regarding individual goal setting and attainment was collected and analyzed via retrospective review of pre/post outcome scores (n = 44) obtained through the Canadian …

Immersive Virtual Reality For The Management Of Pain In Community-Dwelling Older Adults., Sara Benham, Minhee Kang, Namrata Grampurohit

Department of Occupational Therapy Faculty Papers

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 …

A Systematic Review Of Ayres Sensory Integration Intervention For Children With Autism., Sarah A. Schoen, Shelly J. Lane, Zoe Mailloux, Teresa May-Benson, L. Dianne Parham, Susanne Smith Roley, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

Sensory integration is one of the most highly utilized interventions in autism, however, a lack of consensus exists regarding its evidence base. An increasing number of studies are investigating the effectiveness of this approach. This study used the Council for Exceptional Children (CEC) Standards for Evidence-based Practices in Special Education to evaluate the effectiveness research from 2006 to 2017 on Ayres Sensory Integration (ASI) intervention for children with autism. A systematic review was conducted in three stages. Stage 1 involved an extensive database search for relevant studies using search terms related to sensory integration and autism, interventions suggesting a sensory …

Implementation Of An Evidence-Based Intervention To Improve The Wellbeing Of People With Dementia And Their Carers: Study Protocol For 'Care Of People With Dementia In Their Environments (Cope)' In The Australian Context., Lindy Clemson, Kate Laver, Yun-Hee Jeon, Tracy A. Comans, Justin Scanlan, Miia Rahja, Jennifer Culph, Lee-Fay Low, Sally Day, Monica Cations, Maria Crotty, Susan Kurrle, Catherine V. Piersol, Laura N Gitlin

Department of Occupational Therapy Faculty Papers

BACKGROUND: There are effective non-pharmacological treatment programs that reduce functional disability and changed behaviours in people with dementia. However, these programs (such as the Care of People with dementia in their Environments (COPE) program) are not widely available. The primary aim of this study is to determine the strategies and processes that enable the COPE program to be implemented into existing dementia care services in Australia.

METHODS: This study uses a mixed methods approach to test an implementation strategy. The COPE intervention (up to ten consultations with an occupational therapist and up to two consultations with a nurse) will be …