Occupational Therapy Commons^™

Cracking The Code: The Systematic Development Of A Coding Matrix For Qualitative Data Analysis, Greta Gray, Marie-Christine Potvin

Department of Occupational Therapy Faculty Papers

A systematic approach was used to develop a coding matrix for a qualitative study with the intent to strengthen the credibility and dependability of the findings. Coding matrixes are commonly used in qualitative studies to organize data into meaningful units of text to be interpreted by the researchers. Current methods of coding matrix development can be problematic as they may introduce biases in the results and have limited reproducibility. A novel approach was employed to address this need with the “a priori” development of a coding matrix using a multi-step deductive and inductive process with multi-coders (n=5).  The coders who …

Patterns Recognized In Ayres Sensory Integration®: A Scoping Review, Marica Botha, Janine Van Der Linde, Zoe Mailloux

Department of Occupational Therapy Faculty Papers

Background/Objectives: Associations between scores on tests of sensory integration functions demonstrated in numerous studies over six decades have contributed to the development of Ayres Sensory Integration® (ASI) theory and practice. Understanding these "patterns" aids therapists in their interpretation of assessment results, ensuring appropriate and effective intervention. This study aimed to describe and discuss published research on identified patterns related to constructs in the Ayres Sensory Integration® approach. Methods: Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist were used. The literature review search was guided by the following …

Plans4care, A Web Application Providing Caregivers Personalized Solutions To Manage Dementia-Related Care Challenges: Proof Of Concept And Efficacy Trial, Laura N. Gitlin, Eric Jutkowitz, Catherine V. Piersol, Sokha Koeuth, Taylor Sivori, Melinda J. Webster, Rachel N. Barnett, David L. Roth

Department of Occupational Therapy Faculty Papers

OBJECTIVE: Few dementia caregivers have access to evidence-based support programs. Web applications (app) may address this gap. Plans4Care, a web app, provides caregivers with on-demand personalized solutions to address care challenges. We present results of a proof-of-concept study and describe a trial protocol to test efficacy.

METHODS: To use Plans4Care, caregivers respond to brief onboarding questions, assess dementia patients' cognitive function, identify care challenges, and generate "action plans" (personalized strategies). Telehealth sessions with dementia-trained care advisors are available. A proof-of-concept study evaluated a clickable prototype using standardized technology scales to determine if >75 % scored positively on four criteria (acceptability, …

A Cascading Effects Model Of Early Sensory Development In Autism, Natalie Russo, Carissa J. Cascio, Grace T. Baranek, Tiffany G. Woynaroski, Zachary J. Williams, Shulamite A. Green, Roseann Schaaf

Department of Occupational Therapy Faculty Papers

Autism has historically been defined by the presence of differences in social communication and restricted, repetitive patterns of behavior, interests, or activities (RRBs). Since 2013 when the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders was published, sensory features were added as one of the polythetic restricted and repetitive behavior diagnostic criteria of autism, though it has remained understudied. Here, we summarize theory and research to provide support for the perspective that early sensory functions and experiences play a primary role in autism and have downstream effects on social communication and repetitive behavioral features of autism. The …

Training To Move An Evidence-Based Dementia Caregiver Support Program Into Practice: A Pragmatic, Randomized, Non-Inferiority Trial Protocol, Nancy A. Hodgson, Miranda V. Mcphillips, Karen B. Hirschman, Emily Summerhayes, Catherine Verrier Piersol, Laura N. Gitlin

Department of Occupational Therapy Faculty Papers

Background

Objective

Using The 5ms Framework To Advance Aging-Responsive Care For Heart Failure With Reduced Ejection Fraction, Abigail Latimer, Debra K. Moser, Jia-Rong Wu, Kim K. Birtcher, Malachy J. Clancy, Jennifer D. Portz, Joanna Paladino, Daniel D. Matlock, Christopher E. Knoepke

Department of Occupational Therapy Faculty Papers

Complexity of care is the inevitable consequence of an aging population and is particularly true in instances where patients are managing chronic conditions such as heart failure with reduced ejection fraction (HFrEF). HFrEF itself is complex, with an undulating course of illness, increased risk of sudden cardiac death, and myriad accompanying treatment considerations. Generalist management of HFrEF among older patients is further complicated by competing comorbidities, potential for financial toxicity, potential for mental health symptoms, and risk of care with does not align with goals and preferences. The 5Ms (multicomplexity, mind, mobility, medications, and matters most) is a holistic conceptualization …

Generative Artificial Intelligence In Education: Insights From Rehabilitation Sciences Students, Robert Dekerlegand, Alison Bell, Malachy Clancy, Erin Pletcher, Travis Pollen

Department of Occupational Therapy Faculty Papers

Little is known about how students in rehabilitation sciences accept and use generative artificial intelligence (GenAI) in their educational endeavors. We explored student perceptions, acceptance, and utilization of GenAI in school and their beliefs about its usefulness and ease of use. A cross-sectional online survey was conducted of adult students enrolled in rehabilitation sciences programs within a private urban academic university. The survey was based on the Technology Acceptance Model with questions specific to the use of GenAI in school. A total of 196 responses were included in the analysis (32.9% response rate), with responses received across all rehabilitation sciences …

Nursing Home Staff Perspectives Of The Benefits And Challenges Of Providing Dementia Care, Carin M. Wong, Dominique H. Como, Cara Lekovitch, Felicia Chew, Natalie E. Leland

Department of Occupational Therapy Faculty Papers

OBJECTIVES: To capture nursing home staff perspectives on the benefits and challenges related to caring for residents living with Alzheimer disease and other related dementias. These perspectives will inform the initial development of strategies to help with staff retention.

DESIGN: A secondary qualitative analysis of semistructured interviews conducted with nursing home staff, which was embedded within a pragmatic clinical trial.

SETTING AND PARTICIPANTS: Purposive sampling was used to capture perspectives of staff spanning across job roles from 23 nursing homes.

METHODS: During the parent study primary analysis, staff experiences providing dementia care were consistently described. In response, this study completed …

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 …

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 …

Outcomes Of The Nurosleeve And Occupational Ther E And Occupational Therapy On Upper Y On Upper Limb Function Of An Individual With Chronic Hemiparesis Following A Stroke: A Case Report, Nicole M. Gerhardt, Jeremy P. Armstrong, Mijail D. Serruya, Mj Mulcahey

Department of Occupational Therapy Faculty Papers

Background: Upper limb neuromuscular impairments can adversely impact function. This case report investigates the process and outcomes of occupational therapy (OT) for training in the use of the NuroSleeve, a novel research-grade exoskeletal powered orthosis, with a participant with chronic right hemiparesis following a stroke.

Method: The participant engaged in 24 OT sessions using the NuroSleeve over 10 weeks. Therapeutic interventions included neuromuscular reeducation, device management, and engagement in occupationbased activities with training to use the NuroSleeve. The Canadian Occupational Performance Measure (COPM), ABILHAND, Patient Reported Outcomes Measurement Information System Upper Extremity Short Form 7a (PROMIS UE SF), Action Research …

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", …

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 …

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 …

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 …