Occupational Therapy Commons^™

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 …

Perceptions About Authentic Leadership Development: South African Occupational Therapy Students' Camp Experience, Fatima Hendricks, Susan Toth-Cohen

Department of Occupational Therapy Faculty Papers

Background. Twenty-three years into democracy, concern is deepening regarding the slow progress of Occupational Therapy (OT) in South Africa, especially with regard to diversity and inclusion within OT. Methods. This study explores authentic leadership development primarily among Black OT students attending a pilot Occupational Therapy Association of South Africa (OTASA) National Student Leadership Camp. It seeks to ascertain their perceptions on leadership and leadership development. This descriptive pilot study employs in-depth interviews and subsequent content analysis, with 12 OT students from six university OT programs in South Africa. Findings. Four categories of participant perceptions on authentic leadership development emerged from …

Outcomes Of An Evidence-Based, Data Driven-Model Fieldwork Experience For Occupational Therapy Students, Amy P. Carroll, E. Adel Herge, Lindsay Johnson, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

Over the past decade, there has been an increased emphasis on evidence-based practice (EBP) and the use of outcome measurement in clinical practice, however, the implementation of evidence into practice remains challenging and irregular. During fieldwork, students often experience a disconnect between the emphasis on EBP in the classroom and lack of use in the clinic. Recognizing the need to develop high-quality, evidence-based and data-driven models of practice for student training, we partnered with local fieldwork educators to develop an innovative program that guides students and simultaneously trains fieldwork educators (FWE) in the use of a systematic data driven decision …

Promoting Environments That Measure Outcomes: Partnerships For Change, Roseann C. Schaaf, Amy P. Carroll, Susan Toth-Cohen, Janice P. Burke, Caryn Johnson, E. Adel Herge

Department of Occupational Therapy Faculty Papers

This paper describes the development of the PrEMO^© (Promoting Environments that Measure Outcomes) program. PrEMO^© is an innovative model promoting evidence-based practice (EBP) while developing capacity and quality of Level II fieldwork placements. The PrEMO^© program is described from initiation to completion, including development of site-specific learning objectives, the twelve week schedule and the role of faculty mentorship. Occupational therapy (OT) students, and university OT program faculty including academic fieldwork coordinators, partner with fieldwork educators at the site to implement EBP using a data-driven decision making (DDDM) process to guide the development of evidence-based practices. PrEMO^{© …}

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 …

The Teaching Self-Reflection Tool And Skills Checklist, Arlene Lorch, Otd, Otr/L, Ches

Department of Occupational Therapy Faculty Papers

OBJECTIVE.

To provide occupational therapy faculty with a collaborative system to review and improve teaching skills within the educational program.

METHOD.

Six faculty members completed a self-assessment using self-reflection tools and feedback from an interview with a fellow faculty member serving as consultant. Surveys evaluated perceptions of the experience.

RESULTS.

Survey responses indicated strong approval of the peer review process as a valuable method for faculty development. Results identified aspects of the process that needed revision, specifically, the burden of time required to complete the process.

CONCLUSION.

Findings support the need for a peer review process because it benefits faculty, …

An Intervention For Sensory Difficulties In Children With Autism: A Randomized Trial., Roseann C Schaaf, Teal W. Benevides, Zoe Mailloux, Patricia Faller, Joanne Hunt, Elke Van Hooydonk, Regina Freeman, Benjamin E Leiby, Jocelyn Sendecki, Donna Kelly

Department of Occupational Therapy Faculty Papers

This study evaluated a manualized intervention for sensory difficulties for children with autism, ages 4-8 years, using a randomized trial design. Diagnosis of autism was confirmed using gold standard measures. Results show that the children in the treatment group (n = 17) who received 30 sessions of the occupational therapy intervention scored significantly higher (p = 0.003, d = 1.2) on Goal Attainment Scales (primary outcome), and also scored significantly better on measures of caregiver assistance in self-care (p = 0.008 d = 0.9) and socialization (p = 0.04, d = 0.7) than the Usual Care control group (n = …

Evidence-Based Practice In Occupational Therapy Curricula., Tina Angelis, Edd, Otr/L, Thomas G Dimarco, Susan Toth-Cohen, Edd, Otr/L

Department of Occupational Therapy Faculty Papers

The purpose of this study is to describe currently used educational strategies for teaching evidence-based practice (EBP) in entry-level master's degree occupational therapy programs in the United States. Fifty-eight entry-level occupational therapy program directors completed a survey. Results showed that occupational therapy programs consistently use a wide variety of EBP resources for teaching EBP including database searches, literature reviews, and the development of a research proposal. Less commonly used strategies include the use of case stories and journal clubs. The current study provides a baseline of existing strategies taught in entry level programs that may be built upon to gather …

Early Intervention Provider Use Of Child Caregiver-Teaching Strategies, Philippa Campbell, Phd, Catherine Ehret-Coletti, Ms

Department of Occupational Therapy Faculty Papers

Most current early intervention approaches emphasize the importance of a provider role as teacher or coach, a role in which providers give parents or other caregivers information about how to optimize children’s growth and development (Stremel & Campbell, 2007). However, few studies have examined the information that should be provided for caregivers or how this information is best delivered to caregivers although a number of rating scales are able to distinguish between roles of direct service provider for the child (e.g., traditional) and triadic interaction among provider, caregiver, and child (Campbell & Sawyer, 2007; Salisbury & Cushing, 2013). Related factors …

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.

How Do We Change Practice When We Have The Evidence?, Janice P Burke, Laura N. Gitlin

Department of Occupational Therapy Faculty Papers

Translating research findings into practice includes myriad pragmatic realities, including understanding the suitability of the data to a particular patient group, writing new guidelines for occupational therapy practitioners, facilitating adoption of the guidelines, and instituting new patterns of care for patients. The process is more than a matter of disseminating the information to practitioners and expecting immediate change in patient treatment. Indeed, the field of implementation science is devoted to the identification of the numerous barriers and supports that constrain or expedite practice change in response to research. Moving forward and adopting evidence-based findings will require a focused understanding of …

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. …

Occupational Therapy And Sensory Integration For Children With Autism: A Feasibility, Safety, Acceptability And Fidelity Study., Roseann C Schaaf, Teal W. Benevides, Donna Kelly, Zoe Mailloux-Maggio

Department of Occupational Therapy Faculty Papers

Objective: To examine the feasibility, safety, and acceptability of a manualized protocol of occupational therapy using sensory integration principles for children with autism. Methods: Ten children diagnosed with autism spectrum disorder ages 4-8 years received intensive occupational therapy intervention using sensory integration principles following a manualized protocol. Measures of feasibility, acceptability and safety were collected from parents and interveners, and fidelity was measured using a valid and reliable fidelity instrument. Results: The intervention is safe and feasible to implement, acceptable to parents and therapist, and therapists were able to implement protocol with adequate fidelity. These data provide support for implementation …

Use Of Robotics In Spinal Cord Injury: A Case Report., Lori Siedziewski, Roseann C. Schaaf, Julie Mount

Department of Occupational Therapy Faculty Papers

OBJECTIVE: We examined the use of robotics to treat upper-extremity (UE) dysfunction in tetraplegic patients with spinal cord injury (SCI).

METHOD: a 51-yr-old man with incomplete SCI participated in an occupational therapy program that combined traditional occupational therapy with Reo Go®, a comprehensive therapy platform that includes a robotic guide featuring a telescopic arm to enable high repetitions of functionally relevant UE exercises.

RESULTS: The participant demonstrated measurable improvements in active range of motion, muscle strength as measured through manual muscle testing, perceived right UE function, and self-care performance as measured by the FIM™.

CONCLUSION: The findings from this case …

Development Of A Fidelity Measure For Research On The Effectiveness Of The Ayres Sensory Integration Intervention., L Diane Parham, Susanne Smith Roley, Teresa A. May-Benson, Jane Koomar, Barbara Brett-Green, Janice P Burke, Ellen S. Cohn, Zoe Mailloux, Lucy J. Miller, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

OBJECTIVE: We developed a reliable and valid fidelity measure for use in research on Ayres Sensory Integration (ASI) intervention.

METHOD: We designed a fidelity instrument to measure structural and process aspects of ASI intervention. Because scoring of process involves subjectivity, we conducted a series of reliability and validity studies on the process section. Raters were trained to score therapist strategies observed in video recordings of adult-child dyads. We examined content validity through expert ratings.

RESULTS: Reliability of the process section was strong for total fidelity score (ICC = .99, Cronbach's alpha = .99) and acceptable for most items. Total score …

What's Going On Here? Deconstructing The Interactive Encounter., Janice P Burke

Department of Occupational Therapy Faculty Papers

Eleanor Clarke Sagle Lecture

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.

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

Department of Occupational Therapy Faculty Papers

No abstract provided.

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 …

Parasympathetic Functions In Children With Sensory Processing Disorder., Roseann C. Schaaf, Teal W. Benevides, Erna Imperatore Blanche, Barbara A. Brett-Green, Janice P. Burke, Ellen S. Cohn, Jane Koomar, Shelly J. Lane, Lucy Jane Miller, Teresa A. May-Benson, Diane Parham, Stacey Reynolds, Sarah A. Schoen

Department of Occupational Therapy Faculty Papers

The overall goal of this study was to determine if parasympathetic nervous system (PsNS) activity is a significant biomarker of sensory processing difficulties in children. Several studies have demonstrated that PsNS activity is an important regulator of reactivity in children, and thus, it is of interest to study whether PsNS activity is related to sensory reactivity in children who have a type of condition associated with sensory processing disorders termed sensory modulation dysfunction (SMD). If so, this will have important implications for understanding the mechanisms underlying sensory processing problems of children and for developing intervention strategies to address them. The …

Development And Evaluation Of Health And Wellness Exhibits At The Jefferson Occupational Therapy Education Center In Second Life, Susan Toth-Cohen, Therese Gallagher

Department of Occupational Therapy Faculty Papers

Virtual worlds such as Second Life are increasingly used for consumer health and higher education. The present paper will describe the development and evaluation of public exhibits on health and wellness at the Jefferson occupational therapy education center in Second Life.

Making The Muve To Virtual Education, Kevin Jarrett, Caren Levine, Marianne Malmstrom, Fil Santiago, Susan Toth-Cohen

Department of Occupational Therapy Faculty Papers

Second Life, a 3D multi-user virtual environment (MUVE), is becoming an increasingly popular topic at educational technology conferences and in the media these days. What’s all the fuss about?

Using Cultural-Historical Activity To Study Clinical Reasoning In Context, Susan Toth-Cohen

Department of Occupational Therapy Faculty Papers

The aim of this paper is to describe sources of conflict and congruence in critical areas of practice with caregivers of persons with dementia, using cultural-historical activity theory as an analytic framework. Findings are drawn from an ethnographic study that described the context of occupational therapists’ (OTs’) clinical reasoning in a funded, home-based environmental skill-building program designed to help caregivers manage the daily care of a family member with dementia. Data were gathered through observation of intervention sessions, debriefing sessions, semi-structured interviews with therapists, and review of intervention documentation. Primary sources of conflict and congruence within the identified practice context …

Adaptation Interventions To Promote Participation In Natural Settings, Philippa H. Campbell, Ph.D, Suzanne Milbourne, M.S, M. Jeanne Wilcox, Ph.D.

Department of Occupational Therapy Faculty Papers

Children's participation in everyday activities and routines in home and community settings is an important focus of services for infants and young children with disabilities. Data indicate that assistive technology (AT) is not widely used nor do early intervention service providers report frequent use of AT devices with infant-toddlers. Adaptation interventions combine environmental accommodations and AT in ways that promote children's participation in activities and routines and provide functional skill-building learning opportunities. A decision-making process for planning and implementing adaptation interventions is outlined with examples of strategies and formats that service providers can use to create successful interventions for infants …