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Introduction/objectives: Companion animals (CAs) may benefit human health, but few studies have examined their impact on stroke survivors. This study examines participation, quality of life (QoL), attachment, cognition, and executive function differences between stroke survivors living with and without CAs., Methods: In this cross-sectional, community-setting study, 25 stroke survivors with a CA and a matched group of 27 without a CA completed standard tools., Results: Stroke survivors with a CA scored significantly higher in participation and 1 cognitive performance test. No significant differences were found in other cognitive measures or QoL, and attachment to a CA was not correlated with participation or QoL within the research group. However, lower attachment avoidance correlated with better participation in survivors living with dogs., Conclusion: Living with CAs, especially dogs, might be associated with some cognitive function and participation benefits among stroke survivors. The link between CAs and cognitive function is unclear: Survivors with higher cognitive functioning might be more capable of caring for a CA, or having and caring for a CA might promote better cognitive function. Attachment patterns also might explain stroke survivors' participation levels. Further study is warranted., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Daily Living Questionnaire (DLQ) constitutes one of a number of functional cognitive measures, commonly employed in a range of medical and rehabilitation settings. One of the drawbacks of the DLQ is its length which poses an obstacle to conducting efficient and widespread screening of the public and which incurs inaccuracies due to the length and fatigue of the subjects., Objective: This study aims to use Machine Learning (ML) to modify and abridge the DLQ without compromising its fidelity and accuracy., Method: Participants were interviewed in two separate research studies conducted in the United States of America and Israel, and one unified file was created for ML analysis. An ML-based Computerized Adaptive Testing (ML-CAT) algorithm was applied to the DLQ database to create an adaptive testing instrument-with a shortened test form adapted to individual test scores., Results: The ML-CAT approach was shown to reduce the number of tests required on average by 25% per individual when predicting each of the seven DLQ output scores independently and reduce by over 50% when predicting all seven scores concurrently using a single model. These results maintained an accuracy of 95% (5% error) across subject scores. The study pinpoints which DLQ items are more informative in predicting DLQ scores., Conclusions: Applying the ML-CAT model can thus serve to modify, refine and even abridge the current DLQ, thereby enabling wider community screening while also enhancing clinical and research utility., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

This preliminary study aims to demonstrate the reliability and validity of the adapted Do-Eat Basic activities of daily living (BADL) assessment for children with autism spectrum disorder (ASD). Participants were 53 children ages 6-10 years: 17 diagnosed with high-severity ASD (HS-ASD) and 16 with low-severity ASD according to the DSM-5 and based on the CARS-2, and 20 controls with typical development. Measurement tools were the adapted Do-Eat Washy (Washy), Participation in Childhood Occupations Questionnaire (PICO-Q), and Pediatric Evaluation of Disability Inventory (PEDI). The Washy domains exhibited high internal consistency (α = 0.841-0.856). Significant differences were found between the HS-ASD and other groups in the Washy domains, exhibiting discriminant validity. The Washy convergent and concurrent validity indicated good results. A highly substantial negative correlation was shown between the Washy and three PICO-Q ADL difficulty-in-performance items ( p < 0.001): bathing (-0.550), hygiene (-0.571), and handwashing (-0.733). The Washy performance scores and the PEDI total score demonstrated a strong correlation. ( r = 0.799, p < 0.001). Primary results indicate that, following further research on larger representative samples, the Washy may be a reliable and valid tool for assessing BADL among children with ASD.

Background: People with Parkinson's disease (PwP) may experience gait impairment and freezing of gait (FOG), a major cause of falls. External cueing, including visual (e.g., spaced lines on the floor) and auditory (e.g., rhythmic metronome beats) stimuli, are considered effective in alleviating mobility deficits and FOG. Currently, there is a need for a technology that delivers automatic, individually adjusted cues in the homes of PwP. The aims of this feasibility study were to describe the first step toward the development of a home-based technology that delivers external cues, test its effect on gait, and assess user experience., Methods: Iterative system development was performed by our multidisciplinary team. The system was designed to deliver visual and auditory cues: light stripes projected on the floor and metronome beats, separately. Initial testing was performed using the feedback of five healthy elderly individuals on the cues' clarity (clear visibility of the light stripes and the sound of metronome beats) and discomfort experienced. A pilot study was subsequently conducted in the homes of 15 PwP with daily FOG. We measured participants' walking under three conditions: baseline (with no cues), walking with light stripes, and walking to metronome beats. Outcome measures included step length and step time. User experience was also captured in semi-structured interviews., Results: Repeated-measures ANOVA of gait assessment in PwP revealed that light stripes significantly improved step length (p = 0.009) and step time (p = 0.019) of PwP. No significant changes were measured in the metronome condition. PwP reported that both cueing modalities improved their gait, confidence, and stability. Most PwP did not report any discomfort in either modality and expressed a desire to have such a technology in their homes. The metronome was preferred by the majority of participants., Conclusions: This feasibility study demonstrated the usability and potential effect of a novel cueing technology on gait, and represents an important first step toward the development of a technology aimed to prevent FOG by delivering individually adjusted cues automatically. A further full-scale study is needed. Trial registration This study was registered in ClinicalTrials.gov at 1/2/2022 NCT05211687., (© 2023. The Author(s).)

Background: Literature explains participation limitations among people with schizophrenia through the context of metacognitive limitations, specifically in symptoms and in executive functions (EF). Research has shown mixed results regarding associations between symptoms and participation, reporting association with negative symptoms, positive symptoms, or only metacognitive limitations. The aim of this study was to deepen understanding of the symptoms' impact on the association between participation and executive function among people with schizophrenia., Methods: Forty-three participants with schizophrenia received 8 group sessions of focused metacognitive intervention (MCG) aimed at promoting participation by focusing on EF components (e.g., analyzing individual cognitive strategy use). Three measures were administered: the Positive and Negative Syndrome Scale (PANSS) to evaluate symptoms, the Weekly Calendar Planning Assessment (WCPA) to assess EF, and the Activity Card Sort (ACS) to measure participation at the baseline and 12 weeks following completion of the intervention. Scores were compared to a matched control group of 41 people with schizophrenia who instead received treatment as usual. The role of PANSS as moderator was examined using multiple hierarchical regressions, entering interactions between the PANSS scores and WCPA change scores in the final regression step., Results: Relationships were not significant for participants with high PANSS scores. A positive relationship existed between change in WCPA and change in ACS for participants with low PANSS scores., Conclusions: These results demonstrate that low PANSS scores moderate the association between EF and participation and highlight the importance of symptoms as a predictor of participation following the MCG intervention., Trial Registration: The trial was retrospectively registered at clinical., Trial: gov., Clinicaltrials: gov Identifier: NCT05556941. Clinicaltrial.gov registration date: 27/09/2022., (© 2023. The Author(s).)

Introduction/objectives: The COVID-19 pandemic has long-term implications for adult health and function, whether or not people were infected with the disease. Although cognitive disruptions are among the major symptoms of COVID-19, most research focused on managing medical symptoms, such as respiratory symptoms or pain. Thus, less is known about the pandemic's long-term implications for assessing functional cognition. This study aimed to examine COVID-19's effects on community-dwelling adults' functional cognition and health, comparing gender differences., Methods: This cross-sectional study divided 118 community-dwelling adults (25 previously infected with COVID-19) into gender groups. Primary outcome measures included the Daily Living Questionnaire (DLQ) and short form health status survey, SF-12., Results: No significant differences were found in functional cognition or health between participants who had contracted COVID-19 and those who remained healthy, but men had better functional cognition and health measures in comparison with women., Conclusions: Gender differences in functional cognition and health state may relate to gender-based family roles. It is essential to assess functional cognition of young adults who were exposed to a pandemic, such as COVID-19, because it may significantly affect their health and functional status. The DLQ is a reliable, valid assessment of functional cognition that may suit individuals who previously contracted COVID-19., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Individuals with severe mental illnesses (SMI) often have difficulty performing daily activities that require intact executive functions, such as grocery shopping. Performance-based evaluations are valuable but lack the subjects' viewpoints during task performance. This study aims to combine performance-based observation and cognitive science methods to provide insights regarding real-life behavior and problem-solving in populations with SMI. In this correlational-research study, 42 participants (10 in the SMI group and 32 in the control group) performed the Test of Grocery Shopping Skills (TOGSS) while wearing an eye-tracking device. We hypothesized that patterns in task planning, task-time use, and attention allocation to written information relevant to the task would differ between the groups during the task. The results showed between-group differences in both TOGSS efficiency outcomes (time and redundancy), duration, and number of fixations. An eye-tracking pattern analysis determined between-group differences in scanning patterns of the grocery list but similarities in task planning. The selection process was found to be significantly more accurate and efficient for the control group than for the SMI group. Our findings suggest that a combination of perspectives allows us to better understand the behavior of SMI individuals in a regular daily task.

Personal computers, tablets, and smartphones may support older adults' engagement when people are required to stay home and opportunities to engage in meaningful activities are reduced during the COVID-19 period. This study aims to screen older adults' technology-use characteristics across social, leisure, and education domains during the COVID-19 pandemic from a crosscultural viewpoint. The sample included 576 participants aged 60 and older from France ( n  = 62), Spain ( n  = 110), and Israel ( n  = 404). Participants completed the technology-use survey, which consists of questions about their facilities, technology usability, need for adaptations to support technology use, and changes in technology use since COVID-19. Significant differences were found between countries in facilities, χ 2 (2) = 25.16, p  < .001, and usability, χ 2 (2) = 64.14, p  < .001, across the three domains. Furthermore, 34% of technological usability was predicted by country and facilities, F (4, 568) = 72.39, p < .001. Participants noted a willingness to use technology if it was adapted for social (61%-73%), leisure (51%-71%), or educational (67%-76%) activities and that they devoted substantially more time to technology across domains (>58%) due to COVID-19. These findings highlight culture and facilities as factors that play an imperative role in supporting and enhancing the usability of technology among older adults., (© 2022 Published by Elsevier Ltd.)

Background: Cognition affects poststroke recovery, but meta-analyses of cognition have not yet provided a comparison of observational and intervention evidence., Objective: To describe the trajectory of poststroke cognition and the factors that moderate it across intervention and observational cohorts., Methods: Six databases were searched up to January 2020. Studies describing quantitative changes in cognition in adults poststroke were included. Interventions were classified into pharmacological, therapist-led, nonroutine/alternative, and usual care. Summary estimates were compared via hierarchical mixed-effects models. Age, recovery stage, stroke etiology, cognitive domain targeted in studies, and intervention types were investigated as moderators of cognition. Recovery stage and intervention were further analyzed in a multiplicative metaregression model., Results: A total of 43 intervention trials and 79 observation cohorts involving 28 222 stroke participants were included. Heterogeneity was significant (τ 2 = 0.09; CI = 0.01-0.21, P < .001) with no evidence of publication bias. Cognitive recovery was greater in intervention trials ( g = 0.47; CI = 0.37-0.58) than observational cohorts ( g = 0.28; CI = 0.20-0.36) across all moderators analyzed. Nonroutine/alternative and pharmacological trials achieved the best overall results ( g = 0.57, CI = 0.42-0.73, and g = 0.52, CI = 0.30-0.74, respectively), followed by therapist-led ( g = 0.46; CI = 0.17-0.74), and usual care ( g = 0.28; CI = 0.11-0.45) interventions. Medium recovery effects (ie, g ≥ 0.5) were observed in examining first-ever stroke, executive function, visuo-perceptual, consciousness, and psychomotor skills, 61 to 180 days poststroke, in participants aged 65 to 70 years., Conclusion: Cognitive recovery is possible using different controlled interventions in all recovery stages, with smaller benefits ≥2 years poststroke. Longer-term studies are needed to determine the role of nonroutine/alternative therapies and the association between cognitive recovery and performance in everyday activities.

Adolescents with autism spectrum disorder show low independence levels and difficulty performing complex daily activities. The many intervention approaches for these individuals include deconstructing complex activities into basic components, processing and practicing tasks, and developing compensation strategies. The aim of this study was to examine the effectiveness of a short-term metacognitive intervention combined with virtual supermarket practice to improve the independent implementation of a shopping task among adolescents with autism spectrum disorder. The study included 56 adolescents with autism spectrum disorder, of whom 33 performed the metacognitive intervention and 23 served as controls. Outcome measures included assessments of cognitive and metacognitive functions and a performance-based evaluation of a shopping task in the natural environment. Compared to the control group, the intervention group experienced significant improvement in accuracy and efficiency while performing a shopping task. In addition, the executive functions domain was found to be the main predictor of accuracy and efficiency in performing the shopping task. These findings indicate the short-term metacognitive intervention, reinforced by a technology-based training programme, may effectively enhance the independent execution of a shopping task by adolescents with autism spectrum disorder and expand their potential participation in the community.

Adolescents with neurodevelopmental difficulties struggle to perform daily activities, reflecting the significant impact of executive functions on their participation. This research examines an integrated conceptual model wherein supportive environmental factors in the community, school and home settings explain the children's participation (involvement and frequency) with their daily activities performance as a mediator. Parents of 81 10- to 14-year-old adolescents with and without executive function deficit profiles completed the Participation and Environment Measure for Children and Youth and the Child Evaluation Checklist. A secondary analysis was conducted to examine the structural equation model using AMOS software. The results demonstrated support for the hypothesised model. Supportive environmental demands in school predicted 32% of home participation, and the adolescents' daily performance reflected that executive functions mediated the relationship between them. Together, these findings highlight the school environment as the primary contributor that affects the children's functioning according to their parents' reports and as a predictor of high participation at home in terms of frequency and involvement. This study has implications for multidisciplinary practitioners working with adolescents in general, and in the school setting specifically, to understand meaningful effects of executive functions on adolescents' daily functioning and to provide accurate assistance and intervention.

•Assessment tools have progressed from measuring specific components, to more comprehensive assessments.•Performance-based tools, has the potential to include an EF index as part of the test scoring.•Most researchers either chose short versions of the assessment tools to address the subjects' attentional capacities.•Using more than one evaluation method enabled to draw a more precise picture of the function., Competing Interests: The authors have no conflicts of interest to report., (© 2020 The Authors.)

Purpose: To characterize and analyze the performance of adolescents with executive function deficits through the Children's Cooking Task (CCT) as a performance-based complex ecological assessment., Methods: Participants were 41 adolescents (aged 10-14 years) with normal intellectual function and executive function deficit profiles based on the Behavior Rating Inventory of Executive Function (BRIEF) parent reports and self-reports (BRIEF-SR) and the WebNeuro and 40 controls with typical development matched by age and gender. Participants in both groups performed the CCT, an ecological standardized complex task., Results: Significant group differences were found for all CCT outcome measures (total number of errors, task duration, and all qualitative rating variables). Significant correlations were found among children with executive function deficit profiles between the CCT performance duration and total number of errors and the BRIEF-SR subscale score. Two separate discriminant function analyses described primarily by the CCT correctly classified the study groups., Conclusion: The poor performance of adolescents with executive function deficit profiles exhibited through the standardized complex task, as well as the relationships with their executive functions, supplies better insight about their daily confrontations. Identifying how they perform may lead to development of focused interventions to improve these adolescents' daily performance, participation, and wellbeing., Competing Interests: The authors report no conflict of interest., (Copyright © 2020 Yael Fogel et al.)

Introduction: Adolescents with autism spectrum disorder (ASD) show poor independence in daily activities. Unlike existing instruments, the innovative self-report Daily Routine and Autonomy questionnaire (DRA) addresses their level of and desire for independence in activities throughout a full daily routine. This study describes the DRA development, explores its psychometric properties and internal consistency reliability using full-information factor analysis (FIFA), and identifies levels of and desire for independence among adolescents with ASD., Methods: Seventy-two Israeli adolescents with ASD (58 boys and 14 girls) aged 11-19 years (M = 14.59, SD = 1.61) completed the DRA. Statistical analyses were performed using SPSS and R. Internal consistency reliability, FIFA, Spearman's correlations, t-tests, and Wilcoxon signed-rank were conducted to assess relationships and differences between the DRA parts., Results: The FIFA revealed three factors with high sum-of-squared loadings (4.09-5.13). Of the 31 DRA items, 28 had factor loadings higher than 0.35 and were retained in the study questionnaire. The DRA had moderate-to-high internal reliability for factors (α = 0.65-0.84) and total scores (α = 0.86-0.90). Participants showed partial independence in most daily activities, with high desire for independence in social and leisure activities. Significant gaps in half of the DRA items indicate the participants' desire for independence was significantly higher than their independence level., Conclusion: The DRA provides crucial information about levels of and desire for autonomy that can be used to promote participation of adolescents with ASD in setting their own goals for independent living., Competing Interests: Declaration of competing interest The Authors declares that there is no conflict of interest., (Copyright © 2020 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Background: Cognitive impairment affects up to 80 percent of the stroke population, however, both the available evidence about post-stroke cognition and the measures used to evaluate it longitudinally have not been well described. The aims of this systematic scoping review were: to identify and characterize studies evaluating cognition longitudinally after stroke; to summarize the cognitive instruments used and the domains they target; and to organize cognitive domains assessed using the International Classification of Functioning, Disability and Health (ICF)., Methods: We used a systematic scoping approach to search for peer-reviewed articles involving adults with stroke that evaluated cognition longitudinally. Screening of titles, abstracts, and full reports was completed independently by two reviewers, across six electronic databases (PubMed, PsycInfo, Medline, Cinahl Plus, Embase, and Web of Science). Cognitive domains were mapped to an ICF function independently by the same two reviewers, using a previously tested, standardized approach., Results: A total of 5,540 records were found; 257 were included, representing a total pooled sample of 120,860 stroke survivors. Of these studies, 200 (78%) provided specific cognitive outcomes from the longitudinal evaluations, 57 (22%) reported model predictions, and 77 (30%) included interventions. Cognition was evaluated with 356 unique instruments, targeting 95 distinct cognitive domains, and 17 mental functions from the ICF. The Mini-Mental State Examination was the most frequently used instrument (117 reports, 46%). Other tools used longitudinally were the Trail Making Test (17% of reports), tests of verbal fluency (14%), the Functional Independence Measure (14%), the Montreal Cognitive Assessment (13%), the Digit Span (11%), and the Stroop test (10%). Global cognition was evaluated in 170 reports (66%), followed by higher-level cognitive functioning (29%), memory (28%), language (21%), attention (21%), and perceptual skills (14%). Studies using functional (or performance-based) cognitive assessments over time were scarce (< 1%)., Conclusion: Our findings indicate that whilst there is a substantial number of studies available that report longitudinal evaluations of cognition after stroke, there is large variability in the measures used and the cognitive domains they target. Nonetheless, the available data for evaluation of cognition over time after stroke can be organized and described systematically., Competing Interests: The authors have declared that no competing interests exist.

Background: Family-centred care (FCC) is considered the best practice in paediatric care but it is not always implemented sufficiently. Effective training programmes that enhance health care providers' knowledge and self-efficacy have the potential to improve FCC implementation in their daily practice. The goal of the study was to evaluate the sensitivity of the measure of processes of care (MPOC)-service provider (MPOC-SP) version and MPOC confidence (MPOC-Con) in detecting changes following an FCC training., Methods: The MPOC-Con was developed for this study as a sequel to MPOC-SP to measure self-efficacy related to specific FCC practices. Twenty-four health care providers (occupational and physical therapists, speech pathologist, and special education teacher) participated in a 6-month FCC provider training. The training included 30 contact hours on FCC principles and techniques through experiential learning, reflective exercises, peer mentoring, and case-study analyses. The MPOC-SP and MPOC-Con were administered preparticipation and postparticipation., Results: Repeated multivariate analysis of variance and reliable change index (RCI) analyses indicated a significant group increase in performance and confidence following the training in two of the four MPOC-SP factors and in all MPOC-Con factors, F(1, 7) = 5.17, P = .003, η 2  = .68; RCI > 1.96. Individual change patterns in FCC performance indicated patterns of increased, decreased, or stable performance, with the highest increased performances reported for treating people respectfully (79%) and communicating specific information (71%), mostly stable performance in providing general information (75%) and similar levels of increase and stability (41% and 39%, respectively) for interpersonal sensitivity. The Pearson's correlation between MPOC-SP and MPOC-Con were significant, moderate-strong, and positive (r = .42-.69, P < .05)., Conclusions: The MPOC-SP and the MPOC-Con are sensitive measures suitable for evaluating individual and group changes following training. When designing professional development programmes, managers and educators should consider the interrelation between self-efficacy and implementing acquired knowledge and skills in FCC., (© 2019 John Wiley & Sons Ltd.)

Background/aim: Knowledge and understanding of deficits in executive functions has expanded in recent years and its relevance to occupational therapy has been established. The purpose of this review was to identify, analyse, synthesise and describe the updated occupational therapy scientific literature that addresses the subject of executive functions, specifically focusing on children and adolescents., Method: Scoping review methodology was implemented to map the occupational therapy literature on executive functions in children and adolescents over the past decade. Articles were retrieved from five electronic databases., Results: Fifty publications met the inclusion criteria. The research included a wide age range, different diagnoses, use of diverse executive functions definitions and assortment of assessments and interventions., Conclusion: A unique definition of executive functions among children and adolescents was proposed. This definition can assist both clinicians and researchers in the field. Continued research to establish the profession in a key position is recommended to understand the underlying mechanisms of daily performance., (© 2018 Occupational Therapy Australia.)

Poor cognitive outcomes among people with schizophrenia are associated with poor function in daily life. Cognitive interventions aimed at improving function lead to better cognitive outcomes, but the question of generalization to real-world functioning remains relevant. The ability to generalize or to apply learned skills in the clinic to everyday functioning must include metacognitive components which are the underlying mechanisms of function. To address such generalization, we developed a metacognitive group intervention based on Toglia's (2005) dynamic interactional model, which aims to promote daily activities and participation by focusing on metacognitive components. We assessed 84 participants with schizophrenia (41 in the control group and 43 in the intervention group) before and after completing the intervention and at a 12-week follow-up. Assessments addressed executive function, performance, and participation. The intervention group's performance, participation, and everyday functions significantly increased post-intervention and at follow-up, compared with the control group. Results provide important information about the potential for change in real-world functioning and a basis for the rationale of employing metacognitive interventions in this population., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Participation is a central concept in health and well-being and healthcare, yet operationalizing this concept has been difficult. Its definition, uses in healthcare, and impacts on recovery require ongoing research. Our review question goes like this: from the longitudinal evidence investigating participation among stroke survivors, what are the patterns of participation recovery in stroke survivors over time, and what interventions are used to improve participation? To fully understand these questions, we also ask, how is participation defined in the stroke literature, and what are the measures of participation used in the stroke literature? A systematic scoping review was undertaken using the search terms "stroke," "longitudinal," "participation," and "outcome" in seven databases. Articles included were published until April 2017, written in English, and had at least two longitudinal assessments of participation. Fifty-nine articles met the inclusion criteria. The International Classification of Functioning, Disability and Health was the most frequent definition of participation used (34%). There were 22 different measures of participation. Eight of ten studies demonstrated significant improvements in participation up to 12 months poststroke. Efficacy of interventions and their impact on participation varied. The various definitions, measures, and intervention efficacies of participation highlight the need for further research worldwide into achieving meaningful participation and quality of life among stroke survivors. Future practice should include participation as a main outcome measure.

Background: Cognitive abilities are essential for children's development and independence. Various cognitive assessments, standardized in Western cultures, have yet to be investigated for their multicultural suitability., Aims: To explore the suitability of the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) for a Jordanian population., Methods: Observed cases of 442 Jordanian children aged 6-12 were used to perform exploratory factor analyses using principal components with Varimax rotation (construct validity evidence) and to compute Cronbach's α coefficient (internal consistency reliability)., Results: High total performance on four subscales and a slightly lower total performance on two subscales were observed. Observed performance increased with age on three subtests, whereas a more modest increase was observed on the other three subscales. The expected one-factorial solution confirming the LOTCA's subscales homogeneity (unidimensionality) structure was found on five of six subscales. Variance explained by the subscales ranged from 39 to 82% and internal consistency reliability measured by Cronbach's alpha ranged from .42 to .78., Conclusions: Satisfactory construct validity and internal consistency reliability were demonstrated on two subscales applicable to Jordanian children without adaptation. With adequate cross-cultural adaptation, increasing internal consistency reliability in other subscales could make the LOTCA an effective tool for assessing cognitive abilities in this population.

Overweight and obesity are epidemic in Western countries and the literature suggests a relationship between overweight and executive functions (EF). Shopping is a regular, everyday activity that is strongly related to executive functioning. To date, no assessment tool has been developed to evaluate EF in adults with overweight and obesity, with a focus on the activity of shopping. To determine the factorial validity of the newly developed "Let's Shop" questionnaire. A convenience sample which included three groups of 93 men and women aged 35-60 were included in the study. Thirty three overweight participants and 30 obese participants who sought a clinical dietitian constituted the two research groups, and 30 normal weight participants recruited from a physician's waiting room constituted the control group and were matched to the two research groups by age, gender, education, and socioeconomic status. The "Let's Shop" questionnaire was administered to all participants. An exploratory principal factor extraction with oblimin rotation was conducted for the "Let's Shop" questionnaire. Twenty-one items were entered into the equation; the analysis revealed four distinct factors comprised of 17 items. The cumulative percentage of variance accounted for by the four factors was 44.74%. The four factors were as follows: "planning in action" α = 0.63; " planning ahead" α = 0.71; " impulsivity" α = 0.67; and "habits" α = 0.63. The "Let's Shop" questionnaire was reduced to 17 items. This brief questionnaire will enable rapid administration by researchers and practitioners and determine a potential association between EF in the supermarket arena and weight status.

Background/aim: This article explores the development of a unique, culturally sensitive, designated academic occupational therapy programme for the Ultra-Orthodox (Haredi) minority in Israel. This normative university environment did not provide the opportunity for Haredi participation due to the lack of consideration of the strong commitment to a modest way of life of this community. This prevented their participation in academia and resultant employment that are necessary for economic advancement of the community., Method: A follow-up survey that tracked the programme's graduates' participation in the workforce was used to determine the success of the initial goal of the establishment of the designated programme., Results: Slightly above 97% of the respondents worked as occupational therapists during the first year after completing their bachelor's degree. The employment data obtained from the graduates showed that the central goal of the Council of Higher Education has been achieved. The designated culturally adapted occupational therapy programme has provided varied employment opportunities for its graduates in diverse professional environments., Conclusion: With the implementation of this programme, the occupational therapy department of the University of Haifa has created greater accessibility of the profession to both the occupational therapy providers and the recipients of occupational therapy intervention as well as serve as a model for other communities., (© 2015 Occupational Therapy Australia.)

Children with attention-deficit hyperactivity disorder (ADHD) often present with activities of daily living (ADL) performance deficits. This study aimed to compare the performance characteristics of children with ADHD to those of controls based on the Do-Eat assessment tool, and to establish the tool's validity. Participants were 23 children with ADHD and 24 matched controls, aged 6-9 years. In addition to the Do-Eat, the Children Activity Scale-Parent (ChAS-P) and the Behavioral Rating Inventory of Executive Function (BRIEF) were used to measure sensorimotor abilities and executive function (EF). Significant differences were found in the Do-Eat scores between children with ADHD and controls. Significant moderate correlations were found between the Do-Eat sensorimotor scores, the ChAS-P and the BRIEF scores in the ADHD group. Significant correlations were found between performance on the Do-Eat and the ChAS-P questionnaire scores, verifying the tool's ecological validity. A single discriminant function described primarily by four Do-Eat variables, correctly classified 95.5% of the study participants into their respective study groups, establishing the tool's predictive validity within this population. These preliminary findings indicate that the Do-Eat may serve as a reliable and valid tool that provides insight into the daily functioning characteristics of children with ADHD. However, further research on larger samples is indicated.

The objective was to assess effectiveness of apraxia treatments using a systematic review. In contrast to previous reviews, each study was rated as to its applicability to occupational therapy practice and its focus on occupational performance using the FAME rating system (defined by four categories: Feasibility, Appropriateness, Meaningfulness, Effectiveness). This systematic review included eight studies: four randomized controlled trials (level 1 evidence) and four pre-post designs (level 3 evidence). Three treatment approaches were reported: errorless learning with training of details; gesture training; and strategy training. FAME scores ranged from A to C. All studies reported significant treatment effects, but only one demonstrated an impact on observed occupational performance that transferred from clinic to home., (Copyright 2014, SLACK Incorporated.)

Writing is a complex activity in which lower-level perceptual-motor processes and higher-level cognitive processes continuously interact. Preliminary evidence suggests that writing difficulties are common to children with Neurofibromatosis type 1 (NF1). The aim of this study was to compare the performance of children with and without NF1 in lower (visual perception, motor coordination and visual-motor integration) and higher processes (verbal and performance intelligence, visual spatial organization and visual memory) required for intact writing; and to identify the components that predict the written product's spatial arrangement and content among children with NF1. Thirty children with NF1 (ages 8-16) and 30 typically developing children matched by gender and age were tested, using standardized assessments. Children with NF1 had a significantly inferior performance in comparison to control children, on all tests that measured lower and higher level processes. The cognitive planning skill was found as a predictor of the written product's spatial arrangement. The verbal intelligence predicted the written content level. Results suggest that high level processes underlie the poor quality of writing product in children with NF1. Treatment approaches for children with NF1 must include detailed assessments of cognitive planning and language skills., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: The purpose of this study was to investigate cognitive functioning among elementary school children in Jordan., Methods: A total of 468 children aged 6-12 years were recruited to participate in this study. Cognitive functioning was assessed using the LOTCA battery (Loewenstein Occupational Therapy Cognitive Assessment; Itzkovich et al., 2000). Information obtained from the parents included demographics, work and income data and child's daily behavior and school achievement., Results: The results of this study showed that the cognitive functioning increased by 3.8 points for each increase in the child's GPA and increased by 2.35 points when the child ate breakfast regularly. By contrast, living in rural areas and smoking by a parent decreased cognitive functioning., Conclusions: Understanding of the child's cognitive abilities is critical to establishing intervention goals and to planning therapeutic activities. Screening of cognitive abilities and associated factors is essential for a comprehensive and accurate understanding of the child's abilities and limitations. Further research is recommended to investigate other factors in different populations.

Background: Our objectives are (1) to establish construct validity by comparing task performance with the Virtual Action Planning-Supermarket (VAP-S) by patients with stroke to healthy matched control subjects, (2) to establish concurrent validity by exploring relationships between VAP-S performance and Executive Functions (EFs) and ecological validity by exploring relationships between VAP-S performance and the Observed Tasks of Daily Living-Revised (OTDL-R), a measure of Instrumental Activities of Daily Living (IADL), and (3) to determine which measures predict IADL performance in patients with stroke., Methods: The research group included 24 men and women, aged 44-65 years, poststroke and the control group included 24 matched healthy people. The VAP-S and the Behavioral Assessment of the Dysexecutive Syndrome (BADS) were administered to evaluate EF. The stroke patients were tested with the OTDL-R., Results: Significant differences between groups were found for 2 outcome measures of the VAP-S. In the research group, significant (P ≤ .05) moderate correlations were found between the VAP-S number of purchases and the BADS key search subtest (r = .48) and between the VAP-S number of correct actions and both the BADS action program (r = .47) and key search (r = .52) subtests. An exploratory stepwise multiple regression showed that the VAP-S number of correct actions and the profile score of the BADS were able to predict 56.2% of OTDL-R performance for the clients., Conclusions: The VAP-S showed adequate validity and an ability to predict IADL performance, providing support for its use in cognitive stroke rehabilitation., (Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

Our objective was to examine the association of attention deficit and disorganization in boys with and without specific developmental disorder of motor function. Four groups of boys between the age of 7 and 12 years-(1) Disorganization + coordination disorder (n = 30); (2) Coordination disorder (n = 33); (3) Disorganization (n = 28); and (4) Control (n = 29)-were included. Teachers completed the Questionnaire for Assessing the Students' Organizational Abilities for the Teacher and the Conners' Teachers Rating Scale-Revised. The Movement Assessment Battery for Children and 2 subscales of an intelligence test (vocabulary and similarities) were administered. A significantly increased rate of attention deficit in children with organizational deficit was identified. Attention deficit in children with specific motor disorder was exclusively associated with an organizational deficit. Organizational deficit in childhood is highly associated with attention deficit, and this association is particularly relevant in children with specific coordination disorder.

The present study aimed to compare the executive function (EF) of children with neurofibromatosis type 1 (NF1) to those of typically developing children and to investigate whether those abilities could predict the child's academic success in terms of academic skills and enablers. Twenty-nine children with NF1 and 27 age-and-gender-matched controls (aged 8-16 years) were examined with two tests to measure EF in an ecologically valid manner: the Behavioural Assessment of the Dysexecutive Syndrome in Children (BADS-C) and the parent questionnaire for the Behavior Rating Inventory of Executive Function (BRIEF). In order to evaluate academic success we used the Academic Competence Evaluation Scales (ACES). The performance of the NF1 group was significantly lower on the Water and Key search subtest of the BADS-C and on four scales of the BRIEF: initiate; working memory; plan/organise and organisation of materials. Significant correlations and predictive models via regression analysis were generated for: BADS-C, BRIEF and ACES scores. Based on these findings, children with NF1 have executive dysfunction that partially accounts for their difficulties in academic achievements.

We reviewed 12 articles from 2012 that addressed development and testing of instruments for children and youths and American Journal of Occupational Therapy articles from 2009-2013 that addressed 11 activity and participation instruments to determine how well this group of instruments facilitates the generation of evidence sufficient to support practice in accordance with the Centennial Vision. We observed an increase in the number of instrument development and testing studies and in higher level studies and larger cohorts; funding was provided for almost half of the studies, and attention was given to use of blind testing and transition to adult-age assessments. Further development of performance-based activity and participation instruments; instruments that examine biomedical molecular-cellular, biomedical, and environmental mechanisms; and intervention fidelity measures and increased use of blind testing are necessary for occupational therapy to meet the Centennial Vision., (Copyright © 2013 by the American Occupational Therapy Association, Inc.)

Reliability and validity of the Executive Function Route-finding Task (EFRT) with people diagnosed as having mild cognitive impairment was examined. Twenty-three people with mild cognitive impairment with a mean age of 77.4 (± 7.5) years and 23 healthy controls with a mean age of 74.3 (± 4.9) years participated. The EFRT was administered along with other tests for executive functions: Executive Interview and two subtests from the Executive Functions Performance Test (EFPT). Findings showed high inter-rater reliability for the EFRT. In addition, the control group performed significantly better on all tests, thus confirming the construct validity of the EFRT. However, further examination into the clinical significance of these findings is needed. Concurrent validity was partially demonstrated by low to moderate significant correlation between the EFRT and one subtest from the EFPT. The results of this study support the reliability and validity of the EFRT among people with mild cognitive impairment., (Copyright 2011, SLACK Incorporated.)

The objectives of this study were to describe the nature of the attention deficits in children with Neurofibromatosis type 1 (NF1) in comparison with typically developing (TD) children, using the Virtual Classroom (VC), and to assess the utility of this instrument for detecting attention deficits. Twenty-nine NF1 children and 25 age-and gender-matched controls, aged 8-16, were assessed in a VC. Parents' ratings on the Conners' Parent Rating Scales-Revised: Long (CPRS-R:L) questionnaire were used to screen for Attention Deficit-Hyperactivity Disorder (ADHD). Significant differences were found between the NF1 and the control groups on the number of targets correctly identified (omission errors) and the number of commissions (commission errors) in the VC, with poorer performance by the NF1 children (p < 0.005). Significant correlations were obtained between the number of targets correctly identified, the number of commission errors, and the reaction time. Significant correlations were also found between the total correct hits and the cognitive problems/inattention scale, as well as two other indexes of the CPRS-R:L: the DSM-IV Symptoms Subscale and the ADHD Index. The VC results support the hypothesis that NF1 is marked by inattention and impulsivity and that participants with NF1 are more inattentive (omission errors) and impulsive (commission errors) than normal controls. The VC appears to be a sensitive and ecologically valid assessment tool for use in the diagnosis of attention deficits among children with NF1., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Purpose: This study aimed (1) to compare visual memory and meta-memory abilities, including the use of strategies as context, of children with cochlear implant (CI) and children with normal hearing; (2) to examine the concurrent and construct validity of 'The Contextual Memory Test for Children' (CMT-CH)., Method: Twenty children with CI and 20 children with normal hearing, aged 8-10 years, participated in this study. Memory abilities were measured by two subtests of the Children's Memory Scale (CMS) and by CMT-CH, which also measures meta-memory abilities., Results: Children with CI scored significantly lower in both tests of memory and meta-memory and showed less efficient use of context to memorise. Significant positive correlations were found between CMS and CMT-CH memory tests in both groups., Conclusions: Visual memory and meta-memory abilities may be impaired in children with CI. Evaluation and intervention for children with CI should refer to their memory and meta-memory abilities in order to measure the outcomes of CIs, and enhance language development academic achievements. Although more studies on CMT-CH should be performed, the CMT-CH may be used for the evaluation of visual memory of children with CI.

Aim: The World Health Organization's International Classification of Functioning, Disability and Health adapted for children and young people (ICF-CY) is a framework for describing and classifying health and health-related states. The aim of the present study was to review literature on neurofibromatosis type 1 (NF1) using ICF-CY guidelines and to highlight findings about the quality of life of children with NF1., Method: Electronic databases were searched to identify studies involving children with NF1. Eligible studies were classified according to ICF-CY categories., Results: Children with NF1 have a variety of cognitive and other deficits. However, very little information is available on the impact of these deficits on their daily life., Interpretation: Despite the broad range of functional and structural deficits in children with NF1, the functional assessment of these children remains largely unexplored. Future studies should aim at evaluating the participation of children with NF1 in various situations, using tools with high real-world validity.

The objective of this study was to analyze the process and product of handwriting among children with Neurofibromatosis Type 1 (NF1) in comparison to those of Typically Developing (TD) children. Children with NF1 are at risk for some cognitive deficits, a wide range of deficits in perceptual skills and, motor and visual-motor integration skills which may interfere with handwriting competency, which is an essential ingredient for success at school. Participants were 30 NF1 children and 30 age and gender matched TD children, between the ages 8 and 16.08. The handwriting performance of children with NF1 was evaluated with the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI), for copying text and free style writing tasks, using: (1) Computerized Penmanship Evaluation Tool (ComPET) to assess mechanical aspects of the writing process. (2) The Hebrew Handwriting Evaluation (HHE) to examine product legibility. (3) The Six-Trait Writing Model to judge the quality of the written product. Significant differences between the NF1 children and the control group were found in the process and product measures. Significant correlations were found between the VMI, the ComPET, the HHE and the Six-Trait Writing Model variables for both groups. We suggest a possible relationship between executive dysfunction and poor performance in handwriting.

Cognitive performance is essential for children's functioning and may also predict school readiness. The suitability of Western standardized assessments for cognitive performance among children from different cultures needs to be elaborated. This study referred to the existence of differences in cognitive performance between and within children from the middle-east-Israeli and Palestinian on the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), by elucidating cultural effects on the construct validity of the LOTCA using factor analysis. Participants included 101 Israeli and 125 Palestinian children from kindergarten, first and second grade who underwent the LOTCA. Factor analysis revealed four factors underlying items on the LOTCA, explaining the differences found between Israeli and Palestinian children in most of LOTCA subtests. Culture may affect the construct validity of the LOTCA and may explain the difference in performance between both cultural groups. LOTCA's validity as well as the validity of other instruments on which norms and decisions regarding the child's development and performance are made should be further evaluated among children from different cultural backgrounds., (2010 Elsevier Ltd. All rights reserved.)

Organizational ability constitutes one executive function (EF) component essential for common everyday performance. The study aim was to explore the relationship between handwriting performance and organizational ability in school-aged children. Participants were 58 males, aged 7-8 years, 30 with dysgraphia and 28 with proficient handwriting. Group allocation was based on children's scores in the Handwriting Proficiency Screening Questionnaire (HPSQ). They performed the Hebrew Handwriting Evaluation (HHE), and their parents completed the Questionnaire for Assessing Students' Organizational Abilities-for Parents (QASOA-P). Significant differences were found between the groups for handwriting performance (HHE) and organizational abilities (QASOA-P). Significant correlations were found in the dysgraphic group between handwriting spatial arrangement and the QASOA-P mean score. Linear regression indicated that the QASOA-P mean score explained 42% of variance of handwriting proficiency (HPSQ). Based on one discriminant function, 81% of all participants were correctly classified into groups. Study results strongly recommend assessing organizational difficulties in children referred for therapy due to handwriting deficiency., (Copyright 2009 Elsevier Ltd. All rights reserved.)

In this case study, virtual reality was used to augment imaginal exposure in a protocol based on prolonged exposure. A 29-year-old male patient developed posttraumatic stress disorder after surviving a deadly terrorist bulldozer attack on two civilian buses and several cars in Jerusalem; the traumas witnessed by the survivor included a decapitation. The crowded bus in which the patient was riding was pushed over onto its side by the terrorist, injuring, trapping, and terrifying the passengers and causing gasoline to leak. Guided by his therapist, the patient entered an immersive computer-generated virtual world to go "back" to the scene of the traumatic event to help him gain access to his memories of the event, process and reduce the intensity of the emotions (fear/anger) associated with his pathological memories, and change unhealthy thought patterns. Traumatic memories of childhood abuse and traumatic memories of the bulldozer terrorist attack were treated using imaginal exposure while the patient was in the virtual environment BusWorld. The patient showed large posttreatment reductions in PTSD symptoms, and his Clinician-Administered PTSD Scale (CAPS) scores dropped from 79 pretreatment to zero immediately posttreatment, and CAPS was still at zero 6 months later. Although case studies are inconclusive by nature, these encouraging preliminary results suggest that further exploration of the use of virtual reality during modified prolonged exposure for PTSD is warranted. As terrorist attacks increase in frequency and severity worldwide, research is needed on how to minimize the psychological consequences of terrorism.

The Movement Assessment Battery for Children (M-ABC) is one of the most accepted tools, both in clinical practice and in research, for the diagnosis of Developmental Coordination Disorders (DCDs) in children. The present study aimed to: (1) establish the construct validity of M-ABC in Israel by comparing the motor performance of typically developed children in four age groups (ranging from 6 to 12 years) and (2) examine the impact of socio-demographic parameters on children's motor performance. Participants were 249 typical children, between 4.1 and 12.08 years old, whose motor performance was evaluated by the M-ABC. The results showed that age, gender, mother's education level, and socioeconomic status had an impact on children's motor performance. Thus, the M-ABC may serve as a suitable tool for examining the motor performance of children in Israel. This examination should also refer to socio-demographic factors in order to shed light on the contribution of environmental disadvantages to children's motor performance.

Background: The Do-Eat was developed to evaluate daily task performance abilities among children with developmental coordination disorder (DCD). This study investigated the tool's reliability and validity., Method: Participants were 59 children ages 5 to 6.5 years; 30 children diagnosed with DCD according to the DSM-IV-TR; and a control group of 29 children, who were matched for age, gender, and sociodemographic background., Results: Both the Do-Eat and the accompanying Parent Questionnaire yielded high internal consistency (alpha s = .89-.93). Construct validity was demonstrated by significant between-group differences on the Do-Eat (t[57] = 14.09, p<.001) and the Parent Questionnaire (t[57] = 3.64, p<.001). Significant correlations between children's scores on the sensory-motor component of the Do-Eat and the Movement Assessment Battery for Children final score confirmed concurrent validity (r = -.86, p<.001)., Conclusions: Results suggest that the Do-Eat is a reliable, valid tool for identifying children at risk for DCD.

Persons with Schizophrenia experience difficulties with Executive Functioning (EF) that affect independence and participation in activities. Specifically, EF impacts performance in Instrumental Activities of Daily Living (IADL) that require flexible thinking and accommodation to complex environments. However, less is known how schizophrenia affects EF and individuals' performance in activities. IADL performance can be tested using a virtual reality (VR) environment that simulates real life activities. The purpose of this study was: 1) to examine the feasibility and validity of the Virtual Action Planning-Supermarket (VAP-S) to assess EF in persons with schizophrenia as compared to a standardized EF measure (the Behavioral Assessment of Dysexecutive Syndrome, BADS); 2) to compare performance of persons with schizophrenia and healthy controls in the VAP-S; 3) to assess the ability of the VAP-S to differentiate between different levels of EF within schizophrenia; 4) to explore the relationships between negative and positive symptoms and performance on the tests. Thirty persons with schizophrenia were matched with 30 healthy controls. Significant differences in performance between research and control groups were detected on the VAP-S and BADS, with the research group performing worse. Large variations in number of purchases within the VAP-S by the research group point to level of task completion thus secondary analysis was conducted. There was a significant negative correlation between level of the negative signs and overall performance on the BADS and on most measures of the VAP-S. Results of this study support the use the VAP-S to assess EF among persons with Schizophrenia.

Children's success with participating in life depends heavily on intact executive function (EF) skills. The Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C) was developed to address the need for a standardised ecologically valid test of children's EF performance. This study aimed to establish the construct validity of the BADS-C in relation to socio-demographic parameters. Participants were 208 Israeli children, aged 8-15 years, who were divided into three age groups (8 years to 9 years and 11 months; 10 years to 11 years and 11 months; 12 to 15 years) and tested with the BADS-C. The older age groups achieved significantly better scores than the younger groups. No significant differences were found between genders in any of the BADS-C scores. Similar results were found for familial socio-economic status and parents' education. Construct validity was demonstrated for the BADS-C by providing a profile for different age groups. Additional studies are needed to examine further the validity and reliability of the BADS-C and the relationships between socio-demographic factors and EF.

Purpose: The highest proportion of traumatic brain injuries (TBIs) occurs among adolescents. This study examines the effectiveness of a therapeutic protocol for rehabilitation of adolescents with TBI. This protocol is based on Toglia's (1998, 2005) Dynamic Interactional Model and Expanded Awareness Model (Toglia & Kirk, 2000)., Method: Explanatory case studies presenting 2 adolescents (ages 16-17) with mild to moderate TBI are combined with qualitative and quantitative data assessing self-care, mobility, and graphomotor abilities as well as deficit awareness in these domains. Outcome measures include the FIM, the Canadian Occupational Performance Measure, the Computerized Penmanship Object Evaluation Tool, and the Awareness of Mobility Deficits Questionnaire. Graphic data analysis compared outcome measures before, during, and after intervention., Results: The Dynamic Interactional Model was effective in improving self-care, mobility, and graphomotor abilities and identified awareness of deficits in these domains., Conclusion: These research findings contribute to our theoretical knowledge in rehabilitation and promote adopting this approach for rehabilitation of adolescents with TBI.

Background: Although executive functioning (EF) was found to be associated with cognitive deterioration, the majority of the tests for assessing EF lack ecological validity., Aims: To examine the feasibility and the validity of the virtual action planning supermarket (VAP-S) for the diagnosis of patients with mild cognitive impairment (MCI)., Methods: Thirty MCI patients (mean age = 69.5 years) were compared to 30 healthy elderly persons (mean age = 69.2 years) in their performance of the VAP-S., Results: Significant differences were found between the groups in the majority of the measures of the VAP-S. The combination of the MMSE and the trajectory duration provided the best predictive classification for the groups., Conclusion: MCI patients have EF deficits, and the VAP-S is a viable tool to assess EF deficits in patients with MCI and healthy elderly.

Exposure therapy treatment can lead to large reductions in posttraumatic stress disorder (PTSD) symptoms. Virtual reality exposure (VRE) therapy is designed to facilitate cognitive behavioral therapy for PTSD. During VRE therapy, patients go into an immersive computer-generated environment (go back to the scene of the traumatic event) to help them gain access to their memories of the traumatic event, change unhealthy thought patterns, gradually habituate to their anxiety, and reduce the intensity of associated emotions. The therapist's ability to manipulate the amount of anxiety experienced by the client during therapy is an important element of successful exposure therapy. Using a within-subjects design, 30 asymptomatic volunteers each experienced four levels of a virtual world depicting a terrorist bus bombing, designed to be increasingly distressful. There was a statistically significant difference between the mean subjective units of discomfort scores (SUDS) of the four levels, and several planned paired comparisons showed significantly higher SUDS ratings with higher simulation levels. Results suggest that sound may play an important role in successful elicitation of emotional responses during VRE. The results of this analog study provide initial validation of the potential of BusWorld to provide graded exposure for individuals suffering from PTSD originating from suicide bus bombings. Future research exploring whether VR exposure therapy with BusWorld can reduce PTSD in clinical patients is warranted.

The purpose of this study was to examine how dual-task performance affects the center of pressure (COP) sway characteristics and cognitive performance of children with developmental coordination disorder (DCD). Twenty-six children with DCD (mean age-5.1+/-0.59 years) and 20 typically developing children (mean age-5.0+/-0.57 years) participated in the study. The postural task consisted of standing quietly either on a firm or a compliant surface. The cognitive task involved naming simple objects appearing consecutively on a computer screen. Five tests were presented in random order, with the cognitive and the postural tasks tested either separately or concurrently. Mistakes in naming the objects were recorded, as were COP sway characteristics measured with a force-plate. Children with DCD demonstrated higher COP path-length velocity (PLV), and COP amplitude variability, as well as more mistakes in naming the objects in all stance conditions. A concurrent cognitive task increased all sway measures in both groups, with the effect on PLV greater in children with DCD. Cognitive performance was affected by dual tasking only in the control group. Young children with DCD demonstrated greater postural control activity than did the children in the control group during quiet stance, whether performed as a single or a dual task. This difference is accentuated during dual tasking when the children with DCD seem to prioritize the cognitive task.

Objective: The aim of this study was to compare the handwriting characteristics of children diagnosed with attention deficit hyperactive disorder (ADHD), while on and off medication, as well as with a control group., Methods: Twelve children with ADHD and 12 control children, aged 8-10, performed a paragraph-copying task using a computerized system. The children with ADHD performed the task both while on and off medication. The handwriting product of both groups was then evaluated with the Hebrew Handwriting Evaluation tool., Conclusion: Results provide evidence for poorer performance of children with ADHD in comparison to children without ADHD on most handwriting process and product measures. Children with ADHD demonstrated significantly more total time including in-air time spent in handwriting performance when off medication. The possible implications of these results regarding the future use of handwriting process and product evaluations for children with ADHD in school settings are discussed.

A number of carefully controlled studies have documented the effectiveness of traditional imaginal exposure for the treatment of post-traumatic stress disorder (PTSD). Virtual reality (VR) exposure therapy is based on a similar logic but rather than self-generating imagery, patients wear a VR helmet and go into a three-dimensional (3-D) computer generated virtual world to help them gain access to their memory of the traumatic event. Recent preliminary research has shown that some patients who fail to respond to traditional therapy benefit from virtual reality exposure therapy, presumably because VR helps the patient become emotionally engaged while recollecting/recounting/re-interpreting/emotionally processing what happened during the traumatic event. The present paper presents a brief overview of a new VR World we developed to provide virtual reality therapy for terrorist bus bombing victims in Israel, and a brief description of our research protocol and measures (for details, see www.vrpain.com).