Search

IMPACTS project was a master's level graduate program that prepares occupational therapists, physical therapists, speech and language pathologists, nurses and special educators for early intervention practice. The purpose of this descriptive report is to explain the conceptual framework for the graduate program and to identify themes in students' learning from the portion of the program focused on professional-family relationships-the family practicum. In the family practicum, each student spent 50 hours over 6 months with one family who had a young child with significant disabilities. The students wrote reflective journals during the practicum that revealed how they interpreted their experiences for application to their own practices. Through qualitative analysis of the students' journals, four themes emerged: (1) Acknowledge that parenting a child with a disability is a 24/7 job; (2) Recognize that internal and external resources are essential to family adaptation; (3) Respect parents as the experts on their child; and (4) Accept the family's values. These themes were validated by the families' evaluation of the practicum and provide evidence that students grew in their appreciation of and competence in relationship-centered early intervention.

Objective: Although the prevalence of children with pervasive developmental disorders (PDD) has increased, empirical data about the role and practices of occupational therapists have not been reported in the literature. This descriptive study investigated the practice of occupational therapists with children with PDD., Method: A survey was mailed to 500 occupational therapists in the Sensory Integration Special Interest Section or School System Special Interest Section of the American Occupational Therapy Association in eastern and midwestern United States. The valid return rate was 58% (292 respondents). The survey used Likert scale items to measure frequency of performance problems observed in children with PDD, performance areas addressed in intervention, perceived improvement in performance, and frequency of use of and competency in intervention approaches., Results: The respondents primarily worked in schools and reported that in the past 5 years they had served an increasing number of children with PDD. Most respondents provided direct services and appeared to use holistic approaches in which they addressed multiple performance domains. They applied sensory integration and environmental modification approaches most frequently and believed that they were most competent in using these approaches. Respondents who reported more frequent use of and more competence in sensory integration approaches perceived more improvement in children's sensory processing. Respondents who reported more frequent use of and more competence in child-centered play perceived more improvement in children's sensory integration and play skills.

Occupational and physical therapists are concerned with an infant's ability to perform in object play and manipulation, self-care, mobility, and social function. Within the realm of child psychiatry, occupational and physical therapists contribute to a comprehensive assessment by providing in-depth neuromotor, sensory processing, and functional or adaptive skill analyses. The three theoretic approaches presented in this article represent the current trends within infant and young child assessment in the fields of occupational and physical therapy. In the past, therapists primarily used neuromotor or developmental assessments. Although these assessments have proven to be adequate for discrimination between children with developmental delays and those who are typically developing, they have not been as useful in documentation of progress in treatment or in providing an understanding of qualitative aspects of movement. Qualitative assessments that are more sensitive to change and to the complexity of functional skills have grown with the development of more sophisticated early-intervention strategies. Assessments based on dynamic systems theory allow therapists to quantify abilities, document subtle changes over time, and provide information on the qualitative aspects of movement. Therapists, however, continue to regularly employ assessments from multiple theoretic approaches to complete comprehensive evaluations.

Objective: This study examined preschool children's acquisition of fine motor skills and functional performance when occupational therapy services are included as part of the educational program. It also investigated the relationships among fine motor skills and functional performance in self-care, mobility, and social function., Method: Twenty-six preschool children who received weekly occupational therapy were studied. Measurements of their in-hand manipulation, tool use, eye-hand coordination, grasping strength, and functional performance in self-care, mobility, and social function were taken at the beginning and end of the school year., Results: Raw and scaled scores showed significant improvements in all skill areas; standard scores showed slight improvement in eye-hand coordination and mobility function. Correlations of the motor skill tests with the functional performance scales using year-end data revealed significant correlations for in-hand manipulation, eye-hand coordination, and grasping strength with self-care function and mobility., Conclusions: The results demonstrate the level of change that occurs in fine motor skill and self-care, mobility, and social function during the course of the school year for preschoolers with moderate fine motor delays. The relationships found in the year-end testing imply that performance in underlying fine motor skills as the focus of occupational therapy intervention is associated with self-care and mobility function.

Objectives: This correlational study investigated the relationships among sensorimotor components, standardized measures of fine motor skill, and functional performance in self-care, mobility, and social interaction. It also examined which sensorimotor components and fine motor skills were predictors of functional performance., Method: Thirty preschool children with motor delays were evaluated with tests of in-hand manipulation, tactile defensiveness, stereognosis, grasping strength, and fine motor skill. Parents of the subjects were interviewed with the Pediatric Evaluation of Disabilities Inventory. Correlational and regression analyses were computed., Results: Significant correlations were found among sensorimotor components and discrete fine motor skills as measured on standardized observational tests. Few correlations emerged between foundational components of fine motor skill and functional performance in self-care, mobility, and social function., Conclusion: Lack of significant relationships among the variables, all of which were aspects of functional performance might be due to the difference between judgment-based and observational evaluation, the influence of the environmental context on the child's performance, and the influence of cultural values on the opportunities afforded to the child.