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OBJECTIVE. This study examined the relationships between children's self-reports on their handwriting performance, their actual handwriting process and product, and wider motor-perceived self-efficacy. METHOD. Twenty-one children with dysgraphia and 21 typically developing children copied a paragraph on an electronic tablet as part of a Computerized Penmanship Evaluation Tool. Handwriting product was evaluated by the Hebrew Handwriting Evaluation. Participants completed the Children's Questionnaire for Handwriting Proficiency (CHaP) and the Perceived Efficacy and Goal Setting System (PEGS). RESULTS. The study group's CHaP scores significantly correlated with handwriting process, product measures (rs = .46-.59, ps = .034-.005), and PEGS scores, all of which were significantly poorer compared with those of the control participants. CONCLUSIONS. Children are aware of their handwriting deficits and are able to report them. Children's reports may contribute to the identification of dysgraphia and facilitate their participation in occupational therapy intervention and in class. [ABSTRACT FROM AUTHOR]

Background: Grip strength is frequently used in research and clinical work and is commonly compared to normative data in clinical settings. To enable accurate interpretation of grip strength values, normative reference values should be close to the demographic, occupational, cultural and geographic characteristics of the individual tested., Objective: Investigate the effects of gender, age, work-group and hand dominance on grip strength for the Israeli population, and to compare the grip strength to two normative studies from the United States., Methods: A cross sectional study. The grip strength of 637 healthy adults was measured using a Jamar dynamometer. The effects for age, gender, hand dominance, and work strain were investigated. Israeli sample results were compared to US norms., Results: Within the Israeli sample, a significant age effect was found for both men and women. This effect was most apparent among the 70+ age groups, in which grip strength was weaker than all the other groups. Males were significantly stronger than females, in both hands, and the dominant hand was significantly stronger, regardless of gender. Results also demonstrated a medium to large effect for type of work on grip strength portraying high manual strain workers to have stronger grip strength. Overall, the grip strength in the Israeli sample was weaker than both US samples., Conclusion: Clinicians should be cautious when comparing grip strength to published norms from a different culture/geographical region. The amount of manual strain invested in various occupational roles should be considered in the assessment and intervention process.

Aim: To identify variables that can predict proficiency in powered mobility use for children in young adults., Method: Participants included 80 children and young adults (42 males, 38 females; mean age 10y 2mo, [SD 5y 1mo]; range: 2-22y) with cerebral palsy, neuromuscular disease, and spinal cord injury who participated in the ALYN Hospital Powered Mobility Lending Program from 2009 to 2016. Data were collected and compared before and after participation in the program and powered mobility levels were determined by the Israeli Ministry of Health (MOH) Powered Mobility Proficiency Test. Multivariate logistic regression analysis followed by a bootstrapping procedure that was based on 1000 samples were used to determine if the variables were predictive of success on the Israeli MOH Powered Mobility Proficiency Test., Results: Significant variables for predicting success were identified: manual wheelchair propulsion, go-stop voluntarily upon request, and using a joystick. The model was able to correctly identify 80% of the children., Interpretation: Children and young adults with the ability to go-stop upon request, propel a manual wheelchair short distances, and use a joystick to activate the powered wheelchair had a higher chance of becoming proficient. In countries where wheelchair proficiency is a requirement for powered wheelchair procurement, these findings may support policy changes, as they did in Israel., What This Paper Adds: Using powered wheelchairs offers children earlier and more natural practice to determine driving proficiency. Manual wheelchair propulsion, go-stop voluntarily upon request, and using a joystick were predictors of powered mobility proficiency. More than 80% of children use a joystick with their hand to activate a powered wheelchair., (© 2019 Mac Keith Press.)

Background: The influence of fatigue on residents' performance in laparoscopy was prospectively assessed through a computer-based virtual reality simulation (VRS) model., Study Design: Twenty-six residents (14 novices, 12 experienced) were recruited. In the first stage, each participant was initially tested on 8 VRS-based tasks. In the second, run-in stage, each resident had 8 hours of hands-on practice of the specific tasks chosen. Finally, participants were evaluated before and after 24 hours on call. For each task, a set of parameters reflecting proficiency, efficacy, and safety were documented., Results: In most of the tasks assessed, sleep deprivation had a significant deleterious effect on the performance of residents, both in terms of efficiency (time to complete the task), and safety (errors). These observations were more pronounced among novices. For example, in camera manipulation at a 30-degree angle, the total time to complete the task was slower after sleep deprivation (novices: sleep deprivation = 136 seconds, control = 119 seconds; experienced: sleep deprivation = 112 seconds, control = 103 seconds; p = 0.03). Moreover, accuracy rates were lower after sleep deprivation: in the "grasping and clipping" task, a lower accuracy rate after sleep deprivation was noted (novices: sleep deprivation = 82.8%, control = 87.9%; experienced: sleep deprivation = 87.6%, control = 90.8%; p = 0.05)., Conclusions: In this prospectively controlled study we observed reduced efficiency and safety in the performance of residents after sleep deprivation. Using an innovative study design, we eliminated the learning curve bias. Compared with novices, experienced residents performed relatively better after a night shift, and this may be attributed to better adaptation to sleep deprivation., (Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.)

Purpose: Driving is a meaningful occupation which is ascribed to functional independence in schizophrenia. Although it is estimated that individuals with schizophrenia have two times more traffic accidents, little research has been done in this field. Present research explores differences in mental status, visual working memory and visual organization between drivers and non-drivers with schizophrenia in comparison to healthy drivers., Methods: There were three groups in the study: 20 drivers with schizophrenia, 20 non-driving individuals with schizophrenia and 20 drivers without schizophrenia (DWS). Visual perception was measured with Rey-Osterrieth Complex Figure test and a general cognitive status with Mini-Mental State Examination., Results: The general cognitive status predicted actual driving situation in people with schizophrenia. No statistically significant differences were found between driving and non-driving persons with schizophrenia on any of the visual parameters tested, although these abilities were significantly lower than those of DWS., Conclusion: The research demonstrates that impairment of visual abilities does not prevent people with schizophrenia from driving and emphasizes the importance of general cognitive status for complex and multidimensional everyday tasks. The findings support the need for further investigation in the field of car driving for this population - a move that will considerably contribute to the participation and well-being. Implication for Rehabilitation Unique approach for driving evaluation in schizophrenia should be designed since direct applications of knowledge and practice acquired from other populations are not reliable. This research demonstrates that visual perception deficits in schizophrenia do not prevent clients from driving, and general cognitive status appeared to be a valid determinant for actual driving. We recommended usage of a general test of cognition such as Mini-Mental State Examination, or conjunction number of cognitive factors such as executive functions (e.g., Trail Making Test) and attention (e.g., Continuous Performance Test) in addition to spatial-visual ability tests (e.g., Rey-Osterrieth Complex Figure test) for considering driving status in schizophrenia.

We examined hazard perception (HP) abilities among elderly experienced and experienced drivers, with regard to the presence of pedestrians in residential areas. Two evaluation methods were used: (a) observation of traffic scene videos and pressing a button when a hazardous situation was identified, and (b) driving in a driving simulator. The results of the video observation method showed that elderly drivers had a longer response time for hazard detection. In addition, four of the eight pedestrian-related events were difficult for elderly drivers to perceive when compared to experienced drivers. Elderly drivers, shown to have limited useful field of view, may also be limited in their ability to detect hazards, particularly when located away from the center of the screen. Results from the simulator drive showed that elderly drivers drove about 20% slower than experienced drivers, possibly being aware of their deficiencies in detecting hazards and slower responses. Authorities should be aware of these limitations and increase elderly drivers' awareness to pedestrians by posting traffic signs or dedicated lane marks that inform them of potential upcoming hazards., (2011 Elsevier Ltd. All rights reserved.)

The current study compares hazard perception (HP) performance of 50 male drivers with and without a motorcycle license in order to generalize results. A video-based HP test, measuring reaction times to traffic scenes, was administered to these two groups of drivers. Participants with a motorcycle license performed better than participants without a motorcycle license. ANOVA indicated that learning improved linearly for participants with a motorcycle license but not for participants without a motorcycle license. No evidence that HP was predicted by age was found. HP scores for drivers who reported previous involvement in an accident were lower than for those who reported not being involved in an accident. The results are discussed in the context of sensitivity and response bias models., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

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.

The Cambridge Face Memory Test (CFMT) and Cambridge Face Perception Test (CFPT) have provided the first theoretically strong clinical tests for prosopagnosia based on novel rather than famous faces. Here, we assess the extent to which norms for these tasks must take into account ageing, sex, and testing country. Data were from Australians aged 18 to 88 years (N = 240 for CFMT; 128 for CFPT) and young adult Israelis (N = 49 for CFMT). Participants were unselected for face recognition ability; most were university educated. The diagnosis cut-off for prosopagnosia (2 SDs poorer than mean) was affected by age, participant-stimulus ethnic match (within Caucasians), and sex for middle-aged and older adults on the CFPT. We also report internal reliability, correlation between face memory and face perception, correlations with intelligence-related measures, correlation with self-report, distribution shape for the CFMT, and prevalence of developmental prosopagnosia.

While visual signals that accompany spoken language serve to augment the communicative message, the same visual ingredients form the substance of the linguistic system in sign languages. This article provides an analysis of visual signals that comprise part of the intonational system of a sign language. The system is conveyed mainly by particular actions of the upper face, and is shown to pattern linguistically and predictably in Israeli Sign Language. Its components, aligned with prosodic constituents, are associated with particular but general meanings and may be combined to derive complex meanings. The Brow Raise component is functionally comparable to H tones, signaling continuation and dependency, and characterizing yes/no questions and the if-clause of conditionals, for example. The component Squint instructs the addressee to retrieve information that is not readily accessible, and characterizes relative clauses, topics, and other structures. The details of the componential analysis proposed here explain why the two components together co-occur on such seemingly diverse structures as yes/no questions about mutually retrievable information and counterfactual conditionals. Like auditorily perceived intonational melodies, the visual intonational arrays in sign language provide a subtle, intricately structured, and meaningful accompaniment to the words and sentences of language.

Background: One determinant of participation is activity preferences, which may be influenced by sensory processing patterns., Purpose: To compare daily activity preferences of Israeli children who have typical versus atypical sensory processing patterns, according to age and gender., Methods: Twenty-five children with atypical sensory processing patterns and 109 typical peers aged 6 - 10.75 years completed the Preference for Activities of Children (PAC) questionnaire. Sensory processing patterns were determined according to the Short Sensory Profile (SSP)., Results: Children with atypical sensory processing patterns showed greater preference for active physical activities. Lower energy level was correlated with greater preference for self-improvement activities., Practice Implications: Activity preferences may be affected by children's sensory processing patterns. These effects are minimal among children with atypical sensory processing but no other co-morbidities. Evaluating these effects may assist in establishing occupational therapy interventions, facilitate children's engagement in the intervention, and enhance their participation in daily living.

Objective: To examine the effect of attentional focus instructions and dynamic balance training on ankle sprain recovery., Design: Randomized controlled trial., Setting: Outpatient physical therapy department., Participants: Forty volunteers (age range, 19-33y) referred to treatment within 4 months after sustaining a grade 1 or 2 ankle sprain with no concurrent impairments. Participants were randomly allocated to 1 of 2 groups differing in training instructions., Intervention: Postural control training consisted of ten 20-second trials, performed on 3 consecutive days, at 2 stability levels of the Biodex Stability System (BSS). Training instructions directed the participants to either an internal or an external focus of attention. Assessments were conducted on the BSS pre- and post-training, and 48 hours after the last session (retention test)., Main Outcome Measures: Overall stability as indicated by variance in platform displacement in all directions; anteroposterior (AP) variance of platform displacement; and mediolateral variance of platform displacement., Results: Increases in overall and AP stability were observed immediately following training in both groups and were maintained at the retention test. Interaction effect indicates greater improvement in the external-focus group., Conclusions: Our results suggest that external focus of attention is advantageous for the learning of a postural control task following an ankle injury.

Objective: Offspring of patients with schizophrenia are at-risk for developing schizophrenia in adult life. The aim of this paper is to describe the development from infancy through adolescence of a sample of Israeli young people at-risk for schizophrenia., Methods: The Jerusalem Infant Development Study (JIDS) has followed prospectively from birth through adolescence 15 young people who have a parent with schizophrenia. Neurobehavioral data were gathered at infancy, middle childhood, and adolescence. Mental disorder was assessed at adolescence., Results: Data suggest that some children whose parents have schizophrenia are at increased risk for a variety of neuromotor, cognitive, and attentional problems during infancy and childhood, compared to children whose parents had no mental disorder or nonschizophrenia mental disorder. Those high-risk children with neurobehavioral signs are also more likely to have poorer social adjustment, greater social withdrawal, and more symptoms within the schizophrenia spectrum. Case studies are presented of two children with early neurobehavioral impairment who, as adolescents, developed disorders within the schizophrenia spectrum., Conclusion: Because neurobehavioral impairment may be marking genetic vulnerability to schizophrenia spectrum disorders, clinicians treating children whose parents have schizophrenia need to thoroughly evaluate symptoms of mental disorder--but also neuromotor and neuropsychological functioning.

The study aims were to assess the independent contribution of motor ability to the incidence of school injuries. The study included 2057 pupils in grades 3-6 of primary schools in a city in the north of Israel. A surveillance system gathered information about injuries that occurred on school premises or during school related activities and required medical treatment or caused limitation of usual activities. Children provided information on sensation seeking, self-appraisal of health, academic performance, physical activity, and dominant hand; anthropometric measurements and motor ability tests were performed. The incidence of injury events was 4% (95% CI=3.2-5.0). Injuries increased with increased balance and agility, but there were no differences according to reaction time. No other study variables were associated with the incidence of injuries. Our findings of an increase in the incidence of injuries with better motor ability may express differences in exposure to risk situations between children with better and poorer motor abilities.

Writing and drawing produced by children 28-53 months old were compared. Israeli and Dutch preschoolers were asked to draw and write, to classify their products as drawing and writing, and to decide what they had drawn or written. Israeli and Dutch mothers classified the products. Scores on a scale for writing composed of graphic, "writing-like," and symbolic schemes showed improvement with age. Recognition of drawings as drawings preceded recognition of writings as writings. Scores on writing and drawing were substantially correlated, even with age partialed out, suggesting (a) that when children start drawing objects referentially, they write by drawing "print" and (b) that progress in object drawing involves progress in drawing print, so that their writing becomes more writing-like. Children unable to communicate meaning by writing spontaneously resort to drawing-like devices, indicating the primacy of drawing as a representational-communicative system.

This paper investigated the cognitive, lexical and morpho-syntactic profiles of school-age Israeli children with confirmed diagnosis of Williams syndrome (WS). Children with retardation of unknown etiologies were individually matched to the children with WS. The findings suggest a cognitive profile that was similar to the profile reported for English-speaking children with WS, whose unique features were seen mainly in the discrepancy between verbal IQ and performance IQ and in relatively preserved face recognition abilities (Frangiskakis et al., 1996; Mervis et al., 1999). Contrary to previous findings, cognitive, lexical and morpho-syntactic profiles of individual children were rather similar, confirming the findings that were based on matched-pairs comparisons.

Objective: The purpose of this study was to use computerized temporal measures to examine and compare the writing process of proficient and non-proficient third-grade handwriters., Method: A computerized digitizer system was used to compare the temporal handwriting measures of two groups of 8-9-year-old students. Classroom teachers used a questionnaire to identify 50 students who were non-proficient handwriters and 50 students who were proficient handwriters. Multivariate analysis of variance (MANOVA) analyses were used to test for the group differences across tasks for each dependent variable. Total time, "on paper" time, "in air" time, speed, and number of characters per minute were recorded as the participants performed graded writing tasks., Results: Non-proficient handwriters required significantly more time to perform handwriting tasks [F(4,91) = 14.83, p < .0001]; their "in air" time, was especially longer as compared to the proficient handwriters [F(4,91) = 13.63, p < .0001]. Their handwriting speed was slower [F(4,91) = 5.99, p < .0002], and they wrote fewer characters per minute (F(4,91) = 14.63, p < .0001)., Conclusion: The use of a computerized handwriting system provides objective temporal measures of handwriting performance, and may lead to the development of additional tools for the evaluation and treatment of handwriting difficulties.

The purpose of this study was to examine environmental influences on perceptual and motor skills of children from immigrant Ethiopian families in Israel in comparison with those of Israeli-born children. The subjects were divided into groups based on age (6- to 8-yr.-olds and 10- to 12-yr.-olds) and length of time in Israel. The results of this study show that the perceptual and motor performance of 6- to 8-yr.-old, less recent Ethiopian immigrants is similar to that of the recent Ethiopian immigrants of the same age. A difference exists between those two groups and the Israeli-born children of the same age. In the 10- to 12-yr.-old age group, there is a marked difference between the performance of the two groups of Ethiopian immigrants. The difference between the less recent immigrants and the Israeli-born children is smaller for most tasks; however, the less recent immigrants' performance is still poorer than that of the Israeli children. These results are compatible with those of other studies describing the difficulties encountered by children who had not studied in formal educational settings and those who have had that experience.

Protective gear is mandatory for medical personnel treating casualties in a contaminated environment. In the present study, we assessed the ability of emergency medical technicians to insert an intravenous line in this situation. Sixty emergency medical technicians were randomized to a control group, wearing fatigues, and a study group, wearing full protective gear. The ability to insert an intravenous line in healthy volunteers was assessed 1, 2, 4, and 8 hours after randomization. We found no effect of protective gear (p = 0.543) or time in protective gear (p = 0.8869) on success rate or on time needed for successful task completion (p = 0.4005 and p = 0.9021, respectively). The overall success rate was 58.6%, 65% in the unprotected state and 56% in the protected state, and the time was 303 +/- 115 and 351 +/- 113 seconds, respectively. These findings suggest that introduction of an intravenous line is possible but time consuming even after a prolonged stay in full protective gear. Alternative methods for antidotal treatment, such as the use of automatic autoinjectors for intramuscular administration, might be suggested.

Objective: The Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) measures the cognitive performance of persons with cerebrovascular accident (CVA). Although this assessment was developed and standardized in Israel, it is frequently used in the United States. The purpose of this study was to identify whether differences in performance on the LOTCA existed between Americans and Israelis who have had strokes. Additionally, this study was designed to compare the performance of persons with right CVA with the performance of persons with left CVA because the normative data for the LOTCA does not include separate information for these two groups., Method: The LOTCA was administered to 25 Americans with CVA (19 right CVA and 6 left CVA) and 56 Israelis with CVA (26 right CVA and 30 left CVA)., Results: On the majority of LOTCA subtests, there were no significant differences between American and Israeli subjects. Only one subtest, Orientation to Time, revealed significant differences between Americans and Israeli subjects both for subjects with right CVA and subjects with left CVA. Examination of subjects with right CVA versus subjects with left CVA also indicated few differences. Only one subtest, Pegboard Construction, revealed significant differences between subjects with right CVA and subjects with left CVA for both American and Israeli subjects., Conclusion: The LOTCA is an appropriate tool for occupational therapists to use in assessing Americans who have had strokes. In addition, for the most part, the subtests of the LOTCA assess cognitive-perceptual abilities that are not specific to the right or left cerebral hemisphere.

This article addresses a number of methodological weaknesses in the group comparison design of the Israeli High-Risk Study. It would seem that 25 years ago constraints of experimental design may have led the investigators to select as schizophrenic probands patients who today would no longer qualify for schizophrenic diagnosis according to DSM-III. In addition, a series of relevant dimensions (e.g. the course of the assumed schizophrenic process, family variables, life circumstances, and psychosocial factors) were not taken into account. For these reasons, many of the study's hypotheses and conclusions can be considered basically speculative, and it is suggested that many of the findings may be artifacts of the research design. Nor are there any evident grounds for the supposition that the differences between kibbutz and town children, in terms of the nature and severity of particular psychopathological problems, should be decisively ascribed to the differences in social framework and childrearing practices in the kibbutz and in town. The weight of many other variables, in particular intrafamily influences, is no less marked in the kibbutz setting than in town.

We have attempted to provide an overview of the initial evaluation of high-risk and control children. Summary measures of pathology were calculated for each clinical evaluation and objective test of the subjects. Correlational analysis revealed a pattern of intercorrelations among clinical subjective measures of pathology, and among objective measures, with no significant cross-correlations between the two types of measures. The one exception was the presence of neurological soft signs, which tended to correlate with both clinically and objectively measured pathology. Cluster analysis revealed three groups of subjects: a small group of index subjects who performed poorly on both clinical and objective measures; a larger cluster, predominantly index subjects, who showed clinical but not objective pathology; and a third group, including most of the controls, who functioned relatively well on both types of measures. Index subjects tended to show more consistent pathology across both clinical-subjective and objective examinations than controls. We hypothesize that our results stem from underlying deficits in attention, motor function, and perceptual-motor integration in offspring of schizophrenic patients. The finding of an inverse relationship between degree of pathology and age among the index children raises the possibility that developmental lags also play a part in the pathology of our high-risk subjects.

Neurological functioning was compared in children at risk for schizophrenia from samples recruited in Israel and Denmark. In both samples neurological signs were assessed in school-age children with one schizophrenic parent and a matched group of children with no mentally ill parents. Multidimensional Scalogram Analysis of data identified, in both samples, a radex structure of neurological functioning, radiating from motor to sensory-perceptual signs. In both samples, the gradient of neurological functioning differed between the offspring of schizophrenics and controls. For both the offspring of schizophrenics and controls, the largest number of children showed no or few signs of neurological dysfunctioning. A subgroup of the offspring of schizophrenics, but not the controls, showed multiple signs of neurological dysfunctioning that varied in pattern among individuals.