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This qualitative study investigated the impacts of a court-ordered service dog training program on justice-involved U.S. veterans. An experienced qualitative research team conducted three focus groups with nine veterans to explore how training service dogs influenced their daily lives. Focus groups were audio recorded, transcribed, and manually coded. Two graduate research assistants developed preliminary themes; the full team generated final themes. Themes illustrated how participation in the program: 1) decreased physical and emotional isolation; 2) assisted veterans with reintegrating into civilian life; 3) improved emotional self-regulation; and 4) helped veterans discover potential; 5) find camaraderie; 6) reconnect with community; and 7) create a sanctuary. In a follow-up session, several participants confirmed that the results accurately captured their experiences. The overall finding suggests the service dog training program served as a rehabilitative process for justice-involved veterans to rediscover their abilities and talents that existed before their experiences in the justice system.

Background: Measures to limit the spread of COVID-19 have disrupted the lives of countless millions of individuals worldwide. Objective: To explore the experiences of occupational disruption and changing social roles among Jordanians during COVID-19 lockdown in 2020. The specific aim was to explore the changing occupations, routines, roles and coping strategies. Material and Methods: This qualitative study used a digital ethnographic approach. Data collection included online observations of Jordanian’s posts of comments, photos and videos on six public Facebook pages during the COVID-19 lockdown for the initial 3-week period. In addition, 150 Jordanians participated in an online interview answering four open-ended questions to achieve triangulation. Qualitative analyses included open coding of the photos, videos and text as well as the interviews independently and blindly by the research team. Results: Four themes were identified: changing daily occupations; changing family roles; missing pre-lockdown life and coping strategies under lockdown. Conclusion: The COVID-19 lockdown restrictions caused direct, significant and immediate changes to Jordanians’ occupations, routines and roles; enforcing new obligatory occupations and eliminating desired ones. Significance: Knowledge from this study highlight the kinds of strategies and supports during and after lockdowns that need to be considered in future planning of occupational therapy practice in Jordan. Open Access funding provided by the Qatar National Library. The authors would like to acknowledge the participants who filled the survey. The authors received no financial support for the research, authorship and/or publication of this article.

Background: People with disabilities are facing not just health problems; they also experience restriction of participation due to various barriers. However, there is limited knowledge of which factors can be important to their community participation. Aim: This study investigated the factors that are associated with community participation of people with disabilities. Methods: A sample of 270 people with disabilities (aged range 18–55 years) recruited randomly through the “Turkish People with Disabilities Association”. This study, followed a survey design, took place in 15 cities in Turkey and a city of Turkish Republic of Northern Cyprus. Community Integration Questionnaire (CIQ), Functional Independence Measure, Measure of Quality of the Environment, Leisure Satisfaction Scale, State-Trait Anxiety Inventory, and Short-Form-12 were used. A stepwise multiple regression analysis was conducted to analyze the relationship of the dependent variable (CIQ) with the factors. Results: The results indicated that the community participation was importantly associated with employment and educational status, functional level, quality of life and satisfaction from leisure activities (p p Conclusions: The study provides a rich description of the multifaced nature of participation and its association with the factors such as employment, education, and leisure. Moreover, in terms of these factors and community participation, wheelchair users were the most disadvantaged group of people with disabilities at different mobility level.

This study examined similarities and differences between mothers of preschool children with autism spectrum disorders (ASD) and mothers of preschool children with typical development (TD) in their perceptions of four mealtime outcomes: nutritional intake, stress, time, and assistance given. One group of 24 mothers of children with ASD and one group of 24 mothers of children with TD completed a 3-day mealtime survey that addressed these four mealtime perceptions. Results from this study showed many similarities and some significant differences between the two groups of mothers during specific mealtimes. Mothers of children with ASD reported they perceived their child ate less nutritiously during breakfast, felt more stressed during dinner, and required more assistance during breakfast and snacks compared to mothers of children with TD. Family’s mealtime expectations and mealtime routines are discussed. Implications for interdisciplinary mealtime interventions for families with children with ASD. Fu...

The purpose of this study was to understand the influence of a cultural immersion experience on personal and professional healthcare practices of occupational therapists. The experience, a 10-day course in Oaxaca, Mexico, exposed participants to alternative and complementary medicine through interactive sessions with Mexican indigenous traditional healers. The literature indicates that cultural immersion experiences can increase the perceived cultural effectiveness of healthcare professionals. Three focus groups were conducted with eight occupational therapists and two occupational therapy fieldwork students who had participated in the course. Themes were coded based on responses to each question by two graduate students and a qualitative researcher. Four major themes emerged regarding the influence of a cultural immersion experience on personal and professional healthcare practices of occupational therapists: (1) Natural Remedies; (2) Mind, Body, Spirit Connection; (3) Increased Openness; and (4) Challenges of Integrating Traditional and Western Medicine. The themes derived from this study confirmed the advantages of a cultural immersion experience on both the personal and professional views and practices of occupational therapists. Cultural immersion courses can assist occupational therapists to better understand different cultural views of health, disability and healing in order to provide quality occupational therapy care in a multicultural society. Copyright © 2016 John Wiley & Sons, Ltd.

This mixed methods study describes the occupational performance goals of mothers of adolescents with disabilities and mothers of typically developing adolescents. A sample of 40 mothers was recruited, 20 mothers of typically developing adolescents and 20 mothers of adolescents with disabilities. Semi-structured interviews guided by the Canadian Occupational Performance Measure were used to gather descriptive data from the mothers. The data were then qualitatively analyzed, compared, and organized into six themes describing the mothers’ occupational performance goals. The six themes were Taking Care of Myself, Making Time for Own Occupations, Life Organization, Quality Time with Others, Sharing the Load, Supporting/Encouraging Adolescent Development. Five of the six themes were shared between both groups. The final theme was only evident in the group of mothers of adolescents with disabilities. The findings highlight the differences and similarities of occupational performance goals between mothers...

This study explored the dynamics of veteran/service dog partnerships by gathering the perspectives of veterans with a history of post-traumatic stress disorder and/or traumatic brain injury.Exploratory qualitative methods (focus groups and individual interviews) were used to investigate veteran/service dog relationships related to community involvement, family and friend relationships, self-care, work, and leisure. Nine male veterans, Paws, and Stripes program graduates participated. Data were audio recorded and transcribed by two research team members who used qualitative analytic software to manage and code the data. The full research team discussed themes and reached consensus on the themes that emerged from analysis.Five themes emerged about the perceived benefit of veteran/service dog relationship: Secluded but Seeking Society (moving from isolation to reconnection); Opening Opportunities (navigating daily life); Bridging the Gap (facilitating social opportunities); and Reclaiming Life (transforming sense of worth and purpose). An overarching theme, Calming Catalyst, connected the other four themes.Veterans in this study reported that their goal was to reclaim and develop key aspects of their lives and they perceived service dogs as a support in their transition from isolation to reintegration. This study found that service dogs supported the veterans to meet their goal. Implications for rehabilitation There are a significant number of veterans with post-traumatic stress disorder and/or traumatic brain injury who are facing life challenges including self-care, securing work, participating in leisure activities, and integrating into the community. Service dogs are an emerging intervention used to assist veterans with reintegration into civilian life. There is a need for professionals to be aware of potential benefits of service dog/veteran partnerships. Based on our findings, veterans could benefit from being paired with a service dog to facilitate their successful return to community life.

Participation in activities is essential to the development of skills and social relationships. Children from different ethnic backgrounds living in poverty often experience limited access to participation opportunities. Sixty parents of children (20 Caucasian, 20 Hispanic, 20 Native American) enrolled in Head Start programs completed the Assessment of Preschool Children’s Participation. Significant differences in skill development activities were found between ethnic groups and between genders. No differences were found in other areas of participation. To effectively promote the participation of children from different ethnic groups living in poverty, occupational therapists need to collaborate with parents within their cultural context.

OBJECTIVE. The purpose of this study was to examine the effects of partnerships between people with disabilities and service dogs on functional performance and social interaction. METHOD. A single-subject, alternating treatment design was used. The participants were 3 women with mobility challenges who owned service dogs. For each participant, time and perceived amount of effort for two tasks were measured for functional performance. Interaction and satisfaction levels were measured for social interactions. RESULTS. Primary findings were that service dog partnerships decreased performance time for four of the six tasks, decreased effort for five of the six tasks, increased social interactions for 2 of the participants, and increased levels of satisfaction with social interactions for all participants. CONCLUSION. For adult women with mobility challenges, service dog partnerships may contribute to energy conservation through decreased time and effort required to complete some tasks and may increase social interactions.

The purpose of this study was to investigate the relationship of vestibular function to motor proficiency, including balance, in children with hearing impairments. Thirteen children with normal hearing and 29 children with hearing impairments, ranging in age from 7 to 13 years, were classified into categories based on vestibular function using neuro-otologic measures (ie, vestibulo-ocular reflex function and posturography). Children in each category were tested for motor proficiency using clinical assessment measures (eg, balance, muscle tone, and coordination). The test results indicated that the children with hearing impairments and normal peripheral vestibular function (n = 7) exhibited normal motor proficiency, including balance. The children with hearing impairments and loss of peripheral vestibular sensitivity (n = 19) also demonstrated normal motor proficiency, except for balance ability. The children with hearing impairments and sensory organization deficits (n = 3), however, exhibited motor deficits in many areas. The results of this study indicate that motor proficiency in children with hearing impairments depends on vestibular function. Interventions for motor deficits in children with hearing impairments, therefore, must consider vestibular function as well as motor performance.

Occupational therapists have recognized the benefits that service dogs can provide people with disabilities. There are many anecdotal publications extolling the benefits of working with service dogs, but few rigorous studies exist to provide the evidence of the usefulness of this type of assistive technology option. This systematic review evaluates the published research that supports the use of service dogs for people with mobility-related physical disabilities. Articles were identified by computerized search of PubMed, CINAHL, PsycINFO, OT Seeker, the Cochrane Database of Systematic Reviews, SportDiscus, Education Research Complete, Public Administration Abstracts, Web of Knowledge and Academic Search Premier databases with no date range specified. The keywords used in the search included disabled persons, assistance dogs or service dogs and mobility impairments. The reference lists of the research papers were checked as was the personal citation database of the lead author. Twelve studies met the inclusion criteria and whereas the findings are promising, they are inconclusive and limited because of the level of evidence, which included one Level I, six Level III, four Level IV and one Level V. All of the studies reviewed had research design quality concerns including small participant sizes, poor descriptions of the interventions, outcome measures with minimal psychometrics and lack of power calculations. Findings indicated three major themes including social/participation, functional and psychological outcomes; all of which are areas in the occupational therapy scope of practice. Occupational therapists may play a critical role in referral, assessment, assisting clients and consulting with training organizations before, during and after the service dog placement process. In order for health care professionals to have confidence in recommending this type of assistive technology, the evidence to support such decisions must be strengthened.

Many neonatal intensive care units (NICUs) are experiencing changes in their approaches to preterm infant care as they consider and incorporate the philosophy of individualized developmental care. The aim of this systematic review is to research current literature documenting the short-term effects of developmental care and the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). The following databases were reviewed: PubMED, CINAHL, and PsychINFO by using the keywords developmental care, individualized care, preterm infant, early intervention, and NIDCAP. Fifty-four articles were found with a total of 15 matching the selection criteria. All 15 articles were assessed using a research design developed by the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM). Twelve of the 15 articles contained strong Levels of Evidence (I or II). Our findings suggest evidence supporting developmental care and NIDCAP, however, further research documenting outcomes for preterm infants receiving developmental care and/or NIDCAP is needed.

The purpose of this study was to compare the time use of mothers with adolescents with disabilities and mothers of adolescents without disabilities. Twenty mothers of adolescents (13 to 19 years old) with disabilities and 20 mothers of adolescents without disabilities completed time diaries for a period of seven 24-hour days. Mothers of adolescents with disabilities spent significantly more time in activities related to supervising their adolescents and less time in participation and socialization activities than mothers of adolescents without disabilities. As a child gets older, there is generally a decrease in the amount of time all mothers spend in childcare activities. However, mothers' occupations are impacted by having a child with a disability. Professionals working in partnership with families need to understand that the role of being a mother evolves as a child matures, and that a mother's time demands may impact the occupational engagement of all family members.

Time use patterns were systematically assessed in a sample of women with children living in a domestic violence shelter. A convenience sample of 23 women residing in a homeless shelter for women escaping domestic violence participated in this study. Time use patterns were obtained by the participants verbally reviewing a previous weekday and weekend day with the research team members. While staying at an emergency shelter for women fleeing violence, the women in this study spent significant amounts of time in sleep and rest activities, passive recreation, and socializing with other shelter residents. The daily activities engaged in by women with children living in an emergency shelter for survivors of domestic violence reflect the complex housing and personal transitions they face. Their activity patterns reflect the prevalence of psychiatric symptoms and conditions in this population and the crisis nature of surviving without stable housing in a shelter.

Occupational therapists working with Mexican and Mexican American populations may encounter traditional healing practices associated with curanderismo within a variety of practice settings. Curanderismo is a term referring to the practice of traditional healing in Latin American (Hispanic) cultures. This article reviews from the literature the different types of traditional healers (curanderos/as), the remedies recommended by traditional healers and common traditional illnesses treated. Traditional healing practices among Mexican and Mexican Americans may be as high as 50-75% in some parts of the United States. Further research is needed to investigate the effectiveness of curanderismo and its impact on quality of life, activities of daily living and overall social participation.

This article describes the experience of two occupational therapy educators who have spent time doing disability-related work in Cambodia, a country that is in the process of rebuilding its economic, education, and health infrastructure after years of war and turbulence. The authors describe their experiences, and reflect on important principles of working overseas including: setting aside assumptions and pre-laid plans; letting the reality on the ground guide decision-making and action; respecting local culture; creating strong programs through local participation and capacity-building; attending to systems issues; building bridges through attention to language and communication; and valuing the unique contributions that occupational therapy can make to international development efforts.

SUMMARY This study examined the impact of children's disabilities on the time use of mothers of young children. 45 mothers of young children with multiple disabilities and significant functional impairments and 45 mothers of children with Down syndrome were compared with 45 mothers of typically developing children. The children were aged between six months and five years. Using a seven-day time diary (the CARE inventory), it was found that mothers of children with multiple disabilities spent significantly more hours on child-related activities than did mothers of children with Down syndrome and controls. There were no significant differences between groups in the amount of time that mothers spent in recreational leisure activities; however, control mothers spent significantly more time socializing with other people than did mothers of children with disabilities. RESUME Emploi du temps des meres avec jeunes enfants: I'impact des incapacites de I'enfant Cette etude apprecie I'impact des incapacites des enfants sur I'emploi du temps des meres de jeunes enfants. 45 meres de jeunes enfants avec multiples incapacites et deficits fonctionnels significatifs, et 45 meres de trisomiques 21 ont ete comparees a 45 meres d'enfants se developpant normalement. Les enfants etaient ages de six mois a cinq ans. Utilisant un journal de sept jours (le CARE), il a ete trouve que les meres d'enfants avec incapacites multiples passaient significativement plus d'heures a des activites rapportees a l'enfant que ne le faisaient les meres de trisomiques et les controes. II n'y avait pas de difference significative entre les groupes pour le temps que les meres passaient en activites de loisirs; cependant les meres controles consacraient significativement plus de temps aux rencontres sociales que ne le faisaient les meres avec enfants porteurs d'incapacites. ZUSAMMENFASSUNG Wieviel Zeit brauchen Mutter fur Kleinkinder? Zusarzliche Belastung durch die Behinderung eines Kindes In dieser Studie wurde untersucht, wieviel mehr Zeit durch eine Behinderung des Kindes von Muttern gefordert wird. 45 Mutter von Kleinkindern mit multiplen Behinderungen und signifikanten funktionellen Storungen und 45 Mutter von Kindern mit Down Syndrom wurden mit 45 Muttern von sich normal entwickelnden Kindern verglichen. Die Kinder waren im Alter zwischen sechs Monaten und funf Jahren. Genaue Zeitaufzeichnungen uber sieben Tage (the CARE), zeigten, daβ Mutter von Kindern mit multiplen Behinderungen signifikant mehr Stunden mit Aktivitaten fur das Kind verbrachten als Mutter von Kindern mit Down Syndrom und Mutter von Kontrollen. Es fand sich kein signifikanter Unterschied zwischen den Gruppen hinsichtlich der Zeit, die die Mutter in Freizeit-aktivitaten verbrachten, die Mutter der Kontrollen hatten jedoch signifikant mehr Zeit fur Treffen mit anderen Leuten als die Mutter von behinderten Kindern. RESUMEN Tiempo pasado por las madres con ninos pequenos: el impacto de una incapacidad infantil Este estudio examina el impacto de las incapacidades de ninos sobre el tiempo utilizado para atenderlos de sus madres. 45 madres de ninos pequenos con multiples incapacidades y alteraciones funcionales significativas y 45 madres de ninos con sindrome de Down se compararon con 45 madres de ninos con desarrollo normal. La edad de los ninos era de seis meses a cinco anos. Utilizando un dietario semanal se vio que las madres de los ninos con discapacidades multiples pasaban muchas mas horas en actividades relacionadas con los nins que las madres con ninTos con sindrome de Down y las controles. No habia diferencias significativas entre ambos grupos en la cantidad de tiempo gastado por la madre en actividades recreativas y de ocio; sin embargo las madres control pasaban mas tiempo en actividades sociales con otras personas que las madres con ninos con incapacitades.

SUMMARY The purpose of this exploratory study was to describe the occupational goals and concerns of women who are homeless with children. Twenty-seven women with children living in homeless shelters completed interviews using the Canadian Occupational Performance Measure (COPM). Occupational issues and concerns were identified for each participant, and then they were pooled. A total of 169 occupational concerns were described and analyzed. The most common occupational issues identified by participants concerned finances, employment, education, transportation, housing, time for self, personal appearance, home management, and parenting. Analysis of identified occupational concerns suggests that the homeless women with children experienced a range of institutional and social barriers to occupational participation: essentially a form of occupational injustice. This study raises questions concerning the most effective roles for occupational therapists to facilitate empowerment so that women who are homeless may fully participate in the communities where they live.

OBJECTIVE. The purpose of this study was to compare the time use of mothers of children with disabilities with the time use of mothers of children without disabilities. METHOD. Sixty mothers with children 3 to 14 years of age (30 mothers with children with disabilities and 30 mothers with children without disabilities) completed time diaries over seven 24-hour days. RESULTS. Significant differences were found between the two groups when comparing mean hours spent per week by mothers in occupations involving child-care activities and recreational activities. Mothers of children with disabilities spent significantly more time in child-care activities and significantly less time in recreational activities. In addition, mothers of children with disabilities reported fewer typical days and rated the quality of days as poorer. As children got older, the gap between the time mothers devoted to child care increased between the two groups. CONCLUSION. The type of occupations a mother participates in varies significantly dependent upon whether a child in the family has a disability and the age of the child. Professionals need to work collaboratively with families to assist parents to meet the family’s daily needs particularly in light of the time demands of the mother.

The use of wheelchairs or other mobility aids often limits the community participation of people with disabilities because of architectural barriers present in buildings. Although this has been recognized as a global problem, little research has been done to document accessibility standards on an international level. This study reports results from a survey using the Americans With Disabilities Act Accessibility Guidelines Checklist for Buildings and Facilities to measure the differences in levels of accessibility in Albuquerque, New Mexico, United States, and Oaxaca, Oaxaca, Mexico. Investigators surveyed four building types (stores, restaurants, churches, and government buildings or public museums) in both geographic locations to determine whether each building was accessible. The findings showed that buildings in Albuquerque were significantly ( p < .0001) more accessible than buildings in Oaxaca on all measurement items and across all four building types. However, many buildings in Albuquerque were not fully accessible.

Mothers of children with disabilities have identified multiple challenges associated with achieving occupational balance in their lives. Occupational therapists are just beginning to explore the occupational and time use strategies that mothers use to successfully care for their children and get through the day in a positive manner. The Person—Environment—Occupation model was used to guide an occupational therapy intervention program called “Project Bien Estar,” which was designed to increase the satisfaction, time use, and occupational performance of mothers of school-aged children with disabilities. This article focuses on the rich content of the group discussions and individual reflections, providing insight into the world of women caring for children with disabilities. Thematic analysis was used to identify person, environment, and occupation factors that contribute positively and negatively to the mothers' well-being, and the effects of the occupational therapy intervention are discussed.

OBJECTIVE. This experimental research study evaluated the impact of an 8-week psychosocial occupational therapy intervention program for mothers who have children with disabilities. METHOD. Thirty-eight mothers of children with disabilities were randomly assigned to participate either in the treatment or the control group (19 in each). The occupational therapy intervention was designed to facilitate increased perceptions of satisfaction with time use and occupational performance, thereby positively affecting maternal and family well-being. The Canadian Occupational Performance Measure (COPM) was administered to measure self-perceptions of occupational performance and satisfaction over time. RESULTS. No significant differences were found between the two groups on time use perceptions. Although no significant differences were found between the two groups on the COPM Performance subscale, the treatment group demonstrated significantly greater score increases (p < .05) on the COPM Satisfaction subscale. CONCLUSION. This preliminary study suggests that attending to the time use and occupational concerns of mothers of children with disabilities can have a positive impact on their satisfaction with occupational performance.

Purpose: The purpose of this study was to identify current practice in assessment useof school-based occupational therapy practitioners and to identify their expectations of student performance in assessment upon completion of the pediatric Fieldwork II experience. A survey of school-based occupational therapists in the southwestern states was conducted to answer three research questions: (1) what standardized assessments are currently used frequently and occasionally by occupational therapy practitioners in the school setting, (2) what level of competency in assessment administration by Fieldwork II students is expected by supervising occupational therapists, and (3) what educational preparation did the practitioners receive prior to their employment in schools and what professional support is currently available to them? Method: A five page questionnaire was mailed to 406 practicing thera-pists in four southwestern states with a response rate of 74.1 percent using Dillman's Total Design Method. Results:...

Changes in the perceived self-images and coping strategies of mothers of children with special needs after they participated in a short-term occupational therapy intervention (Project Bien Estar) are discussed. We conducted focus groups to ascertain whether women's coping strategies and views of themselves had changed as a result of participation in the program. The results of this study found that participating in Project Bien Estar enabled participants to share their perceptions of their self-image such as feeling overwhelmed with their daily care routine, being socially isolated, losing their identity, and expecting less from their careers. Participants expressed that participating in the program helped them to feel strong, attractive, resilient, respected, and accepted. After participating in the program, they expressed they had gained coping skills such as increased ability to advocate for themselves and their child, more relaxed expectations about their responsibilities and what is needed to care well for their child, and increased self-care practices.

SUMMARY To become competent occupational therapy practitioners, students must develop the ability to reflect upon their current and future professional development. This paper presents one curriculum's approach (the University of New Mexico) to using evaluation activities in problem-based learning to enhance students' cultivation of professional reflection skills. A description of these evaluation activities and accompanying tools is provided along with a critique of their strengths and limitations.

Over a period of 30 years, Dr. A. Jean Ayres conducted and disseminated research related to the theory and practice of sensory integration. The Center for the Study of Sensory Integrative Dysfunction was established to promote Ayres' research with 66 faculty members recruited by 1982. To describe how Dr. Ayres may have influenced the occupational therapy profession, a survey was conducted to document the scholarly/leadership productivity of Sensory Integration faculty. Of the 66 faculty members, 48 were located and sent survey packets. The return rate was 79% (n = 38). Respondents documented their productivity in eight categories and answered 18 questions about their leadership qualities. Ninety-seven percent of respondents indicated that Ayres had professionally influenced them. Fifty-one percent of respondents had doctorate degrees with 78% reported having academic teaching experience. This group of 38 professionals had produced 438 peer-reviewed articles, 707 nonpeer-reviewed publications, and 265 grants. Ayres' legacy is continued with the scholarly work of the Sensory Integration faculty who received professional mentorship.

The sleep patterns of 45 mothers of children with moderate to severe multiple disabilities, 45 mothers of children with Down syndrome, and 45 mothers of typically developing children were compared by means of a 7-day diary. The children ranged in age from 6 months to 5 years. The Caregiver's Activity and Recording of Events (CARE) Inventory was completed by each subject to record mothers' activities in half-hour segments throughout a 24-hour day. Activities were coded into nine categories including rest/sleep. The three groups of mothers were compared on total hours of rest/sleep per day, number of sleep interruptions, reason for sleep interruptions, influences of siblings of target children, and number of times the father attended to the target child during the night as perceived by the mother. Surprisingly, the results indicated that mothers of children with multiple disabilities reported more sleep than did mothers in the other two groups. There were no significant differences found among the groups in the following: amount of weekly daytime sleep; frequency and duration of child-related interruptions per week; number of nights of uninterrupted sleep per week; maximum number of sleep interruptions in one night; and mothers' perception of fathers' nighttime assistance. The data indicated that many mothers in all three groups experienced numerous weekly sleep interruptions, particularly mothers of infants 6 to 12 months of age. Professionals working with mothers of young children must consider the effects of shortened and interrupted sleep patterns on the day time functioning and health of mothers and the effect on the well-being of the entire family.

The ability of children with learning disabilities and motor delays to maintain postural stability under conditions of sensory conflict was compared to that of children who were typically developing. Thirty-six children, 6 through 9 years of age, with identified learning disabilities and motor delays were matched according to age, sex, and ethnicity with 36 children who were typically developing. The Pediatric Clinical Test of Sensory Interactions for Balance (P-CTSIB) was administered to both groups. This test requires children to maintain standing balance while the sensory environment is systematically altered. Performance of the two groups on six sensory system scales were compared using the Mann-Whitney U. The children with learning disabilities and motor delays received significantly lower scores on four of the six sensory system scales. These results suggest that some children with learning disabilities and motor delays have defecits in sensory organization related to balance which may contribute to...

Twenty-four children age four through nice years who were typically developing were given the Pediatric Clinical Test of Sensory Interaction for Balance (P-CTSIB) on tow occasions separated by approximately one week. Test-retest reliability and the magnitudes of difference between test and retest scores were examined for both the Feet-Together and Heel-Toe Positions for the sway and duration scores separately and for the combined sway and duration scores by different sensory conditions. Spearman rank correlation coefficients for the sway and duration scores ranged form very low to moderate. Reliability coefficients improved when examining combined sensory condition scores for a low of .44 to a high of .83. Although some of these reliability coefficients were low, they are comparable to those on other published balance tests. The magnitudes of difference between test and retest combined sensory condition scores were minimal for the Feet-Together P-CTSIB. For the Heel-Toe P-CTSIB, the magnitudes of differen...

Standardized pediatric testing is a common tool used to gather information is the assessment process for occupational and physical therapists. A description of the application of the standard error of measurement (SEM) for interpretation of children's scores from standardized norm- referenced tests is given. Three case examples are presented to demonstrate the use of the SEM and its impact on children's test scores when therapist are making critical clinical decisions. Recommendations for therapist related to interpreting standardized testing, reporting test scores, and measuring intervention progress are included.

Occupational therapists have recognized the benefits that service dogs can provide people with disabilities. There are many anecdotal publications extolling the benefits of working with service dogs, but few rigorous studies exist to provide the evidence of the usefulness of this type of assistive technology option. This systematic review evaluates the published research that supports the use of service dogs for people with mobility-related physical disabilities. Articles were identified by computerized search of PubMed, CINAHL, PsycINFO, OT Seeker, the Cochrane Database of Systematic Reviews, SportDiscus, Education Research Complete, Public Administration Abstracts, Web of Knowledge and Academic Search Premier databases with no date range specified. The keywords used in the search included disabled persons, assistance dogs or service dogs and mobility impairments. The reference lists of the research papers were checked as was the personal citation database of the lead author. Twelve studies met the inclusion criteria and whereas the findings are promising, they are inconclusive and limited because of the level of evidence, which included one Level I, six Level III, four Level IV and one Level V. All of the studies reviewed had research design quality concerns including small participant sizes, poor descriptions of the interventions, outcome measures with minimal psychometrics and lack of power calculations. Findings indicated three major themes including social/participation, functional and psychological outcomes; all of which are areas in the occupational therapy scope of practice. Occupational therapists may play a critical role in referral, assessment, assisting clients and consulting with training organizations before, during and after the service dog placement process. In order for health care professionals to have confidence in recommending this type of assistive technology, the evidence to support such decisions must be strengthened.

This study identified mealtime behaviors of young children (3-6 years old) with autism spectrum disorder (ASD) and compared these behaviors to children with typical development matched for age, gender, and ethnicity. The parents of children with ASD (n = 24) and children with typical development (n = 24) completed a mealtime survey to assess early mealtime history, mealtime location and behaviors, food preferences and behaviors, and eating problems. Parental concerns increased significantly after age 1 year in the children with ASD. Matched analysis results showed significant differences between the pairs of children in specific mealtime behaviors. More children with ASD were picky eaters, mouthed nonfood items, resisted new foods, limited foods based on textures, had problems with gagging, had difficulty eating at regular restaurants or at school, resisted sitting at the table, and threw or dumped food. Knowledge of these early differences can help pediatric therapists to assess feeding issues and plan interventions.

The purpose of this study was to collect and examine descriptive data on the Pediatric Clinical Test of Sensory Interaction for Balance (P-CTSIB) for children ages 6 to 9 years. To guide decisions regarding grouping of data, hypotheses were tested concerning differences among means for duration of stance for gender and for age. Because results were inconclusive, descriptive data for duration of stance and degrees of sway for each of the six P-CTSIB Feet-Together tests and each of the six P-CTSIB Heel-Toe tests are reported by gender and age category. Recommendations are made for clinical use of this test, and directions for future research are identified.

The interrater reliability of a new standing balance test, the pediatric version of the Clinical Test of Sensory Interaction for Balance (CTSIB), was examined. The CTSIB is a test that evaluates a ...

This study compares rural and urban occupational therapy practice in school systems. Two hundred and fifty-two occupational therapists in the Northwest region of the United States were surveyed. Service delivery mechanisms, caseloads, continuing education, and academic preparation were issues of concern, especially for rural therapists. Implications for future occupational therapy practice in rural school systems are discussed.

The passage of PL 94-142 created a need to focus on the roles of occupational therapists in school system practice. This survey was designed to identify the current state of practice of school system occupational therapists in the Northwest region of the United States. Questionnaires were mailed to 355 occupational therapists with 80.8% of the therapists responding. Survey questions focused on demographic information, job descriptions, frames of reference used in practice and problems encountered. Approximately 60 percent of the therapists did not feel adequately prepared for school system practice, although this percentage was decreased to 39 percent among those therapists who had taken a Fieldwork II placement in a school setting. Eighty-four percent described their jobs as itinerant. The mean number of hours therapists worked per week was 29.1 hours. The largest amount of time was spent in direct service, followed by monitoring and consultation. Major problems identified included large case loads, litt...

Parents of children with autism spectrum disorder (ASD) frequently report that their children have selective eating behaviors and refuse many foods, which could result in inadequate nutrient intake. This preliminary cross-sectional descriptive study investigated dietary intake and parents' reported perception of food behaviors of 20 3- to 5-year-old children with ASD. Twenty typically developing children matched for sex, age, and ethnicity were also studied as a case-control comparison. Nutrient intake determined from 3-day food records was adjusted for day-to-day variation to determine the estimate of usual intake distribution for the two groups. This distribution was compared with the Estimated Average Requirement or Adequate Intake recommendations. The reported food behaviors and use of vitamin or mineral supplements were compared for matched pairs using the exact McNemar test. Nutrient intake was similar for both groups of children, with the majority of children consuming more than the recommended amounts for most nutrients. Nutrients least likely to be consumed in recommended amounts were vitamin A, vitamin E, fiber, and calcium. Children with ASD were more likely to consume vitamin/mineral supplements than typically developing children. Compared with parents of typically developing children, parents of children with ASD were more likely to report that their children were picky eaters and resisted trying new foods, and they were less likely to describe their children as healthy eaters or that they eat a variety of foods. Despite the similar and generally adequate nutrient intake for the 40 children in this study, parents of children with ASD had more negative perceptions of their children's dietary behaviors.

OBJECTIVE. The purpose of this study was to describe the occupational concerns and goals of mothers who care for children with disabilities. METHOD. Retrospective data collected from 38 mothers of children with disabilities using the Canadian Occupational Performance Measure (COPM) were analyzed qualitatively. RESULTS. Six themes emerged: (I) doing and being alone: taking care of my own health and well-being; (II) doing and being with others: expanding my social life; (III) improving my child’s quality of life; (IV) household management: organizing time and resources; (V) balancing work, home, and community responsibilities; and (VI) sharing the workload. CONCLUSION. Overarching patterns in the data suggested that the occupational performance of mothers of children with disabilities is constrained by time, overlaid by difficult emotions, and involves a desire for increased social contact. Qualitative analysis of data from the COPM may provide insight into contextual factors that affect occupational performance as well as signaling point of entry for therapists to facilitate client-centered occupational goals.

The purpose of this study was to identify current practice in assessment use of school-based occupational therapy practitioners and to identify their expectations of student performance in assessment upon completion of the pediatric Fieldwork II experience. A survey of school-based occupational therapists in the southwestern states was conducted to answer three research questions: (1) what standardized assessments are currently used frequently and occasionally by occupational therapy practitioners in the school setting, (2) what level of competency in assessment administration by Fieldwork II students is expected by supervising occupational therapists, and (3) what educational preparation did the practitioners receive prior to their employment in schools and what professional support is currently available to them?A five page questionnaire was mailed to 406 practicing therapists in four southwestern states with a response rate of 74.1 percent using Dillman's Total Design Method.Respondents reported use of motor and visual perception tests most frequently in their practice. When trends of this survey were compared to previous surveys, practitioners reported similar use of motor and visual perception tests, a decreased use of sensory integration measures, and an increase in the use of function-based assessments.

Objective. This study examined and compared mothers’ perceptions of child care assistance provided by fathers and other caregivers. Awareness of child care division of labor will assist occupational therapists in addressing the needs of children with disabilities within the family context. Method. One hundred and thirty-five mothers living in two-parent households kept a time diary of their daily activities for 7 consecutive days using the Caregiver’s Activity and Recording of Events Inventory and estimated the percentage of child care their partners performed, the amount of child care their partners performed, and their satisfaction with this division of labor. One third of the women had children with multiple disabilities, one third had children with Down syndrome, and one third had children who were typically developing. Results. The majority of mothers in all three groups perceived that they were responsible for the majority of child care. There were no significant differences between groups in terms of mothers’ perceptions of the amount of child care provided by fathers and other caregivers, including relatives, childsitters, nurses, school personnel, and neighbors. However, there were wide variations among families concerning child care arrangements and division of labor. Seventy-five percent of mothers indicated that they were satisfied with the division of child care labor between mothers and fathers, and no significant correlation was found between perceived percentage of child care performed and satisfaction with the division of labor. Conclusion. Mothers in this study were responsible for the majority of child care whether their child had a disability. The variation in number of hours that others spent performing child care activities within individual families suggests that there is no “best” or typical pattern. Occupational therapists need to collaborate with families to determine a system of accommodations to manage their daily routine that most effectively meets the family’s needs.

Objective. The purpose of this study was to examine and compare the perceived past, present, and future occupational roles of mothers of young children. Awareness of the role demands placed on mothers will assist occupational therapists in addressing the needs of children with disabilities within the family context. Method. One hundred and thirty-five mothers of children 6 months to 5 years of age completed the Role Checklist, which examines participants’ perceptions of past, present, and future occupational roles. Forty-five participants had children with multiple disabilities and major functional limitations, 45 had children with Down’s syndrome, and 45 had children who were typically developing. Results. The group of mothers of children who were typically developing was found to have significantly more present roles than the other two groups. All three groups lost significant numbers of roles from past (before birth of child) to present and anticipated adding significant numbers of future roles. There were no significant differences among the three groups in value placed on occupational roles. Conclusion. Role demands of caring for a young child were high for all participants, particularly if the child had a disability. Participants seemed to respond to these demands by giving up other discretionary roles in order to meet their caregiving obligations. Thus, asking mothers of children with disabilities to take on therapy-related caregiving tasks may contribute to role strain.

The study summarized in this report examined the stability in 30 family routines practiced by families with children with disabilities. Forty-one mothers with children with disabilities participated. The results indicated that participants' routines and the value that they placed on the routines changed over time.