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American Journal of Occupational Therapy
Journal Prestige (SJR): 0.821
Citation Impact (citeScore): 2
Number of Followers: 206  
 
  Partially Free Journal Partially Free Journal
ISSN (Print) 0272-9490 - ISSN (Online) 1943-7676
Published by AOTA Homepage  [1 journal]
  • Becoming Critical Consumers of Evidence in Occupational Therapy for
           Children and Youth
    • Authors: Grajo LC; Laverdure P, Weaver LL, et al.
      Abstract: This special issue of the American Journal of Occupational Therapy on interventions for children and youth highlights the current developments in and evidence for the effectiveness of occupational therapy interventions and psychometric properties of assessments for children and youth. In this guest editorial, we identify various factors that challenge the implementation of evidence-based strategies in daily clinical practice. We assert that scholars, educators, and practitioners need to address several strategic steps. To facilitate critical consumption of evidence in practice, efforts need to be made to build capacity for evidence production and evidence use through implementation science and to ensure that evidence-based practice is not only taught but also reflectively applied across the educational curriculum and that clinicians are given more access to resources that are easy to translate to daily clinical practice.
      PubDate: Tue, 17 Mar 2020 00:00:00 GMT
       
  • Understanding Policy Influences on Health and Occupation Through the Use
           of the Life Course Health Development (LCHD) Framework
    • Authors: Pitonyak JS; Pergolotti M, Gupta J.
      Abstract: Life course health development (LCHD) is a framework that considers the transactional nature of risks and protective factors along the life trajectory and how this context influences health. Public policies, from health care to education to social services to labor laws, have many goals, including lessening and eliminating health disparities, yet inequities in health services and outcomes remain. Policy is a contextual factor that may be overlooked when examining influences on health and occupation. As such, the LCHD framework may assist occupational therapy practitioners in understanding the influences of policy—both successes and failures—on occupation. In this article, we introduce the principles of LCHD and use this framework to illustrate analysis of a policy example of paid family leave, demonstrating how gaps in or unintended consequences of policy may contribute to disparities in health and occupation for certain populations.
      PubDate: Wed, 05 Feb 2020 00:00:00 GMT
       
  • Pediatric Persistent Pain: Associations Among Sensory Modulation,
           Attachment, Functional Disability, and Quality of Life
    • Authors: Sinclair C; Meredith P, Strong J.
      Abstract: Importance: Although attachment is associated with sensory modulation among children and adolescents and insecure attachment is associated with pain severity among adolescents, relationships among sensory modulation, attachment, and function have not previously been demonstrated in a clinical sample of children and adolescents with complex persistent pain.Objective: To investigate relationships among sensory modulation, attachment, function, and quality of life (QOL) in a pediatric population with persistent pain.Design: Cross-sectional quantitative design. From October 2015 to July 2017, all children, adolescents, and parents attending a clinic for assessment completed questionnaires and were provided information and consent forms. Those who consented completed sensory modulation and attachment questionnaires.Setting: Tertiary pain management clinic.Participants: Children (ages 8–12 yr) and adolescents (ages 13–18 yr) with persistent pain (pain of >3 mo duration or a specific pain disorder) and the capacity to answer questionnaires independently.Measures: Standardized sensory modulation, attachment, pain intensity, functional disability, and QOL questionnaires. Hypotheses were generated before data collection.Results: Of 152 children and adolescents, 114 children (30 girls, 9 boys) and adolescents (68 girls, 7 boys) met study criteria and consented to participate. Hierarchical multiple regression analyses revealed that sensory sensitivity predicted disability for children and adolescents, and attachment anxiety mediated the relationship between low registration and poorer school-related QOL.Conclusion and Relevance: Behaviors related to insecure attachment patterns provide a mediating pathway from sensory modulation to functional disability; addressing such behaviors clinically may facilitate engagement in daily activities for children and adolescents with persistent pain.What This Article Adds: Results support the need to consider the interactions between sensory modulation and attachment when addressing functional abilities with occupational therapy treatment.
      PubDate: Wed, 05 Feb 2020 00:00:00 GMT
       
  • Brain Mapping Performance as an Occupational Therapy Assessment Aid in
           Attention Deficit Hyperactivity Disorder
    • Authors: Chatthong W; Khemthong S, Wongsawat Y.
      Abstract: Importance: Brain mapping performance (BMP) may provide strong predictors to analyze primary functional outcomes and support occupational therapy with clients with attention deficit hyperactivity disorder (ADHD).Objective: To clarify the value of quantitative electroencephalography to indicate BMP in children with ADHD.Design: One-year cross-sectional study.Setting: Brain Computer Interface Laboratory, Mahidol University, Salaya, Nakhon Pathom, Thailand.Participants: Thai school-age children with and without ADHD (N = 305).Outcomes and Measures: We used θ relative power in concordance with stepwise multiple regression analysis. Outcomes included measures of 12 brain locations that were compared between children with and without ADHD.Results: Significant differences were found between the groups, especially for Cz, T3, Fp1, Fz, F4, and F7. According to BMP, the group with ADHD had higher emotional awareness and language comprehension than the group without ADHD.Conclusions and Relevance: Occupational therapy practitioners can use BMP as a valuable tool for setting occupational goals to help children with ADHD improve their social–emotional learning performance in school and in the community. BMP may provide an evaluation to support occupational therapy services for clients with ADHD. The result can be applied in clinical settings by quantitative electroencephalography training.What This Article Adds: BMP can be used as a neuropsychological and behavioral assessment tool for setting SMART (specific, measurable, attainable, relevant, and time-oriented) goals for occupational therapy services for clients with ADHD.
      PubDate: Fri, 31 Jan 2020 00:00:00 GMT
       
  • Interrater Reliability and Concurrent Validity of the Neonatal Eating
           Outcome Assessment
    • Authors: Pineda R; Liszka L, Kwon J, et al.
      Abstract: Importance: Few neonatal feeding assessments are currently available, and the Neonatal Eating Outcome Assessment is the only one that identifies feeding impairment while considering the developmental changes that occur from preterm birth to term-equivalent age.Objective: To determine the interrater reliability and concurrent validity of the Neonatal Eating Outcome Assessment.Design: Prospective, observational study.Setting: Level 4 neonatal intensive care unit.Participants: A convenience sample of 7 neonatal therapists participated in reliability testing. For concurrent validity, a prospective cohort of 52 preterm infants born ≤32 wk gestation had feeding assessed at term-equivalent age.Outcomes and Measures: Intraclass correlations (ICCs) and Fleiss’s κ statistics were used to define reliability across therapists, who independently scored five videos of preterm infants orally feeding using the Neonatal Eating Outcome Assessment. Concurrent validity was determined by evaluating relationships between the Neonatal Oral Motor Assessment Scale (NOMAS) and the Neonatal Eating Outcome Assessment using an independent-samples t test and χ2 analysis.Results: The ICC for the Neonatal Eating Outcome Assessment total score was 0.90 (confidence interval [CI] [0.70, 0.99]). Fleiss’s κ scores for the 19 scorable items on the Neonatal Eating Outcome Assessment had predominately moderate, fair, and slight agreement, with 3 items having poor agreement. Dysfunctional NOMAS scores were related to lower Neonatal Eating Outcome Assessment scores (t[49.4] = 3.72, mean difference = 12.2, 95% CI [5.60, 18.75], p = .001).Conclusions and Relevance: The Neonatal Eating Outcome Assessment has excellent reliability. Concurrent validity was established.What This Article Adds: This article reports that the final version of the Neonatal Eating Outcome Assessment (Version 5.7) has excellent interrater and concurrent validity and is an important tool to assess the occupation of infant feeding in clinical practice.
      PubDate: Tue, 28 Jan 2020 00:00:00 GMT
       
  • Fine Motor Activities in Elementary School Children: A Replication Study
    • Authors: Caramia S; Gill A, Ohl A, et al.
      Abstract: Importance: The educational landscape is continually changing in response to legislation and the adoption of new standards, such as the Common Core. Currently, little is known about how these changes have influenced the school day.Objective: To examine the motor and technology requirements of kindergarten, second-, and fourth-grade general education classrooms.Design: For 6 full school days, we made unobtrusive observations of and took notes that described classroom activities throughout the day. Data were coded by a committee, allocating each minute of the day into 1 of 10 activity categories.Setting: Kindergarten, second-, and fourth-grade classrooms.Participants: Three general education classrooms with approximately 20 students in each class.Results: Students spent between 37.1% and 60.2% of the school day performing fine motor activities, with handwriting accounting for 3.4%–18.0% of the day. Time spent using technology was relatively sparse in kindergarten (4.8%) and second grade (3.1%) compared with fourth grade (14.3%). Transitions between activities (18.9%–23.4% of time spent) exceeded time spent handwriting.Conclusion and Relevance: This article provides an updated estimate of motor demands throughout the school day. Estimates of fine motor activities were consistent with previous research, but the focus on handwriting appears to have substantially diminished.What This Article Adds: Within the context of their own school, occupational therapists may find transitions to be a good opportunity for providing services within the classroom. In addition, handwriting practice outside of school may be more necessary in the current educational climate than in previous years.
      PubDate: Tue, 28 Jan 2020 00:00:00 GMT
       
  • Reliability and Validity of the Chinese Version of the Infant/Toddler
           Sensory Profile
    • Authors: Yang C; Tseng M, Cermak SA, et al.
      Abstract: Importance: In Chinese-speaking societies, a reliable and valid measure is needed to enable early identification of young children’s challenges in sensory processing.Objective: To examine the psychometric properties of the Chinese version of the Infant/Toddler Sensory Profile (ITSP–C) when used with Taiwanese children.Design: Prospective study.Setting: Multiple settings.Participants: Participants were 367 typically developing (TD) infants ages 0–6 mo (mean [M] age = 3.44 mo, standard deviation [SD] = 1.82) and 677 toddlers ages 7–36 mo (M age = 22.33 mo, SD = 8.15), along with 42 toddlers with developmental disabilities (DD; M age = 28.4 mo, SD = 6.7).Outcomes and Measures: The ITSP, a caregiver questionnaire that measures how children respond to sensory events in daily life, was translated and cross-culturally adapted into a Chinese version (ITSP–C).Results: Internal consistency was high for the 0–6 mo subscale (α = .80) and the 7–36 mo subscale (α = .82). Test–retest reliability was excellent for the 7–36 mo subscale (intraclass correlation coefficient = .94). Logistic regression analysis demonstrated that the ITSP–C discriminated between children with DD and TD children.Conclusions and Relevance: The ITSP was successfully adapted to Chinese with similar reliability and validity to the original ITSP. The 7–36 mo subscale had a higher level of reliability than the 0–6 mo subscale, and quadrant scores were more reliable than section scores. Moreover, the ITSP–C discriminated children with DD from TD children on the basis of their sensory processing patterns.What This Article Adds: The ITSP–C has sound psychometric properties and support for its use in early identification of sensory processing difficulties in young Chinese-speaking children.
      PubDate: Tue, 28 Jan 2020 00:00:00 GMT
       
  • Parents’ Perspectives: An Expanded View of Occupational and
           Co-Occupational Performance in the Neonatal Intensive Care Unit
    • Authors: Cardin AD.
      Abstract: Importance: One limitation of occupation-based neonatal practice is the lack of clarity surrounding what parent and infant occupations exist in the neonatal intensive care unit (NICU). Without clear definitions and examples of these constructs, occupational therapists may not recognize or value them as part of practice.Objective: To explore concepts of occupational and co-occupational performance in the NICU and provide richly expanded descriptions of parent and infant occupations in this setting.Design: Phenomenological study with convenience sampling. Participants engaged in semistructured interviews. Inductive content analysis, in vivo and process coding methods, and cross-case analysis were used. Member checking and expert review of emergent themes were used to ensure authenticity.Setting: A metropolitan 48-bed Level 3 NICU with single-family rooms in the midwestern United States.Participants: Fourteen parents (mean age = 29.7 yr; range = 19–37 yr) volunteered for the study.Results: Five themes of active occupational engagement emerged: (1) perceiving “they” versus “I”; (2) maintaining proximity; (3) expressing emotions, values, and beliefs; (4) addressing health issues; and (5) analyzing. A matrix framework displayed emergent themes with definitions of parent occupations, infant occupations, and parent–infant co-occupations. Examples of both directly observable and hidden occupations were found at matrix intersections.Conclusions and Relevance: Occupational performance prevalently reflected attempts to balance power differentials and pursue meaningful engagement through observable and hidden participation in caregiving. Findings suggest that beyond typical occupations (e.g., feeding, socializing), neonatal therapists can address the doing, being, and becoming occupations expressed by parents in this study.What This Article Adds: Parents described five broad thematic categories of NICU-based occupation and co-occupation, which may be valuable to therapists seeking to strengthen the occupational focus of neonatal intervention. Neonatal therapists may need to advocate for service provision policy change to fully address the observable and nonobservable doing, being, and becoming occupational and co-occupational needs of parents and infants.
      PubDate: Tue, 28 Jan 2020 00:00:00 GMT
       
  • Interventions Within the Scope of Occupational Therapy to Improve
           Children’s Academic Participation: A Systematic Review
    • Authors: Grajo LC; Candler C, Sarafian A.
      Abstract: Importance: Occupational therapy practitioners evaluate students’ ability to participate in school and may provide services to improve learning, academic performance, and participation.Objective: To examine the effectiveness of interventions within the scope of occupational therapy practice to improve academic participation of children and youth ages 5–21 yr.Data Sources: We searched MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases for articles published from 2000 to 2017 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Study Selection and Data Collection: Within the scope of occupational therapy practice and focused on children ages 5–21 yr.Findings: Forty-six studies were included, based on three themes: (1) interventions to support participation and learning in the classroom; (2) interventions to support motivation and participation in literacy, including combined reading, written expression, and comprehension; and (3) interventions to support handwriting. Low strength of evidence supports the use of weighted vests and stability balls, and moderate strength of evidence supports the use of yoga to enhance educational participation. Moderate strength of evidence supports the use of creative activities, parent-mediated interventions, and peer-supported interventions to enhance literacy participation. Strong evidence supports therapeutic practice for handwriting intervention, and low strength of evidence supports various handwriting programs as replacement or additional instructional strategies to enhance handwriting abilities.Conclusions and Relevance: More rigorous studies are needed that are conducted by occupational therapy practitioners in school-based settings and that use measures of participation and academic outcomes.What This Article Adds: This systematic review provides occupational therapy practitioners with evidence on the use of activity-based and occupation-centered interventions to increase children’s participation and learning in school.
      PubDate: Tue, 28 Jan 2020 00:00:00 GMT
       
 
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