American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association

In 45 of 50 states, occupational therapists are not eligible to pursue formal administrative positions in public school systems (e.g., director of transition services, special education director) on the basis of state-level legislation and credentialing. Most state boards of education, however, recognize other related service providers (e.g., speech-language pathologists, social workers) as credentialed educators. Most states require education credentials to pursue further administrative credentials and, thus, administrative positions...

IMPORTANCE: Supporting community residency of adults with Alzheimer's disease (AD) is a critical public health initiative. Occupational therapy can contribute to this goal. OBJECTIVE: To assess the feasibility of a novel telehealth intervention to support occupational engagement in community-residing people with AD. DESIGN: Single-blind, three-arm, parallel, randomized controlled trial. SETTING: Occupational therapy delivered through telehealth in participants' homes...

IMPORTANCE: Occupational therapy practitioners are uniquely qualified to address the occupational needs of people with traumatic brain injury (TBI) and their caregivers to maximize participation, health, and well-being. OBJECTIVE: These Practice Guidelines are informed by systematic reviews of the effectiveness of interventions that address impairments and skills to improve the occupational performance of people with TBI, as well as interventions for caregivers of people with TBI...

IMPORTANCE: Although occupational balance (OB) is a construct of importance to occupational therapy, existing OB assessments have not been validated in clinical populations. OBJECTIVE: To examine the validity and reliability of the 11-item version of the Occupational Balance Questionnaire (OBQ11) in U.S. adults with Type 1 diabetes. DESIGN: Data were analyzed from adults with Type 1 diabetes enrolled in a larger longitudinal study examining the relationships among blood glucose, emotion, and functioning...

IMPORTANCE: Impaired tactile perception frequently accompanies motor deficits in children with cerebral palsy (CP). Assessing tactile perception precisely for children with CP remains challenging because of a lack of assessments with robust psychometric evidence or standard procedures. OBJECTIVE: To develop a standardized assessment tool, the Tactile Perceptual Test (TPT), for measuring tactile perception in children with CP and to examine its psychometric properties...

IMPORTANCE: Emerging research has demonstrated that constraint-induced movement therapy (CIMT) and bimanual intensive training (BIT) show promising effectiveness for children with unilateral cerebral palsy (UCP). Considering that neurorehabilitative programs have always been designed with long training periods, psychosocial outcomes have received scarce attention and thus have not been investigated sufficiently. OBJECTIVE: To compare the efficacy of CIMT and BIT with 36-hr interventional dosages for both motor and psychosocial outcomes...

IMPORTANCE: Children with cerebral palsy (CP) and severe hand impairment have limited options for upper extremity (UE) orthoses. OBJECTIVE: To (1) design and fabricate a customized low-cost, functional, three-dimensional (3D) printed dynamic upper extremity orthosis (DUEO) and (2) examine, using a comprehensive evaluation, the effect of the orthosis on the UE function of children with unilateral UE CP, Manual Ability Classification System (MACS) Levels III to V...

IMPORTANCE: Although subjective memory complaints (SMCs) have been suggested to be associated with future memory impairment, limitations in instrumental activities of daily living (IADLs), and social participation restriction, these associations are still inconclusive. OBJECTIVE: To determine whether changes in SMCs over time predict decline in memory, IADLs, and social participation in older adults. DESIGN: Longitudinal study. SETTING: Community...

IMPORTANCE: Wicked problems are those that are messy and complex and have no obvious solution. Occupational therapists and their clients encounter wicked problems in all areas of practice, and therefore it is essential that they know how to address them. OBJECTIVE: To identify the key constructs involved in addressing wicked problems, discover considerations for occupational therapists, and develop a conceptual model that supports how to address these problems. DESIGN: This study had a critical review design and focused on literature from sectors such as health care, social services, policy, business, management, and leadership...

IMPORTANCE: Driving cessation affects older drivers and, possibly, also care partners (most of whom tend to be women). Although tools exist to assess the effects on family and friends of providing informal care to someone who needs assistance, no tool is available to clinicians that specifically focuses on the effects of driving cessation. OBJECTIVE: To develop the Transportation Support Scale (TSS) to measure care partners' responses-both negative and positive-to driving cessation and assuming transportation responsibilities...

IMPORTANCE: Routine measurements used in clinical settings can foster evidence-based interventions and show the treatment effectiveness. OBJECTIVE: To examine the efficacy of occupational therapy services for health outcomes, as determined by modified self-care and mobility items of the Continuity Assessment Record and Evaluation Tool, also known as Section GG. DESIGN: Retrospective and longitudinal. Data were obtained from medical records at four time points over 1 yr...

IMPORTANCE: Assessment of praxis using valid and reliable measures is important for understanding factors affecting occupational participation. OBJECTIVE: To evaluate evidence of construct validity and internal reliability of data gathered with four newly developed praxis tests. DESIGN: Comparative descriptive design. SETTING: Homes, schools, and therapy practices across the United States. PARTICIPANTS: A control group consisting of 163 children without any concerns or diagnoses and a case group of 145 children with sensory integration difficulties, ages 3 to 12 yr...

IMPORTANCE: Limited evidence exists to support cognitive intervention improving the daily function of adults with subjective cognitive decline (SCD). OBJECTIVE: To examine the preliminary efficacy of a group-based multicomponent cognitive intervention that integrates Lifestyle Redesign® (LR) techniques. DESIGN: Single-arm two-period crossover trial; 16-wk waiting period, 16-wk intervention, and 16-wk follow-up. SETTING: Memory clinic in a medical center, Taiwan...

IMPORTANCE: The ability to perform voluntary actions is disrupted in Parkinson's disease (PD). Voluntary activities play a critical role in generating sense of agency, which underpins the concept of responsibility for people's daily occupations and their outcomes. According to this concept, the dearth of research regarding the concept of responsibility in rehabilitation hampers practitioners in delivering evidence-based care. OBJECTIVE: To generate a list of occupations that enhance an inherent sense of responsibility among people with PD that is based on consensus among experts...

IMPORTANCE: Sense of agency is associated with a sense of responsibility, which is essential to performing goal-directed occupations. OBJECTIVE: To reach consensus on a set of extrinsic feedback statements that have the potential to create a sense of responsibility among patients with neurological disorders in the course of performing daily or social occupations. DESIGN: Anonymous Delphi study with two rounds with international experts and one round with Irani patients with Parkinson's disease (PD)...

IMPORTANCE: Only a limited amount of research has investigated the impact of prolonged refugee status of Palestinian refugees who have been displaced for more than 70 yr. OBJECTIVE: To explore lived experiences of Palestinian refugees in Jordan and understand their occupational disruption. DESIGN: Thematic analysis guided by descriptive phenomenology with one-on-one and group interviews. SETTING: An AlBaqa'a community-based rehabilitation center or participants' homes...

There is a growing recognition that social determinants of health (or social drivers of health [SDOH]) affect physical well-being. In this Health Policy Perspectives column, we describe SDOH and the evolving landscape in health care. Policymakers are facilitating notable investments in social care and putting forth requirements for health care organizations to address SDOH. We share insights and perspectives on the roles occupational therapy practitioners can play in these efforts to address SDOH and the building ecosystems connecting health care and social care...

IMPORTANCE: Outcomes research on the impact of seating and mobility services delivered using a short-term medical mission (STMM) model is limited. OBJECTIVE: To evaluate the impact of seating and mobility services on the occupational performance of individuals with disabilities in El Salvador. DESIGN: One-group retrospective pretest-posttest. SETTING: Clinical (El Salvador). PARTICIPANTS: Individuals with disabilities in El Salvador...

IMPORTANCE: The coronavirus disease 2019 (COVID-19) pandemic disrupted participation in routines and daily activities. It is unclear how children reengaged in activities during the pandemic, particularly as a new school year began. Differences in school instruction mode (in person, hybrid, or remote) during the pandemic could further affect activity participation. OBJECTIVE: To examine changes in sedentary and nonsedentary activity participation in children and to determine whether school instruction mode was associated with participation...

IMPORTANCE: Clinical application of electrical stimulation (ES) to address functional deficits for those with spinal cord injury (SCI) is not consistent among occupational therapy practitioners, likely because of limited occupational therapy-specific clinical guidelines (OT-CG). Clinicians report the need for evidence-based guidance that supports their practice. OBJECTIVE: To identify occupational therapy practitioners' needs to support ES application in treatment sessions, utility of existing clinical practice guidelines for occupational therapy practitioners, challenges and opportunities to translate research findings into clinical practice, and desirable characteristics for an occupational therapy-specific ES clinical guide...