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

IMPORTANCE: Playgrounds facilitate important opportunities for growth and development during childhood. Despite accessibility regulations, these experiences are not afforded to children with disabilities as a result of environmental and societal barriers. OBJECTIVE: To identify and synthesize existing research on the relationship between key areas of development and accessible play settings for children with disabilities to inform evidence-based interventions and advocacy work...

IMPORTANCE: Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders and is characterized by compromised social interactions, reduced verbal communication, stereotyped repetitive behaviors, restricted interests, and sensory abnormalities. Yet absent from the knowledge base is information about sensory abnormalities related to pain experiences. Exploring the pain experiences of people with ASD may provide occupational therapy practitioners with a baseline to determine areas of need and effective interventions...

IMPORTANCE: Some autistic adults experience depression and anxiety related to their social relationships. There is a need for evidence-based occupational therapy interventions that decrease depression and anxiety and improve the health of social relationships for autistic adults. OBJECTIVE: To determine the feasibility and preliminary effectiveness of the Healthy Relationships on the Autism Spectrum (HEARTS) intervention, a six-session, group-based psychoeducational intervention for the improvement of relationship health...

IMPORTANCE: Limited research has elucidated factors predicting occupational therapy-specific service utilization by children with autism. Such research is needed to inform reasons for receipt of services. OBJECTIVE: To examine factors associated with occupational therapy service utilization by children with autism. We hypothesized that elevated sensory hyperresponsiveness; greater sensory interests, repetitions, and seeking; and lower adaptive behavior would predict more service utilization...

Executive functions-specifically, problem-solving skills-are crucial for school success. Challenges in these functions faced by autistic adolescents are often unrecognized or viewed through a behavioral lens that requires correction or normalization. A lack of development of higher order problem-solving skills leads to increased instances of secondary mental health issues, creating further behavioral and social challenges. We propose using the Engineering Design Process (EDP), a flexible, cyclical, top-down, self-sustaining approach that uses peer mediation to teach group problem-solving skills...

IMPORTANCE: Ayres Sensory Integration® (ASI) is commonly used with children on the autism spectrum to promote sensory processing and improved occupational performance, including play. To date, there has been no explicit effort to examine improvements in playfulness through ASI. OBJECTIVE: To explore whether ASI, coupled with parent training, improves child playfulness and fathers' support of child playfulness. DESIGN: Single-subject A-B-BC design secondary analysis of a nonconcurrent multiple-baseline study...

IMPORTANCE: Autistic children experience reduced participation in life activities. One factor that may contribute to their reduced levels of participation is anxiety, which is identified at higher rates among young autistic children than among their neurotypical peers. Anxiety is also strongly associated with sensory overresponsivity and has a considerable impact on daily functioning. OBJECTIVE: To determine the feasibility, acceptability, and usefulness of a small-group, parent-mediated intervention to prevent and reduce anxiety...

IMPORTANCE: A viable occupational therapy program based on joint attention is needed to ensure that children with autism spectrum disorder (ASD) lead lives in which they interact socially. OBJECTIVE: To explore the benefit of a joint attention-based occupational therapy program offered simultaneously with the usual special education program (USEP) compared with USEP alone. DESIGN: Randomized controlled study, including pre-, post-, and follow-up testing...

The coronavirus disease 2019 pandemic accelerated the impending youth mental health crisis in the United States, necessitating a comprehensive approach to providing mental health education and interventions. School-based occupational therapy practitioners' scope of practice includes wellness promotion, early detection, and evidence-based interventions for mental health challenges. Given the rise of school-based wellness programs, the growing legislation supporting the formation of such programs, and the burgeoning burden of pediatric mental health concerns, occupational therapy practitioners are uniquely positioned to create and implement interventions to support student access to the general education curriculum and can do so by using both prepandemic funding sources and pandemic response funds...

Research has indicated a high prevalence of mental health problems among autistic people, with elevated rates of depression, anxiety, and suicidality. The profession of occupational therapy has its roots in mental health and can offer a unique focus on occupation to support the mental health needs of autistic clients. In this Guest Editorial we introduce articles for this special issue of the American Journal of Occupational Therapy related to autism and mental health and use the Person-Environment-Occupation Model...

IMPORTANCE: Low social competence is one of the most complex and resistant challenges faced by adolescents with autism spectrum disorder (ASD). Occupational therapy practitioners have recognized the potential benefits of using the arts, including training in magic tricks, as a therapeutic medium to improve and enhance clients' psychosocial well-being. OBJECTIVE: To describe the efficacy of a virtual magic trick training program (MTTP) to enhance social skills and self-esteem in adolescents with ASD...

Evidence Connection articles are offered by the American Occupational Therapy Association's Evidence-Based Practice Program to inform and assist occupational therapy practitioners in methods that translate findings from the literature into usable knowledge for daily practice. These articles can guide professional reasoning and help practitioners operationalize findings from systematic reviews into practical strategies that can improve patient outcomes and support evidence-based practice. This Evidence Connection article is based on findings from a systematic review of interventions within the scope of occupational therapy practice to improve performance with activities of daily living (ADLs) for adults with Parkinson's disease (Doucet et al...

IMPORTANCE: It is vital that occupational therapy practitioners address caregivers' needs to enable them to maintain participation in caregiving for people poststroke. OBJECTIVE: To explore the evidence for the effectiveness of interventions within the scope of occupational therapy practice for caregivers of people poststroke that facilitate maintaining participation in the caregiver role. DATA SOURCES: We conducted a narrative synthesis systematic review of the literature published in the MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases between January 1, 1999, and December 31, 2019...

IMPORTANCE: Environmental and contextual factors may facilitate or limit participation in daily activities. A detailed, systematic categorization of such factors enhances evaluation and intervention and promotes occupational engagement. OBJECTIVE: To develop an inclusive, detailed, and comprehensive typology of terms for environmental and contextual factors that affect occupational engagement and participation. DATA SOURCES: We searched the Avery Index of Architectural Periodicals, ERIC, EMBASE, CINAHL, MEDLINE, Google Scholar, and Engineering Village databases, using the keywords environment, factors, context, participation, people, disability, disabilities, aspects, barriers, assessment, and evaluation...

IMPORTANCE: When providing services, occupational therapists encounter social inequities that affect the health and well-being of their clients and create ethical tensions. OBJECTIVE: To develop an understanding of the ethical tensions encountered by occupational therapists working with clients experiencing social inequity and how such tensions are navigated. DESIGN: This qualitative study used an interpretive description methodology. SETTING: Community and tertiary health settings...

IMPORTANCE: Adaptive equipment, such as shower grab bars and modified toilet seating, is effective but underused in the United States. To change this, a better understanding of how equipment ends up being installed is needed. We hypothesized that rehabilitation services were a major mechanism. OBJECTIVE: To examine the association between receipt of rehabilitation services and installation of adaptive equipment. DESIGN: Observational cohort of the National Health and Aging Trends Study in 2015 and 2016...

IMPORTANCE: Parent training is an essential part of occupational therapy intervention for children with sensory processing and sensory integration (SP-SI) challenges, and parents' learning needs should be considered. OBJECTIVE: To identify the extent to which adult learning needs are considered in occupational therapy literature addressing parent training as a part of intervention for children with SP-SI challenges. DATA SOURCES: Searches were performed of the following databases: MEDLINE, PsycINFO, CINAHL, Web of Science, EMBASE, and ERIC...

IMPORTANCE: Parenting may influence perceptions of occupational balance (OB), particularly among parents of children with disabilities (PCWD). OBJECTIVE: To compare OB among PCWD and parents of typically developing children (PTDC), identify potential predictors of OB, and examine the association between OB and family quality of life (FQOL). DESIGN: Cross-sectional group-comparison design. SETTING: Two hospitals under the Hamad Medical Corporation, Doha, Qatar...

IMPORTANCE: Assessment of tactile perception is foundational for addressing aspects of occupational performance. OBJECTIVE: To evaluate the construct validity and internal reliability of four new tactile perception tests. DESIGN: Causal comparative groups design. SETTINGS: Homes, schools, and therapy practices across the United States. PARTICIPANTS: Children ages 3 to 12 yr: typically developing (n = 174) and those with sensory integration concerns (n = 153)...

IMPORTANCE: In-home therapy provides the opportunity for rehabilitation intervention to be completed in the context of the patient's natural environment. However, most studies have focused on the effects of physical exercise, leaving a gap in understanding the effectiveness of a more task-oriented intervention that addresses individual preferences. OBJECTIVE: To assess the feasibility and preliminary efficacy of the Cognitive Orientation to daily Occupational PerformanceTM (CO-OP) approach, delivered at home with older adults after a hip fracture to improve functional outcomes...