School of Occupational Therapy
Permanent URI for this collectionhttps://hdl.handle.net/11274/8848
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Item Postural control in children with autism(10/21/2020) Coker, Shannon Poth; Baxter, Mary F.This dissertation investigated how balance and postural stability in children with autism spectrum disorders differed from age matched children in three related studies. The clinical balance assessment, the Multi-Directional Reach Test (MDRT) was used as a tool to measure maximum reach distance in the forward, backward, right and left directions in standing with the feet stationary. Test-Retest Reliability was determined to be acceptable in typically developing children with this quick and useful tool for assessing dynamic standing balance. Significant correlations were found between maximum reach and height, weight and age of the typical subjects indicating that as children grow older and taller, they can reach further from their base of support without a loss of balance. The difference seen between gender in typically developing children was likely due to slightly older average age of females in the study rather than a true gender difference. The MDRT was used to determine if there was a difference between two children with autism spectrum disorder and their age, height and weight matched peers. Indeed, the typically developing children outperformed their autistic counterparts in all directions measured. Because postural control is a foundation for the development of fine and gross motor skills for engagement in occupation including daily living skills and school related fine motor skills such as writing, it is important that occupational therapists consider dynamic balance as part of our assessment when we work with children on the autism spectrum for whom this area is often impaired.Item The impact of an occupation-based program for incarcerated women with intellectual and developmental disabilities(10/3/2018) Stelter, Laurie; Evetts, Cynthia L.Incarcerated individuals with IDD and their preparation to successfully re-enter the community represent a significant concern within the criminal justice system. Occupational therapy, with its knowledge of occupational performance within forensic and IDD intervention contexts, has a considerable, unrealized role in addressing this concern. Across relevant disciplines, the literature dealing with the experiences and intervention needs of this population is limited. No known, previous OT studies exist that are specifically focused on incarcerated women with IDD. This dissertation research conducted a systematic evaluation of the impact of an occupation-based intervention for incarcerated women with IDD using a mixed methods design. The mixed methods design included a randomized control trial which is rarely found in the related literature. The manualized OT program utilized in this study, grounded in occupational adaptation and participatory occupational justice theory, was designed to provide meaningful, prosocial occupational role opportunities to offenders with IDD. The study’s mixed methods design incorporated three research strategies to discover the impact of the OT program on offenders’ occupational performance and participation. The stepped wedge randomized control design strategy revealed that program participants had significantly fewer adverse behavioral incidents than a delayed intervention control group. Results of the within-participants repeated measures strategy demonstrated statistically significant improvement in Goal Attainment Scale, Volitional Questionnaire, and Social Profile ratings and generally high relative mastery ratings. The final strategy, qualitative phenomenology, triangulated findings supporting the positive, holistic influence of the program on offender occupational performance patterns and the occupational environment. The outcomes of this study have strong potential utility for enhancing the rehabilitation of incarcerated individuals with IDD and advocating for the consistent inclusion of occupational therapy within criminal justice service provider teams.Item Occupational adaptation in a stroke self-management program: A mixed methods study(11/13/2018) Kitchens, Riqiea F; Neville, MarshaSelf-management programs that provide education, practical skills training can promote lifestyle and behavioral change and reduce the risk of recurrent stroke. Occupational Adaptation describes the use of meaningful occupations as a means to achieve adaptation in a desired role or occupation. This research explored the occupational adaptation process and personal experience of stroke survivors who participated in a stroke specific self-management program. Self-efficacy theory, self-management programming, and the theory of occupational adaptation served as the foundational theoretical concepts for this study. A sequential explanatory mixed methods design was used to analyze data gathered from a sample of five participants who were stroke survivors and had participated in a stroke self-management program. The study was conducted in the outpatient clinic of a large urban community owned hospital system. Quantitative data collected included the use of two standardized assessments, the Health-Promoting Lifestyle Profile II (HPLP II) and a stroke specific version of the Perceived Medical Condition Self-Management Scale (PMCSMS). Descriptive statistics were conducted on the quantitative measures. An interview guide was developed to collect the qualitative interview data. The qualitative data were transcribed, coded, and analyzed for themes. Four key themes were identified: knowledge acquisition promoted a need for change, behavioral change and adjustment in routines, increase proactivity and personal responsibility, and physiological and emotional changes in health. Areas of data convergence included an increase in communication with health care providers and information seeking, increased engagement in productive and leisure activities, increased involved in novel tasks and activities, improved perception of personal health, confidence in caring for themselves, and managing stroke related aspects of health. All five of the participants discussed areas of improvement with self-managing aspects of their stroke-related health, such as an increased monitoring of vitals and adherence to medication regimen, as well as lifestyle modifications that included nutrition and an exercise regimen. The study is the first of its kind to explore the stroke survivors’ experience in a stroke self-management program through the lens of occupational adaptation.Item How the utilization of occupational therapy in end-of-life care is determined(11/19/2020) Chow, Janice Kishi; Pickens, NoralynAging with chronic illness and dying of a terminal disease are complicated and arduous processes. Occupational participation at the end-of-life may offer means to cope, co-exist with dying, and live with purpose and quality of life. Occupational therapists have the expertise to maximize occupational participation in critical end-of-life tasks. However, occupational therapy remains under-utilized in end-of-life services. This grounded theory study, based on the Model of Human Occupation, investigated how the utilization of occupational therapy in end-of-life care is determined, from the perspectives of 21 occupational therapists and 20 decision makers. The model developed suggests utilization is contingent upon the decision maker’s awareness of occupational therapy’s role in end-of-life care and influenced by place of care demands and the decision maker’s ability to adjust focus of the occupational therapy referral to accommodate the patient’s goals and dying process. Although decision makers’ awareness and place of care did not consistently support occupational therapy utilization, occupational therapists were found to facilitate occupational adaptation in their patients through patient-centered care, attention to environmental supports, and focus on participation rather than performance. Utilization also varied by place. In community-based hospices, utilization was contingent upon the decision maker’s understanding of occupational therapy’s value and the Medicare Hospice Benefit. In non-traditional end-of-life care settings, occupational therapists had to autonomously identify and advocate for end-of-life care services. At a Veterans Affairs inpatient hospice setting, the occupational therapist needed to define occupational therapy’s scope of practice to avoid over-utilization. Among the places of this study, occupational therapy was most utilized at community-based, continuum of care settings, due to occupational therapy’s alignment with a common workplace mission to keep patients at home until the end of life and these settings being larger organizations to pool resources for occupational therapy services. There is a lack of decision makers’ awareness of occupational therapy to support the occupational needs of people with life-limiting illness. Further research, occupational therapy educational reforms, and advocacy are warranted to increase greater occupational therapy utilization and to support meaningful occupational participation at the end of life.Item Preliminary measurement properties of the early childhood occupational profile (ecope)(11/19/2020) Moore, Cary Clayton; Bowyer, PatriciaPURPOSE: This dissertation established the preliminary psychometric properties of the Early Childhood Occupational Profile (ECOPE) and investigated the perspectives of occupational therapists on the clinical utility of the tool. METHODS: An embedded mixed methods research design was utilized to support the use of different research questions and unique sets of data. National and international occupational therapists administered the ECOPE on video case studies and on children from their caseload. These data were analyzed using the Rasch goodness of fit statistics to evaluate the validity and reliability of the ECOPE. Participating occupational therapists also completed an anonymous survey to gather information on the clinical utility of the tool. RESULTS: Rasch analysis goodness of fit statistics indicated the ECOPE strongly measures the construct of occupational participation and reliably detects differences in young children’s occupational participation skills. The MnSq values for the ECOPE indicated strong construct validity and person and item fit reliability with scores of 0.93 for person label variables and 0.91 for item responses. The ECOPE item separation statistic of 3.11 and reliability of 0.91 indicated the item structure will accurately measure occupational participation in a new sample. The ECOPE person separation statistic of 3.68 and reliability of 0.93 indicated a high level of stability across new samples. Qualitative data from occupational therapists indicated the ECOPE has strong clinical utility and a positive impact on treatment planning. Participants either strongly agree or agree that the ECOPE is a useful tool with appropriate time requirements for administration and interpretation. Similarly, occupational therapists indicated the tool is useful for understanding the young child’s occupational participation skills and is easy to use in clinical practice. CONCLUSIONS: This dissertation study established the preliminary reliability, validity, and clinical utility of the Early Childhood Occupational Profile (ECOPE). The ECOPE is an occupation-based assessment which reflects the distinct value of occupational therapy while evaluating the young child’s occupational participation skills within the natural contexts of home or community. The ECOPE addressed the need for development and use of occupation-based assessments in pediatric practice as reported in the literature.Item Student conceptions of self-reflection and its relationship to occupational competence and clinical performance in level II fieldwork(11/29/2017) Iliff, Susan Lowell; Bowyer, Patricia; Fletcher, Tina; Freysteinson, Wyona M.; Parham, DianeThis mixed-methods study investigated the relationship between self-reflection, occupational competence, and clinical performance in occupational therapy students in Level II Fieldwork. Occupational therapy student conceptions of self-reflection and its influences during fieldwork were also explored. Convenience sampling was used to recruit 24 participants. Quantitative data was collected via a demographic survey and self-assessment questionnaires measuring self-reflection, occupational competence, and clinical performance. Data were analyzed using multiple linear regression to determine whether self-reflection was a predictor of occupational competence and clinical performance. Twenty-one interviews were also conducted to elicit detailed data on their conceptions of self-reflection. Qualitative data were analyzed using a phenomenographic approach to discover collective findings of the “what” and “how” aspects of self-reflection. Quantitative results revealed a statistically significant relationship between self-reflection and occupational competence. As self-reflection scores increased, occupational competence scores increased (p = 0.0053). Conversely, self-reflection was not a predictor of clinical performance. Five main codes or categories emerged in the phenomenographic analysis of interviews focused on self-reflection: Definition, Example, Outcome, Importance, and Personal Use. Sub-codes further defined the main codes for Outcome (occupational competence—balanced or unbalanced and clinical performance—positive or negative), Importance (growth development), and Personal Use (how—internal or external, when, and where—alone, driving, exercise, or outside in nature). Findings showed that participants defined self-reflection similarly, and those, who were 20-30 years old, self-reflected the most. They felt self-reflection helped balance their well-being and maintain a healthy occupational competence. Participants also valued self-reflection and felt it contributed to their personal and professional growth and had a positive impact on their clinical performance, meaning it informed their decision-making and intervention planning with clients. Findings also showed that participants self-reflected in a variety of ways, times, and purposes. In conclusion, students consider self-reflection beneficial and a vehicle for strengthening performance skills and patterns in occupational therapy students who are preparing for Level II Fieldwork. Teaching a variety of routinely guided self-reflection methods in the classroom may better prepare students for a clinical setting. Providing clinical instructors with training and resources on self-reflection can foster healthy habits and increased clinical performance during fieldwork.Item Comparison of assumptions and core key constructs between the Occupational Adaption Model and the Vona du Toit Model of Creative Ability(11/29/2021) Noack, Joseph E.; Baxter, Mary F.; Keeley, RandaThe purpose of this correlational, explanatory mixed methods study was to explore subject matter experts’ (SME) perceptions and justifications of those perceptions, regarding how assumptions and fundamental core constructs for the OA model and the VdTMoCA model compare with each other for use within the practice of occupational therapy. Fourteen SMEs (n = 9 OA; n = 5 VdTMoCA) participated in an online quantitative survey. Nine of those SMEs agreed to participate in a qualitative interview (n = 5 OA; n = 4 VdTMoCA). Quantitative outcome measures included a researcher created survey containing paired assumption and key core constructs and a “shared” statement from both OA and VdTMoCA, forming an item group. SMEs indicated agreement or disagreement to each statement using a 1 – 4 Likert scale. Qualitative data included interview data informed by the survey responses. Descriptive statistics, intraclass correlation coefficient (ICC), and Cronbach alpha (a) were used to analyze the quantitative data. Qualitative data thematic analysis including descriptive and values coding methods were conducted. The ICC and Cronbach alpha analysis revealed an excellent level of agreement across all item group statements at .91 (p <.001), and a good/excellent level of absolute agreement at .88 (p <.001). The qualitative data revealed three major themes: terminology and meanings of terms used, cultural applicability of models and the need for review and timely revision of models. The need for continued alignment with current trends in practice and world events were revealed. Results indicate that OA and VdTMoCA are similar and comparable practice models based on assumptions and key core constructs.Item Teachers’ experiences with occupational therapy multi-tiered systems support: A qualitative study(11/6/2020) Hintz, Lou Ann; Fletcher, TinaSchool-based occupational therapists are tasked with participating in multi-tiered systems support (MTSS) services to all students, including general education students who may be at risk for school failure. Yet, there is little information in the literature on how school-based therapists achieve this and the perceptions of teachers who engage with occupational therapists providing service within the MTSS framework. The purpose of this study is to understand the experiences of elementary public-school teachers who are working with occupational therapists that provide support within an MTSS framework. A qualitative study with a transcendental phenomenological approach was employed to answer the research question. The occupational adaptation theoretical framework guided sub-questions for this study. The researcher aligned these sub-questions to relative mastery, which occurs when a sense of efficiency, effectiveness, and satisfaction occur (Schkade & Schultz, 1992). Teacher participants were recruited through purposeful sampling and snowball sampling techniques. Thirteen teachers from four different states of the United States participated in this study. Their years of teaching experience ranged from 3 to 21 years. Data sources included verbatim transcribed interviews, survey information, and artifacts. Moustakas (1994) structured approach for data analysis was utilized and resulted in a composite textural, structural description of the teachers’ experiences. Results showed that teachers expressed positive feelings when describing their experiences with occupational therapists who provide service through an MTSS framework. In this study, teachers were participating with occupational therapists through the MTSS framework frequently, ongoing, informally, through whole-class instruction and valued the knowledge gained from occupational therapists. Some barriers identified by the teachers were a lack of MTSS documentation, a lack of understanding of school-based occupational therapists' scope and role, and their need for more occupational therapy services within the MTSS framework. In conclusion, teachers described their experiences with occupational therapy MTSS as satisfactory, efficient, and effective.Item Treatment for cumulative trauma disorders using a person-centered approach: Grounded by the theory of occupational adaptation(12/10/2018) King, James W., M.S.; Neville, MarshaCumulative trauma disorders (CTDs) are musculoskeletal disorders that impact health and productivity. CTD risk factors are present in the workplace, home, and community. Occupational therapists (OTs) are widely involved with this population. Many OTs use a medical model in the assessment, treatment, and prevention of these conditions; however, the medical model has not proven to be consistently effective. This research took a different approach. It explored psychosocial factors in CTD development and progression, then used the findings to develop and test a curriculum designed to guide OTs with a person-centered treatment approach, based on the Theory of Occupational Adaptation (OA). Results indicated the curriculum was effective and relevant for the OT participants. Their feedback highlighted the value of the curriculum content. The study explored the feasibility of performing a multi-center, randomized controlled trial (RCT) to measure the effectiveness of the person-centered approach for improving occupational performance in a CTD population.Item The effects of sensory diets on children with sensory processing disorder(12/17/2018) Pingale, Vidya; Fletcher, TinaSensory diets are one of the interventions occupational therapists use in school-based settings to manage manifestations of sensory processing disorder. However, very few studies have investigated the effectiveness of sensory diets, and the results of these studies were mixed (Devlin, Healy, Leader, & Hughes, 2011; Fazlioğlu & Baran, 2008; Lopez & Swinth, 2008). Past studies also had methodological limitations (Case-Smith, Weaver, & Fristad, 2015; Watling & Hauer, 2015). Therefore, this study investigated the effect of sensory diets on children's sensory processing skills, psychosocial skills, and engagement in classroom activities. This study used a single-subject ABCA design. Five children between the ages of five and eleven years participated in the study. The study consisted of an intial baseline phase A₁, the control intervention phase B, sensory diets intervention phase C, and the second baseline phase A₂. Each phase lasted for seven days. The PI videotaped each participant for fifteen minutes each school day during all phases to collect the data. The participants were videotaped during classroom group activities. Visual analysis of the data showed that sensory diets had a positive effect on participants' sensory processing, psychosocial skills, and classroom engagement.Item The relationship between scores on the American college testing program, the American occupational therapy association registry examination, and grades of selected college courses for occupational therapy students enrolled in the Texas woman's university from 1961 to 1969(1970-05-30) Sens, Lee Anna; Sherrill, ClaudineItem An observation on stereognosis in preschool cerebral palsied children(1972-05) Chen, Mei-jinNo abstract availableItem The effectiveness of activities of daily living training in the stroke patient(1974-05) Wallace, BerthaNo abstract availableItem The effect of pretesting on mastery of course material(1974-08) Kimmel, Judy; Griffin, Nancy; Rosentswieg, Joel; Currie, CatherineItem An electromyographic study of the effects of overflow and cutaneous stimulation(1974-08) Arrington, Jo AnnNo abstract availableItem A computer guidance program for occupational therapy evaluation and treatment planning for the spinal cord injured patient(1975-05) Newsom, Mary Joyce; Robertson, IreneItem The incidence of problems of laterality, directional orientation, and body integration as related to learning disabilities(1975-05) Tenison, Suzanne Rosamond; Pershing, Ruth; Currie, Catherine; Griffin, NancyItem A descriptive study of utilization of inservice for Nursing personnel to promote a better understanding of the Role of Occupational Therapy(1976-05) Ritchie, LeslieNo abstract availableItem Survey of attitudes toward a self-directed approach in field work experience in occupational therapy(1977-12) Parnell, Connie; Griffin, NancyItem A survey of the occupational therapist's perceived role in mental health programs of the 1970s(1978-05) Raffen, Eleanor