Brooke Czuleger, Emily Garnica, Jessica Phung, and Maciej Rzepka
In the past decade, the prevalence of Autism Spectrum Disorder (ASD) and Intellectual Disabilities (ID), has increased. Sensory processing is an area of need for individuals with ASD and ID that requires specialized interventions. In best practices, these services are delivered by an interdisciplinary team, often consisting of an occupational therapist, speech language pathologist, behaviorist and special education teacher. Yet, to date there has been limited research examining interdisciplinary collaboration with the many professionals on the team. The purpose of this study was to empirically examine the interdisciplinary team practices at a special education center in Northern California. This research employed interview methods and qualitative analysis. Results informed a conceptual practice model for collaboration as a highly intentional practice. The model depicts sensory needs of individual students and thusly sensorimotor programming for the classroom as a priority for the interdisciplinary team. Final themes from the analysis as essential to collaboration were: taking action, communicating, addressing barriers, reinforcing team values and understanding interdisciplinary roles. Implications for practice include advocating for the scope of OT, active engagement in the collaborative process at the IEP level, taking leadership roles, creating opportunities for collaboration, engagement in dialogue with administration and formal inservice training.
Age-Related Changes in Visual Processing Speed: A Pilot Study Using the Motor-Free Visual Perception Test- 4 (MVPT-4)
Lauren Gollnick, Kassidy Ha, Stephanie Pawek, Zoe Studer, and Amber Zadravecz
Evidence reveals that visual processing speed decreases with age. The Motor-Free Visual Perception Test- Third Edition (MVPT-3) has an age-normed Response Time Index that measures visual processing speed. In 2015, a new version, Motor-Free Visual Perception Test- Fourth Edition (MVPT-4), was published. The new MVPT-4 does not yet demonstrate its utility in measuring visual processing speed. The purpose of this study was to explore if differences in visual processing speed between younger adults ages 20-35 years and older adults ages 70 years and older could be detected using the new MVPT-4. Results revealed a significant difference between older and younger adults’ time to complete the MVPT-4 (p <.05). This pilot study demonstrated that the MVPT-4 may be able to detect age-related changes in visual processing speed and therefore, a possible clinical tool for occupational therapists.
Evelyn Tang, Blanka Pentek, Laura Greiss Hess, and Katherine Sadoff
Professional collaboration in special education is essential for student success (Barnes & Turner, 2000). However, IDEA legislation does not guide how such collaboration should take place (Pub. L. 108–446). The Conceptual Model for Collaboration (CMC) created by Czuleger and colleagues (2016) described professional collaborative practices of a transdisciplinary team at a special education center. The purpose of this study was to examine the CMC in a broader context.
Madison Marshall, Reinelle Regala, Lucy Gray, Emma Pedlar, and Samantha naguit
The prevalence of illicit substance use among registered nurses, though not widely studied or addressed, is understood to be an essential issue facing healthcare professionals. An impaired nurse is defined as someone who has impaired functioning as a result of substance abuse and it interferes with their professional judgment and ability to deliver safe, high quality care. Registered nurses have access to many high-controlled prescription medications, with little oversight, and the opportunity for substance abuse is significant. In our research, we studied the risk factors, the prevalence, and the preventative measures involved in addressing illicit substance use among nurses.
Discrimination is the act of negatively behaving towards a person or group of people due to the social group these individuals belong to. Although, as a society we like to believe that discrimination does not occur as often as it does, it can take many forms that we can be oblivious to. As a healthcare provider, one is held to a higher standard that many often forget are still human susceptible to the same vices. Discrimination in healthcare is a topic that many are not aware of the prevalence in our healthcare system. It might seem that the societal perceptions of different ethnic groups would not affect the healthcare sector but it does (Yearby, 2010).
The current study examined if unconscious biases had an affect on whether or not certain patients receive full scope treatment. The study proposed that racial discrimination affects the kind of treatment patients receive which leads to alarming health disparities between majority and minority group members. The study aimed to reveal the psychological nature of discrimination and how covert discrimination is the main culprit behind the differences in medical treatments received from healthcare providers. Empathy and personality scales were used to measure whether or not covert discrimination was present in those trying to enter and already working the healthcare field.
Participants were anonymously surveyed and provided their self-identified demographics, were given the student version of Jefferson Empathy Scale, randomly assigned one out of three vignettes about a patient, were asked further questions on how likely the participant would be to treat the patient and the speed in which they would administer pain medication if at all. Then, the participants were asked to rate the patient’s personality through a condensed version of the Big Five Inventory. Lastly, the participants were dismissed with a thank you for participation letter.
A diverse sample of students in healthcare related majors and at a small private liberal arts school and Bay Area healthcare professionals were recruited through social media, email, and an in class presentation for the study. The study was hosted online through SurveyMonkey.com and was open for 60 days.
It was hypothesized that the higher the empathy levels of the healthcare provider, the higher level of care they would administer to a patient. It was also hypothesized that due to subconscious biases that are perpetuated by society, African Americans are more likely to be given less treatment as opposed to Caucasian and Non-Stated race patients or thought to be exaggerating their medical experiences (level of pain) by the healthcare providers (healthcare related majoring students and professionals).
The findings of this study are intended to broaden the awareness of racial discrimination in healthcare and showcase how negative stereotypes of certain ethnic groups affect every aspect of life, including receiving of health care.
Many believe the primary role in life is to settle down and have children. The present study focuses on understanding what can influence a person’s choice to have children. With a wide variety of childhood experiences that exist, as well as the influences of an optimism/pessimism attitude about life, this study will focus on how these characteristics can combine to influence one’s decision to have children.
According to McDonnell (2012), many of those who experienced an unstable or undesirable childhood grow up wanting no children as a way to not repeat the cycle. Meanwhile, some who experienced adversity in childhood seek parenthood as a way to do the opposite of what they experienced, and effort to provide better for their children. What differentiates these responses may have to do with general attitude about the world.
Individuals vary on their optimism-pessimism level. Evidence has been found that show optimism and pessimism to exist on a singular, bi-polar spectrum (Marshall, Wortman, Kusulas, Hervig, & Vickers, 1992); high optimism equates to a low level of pessimism and vice versa.
Studies have also shown that childhood adversities can play a large role when it comes to adulthood dispositional optimism (Korkeila et al, 2004). It is clear, then that childhood experiences, optimism-pessimism, and desire to have children are all somehow interconnected; these relationships suggests the following hypotheses: 1) Adults who had little or no adversity in childhood will desire to have children, independent of their levels of optimism/pessimism; and 2) Adults who did experience childhood adversity only will desire to have children if they are also high in levels of general optimism.
Corinna Louise Venturina Villar
Hypertension, or high blood pressure, occurs when there is long-term force of force of blood against one’s artery walls. When uncontrolled, hypertension may increase the risk of heart attack and stroke. More than 1 in 3 adults live with 1 or more types of cardiovascular disease in the United States alone- with stroke being the fifth leading cause of death. The purpose of my study is to evaluate the environmental influence on hypertension by comparing various factors in cities with high prevalence rates of heart disease to those with lower rates of heart disease. Conducting an environmental scan will serve as the basis of my research, as it will help me assess various neighborhoods based on a set criteria (e.g., accessibility to healthy food places, park access, and neighborhood walkability) that identify potential risk factors for hypertension within each neighborhood. The parks and neighborhoods to be assessed will be determined through a hot spot analysis, which will provide a visual on significant clusters of high and low values of hypertension.
Michelle DAmato, Sophie E. Miller, April Perez, Carmen Joaquin, and Louiza Alexandria Villarina
Approximately 50% of US nursing home residents have a diagnosis of dementia. Abilities Care Approach® was created by occupational therapists (OTs) to promote quality dementia care for residents in skilled nursing facilities (SNFs). Certified nursing assistants (CNAs) are often the primary caregiver for residents with dementia. To ensure carryover of ACA principles, ACE dementia training was targeted towards CNAs. The purpose of this study was to evaluate Abilities Care Experts®(ACE) training program which provides CNAs with an occupation-based dementia care approach by focusing on the importance of occupational engagement and knowledge of dementia stages. Results indicated that ACE trained CNAs (N=13) had significantly higher levels of self-efficacy, knowledge of dementia care approaches, and perceived knowledge of dementia compared to non ACE trained CNAs (N=16). Findings demonstrate the importance of caregiver training focused on strategies to facilitate occupational engagement at each stage of dementia. OT expertise in providing stage-specific dementia care training can improve caregiving educational outcomes. Further empirical research may help to further understand the optimal use of ACA-focused dementia training programs to improve quality of care.
Allison Hunt, Morganne Peterson, and Emily White
The purpose of this study was to fill the gap in literature and further examine the use of sensory diets in the field of occupational therapy. This study investigated the use of sensory diets among California occupational therapy practitioners. A mixed-methods design was used to collect data through a SurveyMonkey survey. The survey was sent out to members of the Occupational Therapy Association of California (OTAC) and received 98 respondents within one month. Participants worked among various clinical settings and implemented sensory diets with various client populations. Practitioners reported using terms such as “sensory strategies,” “sensory tools,” and “sensory supports” which indicates an overall misunderstanding associated with the term “sensory diet.” An alternative name that is more easily understandable and used universally would help decrease confusion among clinicians and clients. Further research is needed to better understand the effectiveness of sensory diets and how they are implemented.
Shannon Almonia, Kimberly Damian, Giuliana Enea, Solveig Karlsen, and Jessica Markham
Prenatal care is a type of preventative health care for pregnant women that is typically initiated in the first trimester. However, when prenatal care is inadequate, initiated past the first trimester or missed, the mother and fetus experience an increased risk for preterm delivery. Adolescents are apart of a specific subgroup of pregnant women that are at a higher risk for adverse outcomes during pregnancy due to knowledge deficits. Therefore, adolescents are especially likely to receive inadequate prenatal services. Numerous studies have been conducted to discover the result of inadequate prenatal care; however, not as many studies explore the factors associated with late entry or lack of entry into prenatal care for adolescents. These factors need to be identified so care providers can accurately identify pregnant adolescents who are at the greatest risk for receiving inadequate care so that they can attempt to prevent preterm births.
Kayla Comer, Tiffany Huang, Kelly Schmidt, and Matthew Tong
As the population and longevity of older adults’ increases, the prevalence of falls is becoming an ever-growing issue. One in three adults aged 65 years and older experience a fall each year. Falls in older adults may lead to sedentary behavior, decreased independence, and lower quality of life. Evidence has shown that traditional exercise programs emphasizing strength and balance exercises can decrease the fall risk in older adults, but may be difficult to sustain over time. Emerging evidence suggests that exercises that are integrated into daily life may have a more lasting effect in reducing fall risk in older adults. This study explored the effectiveness of an integrated exercise program, the modified-LiFE program, in decreasing fall risk in community-dwelling older adults. Results supported integrative exercise programs may decrease fall risk in community-dwelling older adults with previous history of falls. Therefore, integrating exercises into daily life offers occupational therapists an effective occupation-based intervention that promotes safety, independence, and quality of life for older adults.
Samantha L. Alexander, Noelani M. Brisbane, Rebecca M. Schira, and Kaitlyn M. Williams
Fragile X Syndrome (FXS) is the most common form of inherited Intellectual Developmental Disorder and a genetic model for Autism Spectrum Disorder. Those living with FXS face emotional, social, intellectual, and physical challenges that impact engagement in occupations, yet to date, there has been limited qualitative research examining family occupations in FXS. In this research, twelve interviews were transcribed, coded, and analyzed for common themes anchored in the Person, Environment, Occupation (PEO) model. Results indicated that while children with FXS exhibit strengths, there are certain occupations that families find difficult to engage in. A new model was created for consideration of family occupations and FXS. This model depicts family occupations as a complex and ever changing, dynamic interaction between the child and family engaging in varying environments, and activities. This model can further inform clinical reasoning when designing a comprehensive child and family-centered approach supporting participation in occupations.
Raechel Jacala, Holly Snyder, Amanda Lee, and Katelyn Harden
Fragile X Syndrome (FXS) is the most common form of inherited intellectual and developmental disability (IDD), and is a genetic model for autism spectrum disorder (ASD). According to the National Fragile X Foundation (NFXF, 2012), the disorder affects people of all ethnic backgrounds, with an estimate of 1 in 3,600 to 4,000 males and 1 in 4,000 to 6,000 females. A majority of males with FXS have an intellectual disability and up to 50-75% of males with FXS meet the diagnostic criteria for ASD (Roberts, 2016). According to the CDC, a national parent survey found that 46 percent of males and 16 percent of females with FXS have been diagnosed or treated for ASD (Bailey et al., 2008). Additionally, about 10 percent of children with ASD have another genetic and chromosomal disorder, such as FXS (Hall, Lightbody, & Reiss, 2008). Individuals living with FXS experience difficulties with social interaction, communication, sensory processing, and behavioral excesses across their lifespan (Brady et al., 2006). The purpose of our qualitative research is to examine the lived experiences of families who have been touched by FXS through an occupational therapy lens. The research seeks to understand families’ perspectives and occupations via their own voice, through semi-structured, recorded interviews. By analyzing parent routines, behaviors, thoughts, interactions, and contexts, occupational therapists can create individualized interventions and promote research to further the recognition of family values and goals they have for their child.
Karen Huang, Ashley Cook, and Ajay Pala
These pilot case studies investigated the effectiveness of the Functional Cognitive Activities for Adults with Brain Injury: A Sequential Approach (FCA) in generalizing functional cognitive skills across meaningful occupations for adults with traumatic brain injury (TBI). This quasi-experimental pretest-posttest design consisted of two participants with TBI. Both participants received occupation-based intervention sessions twice a week and equaled a total of 14 sessions each. For pretest, the two participants were given three assessments to track changes with aspects of functional cognition and engagement in occupations: the Canadian Occupational Performance Measure (COPM), Kohlman Evaluation of Living Skills (KELS), and Goal Attainment Scale (GAS). After completing the treatment sessions, the participants completed the COPM, KELS, and GAS as posttest measures. Four months later, the COPM and the GAS were administered along with a brief phone interview to determine if generalization of strategies to overcome cognitive deficits has occurred. Findings from this study provide preliminary evidence supporting the effectiveness of the FCA approach in improving functional cognitive skills and generalizability of skills to novel tasks in individuals with TBI.
Margaret Anne DeMayo
Binge drinking is a common problem found among college students. According to the Centers for Disease Control and Prevention (CDC), one in six U.S. adults binge drink about four times a month, consuming about eight drinks per binge." Over time, binge drinking in college can cause negative factors for students such as, poor academics and health problems.
The purpose of my study is to evaluate how stress factors such as environment and peer relationships affect drinking habits in male and female college students. Students experience stress factors such as environment (e.g. housing), peer relationships (e.g. peer pressure, relationships), school (e.g. grade level), and appearance (e.g. body image).
Haley Caruthers, Samantha Talavera, Stephanie Vera, and Jackeline Ulloa
Older adults (OAs) over the age of 65 are the fastest growing age group in the United States. They are also the fastest growing population of Internet users as they use the Internet to access health information related to optimizing independence, productivity, and social engagement. Although there is an abundant amount of information available that is devoted to healthy aging, the validity of the information can be questionable and the information may be confusing.
Dominican University of California’s (DUC) Healthy Aging website contains relevant and evidence-based research, including activities and local community based programs that promote healthy aging. To expand the website, a literature-based needs assessment was conducted, which indicated, the value of health promotion materials that foster of emotional and physical wellness and encourage a safe and active lifestyle in and outside of the home. Specifically, new topics such as “Living Safely Inside and Outside of Home,” “Local Events,” “Emotional Wellness,” “At Your Fingertips,” “Apps You Can Use,” and “ Position, Movement, & Ergonomics” have been added to enhance the DUC Healthy Aging website. The DUC Healthy Aging website is very beneficial to both OAs and health profession majors because it is highly accessible and provides resources and information regarding health promotion and prevention behaviors to live a productive lifestyle.
Past research has indicated that immigrant college students experience acculturative shock and stress, arising from acculturative adjusting (Barlow, 2002; Cohen & Wills, 1985; Lazarus & Folkman, 1984). This study explored the potential relationships between acculturative stress, perceived social support, and self-concealment amongst immigrant college students. Further, the study examined whether social support is related to lower acculturative stress for students. It was hypothesized that strong social support would be negatively related to acculturative stress, and that self-concealment would be positively related to acculturative stress.
Results indicate that there was a significant positive relationship between self-concealment and acculturative stress in this sample, indicating that participants who utilized self-concealment also experienced higher levels of acculturative stress. On the other hand, no relationship was found between perceived social support and acculturative stress. Findings indicate that immigrant students with a high level of self-concealment also experience difficulty acculturating to the culture in which they currently live. This has implications for immigration students’ ability to engage fully in school and for educational policy acculturative stress.
Implementing Multifactorial Education Modules with Older Adults: Individualized and Interactive Fall Prevention Education
Salvador Chavez, Jocelle Flores, and Rachelle Yambao
Falls are a significant concern for community-dwelling older adults (OAs), with one in four OAs reporting a fall every year. Occupational therapy students collaborated with first responders of the Novato Fire District to identify gaps in fall prevention community outreach programs and found that many interventions lack an interactive or individualized approach. Based on the gap analysis and current literature, seven education modules were developed to address key risk factors including home modifications, polypharmacy, fear of falling, and balance exercises. Thirty community-dwelling OAs participated in the education modules and were implemented at two senior community sites in Marin County. Participants were screened via Functional Reach Test (FRT) and completed a survey to determine their personal risk factors for falling, which guided their personalized fall prevention education. Of the participants, 90% rated their experience with the education modules as “very good” or “excellent,” and a majority rated the balance exercises as most important. The interactive 1:1 education modules are an effective and innovative method for fall prevention education and highlight the importance of client-centered treatment.
Carrie Payne and Lauren Kufer
This critically appraised topic explores the functional task performance of adults with low vision utilizing tactile vision substitution systems, specifically tongue display units (TDUs). TDUs are a novel assistive device that functions to provide artificial vision to those with low vision. TDUs pixelate images captured on a camera the person wears and the images are translated via electronic stimulation on the tongue to paint a picture. Two studies that measured functional task performance utilizing a TDU with adults with low vision were explored. Examples of functional tasks measured include word recognition, object recognition, and orientation and mobility tasks. The studies concluded that with skilled training, the TDU may significantly improve functional task performance in tasks previously impossible for the participants. Use of technology such as a TDU can improve functional task performance to enhance overall quality of life for adults with low vision of light perception or less. The results indicate the need for skilled training by professionals such as occupational therapists to best utilize a TDU.
Isabella Jao, Chloe McFadin, Nica Nuguid, Dan Recinto, and Kaitlin Van Ryn
Should schools in the United States require children between the ages of six months to 17 years to have flu vaccination shots? Influenza is a serious disease that can lead to hospitalization and sometimes even death. According to the Center of Disease Control (CDC), every flu season varies, and an influenza infection can affect people differently. Millions of people get the flu every year, hundreds of thousands of people are hospitalized, and thousands or tens of thousands of people die from flu-related causes every year. Everyone is at risk for influenza, but the highest risk lies within children who are still developing their immune systems. However, with vaccines, this risk is easily preventable and can decrease a person’s chances of acquiring the infection. As such, the CDC recommends that every person six months and older should be vaccinated annually. This is even more important for children because they attend schools where they have maximum exposure to various strains of influenza six to ten hours daily. They can easily spread and contract the disease in their school environment, specifically from children that are not vaccinated. This leads to the hypothesis that children six months to 17 years should be required to receive influenza vaccinations.
Kaylee E. Gothelf, Ty Duong, Ana Baldinger, and Theresa Chase
The purpose of this study was to evaluate the use of semi-structured interviews as an outcome measure in a clinical trial for children with fragile X syndrome (FXS) ages 2-6. This qualitative approach was used to analyze twenty-five interviews of parents with children in a double-blind medication trial - sertraline or placebo. The aim was to assess occupational improvements in their child that may not have been detected with the use quantitative outcome measures alone. Results showed greater improvements in the sertraline group in areas of behavior, social participation, sensory-related behaviors, receptive language, education, family impact and therapeutic strategies. Our findings support the use of semi-structured interviews as an additional outcome measure in a medication trial to account for the voice and context of family experiences through an occupation centered lens.
May Anne Gamueda, Janie Grant, America Ortega, and Jordan Song
OBJECTIVE: The purpose of this study was to investigate whether a mobile health application (mHealth app) will result in a decrease in fatigue and an increase in adherence to energy conservation techniques for adults with multiple sclerosis (MS).
METHOD: Using a quantitative, exploratory, pretest and post-test design, we examined the use of the mHealth app, Pace My Day (PMD), by seven participants during one chosen task while incorporating energy conservation strategies for two weeks. Main outcome measures included Modified Fatigue Impact Scale (MFIS) and Canadian Occupational Performance Measure (COPM).
RESULTS: There was a significant decrease in the MFIS scores indicating a decrease in fatigue over the two-week period t(6)=5.75, p=0.001.
CONCLUSION: Use of mHealth apps and energy conservation strategies were found to significantly reduce levels of fatigue and increase self-perceived performance and satisfaction of task execution.
Hannah Tashjian, Phoebe Taasan, and Donielle Hair
This study examines a structured protocol to measure the effects of daily individualized use of Therapeutic Listening - Quickshifts (TL-Q) used to improve occupational performance in children with learning and developmental disabilities. The study identifies a standardized practice-based evidence procedure to measure the outcomes of implementing TL-Q within traditional OT practice. OTs worldwide are using sound-based therapies (SBTs) despite limited supporting evidence available regarding the productivity of these interventions. Even fewer studies have been published on the effects of Therapeutic Listening (TL), a novel intervention shown to increase personal and interpersonal skills including sensory processing skills, visual motor integration, and emotional regulation (Frick & Hacker, 2001). TL-Q is used to modify distressing effects of sensory dysregulation and learning disabilities through an individualized listening program of modified musical patterns that the child listens to through headphones for a set amount of time each day. The music program is implemented at home for a more intensive intervention designed to stimulate neuroplasticity across hemispheres eliciting behavioral changes and improved neurological responses (Wink, McKeown, & Casey, 2017).
Michelle Chan, Kelsie Colombini, Kristen M. Henderson, and Courtney Malachowski
In recent years, the number of inpatient cardiovascular surgeries has significantly increased in hospitals around America. Occupational therapists in the intensive care unit (ICU) at Mills-Peninsula Medical Center (Burlingame, California) currently lack a standard protocol for addressing physical, cognitive, and psychosocial factors in patients post cardiac surgery. Furthermore, interventions are frequently guided by professional experience and clinical reasoning instead of current evidence. The American Occupational Therapy Association’s Centennial Vision encourages occupational therapists to pursue science-driven practices and provide evidence-based interventions. In response to this vision, an extensive review of current literature was conducted and applied to develop an evidence-based clinical pathway for the occupational therapists at Mills-Peninsula Medical Center. The proposed clinical pathway includes intervention guidelines for physical recovery, early detection of cognitive impairment, and psychosocial health for patients post cardiac surgery recovering in the ICU. The clinical pathway would establish a standard of care and facilitate patients’ return to their highest level of function during post-cardiac surgery rehabilitation.