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  Physiological Responses of Adults with Sensory Over-Responsiveness

  Catherine Anne Datu, Nicholas Wing Or, Megan Melody Valentine, and Megan Jeanne Velcich

  The purpose of this research study is to identify if there are physiological response patterns associated with self-reported sensory over-responsiveness (SOR) in typical adults. SOR is the most common sensory modulation disorder and negatively affects the daily experiences of those that report SOR. The first phase of the study consisted of phone interviews where participants were screened for any potential characteristics that could affect physiological function. Then, the SRQ and AASP were used in conjunction to identify low and high SOR, typical adults. The last phase utilized the Sensory Challenge Protocol, which is both standardized and randomized, to expose participants to auditory, olfactory and tactile stimuli while collecting electrodermal response (EDR) data. This research has three major findings. First, EDR differences between high and low SOR groups are not significant, however, the high SOR group had generally higher EDR for almost all stimuli. Second, there was a strong correlation for inter- stimuli EDR, informing us that each individual has a general response style to stimuli regardless of their self-report. Lastly, there is no correlation between self-reported SOR and EDR. It is hypothesized that self-reported SOR is shaped by habituation, coping skills and varying life experiences. EDR can help support the experiences of those with high SOR, however it is not sensitive enough for diagnostic/clinical purposes. Additionally, when an individual has sensitivity in one area, there is likely sensitivity in other sensory areas as well but may be masked by coping skills, habituation or modulation.

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  Fragile X Syndrome and Family Occupations: Sertraline Treatment via Case Studies

  Decerie Mendoza, Tracy P. Ye, Martina C. Dualan, and Elena A. Javier

  Current research on children with Fragile X Syndrome (FXS) lacks inclusion of qualitative outcomes on the child’s daily occupational performance. Standardized measurements are frequently utilized and provide useful information, however, can be less sensitive to change (Berry Kravis et al., 2013) and miss capturing family perspectives and improvements within meaningful occupations. This research incorporates family perspectives via semi-structured interviews to promote an in-depth understanding about FXS and its impact on child and family occupations in addition to standardized assessment scores through in-depth case study analysis. This study used a mixed method research design examining four male participants who were given sertraline in an in-depth case study analysis. Caregivers were interviewed using a semi-structured interview protocol at baseline and at six months post-treatment to discuss their child, occupations, and any potential impacts of sertraline. Baseline and post-testing standardized assessment results were compared to the occupation centered semi-structured interviews. The data was collected from a pre-existing database in a previous study determining the outcome measures of sertraline. Dedoose software was used to code for categories and themes found in the FXS family interviews. Results indicated that standardized assessments have limited sensitivity to fully capture the lived experiences of families with FXS. Standardized assessments test for performance skills that may not necessarily translate to daily occupations as reported by families. While future practitioners should use standardized assessments in their evaluations, they should also include what families report in their daily lives to fully conclude the child’s abilities to participate and engage in their daily occupations

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  Transition in Occupations of Refugees During Resettlement

  Jennifer H. Daine, Adam A. Chan, Jacqueline-Elizabeth Cantrell, and Kimberley Keagan Banuelos

  Purpose: In 2016, there were 22.5 million refugees worldwide (UNHCR, 2017). California resettled just over 5,000 of those 85,000 (Igielnik & Krogstad, 2017). Limited research has been conducted in the United States (U.S.) focusing on the refugee experience; furthermore, there is a significant gap in research regarding the impact of the refugee experience on the occupations of refugees as they transition to living in the U.S. Smith (2012) explored the adaptation of cultural weaving among Karen refugees to maintain their previous occupations and the impact of daily weaving on their lives within Western culture; however, the study focused only on work occupations. This study sought to capture the experience of refugees and the impact of their transition on a broad array of occupations. Adding to occupational science literature regarding the occupational impact of the refugee experience, as well as aiding in addressing issues of occupational justice (Townsend, & Wilcock, 2004).

  Methods: This research was a qualitative-descriptive, phenomenological study. Data was collected through semi-structured interviews. Questions were guided by Person-Environment-Occupation model (Law, et al., 1996) and Transitions Theory (Blair, 2000), to address personal and cultural values, environments where occupations are performed, and occupational patterns to identify changes in meaningful occupations due to the refugee process. Participants have legal status as refugees, have been in the U.S. between one and five years, resettled in Northern California, are at least 18 years old and were not required to speak English. As this study aimed to capture a broad experience of transition and limit confounding factors influencing how the participant responded to changes in occupations, participants could be of any ethnicity, country of origin, or gender. Two participants were recruited through snowball sampling. Interviews were audio taped and transcribed. Interviews were coded using Thematic Analysis to generate common themes across cases (Braun & Clarke, 2006). Rigor was strengthened through member checks and peer review.

  Findings: Through analysis of the interviews, the researchers found five major themes: contextual barriers, internal factors, adaptation, belonging, and transition. The first four themes form a loop and influence each other both positively and negatively and, ultimately, affect engagement in occupations. Transition is the theme that envelops and influences the whole. Using these five themes, the researchers developed the Transition-related Effects on Refugee Occupations (TERO) Model. Key findings include that refugees may experience more meaning and role change/loss in their occupations, rather than adoption of new occupations. Additionally, the researchers found social network to be important for positive occupational engagement throughout country transition.

  Implications: As occupational therapists, the tendency towards working with refugee populations may be to focus on their transitions to new occupations. However, data from this study indicates that it may be more pertinent to address role and meaning change/loss in current occupations.

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  The Impact of Fall Efficacy on Occupational Performance in Community-Dwelling Older Adults

  Michelle Fong, Araya Moua, Erin DeNola, and Merit Franklin

  Falls are a major health concern in the older adult (OA) population. While there is research on falls and their prevention, research on how low fall efficacy (FE) impacts the occupational engagement of the OA population is limited. FE is defined as the confidence a person has in his/her ability to complete a task without falling (Tinetti & Powell, 1993). A qualitative study was conducted using a phenomenological approach to explore the lived experiences of OAs with low FE and the impact on occupational performance. Participants who scored ≤ 6 on the Modified Fall Efficacy Scale (MFES) engaged in a semi-structured interview, that explored the relationship between low FE and participation in occupations. Researchers asked open-ended questions to explore the activities impacted by participants low FE. A constant comparison method was utilized to analyze the interviews. The findings suggested that participants discontinued certain occupations due to a poor fit between the environment and the occupational challenges. However, those who experienced a good fit between the environment and the occupational challenges continued to participate in the activity using environmental modifications when needed. The occupations that had the lowest average scores on the MFES were occupations that mandated a narrow base of support (BOS) and the shifting of one’s weight. Therefore, occupational performance was impacted by the demands of the activity, the functional ability of the person, and environmental modifications.

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  Autism and Occupation: Video Modeling for Maker Activities

  Hannah Gibeson, Kelly Yerby, Molly Smith, and Brittany Yung

  Understanding the lived experiences of individuals with Autism Spectrum Disorder (ASD) using video modeling (VM) while engaging in Maker activities is an essential part of occupational therapy research. Participants in this study were four individuals with ASD recruited from a project-based studio located in San Rafael, CA, and one staff member. The qualitative portion of this study analyzed the lived experiences and perspectives of the individuals with ASD and their service provider through qualitative semi-structured interview methods. The quantitative portion of this study analyzed the effectiveness of VM for Maker activities during the activity of making a box using a machine called a ShopBot^Ⓡ. Quantitative analysis included staff assistance and client performance during standard instruction and subsequent VM intervention. Researchers found that with the VM intervention, staff assistance decreased and client performance increased. Three themes pertinent to use of the VM for the ASD population emerged; what worked, what could be changed, and where else VM could be used. VM helps individuals with ASD learn Maker activities. VM is clear, consistent, and easy to understand for individuals with ASD. Occupational Therapists can utilize VM as another method to teach individuals with ASD new skills, Maker activities, and occupations.

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  Assistive Technology and the Impact of Occupations

  Chelsea Golding, Chantelle Bond, Vhernna Fernandez, and Eizelle Barrientos

  Objective: The purpose of this research was to empirically examine the occupational impact of assistive technology - AT (with a specific focus on word prediction, text to speech and speech recognition) from the perspectives of the end user, family and school personnel (e.g. teachers, therapists & specialists) across various contexts (e.g. home, school, community).

  Method: Qualitative data included semi-structured interviews, audio and video recordings, and records reviews. The data was coded and analyzed using a constant comparison method to identify themes pertaining to the occupational use of AT and thusly the impact to overall occupational performance.

  Findings: Six themes were identified: people, match, features, context, facilitators and barriers. Each theme was central to the implementation of AT and occupational performance. We additionally found that there was a lack of occupational therapy (OT) involvement in the interdisciplinary AT team.

  Discussion: AT has a positive impact on occupational performance and quality of life for the end user and family across contexts. Facilitators and barriers to AT were present within each prominent theme. We have proposed a theoretical model encapsulating how AT supports occupational performance. We further assert that there is a role for OT as an active member on the interdisciplinary AT team when considering the occupational impact of AT.

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  Measuring the Outcomes of Therapeutic Listening® in Children With Learning and Developmental Disabilities

  Donielle Hair, Phoebe Taasan, Hannah Tashjian, and Julia L. Wilbarger

  A practice-based evidence (PBE) approach was used to explore the outcomes of the Therapeutic Listening® technique. PBE examines how effective clinical practice is within the actual clinical context. PBE capitalizes on using customary procedures and measures to establish clinical outcomes. (Horn & Gassaway, 2010; Swisher, 2010).

  Therapeutic Listening® (TL®) is a sound-based intervention broadly used by pediatric OTs as a complement to sensory integration interventions for children with sensory processing disorders.

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  Occupational Responses of Older Adults Following Partner Loss

  Carol Huang, Jane Song, Peter Behr, and Stephanie Sterner

  Spousal loss has been frequently identified as a life stressor that can greatly impede one’s ability to age at home. The purpose of this study is to identify the occupational changes that commonly result after this event and their impacts on one’s ability to age in place. This study utilized a qualitative phenomenological research design. Eight participants were recruited from an educational program for older adults and were interviewed using a semi-structured interview format. Researchers transcribed and coded all interviews to determine emergent themes. Two major categories of themes were found: occupational and intrinsic responses. The areas of occupation that were most commonly identified include: social participation, caregiving, activities of daily living, financial and household management, meal preparation, and leisure. Intrinsic responses were identified as autonomy, intrapersonal transition, and filling in time. Occupational and intrinsic responses occur transactionally and influence each other. Older adults may need to effectively address changes to both of these categories to facilitate successful aging in place after partner loss.

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  Exploratory Application of a Sensory Activity Schedule in Head Start Preschool

  Marian Perez, Elaine Wong, and Michelle Perryman

  Objective: The objective of this research is to determine whether the implementation of sensory activity schedule in a preschool classroom can increase the on-task behaviors of the students.

  Methods: Three students were recruited to participate in a quantitative multiple single subject design with qualitative follow-up study. The participants performed sensorimotor activities before circle time and were monitored for frequency of their off-task behavior using a time sampling frequency data collection. Afterwards, the head teacher was interviewed to discuss the experience.

  Results: Off-task behavior decreased from baseline on all three children, which supports the efficacy of sensory activity schedule in reducing off-task behavior. Cultural disconnect, classroom dynamics, and scheduling conflict were identified as barriers to successful implementation of sensory activity schedule.

  Conclusion: Occupational therapists are encouraged to conduct a needs assessment before starting a research to identify potential barriers. More research is needed to determine the long-term effectiveness of sensory activity schedule in a classroom.

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  A Sensory-Based Program to Enhance Occupational Performance for Dementia

  Naomi Grace Wong, Jacob Joseph Gantan, Ivy Annahi Torres-Flores, and Heather Anne August

  Dementia is a neurological disease, causing behavioral and cognitive symptoms, that progressively impairs an individual’s ability to engage in meaningful activities. Progressive deterioration associated with dementia impacts occupational performance and independence and quality of life. Sensory based interventions, such as drumming groups, have been hypothesized to be a non-pharmacological intervention for individuals with dementia. The purpose of this study was to analyze the effects of a sensory based intervention program, in this case participation in a drumming group, on functional engagement during self-feeding for individuals with dementia. Researchers gathered data over the course of two days using the Functional Behavior Profile, Self-Feeding Questionnaire, Visual Analog Scale, and the Agitated Behavior Scale as outcome measures. The first day was a baseline day, during which participants did not participate in the drumming group. Researchers completed observational questionnaires measuring the participant’s agitation and mood prior to lunch, and during lunch. On the second day, the participants engaged in the drumming group. Agitation, mood, and function was observed before and after the drumming group, and during lunch. Mood was elevated and increased engagement was observed during the drumming group. The effect of the drumming group did not carry over into self-feeding. There was a 20 minute wait period in between the drumming group and lunch time, which may have affected the results. Recommendations for future research include the evaluation of arousal and engagement during the drumming group and its effect on occupational performance.

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  Fragile X Syndrome and Family Occupations: Sertraline Treatment

  Tracy Ye, Decerie Mendoza, Elena A. Javier, and Martina C. Dualan

  Current research on children with Fragile X Syndrome (FXS) lacks inclusion of qualitative outcomes on the child’s daily occupational performance. Standardized measurements are frequently utilized and provide useful information, however, can be less sensitive to change (Berry Kravis et al., 2013) and miss capturing family perspectives and improvements within meaningful occupations. This research incorporates family perspectives via semi-structured interviews to promote an in-depth understanding about FXS and its impact on child and family occupations in addition to standardized assessment scores through in-depth case study analysis. This study used a mixed method research design examining four male participants who were given sertraline in an in-depth case study analysis. Caregivers were interviewed using a semi-structured interview protocol at baseline and at six months post-treatment to discuss their child, occupations, and any potential impacts of sertraline. Baseline and post-testing standardized assessment results were compared to the occupation centered semi-structured interviews. The data was collected from a pre-existing database in a previous study determining the outcome measures of sertraline. Dedoose software was used to code for categories and themes found in the FXS family interviews. Results indicated that standardized assessments have limited sensitivity to fully capture the lived experiences of families with FXS. Standardized assessments test for performance skills that may not necessarily translate to daily occupations as reported by families. While future practitioners should use standardized assessments in their evaluations, they should also include what families report in their daily lives to fully conclude the child’s abilities to participate and engage in their daily occupations

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  Fragile X Syndrome: An Examination of Family Occupations (Preliminary Findings)

  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.

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  Occupations as an Outcome Measure in a Clinical Trial: Fragile X Syndrome and Sertraline

  Michelle Beckwith, Brina Nguyen, Jennifer Sik, Kenneth Yu, and Laura Greiss Hess

  Fragile X Syndrome (FXS) is the most common form of inherited intellectual and developmental disability, and a known genetic cause of autism. Individuals with FXS present with deficits in cognition, social skills, behavior, language and sensory processing skills; all of which are commonly assessed through standardized and norm-referenced assessments. However, these outcome measures are sometimes not sensitive to contextually based changes in daily life. Further, there is limited research employing qualitative methods in the FXS literature. The purpose of this research was to examine family perspectives collected via semi-structured interviews as part of a randomized controlled medication trial of sertraline (Zoloft®) on children two to six years old diagnosed with FXS. The constant comparison method was used to analyze differences in family expressions of their child’s improvements over the course of the 6-month clinical trial. Twelve interviews were analyzed, six-treatment, six-placebo, and all coding was done blind to group assignment. Results indicated greater improvements in the treatment group when compared to the placebo group in: anxiety, receptive / expressive communication, maladaptive behaviors and some sensory issues. These preliminary findings warrant a need for further research with a larger sample.

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  Validation of the Medication Box Task Assessment

  Katherine Blank, Alison Chandler, Malcolm Isely, Serena Soria, and Yamin Zaw

  Individuals with acquired brain injury (ABI) may experience challenges in their everyday occupational performance due to cognitive impairments. Cognitive tabletop and occupation-based assessments are used to evaluate cognition in individuals with ABI. There is a need for cognitive occupation-based assessments as they possess ecological validity: a reflection of an individual’s occupational performance in daily life. This study aimed to validate the Medication Box Task assessment in its use as a cognitive occupation-based assessment. The results of the Medication Box Task assessment were compared against the results of a battery of five gold standard tabletop assessments. Pearson correlations showed significant correlations between type II errors of the Tower of London and the extra and missing pills of the Medication Box Task assessment. No other significant correlations were found between scores of the Medication Box Task assessment and the battery of cognitive tabletop assessments. More importantly, it was discovered that six out of seven participants, who indicated that they managed their own medication, made errors on the Medication Box Task assessment. Based on the results, no conclusion can be made about the Medication Box Task assessment as a valid cognitive occupation-based assessment.

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  Sensory Psychophysiology

  Sarah Button, Emily Minor, and Kristen Christensen

  Objective: Sensory processing issues can have a large negative impact on the ability to participate in daily occupations such as ADLs, access to work, school and leisure environments, and social interactions (Dunn, 2001). The evidence documenting sensory processing issues in adults is sparse. Physiological information can be used as objective evidence to support the claim that those with over-responsivity to sensations are experiencing their environment differently than the typical population. Understanding more about sensory processing in adults may lead to increased recognition of the problem and more opportunities for intervention to increase occupational participation. The purpose of this quantitative study compared the physiological responses to sensation in people who self-report as high in sensory sensitivity compared to people who self-report as low in sensory sensitivity.

  
  Method: Using a quasi-experimental design, physiological responses to sensation in typical adults was measured. The use of the Sensory Profile assessment as a behavioral self-reported measure was used as a pretest and the Sensory Challenge Protocol was used as our physiological outcome measure to quantify participants’ physiological responses to sensation.
  
  Results: No significant differences were shown between experimental and control groups in EDR responses to stimuli. Based on the sensory profile, participants’ in the experimental group who identified as sensory sensitive had higher EDR responses to more the intense sensations, such as mower (1.3), feather (1.8), and camphor (1.7). There is a significant correlation between low registration and sensory sensitive (.678), sensory avoidant (.847) and sensory defensive (.817) for the experimental group’s self-reported scores on the Sensory Profile supporting the idea that people who have sensory sensitivities may also suppress responses to sensation.
  
  Conclusion: There are differential, meaningful patterns observed in how people with sensory sensitivities are responding to sensations. There is high variability in individuals’ personal understanding of their own sensory sensitivities and what sensory stimuli they are responding to. Therefore, it is important to know and understand what certain people in the general population do because overtime it can lead to maladaptive behaviors in daily functioning.

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  Healthy Aging Website: Providing Online Occupation Based Information

  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.

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  Pilot Study: Assistive Technology as a Vocational Support for Individuals with Autism Spectrum Disorder

  Erin Chaffee, Christina Ho, and Kevin Ng

  The purpose of this pilot study was to determine the effectiveness of video-based instruction (VBI) to support completion of vocational tasks. A mixed-method approach was utilized to explore the use of VBI on a personal digital assistant with adults with autism spectrum disorder. Using two assembling cooking tasks, researchers investigated the level of independence with task completion through written instruction versus VBI. The results indicated a small non-significant increase in the level of independence with task completion during the intervention task independent of intelligence quotient (IQ) levels. Participant’s feedback of VBI was also noted as positive to help learn other tasks. This study presents evidence for the use of assistive technology to support task completion in the area of vocation.

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  Occupational Therapy in the Intensive Care Unit

  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.

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  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.

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  Fall Risk Reduction Using Lifestyle-integrated Functional Exercise (LiFE)

  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.

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  A Collaborative Approach to School-Based Sensorimotor Programs

  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.

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  Evaluating the Effectiveness of Abilities Care Approach™ Training

  Michelle E. D'Amato, 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.

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  Managing Fatigue with Technology for Individuals with Multiple Sclerosis

  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.

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  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.

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  Living with Fragile X Syndrome: Occupations as an Outcome Measure in a Clinical Trial

  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.