American Journal of Occupational Therapy最新文献

{"title":"Discriminant Validity of the Electronic Activity Card Sort (ACS3) Among Adults With Traumatic Brain Injury and Multiple Sclerosis.","authors":"Amanda Gahlot, Yael Goverover","doi":"10.5014/ajot.2025.050829","DOIUrl":"10.5014/ajot.2025.050829","url":null,"abstract":"<p><strong>Importance: </strong>The Electronic Activity Card Sort (ACS3) is an online adaptation of the in-person Activity Card Sort (ACS). It is important to validate the ACS3 within clinical populations.</p><p><strong>Objective: </strong>To assess the discriminant validity of the ACS3 between persons with multiple sclerosis (MS) and those with traumatic brain injury (TBI).</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Telehealth.</p><p><strong>Participants: </strong>Community-dwelling adults with either MS (n = 11) or TBI (n = 11).</p><p><strong>Outcomes and measures: </strong>The ACS3 was administered via virtual interview. Analyses (t tests) were conducted to compare persons with TBI and those with MS on the ACS3 and compare the preinjury or preillness and current activity scores for each group. Correlations between demographic characteristics and ACS3 scores were computed, using Pearson correlations for continuous variables and Spearman correlations for categorical data.</p><p><strong>Results: </strong>All participants (n = 22) demonstrated significant reductions from before to after injury/illness for each domain and total ACS3 scores. Furthermore, the MS group retained fewer activities than the TBI group in the ACS3 total score.</p><p><strong>Conclusions and relevance: </strong>The results provide preliminary evidence for the discriminant validity of the ACS3's capacity to distinguish between adults with MS and those with TBI. The ACS3 may be a clinically useful tool for evaluating life participation in persons with chronic neurological conditions. Plain-Language Summary: Involvement in life situations, or participation, is an essential outcome in rehabilitation, and is associated with higher quality of life, decreased depression, and better overall well-being. Changes in health can reduce participation in meaningful life activities, which can negatively affect independence and life satisfaction. Meaningful patient engagement emphasizes and supports patient participation as an essential outcome in rehabilitation that includes occupational therapy. The Electronic Activity Card Sort (ACS3) is an online adaptation of the in-person Activity Card Sort (ACS). The ACS3 is a virtual option for measuring participation in adults with chronic neurological conditions. This study explored using ACS3 to identify changes in participation levels between adults with multiple sclerosis (MS) and those with traumatic brain injury (TBI). The study factored in both current and previous participation levels. Using ACS3, occupational therapists were able to differentiate participation patterns among those with MS and those with TBI. In a clinical setting, ACS3 can be used to guide personalized rehabilitation strategies for two distinct neurological conditions, thereby improving patient outcomes.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to Outpatient Occupational Therapy Services After Inpatient Psychiatric Hospitalization in the Veterans Health Administration.","authors":"Adam R Kinney, Molly E Penzenik, Jeri E Forster, Frederica O'Donnell, Valerie Fox, Lisa A Brenner","doi":"10.5014/ajot.2025.051064","DOIUrl":"10.5014/ajot.2025.051064","url":null,"abstract":"<p><strong>Importance: </strong>Veterans with occupational performance (e.g., activities of daily living [ADL]) limitations who are receiving inpatient psychiatric care may benefit from outpatient occupational therapy upon discharge, but access disparities have not been investigated.</p><p><strong>Objective: </strong>To investigate whether ADL limitations, an indicator of need, are associated with outpatient occupational therapy utilization after inpatient psychiatric hospitalization in the Veterans Health Administration (VHA) and whether this relationship differs by facility characteristics.</p><p><strong>Design: </strong>Secondary analysis of VHA medical record data. Modified Poisson regression was used to model outpatient occupational therapy utilization (yes or no) as a function of ADL limitations, facility characteristics, and sociodemographic and clinical characteristics. Interactions were used to estimate whether the relationship between ADL limitations and outpatient occupational therapy utilization differs across facility characteristics.</p><p><strong>Setting: </strong>VHA outpatient setting.</p><p><strong>Participants: </strong>Veterans who received VHA inpatient psychiatric care from 2015 to 2020 and lived ≥90 days after discharge (N = 117,679).</p><p><strong>Intervention: </strong>None.</p><p><strong>Outcomes and measures: </strong>Outpatient occupational therapy utilization ≤90 days of inpatient psychiatric discharge.</p><p><strong>Results: </strong>Only 13% of Veterans received outpatient occupational therapy services after discharge, and ADL limitations were not associated with receipt of occupational therapy. Veterans receiving care in facilities of lower complexity and those with greater care quality were more likely to receive occupational therapy. Black and Hispanic Veterans were less likely to receive occupational therapy.</p><p><strong>Conclusions and relevance: </strong>Our findings suggest potentially unmet need for outpatient occupational therapy among Veterans discharged from VHA inpatient psychiatric care, laying the foundation for efforts aimed at promoting equitable access. Plain-Language Summary: This is the first study to examine potential disparities in access to outpatient occupational therapy services among Veterans recently discharged from Veterans Health Administration inpatient psychiatric care. The findings suggest a potentially unmet need for these beneficial services in this population. This study lays the foundation for scientific, clinical, and policy efforts aimed at promoting equitable access to outpatient occupational therapy services among Veterans in need, ensuring successful occupational performance and overall well-being among all members of this high-risk population.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Visual Functions and Independence in ADLs and IADLs Among Community-Dwelling Older Adults.","authors":"Yeonju Jin, Kimberly Hreha, Ickpyo Hong","doi":"10.5014/ajot.2025.051016","DOIUrl":"10.5014/ajot.2025.051016","url":null,"abstract":"<p><strong>Importance: </strong>Examining an older adult cohort to determine how different types of visual impairment affect independence in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) is an important first step to better understand how to support older adults with specific types of visual dysfunction and enhance their functional abilities.</p><p><strong>Objective: </strong>To examine the relationship between distance visual acuity, near visual acuity, and contrast sensitivity and individual ADLs (dressing, toileting, bathing, eating) and IADLs (laundry, shopping, making hot meals, money management, self-management of medications) among community-dwelling older adults.</p><p><strong>Design: </strong>A retrospective, cross-sectional design was used to analyze the relationship between visual function and independence in ADLs and IADLs.</p><p><strong>Participants: </strong>We retrieved data for 4,947 people included in the National Health and Aging Trends Study in 2022.</p><p><strong>Outcomes and measures: </strong>We used a series of multivariable logistic regression analyses and estimated the relationship between visual function and independence in specific ADLs and IADLs.</p><p><strong>Results: </strong>Near visual acuity and contrast sensitivity were statistically associated with specific ADLs and IADLs. Distance visual acuity was significantly associated with specific IADLs but was not significantly associated with any ADLs.</p><p><strong>Conclusions and relevance: </strong>Certain visual impairments were associated with specific ADLs and IADLs and therefore should be considered in the care of community-dwelling older adults. Plain-Language Summary: Normal aging can cause vision to decline. Visual impairment and blindness are expected to nearly double by 2050. Vision is a key component of independence for specific activities of daily living (ADLs; such as dressing, toileting, bathing, eating) and instrumental activities of daily living (IADLs; such as laundry, shopping, making hot meals, money management, self-management of medications). This study examined the relationship between visual impairments and individual ADLs and IADLs among community-dwelling older adults. The study found that certain visual impairments were associated with specific ADLs and IADLs and therefore should be considered in the care of community-dwelling older adults. This study also provides evidence that specific visual impairments are closely linked to older adults' ability to perform ADLs and IADLs. The findings confirm the importance of addressing visual function in occupational therapy practice to support the independence of community-dwelling older adults.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Convergent Validity of the Feeding and Eating in AutiSm Together Assessment (FEAST).","authors":"Brittany St John, Hsiang-Ting Chen, Alana Woolley, Karla Ausderau","doi":"10.5014/ajot.2025.051077","DOIUrl":"10.5014/ajot.2025.051077","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Comprehensive and validated assessments for use in clinical and research settings are needed to identify and address the complexities of feeding challenges for autistic children.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To establish the convergent validity of the Feeding and Eating in AutiSm Together (FEAST) questionnaire compared with two other validated parent-reported feeding assessments with similar constructs, the Behavior and Mealtime Behavior Index of Children (BAMBIC) and Screening Tool of Feeding Problems applied to Children (STEP-CHILD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Data from the Survey for Characterization of Feeding Challenges in Autistic Children-US (N = 349) were used to determine the convergence between the FEAST, BAMBIC, and STEP-CHILD using Pearson's correlation tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Cross-sectional validation study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The FEAST total score and FEAST Behavior subscale were found to have moderate, positive correlations with comparison measures, supporting the convergent validity of the FEAST. Relationships between the remaining FEAST subscales and BAMBIC and STEP-CHILD subscales were primarily weak or nonsignificant, demonstrating that their respective scores are capturing distinct factors related to feeding. One expected exception was a moderate positive correlation between the FEAST Oral Motor subscale and the STEP-CHILD Chewing Problems subscale.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;The FEAST demonstrates adequate convergent validity the BAMBIC and STEP-CHILD. The weak correlations of the FEAST Gastrointestinal Health, Sensory Processing, and Oral Motor Skills subscales provide evidence that FEAST may capture additional information about the factors that influence feeding challenges. The FEAST provides clinicians and researchers with a new comprehensive assessment of feeding challenges for autistic children.  Plain Language Summary: This study tested how well the Feeding and Eating in AutiSm Together (FEAST) questionnaire, used to assess feeding and eating challenges among autistic children, matches up with two established feeding assessments, the Behavior and Mealtime Behavior Index of Children (BAMBIC) and the Screening Tool of Feeding Problems applied to Children (STEP-CHILD). Researchers used data from a survey about feeding challenges in autistic kids to compare these feeding assessment tools. They found that the FEAST questionnaire's total score and Behavior subscale scores showed good agreement with the other assessments. Other FEAST subscales (Sensory, Oral-Motor, and Gastrointestinal) were not as related to the BAMBIC or STEP-CHILD scores. This suggests that although FEAST aligns well with general feeding and behavioral concerns, it may offer extra insights into more specific feeding issues. Overall, the FEAST questionnaire could give a more detailed view of feeding challenges among autistic children compared with the other tools. Pos","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serial Trichotomization to Determine Fitness to Drive: Results From a Cohort of Clients Referred to a Neurology Program.","authors":"Michel Bédard, Hillary Maxwell, Sacha Dubois, Stephanie Schurr, Chelsea Swoluk, Andrew Colosimo, Shayna Cummings, Bruce Weaver, Arne Stinchcombe","doi":"10.5014/ajot.2025.050670","DOIUrl":"https://doi.org/10.5014/ajot.2025.050670","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Determining cognitive fitness to drive is challenging. A previous study used serial trichotomization with five cognitive tests to determine whether drivers should continue driving, undergo further evaluation, or stop driving.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine agreement between serial trichotomization and fitness-to-drive determinations made by occupational therapists.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Drivers referred for cognitive screens completed all tests used in the previous study. Occupational therapists provided fitness-to-drive recommendations (safe, indeterminate, or unsafe) using all clinical information available. We examined the agreement between the tests' results (using cut points from the previous study) and occupational therapists' recommendations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Outpatient neurology program at a chronic care and rehabilitation hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;279 clients (M age  = 66.35 yr; SD = 13.25).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes and measures: &lt;/strong&gt;Tests included the Trail Making Tests A and B, the Clock Drawing Test (CDT), the Montreal Cognitive Assessment, and the Motor-Free Visual Perception Test, using a road test as the gold standard. The previous study used dual cut points with 100% sensitivity and specificity to reduce false positives and false negatives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Weighted κs ranged from .03 (95% confidence interval [CI] [-.01, .08]) for the CDT to .54 (95% CI [.46, .62]) for the Trail Making Test, Part B. Although the agreement between serial trichotomization and the final recommendations was moderate (κ = .59; 95% CI [.50, .67]), serial trichotomization appeared useful for identifying unsafe drivers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;These results remind us of the variability inherent in stand-alone cognitive tests, even within a serial trichotomization framework, and the importance of clinical judgement and road tests in decision making about driving. Plain-Language Summary: It can be challenging for occupational therapists to accurately determine a client's cognitive fitness to drive. Many occupational therapists lack the time, have limited training, or do not have access to comprehensive driving evaluation tools. A serial testing approach can support occupational therapists in assessing a client's cognitive fitness to drive. This study used an approach based on a series of five cognitive tests to determine whether a client should continue driving, undergo further evaluation, or stop driving. The series of tests were used to classify drivers as safe, indeterminate, or unsafe. In principle, a driver would take the second test only if the driver was classified as indeterminate on the basis of first test, and so on. By applying the tests in sequence, few drivers should remain classified as indeterminate at the end of the series of tests. This serial approach has the potential to streamline the decision-making proc","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Therapists' Insights on Family Involvement in Videoconferencing-Based Home Assessments and Modifications in the Veterans Health Administration: A Descriptive Qualitative Study.","authors":"Jaewon Kang, Consuelo Kreider, Kelsea LeBeau, Mi Jung Lee, Sharon Mburu, Kimberly Findley, Keith Myers, Sergio Romero","doi":"10.5014/ajot.2025.050879","DOIUrl":"10.5014/ajot.2025.050879","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Collaboration between occupational therapists and family caregivers is essential during home assessments and modifications. The shift to videoconferencing-based assessments suggests increased family caregiver involvement, but the specifics of this change are unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate family caregiver involvement during videoconferencing-based home assessments and subsequent modifications from the perspective of occupational therapists.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This descriptive qualitative study involved virtual, semistructured individual interviews with participants who were recruited through purposeful and snowball sampling. Data analysis followed a descriptive thematic analysis methodology with an inductive approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;All interviews were conducted virtually at each participant's preferred time and location.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Fifteen occupational therapists from the Veterans Health Administration (VHA) with experience in videoconferencing-based home assessments and subsequent modifications for rural veterans.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four key themes were identified: (1) increased active involvement of family caregivers during the home assessment process, (2) circumstances that require family caregiver involvement for videoconferencing, (3) family caregiver-related factors affecting outcomes, and (4) strategies for effective family caregiver involvement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;The findings suggest that veterans' family caregivers play a more active role during videoconferencing-based home assessments than they do during traditional in-person assessments. This increased involvement may lead to a higher workload for VHA occupational therapists, who should now train caregivers, and for family caregivers themselves, who need to perform tasks previously handled by occupational therapists during home visits. To address this challenge, occupational therapists can leverage the insights extracted from this study. Plain-Language Summary: Occupational therapists often collaborate with family caregivers to assess the safety and accessibility of clients in their homes, recommending changes to the home environment accordingly. However, occupational therapy practitioners do not fully understand how much family caregivers are involved in videoconferencing-based home assessments, which is a new remote method, and subsequent modifications to client interventions. In this study, we explored, through interviews with 15 occupational therapists from the Veterans Health Administration (VHA), how family caregivers are involved in videoconferencing-based home assessments and subsequent modifications that are made to client interventions. We found that family caregivers have a greater responsibility for additional tasks during videoconferencing compared with traditional in-person assessments, including conducting measure","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Feeding Management in the School Setting: A Scoping Review.","authors":"Talia J Widrich, Catherine Fournier, Lothika Shanmugarajah, Sandra Fucile","doi":"10.5014/ajot.2025.051029","DOIUrl":"10.5014/ajot.2025.051029","url":null,"abstract":"<p><strong>Importance: </strong>School-based occupational therapists are well positioned to provide oral feeding management, yet understanding of how they can effectively address oral feeding goals in school systems is limited.</p><p><strong>Objective: </strong>To evaluate the current role of occupational therapy in pediatric oral feeding management in school-based settings.</p><p><strong>Evidence review: </strong>The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews was used as a guide. Six databases (CINAHL, Medline, PsycINFO, Embase, Web of Science, and Google Scholar) and four search engines (Bing, Google, Yahoo, and Ask.com) were searched with the keywords feeding, school, and occupational therapist. Studies with the following criteria were included: written in English, services provided in a school setting, children from junior kindergarten to Grade 12, and the management of oral feeding by occupational therapists in schools.</p><p><strong>Findings: </strong>An initial 189 articles were generated, and 10 articles met the eligibility criteria after elimination of duplicate studies and title and abstract screening. Four areas emerged regarding the role of occupational therapy in feeding in schools: (1) using a multidisciplinary collaborative approach to support students with feeding needs; (2) offering assessment strategies that range from informal to standardized methods; (3) implementing various intervention techniques, but evidence is limited, and (4) formalizing policies to include feeding goals in students' individual education plans, although the process for doing so remains unclear.</p><p><strong>Conclusions and relevance: </strong>The field of occupational therapy needs more evidence-based practice, more training in oral feeding management, and updated policies for oral feeding management in schools. Plain-Language Summary: Occupational therapists are well positioned to support the feeding needs of children in schools. This scoping review identifies four key roles for occupational therapists: collaborating with multidisciplinary teams to address feeding issues, conducting assessments from informal to standardized methods, providing a range of intervention strategies, and advocating for formal policies that incorporate feeding goals into students' individual education plans to better manage oral feeding challenges in the school setting.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Therapy Practice in Adult Rehabilitation of Persistent Postconcussion Symptoms: A Scoping Review.","authors":"Lisa Licciardi, Aislinn Lalor, John Olver, Libby Callaway","doi":"10.5014/ajot.2025.051001","DOIUrl":"https://doi.org/10.5014/ajot.2025.051001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;The role of occupational therapy in the rehabilitation of adults with persistent postconcussion symptoms (PPCS) following mild traumatic brain injury is an emerging practice area. Research that contributes to growing knowledge and understanding of the profession's role may increase the recognition and visibility of occupational therapy in concussion rehabilitation programs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify and categorize (using World Health Organization International Classification of Functioning, Disability and Health [WHO ICF] One-Level Classification domains) existing literature that describes occupational therapy practice (including assessments and interventions) in the rehabilitation of adults with PPCS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;Five scientific databases (MEDLINE, Embase, Emcare, PsycINFO, and CINAHL Complete) and gray literature were searched.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study selection and data collection: &lt;/strong&gt;Eligibility criteria included publications between 2013 and 2023, written in English, and within the peer-reviewed literature or on specified web domains (.gov, .edu, or .org).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Nineteen publications from 16 sources met eligibility criteria, consisting of quantitative studies (n = 6); case studies, series, or reports (n = 3); qualitative studies (n = 2); systematic or scoping literature reviews (n = 2); and gray literature sources (n = 3). The United States was the origin for many sources (n = 10). Assessments and interventions reported were heterogenous, mapping across 27 of the 30 WHO ICF One-Level Classifications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Evidence to inform occupational therapy practice in adult PPCS rehabilitation is limited; however, some useful information about the assessments and interventions used by occupational therapists was found. At a time when considerable advancements in concussion rehabilitation are occurring, further research on evidence-informed occupational therapy practice is required. Plain-Language Summary: This study reviewed existing evidence about the role of occupational therapy in the rehabilitation of adults with persistent postconcussion symptoms (PPCS). It identifies and methodically documents a range of occupational therapy assessments and interventions described in the literature that may be used by occupational therapists within concussion rehabilitation programs or research. The study also categorizes these by using an internationally recognized taxonomy, the World Health Organization's International Classification of Functioning, Disability and Health. The review offers a novel synthesis of published evidence to guide occupational therapy practice and inform resource allocation in concussion rehabilitation. It also highlights the need for further research about the role of occupational therapy-including both high-quality evidence of current approaches and identification of future practice opport","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Pelvic Floor Biofeedback for Children With Spinal Cord Injury: A Case Series.","authors":"Meredith Ten Brink, Laura Rucki, Erin Gates","doi":"10.5014/ajot.2025.050792","DOIUrl":"10.5014/ajot.2025.050792","url":null,"abstract":"<p><strong>Importance: </strong>Neurogenic bladder can negatively affect quality of life for children with incomplete spinal cord injury. Occupational therapy practitioners are uniquely able to provide individualized care to address this, which may include external pelvic floor biofeedback.</p><p><strong>Objective: </strong>To describe the implementation of external pelvic floor biofeedback for bladder management within the context of toileting for children with neurogenic bladder dysfunction following incomplete spinal cord injury.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Inpatient rehabilitation unit within a pediatric hospital.</p><p><strong>Participants: </strong>Three children with incomplete spinal cord injury were enrolled.</p><p><strong>Intervention: </strong>External pelvic floor biofeedback.</p><p><strong>Outcomes and measures: </strong>The study used the Functional Independence Measure for Children (WeeFIM®), Activity Measure for Post-Acute Care (AM-PAC) Daily Activities Short Form, Pediatric Spinal Cord Injury Activity Measures (PEDI-SCI AM) Short Forms, and voiding characteristics.</p><p><strong>Results: </strong>No adverse events occurred. Following biofeedback, all children improved their AM-PAC toileting scores, and PEDI-SCI AM scores improved for 2 of 3 children, whereas daily catheterization requirements decreased for all children. The WeeFIM did not detect changes in bladder management for 2 of 3 children.</p><p><strong>Conclusions and relevance: </strong>This case report described how occupational therapy practitioners used external pelvic floor biofeedback as an adjunct conservative treatment strategy when providing care for pediatric children with recent incomplete spinal cord injury. Plain-Language Summary: Neurogenic bladder dysfunction following incomplete spinal cord injury can negatively affect a child's quality of life and social participation. Occupational therapy practitioners are uniquely able to address bladder management within the context of toileting for children with acquired incomplete spinal cord injury. A multimodal approach, which includes biofeedback, may improve the child's level of independence with toileting.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory Family Accommodation for Autistic and Sensory Overresponsive Children: The Mediating Role of Parenting Distress Tolerance.","authors":"Ayelet Ben-Sasson, Adi Zisserman","doi":"10.5014/ajot.2025.050790","DOIUrl":"10.5014/ajot.2025.050790","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Family accommodation of anxiety disorders is associated with poorer outcomes; therefore, they are important to detect. A child's sensory problems often cause anxiety and disrupt family routines, which can increase family accommodation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare family sensory accommodation among children with autism spectrum disorder (ASD), children with sensory overresponsiveness (SOR), and typically developing children (TD). To examine the role of parenting distress tolerance in explaining the relation between SOR and family accommodation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Cross-sectional case control design involving nonrandomized sampling and a survey methodology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Internet.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Parents of 57 ASD children, 54 SOR children, and 48 TD children. Groups were matched on child age and ethnicity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes and measures: &lt;/strong&gt;The Short Sensory Profile 2, Adapted SensOR Inventory (total SOR), Family Accommodations Scale for Sensory Over-Responsivity (FASENS), and the Parenting Distress Tolerance Scale (P-DTS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The groups with ASD or SOR (clinical groups) had a higher frequency of family sensory accommodation, and these accommodations showed greater interference with child and family well-being than among the TD group. The clinical groups had significantly more bothersome sensations and lower P-DTS scores than the TD group. In the clinical groups, the P-DTS mediated the relation between total SOR and FASENS scores, controlling for mother's years of education.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Family sensory accommodation was more frequent among families of children with ASD or SOR and interfered more with child and family well-being. For clinical groups, being bothered by more sensations reduced parenting distress tolerance, which increased family accommodation. Plain-Language Summary: When children have strong reactions to sensory experiences, families often change their routines to prevent discomfort. This is called family sensory accommodation-when family members adjust their behaviors to avoid or minimize their child's sensory challenges and the associated distress. Although this may reduce stress in the short term, it can also reinforce anxiety and limit a child's ability to cope. We found that parents of children with autism spectrum disorder or sensory overresponsiveness were more likely to make these accommodations compared with parents of typically developing children. These accommodations were linked to greater disruptions in both child and family well-being. We also found that parents who had more difficulty managing their own stress were more likely to engage in family sensory accommodation. These findings highlight the need for occupational therapists to support families in reducing restrictive accommodations while helping children build independence and coping skil","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}