American Journal of Occupational Therapy最新文献

{"title":"Letter to the Editor.","authors":"Takao Kaneko, Hirofumi Nagayama","doi":"10.5014/ajot.2025.051360","DOIUrl":"https://doi.org/10.5014/ajot.2025.051360","url":null,"abstract":"","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974582","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":"Facilitating Independence in Self-Care for Pediatric Clients With Amyoplasia: A Case Series.","authors":"Amy Sitabkhan, Grace Evasco, Scott Oishi","doi":"10.5014/ajot.2025.051219","DOIUrl":"10.5014/ajot.2025.051219","url":null,"abstract":"<p><strong>Importance: </strong>Joint contractures can lead to significant limitations in participation in activities of daily living and functional mobility. However, evidence regarding occupational therapy self-care interventions for children diagnosed with amyoplasia is limited.</p><p><strong>Objective: </strong>To provide a detailed observational description of self-care-focused interventions for the pediatric population with amyoplasia.</p><p><strong>Design: </strong>A retrospective case-series design was used to describe a week-long bout of rehabilitation completed to address functional skills.</p><p><strong>Setting: </strong>A pediatric outpatient orthopedic specialty hospital.</p><p><strong>Participants: </strong>Three case series participants were included. Participants were ages 7 to 15 yr, diagnosed with amyoplasia, and completed a week-long bout of therapy.</p><p><strong>Intervention: </strong>Five 90-min visits on consecutive days, including evaluation and discharge visits, targeted occupational performance. Interventions addressed assistive technology (AT) use, caregiver education, and environmental modifications.</p><p><strong>Outcomes and measures: </strong>Clients completed the Canadian Occupational Performance Measure (COPM) and the FIM® or Functional Independence Measure for Children (WeeFIM®) at the evaluation and discharge visits to determine changes in independence in completing self-care skills.</p><p><strong>Results: </strong>All three clients experienced improvements in independence to complete self-care skills. Participants' COPM scores increased from evaluation to discharge. Similarly, FIM and WeeFIM scores indicated improved levels of independence related to targeted goals. It is important to note that changes in outcome measures were only assessed immediately after the therapy episode; longitudinal changes were not tracked.</p><p><strong>Conclusions and relevance: </strong>The findings emphasize the importance of interventions focused on AT, environmental modifications, and caregiver education to address performance of daily activities of children diagnosed with amyoplasia. Plain-Language Summary: The case series adds evidence regarding the importance of occupational therapy in targeting self-care interventions with children diagnosed with amyoplasia. Short consecutive occupational therapy sessions may improve clients' awareness of assistive technology and environmental modifications. A combination of low and high technology may be vital for improving occupational performance in this population. Additionally, it is important for occupational therapy practitioners to address caregiver education throughout sessions to increase carryover of skills and techniques. Practitioners working with clients with amyoplasia should understand pediatric development in addition to body functions and structures to ensure interventions are appropriate, attainable, and meaningful. This information can guide clinical interventions and occ","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876090","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's Role in Schools: A Survey of Occupational Therapy Practitioners.","authors":"Deborah Zeitlin, Ashlyn Case, Caroline Clement, Reagan Cook, Halle Tackett, Ryleigh Thomas, Elizabeth K Schmidt","doi":"10.5014/ajot.2025.051041","DOIUrl":"10.5014/ajot.2025.051041","url":null,"abstract":"<p><strong>Importance: </strong>Limited evidence exists surrounding the diverse, multifaceted nature of responsibilities and challenges among school-based occupational therapy practitioners (SBOTPs).</p><p><strong>Objective: </strong>To describe a service delivery model, feedback provision, intervention approaches, roles and responsibilities, and factors contributing to intervention decisions for SBOTPs.</p><p><strong>Design: </strong>A descriptive electronic survey design with closed- and open-ended questions for January-March 2024.</p><p><strong>Setting: </strong>School-based practice Participants: Participants included 500 SBOTPs across the United States, with the majority having 10 or more years of experience (39.6%) and a master's degree (58.9%).</p><p><strong>Outcomes and measures: </strong>Survey questions describing intervention approaches and frequency of use, service delivery methods, feedback provision, duties, and demographics.</p><p><strong>Results: </strong>Most SBOTPs in elementary school provided direct intervention in therapy rooms (74.2%), whereas SBOTPs in middle and high school primarily provided consultative services (69% and 75.63%, respectively). Feedback was reported to be provided during required reports and meetings across all settings (86.27%, 88.7%, and 91.18%, respectively). The most frequently reported interventions used for SBOTPs in elementary and middle school addressed fine motor skills (98.6% and 69.5%, respectively), whereas those in high school primarily addressed life skills (56.5%). Reportedly, mental health and literacy participation were rarely addressed. Education, years of experience, and caseload size affected choices across all settings.</p><p><strong>Conclusions and relevance: </strong>This study clarifies the roles of U.S. SBOTPs, demonstrating how their expertise supports individual student needs and broader educational goals. By understanding and leveraging SBOTPs' contributions, schools can better address their student populations' diverse needs, ensuring the opportunity to succeed academically and socially. Plain-Language Summary: This study describes a service delivery model, feedback provision, intervention approaches, roles and responsibilities, and factors contributing to intervention decisions for school-based occupational therapy practitioners. We asked 500 practitioners what interventions they use and how often, how they provide the interventions, how they communicate the child's progress, and other tasks for which they are responsible across school settings. In elementary schools, participants said that they provide interventions in therapy rooms, whereas middle and high school practitioners consulted more with teachers and staff to support students. Our participants said that, primarily, they use fine motor and handwriting interventions in elementary and middle school but focus on developing life skills in high school. Few participants said that they address mental health or literacy, bu","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876092","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":"Preliminary Efficacy of Face-to-Face, Telerehabilitation, and Home Program-Based Task-Oriented Circuit Training on the Cognitive and Motor Functions of Older Adults: A Single-Blind Randomized Feasibility Study.","authors":"Ceyhun Turkmen, Aysenur Karakus, Seyma Yilmaz, Feyza Sengül, Ilkem Ceren Sigirtmac","doi":"10.5014/ajot.2025.051237","DOIUrl":"10.5014/ajot.2025.051237","url":null,"abstract":"<p><strong>Importance: </strong>Task-oriented circuit training (TOCT) is a structured intervention to enhance older adults' cognitive and motor functions. However, the feasibility and effectiveness of TOCT delivered through face-to-face, telerehabilitation, and home-based methods remain unclear.</p><p><strong>Objective: </strong>To evaluate the feasibility and preliminary efficacy of TOCT delivered through different modalities on cognitive and motor functions in older adults.</p><p><strong>Design: </strong>A randomized feasibility study.</p><p><strong>Setting: </strong>A state-operated skilled nursing facility in Turkey that provides daily-living assistance with on-site medical coverage for emergencies.</p><p><strong>Participants: </strong>Fifty-four older adults (ages ≥65 yr). Inclusion criteria included Mini-Mental State Examination (MMSE) scores >18. Adults with moderate or severe impairment (MMSE scores ≤18) were excluded.</p><p><strong>Intervention: </strong>Participants were randomly assigned to face-to-face, telerehabilitation, or home-based TOCT. They engaged in structured TOCT activities to improve joint protection, memory, attention, and fine motor skills. Sessions were delivered for 60 min daily for 2 wk. Pre- and postintervention assessments were conducted.</p><p><strong>Outcomes and measures: </strong>Assessments included the MMSE, the Montreal Cognitive Assessment, the Nine-Hole Peg Test, and subscales of the 36-Item Short Form Health Survey.</p><p><strong>Results: </strong>Face-to-face TOCT showed the greatest cognitive improvements (MMSE: d = 1.52), whereas telerehabilitation improved energy and vitality levels (d = 0.91) and social functioning (d = 1.41). Home-based training showed the smallest improvements overall.</p><p><strong>Conclusions and relevance: </strong>TOCT through face-to-face and telerehabilitation methods effectively improved cognitive and motor functions. Face-to-face training yielded the greatest cognitive benefits, whereas telerehabilitation enhanced quality of life. Home-based interventions had limited impact. Future research should explore long-term outcomes and refine home-based programs. Plain-Language Summary: As people age, cognitive and motor skills decline, making daily activities harder. This study examined task-oriented circuit training, a structured program delivered through face-to-face, telerehabilitation, and home-based methods. Face-to-face training showed the greatest cognitive improvements, whereas telerehabilitation enhanced energy and vitality levels and social participation. Home-based programs had minimal benefits. These findings support remote task-oriented circuit training as a viable option, although further research is needed to improve home-based interventions.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876093","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":"Social and Academic Belonging: Developing an Ecological Belonging Program for Occupational Therapy Students.","authors":"Avital S Isenberg, Erin L Mathia, Susie Chen, Erica M McGreevy, Kevin R Binning, Ketki D Raina","doi":"10.5014/ajot.2025.051027","DOIUrl":"10.5014/ajot.2025.051027","url":null,"abstract":"<p><strong>Importance: </strong>Occupational therapy students can experience a lack of social and academic belonging during their education, affecting their well-being and confidence. There is a lack of evidence-based programs to increase social and academic belonging.</p><p><strong>Objective: </strong>To explore experiences of belonging and adversity among entry-level occupational therapy doctorate (OTD) graduate students and develop an ecological belonging program to address the findings.</p><p><strong>Design: </strong>Qualitative descriptive methodology with a constructivist paradigm.</p><p><strong>Setting: </strong>An entry-level OTD program at an urban research university.</p><p><strong>Participants: </strong>Forty-one entry-level OTD students were recruited from a 3-yr graduate program.</p><p><strong>Outcomes and measures: </strong>A semistructured interview guide.</p><p><strong>Results: </strong>Students at different stages in the entry-level OTD program participated in focus groups (n = 41). Themes illustrated that students experienced a lack of social and academic belonging at three program time points related to specific struggles they encountered. Themes included making friends, balancing school and personal life, questioning whether they belonged in occupational therapy, whether they would succeed in fieldwork, and how to excel as an entry-level practitioner. A three-session, evidence-based ecological belonging program, Supporting Hardiness and Inclusion for New Endeavors (SHINE), was developed from focus group findings.</p><p><strong>Conclusions and relevance: </strong>Occupational therapy students experience a lack of social and academic belonging and often feel alone in their struggles throughout graduate school. Evidence-based programs can be tailored and implemented to address this adversity. Educators can support students at key transition points to normalize adversity and encourage success. Plain-Language Summary: This study explored the experiences of belonging and adversity among entry-level occupational therapy doctorate students. The study aimed to develop a program to normalize challenges and address self-doubt among students. Focus groups revealed that students often question their career path and experience feelings of self-doubt, especially during key transitions. These concerns extended to clinical settings, both as students and as future clinicians. The findings informed the development of an evidence-based, ecological belonging program focused on building confidence, belonging, and strategies to overcome self-doubt, helping students develop resilience for success in education and future practice.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884034","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":"Use Challenges and Training Needs of In-Vehicle Technologies for Older Drivers With Vision Impairments.","authors":"Jing Xu, Abbie Hutton","doi":"10.5014/ajot.2025.051078","DOIUrl":"10.5014/ajot.2025.051078","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Older drivers with impaired vision may face challenges using in-vehicle technologies, affecting user experience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore use challenges with in-vehicle technologies and training preferences of older drivers with and without central vision loss (CVL).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A telephone questionnaire on perceptions of driver-vehicle interface use difficulties, challenges with existing advanced driver assistance systems (ADAS), and preferences for ADAS acquisition and training.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Community-dwelling U.S. older adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;A total of 126 volunteers 18 yr and older with valid driver's licenses who had driven within the last 2 mo were recruited. The CVL group self-reported diagnoses of various forms of CVL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Fifty-eight older drivers with CVL (Mdn age = 71.4 yr, 41% male) and 68 without (Mdn age = 71.8 yr, 37% male) completed the questionnaire. The CVL group reported greater difficulty using in-vehicle technologies compared with the non-CVL group, particularly in recognizing visual information in vehicle interfaces. Greater difficulty correlated with poorer self-reported vision status and with increased self-regulated driving exposure. Primary challenges for the CVL group included issues with small button and font sizes, inadequate color contrast, and display glare. Both groups expressed a desire for guidance and training in effective ADAS use, with the CVL group preferring guidance from health care professionals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Older drivers with CVL face challenges using in-vehicle technologies, especially in accessing visual information. They prefer guidance from health care professionals, suggesting potential for tailored support from occupational therapists specializing in driving rehabilitation. Plain-Language Summary: This study explored the challenges faced by older drivers with central vision loss when using in-vehicle technologies. Older drivers with central vision loss reported significantly more difficulty than drivers without central vision loss, particularly in recognizing and using visual information in vehicle interfaces and with advanced driver assistance systems. Challenges included issues with small buttons and font sizes, poor color contrast, and display glare. Individuals with more severe vision impairment, who drive less and avoid more driving situations, face more challenges with in-vehicle technologies, yet these are the drivers who might benefit most from such technologies. Both groups expressed a desire for guidance in selecting and using driver assistance technologies, with drivers with central vision loss preferring support from health care professionals. The study findings highlight the need for tailored training and support, which could enhance occupational therapy clients' ability to effectively use modern vehicle techno","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884035","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":"Reliability and Concurrent Validity of a Low-Cost Handgrip Dynamometer: The Camry.","authors":"Lucía Sánchez-Aranda, Javier Fernández-Ortega, Isabel Martín-Fuentes, Angel Toval, Gregor Jurak, Jonatan R Ruiz, Tamás Csányi, Francisco B Ortega","doi":"10.5014/ajot.2025.051072","DOIUrl":"10.5014/ajot.2025.051072","url":null,"abstract":"<p><strong>Importance: </strong>Handgrip testing is highly valid and reliable, but the high cost of dynamometers limits their use in some settings. A more affordable option, the Camry dynamometer, has recently been used in fitness surveillance; however, its reliability and validity compared with known weights and well-validated models remain unknown.</p><p><strong>Objective: </strong>To investigate test-retest reliability, intermodel reliability (new vs. old Camry), and interinstrument reliability (Camry vs. TKK dynamometer) and concurrent validity of the Camry dynamometer by using calibrated known weights.</p><p><strong>Design: </strong>Comparison study with a digital TKK 5401 dynamometer and two Camry EH101 dynamometers (new and old, with more than 3,000 uses).</p><p><strong>Outcomes and measures: </strong>Intrainstrument and interinstrument reliability and concurrent validity were assessed to compare measures of the dynamometers with calibrated weights using the Bland-Altman method.</p><p><strong>Results: </strong>Intrainstrument (retest minus test) reliability was very high (systematic error for test-retest reliability): new Camry, M = 0.01 kg (SD = 0.49); old Camry, M = -0.10 kg (SD = 0.49); TKK, M = 0.14 kg (SD = 0.76). Comparison showed small mean differences between Camry dynamometers and TKK (new Camry vs. TKK, M = 0.84 kg, SD = 0.79; old Camry vs. TKK, M = 0.88 kg, SD = 0.85). The mean systematic error between the new and old Camry dynamometers was 0.03 kg (SD = 0.57). Concurrent validity showed smaller magnitude systematic errors in the Camry than TKK: new Camry, M = -0.21 kg (SD = 0.35); old Camry, -0.18 kg (SD = 0.79); TKK, M = -1.07 kg (SD = 0.75).</p><p><strong>Conclusions and relevance: </strong>The Camry dynamometer is highly reliable and valid and is a more affordable alternative for handgrip strength assessment. Plain-Language Summary: Handgrip strength is an important measure of health and is linked to outcomes such as overall mortality and illness. Testing handgrip strength is useful for health and fitness-related professionals, including occupational therapists, to track rehabilitation progress. However, the cost of the dynamometers limits their use in some places or large-scale studies. Recently, a cheaper alternative, the Camry dynamometer, has been used, but its accuracy compared with known weights or other validated devices has not been confirmed. This study tested the reliability and accuracy of two Camry dynamometers (a new and an old device) versus the TKK dynamometer and known weights. Results showed that the Camry dynamometer is highly reliable, valid, and durable and remains accurate even after many uses. The findings could make handgrip strength testing more accessible in health care and fitness evaluations.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"79 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884067","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":"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":"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":"<p><strong>Importance: </strong>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.</p><p><strong>Objective: </strong>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).</p><p><strong>Method: </strong>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.</p><p><strong>Design: </strong>Cross-sectional validation study.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions and relevance: </strong>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}