American Journal of Occupational Therapy最新文献

{"title":"Relationship Between Directly Observed Sensory Reactivity Differences and Classroom Behaviors of Autistic Children.","authors":"Hannah Marcham, Teresa Tavassoli","doi":"10.5014/ajot.2024.050345","DOIUrl":"10.5014/ajot.2024.050345","url":null,"abstract":"<p><strong>Importance: </strong>Differences in sensory reactivity are a core feature of autism; however, more remains to be learned about their role in classroom learning.</p><p><strong>Objective: </strong>To use direct observational measures to investigate whether there is a link between sensory reactivity differences and classroom behaviors of autistic children.</p><p><strong>Design: </strong>Correlational study.</p><p><strong>Setting: </strong>Two special educational needs schools.</p><p><strong>Participants: </strong>Children with a clinical diagnosis of autism, ages 5 to 18 yr (N = 53).</p><p><strong>Outcomes and measures: </strong>Sensory reactivity differences were assessed with the Sensory Assessment for Neurodevelopmental Differences. Classroom behaviors were measured using the Behavior Assessment for Children-Second Edition Student Observation System.</p><p><strong>Results: </strong>Total sensory reactivity differences were correlated positively with behaviors that impede learning (r = .31, p < .05) and negatively with behaviors that facilitate learning (r = -.38, p < .05). Hyporeactivity differences were correlated positively with behaviors that impede learning (r = .28, p < .05) and negatively with behaviors that facilitate learning (r = -.31, p < .05). Hyperreactivity and sensory-seeking differences were not significantly correlated with behavior.</p><p><strong>Conclusions and relevance: </strong>Results suggest a link between sensory reactivity differences and classroom behaviors, highlighting a need for further research using observational measures in special education settings. Plain-Language Summary: Differences in hyporeactivity for children with autism may play a bigger role in classroom behavior and learning than previous literature has suggested. This has implications in occupational therapy practice for how to tailor support for children with hyporeactivity differences.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868127","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":"Exploration of the Association Between Sucking Measures and Ability to Attain Independent Oral Feeds Among Infants Who Are Born Preterm.","authors":"Sandra Fucile, Grace Hennessey, Suraya Meghji, Kimberly Dow","doi":"10.5014/ajot.2024.050581","DOIUrl":"10.5014/ajot.2024.050581","url":null,"abstract":"<p><strong>Importance: </strong>Infants who are born preterm often experience difficulty transitioning from full tube to independent oral feeds, which often prolongs their hospital stay. No clinical measures associated with attainment of independent oral feeds are currently available.</p><p><strong>Objective: </strong>To identify specific nutritive sucking measures associated with time to attainment of independent oral feeds among infants who are born preterm.</p><p><strong>Design: </strong>An observational cohort pilot study was undertaken.</p><p><strong>Setting: </strong>A Level 2 to Level 3 neonatal intensive care unit.</p><p><strong>Participants: </strong>Fourteen infants (7 male, 7 female) born at or less than 34 wk gestation were enrolled.</p><p><strong>Outcomes and measures: </strong>The monitored suck measures included average suck strength (millimeters of mercury), average sucking burst duration (seconds), average suck count (number of sucks), and average pause duration (seconds). Time to independent oral feeds (days) and baseline characteristics were also monitored. The nutritive sucking measures were recorded once, during the first 5 min of an oral feed, when infants were taking an average of three to four oral feeds per day using a nipple monitoring device.</p><p><strong>Results: </strong>An inverse relation was found among average suck burst duration (p = .04), gestational age (p = .03), and days to attainment of independent oral feeds.</p><p><strong>Conclusions and relevance: </strong>Study results suggest that average sucking burst duration, during the first 5 min of an oral feed, is associated with time to attain independent oral feeds. Plain-Language Summary: Sucking burst duration is a simple measure that may be used clinically to identify early on infants who may have trouble transitioning from full tube to independent oral feedings. The results of this study suggest that a suck burst duration in the first 5 min of an oral feeding is inversely associated with the length of time to achieve independent oral feeding. The results highlight the importance of considering an infant's nutritive sucking ability when evaluating their potential to achieve independent oral feedings.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858897","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":"The Text-Picture Integration Scale for Perspectives on Mental Illness: Development and Validation.","authors":"Guan-Yu Shih, Shih-Chen Fan, Chung-Hui Lin, Chia-Hui Hung","doi":"10.5014/ajot.2024.050531","DOIUrl":"https://doi.org/10.5014/ajot.2024.050531","url":null,"abstract":"<p><strong>Importance: </strong>Understanding the root cause of mental illness stigma is necessary to adopt effective management strategies.</p><p><strong>Objective: </strong>To establish a stable and effective text-picture integration rating scale to predict public perspectives on mental illness and to examine its reliability and validity.</p><p><strong>Design: </strong>Descriptive cross-sectional study using internet survey data.</p><p><strong>Setting: </strong>Online.</p><p><strong>Participants: </strong>Two hundred volunteers.</p><p><strong>Results: </strong>The 10-item the Text-Picture Integration Scale for Perspectives on Mental Illness was developed. The authors conducted data analysis using SPSS to evaluate the reliability and criterion-related validity of the Mental Health Literacy Scale (MHLS). The Text-Picture Integration Scale's item-level content validity index ranged from 0.83 to 1.00, and the scale-level content validity index was 0.97. The scale demonstrated acceptable reliability (Cronbach's α = .80). The mean value of individual items ranged from 3.18 to 4.48, and the mean total score was 39.44 (SD = 8.47). The Text-Picture Integration Scale exhibited satisfactory criterion-related validity with the MHLS (r = .76, p < .001).</p><p><strong>Conclusions and relevance: </strong>Preliminary analyses support that the Text-Picture Integration Scale is a stable and effective rating scale to determine public perspectives on mental illness and is appropriate for evaluating destigmatization efforts. Plain-Language Summary: The study findings support the use of the Text-Picture Integration Scale as a stable and effective rating scale to determine public perspectives on mental illness. The scale is also appropriate for evaluating ways to address the stigmas that people associate with mental illness, which pose challenges for people in recovery. Occupational therapists can leverage their understanding of public perspectives on mental illness when choosing interventions to support the overall well-being of their clients with mental illness.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867300","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":"Age-Related Changes in Functional Skills and Daily Life Task Management Among Autistic Youth.","authors":"Yeook Kim, Elizabeth G S Munsell, Wendy J Coster, Gael I Orsmond","doi":"10.5014/ajot.2024.050624","DOIUrl":"10.5014/ajot.2024.050624","url":null,"abstract":"<p><strong>Importance: </strong>Autistic youth who graduate with a high school diploma may experience challenges in acquiring functional skills for everyday independence. Few studies have focused on how their functional and self-management skills change during the transition to adulthood.</p><p><strong>Objective: </strong>To examine cross-sectional differences and longitudinal changes in the functional and self-management skills of transition-age autistic youth.</p><p><strong>Design: </strong>Exploratory longitudinal study (18-mo follow-up).</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>Autistic high school students who graduated with a high school diploma and their parents (N = 50).</p><p><strong>Outcomes and measures: </strong>Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (ASD).</p><p><strong>Results: </strong>Older youth (ages 18-20 yr) had significantly lower normative Social/Cognitive and Responsibility domain scores (i.e., self-management) than youth ages 14-17 yr. Approximately 2 yr later, youth in both age groups significantly improved in scaled scores on the Daily Activities and Responsibility domains.</p><p><strong>Conclusions and relevance: </strong>Autistic youth's functional and self-management skills fell below those of nonautistic peers; however, these skills do change over time and are therefore appropriate targets for intervention. Plain-Language Summary: The findings of this study highlight the importance of focusing on the functional and self-management skills of autistic youth as part of their transition to adulthood. Occupational therapists can play a valuable role in helping autistic youth to achieve independence as adults by assessing their functional needs and strengths and by providing client-centered interventions.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11117464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960170","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":"Performance of Medication Tasks: Relationship Among Patient-Reported Outcomes, Performance-Based Assessments, and Objective Assessments.","authors":"Jaclyn K Schwartz, Katherine Aylmer, Samara Green, Sami Tayeb, Timothy J Wolf, Elizabeth Unni, Emily Somerville","doi":"10.5014/ajot.2024.050500","DOIUrl":"10.5014/ajot.2024.050500","url":null,"abstract":"<p><strong>Importance: </strong>Occupational therapy practitioners use standardized assessments to guide their clinical decision-making, but it is unclear how well performance on standardized assessments translates to performance at home.</p><p><strong>Objective: </strong>To understand the concurrent and predictive validity of patient-reported outcomes and performance-based assessments for monitoring performance at home within the context of medication management and adherence.</p><p><strong>Design: </strong>Exploratory study.</p><p><strong>Setting: </strong>Participants completed standardized assessments in a lab or at home, which were followed by home-based electronic monitoring of medication adherence.</p><p><strong>Participants: </strong>Sixty community-dwelling adults with hypertension or stroke who independently took antihypertensive medications.</p><p><strong>Outcomes and measures: </strong>Participants completed the Hill-Bone Medication Adherence Scale, the Hill-Bone Medication Adherence Reasons Scale, the Performance Assessment of Self-Care Skills Medication Management subtask, and the Executive Function Performance Test-Enhanced Medication Management subtest. Then, they used an electronic pill cap to monitor medication adherence at home for 1 month.</p><p><strong>Results: </strong>Patient-reported outcomes and performance-based assessments in the context of medication management and adherence demonstrated poor concurrent and predictive validity to medication adherence at home.</p><p><strong>Conclusions and relevance: </strong>There is a gap between what people think they will do, what they can do on a standardized assessment, and what they actually do at home. Future research is needed to strengthen concurrent and predictive validity to clinically meaningful outcomes. Plain-Language Summary: Occupational therapy practitioners should use caution when using standardized assessments to try to predict client performance at home. They should also continue to use a battery of assessments, clinical reasoning, and client preferences to guide their decision-making for monitoring performance at home within the context of medication management and adherence.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11117467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960175","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":"Occupational Therapy Practice Guidelines for Autistic People Across the Lifespan.","authors":"Kristie K Patten, Kavitha Murthi, Dora D Onwumere, Emily C Skaletski, Lauren M Little, Scott D Tomchek","doi":"10.5014/ajot.2024.078301","DOIUrl":"10.5014/ajot.2024.078301","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Occupational therapy practitioners need evidence to support interventions that promote subjective well-being among autistic people and their families through optimal engagement and participation in occupations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;These Practice Guidelines are informed by systematic reviews to expand knowledge of interventions that promote access, inclusion, engagement, and optimal participation in occupations that are meaningful to autistic people. Our intent was to foster occupational therapy practitioners' clinical decision-making and reasoning when working with autistic people and their care partners.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;These Practice Guidelines were developed on the basis of four systematic reviews, supporting evidence and literature, along with continued revisions and integration through an iterative and collaborative process.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 98 articles were included in the systematic reviews, which are the foundation for practice recommendations in these guidelines. Forty-eight of the systematic review articles were used to inform the clinical recommendations included in these Practice Guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and recommendations: &lt;/strong&gt;Strong to moderate evidence indicates the need for multidisciplinary, goal-oriented interventions to support autistic people in different contexts. Although there is only emerging evidence in the inclusion of autistic people's strengths, interests, and perspectives to guide occupational therapy interventions, such practices can enhance the delivery of neurodiversity-affirming and trauma-informed practices. In addition, evidence is needed to support participation in activities of daily living (ADLs) for autistic youths. We recommend the use of strengths-based language to describe autistic people and the use of environmental adaptations, care partner education, and coaching to enhance occupational therapy service delivery. Plain-Language Summary: The literature is sparse regarding neurodiversity-affirming and trauma-informed practices for autistic youths, as well as for participation in activities of daily living (ADLs). These Practice Guidelines provide new information on positive mental health development; self-determination; ADLs, instrumental ADLs, play, and leisure occupations for children, adolescents, and adults; person-centered planning for adolescents and adults; and rest and sleep. Information on health management is also provided. Positionality Statement: This article uses the identity-first language autistic people. This nonableist language describes their strengths and abilities and is a conscious decision. This language is favored by autistic communities and self-advocates and has been adopted by health care professionals and researchers (Bottema-Beutel et al., 2021; Kenny et al., 2016). However, we respect the use of person-first language and have made a conscious decision to include research a","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960173","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":"Psychometric Properties of the Spanish Version of the Satisfaction With Daily Occupations and Occupational Balance in Spanish Stroke Survivors.","authors":"Cristina de Diego-Alonso, Pablo Bellosta-López, Jenny Hultqvist, Laura Vidaña-Moya, Mona Eklund","doi":"10.5014/ajot.2024.050454","DOIUrl":"https://doi.org/10.5014/ajot.2024.050454","url":null,"abstract":"<p><strong>Importance: </strong>Stroke survivors experience changes in participation level, satisfaction with participation, and participation balance, making it necessary to have a validated tool for their assessment.</p><p><strong>Objective: </strong>To evaluate the psychometric properties of the Spanish version of the Satisfaction With Daily Occupations and Occupational Balance (SDO-OB) in stroke survivors.</p><p><strong>Design: </strong>Psychometric study.</p><p><strong>Setting: </strong>National multicenter study (rehabilitation centers, and hospitals).</p><p><strong>Participants: </strong>One hundred forty stroke survivors with and without a primary caregiver.</p><p><strong>Outcomes and measures: </strong>Participants completed the SDO-OB, the five-level version of the EQ-5D (EQ-5D-5L), and the Activity Card Sort (ACS). Internal consistency, convergent validity, known-groups validity, and floor and ceiling effects were assessed. Intraobserver reliability was assessed 1 wk apart.</p><p><strong>Results: </strong>The internal consistency was acceptable; Cronbach's α = .80, 95% confidence interval (CI) [0.75, 0.85]. A moderate correlation was found between the SDO-OB summed participation level and summed participation satisfaction (ρ = .53). Both SDO-OB summed scores correlated with ACS scores (0.25 < ρ < .61). However, only summed participation satisfaction scores correlated with the emotional component of the EQ-5D-5L (ρ = .32). The SDO-OB discriminated between groups with and without a caregiver (p = .001) and had no floor or ceiling effects (<7%). Good intraclass correlation coefficients (ICCs) were obtained for summed participation level (ICC = .91; 95% CI [.85, .94]) and summed participation satisfaction (ICC = .86; 95% CI [.78, .92]). Standard error of measurement and minimum detectable change were 0.7 and 1.9 points, respectively, for summed participation level and 4.5 and 12.4, respectively, for summed participation satisfaction.</p><p><strong>Conclusions: </strong>The Spanish version of the SDO-OB presented good psychometric properties, making it a suitable instrument to address participation level, participation satisfaction, and participation balance in stroke survivors. Plain-Language Summary: After a stroke, survivors experience changes in their participation in daily activities and how satisfied they are with them. This study examined whether a tool called Satisfaction With Daily Occupations and Occupational Balance (SDO-OB) could provide reliable information about this. We looked at 140 stroke survivors from different places in Spain to see whether they had someone caring for them, how healthy they were, and how their participation in daily activities changed after stroke. We found that the SDO-OB is helpful for understanding a stroke survivor's situation and can identify areas needing intervention and track changes caused by intervention plans.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866306","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":"Difficulties Fulfilling Self-Care Needs Among Family Caregivers: An Observational Study.","authors":"Laura Gonzalo-Ciria, Ana Gascón-Catalán, Ana A Laborda-Soriano, Alba Cambra-Aliaga, María C Ruiz-Garrós, Marta Perez-de-Heredia-Torres","doi":"10.5014/ajot.2024.050528","DOIUrl":"https://doi.org/10.5014/ajot.2024.050528","url":null,"abstract":"<p><strong>Importance: </strong>Assuming the care of a family member with a disability or chronic illness constitutes a health risk factor for caregivers, who frequently overlook their own self-care.</p><p><strong>Objective: </strong>To analyze the self-care activities (SCAs) among caregivers of a family member with a disability or chronic illness and assess the impact on their satisfaction and quality of life (QoL).</p><p><strong>Design: </strong>Descriptive, cross-sectional, analytic study.</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>Five hundred caregivers of family members with a disability or chronic illness in the city of Zaragoza, Spain.</p><p><strong>Outcomes and measures: </strong>The family caregivers' occupational performance and satisfaction were assessed with the Canadian Occupational Performance Measure, and their QoL was assessed with the World Health Organization-Quality of Life.</p><p><strong>Results: </strong>In total, 32.8% of family caregivers had difficulty in all activities related to self-care, 46.6% had difficulty sleeping and resting, 31.6% had difficulty receiving health-related treatments, and 31.2% had difficulty with physical exercise. Women and younger family caregivers showed greater impairment in self-care. Occupational performance, satisfaction, and QoL worsened as the number of affected activities increased.</p><p><strong>Conclusions and relevance: </strong>Caring for a family member with a disability or chronic illness has a negative impact on the SCAs of caregivers, especially among female caregivers and those of younger age. Caregiving is also associated with lower occupational performance, satisfaction, and QoL. Plain-Language Summary: Caring for a family member with a disability or chronic illness can become a health risk for caregivers, who frequently ignore their own self-care. The study results found that women and younger family caregivers showed a greater decline in self-care. This study provides information to help occupational therapists to work with family caregivers to prevent a decline in their self-care and improve their quality of life.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872172","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":"Quantifying Coloring Skills Among Preschoolers.","authors":"Chien-Yu Huang, Gong-Hong Lin, Szu-Ching Lu, Shih-Chieh Lee","doi":"10.5014/ajot.2024.050519","DOIUrl":"https://doi.org/10.5014/ajot.2024.050519","url":null,"abstract":"<p><strong>Importance: </strong>Coloring is popular with preschool children and reveals their developmental state. However, interpreting coloring performances is challenging because descriptive and subjective evaluations are commonly used with large variations.</p><p><strong>Objective: </strong>To develop a scoring method to objectively quantify children's coloring skills.</p><p><strong>Design: </strong>Colored blank train templates were analyzed using four indicators (entropy, complexity, coloring outside the lines, and unexpected blank areas) to form a summed score.</p><p><strong>Setting: </strong>Kindergarten in a urban city (Tainan, Taiwan).</p><p><strong>Participants: </strong>Two hundred thirty-nine typically developing children ages 3 to 6 yr.</p><p><strong>Outcome and measures: </strong>A newly developed method to assess coloring skill on the basis of a colored picture of a train.</p><p><strong>Results: </strong>The summed score exhibited good internal consistency (Cronbach's α = .80), discriminative validity (p = .04), convergent validity (rs = .66 and .59 with age and visual-motor integration), and acceptable factorial validity (comparative fit index = .99, standardized root-mean-square residual = .04, and root-mean-square error of approximation = .13). Moreover, three coloring patterns (mature, transitional, and immature) were identified.</p><p><strong>Conclusions and relevance: </strong>The new method provides objective, reliable, and valid scores representing coloring skills in typically developing children. In addition, the coloring patterns can be recognized. This method can be used to facilitate comparisons of children's coloring skills with peers and provide valuable insight into children's development. Plain-Language Summary: This study proposes a new method to objectively quantify children's coloring skills with sound reliability and validity in typically developing children. The method can be used to evaluate children's coloring skills and patterns to shed light on their developmental stages.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872819","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":"Environmental Modifications for People With Intellectual and Developmental Disabilities: A Policy Analysis of Medicaid Home- and Community-Based Services.","authors":"Carli Friedman, Laura VanPuymbrouck","doi":"10.5014/ajot.2024.050393","DOIUrl":"https://doi.org/10.5014/ajot.2024.050393","url":null,"abstract":"<p><strong>Importance: </strong>Environmental modifications are targets for occupational therapy intervention because they support activities of daily living, self-efficacy, personal control, independence, and community living for people with intellectual and developmental disabilities (IDDs).</p><p><strong>Objective: </strong>To examine how environmental modifications were provided to people with IDDs through Medicaid home- and community-based services (HCBS) waivers across the United States in fiscal year (FY) 2021.</p><p><strong>Design: </strong>Using a mixed-methods policy analysis, we examined FY 2021 Medicaid HCBS 1915(c) waivers from across the United States to examine whether, and how, states provided environmental modifications to people with IDDs.</p><p><strong>Results: </strong>In FY 2021, 35 states projected spending $68.8 million on environmental modifications for 12,671 people with IDDs. The purpose of environmental modifications was most often to promote the health, welfare, and safety of people with IDDs (82.68%), and to promote their independence (69.29%). The most common examples of environmental modifications included ramps and/or lifts (70.08%), widening doorways and/or hallways (61.42%), bathroom modifications (58.27%), specialized electrical and/or plumbing for medical equipment (54.33%), and grab bars and/or handrails (53.54%).</p><p><strong>Conclusions and relevance: </strong>HCBS waiver data on environmental modifications for people with IDDs enhances an understanding of this funding source and provides a foundation of advocacy for occupational therapy practitioners to support people with IDDs with living, as well as aging, in the community rather than in institutions. An expansion of environmental modifications in HCBS for people with IDDs aligns with the aim of Medicaid HCBS waivers to promote community integration, self-determination, and independence, which are all benefits of environmental modifications. Plain-Language Summary: This study can help occupational therapy practitioners determine what funding sources are available in their state to help their clients with intellectual and developmental disabilities access environmental modifications. The findings can also help guide advocacy and lobbying efforts to expand access to environmental modifications.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066632","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}