American Journal of Occupational Therapy最新文献

{"title":"War and Prolonged Early-Life Stressors: Cross-Sectional Comparison of Children's Functional Cognition as Measured With the BRIEF.","authors":"Chagit Hollander, Esther Adi-Japha, Shoshi Dorfberger","doi":"10.5014/ajot.2026.051455","DOIUrl":"10.5014/ajot.2026.051455","url":null,"abstract":"<p><strong>Importance: </strong>Early-life stressors related to war have been linked to disruptions in children's functional cognition, underscoring the need for occupational therapy practitioners to identify and address these difficulties.</p><p><strong>Objective: </strong>To compare functional cognition between cohorts of children before a global crisis and during a prolonged war and to test whether cohort differences vary by educational needs (typical vs. special).</p><p><strong>Design: </strong>Repeated cross-sectional design.</p><p><strong>Setting: </strong>Community-based data collection.</p><p><strong>Participants: </strong>Mothers of two cohorts of second- and third-grade children: Cohort 1 (precrisis, 2016-2017; n = 129) and Cohort 2 (during war, 2024-2025; n = 190).</p><p><strong>Outcomes and measures: </strong>Functional cognition was assessed with the Behavior Rating Inventory of Executive Function (BRIEF) Parent Questionnaire. The BRIEF Global Executive Composite, Behavioral Regulation Index (BRI), and Metacognition Index (MI) were analyzed.</p><p><strong>Results: </strong>After controlling for gender, age, socioeconomic status, and educational needs, children in the Cohort 2 demonstrated significantly lower functional cognition than children in Cohort 1. Multivariate analysis with cohort and educational needs as independent variables and BRI and MI as dependent variables revealed that children exposed to war and those with special educational needs had functional cognition deficits. A significant interaction between cohort and educational needs indicated that exposure to early-life stressors disproportionately affected children with special educational needs.</p><p><strong>Conclusions and relevance: </strong>War-related early-life stressors are associated with reduced functional cognition, particularly among children with special educational needs. The BRIEF Parent Questionnaire may serve as a practical screening measure to identify functional cognition challenges and guide pediatric occupational therapy interventions during and after crises. Plain-Language Summary: Functional cognition supports children's ability to meet the demands of their daily tasks in real-world environments, such as managing daily routines, playing, and participating in school tasks. This study examined how prolonged war-related stress affects children's functional cognition. The study compared children assessed before a global crisis with children assessed during a prolonged war, all from low socioeconomic backgrounds. Mothers reported on their children's everyday functional performance with the Behavior Rating Inventory of Executive Function Parent Questionnaire. The findings showed that children exposed to ongoing war-related stress demonstrated lower functional cognition than children assessed before the war. Children with special educational needs were affected most. These findings highlight the importance of identifying functional cognition difficulties","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610280","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":"Improving Access to Community Occupations via Rideshare: A Pilot Study With Autistic Adults.","authors":"Stacey Reynolds, Karla Estrada, Hannah Feder, Brandon Jenkins, Maria Medina, Austin Miller, Amanda M Robinson, Roy T Sabo, Alissa Molinelli Brooke","doi":"10.5014/ajot.2026.051398","DOIUrl":"10.5014/ajot.2026.051398","url":null,"abstract":"<p><strong>Importance: </strong>Adults with autism often face barriers to community access for work and leisure, yet few programs address transportation independence and safety. This study evaluated the Safe Rideshare Program (SRP), designed to teach autistic adults to use rideshare services.</p><p><strong>Objective: </strong>To assess acceptability, appropriateness, and the potential impact of the SRP and to evaluate changes in rideshare use for community access over a 2-mo follow-up period.</p><p><strong>Design: </strong>A one-group, pretest-posttest study.</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>Thirteen autistic adults.</p><p><strong>Intervention: </strong>The SRP consisted of five virtual training modules completed synchronously with project trainers via Zoom, followed by eight ride-along sessions using either Uber or Lyft rideshare services.</p><p><strong>Outcomes and measures: </strong>Intervention acceptability was rated by participants using the Acceptability of Intervention Measure. Appropriateness of the intervention was assessed by trainers using the Intervention Appropriateness Measure. A 30-item Rideshare Independence Checklist was used to assess independence and safety using rideshare services.</p><p><strong>Results: </strong>Of the 13 enrolled participants, 12 completed the program with strong acceptability and appropriateness ratings (≥75% threshold was met). Independence and safety significantly improved during the intervention, and at the 2-mo follow-up, 8 participants reported increased independent rides (p = .011).</p><p><strong>Conclusions and relevance: </strong>The SRP demonstrated preliminary acceptability and appropriateness, as well as the potential to improve transportation independence, safety, and community access for autistic adults. Plain-Language Summary: Many autistic adults face challenges accessing their communities for work, shopping, or social activities because of transportation barriers. Learning how to use rideshare services, such as Uber or Lyft, can help address this issue, but few programs are designed to teach these skills safely and effectively. To fill this gap, our team developed the Safe Rideshare Program (SRP) and tested its usefulness. Thirteen autistic adults, ages 18 to 24 yr, participated in this study. Most participants completed the entire program and gave it high ratings for being easy to follow and helpful. Trainers who worked with the participants also reported that the program was useful. By the end of the training, participants showed significant improvements in their ability to use rideshare services independently and safely. Two months after finishing the program, many participants continued to use rideshare services. On the basis of our preliminary findings, we believe that the SRP shows promise in helping autistic adults overcome transportation barriers and gain more independence. With improved access to transportation, participants were able ","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505205","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":"Effectiveness of Aquatic Occupational Therapy to Support Water Competency of Children on the Autism Spectrum.","authors":"Erika Kemp, Isabelle Sansone, Claire Black, Jewel Elias Crasta","doi":"10.5014/ajot.2026.051459","DOIUrl":"10.5014/ajot.2026.051459","url":null,"abstract":"<p><strong>Importance: </strong>There is a critical need for therapeutic water competency (water safety and swim skills) interventions tailored to meet the needs of children on the autism spectrum, a group that is at high risk for drowning.</p><p><strong>Objective: </strong>To examine the effect of AquOTic on caregiver- and therapist-based water competency goals for children on the autism spectrum.</p><p><strong>Design: </strong>Pre-post cohort design based on a larger randomized controlled trial.</p><p><strong>Setting: </strong>County Board of Developmental Disabilities therapy pool.</p><p><strong>Participants: </strong>Children on the autism spectrum (N = 37; 28 boys) ages 5 to 9 yr were recruited from the local community.</p><p><strong>Intervention: </strong>AquOTic is a manualized 10-wk occupational therapy-based water competency intervention for children on the autism spectrum. AquOTic incorporates evidence-based therapeutic techniques and embeds individualized therapy (interventionist-child dyads) in a group environment.</p><p><strong>Outcomes and measures: </strong>Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) were completed at baseline and post intervention.</p><p><strong>Results: </strong>Children showed significantly higher GAS T scores and COPM Performance and Satisfaction scores post-AquOTic compared with baseline (effect size d = 2.1-2.3). All goals mapped onto the Occupational Therapy Practice Framework (4th ed.), with motor skills emerging as the most common category for both caregiver- and therapist-derived goals, followed by safety awareness in the aquatic environment and sensory functions.</p><p><strong>Conclusions and relevance: </strong>Children on the autism spectrum demonstrated improved caregiver- and therapist-based water competency goals following the AquOTic intervention. Plain-Language Summary: This study examined the effect of AquOTic, an occupational therapy-based intervention, on parent/caregiver- and therapist-based goals related to water safety and swim skills among children on the autism spectrum. Caregivers identified goals for their children, and therapists developed goals that guided the intervention. After completing the 10-wk intervention, children showed improvements in both caregiver perceptions of their performance and satisfaction with goals set as well as therapist-rated goals. Our results highlight the value and effectiveness of an occupational therapy-based water competency intervention to improve water competency among children on the autism spectrum.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505142","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":"Pain Neuroscience Education for Postamputation Pain and Functioning: Testing Embedded Education in a Mobile App for Occupational Therapy Pain Treatment.","authors":"Tonya L Rich, Katharyn G Cristan, Lindsay Marth, Princess E Ackland","doi":"10.5014/ajot.2026.051449","DOIUrl":"10.5014/ajot.2026.051449","url":null,"abstract":"<p><strong>Importance: </strong>Postamputation pain remains a barrier to return to function. Occupational therapy practitioners often include pain neuroscience education (PNE) to support occupational engagement and health literacy.</p><p><strong>Objective: </strong>To assess perspectives about PNE for postamputation pain.</p><p><strong>Design: </strong>We conducted cognitive interviews in which participants viewed PNE videos that are part of a novel graded motor imagery (GMI) mobile application for pain treatment. The videos were designed to prepare for an occupation-based rehabilitation approach. All interviews were recorded, transcribed, and analyzed using rapid-turnaround methods.</p><p><strong>Setting: </strong>Health care institution, telehealth format.</p><p><strong>Participants: </strong>Eleven Veterans (10 males and 1 female), ages 40-75 yr, with unilateral transtibial amputation ≥1 yr, and with moderate or severe phantom limb pain, completed the study.</p><p><strong>Intervention: </strong>We developed amputation-specific PNE in the form of five recorded videos with images and minimal printed words: (1) First Steps Toward Pain Treatment, (2) Why GMI?, (3) Postamputation Pain Education, (4) Toolbox of Strategies, and (5) Your Nervous System.</p><p><strong>Outcomes and measures: </strong>Cognitive interviews to measure the Veterans' perceptions of the educational content.</p><p><strong>Results: </strong>Three themes were identified: (1) Veterans are willing to try GMI but have mixed opinions on whether it is worth the effort; (2) information about postamputation pain is comforting, but perceptions of when best to receive that information differ; and (3) the educational content is understandable and relatable with respect to lived experience.</p><p><strong>Conclusions and relevance: </strong>PNE provides a shared understanding and can be a promising tool for occupational therapy practitioners to help Veterans manage pain. Plain-Language Summary: This study was done to test a new way of teaching Veterans with phantom limb pain following a below knee amputation. The study used videos that explained pain using mostly pictures that were part of a mobile application for pain treatment. Most Veterans in this study said they were willing to try new treatments. They found the information to be understandable and aligned with their experience of living with pain. This approach to education prepares occupational therapy clients to more actively participate in occupation-based pain treatment.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505207","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":"Supporting Survivors of Military Sexual Trauma: The Imperative for Occupational Therapy in Research and Practice.","authors":"Linna Tam-Seto","doi":"10.5014/ajot.2026.051383","DOIUrl":"10.5014/ajot.2026.051383","url":null,"abstract":"<p><p>Military sexual trauma (MST) disrupts survivors' lives, affecting identity, occupational roles, and relationships. Research often focuses on psychological outcomes, but this column emphasizes the unique contributions of occupational therapy to MST recovery. Taking an approach that is grounded in occupational science and trauma-informed care, I explore how MST affects daily functioning, self-perception, and relational trust. I argue for an expanded role for occupational therapy in supporting survivors through identity reconstruction, reengagement in meaningful roles, and relational repair. By addressing the lived realities of MST, occupational therapists can foster healing, empowerment, and occupational justice within trauma-responsive care systems.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595730","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 Perspectives on Recovery From War-Related Risk Across the Life Course.","authors":"Adam R Kinney, Alison M Cogan, Tonya L Rich, Heidi Cramm","doi":"10.5014/ajot.2026.051622","DOIUrl":"10.5014/ajot.2026.051622","url":null,"abstract":"<p><p>This Special Section presents research that examines recovery from war-related risk across diverse populations, settings, and life stages. Taken together, these articles demonstrate that war-related exposure is a dynamic, longitudinal process that shapes participation in daily roles, routines, relationships, and identity among both combatants and noncombatants. From childhood through late adulthood, the studies highlight the enduring functional consequences of war and the contextual factors that influence recovery. Although many of these insights align with long-standing occupational therapy perspectives, their significance lies in strengthening the empirical foundation for life-course, participation-centered approaches to recovery. In this Guest Editorial, we provide an overview of these studies and outline key future directions for the occupational therapy profession to advance recovery from war-related risk across the lifespan.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628802","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":"Addressing Reintegration Gaps for Student Military Service Members and Veterans: Findings From a Needs Assessment.","authors":"Christine M Laskowski, Victor Michael Camacho","doi":"10.5014/ajot.2026.051446","DOIUrl":"10.5014/ajot.2026.051446","url":null,"abstract":"<p><strong>Importance: </strong>Military-to-civilian reintegration is a complex process shaped by psychological, social, occupational, and cultural transitions. Student Veterans often face barriers in higher education, including social isolation, competing responsibilities, and health challenges, with few structured supports. Occupational therapy practitioners can address these needs by promoting adaptation and meaningful participation.</p><p><strong>Purpose: </strong>To examine reintegration needs among student Veterans and inform development of Battlefield to Playing Field, an occupational therapy-informed, leisure-based pilot program to support reintegration through social participation.</p><p><strong>Participants: </strong>University stakeholders (n = 2); military-affiliated students and community members, including family (n = 22); and military-affiliated students enrolled in university summer 2024 courses (n = 14).</p><p><strong>Outcomes and measures: </strong>Stakeholder interview data and survey responses examining reintegration needs, participation barriers, and preferred leisure and social activities.</p><p><strong>Results: </strong>Literature review and stakeholder interviews identified three domains affecting reintegration: (1) identity (re)construction and belonging, (2) participation in meaningful leisure activities, and (3) campus systems and culture. Participants expressed an interest in recreation and leisure, particularly outdoor activities, team sports, and wellness classes. Facilitators included peer support and flexible scheduling; barriers included time constraints, family obligations, health conditions, and limited awareness of opportunities.</p><p><strong>Conclusions and relevance: </strong>Findings highlighted the need for culturally responsive, peer-driven, leisure interventions in higher education and informed development of Battlefield to Playing Field. Plain-Language Summary: Reintegration after military service involves more than jobs or health care. Many student Veterans struggle with feelings of belonging, balancing school and family responsibilities, and reestablishing social connections. In this study, we asked Veterans, students, and families what would help. Surveys and interviews revealed that sports, outdoor activities, and group recreation can help build confidence and foster connections; however, barriers-including time constraints, family responsibilities, health issues, and a lack of awareness-limit participation. These findings helped shape Battlefield to Playing Field, a new program designed to use leisure and social participation to enhance belonging, well-being, and success for student Veterans in higher education.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628814","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":"A Feasibility Trial of a Telehealth-Adapted Ayres Sensory Integration® Intervention for Autistic Children.","authors":"Natalie R Schiano, Taylor T Sivori, Rachel L Dumont, Molly Weaver, Daniella Soba, Sherly Devasy, Elizabeth M Ridgway, Roseann C Schaaf","doi":"10.5014/ajot.2026.051508","DOIUrl":"10.5014/ajot.2026.051508","url":null,"abstract":"<p><strong>Importance: </strong>Families of autistic children with sensory needs who live in rural areas and places where in-person visits are not possible may benefit from additional therapy delivery options.</p><p><strong>Objective: </strong>To assess parents' and therapists' acceptability of a telehealth delivery of occupational therapy using Ayres Sensory Integration® (OT-ASI) and to evaluate preliminary changes in children's daily life skills and autism symptoms.</p><p><strong>Design: </strong>One-group pilot feasibility trial.</p><p><strong>Setting: </strong>Telehealth delivery to the home environment.</p><p><strong>Participants: </strong>Families (N = 6) with children ages 4 to 12 yr, diagnosed with autism and sensory difficulties, able to follow simple directions, willing to participate in 10 telehealth sessions, willing to complete pre and post measures, and with access to Wi-Fi-enabled devices.</p><p><strong>Intervention: </strong>Telehealth delivery of 10 OT-ASI sessions.</p><p><strong>Outcomes and measures: </strong>Sensory feature measures included the Sensory Processing Measure and a sensory screening tool adapted from the Evaluation of Ayres Sensory Integration®. Parent measures included goal attainment scaling, Pediatric Evaluation of Disability Inventory Computer Adaptive Test, and Pervasive Developmental Disorders Behavior Inventory. The fidelity measure was adapted from the ASI® Fidelity Measure. Acceptability and feasibility were evaluated via semistructured interviews with parents and therapists.</p><p><strong>Results: </strong>Parents and interventionists were highly satisfied with OT-ASI and indicated that it was feasible to deliver. Children improved in individualized goals and functional skills as well as socialization and showed a decrease in overall autism symptomatology.</p><p><strong>Conclusions and relevance: </strong>Telehealth delivery of OT-ASI is feasible and acceptable while maintaining strong fidelity. It can extend the reach and impact of occupational therapy services to autistic children and their families, particularly those facing barriers to in-person care. Plain-Language Summary: Many autistic children process or respond to sensation differently from other children, which can affect their participation in daily life activities. Occupational therapy using Ayres Sensory Integration® (OT-ASI) is an evidence-based intervention that can help these children participate more fully in daily life activities and reach personal goals. During the coronavirus disease 2019 pandemic, the OT-ASI intervention was updated for online delivery. This online approach was rated by parents and interventionists as feasible and helpful. Children met goals and improved social communication and responsibility skills. More research is needed to confirm and expand on these results.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576174","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":"Examination of Total Hours of Volunteering or Informal Helping Among Older Adults and Risk of Future Functional Disability Using Data From a Large Panel Study.","authors":"Raymond Hernandez, Stefan Schneider, Bart Orriens, Elizabeth Zelinski","doi":"10.5014/ajot.2026.051162","DOIUrl":"10.5014/ajot.2026.051162","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;To assist with aging in place, occupational therapy practitioners consider a range of factors that can affect future functional ability. Engagement in volunteering has often been associated with improved future functional ability, but the effect of total helping hours inclusive of volunteering and informal helping has received less attention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine whether total hours helping others, inclusive of formal volunteering and informal helping, was associated with better future functional status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Time-to-event analysis (Cox regression) was conducted on data collected between May 2015 and August 2023 from the Understanding America Study (UAS), a U.S. internet-based longitudinal panel.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;UAS participants age 65 yr and older who did not report difficulties with activities of daily living (ADLs) at baseline (N = 2,434).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measures: &lt;/strong&gt;Measures used included self-reports of ADL status, total hours helping others (i.e., volunteering, informal helping), an approximate indicator of physical capacity (i.e., level of engagement in moderate physical activity), an approximation of mental capacity (i.e., speed of digital device use), and self-reports of preexisting conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;More hours helping others was associated with a subsequently lower risk of developing ADL difficulty at older ages, but the effect was no longer significant after accounting for differences in baseline cognitive capacity, physical capacity, and preexisting conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Findings suggest that past helping behaviors may influence future functional status by improving intrinsic capacity and general health. To support aging in place, occupational therapy practitioners may consider encouraging older adult clients to engage in more hours formally or informally helping others. Plain-Language Summary: Older adults often prefer aging in place, but functional limitations can prevent this from being possible. Among older adults, volunteering has consistently been associated with improved functional status in the future. Informal helping, or helping people outside of one's household in a way that is not structured by an institution (e.g., a charity), has some evidence supporting its association with better physical functioning. In this article, we examine the effect of total time spent formally or informally helping others on future risk of developing difficulty with an activity of daily living. Among adults age 65 and older, more total time helping others was associated with lower risk of developing difficulty with an activity of daily living at older ages. The effect was no longer significant after accounting for an individual's baseline physical and mental capacity and general health. This may suggest that past helping behaviors could influence future functional status ","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041911","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 Intervention to Mitigate Chemotherapy-Induced Cognitive Impairment Among Breast Cancer Patients: A Systematic Review.","authors":"Elisa Castelao-Alburquerque, Elisabet Huertas-Hoyas, Cristina García-Bravo, Ana Poveda-García, Gemma Fernández-Gómez, Madeleine Donovan, Jorge Pérez-Corrales, Mª Pilar Rodríguez-Pérez","doi":"10.5014/ajot.2026.051347","DOIUrl":"10.5014/ajot.2026.051347","url":null,"abstract":"<p><strong>Importance: </strong>Evidence regarding the impact of occupational therapy intervention, with or without transcranial direct current stimulation (tDCS), on chemo-induced cognitive impairment (chemo brain) among women with breast cancer, is limited.</p><p><strong>Objective: </strong>To analyze the impact of occupational therapy interventions, with or without tDCS, on mitigating chemo brain among women with breast cancer and to determine how these interventions affect cognitive functions, occupational performance, and quality of life.</p><p><strong>Data sources: </strong>PubMed/MEDLINE, Scopus, ScienceDirect, and SciELO.</p><p><strong>Study selection and data collection: </strong>A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Sources included clinical trials, observational studies, and systematic reviews published between 2000 and 2024, focusing on women with breast cancer experiencing chemo brain and receiving occupational therapy with or without tDCS intervention. Study quality was assessed using risk-of-bias assessment tools, such as the Critical Appraisal Skills Programme or the Cochrane tools, depending on the study design.</p><p><strong>Findings: </strong>The results indicate that occupational therapy interventions show a positive trend in improving occupational performance, cognitive function (memory, attention), and quality of life among women with breast cancer. Although tDCS showed potential, studies were limited and primarily focused on people with other conditions. The combination of technological and occupational interventions stood out for its positive impact on functional recovery.</p><p><strong>Conclusions and relevance: </strong>Occupational therapy interventions are effective in mitigating the sequelae of chemo brain among breast cancer patients, improving functionality and quality of life. tDCS is a promising but underexplored treatment that requires further specific research with this population. Plain-Language Summary: This systematic review was conducted to assess the effects of occupational therapy, with or without transcranial direct current stimulation (tDCS), on the sequelae of chemotherapy after breast cancer treatment. The analyzed studies indicated that occupational therapy interventions show a positive trend in improving occupational performance, cognitive function (memory, attention), and quality of life of women with breast cancer.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087719","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}