Sensory-motor performance in seven-year-old children born extremely preterm

Background: Children born preterm are prone to motor problems. Research on their motor performance has, however, rarely been integrated with sensory processing. Aim: To examine sensory-motor performance in children born extremely preterm (EPT). Method: In a longitudinal prospective cohort study, 49 EPT (born <28 gestational weeks; 32 boys and 17 girls) and 33 term-born (16 boys and 17 girls) children were assessed with six individual subtests from the Sensory Integration and Praxis Tests at the age of 7.0 to 7.3 years. Results: The rate of test z-scores indicating dysfunction [from - 2 standard deviations (SD) to <-1 SD for mild and <- 2 SD for moderate-to-severe] was significantly higher in EPT children than in term-born children in all the subtests. When comparing mean performance adjusted for gender and mother's education, EPT children performed worse than term-born children in Design Copying (z-score difference - 0.83; 95% confidence interval -1.32 to - 0.34), Motor Accuracy (- 0.82; -1.26 to - 0.38), Postural Praxis (- 0.95; -1.45 to - 0.45), Manual Form Perception (- 0.59; -1.12 to - 0.06), and Finger Identification (- 0.88; -1.45 to - 0.31). Additional adjustment for Full-Scale Intelligence Quotient rendered difference in Manual Form Perception non-significant. Conclusion: Seven-year-old EPT children perform worse than their term-born peers in tests for visual-motor, somatosensory, and motor planning performance.Peer reviewe

Occupational Therapy Student Conceptions of Self-Reflection in Level II Fieldwork

Self-reflection is paramount to the development of professionalism and serves as the foundation of adult education and lifelong learning. Pedagogical approaches in health sciences programs that promote self-reflection are growing in popularity. Current literature identifies a gap in what and how students conceive self-reflection and whether self-reflection is creating professionals that meet the challenges of today’s healthcare climate. This qualitative study explores the conceptions of self-reflection for occupational therapy students in Level II Fieldwork. The use of phenomenographic methodology guided the collection of information-rich data through semi-structured interviews. Twenty-one occupational therapy graduates volunteered to participate in the interviews. Verbatim transcripts were coded to identify categories and patterns in the data. A focused discussion was employed as a member-checking method to ensure accuracy of study outcomes. Participants identified that self-reflection may serve to inform personal and professional practices during occupational therapy student clinical rotations. Although universally defined, student self-reflection occurred in countless ways and took many forms. Participants valued its function in expanded decision making, self-awareness, and competence in fieldwork and everyday occupations. These findings facilitate further research and the creation of new self-reflection educational methods or interventions designed to build or remediate self-reflective capacity of health sciences students during academic and clinical programming

Self-Reflection and its Relationship to Occupational Competence and Clinical Performance in Level II Fieldwork

Purpose: Reflective practitioners embody the ability to critique their own clinical thinking about the dilemmas that frequently arise in professional practice and everyday life. Conflicting evidence exists on whether or not self-reflective practices are effective in promoting academic, clinical, and personal success. This quantitative study investigated self-reflection as a predictor of increased occupational competence and clinical performance in Level II Fieldwork for entry-level Master\u27s degree occupational therapy students. Method: The study used convenience sampling to recruit participants and data were collected via a demographic survey and self-assessment questionnaires. Multiple linear regression analyses were conducted to determine the extent to which self-reflection predicts occupational competence and clinical performance. R2 values were examined to determine the importance of each dependent variable (occupational competence and clinical performance). Results: Findings revealed a statistically significant relationship between self-reflection and occupational competence (p = 0.0053) but not between self-reflection and clinical performance (p = 0.08). Self-reflection accounted for 14% of the variance in clinical performance (R2 = 0.14), and more than one third (R2 = 0.38) of the variance in occupational competence. Results suggest that students who self-reflect regularly during fieldwork may have a greater ability to maintain everyday life routines during the demands of Level II Fieldwork. Conclusions: Self-reflection strongly predicts occupational competence of occupational therapy students during Level II Fieldwork, but does not significantly predict students’ clinical performance. Recommendations: Occupational therapy educators should consider incorporating guided self-reflection activities into the academic program in order to support student occupational competence. Intentional coaching in self-reflection may better prepare students for a clinical setting by supporting healthy daily routines, which may help them to manage stress during Level II Fieldwork. Future research should explore the impact of self-reflection training during clinical rotations (provided by clinical educators) on student clinical performance. Revision of the measurement of clinical performance is warranted to include questions pertaining to soft skills such as self-reflection and awareness

Parasympathetic functions in children with sensory processing disorder.

The overall goal of this study was to determine if parasympathetic nervous system (PsNS) activity is a significant biomarker of sensory processing difficulties in children. Several studies have demonstrated that PsNS activity is an important regulator of reactivity in children, and thus, it is of interest to study whether PsNS activity is related to sensory reactivity in children who have a type of condition associated with sensory processing disorders termed sensory modulation dysfunction (SMD). If so, this will have important implications for understanding the mechanisms underlying sensory processing problems of children and for developing intervention strategies to address them. The primary aims of this project were: (1) to evaluate PsNS activity in children with SMD compared to typically developing (TYP) children, and (2) to determine if PsNS activity is a significant predictor of sensory behaviors and adaptive functions among children with SMD. We examine PsNS activity during the Sensory Challenge Protocol; which includes baseline, the administration of eight sequential stimuli in five sensory domains, recovery, and also evaluate response to a prolonged auditory stimulus. As a secondary aim we examined whether subgroups of children with specific physiological and behavioral sensory reactivity profiles can be identified. Results indicate that as a total group the children with severe SMD demonstrated a trend for low baseline PsNS activity, compared to TYP children, suggesting this may be a biomarker for SMD. In addition, children with SMD as a total group demonstrated significantly poorer adaptive behavior in the communication and daily living subdomains and in the overall Adaptive Behavior Composite of the Vineland than TYP children. Using latent class analysis, the subjects were grouped by severity and the severe SMD group had significantly lower PsNS activity at baseline, tones and prolonged auditory. These results provide preliminary evidence that children who demonstrate severe SMD may have physiological activity that is different from children without SMD, and that these physiological and behavioral manifestations of SMD may affect a child\u27s ability to engage in everyday social, communication, and daily living skills

Development of a fidelity measure for research on the effectiveness of the Ayres Sensory Integration intervention.

OBJECTIVE: We developed a reliable and valid fidelity measure for use in research on Ayres Sensory Integration (ASI) intervention. METHOD: We designed a fidelity instrument to measure structural and process aspects of ASI intervention. Because scoring of process involves subjectivity, we conducted a series of reliability and validity studies on the process section. Raters were trained to score therapist strategies observed in video recordings of adult-child dyads. We examined content validity through expert ratings. RESULTS: Reliability of the process section was strong for total fidelity score (ICC = .99, Cronbach\u27s alpha = .99) and acceptable for most items. Total score significantly differentiated ASI from four alternative interventions. Expert ratings indicated strong agreement that items in the structural and process sections represent ASI intervention. CONCLUSION. The Ayres Sensory Integration Fidelity Measure has strong content validity. The process section is reliable and valid when scored by trained raters with expertise in ASI

Cultural Adaptation of the Evaluation in Ayres Sensory Integration® (EASI) for Spanish-Speaking Populations

[Abstract] Importance: Spanish-speaking populations represent a significant percentage of occupational therapy clientele globally. Culturally appropriate Spanish translations of assessments are therefore imperative. This study describes the process of a culturally adapted translation of a set of tests for use with Spanish-speaking pediatric populations. Objective: To produce a culturally adapted Spanish translation of the Evaluation in Ayres Sensory Integration® (EASI) for international use. Method: We used cultural adaptation methodology that included direct and back translations of the EASI by bilingual translators and interviews with pediatric occupational therapists and children ages 3–6 yr from Spain. Linguistic experts helped revise the translations, and pediatric occupational therapy leaders in five Spanish-speaking North and South American countries reviewed the translations for comprehensibility and cultural appropriateness. Results: Back translations demonstrated equivalence with the original EASI tests except for a few test instructions and scoring criteria. Interviews with occupational therapists and children in Spain revealed some comprehension difficulties for several tests, which were revised in consultation with a linguistic expert. Additional adaptations were made on the basis of recommendations to address cultural differences by occupational therapy leaders from five North and South American countries. Most changes in wording were made in one EASI test (Praxis: Following Directions) that is heavily dependent on language comprehension. Conclusions and Relevance: We used currently recommended methodologies to develop and adapt a Spanish translation of the EASI for use across diverse cultures. What This Article Adds: A Spanish translation of the EASI has been developed for use in culturally diverse Spanish-speaking countries around the world

Goal attainment scaling as a measure of meaningful outcomes for children with sensory integration disorders.

Goal attainment scaling (GAS) is a methodology that shows promise for application to intervention effectiveness research and program evaluation in occupational therapy (Dreiling & Bundy, 2003; King et al., 1999; Lannin, 2003; Mitchell & Cusick, 1998). This article identifies the recent and current applications of GAS to occupational therapy for children with sensory integration dysfunction, as well as the process, usefulness, and problems of application of the GAS methodology to this population. The advantages and disadvantages of using GAS in single-site and multisite research with this population is explored, as well as the potential solutions and future programs that will strengthen the use of GAS as a measure of treatment effectiveness, both in current clinical practice and in much-needed larger, multisite research studies

Fidelity in sensory integration intervention research.

OBJECTIVE: We sought to assess validity of sensory integration outcomes research in relation to fidelity (faithfulness of intervention to underlying therapeutic principles). METHOD: We identified core sensory integration intervention elements through expert review and nominal group process. Elements were classified into structural (e.g., equipment used, therapist training) and therapeutic process categories. We analyzed 34 sensory integration intervention studies for consistency of intervention descriptions with these elements. RESULTS: Most studies described structural elements related to therapeutic equipment and interveners\u27 profession. Of the 10 process elements, only 1 (presentation of sensory opportunities) was addressed in all studies. Most studies described fewer than half of the process elements. Intervention descriptions in 35% of the studies were inconsistent with one process element, therapist-child collaboration. CONCLUSION: Validity of sensory integration outcomes studies is threatened by weak fidelity in regard to therapeutic process. Inferences regarding sensory integration effectiveness cannot be drawn with confidence until fidelity is adequately addressed in outcomes research