Effectiveness of cognitive orientation to (daily) occupational performance (CO-OP) on children with cerebral palsy: A mixed design

Background. Cerebral palsy (CP) is the most common cause of physical disabilities during childhood. Therapeutic interventions mainly focus on impairment reduction to address motor-based difficulties. In contrast, Cognitive Orientation to daily Occupational Performance (CO-OP) is a cognitive approach, providing intervention at the level of activity and participation. Aims. This study aims to determine whether the CO-OP approach improves motor skills and achievement in motor-based occupational performance goals in children with CP. Methods and procedures. In this mixed design research (i.e., a multiple baseline single case experimental design and a one-group pretest-posttest design), five children with CP participated in 12 CO-OP intervention sessions. Repeated measures of motor skills for the multiple baseline single case experimental design were taken using the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP); pre- and post-measures of parent/child perception of performance and satisfaction were identified using the Canadian Occupational Performance Measure (COPM); level of achievement was identified using Goal Attainment Scaling (GAS). Outcomes and results. According to the BOTMP results, all children were able to engage in the CO-OP intervention to improve motor performance. Significant differences after treatment were found in both performance and performance satisfaction ratings using the COPM as rated by parents and children. The GAS results showed progress in achievement levels for all children; all goals were achieved or exceeded. Conclusions and implications. CO-OP intervention can be helpful in improving motor skills and achieving self-identified, motor-based goals in children with CP

Reliability of Persian Handwriting Assessment Tool in Iranian Primary School Students

Objectives: Handwriting problems are among the most frequent reasons for case referrals to school-based occupational therapy centers. Persian Handwriting Assessment Tool (PHAT) is a valid tool available in Iran to evaluate handwriting components in school-aged children. However, its reliability has not been investigated yet. This study aimed to determine the reliability of the PHAT in Iranian primary school-aged children. Methods: The current methodological study was performed in Tehran city, Iran during 2015-2016. In total, 208 primary school-aged students participated in this study that aimed to investigate the internal consistency of the PHAT. Forty-eight students were also recruited to examine the intra- and inter-rater reliabilities of the PHAT. Selection of the schools and sampling were conducted using the random cluster sampling method. Results: Results suggested good to excellent internal consistency (α=0.84 to 0.99) for the measures of PHAT in dictation and copying domains. Intra-rater reliability of the PHAT ranged from 0.87 to 1.00. Furthermore, PHAT inter-rater reliability ranged from 0.7-1.00. Discussion: The PHAT is a reliable tool to evaluate handwriting components in primary school-aged children. It can also be useful for Iranian therapists to identify primary school students with handwriting problems

Nasal carriage screening of community-associated methicillin resistant Staphylococcus aureus in healthy children of a developing country

Background: The rapid emergence and spread of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has raised considerable public health concern in both developed and developing countries. The current study aimed to address the extent of this phenomenon in healthy preschool children of a developing country. Materials and Methods: We conducted a prospective study from April 2013 to March 2014 on 410 healthy 2-6 years old preschool children in Isfahan, Iran. Demographic medical data and nasal samples were collected from the participating children. Isolates were identified as S. aureus and MRSA based on microbiological and molecular tests, including the presence of eap and mecA genes. Results: The overall prevalence of S. aureus and CA-MRSA nasal carriage was 28% (115/410) and 6.1% (25/410), respectively. The identity of isolates was confirmed by molecular assay. The factors that were independently associated with nasal carriage of S. aureus were: Children crowding in day-care nurseries and income level of families. A total of 20/90 (22.2%) of methicillin-susceptible S. aureus and all 25 CA-MRSA displayed multiple drug resistance to 3–8 antibiotics. Conclusions: The current report reflects issues and concerns that the high rate of colonization by CA-MRSA in Iranian healthy children provides obliging evidence that MRSA have established a foothold in the community and are emerging as important health threatening pathogens. It is suggested that we need more effective infection control measures to prevent transmission of nasal CA-MRSA in healthy preschool children