Examining the neuroscience evidence for sensory-driven neuroplasticity: implications for sensory-based occupational therapy for children and adolescents.

When Ayres first presented the theory of sensory integration (SI), she grounded it in the neuroscience literature. Neuroplasticity was then, and is today, considered to be at the heart of this theory. This evidence-based review sought to critically examine the basic science literature to specifically identify evidence for the assumptions and tenets of Ayres\u27 theory of SI. We reviewed literature between 1964 and 2005, within psychological, physiological, and biomedical areas, addressing neuroplasticity. The review focused on sensorimotor-based neuroplasticity; explored the data that addressed the links among sensory input, brain function, and behavior; and evaluated its relevance in terms of supporting or refuting the theoretical premise of occupational therapy using an SI framework (OT/SI) to treatment. Although direct application from basic science to OT/SI is not feasible, we concluded that there was a basis for the assumptions of Ayes\u27 SI theory

Sensory Over-Responsivity and ADHD: Differentiating Using Electrodermal Responses, Cortisol, and Anxiety

Deficits in sensory modulation have been linked clinically with impaired attention, arousal, and impulsivity for years, but a clear understanding of the relationship between sensory modulation disorders and attention deficit hyperactivity disorder (ADHD) has proven elusive. Our preliminary work suggested that patterns of salivary cortisol and electrodermal responsivity to sensation may be linked to different groups of children with ADHD; those with and without sensory over-responsivity (SOR). Additionally, SOR has been linked to anxiety, and anxiety has been linked to ADHD. A clearer understanding of the relationship between anxiety, SOR, and ADHD may support a better understanding of ADHD diagnostic subtypes. We examined neuroendocrine, electrodermal and behavioral characteristics and sought to predict group membership among 6- to 12-year-old children with ADHD and SOR (ADHDs), ADHD and no SOR (ADHDt), and typicals (TYP). Behavioral questionnaires were completed to document SOR and anxiety. Lab testing used a Sensory Challenge Protocol (SCP) with concurrent electrodermal measurement and the collection of cortisol prior to and following the SCP. Results substantiated links between SOR and anxiety, in both TYP and ADHD children. Results suggests that ADHD should be considered in conjunction with anxiety and sensory responsivity; both may be related to bottom-up processing differences, and deficits in prefrontal cortex/hippocampal synaptic gating

Multiple Ways to Persevere: Liar's Bingo

Some readers may already be familiar with the mathematical task of solving Liar's Bingo. In this article, the authors will share the different ways Liar's Bingo has provided both the authors and their students the opportunity to persevere on multiple levels as they and students try to explain the different mathematical patterns that emerge in the strips. The authors will share some extensions to Liar's Bingo that readers can use in their classrooms and some of the observed patterns and some sample explanations. Spoiler alert: the authors have not found explanations for all the observed patterns. (Yet!

If Reasoning, Reflection, and Evidence-Based Practice are Essential to Practice, We Must Define Them

Reasoning, reflection, and evidence-based practice are considered essential to the delivery of high-quality occupational therapy services. These skills are highlighted in occupational therapy practice acts and educational standards. Unfortunately, although clearly integral to practice, reasoning, reflection, and evidence-based practice are rarely and inconsistently defined in the profession of occupational therapy. Because the terms reasoning, reflection, and evidence-based practice are used so frequently, and so often their definitions are assumed, occupational therapy students may be unclear on how they will be evaluated and, ultimately, what they will be expected to do in practice in relation to these skills. Through a review of literature, this paper identifies the need for clear conceptualizations of professional skills in occupational therapy and synthesizes the significance of reasoning, reflection, and evidence-based practice to both the education of occupational therapy students and the practice of occupational therapy. This Opinions in the Profession paper seeks to begin a discussion around actions required to advance occupational therapy as a profession through the process of clarifying how these skills are conceptualized, taught, and implemented to promote clear language in literature, education, and practice with the hope of positively impacting therapy services

A Concept Paper for a VCU Social Sciences Initiative

This project proposes the development of a Social Sciences Initiative at the undergraduate and graduate levels that will provide educational, research and service opportunities for faculty and students. These opportunities are envisioned as interdisciplinary, with a focus on community issues and priorities, and with the potential to create new links among existing educational/research units within the University. The development of a Social Sciences Initiative provides a direct link to the Mission of VCU through several of the Mission’s intents: “activities that increase knowledge and understanding of the world and inspire and enrich teaching” The Social Sciences Initiative will expand current activities and promote innovative teaching in an interdisciplinary manner. “diverse educational programs” The Social Sciences Initiative increases the diversity of educational program offerings. “development of innovative approaches to meet the changing needs of our society” The Social Sciences Initiative will directly address the changing societal needs through support of interdisciplinary education, research, and service. Further, this initiative is consistent with the VCU Vision in that it will “advance a climate of scholarly inquiry…serve as a model of diversity in higher education…addressing urban issues in the nation and the world…build upon its substantial foundations in the…applied social sciences.” (VCU Strategic Plan for the Future of Virginia Commonwealth University, Phase II, 1998)

Test of Ideational Praxis (TIP): Preliminary Findings and Interrater and Test–Retest Reliability With Preschoolers

Praxis is the ability of the brain to develop an idea for action and plan, organize, and execute unfamiliar motor actions. It enables purposeful interaction with people and things in the environment. Ideation is central to praxis but has been little researched. This study investigated the reliability of the Test of Ideational Praxis (TIP) and examined ideational praxis in typical preschoolers. TIP performance for 78 preschoolers ages 3, 4, and 5 yr was videotaped and scored by two trained raters. The TIP has strong interrater reliability, supporting earlier findings. Further, we documented test–retest stability over 2 wk. As a group, preschoolers identified 10.6 affordances (ideas) for action on the TIP; no age differences were found. Training is required for accurate scoring of the TIP; following training, clinicians and researchers may find the TIP a useful tool to screen motor ideational abilities in young children

Relationships Between Reasoning, Reflective Practice, and Evidence-Based Practice: Educators’ Perspectives

Many models of professional thinking exist within occupational therapy, but the relationships among reasoning, reflective practice, and evidence-based practice as essential skills for practice are not clear. Because occupational therapy educators impart these skills to students, understanding how educators conceptualize relationships among skills is necessary. We used Delphi methodology to explore educator conceptualizations of the relationships among clinical reasoning, professional reasoning, reflective practice, and evidence-based practice. Inclusion criteria were: an educator in an occupational therapy program for at least three years at the master’s level or higher, currently an occupational therapy educator based in the United States, and available across multiple survey rounds. Nine participants completed all three survey rounds. Participants agreed that the four skills are reciprocally related to one another, with some discrepancies surrounding differing conceptualizations of clinical and professional reasoning. Additionally, relationships were understood to be non-linear and complex. Continued exploration of how these essential skills are related to one another is needed to support future exploration of how they are integrated in occupational therapy education and how this influences practice

Defining Reasoning, Reflective Practice, and Evidence-Based Practice in Occupational Therapy Education: A Delphi Study

Reasoning, reflective practice, and evidence-based practice are essential skills for occupational therapy practitioners, but it is unclear how these skills are defined in occupational therapy education. We used Delphi methodology to explore educator conceptualizations of clinical reasoning, professional reasoning, reflective practice, and evidence-based practice. Eligible participants on the Delphi expert panel were required to have been an educator in an occupational therapy program for at least three years at the master’s level or higher, to be a current occupational therapy educator, based in the United States, and available across multiple survey rounds. Nine participants completed all three survey rounds. Among members of the expert panel there was continued moderate disagreement about terminology related to reasoning and there were some discrepancies between expert perspectives and the occupational therapy literature. However, these educators largely agreed on key features of the complex constructs. Consistency about the use of these terms will support both education and research related to essential professional skills

Teaching Reasoning, Reflective Practice, and Evidence-Based Practice: Educator Consensus Strategies

Although reasoning, reflective practice, and evidence-based practice are essential professional skills for occupational therapy students, there is not a clear understanding of how these skills are taught. We used Delphi methodology to explore how occupational therapy educators conceptualize best-practices for facilitating the development of clinical reasoning, professional reasoning, reflective practice, and evidence-based practice. Participants were required to be educators in a master’s-level or higher occupational therapy program for at least three years, based in the United States, and available across multiple survey rounds. The nine participants nominated a total of 94 teaching strategies, of which 90.4% (n = 85) reached consensus after Round 3. Consensus strategies were largely experiential, active, and explicit teaching approaches. Consideration of how these teaching strategies used by occupational therapy educators support students in integrating skills with each other and into practice can facilitate increased professional competence within occupational therapy