American Journal of Occupational Therapy

Research about occupational therapy interventions for adult perceptual deficits is needed to examine the relative efficacy of different treatments and to scrutinize the theoretical assumptions underlying those treatments. The former purpose relates to providing optimal services to consumers; the latter, to advancing the knowledge base of the profession. Both of these purposes can be achieved if research questions are derived from the assumptions underlying treatments. This paper delineates those assumptions and suggests some research questions and strategies with which to test them.

Stress is a factor in many modern illnesses. The development of coping skills to deal with stress is an occupational therapy goal for many patients. The program presented here uses stress management techniques to improve the situational coping skills of adult psychiatric patients. When discharged to the outpatient clinic, the patients in this program continue to learn and practice stress management techniques to increase relaxation and lessen anxiety. A case example is presented.

The effects of keyguard use and pelvic positioning (neutral versus posterior tilt) on typing proficiency was studied in an 8-year-old boy with athetoid and spastic cerebral palsy. Speed and accuracy were measured with the Mastertype computer software program (Zweig, 1984). The results showed that the use of a keyguard increased the subject’s typing accuracy and decreased his speed. Neither neutral nor posterior pelvic positioning appeared to have a significant effect on typing speed or on accuracy.

The self-perceived quality of time use of 15 community-based adults with spinal cord injuries was compared with that of 12 age- and sex-matched nondisabled adults through the use of the Activity Configuration Log (modified from an unpublished clinical assessment developed by Claudia Allen). Differences in how subjects classified their daily occupations were found between and within groups, especially for the categories of Work, Self-Maintenance, and Other. The results suggest that the subjects’ classifications of occupations and interpretations of their meanings are important sources of information for both the science of occupation and occupational therapy practice. The subjects with spinal cord injuries had a high rate of unemployment (67%) and much more daily free time than did their nondisabled counterparts. The affective quality of particular occupations was found to be related to the affective quality of the entire day. Occupational therapists agreed more with each other than with the subjects with disabilities when classifying occupations. Implications for practice and research are provided.

A single-subject study with an ABAB design was conducted to examine the effectiveness of an elbow restraint splint in improving the functional hand use of a child with Rett syndrome. The intervention consisted of the child’s wearing an elbow restraint on her nondominant (left) arm during snack time. Her ability to finger-feed cereal from a bowl was evaluated across four phases. An analysis of the data revealed only modest improvements in the amount of cereal consumed and in the time required to complete the eating task. Variability in the subject’s performance made visual interpretation of the data difficult. The findings, however, were in the anticipated direction and provide indications for future research.

This study examined the interrater reliability of two raters on the Fine Motor scale of the Peabody Developmental Motor Scales (Folio & Fewell, 1983). The sample comprised 32 children who were 4 or 5 years of age. Half of the children were considered to have normal development and half had an identified developmental delay. The Pearson product-moment correlation coefficients between the two sets of ratings were r = .97 for the delayed group and r = .77 for the normal group. Intraclass correlations were .97 and .76 for the delayed and normal groups, respectively. These figures appear to reflect the increased variance of the performance of the children with developmental delays. The percentage agreement between the two raters was greater for the group of normal subjects. The results suggest that the Fine Motor scale of the Peabody scales includes enough items to minimize the total score difference between two raters. Individual test items with poor agreement between the two raters were identified.

A reliability study was conducted to determine (a) the intrarater and interrater reliability of goniometric measurement of active and passive wrist motions under clinical conditions and (b) the effect of a therapist’s specialization on the reliability of measurement. Randomly paired therapists performed repeated measurements of active and passive wrist motions in 48 subjects who had been referred to one of four occupational therapy or hand management clinics for evaluation and treatment. The data were analyzed with an intraclass correlation coefficient. A posteriori data analyses were performed to determine the effects of identified sources of error on the reliability of measurement.

The results indicated that measurement of wrist motion by individual therapists is highly reliable and that intrarater reliability is higher than interrater reliability for all active and passive motions. Interrater reliability was generally higher among specialized therapists for reasons not immediately apparent from this study. With the exception of pain, identified sources of error were found to have surprisingly little effect on the reliability of measurement.

Two hundred and seventy occupational therapy clinicians, whose primary or secondary employment function was in direct patient service, were surveyed to determine their perceived roles and attitudes regarding research. Results showed a strong belief in the importance of research in the profession, yet minimal involvement in research due to limited time, money, and skill. The role of collaborator with experienced researchers was rated as highly desirable. Few clinicians indicated no interest in research. Implications of the results and suggestions for strategies to increase clinicians’ involvement and satisfaction in research through mutual experiences and continuing education are given.

This paper depicts an important story in the history of occupational therapy. The story concerns a small group of women, known as the Curriculum Directors, whose influence prevailed in the growth and development of occupational therapy throughout the 1950s. The account is synthesized from both written history sources and oral history interviews with group members and their contemporaries. It characterizes the Curriculum Directors and describes their influence on the profession as well as others’ perceptions of their accomplishments. This paper also chronicles the forces that emerged in reaction to the Curriculum Directors’ authority and briefly details the dissolution of their power.