American Journal of Occupational Therapy

The American Journal of Occupational Therapy (AJOT) has had another successful year, with increases in its journal impact factor and its ranking among rehabilitation journals indexed by Journal Citation Reports. The number of submissions has increased, with manuscripts received from 28 countries. Readership has also increased. AJOT remains the top-ranked occupational therapy journal in the world. In addition to its usual focus on publishing research broadly related to occupational therapy, AJOT created a Centennial section in each issue to celebrate the Centennial of the American Occupational Therapy Association. Centennial section topics were determined on the basis of their relevance to occupational therapy history and to future or emerging or increasing practice areas in occupational therapy. In her presidential address at the American Occupational Therapy Association’s 2017 Annual Conference & Centennial Celebration, Amy Lamb honored occupational therapy’s past and embraced its future. Occupational therapy practitioners have the power to serve as change agents, demonstrating their value during everyday opportunities as they design the future of occupational therapy.

In her presidential address at the American Occupational Therapy Association’s 2017 Annual Conference & Centennial Celebration, Amy Lamb honored occupational therapy’s past and embraced its future. Occupational therapy practitioners have the power to serve as change agents, demonstrating their value during everyday opportunities as they design the future of occupational therapy.

During the first 100 years of occupational therapy, the profession developed a remarkable practice and theory base. All along, technology was an active and core component of practice, but often technology was mentioned only as an adjunct component of therapy and as if it was a specialty. This lecture proposes a new foundational theory that places technology at the heart of occupational therapy as a fundamental part of human occupation and the human experience. Moreover, this new Metaphysical Physical–Emotive Theory of Occupation pushes the occupational therapy profession and the occupational science discipline to overtly consider occupation on the level of a metaphysical-level reality. The presentation of this theory at the Centennial of the profession charges the field to test and further define the theory over the next 100 years and to leverage technology and its role in optimizing occupational performance into the future.

OBJECTIVE. This study is a pilot implementation of an Internationalization at Home (IaH) teaching and learning collaboration to enhance intercultural learning and understanding of concepts of occupation in two cohorts of occupational science and occupational therapy students from the Philippines and the United States.

METHOD. In this collective case study, 149 students (Cohort 1, n = 65; Cohort 2, n = 84) participated. The collaboration included virtual conversations among students, faculty presentations, reflective assignments, and completion of an anonymous online survey.

RESULTS. Analysis yielded three essential themes: (1) perception of increased knowledge about human occupation and the influence of culture, (2) identification of teaching–learning aspects that facilitated intercultural learning outcomes, and (3) identification of factors that were enablers of and barriers to learning.

CONCLUSION. This study provides insights on how intercultural learning experiences can be integrated into occupational science and occupational therapy curricula and can increase understanding of concepts related to human occupation.

OBJECTIVE. In this randomized controlled trial, we investigated the effectiveness of integrated supported employment (ISE) compared with individual placement and support (IPS) and traditional vocational rehabilitation (TVR) for people with schizophrenia in mainland China.

METHOD. One hundred and sixty-two participants with schizophrenia were randomly assigned to ISE (n = 54), IPS (n = 54), or TVR (n = 54). Blinded assessments of employment status, job tenure, and psychological outcomes were conducted at admission; completion of the 3-mo program; and follow-up at 7, 11, and 15 mo.

RESULTS. Significantly higher employment rate and longer job tenure were found in the ISE group (63.0%, 29.56 wk) compared with the IPS group (50.0%, 25.47 wk) and TVR group (33.3%, 9.91 wk). The ISE group also attained the most positive psychological outcomes.

CONCLUSION. Work-related social skills training embedded in ISE with generalization strategies can enhance vocational and nonvocational outcomes for people with schizophrenia in mainland China.

Bathroom assistive devices are used to improve safety during bathing transfers, but biomechanical evidence to support clinical recommendations is lacking. This study evaluated the effectiveness of common bathroom aids in promoting balance control during bathing transfers. Twenty-six healthy adults (12 young, 14 older) stepped into and out of a slippery bathtub while using a vertical grab bar on the side wall, a horizontal grab bar on the back wall, a bath mat, a side wall touch, or no assistance. Balance control was characterized using center of pressure measures and showed greater instability for older adults. The vertical grab bar and wall touch resulted in the safest (best controlled) transfers. The bath mat provided improved balance control in the axis parallel to the bathtub rim but was equivalent to no assistance perpendicular to the rim, in the direction of obstacle crossing. These results can support clinical recommendations for safe bathing transfers.

Handwriting is the cornerstone of written performance and communication for school-age children. This mixed-methods study explored the impact of Common Core State Standards on handwriting instruction and its effects on perceptions regarding children’s written responses in elementary school. Using surveys and interviews of elementary teachers, occupational therapists, and administrators in New York State public schools, we sought to understand current trends in handwriting instruction, changes in time spent on handwriting instruction in the classroom, supports offered to students who did not meet expectations for handwriting, and the impact of Common Core on children’s written expression. Themes emerged revealing decreased handwriting instruction time and inconsistent use of handwriting instructional programs in the classroom after implementation of Common Core. Handwriting should be considered as a greater component in the foundational standards in Common Core. Occupational therapy services can support handwriting instruction implementation.

Studies using parent-report measures have described the high prevalence of food selectivity in children with autism spectrum disorder (ASD). However, few studies have documented food acceptance in a controlled laboratory environment. The objective of this study was to compare laboratory food acceptance in children with ASD with that of children with typical development (TD). In addition, the relationships between food acceptance and the child’s age, sensory processing pattern, and autism severity were explored. Results indicate that children with autism (n = 31) accepted fewer foods in the laboratory environment than the children with TD (n = 21) and that food acceptance was related to age but not to ASD severity. In addition, sensory processing scores were associated with food acceptance for the combined ASD and TD groups. Results are discussed in the context of the literature. This information has the potential to support evaluation and treatment of food selectivity.

OBJECTIVE. The objective of this study was to describe the effects of curriculum activities on changing attitudes of health professional students toward people with intellectual disabilities (IDs).

METHOD. A nonrandomized, pretest–posttest design was used. Participants were college students assigned to one of three groups: two groups of students from different years in the occupational therapy program and one group of public health students. Each group completed the Attitudes Toward Intellectual Disabilities Questionnaire before and after each intervention.

RESULTS. No significant differences were found in change of attitude after a lecture on the effects of stigma on people with disabilities. Length of time in program, age, and amount of experience with people with IDs affected changes in attitude for occupational therapy students after a fieldwork intervention.

CONCLUSION. Level I fieldwork significantly improved the attitudes of occupational therapy students toward people with IDs, whereas a lecture did not.

OBJECTIVES. We sought to define an occupational therapy intervention to promote medication management and to evaluate the acceptability and effectiveness of the intervention.

METHOD. Nineteen adults with chronic health conditions and poor medication adherence participated in a two-group, blinded, randomized study. They received either an occupational therapy or a standard care intervention. We used a qualitative method to measure participants’ changes in medication management through an interview regarding participants’ perceptions and behaviors.

RESULTS. The occupational therapy intervention group reported greater improvements in medication management and implemented twice as many new adaptive strategies as the standard care group. Participants indicated that interventions related to advocacy, education, assistive technology, environmental modifications, self-monitoring, and good rapport were the active ingredients of the intervention.

CONCLUSIONS. Occupational therapy is an acceptable intervention for medication management, and it can lead to self-perceived improvements and the adoption of new medication management behaviors. Further research is warranted.

OBJECTIVE. This study aimed to understand how the Canadian Occupational Performance Measure (COPM) can be used as an outcome measure in primary care and to identify the occupational performance profiles in this setting.

METHOD. First, the COPM was administered to all eligible clients at two sites. Second, a focus group with participating occupational therapists explored the feasibility of using the COPM in primary care.

RESULTS. A total of 161 COPMs were initially administered. Self-care goals were identified most frequently (n = 248), followed by productivity (n = 229) and leisure (n = 179) goals (total goals = 656). Mean initial performance and satisfactions scores were 3.2 and 2.8, respectively. The average change (n = 22) scores were 2.1 and 2.6, respectively.

CONCLUSION. The COPM is an invaluable tool to guide initial assessments and offer an occupation-focused lens. Given the lifespan approach and an emphasis on screening and assessment, the challenge was finding the opportunity for readministration.

OBJECTIVE. A bibliometric analysis was completed of highly cited occupational therapy literature and authors published from 1991 to 2014 and accessible in the Science Citation Index Expanded (SCI–Expanded) and Social Sciences Citation Index (SSCI) databases.

METHOD. Data were obtained from the SCI–Expanded and SSCI. Articles referenced >100 times were categorized as highly cited articles (HCA).

RESULTS. Of 6,486 articles found, 31 were categorized as HCA. The American Journal of Occupational Therapy published the largest number of HCA (n = 8; 26%). The 31 HCA were distributed across seven countries: United States (20 articles), Canada (3), United Kingdom (3), Australia (2), the Netherlands (1), New Zealand (1), and Sweden (1). The three authors with the highest Y-index were S. J. Page, F. Clark, and W. Dunn.

CONCLUSION. A latency period of 4 to 5 yr post-publication appears to be needed for a journal article to gain citations.

An estimated 313 million workplace accidents resulting in injury occur worldwide every year. Therefore, the burden of workplace injury and disability is present at the individual and the societal level and involves several stakeholders. There has been a shift in paradigm from workplace disability and injury treatment to workplace disability prevention. Occupational therapy practitioners are well positioned to address this multifaceted societal issue. Opening communication lines among stakeholders allows for a more holistic, collaborative, and comprehensive approach to disability, injury, and pain management. The positive results researchers have found at the individual level when using a holistic approach translate to benefits for all of the stakeholders involved. Occupational therapy practitioners may espouse a work disability prevention approach to reduce work disability rates and provide timely return-to-work outcomes for clients. The transition to the preventative model requires collaboration among stakeholders but would be beneficial to all stakeholders involved in the workplace.