American Journal of Occupational Therapy

The American Journal of Occupational Therapy (AJOT) has maintained its top-ranking status in the field of occupational therapy while expanding its efforts related to knowledge translation and improving reporting standards. Key outcomes for 2025 showcase the journal’s breadth and depth, with 137 articles published, including a special issue on Diversity, Equity, Inclusion, Justice, Accessibility, and Belonging in Occupational Therapy Practice and Education. The AJOT Authors & Issues interview series also reached more than 21,000 views in 2025, doubling viewership from 2024.

Key outcomes for 2025 showcase the journal’s breadth and depth, with more than 137 articles published, including a special issue on Diversity, Equity, Inclusion, Justice, Access, and Belonging, as well as doubling the total number of views for the AJOT Authors & Issues interview series compared with 2024.

Social isolation and loneliness (SIL) has been deemed an epidemic, with reports indicating dramatic increases in prevalence over the past decade. Despite the growing recognition of SIL as a public health crisis, current interventions remain insufficient to address the need. Occupational therapy practitioners are well positioned to screen for and address SIL, and preliminary evidence suggests that individual and group-based occupational therapy interventions hold promise in reducing SIL. The three aims of this Health Policy Perspectives column are to (1) describe the SIL epidemic in the United States, (2) analyze the strengths and limitations of current initiatives, and (3) identify occupational therapy interventions and approaches that may be integrated into current efforts to combat SIL in the United States.

This Health Policy Perspectives column describes the epidemic of social isolation and loneliness in the United States, analyzes the strengths and limitations of current initiatives, and identifies occupational therapy interventions and approaches that may be integrated into current efforts to combat the issue.

In her farewell Presidential Address at the AOTA INSPIRE 2025 Annual Conference & Expo in Philadelphia, Alyson Stover invited attendees to be a part of shaping the future of occupational therapy.

In her farewell Presidential Address at the AOTA INSPIRE 2025 Annual Conference & Expo in Philadelphia, Alyson Stover invites attendees to be a part of shaping the future of occupational therapy.

In her Inaugural Presidential Address at the AOTA INSPIRE 2025 Annual Conference & Expo in Philadelphia, Dr. Arameh Anvarizadeh encouraged conference attendees to “remain in community and to acknowledge that dehumanization has no room in anyone’s space.” She also challenged the profession to adopt a growth mindset by fostering and embracing a collective diversity. Celebrating and harnessing the strengths of different perspectives, experiences, and backgrounds drives social change and occupational justice, fosters problem-solving and better decision-making, creates collaborative learning opportunities, and promotes empathy and compassion, two of the profession’s greatest strengths.

In her Inaugural Presidential Address at the AOTA INSPIRE 2025 Annual Conference & Expo in Philadelphia, Dr. Arameh Anvarizadeh encouraged conference attendees to “remain in community and to acknowledge that dehumanization has no room in anyone’s space.”

Translation of knowledge about the evidence for occupational therapy interventions is critical to support the profession’s evidence base. It has become increasingly important to guide occupational therapy practice in an evidence-based, outcomes-oriented way and to identify strategies that can foster dissemination and integration of evidence into practice. In this Eleanor Clarke Slagle Lecture, Roseann C. Schaaf introduces the concept of precision occupational therapy using data-driven decision-making (DDDM) as a process to enhance practice, create evidence for occupational therapy, and foster knowledge translation. Precision occupational therapy embodies a personalized approach that respects the individual and considers multiple streams of information simultaneously to design treatments that are individually tailored and measure meaningful, personalized outcomes. It considers the individual’s strengths and needs and customizes interventions to enhance wellness and quality of life; it thus can be a guide for practice and research and can create evidence through practice. Schaaf presents three case examples to exemplify the application of precision occupational therapy using DDDM.

In this Eleanor Clarke Slagle Lecture, Roseann C. Schaaf introduces the concept of precision occupational therapy using data-driven decision-making (DDDM) as a process to enhance practice, create evidence for occupational therapy, and foster knowledge translation.

In her lecture for the inaugural Dr. Lela A. Llorens Award of Excellence for Diversity, Equity, and Inclusion, Dr. Shirley A. Wells acknowledges the growing importance of creating more inclusive and equitable environments across all aspects of health care, with occupational therapy being no exception. Inclusion and integration are fundamental values that should be woven into every part of the practice of occupational therapy. It is not enough to be aware of these concepts; occupational therapists must actively engage in Acts of Inclusion and Integration in their delivery of care, collaboration with clients and colleagues, and shaping of the future of the field. Dr. Wells highlights examples of how occupational therapists can break down barriers to create spaces where everyone feels valued and supported.

In her lecture for the inaugural Dr. Lela A. Llorens Award of Excellence for Diversity, Equity, and Inclusion, Dr. Shirley A. Wells highlights examples of how occupational therapists can break down barriers to create spaces where everyone feels valued and supported.

Importance: Telerehabilitation helps overcome barriers to neonatal follow-up care for children with complex medical conditions; however, existing developmental assessment tools are not suitable for this virtual medium.

Objective: To create the Virtually Guided Infant Developmental Abilities (VIDA) screening tool, intended for children ages 1–18 mo.

Design: The VIDA screening tool was developed using the Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research framework. Phase 1 involved defining developmental domains, generating items via a literature scoping review, and assessing content validity through a modified Delphi survey. Phase 2 included a pilot test to ensure the tool’s clarity and feasibility.

Setting: The VIDA screening tool was developed at the Kingston Health Sciences Centre in Kingston, Ontario, Canada, in a tertiary care setting.

Participants: In Phase 1, which focused on content validity, a modified Delphi survey technique was undertaken with a total of 12 experts (10 occupational therapists, one physiotherapist, and one neonatologist). In Phase 2, which focused on scale development, a pilot test study was conducted with two occupational therapists and three families whose children necessitated neonatal follow-up care.

Results: The final VIDA screening tool includes 81 items that assess a child’s gross motor, fine motor, self-care, and social communication and cognitive skills through prompted responses or parent-reported observations.

Conclusions and Relevance: The VIDA screening tool was developed to increase accessibility to neonatal follow-up care for children with complex medical conditions. The tool consists of observations of a child’s developmental abilities, made through a virtual platform, that can be used by most health professionals to identify children who need further developmental evaluations.

Plain-Language Summary: The authors developed the Virtually Guided Infant Developmental Abilities (VIDA) screening tool to address the lack of virtual developmental assessments. It was created in accordance with the Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research framework. Phase 1 focused on item development and content validity and involved a modified Delphi survey administered to 12 health professional experts, including occupational therapists, a physiotherapist, and a neonatologist. Phase 2 involved scale development through a pilot test with two occupational therapists and three families whose children required neonatal follow-up care. The finalized VIDA tool includes two parts: Part 1 entails an intake form to gather information on parents’ concerns about their children’s development, and Part 2 includes 81 items that assess gross motor, fine motor, self-care, and social communication and cognitive skills through parent-reported observations or prompted responses. Designed for use by most health professionals, the VIDA tool improves accessibility to follow-up care by enabling virtual evaluations of developmental abilities, thereby helping identify children who need in-depth developmental assessments. The VIDA screening tool offers occupational therapists a promising approach to support early developmental monitoring of high-risk infants.

The authors developed the Virtually Guided Infant Developmental Abilities (VIDA) screening tool to address the lack of virtual developmental assessments for children with complex medical conditions.

Importance: Despite the growing recognition of sports as meaningful occupations, occupational therapy’s contributions regarding specific populations, intervention approaches, and outcome measures remain underexplored.

Objective: To map evidence on the characterization of occupational therapy in sports and types of occupational therapy interventions provided to support participation, recovery, and performance in sports-related settings.

Data Sources: A search was conducted across CINAHL, EBSCO, PubMed, and SCOPUS databases, covering studies published from 2000 to 2024.

Study Selection and Data Collection: Peer-reviewed studies were included if they discussed occupational therapy’s role in sports, including leisure and competitive contexts, with interventions focusing on recovery, rehabilitation, or performance enhancement. Data were charted to identify key themes, study characteristics, populations, interventions, and outcomes.

Findings: Thirteen studies were included. Occupational therapy in sports was characterized by its holistic focus on physical, emotional, and social rehabilitation, particularly in adaptive and competitive contexts. Interventions included assistive technology, education, and client-centered approaches, with reported outcomes such as improved quality of life, athletic performance, and psychosocial well-being. Barriers included resource limitations and stigma.

Conclusions and Relevance: Occupational therapy plays a multifaceted role in sports, enhancing participation, recovery, and performance through client-centered and adaptive interventions. Addressing systemic barriers and expanding culturally tailored approaches can further advance occupational therapy’s integration into sports contexts. Future research should focus on underrepresented populations and long-term intervention outcomes to strengthen evidence-based practice.

Plain-Language Summary: Occupational therapy helps athletes and sports participants recover, perform, and engage meaningfully in sports activities. This study reviews evidence on how occupational therapy supports sports participation, including using adaptive tools and education to improve performance and quality of life. Occupational therapy can address athletes’ physical and emotional challenges, but more research is needed to expand occupational therapy’s role in diverse sports settings and ensure accessibility for all.

This study reviewed evidence on how occupational therapy supports sports participation, including using adaptive tools and education to improve performance and quality of life.

Importance: High-risk pregnancies present significant psychological challenges for affected women, and psychosocial interventions may improve their mental health and quality of life.

Objective: To evaluate the effectiveness of psychosocial occupational therapy interventions for managing anxiety, depression, stress, and quality of life among women with high-risk pregnancies.

Data Sources: CINAHL, SocIndex, AMED, Embase via Ovid, MEDLINE in PubMed, Cochrane Library, OTseeker, and PsycINFO.

Study Selection and Data Collection: This systematic review followed Cochrane Collaboration methodology and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies included women with high-risk pregnancies (e.g., gestational diabetes, hypertensive disorders, preterm labor) and examined occupational therapy–related psychosocial interventions. Eligible studies reported outcomes for anxiety, depression, stress, or quality of life and were classified as Level 1b, 2b, or 3b evidence. Data were analyzed using narrative synthesis.

Findings: Thirty-four studies met the inclusion criteria. Cognitive-based and counseling-based interventions showed moderate to strong effectiveness in reducing anxiety, depression, and stress. Emotion-based approaches had low to moderate effectiveness, and sensory-based interventions were largely ineffective. Integrated approaches, such as mindfulness-based cognitive therapy, showed mixed results.

Conclusions and Relevance: Findings support integrating psychosocial interventions into occupational therapy to enhance mental health and occupational engagement for women with high-risk pregnancies.

Plain-Language Summary: This study reviewed 34 studies of psychosocial interventions for women with high-risk pregnancies. Cognitive and counseling-based strategies were most effective in reducing anxiety, depression, and stress. Sensory-based approaches had little impact. These findings reinforce the role of occupational therapists in supporting mental health and inform future practice and education.

The findings of this review reinforce the role of occupational therapists in supporting mental health and inform future practice and education.

Importance: Identifying quality-of-life (QoL) subgroups can optimize occupational therapy interventions for stroke survivors.

Objective: To identify clusters among stroke survivors on the basis of perceived QoL using latent profile analysis (LPA).

Design:Cross-sectional study using LPA to classify QoL levels among stroke survivors and multinomial logistic regression to identify predictors.

Setting: Hospital and university clinic.

Participants: A total of 696 adult stroke survivors age 18 yr or older. Eligible participants were literate and had a Mini-Mental State Examination score of 23 or higher, excluding those with speech disorders or additional chronic neurological, psychiatric, or cognitive conditions.

Outcomes and Measures: The participants were evaluated with the Stroke Impact Scale (SIS), Barthel Index, and the Impact on Participation and Autonomy Questionnaire (IPA). LPA was applied to the SIS data.

Results: Three latent classes were identified: high QoL (n = 232), moderate QoL (n = 322), and low QoL (n = 142). Participants in Class 2 (high QoL) demonstrated higher functional outcomes, whereas those in Class 3 (low QoL) displayed the lowest scores across all scales. Predictors of class membership included age, gender, social relationships, and education level.

Conclusions and Relevance: LPA effectively identified subgroups among stroke survivors, supporting tailored interventions in occupational therapy to improve rehabilitation outcomes. Further research is recommended to validate these findings in diverse populations.

Plain-Language Summary: This study explored quality of life among stroke survivors. Three groups were identified: those with high, moderate, and low quality of life. Factors such as age, social relationships, and education level influenced quality of life after stroke. These findings can help occupational therapists create personalized care plans to support survivors in recovery, focusing on social connections, autonomy, and daily activities.

This study explored quality of life among stroke survivors.

Importance: Pediatric acute-onset neuropsychiatric syndrome (PANS) is a neuroimmune condition that significantly affects children’s occupational performance across multiple domains. However, occupational performance is often overlooked in current PANS clinical frameworks, despite its critical role in daily functioning and well-being.

Objective: To synthesize evidence on the occupational performance challenges experienced by children with PANS, the tools used to assess these challenges, and occupational therapy interventions used with these children.

Data Sources: MEDLINE, CINAHL, Cochrane Library, PsycINFO, SCOPUS, ERIC, and EMBASE were searched from their inception through May 17, 2024.

Study Selection and Data Collection: Peer-reviewed studies addressing PANS and occupational performance were included, with data categorized using the Occupational Therapy Practice Framework, 4th Edition.

Findings: Of 3,431 records, 40 studies met inclusion criteria. Occupational performance challenges centered on communication, nutrition, education, rest/sleep, social participation, and toileting, with limited data on bathing, dressing, personal hygiene, and play and leisure. Assessments emphasized client factors, rarely using occupation-based tools. Only 2 studies mentioned occupational therapy interventions.

Conclusions and Relevance: PANS has a pervasive impact on children’s occupational performance, highlighting the urgent need to prioritize it within clinical frameworks. Future research should focus on occupation-based intervention studies and assessments to enhance outcomes for children with PANS.

Plain-Language Summary: Pediatric acute-onset neuropsychiatric syndrome (PANS) causes sudden, severe symptoms, such as obsessive-compulsive behaviors, eating difficulties, sensory and motor changes, and developmental regression, which significantly disrupt children’s ability to perform daily activities. This study included 40 research articles addressing what is known about the impact of PANS on children’s daily functioning and the role of occupational therapy in managing challenges. Results showed that most studies focused on communication, nutrition, education, sleep, social, and toileting challenges, but few addressed other daily tasks like bathing, dressing, personal hygiene, and play or leisure. Despite identified challenges, only two studies mentioned occupational therapy interventions, highlighting a major gap in the evidence. Assessments focused mainly on a child’s skills and challenges, rather than looking at how the child participates in everyday activities. The findings highlight the need to better understand the challenges children with PANS face in their everyday activities and to provide practical strategies to help them succeed.

Positionality Statement: Newby is a pediatric occupational therapist and researcher with both professional and personal experience of PANS. Her clinical work with children diagnosed with PANS, along with personal experience supporting a family member with this condition, has deepened her interest in the episodic fluctuations in occupational performance that occur during periods of exacerbation and remission. Haracz is an occupational therapist, academic, and researcher with a focus on mental health and the intersection between physical and psychological well-being. Lane is an occupational therapist, academic, and researcher who specializes in the neuroscience of developmental conditions and how sensory processing differences affect children’s engagement in daily occupations. Tona is an occupational therapist and educational psychologist whose interest in neuroinflammatory disorders emerged following a family member’s diagnosis with PANS. Her research explores the characteristics of PANS, treatment access, caregiver burden, and the role of occupational therapy in improving participation in both PANS and long-COVID populations.

This review included research articles addressing what is known about the impact of pediatric acute-onset neuropsychiatric syndrome (PANS) on children’s daily functioning and the role of occupational therapy in managing challenges.

Importance: Parents of autistic daughters may be able to provide insight into how to address menstruation and menstrual hygiene management from their lived experiences. Menstrual hygiene management is considered an activity of daily living that is within the scope of occupational therapy practice.

Objective: To investigate the perspectives of parents of autistic daughters and their firsthand experiences of menstruation and menstrual hygiene management.

Design: This was a qualitative, phenomenological study that used convenience and snowball sampling and an inductive thematic analysis of transcripts of virtual semistructured interviews. Trustworthiness was established through audit trails, member checking, and the use of an interview guide.

Setting: Interviews were conducted through Zoom at the participants’ preferred time and location.

Participants: Parents of autistic daughters (N = 8): seven biological mothers and one adoptive father.

Results: Seven themes emerged from the interviews: (1) inadequate expertise in women’s health for autistic individuals among medical professionals, (2) parental dependency, (3) intensified sensory experiences before and during menstruation, (4) limited menstrual awareness and understanding in individuals with ASD, (5) menstrual product preferences, (6) parental feelings about managing menstruation, and (7) strategies that worked for managing menstruation.

Conclusions and Relevance: The findings suggest that parents face significant challenges when caring for autistic daughters during their menstrual cycles. Occupational therapy practitioners may support autistic individuals as well as their parents and caregivers in this process by having a deeper understanding of their experiences.

Plain-Language Summary: This study sheds light on the perspectives of parents of autistic daughters on the topic of menstruation and menstrual hygiene management, which are considered activities of daily living. Occupational therapy practitioners may gain knowledge from these firsthand perspectives to inform future occupational therapy practice. Menstruation and menstrual hygiene management are important activities of daily living that are not addressed well for individuals living with autism. Occupational therapy practitioners can support autistic individuals and their caregivers in improving the participation and performance in menstruation and menstrual hygiene management.

Occupational therapy practitioners can support autistic individuals as well as their parents and caregivers with menstruation and menstrual hygiene management.

Importance: The demand for effective home-based rehabilitation is increasing with the aging global population. Occupational therapy supports older adults in maintaining and improving activity and participation; however, standardized intervention approaches, consistent outcome measures, and goal-setting frameworks are still lacking.

Objective: To systematically map current home-based occupational therapy interventions aimed at enhancing activity and participation among community-dwelling older adults and identify research gaps in intervention methods, evaluations, and designs.

Data Sources: PubMed, Web of Science, Scopus, Ichushi Web, and J-Stage were searched without time restrictions. Additional relevant studies were identified manually.

Study Selection and Data Collection: Studies involving community-dwelling adults age 65 yr or older were included. Data on intervention strategies, outcome measures, and research designs were extracted and categorized by using qualitative methods.

Findings: Fifty-four studies were included. Interventions ranged from activities of daily living (ADLs) and instrumental ADLs (IADLs) training and environmental modifications to structured programs such as Community Aging in Place—Advancing Better Living for Elders (CAPABLE) and Reablement. However, outcome measures were highly diverse (126 unique tools), and 16 nonstandardized assessments were identified, mostly in case reports. Although many studies showed positive effects, the diversity of study designs and limited use of remote interventions hindered generalizability and long-term evidence building.

Conclusions and Relevance: Home-based occupational therapy can positively affect older adults’ activity, participation, and quality of life. However, standardized evaluation methods, integration of remote approaches, and culturally tailored intervention programs are needed to strengthen evidence and guide clinical practice.

Plain-Language Summary: This review examined studies on home-based occupational therapy for older adults. Interventions often targeted activities of daily living, instrumental activities of daily living, and environmental adaptations. Most occupational therapy interventions showed benefits in everyday function and well-being. However, a lack of standardized tools and goal-setting methods, variation in study quality, and limited evidence on remote rehabilitation remain challenges.

This review of studies on home-based occupational therapy for older adults found that interventions often targeted activities of daily living, instrumental activities of daily living, and environmental adaptations.

Importance: There is a lack of reliable and valid tools to measure self-efficacy of clinical competence in didactic occupational therapy education.

Objective: To determine the content validity, test–retest reliability, internal consistency, convergent validity, and factor structure of the Occupational Therapy Self-Efficacy of Clinical Competence (OT–SECC) assessment.

Design: A cross-sectional psychometric study.

Setting: Two higher education institutions in the northeastern United States.

Participants: Ninety-two first- and second-year master’s-level occupational therapy students.

Outcomes and Measures: The 12-item OT–SECC was developed to measure self-efficacy of clinical competence on a 10-point sliding scale ranging from 0 (cannot do at all) to 10 (highly certain can do). The OT–SECC was psychometrically evaluated using classical test theory approaches.

Results: Overall, results support the reliability and validity of the OT–SECC. For instance, the assessment had good test–retest reliability (intraclass correlation [ICC(2,1) = 0.817, p < .001) and acceptable internal consistency across its two factors (αs = .838 and .923, respectively). The OT–SECC also demonstrated convergent validity across two administrations when compared with a similar assessment, the Physiotherapist Self-Efficacy Questionnaire (rs = .67 and .61, ps < .001, respectively).

Conclusions and Relevance: The OT–SECC is a psychometrically sound assessment that may be used by occupational therapy programs to examine students’ self-efficacy of clinical competence before attending fieldwork.

Plain-Language Summary: There is an increasing responsibility for occupational therapy graduate education programs to prepare students for clinical practice. Although experiential learning activities are commonly used to teach these clinical skills, there are few valid and reliable tools to measure their effectiveness. To address this, the researchers developed the Occupational Therapy Self-Efficacy of Clinical Competence (OT–SECC) assessment. Findings show that the OT–SECC exhibits acceptable content validity, test–retest reliability, convergent validity, internal consistency, and construct validity. The assessment can be used by faculty to select instructional methods, refine experiential learning activities, assist with individual student advisement, and evaluate program effectiveness.

The Occupational Therapy Self-Efficacy of Clinical Competence assessment can be used by faculty to select instructional methods, refine experiential learning activities, assist with individual student advisement, and evaluate program effectiveness.

Importance: Driving assessments are essential in occupational therapy for people with brain injuries. On-road evaluations are considered the gold standard, yet ensuring their psychometric rigor remains a challenge.

Objective: To evaluate the reliability and validity of the closed-course version of the Standardized On-Road Assessment for Drivers (SOAD) using both classical test theory and item response theory (IRT) approaches.

Design: Psychometric study integrating factor analysis and IRT.

Setting: Five rehabilitation hospitals and associated driving schools in Japan.

Participants: A total of 108 patients with mild stroke, referred by physicians for driving evaluation. All participants completed off-road screening before the SOAD closed-course assessment.

Outcomes and Measures: Psychometric properties were examined across five domains: item validity, structural validity, discriminant and convergent validity, internal consistency reliability, and item response. Data were analyzed using exploratory and confirmatory factor analyses and IRT.

Results: Factor analysis reduced the original 40 items to 16 and identified five factors: basic skills, driving attitude, scanning outside the field of view, hazard prediction, and merging. Internal consistency reliability was acceptable (α = .657–.829). Convergent and discriminant validity were supported by average variance extracted values (.482–.877) and squared correlations. IRT showed appropriate item discrimination (.386–.829) and difficulty (−2.508 to .113).

Conclusions and Relevance: This study supports the reliability and validity of the SOAD closed-course version. The tool may be particularly useful in settings with legal constraints on public road driving assessments.

Plain-Language Summary: Driving after a stroke can be difficult, and deciding whether someone is ready to drive again is an important part of occupational therapy. This study examined a tool called the Standardized On-Road Assessment for Drivers (SOAD), which tests driving ability on a safe, closed driving course. The study included 108 people who had experienced a mild stroke. Researchers used statistical methods to check whether the SOAD gives consistent and accurate results. They found that the tool measures five important driving skills and can tell how well someone is performing in each area. These findings mean that therapists can use the SOAD to better understand their clients’ driving abilities and make safer decisions—especially in places where driving on public roads is restricted during assessment. This research helps make driving evaluations safer and more reliable for people recovering from mild brain injuries. The SOAD closed-course version was found to be a reliable and valid on-road test. This on-road test can adequately assess the driving ability of people with mild stroke in some regions and situations.

The study findings show that occupational therapists can use the Standardized On-Road Assessment for Drivers (SOAD) with clients recovering from mild brain injuries.

Importance: Peripheral nerve injury (PNI) in the upper extremity can significantly affect the ability of patients to participate in preferred activities, yet measuring this effect is challenging because of limited suitable tools.

Objective: To understand the impact of PNI on activity participation on basis of the activities’ motor demands (fine motor, gross motor, and/or bimanual). We hypothesized that fine motor activities would show lower retention than gross motor or nonmotor activities, that hand dexterity would correlate with fine motor retention, and that unimanual activities would be retained more than bimanual activities.

Design: Cross-sectional observational study.

Setting: Two upper extremity rehabilitation clinics.

Participants: Forty-eight patients with unilateral PNI in the upper extremity.

Outcomes and Measures: Primary outcome was participation retention rates in five activity dimensions, as assessed with the Activity Card Sort.

Results: Participants retained fewer gross motor activities than fine motor activities. Pain and health-related quality of life were the only patient factors significantly associated with participation. Hand dexterity did not correlate with fine motor retention, and unimanual activities showed higher retention than bimanual activities, regardless of the injured side.

Conclusions and Relevance: Patterns of activity loss after PNI cannot be fully explained by motor demands alone. Although addressing specific motor skills remains important, participation is shaped by a complex interplay of physical, personal, and contextual factors as well as compensation and difficulties with bimanual tasks, even in unilateral injuries. Rehabilitation should incorporate activity-based assessments that capture real-world challenges and support individualized intervention planning.

Plain-Language Summary: Nerve injuries in the upper extremity can significantly affect the ability to engage in essential activities. This study aimed to enhance the assessment of activity participation for people with upper extremity nerve injuries. We found that focusing on specific motor skills, such as fine and gross motor skills, gives a better understanding of how nerve injuries affect engagement in important activities. Hand dexterity, as measured using standard tools, was not linked to the ability to retain fine motor activities. These findings suggest that, to tailor interventions to enhance overall recovery, rehabilitation should include an individualized assessment (in addition to standard scales) to identify the activities that depend on the patient’s specific motor skills impairments.

This study aimed to enhance the assessment of activity participation for people with upper extremity nerve injuries.

Importance: Mild cognitive decline is more likely to affect older adults and often progresses to dementia. Occupational therapists play a key role in delivering interventions that can enhance or sustain participation in meaningful activities.

Objective: To examine occupational therapy interventions used with older adults experiencing mild cognitive decline and determine their effectiveness on participation outcomes.

Data Sources: CINAHL, MEDLINE, and Embase.

Study Selection and Data Collection: Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed. Inclusion criteria were randomized or quasi-randomized controlled trials published in English from inception to August 2024 that evaluated an intervention to address mild cognitive decline delivered or supervised by an occupational therapist. The quality of the included studies was assessed using the Cochrane risk-of-bias tool (ROB2). Results were synthesized both narratively and using a meta-analysis.

Findings: Eleven articles described 10 studies that met the inclusion criteria. All involved cognitive training interventions using a remediation (seven studies) or compensation (one study) approach or both (two studies). Eight studies measured participation and were included in the meta-analysis. Results of the meta-analysis indicate that occupational therapy interventions are effective in enhancing participation of older adults with mild cognitive decline immediately after treatment (standardized mean difference [SMD] = 0.504, 95% confidence interval [CI] [0.194, 0.813]; I ² = 68%) and up to 6 mo later (SMD = 0.271, 95% CI [−0.090, 0.631]; I ² = 71%) but with considerable heterogeneity.

Conclusions: Occupational therapy–delivered interventions are effective for older adults with mild cognitive decline, although further evidence is needed for greater confidence.

Plain-Language Summary: Mild cognitive decline is a deterioration in a person’s thinking and memory that does not have a medical cause. Although it is more likely to affect older adults, it is not considered part of normal aging. However, it can occasionally progress to more severe forms of dementia. Staying active and independent is known to preserve quality of life among older adults with mild cognitive decline. Occupational therapists play a crucial role in supporting older adults in maintaining their independence and quality of life. This study examined different interventions used by occupational therapists to minimize the impact of mild cognitive decline. The authors found that a range of occupational therapy interventions can effectively enhance participation in meaningful activities; these benefits were observed immediately after treatment and up to 6 months later. However, more evidence is needed to understand the full impact of occupational therapy in this context.

This review examines different interventions used by occupational therapists to minimize the impact of cognitive decline.

Importance: Occupational balance is vital for well-being, yet refugees face barriers to maintaining meaningful daily activities. Understanding the social determinants affecting Syrian refugees’ occupational balance is crucial for developing targeted interventions and policies.

Objective: To examine the impact of social determinants such as gender, education level, ethnicity, and household size on the occupational balance of Syrian refugees in Turkey.

Design: This cross-sectional study used a survey-based approach with a sociodemographic information form and the Turkish Occupational Balance Questionnaire–11 (OBQ11–T). Multiple linear regression modeling identified statistically significant predictors of occupational balance.

Setting: The study was conducted in four Turkish cities with diverse socioeconomic characteristics.

Participants: A total of 400 Syrian refugees participated.

Outcomes and Measures: The primary outcome was occupational balance, assessed with the OBQ11–T.

Results: The mean OBQ11–T score was 12.6 (SD = 3.43). Men had higher occupational balance than women (β = 0.869, p = .007). Education was a strong predictor, with illiteracy negatively affecting balance (β = −3.858, p < .001). Arab ethnicity was associated with lower scores (β = −1.282, p = .011), whereas Turkish or Turkoman ethnicity had a positive effect (β = 1.288, p = .013). Household size negatively affected balance (β = −0.624, p < .001).

Conclusions and Relevance: Social determinants substantially influence Syrian refugees’ occupational balance. Gender disparities, education, and ethnicity are key factors. Policies should prioritize education, social integration, and culturally responsive occupational therapy interventions. Future longitudinal research is needed to examine long-term effects.

Plain-Language Summary: Refugees often struggle to find balance in their occupations because of challenges such as limited education and social isolation. This study looked at how different social factors, such as gender, education, ethnicity, and household size, affect the ability of Syrian refugees in Turkey to participate in meaningful occupations. The study found that men had better occupational balance than women, possibly because of cultural restrictions placed on women. Refugees with higher education levels had better balance, whereas those with little or no education struggled the most. Arab refugees had the most difficulty adjusting, whereas Turkish and Turkmen refugees experienced fewer challenges. Larger households were also linked to greater difficulty in maintaining daily routines. These findings highlight the need for education programs, social support, and culturally sensitive occupational therapy interventions to help refugees regain balance in their daily lives. Occupational therapists can use these insights to design better support programs for refugee communities.

The study findings highlight the need for education programs, social support, and culturally sensitive occupational therapy interventions to help refugees regain balance in their daily lives.

Importance: Promoting culturally effective care is a pressing matter for occupational therapy and physical therapy practitioners. Despite the recent advancements, how cultural effectiveness is measured in the rehabilitation context remains elusive.

Objective: To characterize the instruments used to assess cultural effectiveness in the recent occupational therapy and physical therapy literature.

Data Sources: Database searches were conducted in Academic Search Premier, CINAHL, MEDLINE, and PsycINFO. Additional hand searches were performed of key articles and textbooks.

Study Selection and Data Collection: Included articles were (1) published in English in the United States between January 2010 and June 2022, (2) peer reviewed, and (3) methodologically examined or included outcome measures that assessed cultural effectiveness in occupational therapy and physical therapy contexts.

Findings: Seven articles met the inclusion criteria, and six distinct instruments were identified. All of the assessments were self-administered and varied in theoretical foundation, conceptualization, and operationalization. The three most common cultural domains were attitude, knowledge, and skills. Of 249 items pooled across the instruments, only one assessed a provider’s ability to engage in continuous critical reflection.

Conclusions and Relevance: The inconsistencies observed in measuring cultural effectiveness may limit advancement and translation of knowledge in occupational therapy and physical therapy. In addition to the need for client-administered assessments, further research is warranted to explore how self-reflection can catalyze the lifelong process of becoming culturally effective.

Plain-Language Summary: Grounded in the Cultural Effectiveness Model, this study identified assessments that can be used by occupational therapy and physical therapy practitioners to measure and monitor their cultural effectiveness.

This review identifies assessments that can be used by occupational therapy practitioners to measure and monitor their cultural effectiveness.

Importance: Virtual reality (VR) intervention may offer significant benefits in improving motor, cognitive, and sensory-perceptual skills and activity levels among children with developmental coordination disorder (DCD), a condition often affecting daily functioning.

Objective: To examine the effect of VR intervention on motor, cognitive, and sensory-perceptual skills and activity levels among children with DCD from the International Classification of Functioning, Disability and Health perspective.

Design: Single-blind randomized controlled trial.

Setting: University hospital.

Participants: 48 children, ages 5 to 8 yr.

Intervention: The study group received VR in addition to COT, and the control group received only COT. In the COT-only program, sensorimotor-based activity approaches were used to provide children with diverse sensorimotor experiences. Both interventions took place 2×/wk for 8 wk, totaling 16 sessions.

Outcomes and Measures: Participants were evaluated using the Test of Gross Motor Development (2nd ed.), Childhood Executive Functioning Inventory, Sensory Integration and Praxis Test, Motor-Free Visual Perception Test (3rd ed.), and Functional Independence Measure for Children.

Results: The study group showed statistically significant improvements in motor, cognitive, sensory-perceptual skills, and activity levels (p < .05). The control group showed significant improvements in only sensory-perceptual skills and activity levels (p < .05), with no significant differences in motor and cognitive skills (p > .05). The study group showed stronger effects across all measured areas (d > 0.8).

Conclusions and Relevance: Adding VR to COT was more effective than COT alone in enhancing motor, cognitive, and sensory-perceptual skills and activity levels. These results highlight the potential of VR in pediatric rehabilitation to improve therapeutic outcomes.

Plain-Language Summary: This study examined whether the use of virtual reality combined with conventional occupational therapy could improve motor, cognitive, and sensory-perceptual skills and activity levels in children with developmental coordination disorder. A total of 48 children, ages 5 to 8, were randomly assigned to two groups: one received both conventional occupational therapy and virtual reality therapy, and the other received only conventional occupational therapy. The children were tested before and after the intervention on motor skills, cognitive abilities, sensory processing, visual perception, and daily activities. Results showed significant improvements in motor, cognitive, sensory, and visual skills in the virtual reality and conventional occupational therapy group, with larger effects observed. These findings suggest that virtual reality could be a valuable addition to therapeutic programs for children with developmental coordination disorder and help them achieve better outcomes. Furthermore, it suggests that integrating virtual reality into conventional occupational therapy programs could provide therapists with a valuable tool to enhance treatment outcomes.

The findings of this study suggest that virtual reality could be a valuable addition to therapeutic programs for children with developmental coordination disorder and help them achieve better outcomes.

Artificial intelligence (AI) is now increasingly integrated into health care, education, and daily life. It now shapes how people learn, work, communicate, and manage health. For occupational therapy, which centers on enabling meaningful participation across contexts, this technological transformation presents critical challenges and opportunities. Despite AI’s growing presence, the profession lacks cohesive standards or strategies to address its impact on education, clinical reasoning, or client-centered practice. AI is a practice-relevant and educationally urgent phenomenon that demands structured engagement and leadership within the profession to ensure its ethical, inclusive integration. Occupational therapy practitioners must be prepared to support students, practitioners, and clients in navigating these technologies. Without clear competencies and shared frameworks, the profession risks marginalization and missed opportunities to uphold occupational justice. Action is needed in three domains: (1) occupational therapy education, where AI literacy and ethical use must be taught and modeled; (2) clinical practice, where AI tools require critical evaluation and adaptation; and (3) client engagement, where AI use must be recognized and supported as an evolving occupation. Accreditation, continuing education, and public policy must align to support this shift.

In this column, the author calls for immediate and strategic action to adopt cohesive standards to address the impact of artificial intelligence on occupational therapy education, professional practice, and client-centered engagement.

Social prescribing (SP)—the use of nonmedical community activities and supports to enhance health and address social drivers of health, provided in tandem with medical interventions—is embedded in many health care systems around the globe, but its use in the United States is still emerging. Similarities between SP and occupational therapy abound. In this column, the authors take an occupational justice perspective and use the Capabilities, Opportunities, Resources and Environments framework to analyze the relationship between occupational therapy and SP. They argue that the occupational therapy profession needs to be aware of SP, understand its potential for professional role overlap or blurring, and foster the profession’s inclusion in this practice in the United States. They also discuss opportunities for occupational therapy to capitalize on this growing movement to enable a positive outcome.

In this column, the authors take an occupational justice perspective and use the Capabilities, Opportunities, Resources and Environment framework to analyze the relationship between occupational therapy and social prescribing.