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PURPOSE: Communication difficulties in Parkinson’s Disease (PD) are multifactorial. Observing cardinal motor symptoms may be insufficient in qualifying speech dysfunction in people with Parkinson’s Disease (PwPD). This study aimed to use high-speed video (HSV) endoscopy to explore the use of three measures of laryngeal kinematics – spatiotemporal index, asymmetry index, and kinematic stiffness ratio – as a novel means of examining vocal motor control in PD, to better understand the pathophysiology of PwPD within the phonatory subsystem. METHOD: 24 PwPD and 24 age- and sex-matched controls were trained to produce repetitions of a VCV target, /ifi/, while varying their speech rate and vocal effort during simultaneous HSV nasoendoscopic and acoustic recordings. Kinematic measures were calculated from HSV recordings during vocal fold adduction using both manual glottal angle tracking and a semi-automated algorithm. Six separate repeated measures analyses of variance (ANOVAs) were completed to determine the spatiotemporal index, asymmetry index and kinematic stiffness ratio, with main effects of group and condition (fast rate, regular rate, slow rate, mild effort, moderate effort, maximum effort). Alpha levels < .05 were considered statistically significant. Effect sizes of significant differences were calculated by using partial eta squared. RESULTS: The repeated ANOVAs showed a statistically significant effect of group on spatiotemporal index values across both rate (p < .01) and effort (p <.05) and on asymmetry index values across rate (p < .01). No statistically significant main effect of rate or effort or interaction effects between group × rate or group × effort were observed for all kinematic measures. CONCLUSION: This study determined that spatiotemporal index, a measure of variability in movement, and asymmetry index, a measure of movement efficiency, are significantly higher for PwPD compared to controls. These findings are consistent with increased variability and reduced efficiency observed in other speech subsystems in PwPD. Further research is recommended to explore the use of laryngeal kinematics in characterizing the pathophysiology of the laryngeal subsystem in PwPD.

In order to assess the need to formulate training requirements for practitioners of group therapy in therapeutic milieus attached to the Cape Provincial Hospital service , the organization, theoretical framework and functioning of these therapeutic milieus have been cutline. The group therapy component of the therapeutic milieu programmes and the present training provider to all four psyct1iatric disciplines from whose ranks the co-therapists of the therapy groups nrc dravm have been examined . Within this framework an assessment of the need to provide bath improved training and some consider able training in common for the four psychiatric disciplines involved has been made. Evidence from U1e writer's observations reached during thrills' years or supervision of psychic social work students' group therapy in the therapeutic milieus together with examples from the students I process records has been cited to support the conclusion that these needs do exist. The training requirements have been analysed into four components: the theory, experiential group attcnd~1ce, group therapy practice, supervision. The formulation of a training programme embracing these components is advocated . It is concluded that the training programme 3hould to a great extent be applicable to co-therapists from the different psychiatric disciplines. Finally, a number of proposals as to hm-1 improved c1:1d common training programmes can be evaluated and implemented · have been outlined.

OT VetSet: A Clinician’s Manual to Working with Veterans as Clients is designed to educate occupational therapy providers on unique client factors of veterans as well as provide resources to occupational therapy providers for the effective evaluation and treatment of veterans as clients. Using descriptive evidence of veterans as a population in conjunction with literary evidence on how to create effective learning for adults, OT VetSet can be truly considered an evidence-based tool. The tool is split into six lessons which range from introductory information including military terminology, conditions by service era, and considerations for mental health, to two case studies on fictional veterans (that were based on demographic information) as well as a list of resources for both providers and veterans. Each lesson is published in three sections including the introduction, content, and sample administration techniques. This doctoral project presents the evidence behind this design, funding plan, evaluation plan, and dissemination plan as well as a sample manual (via appendices) for future users to be able to replicate OT VetSet in their own facility.

School-based occupational therapy practitioners actively support students’ functional participation in school-related activities. Underlying these daily school activities are executive functioning skills. Although addressing executive functioning (EF) skills is within occupational therapy’s scope of practice, school-based practitioners typically do not support the development of these skills in students. Identified factors that contribute to this gap in practice are limited (1) EF knowledge, (2) availability and access to EF resources, and (3) time to complete job demands. To address this clinical gap, an interactive online course for school-based occupational therapy practitioners was developed which presents current EF research, knowledge, and resources. The course utilizes interactive features to support practitioners in applying course information in the school setting. This includes practicing EF assessments, designing EF interventions, and preparing advocacy resources and dissemination tools to share with school administrators and school staff about the importance of addressing executive functioning skills in school-age students. The objective of the online course is to develop a community of occupational therapy practitioners committed to improving EF skills in students through contributions in research, assessment, interventions, and school collaborations.

The growth and learning needs of pediatric occupational therapists working in the People’s Republic of China (PRC) have not been fully researched or documented at this time. Without a formal occupational therapy association, the communication and planning to identify these professional development needs can be challenging. WFOT resources available for non-member countries combine with some of the traditional occupational therapy resources and initiatives from neighboring member associations. Hong Kong and Taiwan provide practices and materials that reflect Chinese culture and assist in promoting the profession (Lin, 2014; Sinclair, 2015). Language nuances, historical and political issues can make direct transference to the mainland of China problematic. These activities help support occupational therapy as a distinct healthcare profession within these regions of the PRC but may have barriers to direct application in mainland China. A formal needs assessment of the occupational therapists has not yet been undertaken. The steps to develop a pediatric needs assessment are presented in this paper. Research confirms a facilitated needs assessment can assist in determining and understanding learning needs, preferences, patterns, and future topics (Newcomer, Hatry, & Wholey, 2015) for occupational therapists and the groups that provide them professional development training in mainland China. There are three distinct stakeholder groups identified for this research project: pediatric occupational therapists, professional development producers, and families of children receiving therapy services in mainland China. The research team works collaboratively with identified stakeholder partners to identify the training and growth needs of the pediatric occupational therapist to provide the required educational recommendations that will foster competency in practice. Both the occupational therapists and the providers of professional development activities gain a better understanding through participation in the program evaluation processes of surveying learning needs in the context of international evidence-based competency content. The implementation and dissemination of the program verifies, validates and provides a synthesis of perspectives and establishes a connection for the client’s input to the therapy services. The program evaluation summary recommendations are hypothesized to have an impact on improving the perception of the quality of pediatric occupational therapy services received by caregivers and families in mainland China.

Impairments in capacity to accurately perceive one’s self following a traumatic brain injury (TBI) poses serious consequences for not only the individuals who experience these deficits, but also their family members and social supports, treating clinicians, and all levels of the healthcare continuum including rehabilitation institutions and insurers. Individuals with limited understanding of their deficits often take longer to complete the rehabilitation process due to poor motivation, reduced effort, persistence and commitment when faced with repeated task failure. For these reasons, individuals with a TBI resulting in executive dysfunction often require increased support and assistance in daily life long-term. The aim of this project, A Clinician’s Guide to Self-Awareness Training, is to provide occupational therapists working in TBI rehabilitation with an eight-hour continuing education course that will equip them with tools that utilize the existing evidence literature to develop treatments that are conducive to the current state of healthcare and are effective. Such treatments include: detailed behavioral analysis, design of a tailored intervention for a specific target behavior, collection of data, and frequent reassessment throughout treatment phases to monitor effectiveness. A Clinician’s Guide to Self-Awareness Training will focus on strategies to facilitate gains in self-awareness during rehabilitation through attention to key factors such as constructive feedback and structured experiences that seek to promote a sense of understanding, control, and confidence while helping to progressively restructure self-evaluative beliefs about functional capabilities (Barco et al., 1991; Langer & Padrone, 1992; Mateer, 1999).

“Help Me Play,” an evidence-based, client-centered and theory-driven training program facilitated by an occupational therapist, provides educational opportunities for early childhood educators to support the development of social play among preschool students in an inclusive classroom setting. Despite the belief of early childhood educators of the importance of social play, research suggests lack of pre-service or in-service training focusing on how they can support social play effectively in the classroom (Vu, Han, & Buell, 2015). “Help Me Play” consists of four weekly two-hour workshop sessions and an individualized 30-minute coaching and feedback training session. The workshop sessions are held in small groups of eight to 12 individuals, and cover the following topics: definition and benefits of social play, assessment of social play needs, environmental supports and barriers, and strategies to facilitate social play. The coaching and feedback session is held upon completion of the workshops and scheduled at the participants’ convenience. During this session, the facilitator may use prompting, modeling, feedback and encouragement to support the teacher in using scaffolding strategies. In line with adult learning principles highlighting active participation, the workshop sessions are organized using Kolb’s (1984) Model of Experiential Learning, which posits that experience is the building block of learning. Each session begins with concrete experience (i.e. engaging in an activity), followed by reflective observation (i.e. relating the activity to past experience), abstract conceptualization (i.e. gaining knowledge and skills) and active experimentation (i.e. testing out new skills and abilities). Another theoretical framework that guides the program relates to the concepts of zone of proximal development and scaffolding in Vygotsky’s (1978) social development theory. Vygotsky (1978) defined the zone of proximal development as the distance between the developmental level by independent problem solving and under adult guidance, while scaffolding is the process by which adults tailor their guidance with the just-right support to enable the child to perform at a higher level. “Help Me Play” presents a unique opportunity for occupational therapists to engage in a collaborative consultative model of service delivery in preschool settings to foster children’s social play by collaborating and providing training to preschool teachers.  REFERENCES Kolb, D. A. (1984). Experiential learning: Experience at the source of learning and development. Upper Saddle River, NJ: Prentice Hall. Vu, J. A., Han, M., & Buell, M. J. (2015). The effects of in-service training on teachers’ beliefs and practices in children’s play. European Early Childhood Education Research Journal, 23(4), 444–460. doi: 10.1080/1350293X.2015.1087144 Vygotsky, L. S. (1978). Mind in society: The development of higher mental processes. Cambridge, MA: Harvard University Press.

Disability in the Media for Rehabilitation Professionals: A Pilot Program to Foster Reflective Practice is an innovative program that seeks to encourage rehabilitation professionals at a private pediatric practice to engage in thoughtful discussion about tropes about children with disability. The program will utilize various media sources in order to address the problem of a lack of reflective practice among many rehabilitation professionals and the prevalence of negative tropes about children with disabilities (CWDs), which negatively impact therapeutic relationships and therapeutic outcomes for CWDs. It draws upon extensive literature and evidence from two bodies of knowledge — journal clubs and effective strategies for teaching and fostering reflective practice. The use of journal clubs for independent professional development and skill acquisition has been studied and shown to be effective across many medical fields, including rehabilitation professions such as occupational therapy, speech and language pathology, and physical therapy. Strategies for addressing and reflecting on bias within health care, often with a focus on racial, weight, or age biases, have also been a topic interest within the literature as a way to address health disparities that are associated with bias by health care providers. Using the theoretical lenses of social constructionism and cultivation theory, the proposed program seeks to bring together these two fields of evidence in a unique way to address the threat of biases against people with disabilities within rehabilitation. Program content and structure are outlined, as well as best practice for group logistics and bias reduction strategies. A plan for funding, implementing, disseminating, and expanding the reach of the program is outlined.

Incarcerated women face increased barriers to successful community reintegration, often including a history of trauma and poor coping skills. Using a composite of several theories, the author’s proposed model of the problem states that as women return to the community following incarceration, maladaptive thought processes and decreased problem solving abilities may lead to detrimental behavior resulting in recidivism. The author suggests that an occupational therapy emotion regulation and problem solving program beginning in prison and continuing into the community will afford women the skills necessary to respond appropriately to stressors and prevent recidivism. Phase one of the proposed program consists of six modules introduced in three-hour weekly sessions in the prison environment, which will focus on emotion regulation and problem solving strategy development. Phase two of the program begins after the women have reentered the community and consists of monthly individual visits between the occupational therapy facilitator and participants. In addition, weekly phone calls will be initiated to reinforce learned concepts and provide an environment of support. As demonstrated throughout the author’s proposal, this nine-month program has the potential to decrease recidivism, lower taxpayer financial burden, and rebuild damaged communities.