Evidence consistently reveals that taking part in an inclusion classroom does not guarantee that children with disabilities will be accepted, valued, or included (Lindsay & Edwards, 2012; Rillota & Nettelbeck, 2007; Ison et al., 2010). Children with disabilities have been reported to have significantly less friendships and overall social participation within the school environment (Ison et al., 2010). With the growing number of youth with disabilities in the United States and the important push for education in the least restrictive environment (Currie & Kahn, 2012), it is concerning that so many of these children are still feeling devalued among their typically developing peers. Since the 1980s, disability awareness programs have incorporated activities to increase knowledge and understanding of disabilities as a means to improve attitudes toward and acceptance of the growing number of children being mainstreamed (Lindsay & Edwards, 2012). However, these programs are often disjointed from the general education teachers and the general curriculum, and rarely extend the length of an entire academic year; this is a potential cause of their short-lived impact (Lindsay & Edwards, 2012; Rillota & Nettelbeck, 2007; Ison et al., 2010; de Boer, Pijl, Minnaert & Post, 2014; Hurst et al., 2012; Hunt & Hunt, 2004; Favazza, Phillipsen & Kumar, 2000; Freeman 2000). This doctoral project, Inclusion through Infusion: Disability Awareness Training for Elementary Educators, seeks to develop an evidence-based solution to the challenges outlined above. This teacher training program strives to provide education, support and structure for implementation of disability modules within the general curriculum of a New York State first grade inclusion classroom. The program modules aim to eliminate barriers to implementation, such as lack of academic time, knowledge, and confidence in educators, with the greater goal of improving typically developing children’s attitude towards and acceptance of their peers with disabilities.

As a result of increased academic rigor and limited movement opportunities during the school day, students may have more limited focus and difficulty in maintaining attention in the classroom (McMurrer, 2007; Stark, Rentner, & Kober 2014; Common Core State Standards 2014). As students have more difficulty maintaining attention, their learning can be affected and impaired. As the trend for increased academic rigor continues, teachers need strategies to help students maintain attention, such as movement breaks, classroom environmental modifications, and alternative seating suggestions that can be incorporated throughout the day and that do not impede on time spent on academic curriculum guidelines. The research is clear that occupational therapists should focus on best practice including multi-faceted approaches that meet the needs of the children and incorporate self-regulation and sensory integration strategies (Schaaf & Davies, 2010; Cohn, Kramer, Schub, & May-Benson 2014; Reynolds, Glennon, Ausderau, Bendixen, Kuhaneck, Pfeiffer, Watling, Wilkinson, & Bodison, 2017). Interventions in the proposed program will focus on three sensory integration strategies including the use of alternative seating in the classroom by students, modifying the classroom environment through consultation and strategies with the teacher and classroom staff to increase student focus and limit distractions and using classroom-based movement and physical activities. These specific approaches offer a variety of supports in the classroom setting to all children, as well as those with disabilities to help them obtain and maintain optimal attention for learning. The Moving to Learn program will take place for 12 weeks, unless additional consultation time is needed on an individual basis. The program starts with a two-hour in-service and training for regular education and special education teachers during their extended day time. During phase two, the occupational therapist will meet with teachers in small groups, preferably by grade level, in a consultation format in order give them the opportunity to ask questions and discuss the students in need of specific intervention. The occupational therapist will observe specific students in the classroom, following up to see and address the teachers’ concerns. Moving to Learn will be offered first during the Fall Semester of the school year in the school at which that I currently work, but will be offered both in the winter and spring semesters as well to other schools within the Springfield Public School District. Following the implementation of this program in a target elementary school building, teachers will participate in scoring satisfaction surveys. As Moving to Learn is offered in new parts of the school district, more teachers will share to continue the excitement of this important program.

A central concern being addressed in this project is the acknowledged gap between reductionist Western and holistic Eastern approaches to healthcare and the growing global movement aimed at narrowing this gap. In contrast to biomedicine, where the body is understood in terms of the operation of its constituent parts, Eastern medicine is based on recognition of the interconnection of bodily systems and the environment. The Global Holistic Occupational Therapy (GH-OT) course is an intensive program designed for occupational therapy practitioners in India that are interested in expanding their current biomedical based clinical methods by incorporating Eastern medical philosophies and practices. It is comprised of three instructional modules delivered over six days. The teachings of yoga and Ayurveda brought forth by the Bhrigu Yoga BCP Trust, which offers a non-religious method for enhancing human potential, provide the basis for instruction designed to prepare participants to make appropriate use of the ancient wisdom and to integrate an expanded Eastern holistic and inner vision perspective with the customary logical and analytical mindset of clinical reasoning in a way that upholds the theoretical foundations of OT practice. The educational activities include experiential practice of yoga exercises, examination of the current healthcare system and exploration of emerging world trends for promoting health and wellness. The GH-OT course is the beginning of an effort to achieve a transformation in OT education that will be applicable in the future to other regions such as Israel and the United States.

Youth with disabilities, including those with autism spectrum disorder (ASD) and intellectual disability (ID), have difficulty forming and maintaining peer relationships (Carter & Hughes, 2005; Guralnick, 1999; Meyer & Ostrosky, 2014; Petrina, Carter, & Stephenson, 2014; Shattuck, Orsmond, Wagner, & Cooper, 2011; Wagner, Newman, Cameto, Garza, & Levine, 2005). This is of concern considering that early friendships are important to positive social, cognitive, and emotional development, and contribute to future success and wellbeing (Carter & Hughes, 2005; Meyer & Ostrosky, 2014; Petrina et al., 2014; Wagner et al, 2005). Of all youth with disabilities, those diagnosed with ASD and/or ID (ASD/ID) who have greater cognitive and communication challenges may present with the most severe social impairments (de Bildt et al., 2005; Matson et al., 2009; Wilkins & Matson, 2009). However, effective interventions for adolescents with ASD/ID who have limited cognitive and communication skills are limited by gaps in the social intervention literature. In general, the social intervention literature focuses on: (1) younger children (Carter, Sisco, Chung, & Stanton-Chapman, 2010; Hughes et al., 2012), (2) children with ASD/ID who have stronger cognitive and communication skills (Walton & Ingersoll, 2013), (3) only immediate outcomes in the contrived intervention context (Gresham et al., 2001; Hughes et al. 2012; Sheridan, Hungelmann, & Maughan, 1999), and (4) discrete social skills outcomes rather than friendship-based outcomes (Finke, 2016). A program to address these gaps is needed. Class Videos of Important People (Class VIP) is a theory- and evidence-driven school-based social intervention for adolescents with ASD/ID who have limited cognitive and communication skills. The 20-week program will include: (1) video self-modeling, (2) positive self-review, (3) peer disability awareness education, (4) peer training, and (5) teacher training. Goals of the program will be to improve quality of social interactions, increase self-efficacy, and increase friendship formation among students with ASD/ID. The proposed evaluation plan will explore feasibility of program implementation and preliminary outcomes. Potential funding of the program and dissemination activities will also be discussed.

Improving the Care Partner Experience: An Occupational Therapy Intervention proposes a clinic or telehealth based occupational therapy (OT) treatment intervention to teach care partners how to maximize the occupational engagement of care recipients diagnosed with Alzheimer’s disease and related dementias and decrease caregiver burden. Caregiver burden contributes to care partner illness and care recipient institutionalization. The intervention consists of a protocol that is both client-centered and designed to foster self-efficacy of the care partner in providing care. A sense of self-efficacy will decrease caregiving burden and improve quality of life for both partners as described in the evidence supporting the project. The first chapter provides an overview of the intent and genesis of the intervention. It includes a description of the author’s work environment, the problem as it was identified and how the intervention fits within the OT practice framework. The next chapter explores factors contributing to the problem including the rural nature of New Hampshire, barriers to accessing adequate treatment and the theoretical basis grounded in Self-efficacy theory and the Model of Human Occupation. The second half of the chapter explores current best practice that exists in the literature. Several programs and interventions are identified and their efficacy is discussed. Based on the findings in chapter two, the intervention itself is outlined in chapter three, with examples of templates and a case scenario available in the appendices. The intervention, administered in the clinic or via telehealth, is based on the evidence of effective treatment in the home, translated into a clinic or telehealth based model. Administration of the program is fully described and reproducible from this document. Finally, a plan for program evaluation along with a budget and dissemination plan are included in the final chapter. The result is an evidenced based, client-centered occupational therapy treatment that can be administered in a consistent manner and contribute to lower caregiver burden and increased quality of life.

Within occupational therapy and the healthcare community there are calls to promote professionalism through self-awareness and emotional intelligence training (Andonian, 2017), as well as improve therapeutic rapport and performance during clinical fieldwork (Brown, Williams, & Etherington, 2016). Based on literature reviews, an effective way to incorporate training is through mobile applications (Kron, 2016). However, there is limited evidence within the occupational therapy literature to help occupational therapy programs develop self-awareness curriculum. This doctoral project (1) identifies a mobile phone application for occupational therapy students (2) investigates evidence and best practice in developing self-awareness training (3) develops an outline for development of a mobile phone application (4) identifies implementation strategies and (5) identifies evaluation plan. The project’s evaluation results will contribute to three areas within occupational therapy: addressing specific needs of self awareness training (Allen, Montgomery, Tubman, Frazier, & Escovar, 2003), providing more evidenced-based education (AOTA, 2017; Bakker, Kazantzis, Rickwood, & Rickard, 2016), and building self-awareness training into occupational therapy curriculum (Carvalho, et al., 2011; Andonian, 2017). / 2019-10-23T00:00:00Z

Individuals experiencing homelessness face significant barriers to accessing affordable and sustainable housing and to managing their health and well-being (Baggett, O’Connell, Singer, & Rigotta, 2010; Munoz, Garcia, Lisak, & Reichenbach, 2006; National Law Center on Homelessness and Poverty, n. d.). This population experiences a high rate of mental health and substance use disorders, chronic health conditions, and brain injury (Topolovec-Vranic et al., 2017). Health care and housing programs have been implemented in order to address the specific needs of those experiencing homelessness and minimize the barriers to housing and health management (Aubry et al., 2015; Zlotnick, Zerger, & Wolfe, 2013). Although these programs have seen success in increasing housing and health care access, needs remain unmet: individuals require ongoing support to successfully transition into housing, improve their health, and integrate into the community (Cherner, Aubry, & Ecker, 2017; Tsai, Mares, & Rosencheck, 2012). Occupational therapy interventions can address the .additional needs of these programs by providing evaluations of cognition and function and through the implementation of interventions with clients to increase independent living skills. Occupational therapy has demonstrated effectiveness in addressing the functional needs of those with mental health diagnoses, brain injury, and chronic health conditions, as well as with individuals living within homeless shelter settings (Gibson, Jaffe, D’Amico, & Arbesman, 2011; Ikiugu, Nissen, Bellar, Maassen, & Van Peursem, 2017; Phelan, Williams, Penninx, LoGerfo, & Leveille, 2004; Powell et al., 2016; Radomski, Anheluk, Barzen, & Zola, 2016; Roy et al., 2017; Thomas, Gray, & McGinty, 2011). An occupational therapy program was developed within a health care agency specifically serving those experiencing homelessness. This program was designed to meet the needs of the agency and its clients by increasing access to functional rehabilitation services. Occupational therapy services increased access for clients to function-based interventions, improved inter-disciplinary care, and increased knowledge of functional and cognitive abilities of clients. The significance of the outcomes of this occupational therapy program were evaluated in order to demonstrate the effectiveness of this model and provide further evidence into the efficacy of occupational therapy interventions within health care settings serving adults experiencing homelessness. / 2020-10-23T00:00:00Z

One of the distinct values of occupational therapy is its holistic and family-centered approach to care. In the area of feeding-related therapies, the child is often the focus of intervention. Current evidence suggests that caregivers most frequently consult with the Internet and online forums for additional information and support, especially those that do not pursue therapeutic services; however, these sources are not always screened for accuracy, completeness, or best evidence. In addition, these sources may not always serve the direct needs of the caregiver or provide opportunities for skill development. It is the intention of this doctoral project to provide an avenue for supplemental services to support caregivers’ knowledge and self-efficacy in their role caring for a child with feeding-related difficulties. The proposed program is an online psychosocial program to provide self-paced and interactive educational modules for caregivers, as well as an opportunity to interact with a wider community of caregivers and healthcare providers for this unique population. Educational modules will place emphasis on self-care skills in the caregiving role and information related to feeding. This doctoral project will explore the background of the problem, the theoretical and evidence-based literature, a description of the proposed program, evaluation plans, funding plans, and dissemination plans. Additionally, samples of proposed program content are included to support future implementation.

Education and student success are among the U.S. citizens’ highest priorities. Changes in educational policies have led to academic “push down,” in which children are expected to achieve academic milestones in core subjects (reading, writing, and mathematics) at younger grades. However, although performance expectations have increased, child development sequences and timelines have not changed to support expectations. Various solutions including sensorimotor, educational, and play programs have been trialed, but the academic achievement gap continues to grow. Successful programs include opportunities to develop foundational sensorimotor skills, follow developmental sequence, align with curriculum, and use aspects of a child-driven play-based approach to learning. In response to the need to better prepare students to meet academic expectations, the Play2Learn (P2L) program was developed based on the previous evidence. The program’s premise is to use play as a learning tool with an educational approach to promote student academic success. The P2L is a 6-week program (six educational modules) for occupational therapy practitioners and teachers. Each module includes 50- minute interactive lectures, expert mentoring and practical application. Topics include defining play and its benefits, risk factors of play, strategies and justification for play in the classroom, how to be playful with students, and application of play strategies. With this program, teachers will confidently and effectively use play in the classroom setting to promote learning, adapt familiar lessons to make them developmentally appropriate and playful, and justify how it aligns with the curriculum. Program objectives are to enhance student academic performance and improve behavior, attention, sensorimotor skills, social-emotional skills, language, and processing and cognition. The desired long-term outcomes are to increase play during the school day, changes curriculum design to be more developmentally appropriate, develop new ways to assess student performance, and educate all students regardless of their academic abilities.

The goal of the Supported Brewing Initiative is to advocate for OT’s role in work and supported employment by providing meaningful, occupation-based, and client-centered programs designed around unique and non-traditional environments. With a growing number of young adults and veterans entering college with TBI and planning to enter the workforce as gainful individuals, it is imperative that OTs lead the development and implementation of supported employment programs nationwide. Through implementation and redesign, the program intends to expand OT practice and improve opportunities for gainful employment and successful transitions into the working world for millions of college students with TBI. In addition to its pilot nature, review and analysis of the program’s outcomes will determine its effectiveness as an OT intervention and publish results in order to advance OT practice and rehabilitation science as a whole. In combination with the outlined dissemination plan, the Supported Brewing Initiative has the potential to significantly and positively influence OT practice and the lives of young adults and veterans with TBI.