As Ontario faces a major shift in demographics, it is anticipated that the number of community-dwelling people living with cognitive impairment will increase significantly. Occupational therapists (OTs) may play a key role in ensuring timely diagnosis and/or informing a comprehensive plan of care for this population by assessing and reporting on functional abilities. The purpose of this study was to explore the impact of an OT home assessment on diagnosis and plan of care for persons with Mild Cognitive Impairment (MCI) in a primary care Memory Clinic setting using a before and after design. A toolkit of clinical measures was developed to assess self-perception of occupational performance, instrumental activities of daily living (IADLs), falls risk and home safety. Thirty-one participants who had been assessed by a Memory Clinic team completed a one-hour OT home assessment focused on these attributes. A change in the plan of care was proposed for 24 of 31 participants (i.e., 77%) after the assessment findings were reviewed by the lead physicians of three Memory Clinic teams. Clinical information from an OT home assessment was used by the Memory Clinic teams to change follow-up visit times, plan diagnosis and/or medication review and initiate additional community supports for persons with MCI. Women in this sample were more likely than men to experience changes to their plan of care and were also at a higher falls risk as indicated by scores on a screening tool of this attribute. Several time sensitive issues were identified during the OT home assessment including falls risk, home safety issues and participant concern with driving ability. The addition of an OT home visit to an existing Memory Clinic Model has the potential to change the overall plan of care and to identify issues that may impact overall health and wellness, and the ability to live well at home. While the context for this study was an existing Memory Clinic Model in primary care, the findings have implications for older adults in any health setting who are experiencing cognitive changes. / Thesis / Master of Science Rehabilitation Science (MSc)

Accessibility is a very important criterion to make online learning inclusive to students with different abilities. According to Burgstahler, Corrigan and McCarter (2004) unless design of the courses are accessible to all students, including those with disabilities, the ultimate goal of distance learning to make education available to everyone cannot be accomplished. However, accessibility is rarely a priority for online course developers and students with disabilities are not considered as a large group (Treviranus and Roberts, 2006). This exploratory case study investigated the experiences of the students with visual impairment in online learning environments with regards to media used in their courses with the intent of providing suggestions for accessible media design. Media included text, visuals (pictures, diagrams, charts, and graphs), audio, and multimedia (video and animation) used in online learning environments. This study used a purposive sampling technique and participants who are visually impaired, who had an online course experience, and who are older than 18 years old were included in the study. A semi-structured interview protocol was developed and participants were asked about challenges they experienced and what worked well for them in terms of media in online learning environment. Because of the lack of scientific research examining design of online learning for students with visual impairment, this dissertation fills an important research gap and also makes contributions to the field of Instructional Design and Technology by providing students' perspectives and suggestions for accessible design. Suggestions provided in this study is valuable in terms of designing accessible online courses and that there is a lack of information and guidance for answering the needs of students with visual impairment in online learning environments. / Ph. D.

No description available.

No description available.

Currently, students who read tactually must learn specific braille indicators that correspond to typeset changes such as bold, italic, and underline. These symbols do not stand out like printed attributes. To learn emphasis indicators, students must understand the concepts of print and memorize corresponding braille coding, which requires explicit training. Because tactile readers can only "see" that which is under his/her fingers, scanning and locating indicators is difficult. One must scan the passage word by word to find the emphasis indicator. In contrast, a sighted child can quickly glance at a page and recognize attributes instantly. The difficulty in tactually recognizing typeset, leads to slower recognition of important information and potentially affects reading fluency for beginning readers.This research study compared the use of the current braille code (CBC) with two alternate ways of presenting typeset. The research questions were: (a) Is there a difference in speed in finding the emphasis indicators when presented in three different formats? (b) Is there a difference in accuracy of recognizing the emphasis indicator when presented in three different formats? (c) What are the students' perceptions and opinions about the various indicators?A quasi-experimental design was implemented and three types of data were collected: (a) measurement of speed - in seconds, (b) measurement of accuracy - in number of correctly identified words and indicators, and (c) the perceptions of students before and after the data were collected. The independent variables were the three ways of presenting typeset (CBC, Ua, and Ub), and the dependent variables were speed and accuracy. Quantitative data were analyzed using ANOVA for speed and accuracy and correlational data were conducted to determine if relationships existed between speed and accuracy. Qualitative data were categorized and reported.Results showed a statistical difference between the speed at which students located words with emphasis, but no difference was found in their accuracy. Interview data showed that most students did not have a grasp of print concepts or understand the purposes of using the indicators. Students also indicated that they preferred the alternate formats (Ua or Ub), rather than the current braille code (CBC).

No description available.

No description available.

No description available.

No description available.

BACKGROUND. Neuropathological processes affecting the left frontotemporal lobes and their connections with subcortical structures have been reported in individuals who sexually assault minors. However, these findings are not necessarily conclusive, and knowledge is limited as to how such factors influence the 'blocking' adult sexual relations, disinhibition, emotional congruence and sexual arousal to children; or indeed if functional disorders are more significant. METHOD. A combination of neuropsychological (LNNB Form II) and personality (MMPI-2) probes where used to ascertain the profiles of male subjects satisfying DSM-III criteria for paedophilia, and a comparison was made with male rapist and homicide offenders to identify a characteristic neuro-behavioural syndrome. All groups were matched for premorbid intelligence, drug/alcohol abuse, socio-economic status and incarceration period. Hypotheses of greater dysfunction localised to the lefthemisphere fronto-temporal lobe areas, and more disturbed personality and psychopathology in the paedophile offenders were tested. The Multiphasic Sex Inventory (MSI) was also used to confirm the diagnoses of the sexual offenders and to assess psychosexual functioning. RESULTS. The offender groups were undifferentiated in terms of frequency of overall neuropsychological dysfunction, yet 26.8 per cent had clinically significant cognitive impairment, and a further 23.2 per cent were diagnosed as 'Borderline.' However, pattern of expressive speech and writing deficits in the paedophile group's LNNB-11 profile was consistent with subclinical features of Transcortical Motor Aphasia-Type I syndrome (i.e. non-fluent verbal output - decreased spontaneity of expression and impoverished narrative speech, but with intact comprehension, repetition of spoken language; clumsily produced letters and hypereconomy of written content; and apathy). Damage to the left-hemisphere dorsolateral prefrontal cortex (DLPFC) is known to be associated with this type of aphasia, which in tum increases the probability of dysexecutive syndrome (i.e. limited planning and maintenance of goal-directed behaviour and behavioural flexibility). The impact of this syndrome was clearly reflected by socialdeficit type features found in the paedophile's MMPI-2 48' /84' profile which are consistent with a schizotypal personality disorder (i.e. apathy, social withdrawal, constricted affect, odd speech and behaviour). Additionally, psychosexual functioning, rationalisations and cognitive distortions relating to offence behaviours was found to be more deviant in paedophiles than rapists. CONCLUSION. From a developmental perspective, neuropathology of the circuits connecting the dorsolateral prefrontal cortex with sub-cortical areas, presenting as dysexecutive syndrome, may be significant in explaining the paedophile' s lack of adjustment to, indifference for, and alienation from the adult world; increasing the probability for emotional and sexual dependency on children. Several possibilities for future research are identified and practical uses for the findings of this study are presented.