Postsecondary programs for students with intellectual disabilities or neurological and autism spectrum disorders require access to vocational training, continuing education, independent living opportunities, and community participation as defined by the Individuals with Disabilities Act of 2004 (U.S. Department of Education, 2020). According to the Massachusetts Department of Elementary and Secondary Education (2020), students identified through an individual education plan are entitled to receive special education services until their 22nd birthday. Because many postsecondary or transitional programs are offered to these students on high-school campuses, these students often remain at their high schools for 6 years, or until they turn 22 years old. New and creative programming is needed to successfully transition life-skills students into adulthood. Occupational therapy practitioners can play a key role in creating and assessing transition goals and objectives. The goal outcome of the College Access Maximizing Participation for Us (CAMPUS) program is to establish a relationship with an occupational therapy (OT) department at a local community college or university for use of their OT laboratory and academic classroom. In this way, the postsecondary students would gain access to facilities that include a kitchen, laundry, and bedroom space. The collaboration would also create Level I fieldwork placements for OT students because the postsecondary program is run by a school-based occupational therapist. Further, developing a postsecondary program on a college campus allows postsecondary students to interact with age-appropriate peers and work on valuable and meaningful occupations in an adult learning environment.

The Neonatal Intensive Care Unit (NICU) environment exposes infants to a constant barrage of negative stimuli that impact the long-term development of the neonatal brain. Neurodevelopmental Supportive Care (NDSC) are specific applications to protect neonatal brain development and foster family support care. Neonatal occupational therapists (NT OT) are vital members of the NICU team and integral to the implementation of NDSC. Premature births in Greece have increased from 9.62% in 2008 to 11.18% in 2010, to an estimated rate of 20% in 2019, creating dramatic need for preventive interventions. Appropriate neuroprotective care for these infants is of critical importance. However, there is a void of data on NDSC applications and NT OT staffing in Greek NICUs. To facilitate implementation of these practices in Greece, it is important to first raise awareness of NDSC and OT NT to the NICU personnel, medical and other healthcare disciplines, government agencies, and the general public. The author’s “NEOGNO” online program is an innovative health awareness program in Greece aimed at promoting NDSC and NT OT in all NICUs, endorsing future NDSC and NT OT research, and establishing strong advocacy for newborn neuroprotection. The program is guided by the Health Belief Model (HBM) which targets the awareness, attitudes, perceptions, and beliefs of the health care professional community that impact the application of NDSC and neonatal OT in NICUs. NEOGNO’s platform offers a plethora of evidence-based information at different levels of complexity to address the diversity of participants’ interests. The platform also includes a participant program evaluation questionnaire, and an exploratory survey for data collection for an upcoming first exploratory research on NDSC in Greece by the same author. A program evaluation research checklist will assist in the assessment of NEOGNO by stakeholders before, during and after the launching of the program. Dissemination efforts will continue using electronic media and expanding beyond the borders of Greece. Funding of NEOGNO will initially derive from the author’s private practice until other public and private sources are located. NEOGNO is the first of its kind health awareness program in Greece, and a launching point for future change in current practices in Greek NICUs, OT, public and private funding of neonatal neuroprotection, and for the inauguration of NDSC and NT OT research. Most importantly, NEOGNO will become a strong voice for the fragile infants and their families.

Meeting the sensory needs of young children with Autism Spectrum Disorder can be challenging for special education teachers and staff. Children with ASD often experience sensory processing challenge, in turn impacting their ability to participate in daily occupations such as play (Schaff, et al., 2018). Evidence reveals that teachers have varying comfort and competence levels with implementing sensory interventions within the classroom (Noddings, 2012). In order to address these challenges, training and implementation programs need to meet the needs of special education teachers and students. Occupational therapy practitioners utilize their expertise in order to work collaboratively with teachers to allow students with ASD learn in the least restrictive environment. This two-phased proposed program, “Preschool teacher training and education to support the integration of sensory-based curriculum to improve play skills” (PTTE-SI), will provide special education teachers and staff with the knowledge necessary to accommodate each student’s sensory needs throughout the school day. The first phase of the program will occur over three, one-hour in-service sessions within the integrated preschool classroom. Phase two of the program, the implementation phase, will occur over 8 weeks. During this phase the special education teachers and staff will have the opportunity to implement what they learned during training. The occupational therapist and special education teacher will consult weekly in order to adjust sensory programming to meet each individual student’s needs. Goals for the special education teachers and staff include increasing confidence and competence related to knowledge on sensory processing behaviors and needs and increased ability to implement sensory activities into the curriculum. For students, the goal is to decrease undesired behaviors and increase play opportunities throughout the school day. In the long term, the goal is to improve student play skills. This program aims to provide teachers with the necessary resources and evidence-based teaching approaches to support students with ASD within the natural context.

In the United States every year, approximately 7,200 infants are born with a critical congenital heart defect (cCHD), a life-threatening condition that often requires infant hospitalization and multiple surgeries after an infant's birth (CDC, 2020). A diagnosis of cCHD before birth, or prenatally, is almost always unexpected and leads to disruptions in parental occupations, or the everyday activities associated with being a parent. Current literature has revealed that parents are not equipped to navigate the challenges and barriers associated with parenting a hospitalized, critically ill infant. Lack of parent preparedness along with several other contributing factors have been associated with increased parent stress, difficulties with parent/infant bonding and a negative impact on parent mental health and quality of life. Prenatal parent education programs often have positive effects on parent outcomes. However, they typically focus on the childbirth process rather than empowering parents and preparing them for the early stages of parenthood (Entsieh & Hallström, 2016). For decades, occupational therapy practitioners have supported critically ill infants and their parents through family education, health promotion and advocacy, focusing on developmental, physical, and mental health. The following chapters provide an overview of current literature supporting the identified problem and a proposed solution; From Worry, to Warriors, a virtual parent empowerment program that utilizes key constructs from the profession of occupational therapy. Through participation in this program, parents will gain new knowledge, confidence, and a critical support network to navigate the challenges of becoming a parent to a critically ill infant.

School-based occupational therapy practitioners (OTPs) often face challenges impacting their ability to collaborate and communicate consistently with educators, including decreased time, lack of resources, educators’ limited knowledge regarding occupational therapy (OT) scope of practice, informal communication and decreased focus on preventive or classroom-wide strategies (Truong & Hodgetts, 2017; Benson et al., 2016; Bucey & Provident, 2018; Miller-Kuhaneck & Watling, 2018). These factors then decrease carry-over of OT strategies into the classroom for greater generalization of skills (Truong & Hodgetts, 2017). Additionally, educators may have difficulty generating necessary information for OT screening and evaluation referrals (Truong & Hodgetts, 2017). There is a need for collaboration to occur more regularly within a formalized context in the school setting. Best Practices for School-Based Occupational Therapy Practitioners and Elementary School Educators Collaboration: A Hybrid Training Model, seeks to address many of these challenges through a theory-driven and evidence-based educational training program for elementary school educators. The training is provided in a hybrid format with the educational content being presented on the Nearpod platform, and in-person collaboration opportunities with the facilitating OTP to occur twice during the program in order to individualize the program content. The training program seeks to increase the elementary school educators’ knowledge regarding school-based OT scope of practice and increase their self-efficacy and knowledge in relation to implementing OT strategies into their classroom. Long term impacts of the program seek to improve students’ academic Individualized Education Program (IEP) outcomes.

Prolonged life disruptions lead to isolation, stress, role confusion, and loss of meaningful daily life. Physiological, cognitive, emotional, and spiritual fragmentation occurs in body, mind, and spirit during disruptions such as chronic illness, disability, or a public health crisis lasting longer than 12 months. Although this is the case for parents (or primary caregivers) of children with chronic conditions whose health disparities have been extensively documented, it is seldom recognized and leads to lack of individualized care access. Parents of children with chronic conditions experience increased morbidity and mortality risks from cardiovascular disease, autoimmune disorders, cancer, and enteric disruptions. Furthermore, these health disparities manifest as diminished selective attention, decision making, emotional regulation, sense of belonging, and enjoyment in meaningful daily activities, which affects their capacity to manage the family’s health. The Integrative Neural Networks framework was developed to create avenues for occupational therapy practitioners to assess and improve the level of multisystemic disruptions affecting an individual’s health and function. This framework allows for greater access to health care and an interdisciplinary collaborative designed to address body, mind, and spiritual fragmentations in parents of children with chronic conditions. The robust theoretical and evidence base used in developing Integrative Neural Networks serves as a guide for occupational therapy practitioners to understand the problem, lead the interdisciplinary collaborative, and design a neurointegrative plan of care. / 2023-09-14T00:00:00Z

Healing Presence is an innovative program designed to support health professions students at a small university in developing the personal resource of resilience in order to reduce and prevent burnout. Healthcare providers experience high rates of burnout which negatively impacts individual health and wellbeing as well as patient care quality, safety, and costs. However, training in strategies for self-care and resilience are not routinely included in health professions education. A thorough review of the theory and evidence surrounding burnout and burnout interventions is described in support of the Healing Presence program which utilizes a 4-hour training in HeartMath tools and techniques as a mindfulness-based intervention to promote resilience. HeartMath biofeedback tools will be incorporated for a pilot group of participants and the training program is designed to be offered to the entire community of faculty, staff, and students at the target institution. The program also outlines a specific set of strategies to incorporate use of the intervention into the culture of the university. The program evaluation plan includes measurement of changes in resilience, burnout symptoms, depression, and anxiety. Detailed funding and dissemination plans are included.

Occupational therapy practitioners are in a unique position to address occupational injustices through social entrepreneurship—entrepreneurship for a social cause. Despite the potential contribution that occupational therapists can have in this space, they may not understand how they can address occupational injustices as social entrepreneurs and may not receive the education to develop the skills to successfully launch and sustain a social enterprise. A recent review of the top 10 occupational therapy programs in the United States indicated that only half of the programs explicitly included entrepreneurship in their curricula (Gigi, 2020). Anderson and Nelson (2011) also noted this limitation and recommended that the profession offer more academic support to advance students’ knowledge of entrepreneurship. Barriers to implementing such recommendations may include health care professors’ limited knowledge about entrepreneurship and administrators’ lack of support. Further, when entrepreneurship is included in education programs, it is aligned more often with the mission of health care professions than with social entrepreneurship. The proposed program, a certificate in innovation and entrepreneurship with a social-entrepreneurship concentration for entry level Duke University occupational therapy students, addresses some barriers that historically may have impeded the advancement of entrepreneurship education in health professions. The certificate includes two required business fundamental courses and two elective occupational therapy social-entrepreneurship courses followed by group coaching. Duke occupational therapy doctoral students will have the option to focus their capstone on certificate completion. This model can provide occupational therapy students with the foundation they need to optimally address occupational injustices as social entrepreneurs. / 2023-09-21T00:00:00Z

More than half of America’s adolescents do not obtain enough nightly rest to meet their sleep needs. Poor sleep health during this critical developmental period is linked to a myriad of negative health consequences, impairing performance and satisfaction in other meaningful occupations. Adolescents with adverse childhood experiences (ACEs) are at an increased risk of poor sleep health and associated negative outcomes. As a modifiable determinant of health, addressing poor sleep health would not only promote good quality, restorative sleep but also foster optimal occupational performance, supporting individual and societal well-being. Building on the work of previously tested cognitive-behavioral adolescent sleep health interventions, a multi-week, sleep health intervention was piloted at the Children’s Community Support Collaborative in Boston, MA. This intervention was adapted to be more trauma-informed, occupation-based, and centered around the interests of residents, aligning with the Collaborative’s philosophy of care and programming. Participant and staff feedback suggests a high degree of this intervention’s acceptability and favorability. Of the seven participants who completed the intervention, 86% reported an increased ability to sleep well, ​​achieved >70% of their primary sleep-related goals, and demonstrated improved scores in at least one self-reported measure of subjective sleep quality. Collectively, satisfaction with sleep increased from a 6.8 group average pre-intervention to an 8.0 post-intervention on a 10-point Likert scale, with a 10 representing greatest satisfaction. These findings provide support for the efficacy of a trauma-informed, cognitive- behavioral, and occupation-based approach in improving the subjective sleep quality, occupational performance, and functional well-being of this population.

In the United States, goal and value-based conversations between healthcare professionals and patients experiencing chronic critical illness (CCI) in a long-term acute care hospital (LTACH) do not occur routinely as part of the standard of care, leading to a poor quality of life and increased levels of stress, anxiety, and depression among this patient population (Kahn et al., 2015; Lamas et al., 2017a; Lamas et al., 2017b). Since the Theory of Planned Behavior is designed to both explain and predict behavior in specific contexts, such as healthcare professionals’ intentions and behavior to have goal and valued-based conversations with this patient population (Ajzen & Fishbein, 2005), and the literature supports the use of semi-structured interview tools to do so with this patient population (Chochinov et al., 2015; Johnston et al., 2015; Lamas et al., 2017a), this doctoral capstone aims to enhance patient-reported outcomes among this patient population by providing healthcare professionals, specifically occupational therapists, with the most useful semi-structured interview tool (i.e., the Canadian Occupational Performance Measure [COPM]) to facilitate goal and value-based conversations more routinely. The COPM is client-centered OT semi-structured interview tool designed to generally (1) elicit goal and value-based conversations; (2) guide collaborative goal-setting; and (3) measure patient-reported outcomes (Law et al., 2005). The results indicate both clinical and statistical significance over time across patients for the patient-reported outcomes, self-perceived performance and satisfaction, demonstrating support for the establishment of routine goal and value-based conversations as part of the standard of care between healthcare professionals and this patient population.