Neurodivergent elementary school students with attention deficit hyperactivity disorder (ADHD) face extra obstacles on the path to academic and social success in school compared to the average student without ADHD (CDCa, 2022; Rigoni et al., 2020). This problem is rooted in a mismatch between person, environment, and occupation in elementary schools, which can be illustrated by the Person, Environment, and Occupation (PEO) model. A variety of interventions and accommodations have been used to address this problem, including therapies, instructional techniques, and pharmaceutical interventions, among others. Still, the barriers for students with ADHD exist. Additionally, barriers to implementing these interventions and accommodations exist and limit teachers (Gaastra et al., 2020; Lawson et al., 2022; Szép et al., 2021). Based on a review of the current elementary school climate and supports, a new intervention is proposed and outlined in this doctoral paper. The intervention will be a free online application, Go PEO. Go PEO will be a guided problem-solving tool that uses the PEO model to plan and implement evidence-based and neurodiversity affirming support for elementary students with ADHD in the school setting. It will be evaluated through a series of surveys, disseminated through local and national education agencies, and funded through grants and awards. It is anticipated that the Go PEO intervention will improve the well-being of students and elementary school educators, including occupational therapy practitioners, by saving them time and energy when planning and implementing support for students with ADHD. Through the eight chapters and 12 appendices of this doctoral paper, all needed elements of consideration will be described, making this intervention ready for collaboration.

With the growth of the aging population, there are high demands on occupational therapy practitioners (OTPs) to support older adults with maintaining autonomy and participation within their homes through home modification recommendations (Patry et al., 2019). Home modifications are alterations in the environment that improve participation, reduce falls, improve caregiver self-efficacy, and help older adults maintain independent living (Patry et al., 2019). Like many practitioners, occupational therapy practitioners (OTPs) working in home health have been increasingly challenged to provide effective evaluation and intervention via telehealth in recent years. However, current practice resources and technology do not fully meet the needs of OTPs in evaluating both the environment Special Accommodations and performance factors within the home. Most technology-based assessments available for use by OTPs evaluate the built environment almost exclusively, and do not facilitate evaluation of the interaction between the client and their lived environment (Mihandoust et al., 2021). This inability to evaluate participation performance in addition to environmental context significantly limits the ability of OTPs to provide effective evaluation and recommendation for home modifications. To bridge this gap and empower OTPs in providing comprehensive home assessment and modification recommendations, an innovative software application has been developed that records the active relationship between the person and their environment in addition to details of the built environment. / 2024-08-24T00:00:00Z

Managing health conditions and navigating health systems can be complex, challenging, and confusing. The Health Resources and Services Administration [HRSA] (2022) defines personal health literacy as an individual’s capacity to locate, understand, and act upon information and resources to educate decisions and actions about their health, or the health of others. HRSA (2022) further describes organizational health literacy as the ability of organizations to equitably promote an individual’s personal health literacy. These definitions stress the duty of providers and systems to address health literacy to support equitable and accessible health information and care. Health literacy is vital to managing health conditions, influencing behaviors, decision-making, medication use, and participation in visits with health care providers. Some populations are more likely to have lower health literacy skills (Hickey et al., 2018). These individuals are at higher risk for medication errors, difficulty managing chronic conditions, and poorer health outcomes (National Library of Medicine, n.d.). To support client understanding and participation, health care providers, including occupational therapy practitioners (OTPs), must consider the health literacy demands of verbal, visual, and written information shared during visits. They must also address how information is communicated and reviewed. Literature supports a need to increase preparedness of OTPs to address health literacy. Preventative and health promotion interventions are not as regularly integrated into occupational therapy (OT) practice (Turcotte et al., 2015). Limited training and education, as well as availability of OT-related resources are further noted as barriers to OTPs’ familiarity with health literacy (Galati et al., 2018; Attard et al., 2021). OTPs are skilled in analysis of activity and environmental demands to support an individual’s participation and engagement in occupation. In their interactions with clients, OTPs are well-suited professionals to support clients’ own personal health literacy and self-advocacy skills to engage more effectively with their health care providers. OTPs can empower clients to participate more actively in their health management. The proposed program is a workshop for OTPs with application of health literacy strategies and practices within the OT setting. The workshop supports practitioners to promote client understanding and engagement. The program is informed by evidence, best practices, and theory, to shape a pertinent, effective, and succinct program for working OTPs. The workshop aims to increase OTPs’ self-efficacy to address health literacy within their work and use health literacy strategies with all clients.

It is estimated that one in approximately 36 children in the United States qualify for an autism diagnosis (CDC, 2023). Parents of newly diagnosed autistic children often report increased levels of stress, anxiety, and depression after the diagnostic process (Oien & Eisemann, 2016). These mental health challenges are often a result of insufficient post-diagnostic support. Parents frequently report that they wish they had received more information after the diagnostic process related to autism and local resources and support services (Rabba et al., 2019). The intent of this doctoral project is to create an online and asynchronous educational tool for parents to complete after their child receives an autism diagnosis. The program will be divided into four modules and will include background information about autism, connections to local resources and support services, strategies for adopting positive coping strategies, and tools to help plan for their child’s future. It is anticipated that through the completion of the modules, parents will experience reduced levels of stress and anxiety following their child’s diagnosis.

Unprecedented societal changes have provided an opportunity and obligation for occupational therapy (OT) to expand practice to include emerging and innovative practice areas (E/IPA), defined as practice settings and/or client populations without an established OT presence (Hammel, 2021; Moynihan et al., 2021; Vogenberg & Santilli, 2018; Kantartzis, 2020; Larsson-Lund & Nyman, 2020; Holmes & Scaffa, 2009). However, diversification of OT practice is met with numerous challenges, including but not limited to a scarcity of role models to emulate and a paucity of explicit and comprehensive education surrounding intrinsic and extrinsic factors critical to effective practice in these domains (Dancza et al., 2019; Zubriski et al., 2020, Thew et al., 2018; McCombie & Antanavage, 2017; Gray et al., 2021; Morgenroth et al., 2015). This doctoral project sought to explicate the importance of equitable access to role models in E/IPA for the continued growth of the profession. This was done through the development and implementation of a podcast series featuring occupational therapy practitioners (OTPs) working in E/IPA in an entry-level occupational therapy doctoral (El-OTD) course at Boston University (BU). Results suggest that podcasts are a feasible means to support access to role models in E/IPA within an OT academic setting. An introduction to the problem, review of relevant literature, program development specifics based on evidence-based practice for role modeling and podcasting interventions, program evaluation strategies, and funding/dissemination strategies are described.

The transition from high school to adulthood is typically accompanied by student’s prepping and planning for post-secondary education and employment following the completion of their education. Obtaining employment is a key milestone in a young adult’s life and provides the opportunity for earning money, living independently, and actively participating within the community and work environment. Young adults with disabilities (YADs) face numerous barriers when attempting to prepare for and obtain employment. Barriers such as transportation, employer bias, and an individual's interpersonal factors contribute to poorer employment outcomes for YADs when compared to neurotypical same aged peers. Helping Underserved Leaders Transition (HULT) is a school based pre- vocational skills program developed to address poor employment outcomes for YADs. Utilizing a mixed methods research design, HULT derives both qualitative and quantitative data from each program stakeholder including the students, their families and/or caregivers, and the school district administrators assisting with the logistics of the program implementation. Using quantitative data measures such as the use of Likert scales, HULT analyzes several outcomes before and after program participation related to the students’ skills in areas such as level of self-esteem, level of independence while completing vocational tasks, and ability to utilize coping strategies. Pre-vocational training within a school setting provides a dynamic and unique addition to YADs educational experience. HULT in conjunction with community resources and school curriculum allows students to prepare for their future employment endeavors earlier and within an inclusive, client centered environment. HULT demonstrates the importance of pre-vocational skills programming earlier in a student’s education to ensure accessibility and to improve overall employability for YADs.

Children with cancer are living longer than ever before and their care and aftercare in the hospital and school has yet to meet the current standards. Team communication, a consultative program designed by an occupational therapist, is intended to bring together the family, the child, and members of the child with cancer’s interdisciplinary team in the hospital and school settings. This team is responsible for collaboratively developing a plan of care for the child to transition from the hospital to home and school settings. Using the Uncertainty Reduction Theory (URT), the interdisciplinary team members will address communication and its relation to the seven axioms of URT, to gain practical skills for collaboration. Through the education and training efforts by an occupational therapist (OT), the interdisciplinary team will learn to use their similarities to relate to one another in a way they had not been able to do before. The consultative program is intended to increase collaboration and communication for the interdisciplinary team (School team, hospital team, caregivers and child) to increase the quality of life (QOL) of the child and their family in their return to school so they may be able to gain academic occupational success physically, cognitively, socially and emotionally in relation to their same-aged peers.

High school students are currently transitioning out of an autism program at the author’s school, without functional life skills This impacts their ability to live independently and reduces their employment opportunities. Life skills are “skills or tasks that contribute to the successful, independent functioning of an individual in adulthood” (Cronin, 1996, p. 54). A review of the literature suggests autistic individuals are at a disadvantage compared to their same-aged peers when attempting to learn life skills. Their struggles with life skills could be partly due to their difficulties with executive functioning, motor skills, or a combination of their executive functioning and motor deficits. Based on a review of the current practices that support and enhance learning for autistic students, while considering the need for support in executive functioning and motor skills, the author proposes an intervention outlined within this doctoral paper. The intervention is a Functional Life Skills Lab that will be offered as an elective class to autistic high school students where the author works. This proposed intervention would provide hands-on training with real-world materials with a multidisciplinary team approach to teach life skills. It would provide opportunities for autistic students to improve their independence by preparing them for meaningful participation in everyday life skills. The author includes a funding plan that will assist in purchasing the necessary items to make the proposed intervention successful. In addition, this doctoral paper provides a comprehensive program evaluation plan highlighting the key stakeholders and a multiple baseline study designed to evaluate the effectiveness of the program.

Strokes can have a devastating effect on the survivor and can often lead to a high level of disability or death. Many survivors experience functional impairments that impact participation and the ability to engage in meaningful occupations and activities of daily living (ADLs). There is a lack of area of treatment within the acute care setting to address the emotional impacts after suffering from a stroke, as the development of post-stroke depression (PSD) and post-stroke anxiety (PSA) is highly prevalent and correlated with poor functional outcomes. Occupational therapy-focused, adapted protocol, Post-Stroke Surviving Trauma (PSST), was designed to decrease depression and anxiety rates and improve overall function. This 6-day consecutive intervention plan is intended for stroke survivors in the acute care setting, with each intervention lasting 30–45 minutes. The foundations of the protocol are based on the posttraumatic growth (PTG) theory, which can enable survivors to focus on embracing new opportunities, improving personal relationships, heightening their sense of gratitude, and appreciating life, forming greater spiritual connections, and increasing emotional strength (Tedeschi & Calhoun, 2018). PSST can be used as an additional treatment that can be used to help stroke survivors decrease depression and anxiety and increase functional outcomes with the facilitation of PTG in recovery.

This paper examines the role of occupational therapy in the management of headaches among women in military aviation. Headaches are a common complaint among aviation professions and can significantly impact their performance and their quality of life. Through a comprehensive literature review, this paper highlights the unique challenges faced by women in military aviation fields and the various factors that contribute to the headache experience. This paper explores the benefits of occupational therapy interventions utilizing the biopsychosocial model and the integrated headache model. The interventions are designed to address the musculoskeletal symptoms to include injury remediation and prevention, pain management techniques, manual therapy modalities and ergonomic assessments. Additionally, interventions address behavioral factors that support development of health promoting habits, roles and routines. Interventions may include but are not limited to the management of headache triggers such as sleep and rest, stress management and strategies which impact quality of life and the headache experience. The findings of this paper underscore the importance of occupational therapy in the holistic approach to managing headaches among women in military aviation and it highlights the need for further research in this area.