Study's the involvement of occupational therapy and the use of graded, purposeful activities in remediating the symptoms of vestibular disorders.

I utilized this website frequently while completing my rotation in peds. It provides a ton of useful information as well as creative activity/treatment ideas to do with kids!

Interesting study describing the use of Kinesio Taping method for the upper extremity in enhancing functional motor skills in children admitted into an acute rehabilitation program. For inpatient participants, this was the initial rehabilitation following an acquired disability, which included encephalitis, brain tumor, cerebral vascular accident, traumatic brain injury, and spinal cord injury.

I found this website to be helpful in assessing and identifying the important lab values and vital signs when completing chart reviews on patients. It also explains the normal ranges of lab values, as well as when its appropriate to hold patients for abnormal results, for increased safety and modification of evaluations/treatments.

The objective of the study was to assess efficacy of combining daily interruption of sedation with physical and occupational therapy on functional outcomes in patients receiving mechanical ventilation in intensive care. The study was conducted at two university hospitals on patients receiving sedation and mechanical ventilation. A strategy for whole-body rehabilitation consisting of interruption of sedation and physical and occupational therapy in the earliest days of critical illness was safe and well tolerated, and resulted in better functional outcomes at hospital discharge, a shorter duration of delirium, and more ventilator-free days compared with standard care.

I think its important to understand the role occupational therapists can play regarding oncology patients. Recently, I had the experience of working on the oncology floor during my level II fieldwork, in which I found cancer treatments to be both aggressive and debilitating to patients. OTs can provide approaches that enable individuals to complete everyday living skills, regardless of physical or pathological symptoms, and life expectancy. Occupational therapy services can be extremely beneficial and vital for patient's once treatment is completed in order to transition back to their daily activities, as well as while receiving care.

There are increasing demands placed on occupational therapists to ensure their practice is based on sound evidence. This article described and explains the process of evidence-based practice and its application to clinical occupational therapy practice. The benefits of an evidence-based practice approach lie in improvements to patient care, integration of research and practice, and informed decision-making with respect to patient care, management and policy. While this paper has provided some directions for evidence-based practice in clinical settings, in reality, all those who are involved in health care whether clinicians, educators, managers, providers, purchasers or policy-makers need to consider the integration of best evidence into their decision making. Understanding the principles involved and incorporating these into practice is of relevance to all occupational therapists as health care moves to become more evidence-based.

Often, children who are rejected by their peers are disruptive and socially aggressive. Compared with classmates who are accepted or neglected, they are more likely to experience continued social problems, poor school adjustment, loneliness, and poor adult mental health. Social-skill training typically focuses on reinforcing positive behaviors. Its effectiveness with rejected children has not yet been established. Such training might prove more successful with rejected children if it also targeted the children's negative behaviors. For therapists and other providers, the findings suggest that social-skill training using instructions, prohibitions, or a combination of the two can improve the social behavior of boys who are rejected by their peers. Only the combination, however, may improve the boy's acceptance by peers.

Supervision is descried as a process to ensure accountability in the workplace and also to facilitated clinicians to reflect upon their practice. The central themes of effective supervision, as highlighted in the literature, are presented. The benefits and potential difficulties are described, with an emphasis on the need to understand the aims of supervision. The article suggests that supervision should be supportive but challenging in order to be effective. The essential components of quality supervision are presented; for example, written supervision contracts, training in supervision, reviews and feedback for both supervisor and supervisee. A brief overview of a supervision package is provided as one way to implement supervision for occupational therapists. The package offers a practical guide to the process of supervision, with an emphasis on a supportive and enabling approach. Occupational therapists need to debate the merits and pitfalls of supervision to ensure that the supervision offered is effective and of a high quality.

There is limited research into the values of OT profession, and as such, the values have not been made explicit. Explicit values provide insight into what professionalism means to a profession. They can be used by practitioners for self-reflection purposes, and shaping the future of practice of individuals. Clear values can also enable the recognition and management of value conflicts between health professions. The study identified three main professional values: the client and the client-therapist partnership; occupational therapy knowledge, skills and practice; and selfless values. The emerging values guided everyday practice, professional relationships and the responsibilities of being professional.

Narrative reasoning is a central mode of clinical reasoning in OT. Therapists reason narratively when they are concerned with disability as an illness experience, that is, with how a physiological condition is affecting a person's life. The first is the use of narrative as a mode of speech that can be contrasted with biomedical discourse, in which disability is framed as physical pathology. The second involves the creation rather than the telling of stories. Therapists try therapeutic encounters with patients, that is, to help create a therapeutic story that becomes a meaningful short story in the larger life story of the patient. It became clear in the course of the American Occupational Therapy Association/American Occupational Therapy Foundation Clinical Reasoning Study that therapists not only listen to the stories that their patients tell them, but also tell stories about their patients. Furthermore, an important part of this storytelling involves the therapist's understanding of the patient's way of dealing with disability and with puzzling about how to approach a problematic patient. Narrative thinking is central in providing therapists with a way to consider disability in the phenomenological terms of injured lives.

This paper presents findings from an ethnographic study of family members who were caring for frail older people in the community. Themes of ethical dilemmas, are discussed and their relationship to the practice of occupational therapy are explored. The principle of beneficence, that is, do good and do no harm, appeared to be the most overriding and powerful ethical principle of family caregiving. Perceptions of what might constitute harm were sometimes based on inaccurate or incomplete information and fears regarding lack of expertise. At times, a therapist's method or view can interfere significantly with the caregiver's ability to get things done. One of the striking differences between therapists' and caregivers perspective is that OTs place a high value on independent and autonomy. It is important for therapists who work with family members to examine the ethical dilemmas of the caregiving experience and for the professional and caregiver to work together toward shared ethical decision making.

Olson, L., & Moulton, H. (2004). Use Of Weighted Vests In Pediatric Occupational Therapy Practice. Physical & Occupational Therapy in Pediatrics, 24(3), 45-60.

The aim of this study was to investigate pediatric occupational therapists' general experience and practice with weighted vests and their impressions about whether weighted vests are effective in changing specific behaviors of children with whom they have used weighted vests. A survey was mailed to a random sample of 514 pediatric occupational therapists who belonged to the School-Based Systems Special Interest Section or the Sensory Integration Special Interest Section of the American Occupational Therapy Association. The response rate was 68%. The survey included 43 items which covered therapist opinions, procedures, behavioral observations and knowledge about weighted vests, in addition to demographic information. Respondents who use weighted vests were more likely to have advanced degrees or certifications and more years of experience as pediatric therapists. They reported using weighted vests with preschool and young elementary school-aged children with the diagnoses of autism or attention deficit disorder. Staying on task, staying in seat and attention span were the most common behaviors that therapists reported improving when weighted vests were used.

King, G., Tucker, M., Baldwin, P., Lowry, K., Laporta, J., & Martens, L. (2002). A Life Needs Model of Pediatric Service Delivery. Phys Occup Ther Pediatr Physical & Occupational Therapy in Pediatrics, 22(2), 53-77.

This article presents a life needs model of pediatric service delivery that is based on the values of the intrinsic worth, dignity, and strengths of individuals. This developmental, socio-ecological model outlines the major types of service delivery needs of children and youth with disabilities, their families, and their communities within three spheres of life (the personal, interpersonal, and external spheres). The model legitimizes the concept of need, emphasizes the values of family-centered services, and recognizes child and family strengths and capacities. We discuss the utility of this transdisciplinary model in guiding pediatric service delivery to meet the long-range goals of community participation and quality of life of children and youth with disabilities.

Hummell, J. (2010). Effective fieldwork supervision: Occupational therapy student perspectives. Australian Occupational Therapy Journal, 44(4), 147-157.

The study explored occupational therapy student perspectives of the characteristics of effective fieldwork supervisors and the limitations on effective fieldwork supervision. The study also investigated the differences in perceptions between students in each of the 4 years of the undergraduate course. Forty-eight students completed an open-ended questionnaire. The two major characteristics of effective fieldwork supervisors identified by the students were well-developed interpersonal skills and the use of collaborative and facilitatory teaching/learning strategies. The major environmental issue limiting the effectiveness of fieldwork supervisors was lack of time for student supervision. Although students in all years of the occupational therapy course expressed similar viewpoint, variations were identified across the years, particularly with teaching/learning strategies used.

Case-Smith, J., Frolek Clark, G. J., & Schlabach, T. L. (2013). Systematic review of interventions used in occupational therapy to promote motor performance for children ages birth-5 years. American Journal of Occupational Therapy, 67, 413-424. http://dx.doi.org/10.5014/ajot.2013.005959

The article examined the research evidence for interventions used in occupational therapy to promote the motor performance of young children ages 0-5 years old. The study suggests that although the developmental frame of reference is an essential foundation for all practice with children, interventions that are built solely on developmental theory have minimal effects on motor outcomes. Efficacious interventions apply theory-grounded, research-based learning, and behavioral techniques. In summary, motor interventions that resulted in significant changes in children's motor performance incorporated use of meaningful play activities, family, functional goals, and social elements. Successful interventions were based on dynamic systems therapy and motor learning theory, reinforcing the importance of building intervention principles and strategies on research-based theories. Using behavioral (e.g., shaping, reinforcement, fading) and learning (e.g., cueing, motivating, scaffolding, presenting a just-right challenge) principles to undergird intervention strategies appears to be more potent than intervention guided solely by developmental and neurodevelopmental theories. Of the intervention approaches used in occupational therapy, those that embed behavioral and learning principles appear to show positive effects.

Hanna, K., & Rodger, S. (2002). Towards family-centred practice in paediatric occupational therapy: A review of the literature on parent-therapist collaboration. Australian Occupational Therapy Journal, 49, 14-24.

The study reviewed the important of parent involvement in interventions with children. Currently, trends in pediatric service delivery have been towards family-centered care, with a central component of this approach being parent-therapist collaborating in planning and evaluating intervention. The paper provides issues and suggestions for clinical practice, including parent diversity and unique perspectives, development of effective parent-therapist relationships, and establishment and development of goals and priorities of care. Overall, it is critical for occupational therapist to develop these effective skills in building a collaborative partnership with parents, particularly in pediatric settings as it moves toward a more family-centered approach. In general, therapists may need to 'step down from the pedestal of professionalism to learn and share the perspectives and expertise the parents bring to the collaborative process. Often times, parents are expected to contribute opinions and ideas in the professional's environment, where they may not feel comfortable or confident to honestly share. Therefore, OT's may need to utilize a client's home or alternative environment that provides valuable opportunities for assessment and intervention, as well as offers the chance to collaborate with parents where they are likely to feel more comfortable.

Shafaroodi N, Kamali M, Parvizy S, Hassani Mehraban A, O'Toole G. Factors affecting clinical reasoning of occupational therapists: a qualitative study. Med J Islam Repub Iran 2014 (19 Feb). Vol. 28:8.

The article aimed to explore the factors influencing the clinical reasoning of occupational therapists. Researches gathered data from interviews of twelve occupational therapy practitioners working in mental and physical dysfunction fields. Three main themes emerged from the study: 1) sociocultural conditions including client beliefs, therapist values and beliefs, and social attitude to disability; 2) individual (client) and therapist attribution; and 3) workplace environment including: knowledge of the managers of rehabilitation services, working in an inter-professional team, and limited clinical facilities and resources. Overall, the study determined that the influence of attitudes and beliefs on a client, therapist and society about illness, abilities and disabilities upon reasoning were different than previous studies. However, by understanding these factors, they can play a significant role in the quality of occupational therapy care.