Canadian Journal of Occupational Therapy

Published by SAGE Publications
Print ISSN: 0008-4174
Publications
Parent-report measures, such as the Developmental Coordination Disorder Questionnaire'07 (DCDQ'07), are used to identify developmental coordination disorder (DCD) in children. Early identification of this condition is important to mitigate its social-emotional and health consequences. Unfortunately, few French-language assessments are available to therapists working with francophone populations. The aim of this study was to undertake a formal translation of the English DCDQ'07 and begin to examine its psychometric properties. The translation was done using Beaton, Bombardier, and Guillemin's (2000) guidelines for cross-cultural adaptation. Methodologies described by Haccoun (1987) and Vallerand (1989) were used to address the psychometric qualities of the translation. The DCDQ'07 and its French translation (DCDQ-FC) are equivalent, with excellent internal consistency and test-retest reliability. Concurrent and construct validity were adequate for a screening measure; however, low sensitivity was obtained with both measures. The DCDQ-FC is a valid translation for use with a French Canadian population.
 
Internationally, the World Federation of Occupational Therapists has established a minimum of 1,000 hours as the fieldwork standard. To examine student development in fieldwork across placements to determine if students achieve entry-level competence after completion of 1,000 hours of fieldwork. Archival data (N=400) from six occupational therapy programs were analyzed to examine the acquisition of fieldwork competency over time as measured by the Competency Based Fieldwork Evaluation Scale. Competency scores increased with each fieldwork placement, the majority of students achieved entry-level scores upon completion of their final fieldwork placement. While, on average, some competency scores exceeded entry level by 1,000 hours, Practice Knowledge, Clinical Reasoning, and Facilitating Change fell just short. The identification of a plan for addressing the lower ratings in these three competencies should be considered.
 
This historical study focused on understanding the influence of mental health concepts and practices on the profession of occupational therapy in Canada during the first part of the 20th century. The authors examined early editions of the Canadian Journal of Occupational Therapy (CJOT) and other primary works from 1925-1950 to identify key events and themes. Analysis of these key historical documents revealed four themes: (1) Idle hands, emotional mischief, social unrest; (2) The grand vision; (3) Practical reality: Disparity between theory and practice; and (4) Understanding occupation: Approaches and methods to promote mental health. A timeline of key events related to occupational therapy practice and mental health also emerged. Reflecting on the history of a profession can assist its members to understand current practices and future possibilities.
 
Following an introductory summary of role theory, this paper examines one element of professional development -- that of ROLE NEGOTIATION. Research findings as outlined which provide evidence of the need for developing role negotiation skills within the occupational therapy profession in Canada. The paper describes four role strategies which can be used to professional advantage, as therapists negotiate their roles. The final emphasis is on the positive professional implications of effective role negotiations in the 80's.
 
The following report outlines the findings of the CAOT Task Force established in 1980 to undertake a national manpower survey. With the assistance of Statistics Canada a survey was designed and through CAOT, it was distributed in the Fall of 1981. Although a completed methodology and tabulation were sent to the CAOT Executive in March 1982, an analysis was not completed until November 1982. This report is to inform all participants of the findings, implications and future considerations. The objectives, methodology and problems encountered are described. Unfortunately, most of the objectives were not met. The task of developing an effective survey tool and the process of collecting meaningful data was far greater than anticipated. Such a massive project, which entails money and time, requires professional assistance to reduce ambiguities in the survey forms and computerization to correlate the information. Much of the information received could not be used nor correlated; however, the results do give a brief description of the profile of an occupational therapist to build on in the future. In addition, the experience gained will facilitate future survey development and distribution.
 
In honour of the fiftieth anniversary of the first "Convention" held by the Canadian Association of Occupational Therapists (CAOT) in 1931, a brief history of the founding of the CAOT and the early development of the profession in Canada is presented. The early beginnings and activities of the CAOT are traced from its conception during World War 1, through its formation in 1926 to its "coming of age" in 1966. Significant events in the growth of the Association and the practice of occupational therapy in Canada, and the Canadian influence on occupational therapy in Great Britain are outlined. Some issues relevant to yesterday and today are suggested.
 
This paper provides an overview of the evolution of quality assurance within the health care industry, with emphasis on the development of occupational therapy expertise. The current concept of quality assurance, focussed on ongoing monitoring and resolution of patient care problems, is discussed. The results of a national survey are presented, relating to the development of occupational therapy, quality assurance programs in the areas of: expertise in component activities, integration of facility and department programs, use of available resources, and extent of academic teaching. Predicted health care trends and their implications to occupational therapy are presented.
 
This paper addresses the issue of commitment, both to oneself through continuing education and to one's profession through involvement in provincial and national professional organizations. The results of a survey sent to 287 therapists are discussed in relation to a discussion of relevant literature. Results indicate that the respondents are quite involved in both areas with those between the ages of 26 and 40 being most involved in the professional associations. Personal satisfaction was the main reason for this involvement and time was the biggest deterrent to involvement.
 
Individuals in Canada with a disability encounter environmental constraints that limit their active participation in the daily life of our communities. Fundamental inequities in participation and integration continue to exist and there is a need for a concerted effort to eliminate these disabling environments. Several factors, including the built environment, societal production of space, classification of individuals based on norms, the perception of disability as deviance, the power of health disciplines and bureaucracy are examined to determine their contribution to the creation of these disabling environments. Recent modifications to occupational therapy theory and practice, while meaningful, have not fully explored ways in which disabling environments limit occupation. Prevailing ideas about occupation and the environment are examined for their contribution to solving these environmental problems. Principles which can assist occupational therapy intervention directed at changing disabling environments are described. The intent is to define methods of changing disabling environments, based on the desires and active participation of people with disabilities
 
The profession is heading through some treacherous waters and to navigate them the author suggests a return to the sources of occupational therapy practice, and in particular, a shift in attitude towards greater simplicity; listening to clients more sensitively; encouraging their self discovery, values and direction; and a raised consciousness that the subjects of our discipline are human beings who must be considered individually. Dealing with the issue of professional ethics is another suggested shift in attitude as more occupational therapists are confronted with choices. The balance between what is do-able and what is desirable is not always clear, and it is suggested that by fully embracing the two fundamental values of competence and ethics, the profession will ensure that the public confidence necessary to do its work is deserved. The author debates the tension between the particular needs of the client, and the limited technological, financial and human resources that are available, and concludes by challenging us to change some attitudes and to become more open to creative and diverse opinions and experiences.
 
This paper presents the technique of future forecasting through the development of a scenario based on the process of certification. The paper focuses on the demands of consumer groups. influence of world events, actions taken by Government, and developments within medicine, nursing and occupational therapy through the presentation of a scenario which spans the years 1983-2000. No claim is made that the contents of the scenario will become reality. Rather, the technique is presented as another tool that could be used by the profession in the development of future plans and policies.
 
Given the nature of occupational therapy philosophy and practice, it is not surprising that "change agent" has been identified as one of the seven professional roles that occupational therapists fulfill. This Muriel Driver lecture examines the change agent role, what it means, and what knowledge, skills, and personal qualities are necessary to be effective. Overall, relatively little has been written about the change agent role in the occupational therapy literature. Much of what does exist is implicit and often embedded in related topics, such as advocacy. An examination of literature from outside of occupational therapy uncovered four major themes about this role: (a) Change agents are insightful, reflective, and disciplined; (b) Charnge agents are visionary leaders and mobilizers; (c) Change agents are knowledge integrators and translators; and (d) Change agents are diplomatic interventionists who produce meaningful outcomes. These themes point to several areas of silence in the occupational therapy literature. Overcoming these areas of silence and moving forward will require open, challenging, and scholarly debates; reconsideration of change agent role competencies; and clear messaging that we all have the capacity to be competent and effective change agents regardless of our title or setting.
 
The paper begins with a brief look at directions for the future of occupational therapy as expressed in occupational therapy literature over the past six decades. The major contributions in the areas of practice, research and education, professional organization, and theory/knowledge base are highlighted. It then considers current social issues in Canadian society which have a bearing on occupational therapy and implications for its future development: population trends, health status and hospitalization, universal access to health and social services, unemployment, client expectations, multiculturism, medical ethics, family breakdown and child abuse. It looks at the occupational therapy profession in relation to these social issues and concludes with a summary of implications for occupational therapy and predictions for its future into the 21st century based on the analysis of these trends.
 
The Motor-Free Visual Perception Test-3rd edition (MVPT-3) is commonly used to assess the visual perceptual functioning of adults. MVPT-3 users need to be knowledgeable about its factor structure and dimensionality. To investigate the factor structure and dimensionality of the MVPT-3 when used with adults with and without neurological impairment. The MVPT-3 scores of 221 participants aged 20+ years (49 with and 172 without neurological impairment) were used to complete a principal components analysis of the MVPT-3 scale. The MVPT-3 test items loaded upon 11 viable factors, accounting for 58.15% of the test's total variance. The MVPT-3 exhibited multidimensionality instead of the predicted unidimensionality and therefore may not be an appropriate measure of overall visual perceptual ability in its current format. Consequently, healthcare professionals who use the MVPT-3 to assess the visual perception of their clients should exercise caution when attempting to interpret its results.
 
Sensory-processing abilities are known to deteriorate in the elderly. As a result, daily activities such as handwriting may be impaired. Yet, knowledge about sensory-processing involvement in handwriting characteristics among older persons is limited. To examine how age influences sensory-processing abilities and the impact on handwriting as a daily performance. The study participants were 118 healthy, independently functioning adults divided into four age groups: 31-45, 46-60, 61-75 and 76+ years. All participants completed the Adolescent/ Adult Sensory Profile (AASP). Handwriting process was documented using the Computerized Handwriting Penmanship Evaluation Tool (ComPET). Age significantly affects sensory processing and handwriting pressure as well as temporal and spatial measures. Both handwriting time and spatial organization of the written product were predicted by sensory seeking. When examining age contribution to the prediction of handwriting by sensory processing, sensory seeking showed a tendency for predicting handwriting pressure (p = .06), while sensory sensitivity significantly predicted handwriting velocity. Age appears to influence sensory-processing abilities and affect daily performance tasks, such as handwriting, for which sensitivity and seeking for sensations are essential. Awareness of clinicians to sensory-processing deficits among older adults and examining their impact on broader daily activities are essential to improve daily performance and quality of life.
 
In Canada, Aboriginal peoples are affected by colonial relations of power that result in poor health outcomes. Despite occupational therapists' efforts to work in a safe and competent manner with people experiencing challenges to participating in daily life, Western healthcare models reflect values that often undermine Aboriginal peoples' health and well-being. Meaningful, effective, and culturally appropriate healthcare practices cannot be fully implemented by occupational therapists without an ongoing and critical examination of occupational therapy's foundational belief systems. Only a critical examination of these foundational belief systems will enable occupational therapists to take action towards addressing these inequities, which is an important step in moving towards culturally safe care. Canadian health professions, including occupational therapy, have the potential to create positive change at a systems level through the critical exploration of underlying professional assumptions. To advance dialogue about Aboriginal peoples' health, occupational therapists must engage in exploration of their profession's underlying theoretical concepts or risk participating in the perpetuation of health inequities for already at-risk populations.
 
This paper investigates the possible relationship between job satisfaction and academic performance of occupational therapists who have graduated from the University of Western Ontario in the years 1975 to 1978. Fifty-four percent of the graduates of this time period filled out questionnaires eliciting information on their satisfaction with their jobs as occupational therapists and with the profession of occupational therapy. This information was analyzed with the therapists' academic performance of Grade XIII and their four years in the Occupational Therapy Program. The results indicated that although job satisfaction related significantly to three individual academic courses it did not relate to overall performance as measured by grade average.
 
This paper, the second of two companion papers, describes a collaborative research study conducted by academic and fieldwork educators of an undergraduate educational programme in occupational therapy. The study examined the perception of student occupational therapists' ability to integrate and apply academic and theoretical knowledge in fieldwork education sites following the introduction of Integration Tutorials and Seminars to the curriculum. The literature review supports the need to develop educational strategies to improve this integration process. The qualitative research design consisted of guided interviews with preceptors and students during two consecutive fieldwork education experiences. Inductive data analysis revealed three themes that contribute to understanding students' ability to integrate academic learning during their fieldwork education: the fieldwork learning environment; preceptor influence on student learning; and the student learning process over time. The discussion section raises implications for academic and fieldwork education approaches.
 
Occupational therapists regard play as the primary occupation of childhood. However, many authors of play assessments have viewed play either as a functional outcome of other skills or as an indication of the child's developmental level. While such views of play are valid, these approaches to play are broad and do not fully consider the cognitive value of play. A study was undertaken with 82 preschoolers to see if a new play assessment which considers cognitive play skills, called the Child-initiated Pretend Play Assessment, (ChiPPA), possessed acceptable inter-rater reliability, and could discriminate between the play of typically developing preschoolers and preschoolers with pre-academic problems. This assessment evaluates preschoolers' elaborate imaginative actions, number of imitative actions, and number of object substitutions. The ChiPPA was found to have excellent inter-rater reliability and did discriminate between children who were typically developing and children who experienced pre-academic problems. In particular, the elaborateness of a child's play actions and the child's ability to substitute objects were strong discriminators of preschoolers with and without pre-academic problems. Three play profiles which emerged from the research are discussed.
 
In the late 1980's, occupational science was introduced as a basic discipline that would provide a foundation for occupational therapy. As occupational science grows and develops, some question its relationship to occupational therapy and criticize the direction and extent of its growth and development. This study was designed to describe and critically analyze the growth and development of occupational science and characterize how this has shaped its current status and relationship to occupational therapy. Using a mixed methods design, 54 occupational science documents published in the years 1990 and 2000 were critically analyzed to describe changes in the discipline between two points in time. Data describing a range of variables related to authorship, publication source, stated goals for occupational science and type of research were collected. Descriptive statistics, themes and future directions are presented and discussed. Through the support of a discipline that is dedicated to the pursuit of a full understanding of occupation, occupational therapy will help to create a new and complex body of knowledge concerning occupation. However, occupational therapy must continue to make decisions about how knowledge produced within occupational science and other disciplines can be best used in practice.
 
Research shows that sustained employment contributes to a higher quality of life for those with multiple sclerosis (MS). Occupational therapists can work to create therapeutic interventions that assist people with MS with maintaining employment. To detail the problem-focused coping strategies that academics with MS employ to enable them to teach in universities. Semi-structured interviews were conducted with 45 Canadian academics with MS. Thematic analysis was used to generate findings. While there is flexibility in research and service work tasks, teaching tasks are the most seemingly inflexible. This necessitated the development of problem-focused coping strategies to enable teaching. Three categories of strategies were employed: (1) organizational; (2) before/after teaching; and (3) during teaching. This brief report is intended to serve as a resource for occupational therapists and others wanting to gain a better understanding of the types of therapeutic interventions useful to those teaching in universities.
 
The aim of this study was to develop an instrument to measure performance in computer tasks for persons with physical impairments. The objectives were to assure the content validity and the internal consistency of the test as well as the reliability of each task. The first step was to determine the mouse and keyboard actions necessary to use a computer. Resulting from these actions, 15 standardized computer tasks were designed as part of the test. To measure reliability and internal consistency, the test was administered twice to 19 persons without disabilities and 17 persons with disabilities. Reliability was established for most of the tasks and the test showed good internal consistency. This instrument could contribute to the improvement of occupational therapy interventions regarding computer access.
 
Effective use of augmentative communication requires an individual to manage its technical aspects. Motor-skill limitations in cerebral palsy (i.e., individual constraints) can influence this ability as can demands imposed by communication devices (i.e., task constraints). This paper emphasizes the importance of analyzing the confluence of task and individual constraints in promoting a functional fit between the individual with cerebral palsy and the communication device. We demonstrate the utility of current principles of motor control in analyzing this confluence. Task constraints imposed by target selection and individual constraints imposed by cerebral palsy are introduced prior to an analysis of their confluence using the degrees of freedom of the potential planes of limb motion. Occupational therapists should look beyond motor-skill assessment to the confluence of task and individual constraints when customizing target selection in augmentative communication.
 
This study was the last in a series of six investigations of the construct validity of the St. Marys CVA evaluation, a clinician constructed test composed of items designed to evaluate sensory, perceptual, motor, and self care performance in cerebral vascular accident patients. Data for the present study were obtained from 250 new patients referred for occupational therapy services from 1983 to 1988. Factor analysis with varimax orthogonal rotation was performed on 22 items of the evaluation including perception, recovery stages, measures of grasp and pinch strength and other functional variables. Three factors emerged - Right Function, Recovery Stage, and Left Hand Strength. The results of the study, combined with results of previous research, indicate that this CVA Evaluation has reasonable construct validity as an occupational therapy assessment tool in an acute care setting.
 
The purpose of this study was to identify, from the personal perspective of students with disability, their needs for physical and social accommodations in upper secondary schools specially adapted for students with severe physical disabilities. The study also aimed to identify those areas of student-environment fit which were most often achieved. Forty-eight students in four schools in Sweden were assessed by occupational therapists using the School Setting Interview. Forty-seven students reported needs for accommodations in the school setting. The study indicates that schools generally were able to meet the students' accommodation needs in the physical environment. The schools also met students' accommodation needs for field trips, sport activities and assistance. Student-environment fit in occupations requiring reading, remembering and speaking was unsatisfactory. Accommodations on a general, group and individual level are highlighted and discussed. The study recommends that occupational therapists become more involved and offer society their expertise in barrier removal to a greater extent.
 
Professional standards for accountability establish essential competencies for clinical practices and provide strategies for professional advancement. This study examines the perspectives of a sample of occupational therapists on their capacity to engage in continuing education, to provide evidence-based practices and to have confidence in the effectiveness of available quality assurance mechanisms within restructured contexts of occupational therapy practice. The analysis of in-depth interviews with participants from program management, managed competition and private practice suggested three urgent needs: the development of strategies to assist therapists' translation of research evidence into clinical practices, research to determine the effectiveness of models of professional leadership within the workplace that promote professional accountability and alliances to advance policies that eliminate workplace barriers to professional accountability.
 
This article outlines a system of statistics currently used by the Occupational Therapy Department at the Montreal Childrens Hospital. This method was one of the results of a Health Systems Engineering Project conducted in the Occupational Therapy Department by the Montreal Joint Hospital Institute in 1975. The article outlines the problems in maintaining statistics which led to the evolution of the current method. A basic description of the procedure is given, samples of the forms used are included, and 3 sample days are calculated to illustrate the method. However, it is felt that the principles may be useful as a guideline to any type of Occupational Therapy Department. This method adheres to the recording requirements of the Dominion Bureau of Statistics, but also provides a careful breakdown of time and effort in all areas of the department's functioning. Some benefits of maintaining complete, standard statistics are also outlined.
 
Qualitative studies describe environmental influences on participation in adults with chronic disease, but translating these findings into practice can be difficult. This study sought to synthesize qualitative research findings regarding the influence of environmental factors on participation among adults with chronic disease. Searching revealed 31 I articles that describe the link between environment and participation for adults with osteoarthritis, rheumatoid arthritis, diabetes mellitus, heart disease, cancer, chronic obstructive pulmonary disease, and/or depression. Study findings were analyzed using metasynthesis methods to identify themes. For adults with chronic disease, renegotiating their environments and occupations to achieve, maintain, or rework their participation involves understanding support processes, being ordinary and able, navigating systems, and navigating physical environments. Key areas that occupational therapy interventions can target are facilitating constructive collaboration between client and support person, fostering connections with others, recognizing cultural pressure to be ordinary and able, and advocating for supportive policy and practice.
 
Limited self-awareness of disabilities can compromise individuals' occupational performance. The Assessment of Awareness of Disability (AAD) provides occupational therapists with a standardized methodology for measuring clients'self-awareness when performing activities of daily living (ADL). This is the first study that formally examines the stability of the AAD measures. The AAD was administered twice to 15 participants with acquired brain injury (ABI) within one or two days. One participant's data were excluded because significant changes in his ADL process abilities were detected. Two criteria were used to examine the stability of the remaining 14 participants' AAD measures: standardized difference Z-scores and a difference of 0.65 logits. All 14 participants' AAD measures were stable on the basis of theirZ-scores; 13 participants' measures were stable based on the 0.65 logit difference. Occupational therapists can have confidence that the AAD generates stable measures when administered to adults with ABI.
 
Top-cited authors
Mary Law
  • McMaster University
Helene J Polatajko
  • University of Toronto
Sue Baptiste
  • McMaster University
Lori J Letts
  • McMaster University
Susan Strong
  • St. Joseph's Healthcare Hamilton