Development of a psychological health promotion intervention for ultra-orthodox Jewish mothers of children with ADHD using the intervention mapping protocol.

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is a common neuro-developmental health condition in children and adolescents, in which its associated behavior manifestations are known to negatively affect members of the family unit, especially mothers. Ultra-orthodox Jewish (UOJ) community is growing globally and mothers of children with ADHD in this community are potentially at risk for negative health outcomes. As the UOJ community is culturally conservative, maintaining a distinct separation from outside influences, they often avoid utilizing public mental health services due to stigma and a lack of culturally sensitive treatments. Thus, this study aimed to develop a theory-driven and culturally appropriate psychological health promotion intervention for these mothers using the Intervention Mapping protocol. METHODS: A mixed-method design was used. Qualitative content analysis was performed on four focus groups (n=25). Additionally, descriptive statistics including the content validity index was used to measure feedback regarding the developed intervention protocol's relevance, effectiveness, and appropriateness Theoretical models for behavior change, including the Behavior Change Wheel's COM-B system and the Theoretical Domains Framework, and literature on ADHD in the general population and the ultra-orthodox community were integrated in the process. Intervention components were systematically derived from findings. RESULTS: Key determinants of health behavior change were identified, resulting in formulating intervention objectives addressing stigma reduction surrounding ADHD, increasing knowledge about the ADHD condition and treatment, awareness of the school systems' capabilities in meeting the ADHD child's needs, enhancing mothers' advocacy skills, and maternal self-care. Intervention? strategies included a group setting, providing information on health consequences, social support, re-attribution, active learning, goal setting, and promoting an identity associated with the desired behavior change. Mothers' quantitative feedback confirmed the overall relevance, effectiveness, and appropriateness of the interventions' content (CVIavg= .86, .85, .87). CONCLUSIONS: Intervention Mapping facilitated the development of a culturally sensitive psychological health promotion intervention for ultra-orthodox Jewish mothers of children with ADHD. Further research is warranted to assess intervention feasibility and effectiveness.

Coping with emotional dysregulation among young adults with ADHD: A mixed-method study of self-awareness and strategies in daily life.

BACKGROUND: Emotional dysregulation (ED) impacts functional outcomes among individuals with attention-deficit hyperactivity disorder (ADHD). Self-awareness and strategies may enhance coping with ED yet are rarely studied in ADHD. OBJECTIVES: To explore ED-related self-awareness and strategies in daily life of adults with ADHD, and to examine the interrelations between them and their association with symptoms. METHODS: Sixty young adults with ADHD participated in a mixed-method study. At baseline, self-awareness and strategies were assessed using the Self-Regulation Skills Interview (SRSI); ADHD symptoms were self-rated using the ASRS symptom checklist. Then, symptoms were rated over 5-days using ecological momentary assessment (EMA). RESULTS: Significant challenges in self-awareness and strategies were demonstrated quantitatively and qualitatively. Awareness of ED was associated with variability of ADHD symptoms on EMA yet not with symptom severity. Qualitative content analysis revealed a range of self-awareness levels, which were related to noticing ED-related cues and understanding contextual factors predictive of ED. Self-awareness and strategies were significantly associated. Strategies varied regarding effort, individual preference and temporality. CONCLUSIONS: Variability of ADHD symptoms was negatively associated with self-awareness of ED. Strategy selection in daily-life among adults with ADHD may be affected by self-awareness and by a possible trade-off between short-term effort and long-term effectiveness.

Psychological Health and Quality of Life among Ultra-orthodox Mothers of Children with Attention Deficit Hyperactivity Disorder: Impact of Occupational Experiences.

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is a common neuro-developmental health condition in children and adolescents. Parenting a child with ADHD can profoundly affect mothers' health. Research is limited regarding occupational experiences and their impact on health among mothers of children with ADHD (MoCwADHD). Ultra-orthodox MoCwADHD may have unique cultural circumstances that have not been studied. AIMS: To broaden understanding of parental stress, psychological health, and quality of life (QoL) of ultra-orthodox MoCwADHD and explore a possible role of occupational experiences on these outcomes. METHODS: Ultra-orthodox MoCwADHD (N = 114) completed a sociodemographic questionnaire and measurements to assess child ADHD symptomatology, mother's ADHD, parental stress, psychological health, QoL, and occupational experiences. RESULTS: Participants displayed moderate parental stress, and 54.9 percent also showed psychological distress symptoms, similar to the literature on MoCwADHD in the general population. Frequency of engagement in health promoting occupations reflected patterns in line with cultural beliefs. Structure Equation Modeling showed that child ADHD negatively affected mothers' stress, psychological health and QoL. Importantly, occupational experiences directly and indirectly, via parental stress, impacted psychological health and QoL. CONCLUSIONS: MoCwADHD impacts maternal health in the ultra-orthodox population and occupational experiences may be a modifiable target for promoting their health.

A qualitative study on parents of autistic adolescents' experience of OT-ParentShip: A family-centred intervention.

BACKGROUND: OT-ParentShip intervention addresses the needs of autistic adolescents and the physical and emotional burden associated with parental caregiving. AIM: This article describes the qualitative findings of a mixed-method, single-group, pre-test-post-test pilot study to determine whether this intervention has adequate potential for further, large-scale testing. METHOD: The qualitative study sought to understand 14 parents' (N = 4 couples, N = 6 mothers) experiences in the intervention, examine their satisfaction, and receive their suggestions for improvement, using a grounded approach, with the aim of conceptualising a theoretical understanding of the data gathered. RESULTS: A total of five key themes and 14 sub-themes describe parents' experiences. The key themes that were identified were parent-therapist relationship, parent-adolescent relationship, reframing, benefit for family, and parental resilience. Emerging themes shed light on the therapeutic components and change mechanisms of the intervention. CONCLUSION: Self-determination theory was found to be an adequate theoretical framework to map these components and help in understanding their contribution to treatment outcomes. OT-Parentship directly enforces parents' basic psychological needs, who, in turn, support their adolescent child's need for relatedness, competence, and autonomy. An occupational therapy intervention that satisfies these basic needs has the potential to lead to therapeutic alliance and internalisation of goals, thus increasing therapy engagement and outcomes.

Food Perceptions in Adults with and without ADHD.

INTRODUCTION: Adults with attention-deficit/hyperactivity disorder (ADHD) have unhealthy eating habits, associated with overweight/obesity. We explored whether they present with different food-related benefit/risk perceptions, compared to those without ADHD. METHODS: One hundred five university students with (n = 36) and without (n = 69) ADHD, aged 22-30, participated in the study. They rated the level of frequency and likelihood of food consumption, as well as the perceived attractiveness, convenience, and risk of 32 healthy and unhealthy food items. RESULTS: The findings revealed significantly lower healthy/unhealthy food frequency consumption ratios for the ADHD group compared with the non-ADHD one but no differences in the ratios of estimated likelihood of food consumption and perceptions (attractiveness, convenience, and risk). CONCLUSION: The results of this study demonstrated a discrepancy between the eating behavior (more unhealthy eating patterns in adults with ADHD compared with controls) and their food-related perceptions (same perceptions regarding the benefit and risk of foods in both groups).

Psychological Factors Predicting Functional Ability and Participation After Hip Fracture.

IMPORTANCE: Positive psychological factors have been related to better outcomes among adults with various health conditions. OBJECTIVE: To predict functional ability and participation in older adults who had experienced a hip fracture on the basis of data at admission to acute (inpatient) rehabilitation. We measured physical factors, as well as positive and negative psychological factors, at three time points. DESIGN: Prospective and cross-sectional cohort study. Data collection occurred during admission, at discharge, and 6 mo after rehabilitation. SETTING: Inpatient geriatric rehabilitation center and follow-up at home. PARTICIPANTS: Seventy-one older adults (M age = 78.58 yr, SD = 6.09) who had sustained a hip fracture because of a fall and who attended acute rehabilitation; 55 completed follow-up assessments 6 mo after discharge from rehabilitation. MEASURES: Participants completed the Adult Hope Scale, Life Orientation Test, Positive Affect Questionnaire, Geriatric Depression Scale (at admission only), hand-grip strength measures, Numeric Pain Rating Scale, and FIM® Motor domain (mFIM) before and after acute rehabilitation and after 6 mo. The Activity Card Sort (ACS) was administered only at follow-up. Outcome measures were the mFIM and ACS. RESULTS: At 6-mo follow-up, functional ability was correlated more with optimism than with age, gender, or hand-grip strength measured at admission. Participation was predicted by age, the hope-agency component, and pain in walking at admission; however, the hope-agency component was only marginally significant. At discharge, functional ability was strongly predicted by age, hand-grip strength, and mFIM scores at admission. CONCLUSIONS AND RELEVANCE: Optimism and hope played a role in explaining rehabilitation outcomes at 6-mo follow-up. Occupational therapy evaluation should address positive psychological factors, and intervention should aim to strengthen these factors as powerful aids in older adults' recovery from hip fractures. What This Article Adds: This study reflects the philosophy of occupational therapy, which places great emphasis on the connection between clients' mind-body-spirit and their participation in daily life occupations.

Pilot Study of the Cognitive-Functional Intervention for Adults (Cog-Fun A): A Metacognitive-Functional Tool for Adults With Attention Deficit Hyperactivity Disorder.

IMPORTANCE: Adults with attention deficit hyperactivity disorder (ADHD) often experience chronic challenges in their life roles. There is a need for evidence-based occupational therapy interventions to help enhance their functioning. OBJECTIVE: To determine the preliminary effectiveness of the Cognitive-Functional Intervention for Adults (Cog-Fun A), a metacognitive-functional occupational therapy tool for the improvement of occupational performance (OP) and quality of life (QoL) in adults with ADHD. DESIGN: One-group pretest-posttest design with a 3-mo follow-up. SETTING: Community setting in Jerusalem, Israel. PARTICIPANTS: Fourteen adults, ages 18-60 yr, with a valid diagnosis of ADHD and an indication of executive function (EF) impairment. INTERVENTION: Participants received 15 1-hr weekly sessions that addressed self-awareness of strengths and challenges through education and guided discovery as well as strategy acquisition and implementation within a context of occupational goal attainment. OUTCOMES AND MEASURES: The Behavioral Rating Inventory of Executive Function-Adult version, an adult ADHD QoL measure, the Canadian Occupational Performance Measure, and the Self-Regulation Skills Interview were administered. RESULTS: Twelve participants completed the intervention. Posttreatment scores revealed statistically significant improvements in EF, awareness, OP, and QoL. Gains in QoL showed a modest reduction at the 3-mo follow-up. CONCLUSIONS AND RELEVANCE: The Cog-Fun A is a promising intervention for improving OP and QoL among adults with ADHD and should be investigated further. What This Article Adds: The Cog-Fun A offers an effective nonpharmacological, metacognitive-functional, occupation-centered treatment option for adults with ADHD.

Weekly Calendar Planning Activity (WCPA): Validating a Measure of Functional Cognition for Adolescents With Attention Deficit Hyperactivity Disorder.

IMPORTANCE: Adolescents with attention deficit hyperactivity disorder (ADHD) often experience difficulties with executive function and participation in life roles. Ecologically valid performance-based tests (PBTs) are needed to assess functional cognition in this population. OBJECTIVE: To examine the known-groups, concurrent, and ecological validity of a functional cognition PBT, the Hebrew version of the Weekly Calendar Planning Activity (WCPA) Middle/High School Version, among adolescents with and without ADHD. DESIGN: Cross-sectional between-groups design. SETTING: Community. PARTICIPANTS: One hundred two adolescents (ages 12-18 yr), with (n = 52) and without (n = 50) ADHD. OUTCOMES AND MEASURES: The Hebrew version of the WCPA Middle/High School Version, MOXO™-Continuous Performance Test (MOXO-CPT), Behavior Rating Inventory of Executive Function (BRIEF) parent form, and Child and Adolescent Scale of Participation (CASP). RESULTS: The results showed significant between-groups differences with medium to large effect sizes for scores on most WCPA measures, with the ADHD group receiving significantly lower scores. Significant correlations in the expected direction were found between scores on the MOXO-CPT Attention and Hyperactivity indices and WCPA measures. Significant correlations were also found between most WCPA measures and the BRIEF Global Executive Composite (GEC) and the CASP. Multiple linear regression on the CASP indicated that the WCPA strategy score and the BRIEF GEC were significant predictors in the model. CONCLUSIONS AND RELEVANCE: Results support the known-groups validity of the WCPA Middle/High School Version between adolescents with and without ADHD. Concurrent and ecological validity were supported by significant associations with measures of cognition and participation. What This Article Adds: These results reinforce the premise that the WCPA Middle/High School Version can be implemented as a valid measure of functional cognition among adolescents with ADHD.

Emotional dysregulation and health related quality of life in young adults with ADHD: a cross sectional study.

OBJECTIVE: Attention Deficit Hyperactivity Disorder (ADHD) is associated with emotional dysregulation (ED) and impaired health related quality of life (HRQoL). However, the role of ED in explaining the relationship between ADHD and HRQoL is unclear. The purpose of the present study was to do so in a sample of non-referred young adults with and without ADHD. METHOD: The study design was cross-sectional. A non-clinical sample of 63 young adults with ADHD (mean age = 24.86 years, SD = 3.25, 78% university students) and 69 gender-matched controls (mean age = 23.84 years, SD = 2.59, 89% university students) were recruited. The Adult ADHD Quality-of-Life scale was used to measure HRQoL; The Self-Report Wender-Reimherr Adult Attention Deficit Disorder Scale and the Difficulties in Emotion Regulation Scale were used to measure ED. Group differences on all measures were tested using univariate and multivariate analyses of covariance, while controlling for age. Finally, a moderation analysis was used in order to examine the impact of ED on HRQoL beyond that accounted for by ADHD symptoms. RESULTS: Both HRQoL and ED were significantly worse for the ADHD group compared to the control group. The medication status of the ADHD group participants had no significant effect on the level of ADHD symptoms, ED or HRQoL. ED moderated the effect of ADHD symptoms on HRQoL for the ADHD group. CONCLUSION: The findings support the centrality of ED in ADHD and its crucial influence on HRQoL. Young adults with ADHD and high levels of ED are at risk for aversive impact on their well-being regardless of their ADHD symptoms level.

Young adults with Attention Deficit Hyperactivity Disorder (ADHD) struggle with poor quality of life (QoL). Emotional regulation is one's ability to modify their emotional state to promote adaptive, goal-oriented behaviors. Emotional dysregulation is a common yet neglected feature of people with ADHD. Our results show that young adults with ADHD are twice more likely to suffer from emotional dysregulation then their peers. Moreover, higher levels of emotional dysregulation predicted lower levels of QoL. These findings support the centrality of ED in ADHD and their crucial influence on everyday QoL. These findings are important not only on the theoretical level, but may also contribute to the design of interventions that aim to promote quality of life.

Disability Orientation of Occupational Therapy Practitioners in Physical Rehabilitation Settings: Tension Between Medical and Social Models in Theory and Practice.

IMPORTANCE: To date, little is known about the extent to which occupational therapy practitioners have adopted the core insights of disability studies. OBJECTIVE: To examine the degree to which occupational therapy practitioners endorse the medical model of disability versus the social model of disability in theory and in practice. DESIGN: Cross-sectional study. SETTING: Physical rehabilitation facilities, ranging from hospital to community settings. PARTICIPANTS: One hundred two Israeli occupational therapy practitioners. Outcomes and Measures: The Orientation toward Disability Scale, constructed for this study, has two dimensions that distinguish between the medical and social models of disability: locus of intervention (the person or environment) and client involvement (extent to which the practitioner fosters the client's autonomy in the rehabilitation process). Each dimension addresses both theoretical and practical endorsements. RESULTS: Greater support for the social model of disability was mostly evident in the client involvement dimension, whereas support for the medical model of disability was mostly evident in the locus of intervention dimension. Over both dimensions, the medical model of disability was significantly more endorsed in practice than in theory. Work setting and prior exposure to the social model of disability were found to affect practitioners' disability orientation. CONCLUSIONS AND RELEVANCE: Occupational therapy practitioners working in physical rehabilitation are still relatively far from fully adopting the critical insights of the social model of disability. This finding is especially relevant when their actual practice, rather than their theoretical views, is considered and when rehabilitation takes place in out-of-home settings. What This Article Adds: This study offers unique insight into the disability orientation of occupational therapy practitioners, showing a need for more training programs to expose students to the social model of disability. These programs should use critical discussions of the challenges that this model presents to the profession and barriers to implementing it in practice.

The influence of attractiveness and convenience cues on food appeal in adults with and without ADHD.

OBJECTIVE: Previous research on adults with ADHD revealed high rates of overweight and obesity, as well as unhealthy diet habits. Other studies demonstrated that social-affective contexts can influence food choice. This study examines the sensitivity of adults with ADHD to cues of food attractiveness and convenience, for healthy and unhealthy foods. METHOD: One hundred and seventy-two university students with (n = 59) and without (n = 113) ADHD, aged 19-40, participated in the study. Participants rated the level of appeal of 32 pictures of healthy and unhealthy foods, which varied in the degree of attractiveness and convenience. RESULTS: The findings reveal a higher level of appeal of attractive food items compared to non-attractive ones (p < .001), as well as of convenient compared to non-convenient food items (p = .005). Type of diagnostic group did not have an effect on the level of appeal. CONCLUSION: Increasing the attractiveness and convenience of food items increased the level of appeal for both students with and without ADHD. These findings emphasize the importance of environmental health intervention to potentially reduce abnormal eating pattern in the ADHD adult population, which may contribute in preventing the reported higher risk of obesity in this population.

Feasibility Study of a Therapeutic Mobility Summer Camp for Children with Severe Cerebral Palsy: Power Fun.

Aim: Powered mobility has positive effects on development of children with limited independent locomotion, but many are deprived of this opportunity due to their limitations. This study aimed to evaluate the feasibility of Power Fun, a therapeutic summer camp, for students with severe cerebral palsy (CP).Methods: Five students with CP, ages 11-15, received personally adapted powered wheelchairs and participated daily in the camp. The camp ran five days a week during three weeks and included two mobility sessions daily. Assessments were conducted three weeks prior to the camp (T1), at baseline (T2), post-intervention (T3) and six weeks follow-up (T4). Measures used were Power Mobility Program (PMP), Assessment of Learning Power mobility use (ALP), Wheelchair Outcome Measure for Young People (WhOM-YP), Goal Attainment Scaling (GAS) and Dimensions of Mastery Questionnaire (DMQ).Results: All participants finished the camp. Outcome measures showed no change between T1-T2 but improved significantly (p<.05) after the intervention (T2-T3), and gains were maintained at T4 (Wilcoxon signed-rank test). Goals improved to slightly above the expected outcome (GAS average 0.11).Conclusions: Power Fun shows good feasibility and significant improvement in mobility skills and goals of children with severe CP. Further studies are warranted.

Content Validity of the Parentship Protocol: A Multidimensional Intervention for Parents of Adolescents with High-Functioning Autism Spectrum Disorder.

The Parentship protocol is a short-term intervention program in occupational therapy for parents of adolescents with High-Functioning Autism Spectrum Disorder (HFASD). Its purpose is to promote parental resilience and enhance adolescents' participation in daily life. Aims: To explore and analyze the perceptions of occupational therapists and parents of individuals with HFASD, regarding the content of the protocol and its theoretical framework. Methods: Implementation of a phenomenological qualitative approach using two focus groups (six occupational therapists and five parents). A transcript-based analysis was used for analyzing the data. Results: The degree of agreement regarding the potential purposes and contents of the protocol was high. In addition, nine themes were raised and led to changes and additions in the protocol. Conclusions: The study provided support for content validity and acceptability of the Parentship protocol. Future research should test the feasibility of this new intervention program.

Dysfunctional Eating Patterns of Adults With Attention Deficit Hyperactivity Disorder.

This study aimed to examine whether adult attention deficit hyperactivity disorder (ADHD) in students is associated with overeating or with unhealthy food choices. Sixty university students with and without ADHD, aged 20 to 30 years, completed the Food Frequency Questionnaire and reported their height and weight. Students with ADHD had a higher body mass index compared with students without ADHD. Although participants in both groups consumed similar amounts of servings, calories, and nutrients, students with ADHD reported lower healthy/unhealthy food consumption ratio. These findings suggest that ADHD in students is not associated with general overeating, but with a biased proportion of unhealthy versus healthy food consumption.

Comparison of Children With and Without ADHD on a New Pictorial Self-Assessment of Executive Functions.

OBJECTIVE: We examined the Pictorial Interview of Children's Metacognition and Executive Functions' (PIC-ME's) reliability and validity, targeting children's appraisal of their executive function (EF) in daily life. METHOD: One hundred children with attention deficit hyperactivity disorder (ADHD) and 44 typically developing children (ages 5-10 yr) completed the PIC-ME. Parents completed the PIC-ME and Behavior Rating Inventory of Executive Function (BRIEF). RESULTS: Cronbach's α for the child PIC-ME was .914. A high correlation was found between the parent PIC-ME total and the BRIEF (r = .724). Comparisons between groups revealed significant differences on the parent PIC-ME (p < .0001) but none on the child PIC-ME. Children with ADHD identified a median of eight EF challenges they wanted to set as treatment goals. CONCLUSION: Results support the PIC-ME's initial reliability and validity among children with ADHD. Children were able to identify several EF challenges and engage in goal setting.

Here's How I Write-Hebrew: Psychometric Properties and Handwriting Self-Awareness Among Schoolchildren With and Without Dysgraphia.

OBJECTIVE: This study investigated the psychometric properties of the Here's How I Write-Hebrew (HHIW-HE) and compared handwriting self-awareness between children with and without dysgraphia. METHOD: Fifty-eight children (29 with and 29 without dysgraphia) completed the HHIW-HE. Occupational therapists provided corresponding ratings that were based on objective handwriting assessments. Self-awareness was measured through child-therapist consensus. RESULTS: The HHIW-HE has an internal consistency of α = .884. Children with dysgraphia rated themselves as significantly more impaired than controls on 6 of 24 HHIW-HE items and on the total score, with medium to large effect sizes (0.37-0.61). Mean child-therapist agreement was significantly higher for the controls than for the research group, t(56) = 4.268, p = .000. CONCLUSION: Results support the HHIW-HE's validity. Children with dysgraphia reported more handwriting difficulties than did controls; however, they tended to overestimate their handwriting abilities.

Cognitive-Functional (Cog-Fun) Dyadic Intervention for Children with ADHD and Their Parents: Impact on Parenting Self-Efficacy.

AIM: The family context of children with ADHD plays a role in intervention outcomes, especially when parents are involved in treatment. Parental participation in evidence-based treatment for ADHD may play a role in improving their own parenting self-efficacy (PSE) as well as child outcomes. This study examined the impact of Cognitive-Functional (Cog-Fun) intervention in occupational therapy (OT) for school-aged children with ADHD, on PSE. METHODS: In this randomized controlled trial with crossover design, 107 children were allocated to intervention and waitlist control groups. Intervention participants (n = 50) received Cog-Fun after baseline assessment and waitlist controls (n = 49) received treatment 3 months later. Intervention participants received 3-month follow-up assessment. Treatment included 10 parent-child Cog-Fun weekly sessions. PSE was assessed with the Tool to measure Parenting Self-Efficacy (TOPSE). RESULTS: All children who began treatment completed it. Mixed ANOVA revealed significant Time x Group interaction effects on TOPSE scales of Play and Enjoyment, Control, Self-Acceptance, Knowledge and Learning and Total score, which showed significant improvement with moderate treatment effects for the intervention group. Results were replicated in the control group after crossover. CONCLUSION: The findings of this study suggest that Cog-Fun OT intervention may be effective for improving aspects of PSE among parents of children with ADHD.

Impact of the Cognitive-Functional (Cog-Fun) Intervention on Executive Functions and Participation Among Children With Attention Deficit Hyperactivity Disorder: A Randomized Controlled Trial.

OBJECTIVE: We examined the effect of the Cognitive-Functional (Cog-Fun) occupational therapy intervention on executive functions and participation among children with attention deficit hyperactivity disorder (ADHD). METHOD: We used a randomized, controlled study with a crossover design. One hundred and seven children age 7-10 yr diagnosed with ADHD were allocated to treatment or wait-list control group. The control group received treatment after a 3-mo wait. Outcome measures included the Behavior Rating Inventory of Executive Function (BRIEF) and the Canadian Occupational Performance Measure (COPM). RESULTS: Significant improvements were found on both the BRIEF and COPM after intervention with large treatment effects. Before crossover, significant Time × Group interactions were found on the BRIEF. CONCLUSION: This study supports the effectiveness of the Cog-Fun intervention in improving executive functions and participation among children with ADHD.

Stenosing flexor tenosynovitis: Validity of standard assessment tools of daily functioning and quality of life.

STUDY DESIGN: Cross-sectional. INTRODUCTION: Stenosing flexor tenosynovitis (SFT) is a common hand disease, yet there is a lack of valid standard assessments for this population. PURPOSE OF THE STUDY: Validation of assessment for the evaluation of disability and quality of life related to SFT clinical severity. METHODS: Sixty five participants with SFT were matched to 71 controls. Participant's symptoms were graded using the Quinnell classification. Disability and quality of life were evaluated using the DASH and WHOQOL-BREF questionnaires. RESULTS: Small to moderate correlations were found between SFT grade and the DASH and WHOQOL-BREF. Both questionnaires differentiated between the first and third clinical grades and between SFT and healthy groups. DISCUSSION: Both questionnaires are useful tools to distinguish between participants with SFT and controls and between mild and severe clinical grades. CONCLUSION: The DASH and WHOQOL-BREF may be implemented in the clinical management and research of SFT. LEVEL OF EVIDENCE: Diagnostic III.

Effectiveness of a cognitive-functional group intervention among preschoolers with attention deficit hyperactivity disorder: a pilot study.

OBJECTIVE: To test functional improvement after a group cognitive-functional occupational therapy intervention for preschoolers with attention deficit hyperactivity disorder (ADHD). METHOD: Seventeen preschooler-parent dyads attended 11 weekly group sessions focused on acquiring executive strategies through occupational performance. Functional improvement was measured using the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS); executive function, using the Behavior Rating Inventory of Executive Function-Pediatric; ADHD symptomatology, using Conners' Parent Rating Scale-Revised and Conners' Teacher Rating Scale-Revised; and social functioning, using the Social Participation scale of the Sensory Processing Measure. RESULTS: Significant improvement was found on the COPM and GAS measures, whereas mixed results were found on the other measures, with improvements found in children whose scores indicated impairment at baseline. CONCLUSIONS: Cognitive-functional group intervention appears to significantly improve daily functioning, executive function, and social functioning for children who demonstrate clinical impairment. Further research with a larger sample, a control group, and follow-up is required.