Parent Perspectives on Assisted Communication and Autism Spectrum Disorder.

IMPORTANCE: Parents of nonspeaking children with autism spectrum disorder (ASD) may present with complex challenges associated with communicating with their children. OBJECTIVE: To explore the firsthand experiences of parents of children with ASD who use assisted communication (AC) to communicate, which has yet to be explored in the literature. DESIGN: Semistructured interviews with ten parents of individuals with ASD, age 15 to 36 yr, who use AC to communicate. RESULTS: Analysis of the data revealed four superordinate themes, each with two subthemes: (1) Relationship (subthemes: Involving the Child, Improved Relationship), (2) Future (subthemes: Hopes and Dreams, Planning), (3) Support (subthemes: Limited Availability of Service Providers, Underestimation), and (4) Understanding (subthemes: Communication, Understanding of the Child). The themes illustrated that using AC modalities improved the parent-child relationship (Relationship) and helped parents understand their child on a deeper level (Understanding). A positive outcome of having a new means of communication with their child was that parents could better plan for a future that reflects their child's innermost hopes and dreams (Future). Parents also reported that the lack of a consensus concerning using AC with nonspeaking children led to decreased support (Support) from professionals and educators, limiting the child's opportunities. CONCLUSIONS AND RELEVANCE: This study provides phenomenological qualitative evidence that use of AC provides benefits to the parent-child relationship. Plain-Language Summary: This study investigated the lived experience of parents of children with autism spectrum disorder (ASD) and how the use of assisted communication (AC) affected their relationship with their child. Ten parents were interviewed. Four main topics emerged from the analysis of these interviews: (1) improved closeness in relationship, (2) improved ability to plan for the future, (3) wish for improved availability of service providers, and (4) improved understanding of who the child is as a person. Parents play a key role as team members in support of the child's performance in occupations. The results of this study suggest that AC plays an important role in supporting the parent-child relationship; therefore, AC programs should be considered when implementing and planning occupational therapy treatments for individuals who have communication impairments.

Upright vs. supine shape-capturing comparison for custom-contoured cushions.

AIMS: This study aims to explore best practices of shape capturing methods for creating custom-contoured wheelchair cushions for the purpose of reducing pressure injury risk. MATERIALS AND METHODS: Pressure redistribution qualities were measured by peak pressure index (PPI) and compared between custom-contoured seating systems molded in supine vs. upright shape-capturing positions. Subjects consisted of 14 able-bodied participants in a within-subjects comparison. RESULTS: A Wilcoxon signed-rank test and paired t-test were calculated to compare the mean differences of the PPI between shape-capturing positions. Supine shape-capturing resulted in a statistically significant lower PPI compared to upright (z = 2.040, p < . 05) (t = -2.28, p < .05). CONCLUSION: Shape-capturing in the supine position provided greater pressure distribution as opposed to an upright position. Creating custom-contoured cushions molded in a supine position can reduce the risk of pressure injury to the patient.

Custom-contoured seating from unloaded shape capture: A pilot study.

AIMS: Traditional methods of shape-capture for creating custom-contoured seating have commonly consisted of capturing the buttocks in a loaded position. This study seeks to compare an innovative unloaded shape capture method to off-the-shelf pressure relieving cushions. MATERIALS AND METHODS: The pressure redistribution and support characteristics of a cushion designed using an unloaded shape-capture method was compared to off-the-shelf pressure redistributing cushions. The methods of this pilot trial are described, and the outcomes are analyzed and summarized through descriptive statistics, including peak pressure index, average pressure, surface contact, quadrant distribution and perception of postural support. RESULTS: A Wilcoxon signed-rank test was calculated to compare the mean difference in PPI between the unloaded shape-capture cushion among the other cushions. Differences in peak pressure between the unloaded shape capture cushion and off-the-shelf pressure relieving cushions were not significant, however there was a significant reduction in pressure between the unloaded shape-capture cushion and both sling seat and baseline non-contoured foam cushion (z = 2.673, p = .008). CONCLUSION: The unloaded shape-capture method results in a cushion with pressure redistribution characteristics similar to off-the-shelf pressure redistributing cushions while providing superior postural support. The unloaded shape-capture method appears to be a feasible alternative to traditional loaded methods and is worthy of further research.

Inter-Rater Reliability of the Pizzi Health and Wellness Assessment (PHWA).

The objective of this study is to determine the inter-rater reliability of the Pizzi Health and Wellness Assessment (PHWA) by comparing the consistency in scores between clients and their caregivers in the following areas of participation: social, physical, family, occupational, mental/emotional, and spiritual. A retrospective inter-rater correlational design was used to analyze the agreement of scores from a convenience sample consisting of two groups: clients with disabilities (n = 19) and their healthy caregivers (n = 19). Inter-rater reliability was calculated using correlations for the PHWA as a whole, and for the current level of participation and wishing to improve participation subsections. Inter-rater reliability as calculated by an Intraclass Correlation Coefficient, and either the Pearson or Spearman rho correlation and found to be reliable between clients and caregivers (rICC = .636, p < .001; rho = .642, p < .001). More specifically, current level of participation demonstrated acceptable reliability (rICC = .513, p < .001; r = .521, p < .001) as did wishing to improve participation (rICC = .689, p < .001; r = .725, p < .001). This supports the PHWA as a clinically relevant health and wellness occupational therapy assessment.

Health, Well-Being, and Health-Related Quality of Life Following COVID-19.

Coronavirus disease 2019 (COVID-19 may have serious effects on health, well-being, and quality of life (QoL). This study explores the perceptions of health, well-being, and QoL in those who contracted the COVID-19 virus compared with those who did not. A convergent mixed-methods design with convenience sampling (n = 41) was conducted between December 2020 and January 2021. The outcome measures included the Short Form-36 and the Pizzi Health and Wellness Assessment. There were no statistically significant differences in perceived health, well-being, and QoL. However, qualitative analysis revealed mental, physical, social, and family health impacts across both groups, with the COVID-19 survivors reporting greater feelings of isolation and fear, resulting in decreased social and family participation. The results indicate that all persons who have experienced the COVID-19 pandemic have experienced negative health-related impacts, but those who actually contracted the virus experienced greater impacts on QoL in areas related to occupational health and participation.

A systematic review of the effectiveness of pressure relieving cushions in reducing pressure injury.

This systematic review seeks to gather and analyze the evidence on wheelchair pressure relieving cushions, and report on the optimal materials and designs for reducing pressure injury risk. The following research question guides this study: Which wheelchair cushions best reduce pressure injury risk? PIs continue to impact the health and function of wheelchairs users with significant mobility impairments. Pressure relieving cushions are typically prescribed to provide pressure relief in the pre-wound, wound, and post-wound phases. Presently, no published reviews analyze all of the commonly available cushion materials. Most comparison studies typically address a specific population such as spinal cord injury, or only a few styles of cushion design/materials. Results suggest air-cell cushions provide optimal pressure relief and shear reduction. Furthermore, small sample single cohort studies suggest off-loading cushions provide superior pressure relief beyond that of air-celled cushions but require additional research for greater generalizability.

Upper extremity neuro-rehabilitation through the use of power mobility.

Power mobility is typically used as an accommodative form of assistive technology allowing individuals with impaired ambulation to remain mobile. While research has focused on the cognitive development and social benefits of power mobility for individuals with developmental disabilities, research is lacking on using this technology to rehabilitate physical dysfunction. Recent technology, such as robot-mediated neuro-rehabilitation, is proving effective in upper extremity rehabilitation, but lacks the movement feedback of power mobility. This article presents a case study of a client with cerebral palsy who experienced severe neural impairment following a motor vehicle accident. As a previous power mobility user, the client identified returning to using power mobility with the affected upper extremity as a key functional goal. This case study describes the series of steps that returned the client to independent mobility and increased upper extremity function.