The application of client-centred occupational therapy for Korean children with developmental disabilities.

The aim of this paper was to investigate the effectiveness of client-centred occupational therapy using the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS). Eight girls and 23 boys from Korea, with developmental disabilities and from 3 to 10 years of age participated in this study. Each child participated in 20 to 24 sessions of client-centred occupational therapy. Both the COPM and the AMPS change scores demonstrated statistically significant improvement (p < 0.01) in occupational performance. Significant correlations were found between COPM - Performance and AMPS - Motor skills (r(s) = 0.64, p < 0.05), and COPM - Satisfaction and AMPS - Process skills (r(s) = 0.62, p < 0.05) in a group positive towards client-centred occupational therapy. The COPM was a valuable tool in guiding and measuring the client-centred occupational therapy for children with developmental disabilities. The small sample size of 31 children limits the generalizability of the study's results. Future research needs to use a larger and more diverse sample of children to further validate the effectiveness of client-centred occupational therapy.

Assessing and treating vocal stereotypy in children with autism.

Previous research implies that stereotypic behavior tends to be maintained by the sensory consequences produced by engaging in the response. Few investigations, however, have focused on vocal stereotypy. The current study examined the noncommunicative vocalizations of 4 children with an autism spectrum disorder. First, functional analyses were conducted in an attempt to identify the function of each child's behavior. For each of the participants, it was found that vocal stereotypy was likely not maintained by the social consequences. Following assessment, response interruption and redirection (RIRD) was implemented in an ABAB design to determine whether vocal stereotypy could be successfully redirected. RIRD involved a teacher issuing a series of vocal demands the child readily complied with during regular academic programming. Vocal demands were presented contingent on the occurrence of vocal stereotypy and were continuously presented until the child complied with three consecutively issued demands without emitting vocal stereotypy. For each child, RIRD produced levels of vocal stereotypy substantially lower than those observed in baseline. For 3 of the children, an increase in appropriate communication was also observed. The children's teachers were trained to implement RIRD. Brief follow-up probes and anecdotal information implied that the treatment had a positive impact in the natural environment.

Persistence of stereotypic behavior: examining the effects of external reinforcers.

Basic research has shown that behavioral persistence is often positively related to rate of reinforcement. This relation, expressed in the metaphor of behavioral momentum, has potentially important implications for clinical application. The current study examined one prediction of the momentum metaphor for automatically reinforced behavior. Participants were 3 children who had been diagnosed with an autism spectrum disorder and who engaged in stereotypic behavior maintained by automatic reinforcement. Results suggested that stereotypic behavior was more resistant to disruption following periods of access to preferred stimuli delivered on a variable-time schedule than following periods without access to preferred stimuli. The implications of these findings for the treatment of automatically reinforced behavior are discussed.

Effects of forced use combined with scheduled home exercise program on upper extremity functioning in individuals with hemiparesis.

OBJECTIVES: The aims of this study were to 1) investigate the effects of forced use combined with scheduled home exercise program compared to forced use only on increasing upper extremity functioning, 2) examine whether increased upper extremity functioning generalized to activities of daily living (ADL) functioning, and 3) explore participants' psychosocial functioning. METHODS: A single-subject A-B-A'-C research design was employed in this study. The intervention consisted of two conditions: forced use only (intervention period B), and forced use in addtion to scheduled home exercise program (intervention period C). RESULTS: The results were as follows: 1) Forced use combined with scheduled home exercise program compared to forced use only allowed individuals with stroke to take part in exercise programs on their own within their home setting, ultimately improving their upper extremity functioning. 2) The program's promotion of performance in ADL tasks have the advantage of keeping participants focused so that a number of exercises can be maintained throughout the intervention. 3) Finally, forced use combined with scheduled home exercise program showed partial effects on improving the participants' psychosocial functioning. CONCLUSION: The results of the present study suggest that forced use combined with scheduled home exercise program compared to forced use only has the potential to be a cost- and resource-efficient method for intensifying rehabilitation.

The effect of visual feedback plus mental practice on symmetrical weight-bearing training in people with hemiparesis.

OBJECTIVE: To investigate the effect of visual feedback with mental practice on symmetrical weight-bearing training in three individuals with hemiparetic stroke. DESIGN: A single-subject experimental design, alternating with multiple baselines across individuals. SETTING: Laboratory of a department of occupational therapy. PARTICIPANTS: Three individuals with left hemiparesis from stroke. INTERVENTION: Visual feedback with mental practice on symmetrical weight-bearing training. MAIN OUTCOME MEASURES: The proportion of the participant's weight-bearing by the affected limb while standing was measured using Limloader. RESULTS: For participants 1, 2 and 3, the respective average weight-bearing proportions of the affected limb were 27%, 31% and 21% at baseline, 47%, 48% and 47% after visual feedback with mental practice, and 42%, 48% and 42% after visual feedback only, immediately following each training session. When the participants had visual feedback with mental practice, they placed a greater proportion of their weight on the affected limb, and this effect was maintained for 1 h. CONCLUSION: These findings indicate that the visual feedback approach alone can effect improvement but visual feedback together with mental practice produces further positive effect on improving and maintaining a symmetrical stance posture in people with hemiparetic stroke.