This issue of the American Journal of Occupational Therapy is dedicated to the life and legacy of Jane Case-Smith, an occupational therapy scholar and servant–leader of the highest order. Her work, diverse in its breadth and depth, touched the lives of countless children; families; and occupational therapy students, clinicians, and educators. In the year since her passing, those of us who were blessed to know Jane have cherished precious memories and missed her dearly. Jane was a truly exceptional mentor. I, for my part, am just one of her many protégés, honored to have trained alongside her.
In his meditation on showing gratitude to one’s mentors, Pausch (2008) wrote, “I could never adequately pay him back, so I just have to pay it forward” (p. 157). This statement feels appropriate as I think about Jane. Many of the profession’s best and brightest have benefited from the guidance and support she gave freely. It is right, then, that we celebrate Jane’s generosity to the profession by paying it forward. As guest editor for this special issue, I am honored to present articles that reflect Jane’s enduring passions for occupational therapy education and research.
Pediatric Constraint-Induced Movement Therapy
In 2004, in collaboration with Sharon Ramey, Stephanie DeLuca, and Richard Stevenson, Jane undertook a series of randomized controlled trials (RCTs) of pediatric constraint-induced movement therapy (pCIMT; DeLuca, Case-Smith, Stevenson, & Ramey, 2012). This work “demonstrated the efficacy of shorter duration (e.g., 3 hours) pCIMT in natural settings” (Persch et al., 2014, p. 650), a finding that led to larger, National Institutes of Health–funded, multisite RCTs of pCIMT. Included in this special issue are two articles specific to this powerful therapy. DeLuca, Ramey, Trucks, and Wallace (2015) present data that demonstrate the efficacy of multiple (i.e., repeated) episodes of pCIMT. These findings are consistent with and extend previous research (Charles & Gordon, 2007) and are responsive to the recently published guidelines for research in pCIMT (Eliasson et al., 2014) that make the effect of repeated pCIMT the highest priority for research in this area.
The article by Christman, McAllister, Claar, Kaufman, and Page (2015) reveals therapists’ preference for shorter, more distributed forms of pCIMT. This finding complements the research conducted by DeLuca et al. (2012), which demonstrated the efficacy of shorter (e.g., 3-hr) pCIMT, yet challenges the field to continue to refine pCIMT models to ensure that they are generalizable.
Sensory integration (SI) was another pillar of Jane’s work. She published widely on the subject (Case-Smith, 1989, 1997; Case-Smith & Bryan, 1999; Case-Smith, Butcher, & Reed, 1998; Hall & Case-Smith, 2007) and defended it from bias (Case-Smith & Schaaf, 2012; Schaaf & Case-Smith, 2014). Most recently, she published a comprehensive systematic review of sensory processing interventions for children with autism spectrum disorder (ASD; Case-Smith, Weaver, & Fristad, 2015).
Three of the articles included in this special issue are relevant to SI and pay it forward. With their The Issue Is article, Schaaf et al. (2015) provide the definitive summary of SI theory and research to date. On the basis of this foundation, they articulate a vision for moving SI forward through concerted efforts in the areas of practice, advocacy, and education. The article by Tanner et al. (2015) reports findings from a study designed to elucidate the interplay among selective eating, sensory reactivity, and behavior in children with ASD. This article, which Jane coauthored, provides new evidence for practice in supporting children with ASD. Similarly, with their Classroom Sensory Environment Assessment, Miller Kuhaneck and Kelleher (2015) provide a novel tool that will enable occupational therapy practitioners to evaluate the sensory characteristics of classrooms.
Jane was passionate about school-based practice and spent countless hours testing the efficacy of school-based interventions. Her Write Start “project evaluated the effectiveness of handwriting interventions delivered by therapist–educator teams in natural environments” (Persch et al., 2014, p. 650). Findings demonstrated that the Write Start intervention resulted in increased writing fluency and legibility and that therapist-educator partnerships were feasible and effective (Case-Smith, Holland, & White, 2014). In this issue, Donica (2015) presents results from a cohort-controlled trial designed to determine the effectiveness of Handwriting Without Tears (HWT) delivered via a consultative model. Results demonstrated that HWT can be implemented through consultation with general education teachers to improve kindergarteners’ legibility and support the role of occupational therapy practitioners in early intervention and response-to-intervention models.
Pediatric Occupational Therapy
As a scholar of pediatric occupational therapy, Jane was keenly aware of how occupational therapy’s rise within the public schools was paralleled by its decline in mental health settings, which did not sit well with her. She admired the work of Sue Bazyk, who has championed efforts to improve mental health services for children and adolescents, and insisted that Ohio State students receive training in this important area. Two articles included in this special issue pay this work forward. Bazyk et al. (2015) report the results of their efforts to increase occupational therapy practitioners’ capacity to intervene in ways that support the mental health of children and youths. By using communities of practice to promote knowledge translation, Bazyk et al. demonstrate that it is possible to change the capabilities of pediatric occupational therapy practitioners on a statewide level. This important research provides a model for building capacity and a mechanism for the profession to increase its role in mental health.
Weaver and Darragh (2015) add to this literature with a systematic review of yoga to reduce anxiety in children and adolescents. Their findings provide initial evidence to support the use of yoga to reduce anxiety and call for increased consistency in implementation of efficacy trials.
Jane began her career as an occupational therapist in a neonatal intensive care unit and quickly developed expertise in early intervention. She enjoyed working with children of all ages but admitted that the little ones had her heart. However, in working with children for more than 30 yr, Jane was in a position to watch many of them grow into adulthood. Jane observed that many of the children she worked with struggled to find their way after high school and thought that more can and should be done to help them create meaningful, productive lives. As a pediatric occupational therapist interested in transition, I approached Jane about pursuing a PhD. The timing was right, and Jane supported my efforts to develop assessment and intervention strategies designed to improve the transition to postsecondary employment. Indeed, the title of her seminal text Occupational Therapy for Children (Case-Smith & O’Brien, 2010) was revised to Occupational Therapy for Children and Adolescents (Case-Smith & O’Brien, 2015) as her appreciation for the needs of adolescents and young adults evolved. Together with Dennis Cleary, we developed the Vocational Fit Assessment, a tool designed to inform the job-matching decisions that key stakeholders make during the transition to adulthood. Here, we report on the process of developing and validating that tool (Persch, Gugiu, Onate, & Cleary, 2015)—one small attempt to pay it forward.
The work presented in this special issue is a tribute to Jane’s commitment to occupational therapy education and research. Indeed, many of the authors represented in this issue were Jane’s students. She would be happy that their work is included here. Similarly, the research presented in this issue was conducted in areas that were meaningful to her. Because we cannot adequately repay Jane for all that she contributed to occupational therapy, we must simply pay it forward. I suggest that we accomplish this mission by following her example. To truly honor Jane, mentor a student, advocate for the profession, and support and conduct research that informs practice as the profession moves into its second century.