Date Presented 03/26/20 The purpose of this study was to determine the average change score on the VMI that would represent a clinically important change in functional skills. Anchor-based methods were used to compare VMI change scores to Likert scale ratings of children’s performance in fine-motor tasks, handwriting, and activities of daily living. Results indicated that children with improvements in functional skills had VMI scores that declined. These findings question the utility of VMI scores as indicators of progress in children. Primary Author and Speaker: Alisha Ohl Additional Authors and Speakers: David Schelly Contributing Authors: Shari Sharpe

Importance: The educational landscape is continually changing in response to legislation and the adoption of new standards, such as the Common Core. Currently, little is known about how these changes have influenced the school day. Objective: To examine the motor and technology requirements of kindergarten, second-, and fourth-grade general education classrooms. Design: For 6 full school days, we made unobtrusive observations of and took notes that described classroom activities throughout the day. Data were coded by a committee, allocating each minute of the day into 1 of 10 activity categories. Setting: Kindergarten, second-, and fourth-grade classrooms. Participants: Three general education classrooms with approximately 20 students in each class. Results: Students spent between 37.1% and 60.2% of the school day performing fine motor activities, with handwriting accounting for 3.4%–18.0% of the day. Time spent using technology was relatively sparse in kindergarten (4.8%) and second grade (3.1%) compared with fourth grade (14.3%). Transitions between activities (18.9%–23.4% of time spent) exceeded time spent handwriting. Conclusion and Relevance: This article provides an updated estimate of motor demands throughout the school day. Estimates of fine motor activities were consistent with previous research, but the focus on handwriting appears to have substantially diminished. What This Article Adds: Within the context of their own school, occupational therapists may find transitions to be a good opportunity for providing services within the classroom. In addition, handwriting practice outside of school may be more necessary in the current educational climate than in previous years.

Date Presented 04/05/19 This research considered attendance in the Well Elderly II intervention to determine the dosage effect on depression scores. In particular, how many hours of OT sessions are necessary to produce meaningful reductions in depressive symptoms? Our analysis suggests that the small improvements in depression scores do not appear to be associated with the dosage of the intervention received; therefore, any preventative effects of the intervention need to be reconsidered. Primary Author and Speaker: David Schelly Additional Authors and Speakers: Ramona Nadres, Alisha Ohl

OBJECTIVE. Randomized controlled trial (RCT) interventions often rely on p values, where statistical significance is assumed to provide evidence of an intervention effect. This study provides a secondary data analysis of the Well Elderly II RCT using multiple approaches that examine clinical meaningfulness. METHOD. We reanalyzed the Well Elderly II RCT using effect size, standard deviation, standard error of measurement, minimal difference, a fragility index, an assessment of poor scores at baseline, and an analysis with a small subgroup of participants removed. RESULTS. Although some participants improved on several scales, most stayed the same, and a small subset declined. Omitting a small subgroup of participants led to nonsignificant p values. CONCLUSION. There is evidence that disparities in baseline scores and regression to the mean may have created the appearance of an intervention effect. Our methods of considering clinical meaningfulness suggest improved approaches to analyzing RCT data.

Date Presented 4/19/2018 We present methods used to examine clinical relevance, illustrated by reexamining the findings of a popular occupational therapy intervention study, the Well Elderly II randomized controlled trial. Primary Author and Speaker: David Schelly Additional Authors and Speakers: Alisha Ohl