Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This qualitative, observational research study explored treatment encounters between patients with disorders of consciousness, rehabilitation practitioners, and family to understand how treatment decisions occurred. The data showed shared decision making (SDM) occurring as a process, meaning that not all five principles of SDM occur in one clinical encounter but rather unfold across multiple clinical encounters. We delineate differences in SDM between rehabilitation and the medical model. Primary Author and Speaker: Jennifer Weaver Contributing Authors: Trudy Mallinson, Leslie Davidson, Christina Papadimitriou, Ann Guernon, and Philip van der Wees

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. We used two different quantitative analytic approaches to examine whether there were sex differences in self-reported participation restrictions among male and female veterans with traumatic brain injury. Findings suggest that women have more challenges with leisure and employment and fewer challenges with residence and financial management than men. Total raw scores may obscure important differences in how men and women self-report participation restrictions. Primary Author and Speaker: Alison M. Cogan Contributing Authors: Jennifer A. Weaver, Trudy Mallinson, Theresa Bender Pape, and Joel Scholten

Date Presented 04/9/21 OTs use the Coma Recovery Scale–Revised (CRS–R) to evaluate and make treatment decisions for individuals with disorders of consciousness (DoC) after a brain injury. This session will describe psychometric properties of the assessment and examine the association with state of consciousness. State of consciousness influences how therapists think about the patient’s prognosis, plan of care, and rehabilitation outcomes. Primary Author and Speaker: Jennifer Weaver Additional Authors and Speakers: Sara Stephenson

Date Presented 03/28/20 We report rehabilitation interventions delivered to facilitate recovery of consciousness for patients with a traumatic brain injury. Interventions reported may prompt OT practitioners to seek advanced training in preparatory stimulation methods. The results of this review identify gaps in the literature, specifically the content of OT treatment. Primary Author and Speaker: Jennifer Weaver Additional Authors and Speakers: Kristen Maisano, Alison Cogan, Trudy Mallinson Contributing Authors: Sophie Leeds, Ann Guernon, Kelsey Watters, Jennifer Nebel, Theresa Bender Pape

Date Presented 04/04/19 The study findings revealed significant differences in the outcomes of inpatient and skilled-nursing stroke rehabilitation within US stroke rehabilitation services. Researchers need to investigate patient and facility factors associated with skilled-nursing stroke rehabilitation. Primary Author and Speaker: Timothy Reistetter Additional Authors and Speakers: Ickpyo Hong, Trudy Mallinson, Clark Anderson, Yong-Fang Kuo, Kenneth Ottenbacher, James Goodwin

Date Presented 4/21/2018 The study findings revealed significant differences in self‐care and mobility outcomes for inpatient and skilled nursing stroke rehabilitation in the United States. Clinicians and researchers need to investigate patient and facility factors associated with skilled nursing stroke rehabilitation outcomes. Primary Author and Speaker: Timothy Reistetter Additional Authors and Speakers: Ickpyo Hong, Trudy Mallinson Contributing Authors: Clark Anderson, Young‐Fang Kuo, James S. Goodwin

Date Presented 4/20/2018 This poster focuses on how clinicians interpret patients’ behaviors to communicate improvement, deterioration or plateau in inpatient rehabilitation for persons with disordered states of consciousness following traumatic brain injury with other clinicians and caregivers. Primary Author and Speaker: Jennifer Weaver Additional Authors and Speakers: Trudy Mallinson Contributing Authors: Ann Guernon, Elyse Walsh, Theresa L.-B. Pape, Christina Papadimitriou

OBJECTIVE. To describe sleeping behaviors and trends over time among an ethnically diverse group of community-living older adults. METHOD. A descriptive secondary data analysis of a subsample (n = 217) from the Lifestyle Redesign randomized controlled trial was done to explore baseline napping and sleeping patterns as well as 6-mo changes in these outcomes. RESULTS. At baseline, the average time sleeping was 8.2 hr daily (standard deviation = 1.7). Among all participants, 29% reported daytime napping at baseline, of which 36% no longer napped at follow-up. Among participants who stopped napping, those who received an occupation-based intervention (n = 98) replaced napping time with nighttime sleep, and those not receiving an intervention (n = 119) experienced a net loss of total sleep (p < .05). CONCLUSION. Among participants who stopped napping, the occupation-based intervention may be related to enhanced sleep. More research examining the role of occupation-based interventions in improving sleep is warranted.

Date Presented 4/16/2015 Sleep problems threaten occupational engagement in older adults. This pilot study suggests that occupational therapy may enhance sleep by targeting engagement in occupation. This study provides a structure for future researchers analyzing the role of occupational therapy in older adult sleep behaviors.

This article describes the development of the Adult Sensory Processing Scale (ASPS), a sensory processing questionnaire for adults. The ASPS measures self-reported responses to input from distinct sensory systems and is intended to be sensitive to individual differences in the adult population. ASPS construction involved two phases: item development and instrument construction. During item development, content validity of 71 items was assessed by means of expert ratings. During instrument construction, items were evaluated using data from an online survey of 491 adults. Exploratory factor analysis and Rasch analysis yielded an optimal solution of eight factors representing vestibular overresponsiveness, auditory overresponsiveness, visual overresponsiveness, social tactile overresponsiveness, proprioceptive seeking, general underresponsiveness, vestibular–proprioceptive underresponsiveness affecting postural control, and vestibular overresponsiveness–intolerance to movement. The final ASPS contains 39 items and demonstrates acceptable internal consistency, strong content validity, and adequate construct validity.

In this study, we conducted a pretest–posttest investigation of a sports-oriented occupational therapy intervention using surfing in an experiential, skills-based program to support veterans with symptoms of posttraumatic stress disorder (PTSD) in their transition to civilian life. The purpose of this feasibility study was to evaluate the intervention for attendance rates and retention in the program provided in 5 sessions over 5 wk. Fourteen veterans from a specialty postdeployment clinic at a Veterans Affairs hospital were enrolled; 11 completed the study, and 10 attended ≥3 sessions. Participants reported clinically meaningful improvement in PTSD symptom severity (PTSD Checklist—Military Version, Wilcoxon signed rank Z = 2.5, p = .01) and in depressive symptoms (Major Depression Inventory, Wilcoxon signed rank Z = 2.05, p = .04). The results of this small, uncontrolled study suggest that a sports-oriented occupational therapy intervention has potential as a feasible adjunct intervention for veterans seeking mental health treatment for symptoms of PTSD.

OBJECTIVES. Relatively little is known about the treatment effectiveness and functional outcomes of pediatric rehabilitation therapies. This study was conducted to gain knowledge of the type and quantity of inpatient rehabilitation services provided to children who received acute inpatient rehabilitation and compare functional gains by age and diagnosis. METHOD. A retrospective cohort design was used. Records of rehabilitation therapies and functional assessments of 814 pediatric patients who received inpatient rehabilitation during 1996, 1997, and 1998 were collected. The admission and discharge item ratings of the WeeFIM® instrument were first transformed into inter-val-level measures of self-care, mobility, and cognition. Parametric analyses were used to compare functional gains across impairment groups and to examine the relationship between amount of treatment and functional gains. RESULTS. Occupational therapy and physical therapy were the primary rehabilitation services received by patients across impairment groups (98% and 99%, respectively). A large proportion of children with traumatic brain injuries also received speech therapy (97%) and psychology services (60%). Across domains (selfcare, mobility, cognition), the largest gains were made by children who were older than 7 years and had traumatic injuries. Functional gains were significantly related to the amount of discipline-specific treatment received, after controlling for age, impairment, and functional status at admission. CONCLUSION. Rehabilitation therapy provision in pediatric inpatient rehabilitation varies greatly depending on children’s age and the nature of the impairment. Systematic reporting of type and quantity of rehabilitation therapies along with functional assessments before and after hospitalization would allow researchers to track functional changes and study the determinants of functional improvement.

Objective. This study examined the validity of the Occupational Identity, Occupational Competency, and Occupational Behavior Settings scales of the second version of the Occupational Performance History Interview (OPHI-II). The study also asked whether the scales’ items were targeted to and could effectively discriminate between persons at different levels of adaptation. Method. Data were collected from 151 raters on 249 subjects from eight countries and in six languages. Many-faceted Rasch analysis was used to analyze the data. Results. The items of each scale worked effectively to measure the underlying construct for which they were designed. All three scales validly measured more than 90% of the subjects, who varied by nationality, culture, age, and diagnostic status. Each scale’s items were appropriately targeted to the subjects, and all three scales distinguished subjects into approximately three different levels. More than 90% of the raters used the three scales validly and had approximately the same degree of severity or leniency. The scales were valid across subjects with physical dysfunction and psychiatric conditions as well as subjects with no active diagnosed condition. Conclusion. The three scales of the OPHI-II are valid across age, diagnosis, culture, and language and effectively measure a wide range of persons. Raters can readily use the OPHI-II validly without formal training.