Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. It is important for humans to efficiently detect changes occurring around them for social interaction, learning, and movement, as well as survival and protection (Kessler, 2006). Adolescents with attention deficit hyperactivity disorder demonstrate strengths and difficulties in change detection that may affect areas of everyday participation. OTs have an important role in defining these areas, facilitating information processing to enhance adaptive responses, and developing occupational-based interventions. Primary Author and Speaker: Michal Hochhauser Contributing Authors: Adi Aran, Ouriel Grynszpan

Importance: The prevalence of low vision increases with age. Low vision has detrimental effects on older adults’ independence. Objective: To identify the effectiveness of interventions within the scope of occupational therapy practice to maintain, restore, and improve performance in daily activities for older adults with low vision. Data Sources: Literature published between 2010 and 2017 was searched in CINAHL, Cochrane Databases, MEDLINE, OTseeker, and PsycINFO. Study Selection and Data Collection: The authors screened and appraised studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Studies were eligible if the participants’ mean age was 55 yr or older, the level of evidence was Level III or higher, the intervention was within the scope of occupational therapy practice, and the outcome measures assessed the performance of daily activities. Findings: Fourteen studies met the review criteria. Three intervention themes were identified: low vision rehabilitation services (n = 6), self-management approach (n = 6), and tango (n = 2). Moderate evidence was found for low vision rehabilitation services. Low evidence was found for using the self-management approach or adding the self-management approach to existing low vision rehabilitation services. Low evidence was found for tango. Conclusion and Relevance: This systematic review supports the use of low vision rehabilitation services as an effective approach. Occupational therapy practitioners are encouraged to be part of multidisciplinary teams that offer comprehensive low vision evaluations and multicomponent services. What This Article Adds: Low vision rehabilitation that offers multidisciplinary services, including occupational therapy, is effective in promoting independence among older adults with low vision.

This issue of AJOT adds to the growing and evolving understanding of the effectiveness of occupational therapy interventions to meet the needs of older adults living with low vision; additional high-quality research is needed.

The impact of age-related vision loss on older adults’ independence at home is profound. The purpose of this systematic review was to identify the effectiveness of interventions within the scope of occupational therapy practice to maintain, restore, and improve performance in daily activities at home for older adults with low vision. We searched and screened abstracts from multiple electronic databases and identified 17 studies that fulfilled our inclusion and exclusion criteria. Three themes in intervention approaches emerged: multicomponent intervention, single-component intervention, and multidisciplinary intervention. Strong evidence of effectiveness was found in studies that applied a multicomponent approach; these interventions involved teaching knowledge and skills that older adults with low vision need to help overcome the disablement process. Evidence also suggests that multiple sessions of training with low vision devices and special viewing skills to compensate for vision loss are necessary to have a positive effect on daily activities. Finally, multidisciplinary intervention that focused on personal goals yielded greater positive outcomes than interventions that were not personalized.

This systematic review examined evidence regarding the effectiveness of interventions within the scope of occupational therapy practice to maintain, restore, and improve performance in leisure and social participation for older adults with low vision. We identified and reviewed 13 articles that met the inclusion criteria. Four themes related to interventions to improve leisure and social participation emerged from the literature review: using a problem-solving approach, delivering a combination of services, providing skills training, and making home visits and environmental adaptations. The strongest evidence supports using a problem-solving approach to improve leisure and social participation for older adults with low vision. Evidence was moderate supporting the delivery of a combination of services, either by one professional or through an interdisciplinary approach. Results for the effectiveness of skills training and home visits and home adaptations were mixed. Implications for practice, education, and research are discussed.

Although more therapists are responding to the increasing need for visual rehabilitation services for older adults, little is reported in the literature about the emotional experience of vision loss, especially in the words of persons with low vision themselves. This paper reports findings from a qualitative inquiry involving focus groups and in-depth interviews with 15 older adults using or considering using low vision assistive devices (Copolillo & Teitelman, 2005). Although the study’s original intent was to focus primarily on decisions about LVAD use, psychological and social implications of vision loss emerged spontaneously as a dominant area of concern for participants. From an analysis of 154 codes derived from transcripted data, three themes related to psychosocial experience were generated: (a) Emotional Challenges, (b) Negative Emotional Outcomes, and (c) Indicators of Emotional Adaptation. In this article, individual components of the themes are described using illustrative quotes, and potential practice implications for therapists are presented.

Diabetes affects 5.2% of the population; many of those persons experience loss of vision as one complication of the disease. Occupational therapists are treating these persons, often for other resulting complications (such as stroke or amputations), or are being asked to adapt techniques or equipment (such as insulin-drawing devices) needed for diabetes management. Because no guidelines exist for occupational therapy with persons with diabetes or vision loss or both, occupational therapists may be unsure of appropriate treatment approaches. Among the approaches described in the occupational therapy literature, common ones include collaboration with other professionals and incorporation of one or more aspects of the diabetes regimen into the person’s life-style. When addressing persons who have both diabetes and vision loss, therapists consider their own knowledge base as well as the persons’ needs in managing their diabetes. Treatment ideas include enhancing the visual environment or incorporating tactile and auditory feedback with self-management tasks such as testing blood glucose levels. Collaboration with and referral to diabetes and low-vision professionals are adjuncts to therapy and ensure a comprehensive and ongoing diabetes management program.