Importance: Motor vehicle accidents are the leading cause of unintentional deaths of children ages 1 and older, particularly children with health care needs. Objective: To explore family caregivers’ experiences and current practices while transporting children diagnosed with autism spectrum disorder (ASD). Design: A concurrent nested mixed-methods approach was used to gain insight into caregiver experiences. Setting: Participants completed an online Qualtrics survey. Participants: A convenience sample of 54 caregivers of children with ASD from 17 U.S. states. Results: Themes that emerged include sensory behaviors of children, education related to child passenger safety, and participation in the community. Statistically significant findings suggest a correlation between caregivers (n = 39) being less likely to participate in activities away from home if the child had attempted to elope (p = .013), displayed aggressive behaviors (p = .005), or demonstrated self-injurious behaviors (p = .001). Conclusions and Relevance: The findings suggest a correlation between caregivers limiting the distance traveled during vehicular transportation and behavioral safety concerns. If caregivers must limit travel, they may refrain from accessing the community and engaging in leisure pursuits. What This Article Adds: The findings suggest that therapists who treat children with ASD should be familiar with child passenger safety restraints, particularly for elopement.

Importance: Informal caregivers often receive limited training and support, especially in providing assistance with toileting, a physically and emotionally demanding activity of daily living. This increases caregivers’ risk for physical injury and burnout and jeopardizes older adults’ ability to age in place. Objective: To assess the feasibility, acceptability, and preliminary efficacy of a toileting intervention using an automated bidet to reduce the amount of physical assistance required from caregivers. Design: Randomized wait-list control feasibility study. Setting: Caregiver’s home. Participants: Ten informal caregivers. Intervention: An occupational therapy intervention to educate and train caregiving dyads to use an automated bidet system. Outcomes and Measures: Feasibility was measured in terms of recruitment and retention, bidet installation, ability to operate the bidet, acceptability (a process evaluation), preliminary efficacy (physical barriers and impact on caregiver outcomes of performance, satisfaction, and self-efficacy), and adverse events. Results: All bidets were installed successfully. All caregivers reported that the intervention made toileting easier and increased their confidence. Physical barriers decreased for the treatment group. The bidet had a large effect on self-efficacy for the treatment group. Conclusions and Relevance: The results suggest that the automated bidet intervention is feasible and acceptable and can have a positive impact on caregiver outcomes when assisting with toileting. What This Article Adds: A toileting intervention using an automated bidet is feasible and acceptable for caregivers of older adults and can reduce the amount of physical assistance required from caregivers.

Unpaid caregivers are often expected to help family members or friends overcome activity limitations and participation restrictions to successfully age in place. Caregivers assume multiple responsibilities, such as managing their own physical and psychosocial needs and navigating a complex health care system, and many feel ill equipped to fulfill the necessary health care responsibilities for their care recipients. Underprepared caregivers may cause poor outcomes for care recipients. Federal and state policy proposals call attention to the need to better support caregivers, especially as their numbers increase. Occupational therapy practitioners are well positioned to effectively engage caregivers as they navigate the health care system. The occupational therapy process looks broadly at the functional abilities, environmental contexts, and occupational demands that play a pivotal role in successful aging in place for clients and better outcomes for their caregivers. Now is the time to define occupational therapy’s distinct value to this area.

Date Presented 04/20/21 This systematic review included 11 studies examining the effects of caregiver–care recipient dyad exercise interventions on caregiver health outcomes. Benefits for caregivers were compared among those participating in dyadic exercise with a care recipient, those receiving a separate nonexercise intervention while their care recipients exercised, and those remaining in their role with usual care. Results suggest involvement in dyadic exercise produces both physical and psychosocial benefits. Primary Author and Speaker: Kecia Doyle Contributing Authors: Erika Kemp

Date Presented 04/13/21 The value of family-centered care is identified in the literature, highlighting the need for therapists to use a variety of approaches. However, there is limited evidence as to how to best provide care with families dealing with complex contexts such as language, cultural, and socioeconomic differences. This session will provide the perspectives of eight OTs who identified strategies to support the primary caregiver and ways in which to build therapeutic alliances. Primary Author and Speaker: Tamera Keiter Humbert Additional Authors and Speakers: Patricia A. Henton Contributing Authors: Shelley Dean

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. OT increasingly supports a family and caregiver support perspective and service provision relevant to cultural, personal, and social contexts. A descriptive needs assessment of adoptive parents found that children’s mental health correlated with support seeking, but no perceived relationship was found between mental health and contextual factors such as racial discrimination. Implications include interdisciplinary collaboration with a focus on parent education and support. Primary Author and Speaker: Sheryl Ryan

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. A family's story creates the context for child maturation, and it is critical to understand when that story includes parental childhood trauma. This study describes how maternal early life stress impacted the role of caregiver and reduced competency within the mother–child system. Using a trauma-informed approach for the mother improved participation in developmentally appropriate play routines for the child. The occupational profile for mothers guided a client-centered plan of intervention. Primary Author and Speaker: Rondalyn Varney Whitney

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Hospital discharge readiness is an important yet often elusive matter for pediatric patients, families, and health care providers. Caregiver readiness for discharge should be assessed both at admission and before discharge to allow for timely education and training. The Pediatric Readiness for Hospital Discharge Scale is recommended for use by OTs in an acute rehabilitation setting because they harness the unique ability to address both physical and psychosocial aspects of the child and family encompassed by the measure. Primary Author and Speaker: Lori B. Ragni Additional Authors and Speakers: Camille Velasco, Teresa Fitzsimons, and Katie Shniderman

Date Presented 04/13/21 Sensory processing challenges are measured by caregiver report and clinician observation and affect many people with autism spectrum disorder and their caregivers. It is unclear how caregiver stress influences the correlation between scores on caregiver report and observational measures. The present analysis explores correlations between two formats of tools to assess sensory processing and indicates that caregiver stress moderates the association between sensory-seeking scores on the measures. Primary Author and Speaker: Emily Campi Additional Authors and Speakers: Abdullah S. Alsaeed, Kecia Doyle, Shanda N. Geil, and Kristen A. Pickett Contributing Authors: Noah T. Herzog

Date Presented 04/13/21 Informal caregivers are at risk for experiencing stress, anxiety, and other concerns that influence quality of life and that have a direct effect on the care recipient. Preliminary evidence suggests that Health Coaching in Context may help address the needs of mothers who are caring for a child with spinal cord injury. Using this client-centered and solution-focused approach, OTs develop a partnership that is connected by authenticity and trust through the use of skillful, constructive dialogue. Primary Author and Speaker: Bernadette Alpajora Additional Authors and Speakers: Rochelle Mendonca

Date Presented 04/9/21 Development in the first years of life is often characterized by a child’s aptitude to complete discrete tasks, such as walking or stacking blocks. True participation requires the child to incorporate skills into everyday activities. This presentation will provide an overview of the Infant Toddler Activity Card Sort, the initial psychometrics, and a Rasch analysis. Primary Author and Speaker: Catherine R. Hoyt Contributing Authors: Ching-Fan Sheu

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Primary care encounters can be challenging for adults with autism spectrum disorder. The purpose of this presentation is to identify challenges experienced by this population as well as strategies to mitigate these difficulties. Primary Author and Speaker: Leah I. Stein Duker Additional Authors and Speakers: Elizabeth Pfeiffer, Amber Davidson, and Hee Kyung Sadie Kim

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This study investigated the experience of primary caregivers of stroke survivors, while acknowledging limited theories that inform caregiving over time. Interviews and detailed data analysis yielded preliminary theoretical constructs that address disruption in occupations, caregiver burden, coping, and the subjective experience of navigating the health care system. Additional support mechanisms within current OT practice could prevent caregiver burden and occupational loss. Primary Author and Speaker: Angela Salvadia Additional Authors and Speakers: Deanna Bertone, Shaylyn Fisher, Kaitlyn Fisher, and Emily Nelson Contributing Authors: Tamera Keiter Humbert

Date Presented 04/13/21 Researchers examined caregiver experiences surrounding the transition out of the educational system for children with cognitive disabilities. Researchers analyzed 66 survey responses to the UW Caregiver Stress Scale and open-ended questions. Results suggest caregiver stress is constant throughout the transition, and perceived supports are strongly lacking. Meaningful occupational engagement outside the school structure was an overwhelming concern, substantiating a critical role for intervention. Primary Author and Speaker: Elizabeth Brooke Preble Contributing Authors: Diane Long, Tina Caswell

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Coaching models are considered best practice when providing services in early intervention (EI) programs. Although coaching is considered best practice, no true pragmatic definition exists to aid practitioners in implementation. Core constructs of OT align well with the principles of caregiver coaching to create interventions maximizing participation. This scoping review explored the conceptual and practice definitions of caregiver coaching in EI and the use of this model in OT intervention. Primary Author and Speaker: Francine M. Seruya Additional Authors and Speakers: Melissa Celio, Emily Feit, Diana Ottomanelli, and Alexys Tirado

Date Presented 04/13/21 The MAPCD project uses the WayFinder3 GPS app and comprehensive trainings to improve community mobility for individuals with cognitive disabilities and their caregivers. Participants used the app in their daily lives, and preliminary findings demonstrate unique and substantial benefits including increased autonomy and improved quality of life. This research advances the field of OT through the implementation of innovative assistive technology to improve independence in community mobility. Primary Author and Speaker: Kaetlyn E. Culter

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This study used Photovoice methodology with the parents of a child with a disability living in a marginalized community in a low- and middle-income country. Themes illuminate the influence of social problems and community and cultural stigma on parenting occupations and also demonstrate how parents can be empowered to become agents of change. OTs can use this knowledge to increase occupational satisfaction with parenting occupations and provide family-centered care. Primary Author and Speaker: Paula Ann Rabaey Additional Authors and Speakers: Hayley Manley Contributing Authors: Renee Hepperlen

Date Presented 04/21/21 A community adaptive sports and recreation program promotes social, physical, and emotional health and well-being for people with disabilities. Since the program's inception, many participants have voluntarily submitted letters and stories describing the program's impact on their daily lives. This research qualitatively examined the significance of engagement in this program on participants' health and well-being by analyzing their true lived experiences, expressed in their own words. Primary Author and Speaker: Sandra Brown Additional Authors and Speakers: Carly Peters, Renee Watling

Date Presented 04/13/21 The purpose of this study was to explore the relationship between caregiver mental illness, breastfeeding frequency and duration, and infant sleep and sensory profiles. Neurotypical infant–maternal dyads took part in the IDAHO Mom Study. The findings suggest that maternal mental health, actual or perceived, has an influence on sensory processing profiles in infants and toddlers. Primary Author and Speaker: Bryan M. Gee Additional Authors and Speakers: Rachel Allen-McHugh, Kelsey Huss Contributing Authors: Andrew Galvez, Taylor Pirillo, Sabrina DeHerrera, and Jessica Pottebaum

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This study surveyed 101 Asian-American caregivers of elderly people on factors that influence perceived caregiver burden. Spirituality was found to be a statistically significant predictor of caregiver burden. Furthermore, mental health help-seeking attitudes were negatively correlated with caregiver burden. This research informs OTs of the value of incorporating spirituality and mental health education with family caregivers to provide holistic, culturally competent services. Primary Author and Speaker: Yan-hua Huang Additional Authors and Speakers: Ciara Nagao, Kelsey Michelle Santos, and Madison Werchowsky