Date Presented 04/13/21 Racial bias is defined as the negative evaluation of a group and its members relative to another and can exist on explicit and implicit levels. This is an exploratory study to examine the presence of implicit and explicit racial bias among OT professionals across the United States. The results (N = 201) highlight the presence of implicit and explicit racial biases among OT professionals in the United States and the need for further education on racial bias. Primary Author and Speaker: Alaa Abou-Arab Additional Authors and Speakers: Alee Leteria, Kristina Zanayed, and Susanne Higgins

Importance: Missing from the recent literature is information about specific categories of assistive technology (AT) education provided in entry-level occupational therapy curricula. Objective: To examine occupational therapists’ perceptions of the AT education received in occupational therapy entry-level programs, specifically the AT categories in which therapists received training. Design: Quantitative survey study with Likert-scale, multiple-choice, or ordinal ranking-scale questions and three open-response questions. Format was a web-based Qualtrics survey tool; participants had approximately 2 mo to respond. Participants: Occupational therapists certified as Assistive Technology Professionals (ATPs) were recruited through the Rehabilitation and Engineering Society of North America email database (response rate of 21%; N = 148). Outcomes and Measures: Outcomes may contribute to determining what categories of AT are missing from occupational therapy entry-level curricula and what further education is needed to develop competency. Results: Occupational therapists with ATP certification did not perceive their entry-level curricula as having adequately prepared them in the AT categories of technology for learning disabilities (67%), computer access (57%), augmentative and alternative communication (57%), and accessible transportation (52%). Conclusions and Relevance: This study supports the need for occupational therapy entry-level programs to reexamine the categories and amount of AT training they currently provide. Future research with a larger and more generalized sample could provide more detailed evidence of which AT categories should be provided. What This Article Adds: This article provides evidence that to use AT in intervention, entry-level occupational therapists require increased training in specific AT categories.

After traumatic brain injury (TBI), many people experience significant motor function impairments. To help occupational therapy practitioners make informed decisions in choosing treatment strategies to improve clients’ motor function, we undertook a systematic review and synthesized applicable findings of intervention studies. Of 2,306 articles identified in the literature search, we reviewed 47 full-text articles, of which 16 met approved criteria. We found moderate evidence that various exercise programs increase motor function and limited evidence that people with TBI can benefit from rehabilitation and computer-based programs. We offer implications for practice, education, and research.

OBJECTIVE. To determine the effectiveness of interventions addressing cognitive impairments to improve occupational performance for people with traumatic brain injury. METHOD. A total of 37 studies met inclusion criteria: 9 Level I systematic reviews, 14 Level I studies, 5 Level II studies, and 9 Level III studies. RESULTS. Strong evidence supports use of direct attention training, dual-task training, and strategy training to optimize executive functioning, encoding, and use of memory compensations, including assistive technology. However, in most studies, occupational performance was a secondary outcome, if it was evaluated at all. CONCLUSION. Although evidence supports many intervention approaches used by occupational therapy practitioners to address cognitive impairments of adults with traumatic brain injury, more studies are needed in which occupational performance is the primary outcome of cognitive intervention.

An ongoing challenge to occupational therapy educators is how to provide resources and strategies that best assist students in learning, retaining, and replicating protocols in clinical manual assessment. This pilot survey study explored how 43 first-year master’s of occupational therapy students enrolled in a kinesiology course perceived the value of implementing instructor-produced YouTube^® videos of in-class assessment demonstrations. The videos, taken on a smartphone, were uploaded to a private YouTube URL created by the instructor and then linked to a pre-established Moodle learning platform. By the end of the 6-wk course, students had registered 2,573 views averaging 60 views per student. Postcourse mixed survey results revealed students perceived that the videos improved the quality of the course, increased their level of engagement and learning, and boosted confidence in their manual skills. Survey results also found that students correlated the instructor’s willingness to develop online videos with a commitment to student learning.

People with multiple physical impairments are not capable of using proper pointer devices, thus diminishing their opportunities to communicate and learn through computers. This research design used a replicated single-case experimental approach to compare the individual performance of two students with speech impairments and quadriplegic athetoid cerebral palsy in using four different computer-access solutions (the CameraMouse, the ASL Head Array mouse emulator, the CrossScanner, and the Quick Glance Eye Tracking System). The results demonstrate statistical significance in the correlation of movement time and accuracy to the level of comfort and satisfaction, which was used to guide the selection of computer-access solutions for clinical interventions. The WinFitts and Assessment of Comfort tests used in this study can be replicated for further clinical research into computer-access systems.

The purpose of this pilot study was to explore the experience with computers and the meaning of computers to a group of homeless men living in a long-term shelter. This descriptive exploratory study used semistructured interviews with seven men who had been given access to computers and had participated in individually tailored occupation based interventions through a Work Readiness Program. Three themes emerged from analyzing the interviews: access to computers, computers as a bridge to life-skill development, and changed self-perceptions as a result of connecting to technology. Because they lacked computer knowledge and feared failure, the majority of study participants had not sought out computers available through public access. The need for access to computers, the potential use of computers as a medium for intervention, and the meaning of computers to these men who represent the digital divide are described in this study.

OBJECTIVE. The purpose of this study was to investigate whether occupational therapy intervention that focused on teaching children to use word processing, either alone or with word prediction, was effective in improving the written communication skills of children with learning disabilities and handwriting problems. METHOD. A single-subject alternating treatments design was replicated across three children in grades 4 and 5. During the baseline phase the children wrote stories by hand; during the intervention phase, the children wrote stories, alternating among handwriting, word processing, and word processing with word prediction. Dependent variables focused on percentages of legible words, percentages of correctly spelled words, total amount written, and rate of writing. Data were analyzed by visual inspection. RESULTS. Results were variable. Two children had clear improvements in legibility when using either word processing alone or with word prediction. These same children demonstrated clear improvements in spelling when using word prediction. Though rate of writing was best for two children when using handwriting, relative to total amount produced, one method was not clearly preferable to another. CONCLUSION. Occupational therapy intervention involving word processing with word prediction improves the legibility and spelling of written assignments completed by some children with learning disabilities and handwriting difficulties. It is important to evaluate each child individually and provide training and ongoing support for technology use.

OBJECTIVE. The purpose of this study was to determine the psychometric properties of the Assessment of Computer Task Performance, specifically, the test–retest reliability, internal consistency, construct validity, and ability to discriminate between known groups. METHOD. This assessment comprises 14 standardized and timed tasks. It was administered to 24 persons with upper-extremity impairments and 30 with no impairments by a trained occupational therapist. To assess the test–retest reliability, participants in the impaired group were retested within 2 to 7 days. Intraclass correlation coefficients were calculated to determine test–retest reliability. Internal consistency was assessed with Cronbach’s alpha, and factor analysis was conducted to examine construct validity. The Mann Whitney U Test was used to assess the test’s ability to discriminate between the groups. RESULTS. Results indicated that the tool has excellent reliability and internal consistency, can discriminate between groups, and has appropriate construct validity. CONCLUSION. The Assessment of Computer Task Performance provides occupational therapists with an accurate test to measure computer performance and can assist them in providing computer access services.

OBJECTIVES. This study examined the relationships between sixth-grade students’ handwriting speed and legibility and their keyboarding speed and error rate. A second purpose was to examine how well handwriting performance discriminates students as slow or fast in computer keyboarding. METHOD. After participation in a school-required keyboarding class, 40 sixth-grade students were asked to copy a familiar poem using handwriting and keyboarding. Handwriting legibility and speed and keyboarding speed and errors were measured. Relationships among these variables were analyzed using Pearson product-moment correlations and discriminant analysis. RESULTS. Keyboarding speed correlated with handwriting legibility (n = 38, r = .361, p = .026), suggesting that handwriting performance accounts for 12% to 13% of the variance in keyboarding performance. Handwriting speed and legibility together accurately categorized 71% of students as slow or fast in keyboarding. On average, students were able to keyboard faster than handwrite. Of the 20 slowest handwriters, 75% achieved more text production with keyboarding than with handwriting. CONCLUSION. Keyboarding performance demonstrated low to moderate correlation with handwriting performance, suggesting that these forms of written expression require distinctly different skills. Most students who were slow at handwriting or had poor legibility increased the quantity and overall legibility of text they produced with a keyboard. These results suggest that keyboarding has the potential to increase and improve a student’s written output.

Objective. To determine whether the Touch Window or the mouse with an enlarged on-screen arrow was more effective or efficient for an on-screen letter-matching task completed by a boy 9 years of age with spastic quadriplegic cerebral palsy and visual and cognitive deficits. Method. A single-subject research design of 5 treatment phases, A1, B1, A2, B2, and A & B, was used. The total percentage of correct letter matches per treatment session, the total percentage correct per letter, and the amount of time needed to match 5 consecutive letters correctly were evaluated. Results. The range and variability of letters correctly matched per session decreased and trends for correct letter matches accelerated when the participant used the mouse interface. Accuracy with matching 18 of 26 (69%) letters of the alphabet increased when selections were made with the mouse interface. The participant was faster when using the Touch Window to match 5 consecutive letters correctly; however, regardless of the interface device used, letter matching remained slow and tedious. Conclusion. The mouse with an enlarged on-screen arrow and cursor was the more effective interface device with this child. Making a minor adjustment such as increasing the size of the on-screen arrow can make a common piece of equipment accessible to a person with disabilities.

Objective. Functional written communication, an important goal in the rehabilitation of persons with tetraplegia, frequently is met through the use of personal computers and alternative computer access systems. To make informed decisions about alternative access systems, the therapist needs information on the efficacy of the available choices. The purpose of this study was to investigate the effectiveness of two commercially available systems for text entry, the traditional mouthstick and the Prentke Romich HeadMaster. Method. Participants were a 25-year-old man and 76 year-old woman who both functioned at a C5 neurological level. Neither participant had previous experience with either system for text entry. A single-subject research design was used whereby Participant 1 experienced six phases of treatment (i.e., CBCBCB, where C= mouthstick and B = HeadMaster), and Participant 2 experienced four phases of treatment (i.e., BCBC). Results. Participant 1 achieved a maximum rate of text entry of5.85 wpm with both the HeadMaster and the mouthstick, whereas Participant 2 achieved a maximum rate of7.15 wpm with the mouthstick and 4.85 wpm with the HeadMaster. Results from this study were similar to the results from previous comparison studies of persons with severe disabilities who had no experience with alternative computer access systems. Conclusion. Both participants were able to use both systems successfully; however, their respective rates of text entry were too slow to be functional in most employment situations.

Objective. The purpose of this study was to evaluate the ability of a basic driving simulator program to evaluate and train children with disabilities in their ability to operate a powered wheelchair. Method. With a rating scale of skills considered essential for safe and efficient wheelchair operation, 22 children 7 to 22 years of age with either progressive muscular dystrophy or cerebral palsy were evaluated in their ability to drive a powered wheelchair through a driving course. They were divided into two groups: one without prior experience driving a powered wheelchair and the other with experience. After the driving assessment with an actual powered wheelchair, the inexperienced drivers were trained on a joystick-controlled computer game in which they navigated through labyrinths similar in layout to their own school environment. A test maze was administered before and after this training. Both groups were then evaluated on their ability to drive a powered wheelchair through the driving course. Results. The inexperienced drivers significantly increased their simulator scores over the training period. Their wheelchair driving performance was significantly better after the simulator training, although their performance remained poorer than that of the experienced drivers. Conclusion. A simulator program can assist in the development and evaluation of the skills required to operate a powered wheelchair.

Objective. The purpose of this study was to determine whether switch control site (hand vs. head) affects the age at which children can successfully activate a computer to play a cause-and-effect game. Method. The sample consisted of 72 participants randomly divided into two groups (head switch and hand switch), with stratification for gender and age (9–11 months, 12–14 months, 15–17 months). All participants were typically developing. After a maximum of 5 min of training, each participant was given five opportunities to activate a Jelly Bean switch to play a computer game. Competency was defined as four to five successful switch activations. Results. Most participants in the 9-month to 11-month age group could successfully use a hand switch to activate a computer, and for the 15-month to 17-month age group, 100% of the participants met with success. By contrast, in the head switch condition, approximately one third of the participants in each of the three age ranges were successful in activating the computer to play a cause-and-effect game. Conclusion. The findings from this study provide developmental guidelines for using switches (head vs. hand) to activate computers to play cause-and-effect games and suggest that the clinician may consider introducing basic computer and switch skills to children as young as 9 months of age. However, the clinician is cautioned that the head switch may be more difficult to master than the hand switch and that additional research involving children with motor impairments is needed.

Occupational therapy personnel spend considerable time on functional assessment and documentation. The rapid and error-free information processing ability of computers offers methods for data collection, clinical decision making, and reporting of functional assessment results, which may be more effective and efficient than the current paper-and-pencil methods. Computers can provide assistance throughout the many steps of the functional assessment and reporting process. Software is available to assist in direct data collection, data reduction, and analysis, or to assess complex data systems and databases. Additionally, computers can use assessment techniques, such as dynamic question sets and expert systems, which have not been possible with paper-and-pencil methods. Furthermore, data collected on computers are readily available to be integrated in computer-assisted report writing and can be compiled into large databases for analysis. These databases can be used for program evaluation, continuous quality improvement exercises, and other research objectives. This paper provides a snapshot of these computer uses in the assessment process.