Understanding Travel for Families with a Physically Disabled Child through the Occupational Therapy Lens
Dinah Adams, Karen Park, and Susan MacDermott
Travel is a complex occupation that involves interactions between body function, activity participation, and the environment. For families traveling with a physically disabled child this occupation becomes even more complex. The available literature on the lived experiences of these families is significantly limited. This project aims to determine participants’ experiences of commercial airline travel with a child who has a physical disability. Through the participants experiences, barriers and needs of this population can be identified. Through identification of barriers, the needs of this population are highlighted as well as ways they can be supported and advocated for.
Since the start of the global pandemic, stay-at-home orders forced IPV survivors to stay in the home with abusers, increasing the risk of abuse, and the impact of psychological trauma. (Bright et al., 2020). Occupational therapists are trained professionals in incorporating sensory-based strategies to focus on the somatic manifestations experienced by the body from trauma and can help to regulate physiological and psychological responses through sensory stimuli (Mcgreevy & Boland et al., 2020). The development of this project sparked an opportunity to publish a new framework to introduce the role of sensory integration in treating survivors of intimate partner violence (IPV). This framework guides the Sensory Room Manual developed to support clinicians in introducing sensory integration as a treatment approach to support trauma recovery. The purpose of this manual is to advocate for more on-site sensory rooms and occupational therapists on the interdisciplinary team for survivors of IPV.
Amanda Amaro, Lisa Griggs-Stapleton, and Jennifer Summers
This advocacy project titled, A Call for Occupational Justice: Amending Medicare Policy focuses on advocating for increased access to occupational therapy (OT) services for elderly individuals within home health settings and bridging the health equity gap. The student was able to collaborate with the AOTA Federal Affairs Department throughout their capstone advocacy experience. They began the process of addressing Medicare home health policy serving as an environmental barrier for quality of life within this population through preparing to introduce legislation amending Medicare policy. This Medicare home health legislation would allow OT to be recognized as a Medicare qualifying home health service, meaning that OT could provide home health services to Medicare recipients standing alone. The student created a white paper as the final product discussing chronic condition mismanagement, the impact within home health settings and OT’s role in mitigating this crisis through effective chronic condition management with this new legislation. The white paper consisted of a culmination of anecdotes, and evidence from the literature to maximize advocacy efforts to support this legislation. The AOTA Federal Affairs Department will utilize this resource to further legislative efforts toward this bill.
Occupational Rights Workshops: Critical Reflection, Discussion, and Collaboration with Occupational Therapists
Michelle Arakaki and Susan MacDermott
In the summer of 2020, occupational therapy organizations condemned systemic racism and called on the profession to improve its’ practices in promoting justice and enhancing efforts in increasing diversity, equity, and inclusion (DEI) (American Occupational Therapy Association, 2020; World Federation of Occupational Therapists). Since then, there have been formations of DEI committees, opportunities for continuing education in justice and antiracist practice, and more discussion in the literature on how therapists could support the occupational rights of their clients. Occupational rights are “the right of all people to engage in occupations that contribute positively to their well-being and the well-being of their communities” (Hammell, 2008, p. 62).
The problem is that there is a lack of discussion on how to promote occupational rights in occupational therapy practice when faced with institutional, cultural, political, personal, and interpersonal barriers in the workplace. To address this problem, this capstone looked to increase the knowledge and practice of occupational rights among occupational therapists by facilitating interacting workshops that stimulated individual and collective critical reflection, discussion, and collaboration on how to implement occupational rights into daily practice.
Four sites with practicing occupational therapists, four didactic occupational therapy graduate students, and a small group of occupational therapy faculty participated in a workshop or focus group that centered the conversation around occupational rights. Each workshop and focus group received background information about occupational rights, participated in an activity and/or discussion about occupational rights, and ended the experience with group reflections and collective accountability commitments on how to continue to learn and incorporate occupational rights into practice. Results of the workshops and focus groups saw most participants understanding how occupational rights connect with other justice concepts, feeling comfortable discussing the topic with their peers, and wanting to participate in more workshops like the one they attended.
This project explored the experiences of caregivers interacting within the pediatric primary care setting in order to determine a need for occupational therapy to help support acquisition of child developmental milestones, screening for developmental delays, and implementation of health behaviors into family routines. An IRB research study was conducted to survey primary caregivers of children across the country to ascertain their experiences and knowledge of OT, ease of health behavior implementation, and comfortably discussing child development with their pediatrician's. A needs assessment survey was distributed at a San Diego pediatric primary care clinic, and a program was developed to support common areas of concern regarding child development and family routines.
Jessica Blum, Susan MacDermott, and Karen McCarthy
Background: Limited research has been conducted that explores the experience of dating as a member of the surviving partner community. This study aims to address this gap in literature by capturing the dating experience for those who are surviving partners.
Method: A qualitative, phenomenological research design was used to gather data from thirteen surviving partners who have actively dated in the past, are currently dating, or are currently in a casual or serious relationship.
Results: Interview data revealed that the participants' dating experiences were impacted by their identity as a surviving partner. Participants reported experiencing pressure to engage in dating from their friends and family after losing their partner. Participants also experienced stigma from the general dating pool as well as judgment from inside and outside the surviving partner community. The importance of co-occupation to honor and remember their late partner with their current partner was a unique aspect of the surviving partner dating experience.
Conclusion: This research adds to the body of knowledge regarding the surviving partner dating experience as well as the importance of co-occupation. Occupational therapists need to inquire about dating during evaluation and be aware of the impact of the surviving partner identity on occupation.
Austin Brown, Keegan McKay, Lisa Griggs-Stapleton, and Rene Wren
This capstone project involved the creation of a group therapy program that used leisure activity and social participation to address geriatric depression.
LeeAnne A. Bugter-vanLoon, Pam Kasyan-Howe, Kristin Domville, and Lisa Schubert
Occupational therapists are qualified mental health providers, however, inadequate numbers of practitioners work in the community to treat individuals with mental health conditions. A program to advocate for the profession of occupational therapy in community-based mental health was created to increase capacity for occupational therapy practitioners in this setting. A two-hour virtual workshop was implemented to educate participants on occupational therapy's role, the barriers that limit occupational therapy inclusion, and methods to increase occupational therapy inclusion. Results indicate the virtual workshop was effective at increasing an individuals knowledge on the roles, limitations, and opportunities for occupational therapy practitioners in community mental health settings. Future recommendations include providing additional workshops to improve advocacy efforts through increased attendance.
Childhood obesity is a growing public health epidemic of the 21st century (Sahoo et al, 2015), in which the Hispanic population is disproportionately an affected population in the U.S for obesity and other health risks (Garcia et al, 2019). Predominantly, 40% of Hispanic children in the U.S. are considered overweight or obese, higher than many other racial and ethnic populations, leading to an increased risk in chronic health conditions, such as Type 2 diabetes, cardiovascular disease, asthma, and decrease in mental well-being. The purpose of this capstone was to develop an occupation-based, health and wellness program through the scope of occupational therapy, for Hispanic children and parents to combat obesity and other health risk factors for this vulnerable population. The creation of the Salud y Sanación program was to educate children on the importance of establishing healthy habits and routines in early childhood to reinforce those skill-building techniques for adulthood and increase overall health autonomy.
Gerald Deocariza Jr. and Karen Park
Climbing, racing, playing by the fire, building forts with hammers, and free independent exploration are all examples of risky play. The inherent risk-taking that comes with play is essential to children’s physical and cognitive development, social and emotional well-being, confidence, self-esteem, and risk management. However, as many as two thirds of adults in United States have reported to come across at least one adverse childhood experience (ACE) growing up. The exposures to childhood trauma have been linked to a variety of negative health, psychiatric, and behavioral outcomes. Societal attitudes may further refrain at-risk youth from opportunities to gain essential skills and independence. This project aims to determine ways to encourage risky play for at-risk youth, while also at the same time, exploring occupational therapy’s potential role and impact when working with at-risk youth and the community-based youth programs. Through lived experiences of at-risk youth as well as collaboration with caregivers, barriers and needs can be identified to better facilitate opportunities for at-risk youth to engage in risky play experiences.
Qualitative Exploration of the Perception and Satisfaction of Occupational Engagement and Level of Awareness of Treatment options for Parous Women with Pelvic Floor Dysfunction.
Sterling Donald, Pam Kasyan-Howe, Kristin Domville, and Lisa Schubert
This poster looks to provide an overview of the results of the capstone project looking to fill a gap in the literature regarding the impact that pelvic floor dysfunction has on the occupational engagement of parous women, and their knowledge of occupational therapy treatment options for pelvic floor dysfunction (Burkhart et al, 2021). Data collection occurred over 2 weeks and the inclusion criteria for this study consisted of parous (having beard children) women, ages 18 to 65, and having at least 1 symptom of pelvic floor dysfunction (i.e., urinary problem, bowel problem, or pelvic organ prolapse). The research questions were, what are common problem areas in occupational performance for parous women diagnosed with pelvic floor dysfunction? How do parous women diagnosed with pelvic floor dysfunction rate their satisfaction related to problem areas in occupational performance? Lastly, what awareness do parous women with pelvic floor dysfunction have of treatment options available to them? Although all areas presented to be problems areas for the participants of this study, the most common problem areas were functional mobility, active recreation, and self-care. The average satisfaction of each occupation was less than a 5.5 out of 10. 84.6% of participants state that they were not at all aware that occupational therapists treat pelvic floor concerns. At least 61.5% of participants rated themselves as not having any knowledge of treatment options concerning their pelvic floor symptoms based on the 1-10-point Likert scale interview.
Peyton Dooley, Claribell Bayona, and Krisitin Domville
Parkinson’s disease is a commonly known movement and neurodegenerative disorder affecting a large portion of the male population. This disease is gruesome and progressive; it often interferes with a person’s daily routines and activities due to deficits in postural stability, tremors, slowed movement, and rigidity (Tysnes et al., 2017). Most persons with Parkinson’s have informal caregivers, often female spouses, or significant others of the individual. Caregivers of Parkinson’s disease prioritize their loved ones needs over their own, neglecting their own daily activities and routines including self-care, social participation, leisure, and physical activity. Occupational therapists and other health care professionals often fail to recognize the burdens placed on Parkinson’s caregivers. Due to the unmet needs of Parkinson’s caregivers, they experience reduced quality of life which negatively affects their loved ones’ quality of life (Lageman et al., 2018). This quantitative research study set out to understand the relationship between Parkinson’s disease symptoms and caregiver occupational performance resulting in decreased quality of life, health, and well-being among caregivers (Henry et al., 2020; Turney et al., 2017). Using the Parkinson's Disease Questionnaire-Carer (PDQ-Carer), this project will measure caregivers' quality of life using a 5-point Likert scale (Morley et al., 2012). The purpose of this study is to analyze the relationship between Parkinson’s disease symptoms and caregiver occupational performance to improve quality of life, health, and well-being (Henry et al., 2020).
Katherine Eglin and Angela Blackwell
This is a poster presentation on an education and training program, created for a capstone project. The program, Coaching Critical Moments (CCM), is designed to provide occupation-based coaching education through learning modules and training through simulation. The poster highlights the background literature about occupation-based coaching in occupational therapy, the problem and purpose statements for the capstone project, the methodology for creating the program, the theoretical foundation for the project, the contents of the program, and a discussion.
Promoting Socio-Emotional Skills Through a Strength-Based Dance Program for Children Who Have Experienced Trauma
Lillian Tami Endow
Negative outcomes as a result of trauma are multifaceted and can impact an individual throughout the lifespan. Younger children exposed to trauma are at higher risk for experiencing negative outcomes due to underdeveloped neurobiological capacities impacting their ability to appropriately respond to stressful stimuli (Price et al., 2013). Adversities including poor socio-emotional skills, mental and physical health challenges, and behavioral problems were identified among children exposed to trauma (Hovens et al., 2015). Occupational therapists are equipped to provide services for this vulnerable population by promoting socio-emotional skills necessary to cope with traumatic stressors through engagement in meaningful occupations. The occupation of dance was found to increase socio-emotional skills among trauma-based services, however, there is a lack of research that focuses on dance as an evidence-based intervention (Cook et al., 2005; Prieto, 2020). Furthermore, there are limited reports on occupation-based treatments specifically directed by an occupational therapist within the mental health setting (Cahill et al., 2020). The purpose of the project is to develop a strength-based dance program to promote socio-emotional skills for children exposed to trauma with an emphasis on the sensory system. The dance program was implemented at a community mental health program for children ages 4 to 5 once a week for 5 weeks. Based on the program results, staff and caregivers of the participants reported the most improvement in self-management skills. The staff members also reported improvement in social awareness, responsible decision-making skills, and body awareness. Practitioners should consider dance as a viable occupation-based treatment to improve socio-emotional skills in a variety of settings across the lifespan.
Kimberly Everett-Eaton, Susan MacDermott, and Jazminne Orozco Arteaga
Suicide is the fastest-growing cause of death for adolescents ages 10-14 (Horowitz et al., 2020). In the United States, the youth suicide rate tripled from 2007 to 2017, making suicide the second leading cause of death for those ages 10-24 (Curtis, 2019). This prevention program, Brighter Days Collective, utilizes occupational therapy (OT) practitioners to support middle school-aged adolescents by applying OT interventions based on theory and evidence-based practices. Brighter Days Collective aims to utilize OT practitioner expertise to support adolescents through educating students about mental health and employing occupations that enhance connection, coping skills, and living a purposeful life.
This 7-week program was developed through findings during experiences with multiple partners. Although this program was unable to be implemented due to time constraints, initial content evaluations were given to determine the feasibility and face validity of Brighter Days Collective. Multiple stakeholders reported that the program demonstrated a need and was unique in its content delivery. Stakeholders also strongly agreed that the program addresses relevant aspects of youth mental health and suicide prevention in a manner that is easily delivered as a school-wide intervention. Better Days Collective demonstrates OT’s unique ability to address mental health while considering students’ individual experiences, the school environment, and specific occupational supports and barriers.
Hattie Fleming and Karen Park
This program aimed to address the disparity in access to early intervention (EI) occupational therapy (OT) services which exists in certain communities abroad. This project worked with The Inspiration Center (TIC) in Belize, a community identified through needs assessment as having limited access to OT services, to expand current programming to include EI OT services, to increase understanding of the role of OT, to advocate for the OT profession within Belize, and to increase access to EI services for families with children with disability and/or developmental delay within the country. An emphasis was placed on caregiver coaching and culturally responsive approaches to improve sustainable and ethical program development. Needs assessment involved observations of OT sessions delivered to EI populations in American Samoa and Belize via telehealth, literature review, attendance of a cultural training program, and interviews with providers with experience in international service delivery. Program development included a culturally immersive service learning trip to Belize, advocacy for EI and OT, education on the role of OT, and supporting TIC for further program expansion. Program results included increased understanding of the role of OT among TIC staff, improved access to OT for EI populations, and community advocacy for the OT profession.
Haleigh Freeman, Angela L. Blackwell, and Erik Pérez
Approximately 17% of children from the ages six to 17 in the U.S. have a treatable mental health disorder, however, of those children, 70% have not received appropriate mental health care to address their mental health problems (MHP) (American Academy of Family Physicians, 2019; Mental Health Foundation, 2016). The severity of MHP identified within the literature points to a distinct need for mental health promotion, prevention, and intervention to address those needs (Albuquerque et al., 2020). Specifically, the need for school-based and after-school based mental health services continues growing at alarming rates (Map, 2013). However, school systems often lack provisions of appropriate mental health services for a variety of reasons, leaving gaps in mental health services focused on positive mental health or the state of mental well-being in which children are able to achieve occupations and activities (Bazyk, 2011; Mental Health Foundation, 2016). Therefore, after-school programs provide a unique environment to implement mental health services while bypassing some of the barriers typically presented in a school setting. Happy and Healthy is a positive mental health program for early elementary school-aged children based on principles of the Synthesis of Child, Occupational, Performance, and Environment-In Time (SCOPE-IT), PERMA model of positive psychology, and social emotional learning (SEL). Happy and Healthy was aimed at promoting occupational performance, occupational participation, quality of life, and well-being for early elementary aged children (K-2) at the Extend-A-Care (EAC) YMCA in Austin, TX.
Sarah Garces and Steven M. Gerardi
Alcohol use disorder (AUD) is an ongoing chronic health problem affecting millions of people worldwide. Habituation is a construct used by the occupational therapy (OT) practice model, the Model of Human Occupation (MOHO). Habituation relates to a persons’ roles, habits, and routines, and how these interact to shape occupational participation and performance. Since the habitual use of alcohol is a key component of AUD, an understanding of how habituation is addressed in OT intervention is essential. The OT literature has not been systematically reviewed to determine how habituation is addressed in OT practice in clients with AUD, leaving it difficult for practitioners to address clients’ habituation in OT intervention. The purpose of this project was to conduct a scoping review of the literature to identify how habituation was addressed in OT intervention with clients with AUD. This study aimed to answer: How is habituation addressed in the literature addressing occupational therapy intervention with clients with alcohol use disorder? Established scoping review methodology guided this review. Of 156 identified articles, 14 studies met the inclusion criteria and were reviewed. Data was grouped into themes and is displayed in frequency tables in relation to the major MOHO constructs. Findings indicate that the MOHO construct of habituation was discussed in the literature more than the other MOHO constructs but was addressed the least in OT interventions. This disconnect suggests that OT intervention should have a more focused approach to habituation in intervention planning.
Improving Occupational Engagement: An Occupation-Based Virtual Program For Caregivers of Individuals with Dementia
Betsabel Garcia, Pam Kasyan-Howe, Kristin Domville, and Lisa Schubert
Dementia is a progressive disorder that affects many people worldwide including informal caregivers of individuals with dementia (Harrison et al., 2019). Every year, more than 16 million Americans provide more than 17 billion hours of unpaid care for family and friends with Alzheimer’s disease or other related dementias (CDC, 2019). As a result, many informal caregivers experience higher levels of caregiver burden, depression, and anxiety (Amato et al., 2021; Raj et al., 2021; Walter & Pinquart, 2020). This causes an occupational imbalance in caregivers' ability to meet their needs and those of their loved one. Leisure is within occupational therapy's (OT's) practice domain and utilized to facilitate occupational engagement (AOTA, 2020). The purpose of the program development type project was to implement an occupation-based program for informal caregivers of individuals with dementia that incorporates leisure to help improve occupational engagement (Chiu et al., 2020; DiLauro et al., 2017; Lee et al., 2020).
Fostering Community Participation for Youth with Intellectual and Developmental Disabilities: An Occupation-Based Program for Caregivers
Mindy Goltiao, Kristin Domville, Pam Kasyan-Howe, and Lisa Schubert
Caregiver expectations influence outcomes of youth with intellectual and developmental disabilities (IDD) as they seek more independence transitioning from adolescence to adulthood. The purpose of this program development capstone project is to promote realistic expectations of caregivers of youth by improving caregiver youth relationships and facilitating activities. Strategies of current and evidence-based programs that support caregivers of youth with IDD, such as Maximizing Adolescent Post-Secondary Success and TrASDition training. The American Occupational Therapy Association Vision 2025 aligns with the program as it aims to provide caregivers equal opportunity, access to care, and expands an individual’s capacity to advocate for caregivers. Program participants met inclusion criteria: youth 14 to 24 year’s old, caregivers and youth speak and understand English, and have an electronic device to access the virtual program. Flyers were handed out to identified pairs as candidates most receptive and those who would gain the most benefit from the 6-week program. Ensuring caregivers had unrealistic expectations rather than realistic expectations and lack of clinical experience working with caregivers and youth with IDD were challenges for the project. Site staff knowledge of current skills and preferences of caregivers and youth, local resources to direct caregivers to, and mentorship during development of program were supports for the project. The Model of Human Occupation takes a holistic approach on viewing meaningful activities and relationships of caregivers in their environment and was used in the program to look at how caregivers organize their thoughts, roles, and choose tasks to participate in.
Sensory Preference and Learning Preference in Children with Attention Deficit/Hyperactivity Disorder and Dyslexia
Jennifer Gomez, Hope McCarroll, and Lisa Griggs-Stapleton
Is there a connection between a child’s sensory preferences and their learning preference? Sensory processing disorders are a heavily researched topic in current literature and many children with sensory differences present with learning disabilities, but research is lacking concerning any connection between sensory processing and learning. This research study examines children’s sensory preferences and learning preferences and denotes trends between these two variables. 15 participants were recruited from the Accommodated Learning Academy in Grapevine, Texas, a private school for students 1st-12th grade with learning delays. The sample of 15 participants consisted of 12 females and 3 males, aged 11-15 years old, with the average age being 13.3 years. Data on these variables were collected through the Adult/Adolescent Sensory Profile 2 and the Visual Aural Kinesthetic (VAK) Learning Style Self-Assessment Questionnaire. Data analysis showed that the majority of participants presented with a kinesthetic learning preference, participants who had a visual learning preference tended to be visually under-responsive, and of the participants who had a kinesthetic learning preference, none were over-responsive to vestibular/proprioceptive stimuli. Only two of the 15 participants had an auditory learning preference, so data was too limited here to see any sensory preference trends. This data suggests a possible connection between sensory preference and learning preference, but further research is required to find a statistically significant answer to the research question.
Amy Griswold and Susan MacDermott
The purpose of this project was to (1) identify barriers to participation in competitive adaptive rock climbing for adults with a physical disability and (2) create and distribute virtual educational resources to meet identified barriers. The need for this project was highlighted by athlete and coach self-report of limited ability to engage in competitive adaptive rock climbing, also known as paraclimbing.
The sample consisted of 108 adaptive athletes, adaptive rock-climbing coaches, staff members in rock climbing gyms, and volunteers at adaptive rock climbing events. Participants anonymously completed a ten-minute mixed methods virtual survey using Microsoft Forms.
Statistical analyses suggest recurrent barriers to participation in competitive paraclimbing including lack of accessibility within the gym environment, limited financial and social resources, and confusion regarding the paraclimbing classification criteria and competition rulebook for national and world cup competitions. Thematic analysis of free response questions suggests additional barriers of poor disability etiquette from able-bodied staff and volunteers, a lack of “community” at the climbing gym, and limited diversity in the climbing community. Educational resources were created and published through a novel corporation created by the author, the Adaptive Climbing Alliance LLC. Resources were distributed virtually after being published on a freely accessible, community centered domain entitled Paraclimbing Info. Resources promote equity for paraclimbers and support the growing field of adaptive athletics.
Kylee Hall, Helen Carey, Lauren Webb, and Lisa Griggs-Stapleton
This program adds a new component to the Les Turner ALS Foundation’s already established online educational programs. The foundation had a program for people living with ALS but did not have a program for caregivers prior to this project.
A needs assessment was completed to determine caregiver needs and materials for caregivers were developed based on the needs found. The materials developed were implemented with ten caregivers to determine effectiveness and outcomes before launching the program to the general public.
Kelsey Hamilton, Karen Park, and Susan MacDermott
The purpose of this capstone research project was to examine the impact of having a child in competitive sports has on the performance patterns of a family. As youth sports culture intensifies in America, it is important to provide an occupational therapy perspective on this aspect of life. A mixed methods research study was conducted with twenty-seven parents of children in competitive team sports. Survey and semi-structured interviews provided insight into the lived experiences of families with a child in competitive sports.
Bethanie Hernandez, Angela Labrie Blackwell, and Evan Edward Dean
Individuals with disabilities tend to face poverty at a higher rate compared to those without disabilities (Kelley, 2016). Individuals with intellectual and developmental disabilities (IDD) benefit from a variety of supports to work in their communities. Not providing services to address these needs can cause increased unemployment rates and dependence on others. Currently, there is a lack of attention by OTP on supporting individuals with IDD (14-26 years) when acquiring meaningful employment. Increasing OTP’s awareness about the relationship between self-determination and employment can promote more services. Self-Determination is about acting or causing things to happen in your life as you work toward your goals (Shogren et al., 2015), and has been linked to enhanced employment outcomes and higher quality of life (Mumbardo-Adam et al., 2020). Advocating for the use of the Self-Determined Career Design Model (SDCDM) by occupational therapy practitioners (OTP) when working with individuals with IDD will help provide employment opportunity, equality, and life-fulfillment to those searching for meaningful employment.
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