Using Outcome Measures To Improve ... - Fox Rehabilitation

AOTA THE AMERICAN OCCUPATIONAL THERAPY ASSOCIATION
Mobile Software Apps
for Individuals
With Disabilities
Touch Tablets:
Helping High Schoolers
Transition
Electronic
Multitasking:
Analyzing
Work Routines
PLUS
Social Media Spotlight
Organizational Needs Assessments
News, Capital Briefing, & More
JUNE 20, 2011
Technology
CE ARTICLE
Using Outcome Measures
To Improve Occupational
Therapy Practice in
Physical Rehabilitation
®

AOTA Members: QU’s Application Deadline is Approaching!
The popularity of Quinnipiac’s Post-Professional Master of Science in Occupational
Therapy has led to an enormous number of inquiries. Please be aware the deadline
to complete your admissions file for consideration for the fall is July 15, 2011.
Quinnipiac’s OT faculty was proud to be a major contributor
to this year’s AOTA conference. Their expertise in the
following areas (as seen in their presentations) has made
our curriculum one of the top-rated graduate OT programs
in the nation and why interest is soaring.
n Academic & Fieldwork Education
n Children & Youth
n Rehabilitation, Disability & Participation
n Productive Aging
n Professional Issues
n Mental Health
Quinnipiac’s School of Health Sciences proudly offers an
online post-professional master’s degree in occupational
therapy via Quinnipiac University Online. This unique
program enables occupational therapy professionals to
advance their knowledge of emerging research, leadership,
critical thinking and entrepreneurial concepts of
occupational therapy.
This is an unprecedented opportunity for practicing
occupational therapists to learn from our superior
faculty and continue with a quality education — without
interrupting their careers. Our post-professional master’s
degree can be completed in five semesters in an online
format with a one day on-campus requirement. The
program’s pace affords a steady accumulation of skills
that can be applied immediately to the workplace.
Practioners develop leadership skills so they can:
n Build on experience
n Refine clinical skills in specialized practice
n Participate in research
The curriculum, faculty and online learning environment
enable students to attain advanced skills that are in high
demand today and will continue to be valued in the future.
With a smart, intuitive interface, engineered by an awardwinning
team of professionals, our online program is
convenient and flexible.
D-5498
Application Deadline is July 15, 2011
Nancy Bagatell Salvador Bondoc
Tara Glennon
Martha Sanders Francine Seruya
Roseanna Tufano
877.403.4277
Kimberly Hartmann
Tracy Van Oss
quinnipiac.edu/quonline
To learn more about the Post-Professional Masters
in Occupational Therapy online degree program,
please call or visit us online.

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OT Practice External Advisory Board
Asha Asher, Chairperson, Developmental
Disabilities Special Interest Section
Salvador Bondoc, Chairperson, Physical
Disabilities Special Interest Section
Tina Champagne, Chairperson, Mental Health
Special Interest Section
Donna Costa, Chairperson, Education Special
Interest Section
Tara Glennon, Chairperson, Administration
& Management Special Interest Section
Leslie Jackson, Chairperson, Early Intervention
& School Special Interest Section
Gavin Jenkins, Chairperson, Technology Special
Interest Section
Kathy Maltchev, Chairperson, Work & Industry
Special Interest Section
Regula Robnett, Chairperson, Gerontology
Special Interest Section
Pamela Toto, Chairperson, Special Interest
Sections Council
Renee Watling, Chairperson,
Sensory Integration Special Interest Section
Missi Zahoransky, Chairperson, Home &
Community Health Special Interest Section
AOTA President: Florence Clark
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Chief Public Affairs Officer: Christina Metzler
Chief Financial Officer: Chuck Partridge
Chief Professional Affairs Officer: Maureen Peterson
© 2011 by The American Occupational Therapy Association, Inc.
OT Practice (ISSN 1084-4902) is published 22 times a year,
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OT PRACTICE • JUNE 20, 2011
Technology
Focus on
AOTA • THE AMERICAN OCCUPATIONAL THERAPY ASSOCIATION
VOLUME 16 • ISSUE 11 • JUNE 20, 2011
COVER ILLUSTRATION © RYCCIO / ISTOCKPHOTO
DEPARTMENTS
News 2
Capital Briefing 5
CMS Proposes to Change SNF PPS Rule
on Group Therapy and More
In the Clinic 6
Electronic
Multitasking:
Analyzing
Work Routines
Practice Perks 23
Developing Needs Assessments
for Organizations
Social Media Spotlight 25
Updates From Facebook, Twitter,
and OTConnections
Calendar 26
Continuing Education Opportunities
Employment Opportunities 31
FEATURES
App Support 8
Mobile Software Applications
for Individuals Wth Cognitive
and Behavioral Challenges
Lindsey Aftel, Mary Freeman, Jessica
Lynn, and Whitney Mercer describe how
mobile devices are helping practitioners
support individuals with disabilities in
myriad ways.
Electronic Slates 19
Tablets and Handheld Devices
Help High Schoolers Transition
Karen Majeski, Melissa R.
Olson, and Kimberly
Hartmann discuss how
practitioners can use
electronic devices to
help students build
independence in a
range of functional skills.
CE Article
Using Outcome Measures To Improve
Occupational Therapy Practice in
Physical Rehabilitation
Earn .1 AOTA CEU (1 contact
hour or NBCOT professional
development unit) with this
creative approach to independent learning.
Research Update 33
Upper-Limb Rehabilitation,
Meal Preparation Poststroke,
and Sensory Hypersensitivities
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1

AOTA News
News
AOTA Part of
RT Grant
AOTA received $10,000
as part of a 3-year grant
awarded to Rebuilding
Together (RT) by the Department
of Housing and Urban
Development. Beginning May 1,
2011, the grant supports a pilot
project with four RT affiliates,
in Pittsburgh, Pennsylvania;
Denver, Colorado; Tampa,
Florida; and Columbus, Ohio.
AOTA occupational therapy
staff and members will be
providing home assessments
for safety and accessibility, and
other RT staff or volunteers will
be assessing additional aspects
of a healthy home.
OT Practice
Thanks Reviewers
The staff members of OT
Practice thank the following
persons for sharing
their expertise by providing
content reviews of manuscripts
and articles from April 11
through June 20: Sue Berger,
Lenore Frost, Dottie Handley-
More, Gavin Jenkins, Deborah
Lieberman, Robyn Otty, Laurel
Radley, Shannon Radmacher,
Douglas Rakoski, Camille
Sauerwald, Sandy Schefkind,
Debee Slater, Tracy Van Oss,
and Renee Watling.
Upcoming Pediatric
Virtual Chats
Join AOTA staffers and
other occupational therapy
professionals for two
upcoming AOTA-sponsored
pediatric virtual chats: “Mealtime
and Feeding Issues for
Association updates...profession and industry news
Children With ASD,” on July
19 at 7 pm EST, and “Use of
Telehealth in Early Intervention
and School System Practice,”
on August 1 at 2 pm EST. To
listen to these upcoming chats
as well as past episodes, go to
www.talkshoe.com/tc/73733.
Industry News
Pi Theta Epsilon
Annual Business
Meeting
Pi Theta’s Annual Business
meeting this year will be
held the morning of Friday
November 11, 2011, at the 2011
AOTA/NBCOT National Student
Conclave in Providence, Rhode
Island. Delegate packets will
be sent out to Pi Theta Epsilon
members in the fall with more
details. All PTE members,
including faculty advisors, are
welcome to attend. For more
information, contact Jessica
Halterman at jhalterman@
aotf.org.
Resources
New HHS
Interactive Video
on Health Care
Infections
Health care–associated
infections harm many
patients, causing injuries
and raising costs, according to
the U.S. Department of Health
and Human Services (HHS).
At any given time, about 1 in
every 20 patients is affected by
an infection related to hospital
care. To help prevent infections
acquired in hospitals and
other health care settings, the
HHS Office to the Assistant
Secretary for Health in May
2011 released an interactive,
computer-based video-simulation
training program called
Partnering to Heal: Teaming up
Against Health Care-Associated
Infections, which permits users
to “become” one of five characters
who make decisions that
impact health risks, then examine
the results of the choices
and learn from the outcomes.
The program is designed for
students in the health professions,
early career clinicians,
other health care personnel,
patients, and families. Available
free online, the video promotes
a team-based approach to
reducing preventable infections
and deaths in the United
States. To access the Partnering
to Heal training video, visit
www.hhs.gov/partneringtoheal.
For more information about
Partnership for Patients, visit
www.healthcare.gov/center/
programs/partnership.
Consumer Guide
for Reducing
Medication Errors
with three out of four
U.S. patients failing to
follow their physician’s
advice about taking prescription
medication, according to
U.S. Surgeon General Regina
Benjamin, MB, MBA, the U.S.
Department of Health & Human
Services’ Agency for Healthcare
Research and Quality and the
National Council on Patient
Information and Education
recently released a revised
booklet for consumers on taking
medicines safely. Called
Your Medicines: Be Smart. Be
Safe, the booklet is available
in English and Spanish and
includes a detachable, walletsized
card that can be personalized
to track all medicines
patients are taking. The guide
may be downloaded at www.
ahrq.gov/consumer/safemeds/
yourmeds.htm.
STARs Come Out
The Beverly Foundation
recently announced the
winners of its 2011 STAR
Awards for Excellence, which
enable recipients to promote
and provide transportation
services to older adults. Winners
of the $20,000 STAR
awards included Community
Partners in Caring, in Santa
Maria, California; Friendship-
Works, in Boston, Massachusetts;
and Senior Services, in
Seattle, Washington. Winners
of the $15,000 STAR Special
Recognition Awards included
the College of Southern Idaho
Office on Aging, in Twin Falls,
Idaho; Elder Services of the
Merrimack Valley, in Lawrence,
Massachusetts; and the Grafton
County Senior Citizens Council,
in Lebanon, New Hampshire.
Two occupational therapists—Elin
Schold Davis,
OTR/L, CDRS, AOTA’s Older
Driver Initiative coordinator,
and Dennis McCarthy, PhD,
ORT/L, assistant professor
in the Occupational Therapy
Department at Florida International
University’s College of
Nursing and Health Sciences—
were on the review committee
this year for the Star Awards.
The Beverly Foundation
undertakes research, technical
materials development, assistance,
and program recognition
to encourage and facilitate
mobility and transportation for
2 JUNE 20, 2011 • WWW.AOTA.ORG

older adults. For more information
about the STAR awards,
including additional winners,
visit www.beverlyfoundation.org.
Intersections
n A number of AOTA members
and staff recently attended an
Institute of Medicine (IOM)
meeting to ensure occupational
therapy continues to
be included in health care
reform implementation. AOTA
member Joan C. Rogers, PhD,
OTR/L, FAOTA, chairperson
of the Department of Occupational
Therapy at the School
of Health and Rehabilitation
Sciences at the University of
Pittsburgh, participated in the
panel presentation at the IOM’s
Board on Health Care Services
Workshop on the Allied Health
Workforce and Services, held
May 9 to 10 in Washington, DC.
Rogers’ presentation, titled
Allied Health Professionals as
Core Team Members Under
Health Care Reform, covered a
variety of topics, including how
allied health professionals are
well positioned to deliver both
patient-centered and team-
centered contributions to
health care reform.
Participants in the IOM
meeting also included Shaun
Conway, OTR, director of
Credentialing Services of the
National Board for Certification
in Occupational Therapy; Roy
A. Swift, PhD, FAOTA, senior
director of Personnel Credentialing
Accreditation Programs
at the American National
Standards Institute; and Chuck
Willmarth, AOTA’s director of
State Affairs and Reimbursement
and Regulatory Policy.
n AOTA Executive Director
Fred Somers was recognized
by the National Association of
Rehabilitation Providers and
Agencies (NARA) for AOTA’s
collaboration with the organization
and its members, who
OT PRACTICE • JUNE 20, 2011
represent rehab businesses
consisting of more than 15,000
health care professionals
providing skilled rehabilitation
therapy services to individuals
in a variety of settings.
Practitioners in the News
n Sarah Burton, MS, OT/L,
FAOTA; Joyce Mistrilli, MS,
OT/L; Jodie Williams, OT/L,
MHA; and Sue Cecere, PT,
MHS, represented the Maryland
State Steering Committee
for Occupational Therapy and
Physical Therapy Services at
in the Council for Exceptional
Children (CEC) National
Conventional and Expo, held
on April 26, 2011, at National
Harbor, Maryland. Their
presentation on “Occupational
Therapy and Physical Therapy:
A Model Guide for Services,
Birth Through 21,” highlighted
the responsibilities, ethical considerations,
and other issues
of integrating federal and state
regulations, state practice acts,
and professional frameworks
with school-based and early
intervention practice.
n Margo Gross, EdD, OTR/L,
LMT, LMFT, assistant professor
of occupational therapy
at Sacred Heart University, in
Fairfield, Connecticut, will give
a presentation on “Perseverance,
Patience, and Possibility:
Teaching Intimate Self-Care
Skills,” at the Autism Society
of America’s 42nd National
Conference and Exposition,
to be held July 6 to 9, 2011, in
Orlando, Florida.
n Florence Hannes, MS, OTR,
FAOTA, chairperson of the
Occupational Therapy Assistant
Department at Orange County
Community College (OCCC),
in Middletown, New York, was
one of eight women to receive
the 2011 Tribute to Women
of Achievement of Orange
continued on page 4
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3

County, awarded by the Girl
Scouts Heart of the Hudson and
YMCA Orange County. Hannes
was instrumental in founding
OCCC’s Center for Assistive
and Rehabilitative Technology
last year and is a 33-year faculty
member of OCCC, which is
part of the State University of
New York system.
n Karen Jacobs, EdD, OTR/L,
CPE, FAOTA, clinical professor
in the Department of Occupational
Therapy at Boston
University’s Sargent College
of Health and Rehabilitation
Sciences, was recently featured
in the Boston Globe for her
work supporting good posture
and intelligent office design as
a way to offset the risks posed
by today’s technology-driven
and deskbound lifestyles. To
view the article, visit http://
articles.boston.com/2011-05-23/
lifestyle/29574829_1_tai-chiposture-notebook-computers.
n Carly Rogers, MA, OTR/L,
was highlighted in a Reuters
feature picked up by several
publications featuring her
“Ocean Therapy” for military
veterans, which combines the
activity of surfing with group
discussions in an attempt to
alleviate symptoms of mental
and emotional disorders that
can affect veterans. See the
Reuters story at http://blogs.
reuters.com/photo/2011/05/18/
surf-therapy/ and a local Patch.
com article and video available
at http://manhattanbeach.
patch.com/articles/surf-washesthe-pain-away#video-6077337.
n S. Maggie Reitz, PhD, OTR/L,
FAOTA, received the Towson
University College of Health
Professions Dean’s Alumni
Recognition Award for her
scholarship as well as her long
history of service to Towson
University and the profession of
occupational therapy. Her contributions
include serving as a
past president of the Maryland
Occupational Therapy Association
and chair of AOTA’s Ethics
Commission.
n Beth Merryman, PhD, OTR/L,
associate professor at Towson
University’s Department
of Occupational Therapy &
Occupational Science, and her
students are helping Baltimore,
Maryland, Police Department
(BPD) officers achieve their
BEST—Behavioral Emergency
Services Team training—
which teaches them how to
deal with people with mental
illness. All new BPD recruits
are required to complete the
training. A recent story by WJZ,
Baltimore’s CBS affiliate, can
be found at http://baltimore.
cbslocal.com/2011/05/08/balti
more-police-officers-learn-tohelp-those-with-mental-illness.
n Christine Wietlisbach, OTD,
MPA, OTR/L, CHT, was elected
chair of the California Board of
Behavioral Sciences on May 19.
The Board of Behavioral Sciences
regulates the practice in
California of licensed educational
psychologists, licensed
clinical social workers, marriage
and family therapists, and
licensed professional clinical
counselors. Wietlisbach is a
practicing occupational therapist
at Eisenhower Medical
Center and a faculty member at
Loma Linda University, in Loma
Linda, California.
Andrew Waite is the associate editor of
OT Practice.
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CE-205

c APi TAl B riefiN g
TCMS Proposes to Change SNF PPS Rule
on Group Therapy and More
he Centers for Medicare & Medicaid
Services (CMS) published its proposed
2011 Skilled Nursing Facility
Prospective Payment System (PPS)
rule for fiscal year (FY) 2012 in the
May 6, 2011, Federal Register. The
proposed rule includes significant
changes that would affect occupational
therapy practitioners who work
in skilled nursing facilities (SNFs).
The final rule is expected in late July
or August 2011 and will take effect on
October 1, 2011. AOTA is currently
analyzing the implications of the proposed
rule for therapy and drafting
comments to assert the Association’s
positions to CMS. AOTA is consulting
with members, our therapy association
partners, and industry leaders
to craft a powerful response to the
proposal. Comments are due
June 27, 2011.
Group Therapy: CMS is proposing to
change the way group therapy minutes
are counted. CMS believes that
patients receive the maximum benefit
of group therapy when there are four
patients in the group and is proposing
to allocate group therapy minutes on
the basis of four patients, regardless
of the number of people in the group.
For example, a therapy practitioner
treating four patients in a group for 60
minutes would count 15 minutes for
each patient. AOTA is reviewing the
research regarding group therapy.
Therapy Documentation: CMS
clarified its expectations for clinical
documentation needed to support
each patient’s plan of care, including
group therapy interventions. The
plan of care would need to include
an explicit justification for the use
OT PRACTICE • JUNE 20, 2011
Jennifer Bogenrief
of group, rather than individual or
concurrent, therapy. If the use of
therapy services deviates significantly
from the patient’s original plan of
care, the therapist would also have to
clearly describe the reasons for those
changes in the plan of care.
Resident Assessments: CMS is proposing
modifications to the schedule for
completing the Minimum Data Set,
Version 3.0 (MDS 3.0). An End-of-
Therapy (EOT) Other Medicare-
Required Assessment (OMRA) would
have to be completed once all therapy
services cease for 3 consecutive days,
regardless of the reason. CMS is also
proposing to eliminate the distinction
between a 5-day or 7-day-a-week
facility. CMS is proposing a new
assessment called an End-of-Therapy
Resumption (EOT-R) OMRA. If a
patient does not receive therapy for
up to 5 consecutive calendar days and
resumes at the same RUG-IV classification
level (mode and intensity)
as before, then an EOT-R may be
completed, instead of doing an EOT
and a subsequent new therapy evaluation
or a Start-of-Therapy OMRA.
In addition, CMS is proposing a new
Medicare-required assessment, the
Change-of-Therapy (COT) OMRA,
to be completed by SNFs whenever
the intensity of therapy changes to
a degree that no longer reflects the
RUG-IV classification and payment
assigned to the patient based on the
most recent assessment. This would
require assessing reimbursable therapy
minutes every 7 days to determine
whether a COT OMRA is required.
AOTA would like to hear from members
about the administrative burden
of these assessments.
Student Supervision: CMS is proposing
to remove the requirement for
line-of-sight supervision of a student.
This change in policy would require
revisions to the Resident Assessment
Instrument Manual for the MDS 3.0.
Rates: CMS is proposing two options
for updating the payment rates used
under the SNF PPS: (1) apply the
standard update without recalibration,
which would result in a $530 million
(1.5%) increase, or (2) a $3.94 billion
(11.3%) reduction in payments to
adjust for an unexpected increase in
nursing home payments during FY
2011 by restoring overall payments
to their intended levels on a prospective
basis. According to CMS, initial
data reflecting actual RUG-IV claims
show that patients are being classified
into one of the highest paying RUG-
IV therapy groups 43% of the time,
while CMS projected less than 10% of
the time. CMS believes this is due to
a significant reduction in the use of
concurrent therapy, and a significant
increase in the use of individual and
group therapy. As a result, FY 2011
Medicare SNF payments are much
higher than the original projections. If
this continues, CMS may have to recalibrate
the parity adjustment in order
to transition from RUG-III to RUG-IV
in a budget-neutral manner.
A detailed analysis of the proposed
rule is available on our Web site at
www.aota.org. Please e-mail your
thoughts to rrpd@aota.org. n
Jennifer Bogenrief is AOTA’s senior regulatory
analyst in the Reimbursement and Regulatory
Policy Department. She can be reached at
jbogenrief@aota.org.
5

iN THe cliN ic
e
Electronic Multitasking
Analyzing Work Routines
lectronic devices have permeated
the lives of young adults, providing
access day and night to information
(Internet), instant socialization
(e.g., Twitter, Facebook), shopping,
electronic books, YouTube videos,
and more. These virtual electronic
media have an ever-increasing
popularity and are considered an
important component of everyday
life for young adults. 1 These virtual
contexts, as described in occupational
therapy terminology, 2 are characterized
by instantaneous access,
simultaneous viewing by multiple
individuals, and influence on clients’
daily occupations. 3–4
Although the virtual context creates
easy opportunities to electronically
multitask, 5 the degree to which
electronic multitasking is effective in
helping complete daily occupations is
questionable. Occupational therapy
can play an important role in determining
effective habits and routines
that promote, establish, or modify
electronic multitasking for increased
productivity in daily occupations.
THE DILEMMA
Multitasking, which can be operationally
defined as “the concurrent processing
of two or more tasks through a
process of context switching” (p. 2), 6
seems to be the answer to the dilemma
of too much to do and too little
time. However, neuroscientists have
discovered that people aren’t really
doing two activities at the same time,
except when combining simple tasks
with highly routine activities, such
as walking and talking. 7–8 Instead,
we cognitively switch back and forth
from one activity to another. 9–10 This
Kimberly Hartmann Barbara Nadeau Martha Sanders
finding suggests that multitasking
may actually make us less efficient,
because we need to constantly refocus
and retain the contents of the previous
task. A recent study from the Henry J.
Kaiser Family Foundation examined
the use of media among 8 to 18 year
olds. 11 Electronic multitasking among
this group increased from 16% in 1999
to 29% 2009, but even these young
people, who have grown up in an environment
of electronic multitasking,
struggle to multitask effectively. Those
who multitask the most exhibit greater
challenges on attention, learning, and
occupations. 12–13 Occupational therapists
can evaluate individuals’ and
organizations’ environmental, temporal,
and virtual contexts to determine
how the performance patterns or routines
of electronic multitasking may
influence the occupation of work. 2
MARIA: NEGATIVE IMPACT OF
ELECTRONIC MULTITASKING ON
WORK PRODUCTIVITy
Maria is currently a 20 year old who
holds a high school diploma and works
at an oil company doing accounts
receivable and payable as well as
receptionist work during the busy
times of day. In the fall of her senior
year in high school, she experienced
an elbow to the forehead during a
basketball game that resulted in a
concussion and 6-day hospitalization.
Maria had outpatient brain injury rehabilitation
and daily schooling at home
for the remainder of her senior year.
Her connections to friends, teachers,
and the basketball team were
primarily virtual: e-mail, Facebook,
Twitter, and instant messaging or text.
Her friends went to college and she
went to work. She received ongoing
cognitive rehabilitation with a clinical
psychologist; however, she continued
to experience difficulties in attention,
concentration, working memory, and
sequencing of tasks. Her strong skills
in using electronic spreadsheets and
applying accounting principles, and
her interpersonal skills, allowed her
to meet the performance standards in
the accounting department at the oil
company. But 1 year into her job, her
psychologist referred her for an occupational
therapy consultation because
her work production had decreased,
and neither she nor her supervisor
were able to identify the source of the
problem.
Maria provided recent medical
reports that indicated no changes in
her medical status. She reported no
changes in her personal life, home
life, or job responsibilities. Maria
reported that she knew she was making
mistakes in account data entry,
was confusing the names of people
who came to the receptionist desk,
and was misplacing mail and checks
for accounts receivable. Maria agreed
to a work-site observation in order to
discover why she was making mistakes
and having decreased work performance.
The occupational therapy
consultant performed an analysis of
occupational performance by observing
Maria in the work environment.
The targeted outcome of the activity
analysis was to improve work productivity
and decrease errors. An 8-hour
observation yielded no observed
problems in the required body functions
to do any activities, no barriers
in space demands, and complete and
accurate control over the objects and
6 JUNE 20, 2011 • WWW.AOTA.ORG

PHOTOGRAPH © TImIRAOS STUDIO / ISTOCKPHOTO
The literature indicates that electronic
multitasking...may represent a shifting in
cognitive skills (exacerbated by technology)
rather than a change in actual functional routine.
This cognitive shifting may lead to a decrease in
efficient work production.
materials required to perform her work.
But Maria was observed to have developed
a regular and repetitive behavior, a
routine 2 of shifting her attention between
three or more electronic media on her
computer. For example, when recording
accounts received into an electronic
spreadsheet, she felt compelled to shift to
the company electronic banking account
to see what electronic payments were
made. Once there, Facebook and other
Web sites distracted her, and she shifted
to those electronic media to complete
personal activities. When she was working
as the receptionist, she would surf
the Internet and check a variety of social
media looking for information about her
high school friends. When a customer
arrived, she would have to shift her attention
from the electronic media to the
customer, often calling the customer by a
friend’s name and then not being able to
recall the customer’s name for recording
in the register.
A similar routine was dominating her
break and lunch times. Maria would begin
to text, Tweet, e-mail, and check Face-
OT PRACTICE • JUNE 20, 2011
book on her smart phone as she walked
through the company halls, ignoring the
face-to-face socialization that her supervisor
considered important. Her bathroom
and planned breaks were double the
typical length deemed appropriate by
the supervisor because Maria used that
time to text message her friends. Maria
explained that her typing was slow and
was necessary to complete her personal
business and connections. The completed
activity analysis yielded unsuccessful
attempts of significantly consistent
routines of electronic multitasking. These
routines led to decreased work production,
supervisor dissatisfaction with
Maria’s performance, and frustration for
Maria because she could not manage the
distractions of the electronics while trying
to stay connected in her personal life.
Maria said that at the end of a work day,
she recognized she had not completed
her work and that the quality of the completed
work had decreased, yet she could
not identify the reason why.
Maria’s goals were to improve work
productivity to her previous level while
feeling connected to her high school
peers who were now in college. Based
on observations of her performance
skills, performance patterns, and an
activity-demand analysis, the consultant
hypothesized that the temporal and
virtual contexts needed revision and
the occupational therapy approaches of
restoration and modification might be the
most appropriate approaches for intervention.
The objective was to prioritize
work tasks, remove potentially distracting
electronic stimuli during work hours, and
educate Maria about the negative influences
of electronic multitasking. Work
modifications using the computer were
explored. A hard copy of the accounts
receivable and payable was made and
the computer was shut off. Maria then
entered all of the bills to be paid and all of
the checks received manually onto paper.
Once completed, she entered the figures
into the electronic spreadsheets and completed
the electronic banking. Facebook
was time-blocked by the employer’s
continued on page 24
7

App Support
Mobile Software Applications for Individuals
With Cognitive and Behavioral Challenges
A
s occupational therapy prac
titioners, we spend our days
analyzing activities activities and
generating creative ways
to make everyday tasks
easier for for our clients with cognitive and
behavioral deficits, in order to promote
greater independence. Many individuals
with disabilities need support for
transitioning, sequencing, memory,
planning, motivating, deciding, choosing,
processing, organizing, and
communicating. Developers of cellular
phone– and personal digital assistant
(PDA)–based applications (apps) are
also working hard using their knowledge
of computer programming to
create a plethora of smart technology
programs aimed at making life easier
for the general public. Combine the
two worlds and you get promising
new options for occupational therapy
practice.
Individuals with disabilities may not
have been the population developers
were originally targeting for some of
these applications. However, inspired
by its mainstream popularity, smart
technology has been quickly adopted
among many individuals with disabilities,
their families, and service
providers as an innovative solution to
many everyday challenges. With each
new version and generation of devices
equipped to support apps, accessibility
features continue to expand exponentially.
This is made possible in part by
feedback from the public to guide the
development of a universally accessible
device. Considering the current trends
among both the mainstream population
LINDSEy AFTEL
MARy FREEMAN
JESSICA LyNN
WHITNEy MERCER
and individuals with disabilities, the
market continues to respond with more
and more cutting-edge devices.
How then are such devices being
used as assistive technology (AT) for
occupational therapy clients, and what
role do practitioners play in helping
clients use it? The devices offer many
simple and intuitive solutions (for
examples of available applications, see
Table 1 on p. 11), but of course there
is more to AT than just handing it out.
Occupational therapists are responsible
for evaluating the needs and skills of
their client, selecting AT systems, providing
training for all parties involved,
and continuously evaluating to ensure
successful intervention. 1 Without evaluation,
assessment, training, and followup
from an occupational therapist, even
the most revolutionary and attractive
piece of AT is likely to end up on a shelf
in the closet.
As far as training for the practitioners
in using this technology, many
college and university occupational
therapy programs discuss modern
assistive technology as part of their
curricula. But by using clinical reasoning
and AT frameworks, occupational
therapists currently in practice are
already well equipped to evaluate and
select appropriate smart devices for
their clients.
MOBILE APPS’ ADVANTAGES
Before suggesting smart devices to
a client, it is a good idea to take an
opportunity to visit a local retailer and
explore some of the devices. Although
the devices are designed to be simple
and intuitive to use, and usually are,
it is important to be well versed in the
specifications of the various models.
Any particular feature of a device
is important within the context of
occupational therapy only if it provides
the necessary support specific
to the client’s needs. With that said, it
is important to know the most basic
skills necessary for any client to be able
to access apps on one of the various
devices (e.g., dexterity, visual acuity,
cause and effect).
Occupational therapy practitioners
are historically known for being experts
in AT, facilitating the use of technology
to achieve maximum independence. By
analyzing performance patterns, skills,
habits, routines, and activity demands,
practitioners take a holistic perspective.
The Human Activity Assistive
Technology (HAAT) model provides a
framework for occupational therapists
to simultaneously look at the human,
the activity, the technology, and the
context in order to evaluate the role
AT plays in a person’s life. 1 The HAAT
model can be used across contexts,
with persons of varying disabilities, and
throughout the life course. The following
case examples illustrate ways in
8 JUNE 20, 2011 • WWW.AOTA.ORG

ILLUSTRATION © RYCCIO / ISTOCKPHOTO
The ubiquity of mobile devices is helping
occupational therapy practitioners support
individuals with disabilities in myriad ways.
which occupational therapists can work
with clients to use AT effectively.
CASE ExAMPLE: TRISH
Trish was a 30-year-old woman with
autism who recently moved from a
group home to living independently in
an apartment. Although excited about
a potential employment opportunity
at a nearby shop, which was within
walking distance from her apartment,
Trish and her occupational therapist
had concerns about navigating the
several turns through the neighborhood
to get there. How could an app
assist Trish in getting to work and
increase her confidence in feeling safe
doing so? Trish already had an iPhone
and enjoyed using it, so when the
occupational therapist suggested using
an app for support, she was extremely
motivated to do so. She was already
very proficient using the iPhone and
was pleasantly surprised to hear how
it could help her. Trish’s occupational
therapist was equally excited about
the match because of her knowledge
of existing research supporting the
benefits of the use of PDAs as cognitive
aids for individuals with autism. 2
To guide the selection of AT, an
occupational therapist and client typically
look together at the specific tasks
that make up the activity, the contexts
within which it will be performed, and
the person’s performance skills and client
factors. The AT acts as an enabler
of success that might ordinarily be hindered
by the person’s deficits. 1 Because
Trish had difficulty with organization,
sequencing, ignoring distractions, and
OT PRACTICE • JUNE 20, 2011
responding appropriately to interruptions
or changes in normal routines, her
occupational therapist suggested using
the iPhone’s built-in “Maps” feature, a
GPS app, for support in these areas.
The occupational therapist hoped that
by providing Trish with visual turnby-turn
feedback, she would be able
to stay on her route as she walked to
work.
After selecting the appropriate
AT and providing initial instructions,
occupational therapists continue to
re-evaluate as the client’s contexts,
skills, abilities, and needs change and
technologies evolve, to ensure the
effectiveness of the AT over time. After
a trial run with Trish to evaluate how
well the selected AT option was working
for her, the occupational therapist
found that Trish might have difficulty
relating the maps to her real-life walk
to the shop when alone. So the occupational
therapist decided to take a different
approach and have Trish download
My Pictures Talk, a video self-modeling
app, in order to video record Trish
walking to the shop. The video is available
on her iPhone so she can easily
access it every time she walks to work.
As the occupational therapist expected,
this is a much better option for Trish
because the connection between
abstract and concrete is made for her.
She watches the video as she walks,
which includes prompts to pause and
look for oncoming traffic and other
safety hazards, ultimately giving her
confidence to make it there safely.
9

Throughout the entire AT process,
occupational therapy practitioners
collaborate with, educate, and value
the interests of the client and his or
her support system. In this case, the
occupational therapist spoke with
Trish’s job coach and employer prior
to selecting a device and frequently
throughout Trish’s use of the device
to monitor progress. The occupational
therapist was also able to recommend
other uses of the iPhone that might
benefit Trish throughout her workday,
such as a visual schedule of daily tasks
to complete. The therapist also sent
home educational materials to Trish’s
family about how she was using her
iPhone for support so that they would
be on the same page and better able to
help Trish outside of her occupational
therapy sessions.
CASE ExAMPLE: TREy
Trey is a high functioning 20-year-old
male with autism and obsessive-compulsive
disorder. Although he is able to
live somewhat independently in a small
apartment attached to his parents’
house, Trey still faces many day-to-day
challenges associated with his disorders.
He often becomes lost in tasks
when there is an element of tactile sensory
stimulation, leading to perseveration
and failure to complete the entire
task. In addition to having difficulty
sequencing parts of a larger task,
Trey requires a lot of support
to be productive throughout
all aspects of his life. He relies
heavily on cues from teachers,
employers, and family members
to complete assignments, work
tasks, and activities of daily living.
Further, his mind is often
flooded with obsessive thoughts
that not only distract him from
the task at hand, but also can be
emotionally challenging.
Trey is employed at a local
fast food restaurant where he
is required to perform 12 daily
tasks. With an iTouch in hand,
though, Trey can access various
apps throughout the day that
help him get his job done.
After clocking in, Trey opens
up Visules, a visual checklist
app that sequences his daily
work tasks. Actual pictures of
Inspired by its mainstream
popularity, smart technology
has been quickly adopted
among many individuals with
disabilities, their families,
and service providers as an
innovative solution to many
everyday challenges.
Trey performing each task are even
uploaded to the app to further help
him perform the task proficiently. With
an alarm set, Trey begins his work.
When the alarm goes off, Trey places a
check next to the task that he has just
completed, and he moves down the
list efficiently. The alarm helps Trey
keep track of time and prevents him
from fixating on a single task such as
washing tables. When a customer walks
in and the restaurant’s door chime
goes off, Trey is flooded with intrusive
thoughts about being attacked.
Although Trey has been working
through these issues with a counselor,
he is often unable to disregard them.
He accesses iCounselor: OCD, a colorcoded
scale in which he can rate the
severity of his obsessive thoughts.
By touching the button that matches
the level of his OCD, Trey is instantly
connected to strategies for coping and
chooses to engage in deep breathing
in a quiet place, taking little time away
from his task. With supports in place,
Trey is able to work with increased
levels of independence and pride.
REACHING IEP GOALS THROUGH AT
With the many apps offered on the
Apple iPad and iTouch as well as the
many other tablet and smart phone
products on the market, Jennifer Dickerson,
OTR/L, a school-based occupational
therapist in Hanover County,
Virginia, is finding lots of opportunities
to help students reach some of their
individualized education program goals
through the use of AT. In talking with
Dickerson, the authors found there
is an app for many areas of occupation
and skills, including addressing
self-regulation, behavior management,
attention to task, and academic
achievement. For instance, apps such
as iReward, a behavioral management
reward system, allow you to post
pictures of a personalized reward that
a child can work up to by earning a set
amount of stars. Other apps, including
ABC Data and BehaviorTrackerPro, collect
data on the frequency and duration
of behaviors and produce graphs and
percentages to aid in assessment. Low-
and high-tech strategies can help
children successfully participate
in school activities and facilitate
access to a free and appropriate
public education for all students.
Working primarily with students
who have autism, cerebral palsy,
speech or language impairments,
and other health conditions,
Dickerson is able to use
the apps as AT tools to facilitate
students’ communication,
accommodations, transition to
work, and access to participation
in general education with their
peers. Communication apps like
Proloquo2go, iCommunicate, and
Voice4U offer text-to-speech or
picture-communication options,
for example.
Although the use of apps
in school-based occupational
therapy might be an emerging
approach, the students in
10 JUNE 20, 2011 • WWW.AOTA.ORG
PHOTOGRAPH © ARTHUR CARLO FRANCO / ISTOCKPHOTO

Table 1. App Examples
App Function Cost*
Voice4U Includes a library of picture and voice prompts (for individuals with speech difficulties)
Allows download of your own photos and audio prompts
OT PRACTICE • JUNE 20, 2011
Communication
Proloquo2Go Full-feature augmentative and alternative communication solution
Provides natural sounding, text-to-speech voices
iCommunicate Offers preloaded pictures and storyboards or routines (e.g., schedules) that facilitate language
comprehension
Speak it! Copy or type text for text-to-speech voices
Uses natural sounding voices
Behavior
iReward Behavioral management reward system
Allows you to post a picture of a reward and give stars for behaviors that will win the reward
ABC Data Data collection tool for counting behavior by simple tallies or percentages, recording the session
duration, and e-mailing the data
Aids for Daily Living
$29.99
$189.99
Picture Scheduler Task organizer—attach photo, video, or audio to reminder message $2.99
Grocery IQ Make shopping lists, aisle by aisle, with mini-lists for usual and unusual purchases
Ability to scan bar codes with mobile camera
iPrompts Create picture-and-text task sequences for multistep activities, create choice sets and activity schedules $49.99
My Med Schedule Web-based application that sends text alarms as reminders for taking medications free
iDress for Weather Provides images of clothing and weather conditions daily
Clearly displays the daily temperature (daily highs and lows)
Ability to customize the closet using personalized images or photos
Stories2learn
School
Create personalized social stories using photos, texts, and audio messages $13.99
Math Magic Addition, subtraction, multiplication, and division with visual supports, solution choices, reinforcers,
and rewards (star system)
myHomework Allows students to keep track of their homework, classes, projects, and tests free
Awesomenote Notetaking application and to-do manager $3.99
Other
Nav4All Navigation system for driving or walking (mobile phone navigation)
Tracking and tracing feature available (allows viewing of vehicle movements)
iCounselor: OCD Rate the frequency and strength of obsessive–compulsive disorder thoughts on a color-coded scale
Choose 1/10 calming activities then 1/10 ways to change those thoughts
*Apps and prices are subject to change.
While this article focuses primarily on Apple products, there are many devices on the market that are compatible with the apps presented above.
$34.99
$1.99
$4.99
$4.99
$.99
$1.99
$0.99
free
$0.99
11

Hanover County have taken to the
technology quickly, probably because
of the popularity of video game systems
and other handheld technology devices
they already use. Typically, AT devices
bought by public school systems stay
in the school system after students
graduate. This leaves parents with the
responsibility of finding funds to purchase
devices that their children are
familiar with, which can be a burden.
But because they are so widely used,
smart technology devices with multifunctional
features are often more
affordable and easier for consumers
to access. For example, many school
systems loan out word processing
devices to their students that begin
at $150 and typically serve only one
purpose: assisting with written communication
for completing classroom
assignments. However, with a smart
device, the student could use AT not
only for written communication, but
also for assistance in verbal communication,
social skills, transitioning, and
behavior modification. Although the
device may cost around $500, there is
a wide price range for the apps, some
of which are free, enabling a family to
purchase within their means. If the
initial purchase is not a realistic option
for a family, occupational therapy
practitioners can help connect parents
of students with disabilities to grant
programs, among other resources.
WORKADAy APPS
Tony Gentry, PhD, OTR/L, assistant
professor at Virginia Commonwealth
University in Richmond, is conducting
research on the implementation
of apps, iPhones, iPods, and iPads
to enable individuals with disabilities
to function more independently
throughout their daily lives. As the
principal investigator of a National
Institute on Disability and Rehabilitation
Research–funded study, Gentry
will be specifically looking at personal
digital assistant (PDA)–enabled job
support for young adults with autism.
In a previous community-based trial
examining the efficacy of PDAs, Gentry
confirmed his hypotheses and expectations
of using PDAs as cognitive aids
for individuals with autism. 2 Students
with autism were provided with a Palm
Zire 31 PDA and trained to use it as a
f O r MOre i N f O r MATi ON
Apps for Children With Special Needs
http://a4cwsn.com
Technology Forum on OT Connections
www.otconnections.com.org
AOTA Online Course: Understanding the
Assistive Technology Process To Promote
School-Based Occupation Outcomes
Presented by B. Goodrich, L. Gitlow, & J.
Schoonover, 2009. Bethesda, MD: American
Occupational Therapy Association. (Earn 1 AOTA
CEU [10 NBCOT PDUs/10 contact hours]. $225
for members, $320 for nonmembers. To order,
call toll free 877-404-AOTA or shop online at
http://store.aota.org/view/?SKU=OL31. Order
#OL31, Promo code MI)
Assistive Technology in the Workplace
By D. de Jonge, M. Scherer, & S. Rodger, 2007.
St. Louis, MO: Mosby-Elsevier. ($54.95 for
members, $78 for nonmembers. To order, call
toll free 877-404-AOTA or shop online at http://
store.aota.org/view/?SKU=1423. Order #1423,
Promo code MI)
Cook & Hussey’s Assistive Technologies:
Principles and Practice, 3rd Edition
By A. M. Cook & J. M. Polgar, 2008. St. Louis:
Mosby-Elsevier. ($87.95 for members, $124.95
for nonmembers. To order, call toll free 877-
404-AOTA or shop online at http://store.aota.
org/view/?SKU=1422. Order #1422, Promo
code MI)
CONNECTIONS
Discuss this and other articles on
the OT Practice Magazine public forum
at http://www.OTConnections.org.
cognitive aid. Although many features
of smart devices and PDAs have the
potential to benefit individuals with
autism, this study focused solely on the
use of basic PDA task organizational
features such as reminder alarms, to-do
lists, and address books. The Canadian
Occupational Performance Measure
(COPM) was administered prior to
treatment and 8 weeks after the end
of PDA training. During the COPM
interview, each participant and parent
identified five functional deficits that
most affected the participant’s performance
of everyday tasks. Performance
in each deficit area, as well as
satisfaction with performance, were
rated on a scale of 1 to 10. Although
deficit areas were individualized, the
activities most often cited fell into the
following four categories: (1) forgetting
appointments, (2) managing household
activities of daily living and chores, (3)
managing homework, and (4) managing
medication. Following an 8-week
period of PDA use, the students were
reassessed. Results demonstrated
significantly improved self-report of
occupational performance and satisfaction
across everyday tasks. Additionally,
findings demonstrated retention of
training and routine use of the PDA as
a task management aid over the 8-week
period. These results support the use
of a brief, client-centered, home-based
training intervention and the use of
consumer-level PDAs as cognitive aids,
suggesting that teenagers with autismrelated
executive dysfunction can learn
how to use and benefit from a PDA as
AT. 2
CONCLUSION
These case examples are intended to
highlight a few current occupational
therapy practices implementing mobile
apps and the benefits such technology
potentially offers. Along with the apps
mentioned, there are many additional
non-Apple apps that may be relevant
and beneficial to the lives of occupational
therapy clients. n
This article is derived from a student
project for Tony Gentry’s course on
adult physical disabilities in the
Occupational Therapy Department at
Virginia Commonwealth University.
References
1. Cook, A. M., & Polgar, J. M. (2008). Cook &
Hussey’s assistive technologies: Principles and
practice (3rd ed.). St. Louis, MO: Mosby.
2. Gentry, T., Wallace, J., Kvarfordt, C., & Lynch, K.
B. (2010). Personal digital assistants as cognitive
aids for high school students with autism:
Results of a community-based trial. Journal of
Vocational Rehabilitation, 32, 101–107.
Jessica Lynn is a student at the Department of
Occupational Therapy at Virginia Commonwealth
University, in Richmond.
Mary Freeman is a student at the Department of
Occupational Therapy at Virginia Commonwealth
University.
Whitney Mercer is a student at the Department of
Occupational Therapy at Virginia Commonwealth
University.
Lindsey Aftel is a student at the Department of
Occupational Therapy at Virginia Commonwealth
University.
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P-5502

PHOTOGRAPH © KIzILKAYAPHOTOS (TOP) AND YINYANG (BOTTOm) ISTOCKPHOTO
OT PRACTICE • JUNE 20, 2011
H
Electronic
Slates
Tablets and
Handheld Devices
Help High Schoolers
Transition
KAREN MAJESKI
MELISSA R. OLSON
KIMBERLy HARTMANN
How practitioners use
electronic devices as part of
high school transition programs,
building independence
in a range of functional skills.
igh school transition programs typically
support developing functional
skills necessary for getting jobs, living
in the community, engaging in lifelong
learning experiences, and socializing
with people outside of the high school
peer group. The individualized transition
plan (ITP), as mandated by the
Individuals with Disabilities Education
Act (IDEA), 1 is critical to identifying
the skills necessary for each individual
and developing a collaborative team
plan for achieving these skills. 2–3 Occupational
therapy practitioners have the
knowledge and ability to be integral
members of ITP teams. 4 As part of
these teams, they should consider
using technology as a tool for building
independence in functional skills.
As with society generally, technology
is an increasingly everyday tool
in the educational process to provide
access to the curriculum and improve
success in developing general skills
and life skills, 5 as well as improve
access to information, entertainment,
and social milieus, and support continued
learning. 6 Because of their knowl-
19

Table 1. Accessibility features: Setting>General>Accessibility
Accessibility Option Feature Description
VoiceOver “Speaks” items on the screen; can be used for students with poor vision or
students with limited literacy skills
Zoom Magnifies the screen; can be used for individuals with visual impairments
Large Text Enlarges text size in contacts, e-mail, messages, and notes
White on Black Provides high contrast to all screens
Speak Auto-text Automatically “speaks” auto-corrections and auto-capitalizations
edge and skills in activity analysis,
contexts, occupational domains, 7 and
environment and technology, 8 occupational
therapy practitioners can be key
members of ITP teams using technology
to foster independence in students’
functional ITP goals and objectives.
This article will explore one collaborative
transition program in which
occupational therapy team members
are using iPad and iTouch tablets for
success in meeting the functional skills
of high school students in transition.
Apple products were used for this program
because they were available for
use; however, several other brands and
types of touch tablet devices available
on the market can offer similar features
in meeting students’ needs.
USING THE TECHNOLOGy
Touch tablets, whether large or small,
require a unique set of skills and abilities
for access. The role of the occupational
therapist includes evaluating performance
skills to determine whether a student
has the motor, visual motor, visual,
motor planning, and sensory skills
needed to use a touch tablet device.
Accurate finger isolation, for example, is
needed to make selections and use the
keyboard. If finger isolation is poor, a
special stylus designed for touch tablets
can be used, such as the Pogo Stylus or
the Pogo Sketch from Ten One Designs.
Precise visual motor control is also
necessary to make accurate selections.
If visual motor accuracy is not precise,
a larger device (such as an iPad) should
be considered over a handheld device
(such as the iPod Touch). A critical
skill to evaluate is the ability to swipe
across the screen both vertically and
horizontally. Screen and page navigation
depend on the user’s ability to touch–
swipe–release in rapid succession. The
evaluation should also include determining
whether the student has the ability
to hold a device in the palm of his or her
hand, or if alternatives to stabilize the
device such as the Hand-e-holder may
be needed. Consideration is also needed
for device stands that allow for visual
placement that may increase use. The
evaluation process should also include
assessing visual skills, which are necessary
to identify features and applications
in order to make choices, and tactile
and proprioceptive skills, which may
influence the gradation of movement
and activating buttons. The occupational
therapist may use accessibility
options to help circumvent these issues
(for more on this, see Table 1). The
occupational therapist must also work
collaboratively with classroom staff to
consider students’ literacy and cognitive
skills. Memory, attention, and language
abilities will influence students’ use of
a touch tablet. Considering these skills
early on will be valuable when preparing
to implement the touch tablet in
functional activities.
The occupational therapist must
also consider the environment during
the evaluation. The following are some
important environmental considerations:
Does the student have freely accessible
Wi-Fi access in his or her home, school,
and work environments? Does the
school or facility have a Web filter that
blocks the content? If either of these
situations occurs, then the occupational
therapist doing the evaluation and
planning the intervention may want to
consider a device that offers 3G service,
available from a number of manufacturers.
This type of service works from a
satellite, so an Internet connection is not
needed to use the device, though data
plans must be purchased. Hidden costs
such as monthly service plans and Wi-Fi
accessibility need to be considered
when recommending the use of these
products.
THE INTERVENTION PROCESS
When implementing large or small touch
tablet use with students, collaborating
with classroom staff and forming
an implementation plan that outlines
individual roles, responsibilities, and
timelines helps ensure that the intervention
team continually receives recommendations
about effective strategies
and tactics for supporting performance
in occupations. Team discussion on how
the smartphone or touch tablet can support
students’ meaningful participation
in occupations is critical. The team can,
for example, evaluate the student’s day
and determine where such technology
can provide support and in what ways
(i.e., can this technology facilitate communication,
participation in vocational
activities, or participation in leisure
activities; if so, how?).
In looking at all the tasks that the
student is participating in during his
or her day, the team must prioritize
which tasks require intervention (e.g.,
time management, communication).
After the task and outcome are determined,
then specific application trials
to increase independence can begin.
Among other things, sharing knowledge
20 JUNE 20, 2011 • WWW.AOTA.ORG
PHOTOGRAPH © GERI LAVROV / GETTY ImAGES

with classroom staff on using applications
(apps) in ways other than which
they were intended fosters creative
ways of using the devices for functional
skills. For example, students can use
StoryKit, an app for writing stories, to
share information about the day’s events
with peers and family members or as
conversation starters. For a listing of
many other apps, see Table 2.
When integrating the devices into
functional activities, students need
instructions on how to set them up
and create access apps online. Prior to
formal training, a preparatory session
to explore the smartphone and tablet
allows students to recognize that
mistakes can happen and be corrected.
During this time, practicing basic device
navigation (such as pressing the on/
off and volume buttons or sliding the
screen to unlock the device or navigate
pages) will build confidence.
In addition, student safety when
using a device is of critical importance
to parents and school officials. Restrictions,
established via a password, can be
set before giving the device to a student.
Occupation-based interventions are
introduced by integrating the devices
into daily tasks for each student’s ITP.
For example, during the calendar portion
of morning work, a student can
be shown how to access the calendars
on whatever smart phone or tablet
device he or she is using. Features
on the device’s calendar app, such as
the alarm, can provide a student with
a quick, effective way to better manage
his or her time. In using preparatory
methods, the clinician can review
the specific skills needed to use each
feature and/or application, followed by
practice with students during meaningful
occupations. As student performance
is observed, adjustments to the
application or the environment can
then be made. For example, a student
who had a tendency to select items in
error by tapping the device with her
thumb for stabilization was provided
with a protective case by the authors,
which decreased errors. Throughout the
intervention and re-evaluation process,
clinical observation skills should be
used to evaluate the tasks, the environments,
and student abilities to maintain
success in daily occupations. As with
all assistive technology, issues of cost,
OT PRACTICE • JUNE 20, 2011
Table 2. Partial List of Applications
Application Description Occupational Therapy Domain
iPrompt** Pictures are used to create Activities of daily living (ADLs),
sequences for prompting Instrumental ADLs (IADLs)
iInteract** A basic text-communication tool Communication,
Social Participation
iComm** A basic symbol- and text- Communication,
based communication tool Social Participation
Brain Pop** Lifelong learning is prompted Education, Leisure
through movies
Making Change** Teaches how to make change Education
Money Counting Money skills or tool to count Education, Financial
Calc** money when shopping Management
Bread & Milk Creates a grocery shopping IADLs
Classic** list and estimated bill
MSNBC.com** Current events through videos Work, Social Participation,
and stories. Leisure
BugMe!— Quick color-coded handwritten ADLs, IADLs, Work, Education,
Ink Notepad or typed “Post-it” notes, reminders, Leisure, Social Participation
& Alarms** and alarms
Vocal Voice A voice-reminder system ADLs, IADLs,
Reminder** allows for custom alert settings Social Participation
Time Timer** A visual timer allows user to ADLs, IADLs, Work,
see how much time is left in a task Education
Speak It Text to speech that can be used as a Communication, Education,
Text to Speech** communication system Work, Social Participation
Facetime iPhone and iPod Touch feature that Social Participation
Communication provides the ability to virtually
communicate
Stories 2 Learn** Personalized stories using photos, Social Participation,
text, and audio messages Education, Leisure
Story Kit** Creates electronic storybooks using Social Participation,
pictures, text, drawing, and audio Leisure, Education, Work,
recordings IADLs, ADLs
Pictello** Similar to StoryKit, allowing more Social Participation,
independence in creating journals Leisure, Education, Work,
and stories IADLs, ADLs
Penultimate* Allows for notes, sketches, or sharing Education, Leisure,
ideas Social Participation
Autism News Customizes the top stories from the Education, Leisure,
Reader** best health news and information sites Social Participation
and delivers them to your device
Dragon Voice to text that converts speech Work, Education,
Dictation** to text. E-mail or place in any text Social Participation
document
Dragon Search** Speak your search queries and get Work, Education,
instant results Social Participation
MemMatches Classic card matching game Leisure
iDress for Weather** A picture-based tool to check the ADLs
weather and determine what type
of clothing is appropriate after
checking in the virtual closet
Living Safely**+ Home and personal safety lessons ADLs, IADLs
Everyday Skills**+ Learning sessions regarding the ADLs, IADLs, Education
community, personal skills, Social Participation
transition, and transportation
Community Acts as a travel companion and will Work, Leisure,
Sidekick**+ track the location of an individual and Social Participation
send e-mail messages with map links
Key: *iPad only, **All Apple operating system (iOS) devices, +Pricing may vary with device
21

extended warranty, maintenance, storage,
transport, and safety all need to be
considered as part of the intervention
planning process.
TWO CASE ExAMPLES:
JACOB AND MONIQUE
The transitional high school program
where the authors used the touch tablet
devices focuses on having students
with cognitive challenges participate
in everyday occupations with objects
and tools that are used by their peers
and that will be used in the community.
Because of our knowledge and skills of
occupations, assistive technology, and
environmental adaptations, we were
able to easily integrate devices into the
program. Jacob and Monique are two
case examples of students who found
success using these tools.
Jacob is 20 years old and has an intellectual
disability. His verbal expression
is much greater than his reading and
writing abilities, and he has social interests,
such as having lunch and chatting
with friends, that are similar to those of
his peers without disabilities. However,
he is unable to write e-mails and send
text messages to friends to, say, invite
them to lunch or coffee. To address this
concern, the occupational therapist
recommended the Dragon Dictation app
on his iTouch to independently dictate
his message to the device and then send
the message to friends by e-mail or text
message. His contacts were pre-loaded
into his iTouch with the assistance of an
occupational therapy student, so that
he can easily contact friends and invite,
confirm, or reschedule meetings with
friends. Lunch meetings with his peer
buddy have now become the highlight
of his day. The technology facilitated his
social participation and inclusion during
lunchtime routines, building his selfesteem
and sense of belonging in the
school environment.
Monique is 19 years old and has
Down syndrome. She has good sight
word vocabulary for reading and writing
tasks and is able follow directions
written in clear simple language. She
can also write and type many familiar
words when describing her activities.
She works diligently on preferred tasks;
however, at times, she needs behavior
support plans to help her complete
assigned tasks. As part of her transition
f O r MOre i N f O r MATi ON
AOTA Online Course: Understanding the
Assistive Technology Process To Promote
School-Based Occupation Outcomes
Presented by B. Goodrich, L. Gitlow, & J.
Schoonover, 2009. Bethesda, MD: American
Occupational Therapy Association. (Earn 1 AOTA
CEU [10 NBCOT PDUs/10 contact hours]. $225
for members, $320 for nonmembers. To order,
call toll free 877-404-AOTA or shop online at
http://store.aota.org/view/?SKU=OL31. Order
#OL31, Promo code MI)
AOTA CEonCD: Staying Updated in School-
Based Practice
Presented by Y. Swinth & M. Muhlenhaupt,
2009. Bethesda, MD: American Occupational
Therapy Association. (Earn .15 AOTA CEU
[1.5 NBCOT PDUs/1.5 contact hours]. $51 for
members, $73 for nonmembers. To order, call
toll free 877-404-AOTA or shop online at http://
store.aota.org/view/?SKU=4835. Order #4835,
Promo code MI)
Collaborating for Student Success: A Guide for
School-Based Occupational Therapy
By B. Hanft & J. Shepherd, 2008. Bethesda,
MD: AOTA Press. ($63 for members, $89 for
nonmembers. To order, call toll free 877-404-
AOTA or shop online at http://store.aota.org/
view/?SKU=1250. Order #1250, Promo code MI)
CONNECTIONS
Discuss this and other articles on
the OT Practice Magazine public forum
at http://www.OTConnections.org.
program, she works with a job coach in
a supported employment environment.
She and her coach use the iReward app
on her iTouch. Her coach programs her
desired work behavior into iReward,
and Monique receives a star at periodic
intervals when she successfully
completes her tasks. Monique earns a
reward of her choice when she receives
all of her stars. She most commonly
chooses free time playing on her iTouch.
The app meets the demands of the job
and is very easy to program. Due to
difficulties in articulation and a desire
to communicate with friends, Monique
also uses StoryKit. She takes pictures
of a few important activities and places
them into a personal story about her
day. She can add a few words into her
story as well as an audio file to describe
each picture. This technology increases
her work performance on her job as well
as her communication with her family,
as she can now better share her work
experiences with them when she comes
home from work.
CONCLUSION
Occupational therapy can be an integral
service in programs for high school
students who are developing functional
skills for the transition to postsecondary
school environments. Analyzing
performance skills, activities, and the
environment provide a strong foundation
for developing purposeful activities
that build into occupations. A significant
meaningful activity in the lives of
students today is using technology, particularly
touch tablets and smartphones,
so incorporating them into therapy can
provide a normalized activity accepted
by peers without disabilities that supports
independence in functional activities.
n
References
1. Individuals with Disabilities Education Improvement
Act of 2004. Pub. L. 108-446.
2. Brollier, C., Shepherd, J., & Markley, K. F. (1994).
Transition from school to community living.
American Journal of Occupational Therapy, 48,
346–353.
3. Spencer, J. E., Emery, L. J., & Schneck, C. M.
(2003). Occupational therapy in transitioning adolescents
to post-secondary activities. American
Journal of Occupational Therapy, 57, 435–441.
4. Kardos, M. R., & White, B. P. (2006). Evaluation
options for secondary transition planning.
American Journal of Occupational Therapy, 60,
333–339.
5. Peterson-Karlan, G. R., & Parette, H. P. (2007).
Evidence-based practice and the consideration
of assistive technology. Assistive Technology
Outcomes and Benefits, 4(1), 130–139.
6. Kirschner, P. A., & Karpinski, A. C. (2010). Facebook
and academic performance. Computers in
Human Behavior, 26, 1237–1245.
7. American Occupational Therapy Association.
(2008). Occupational therapy practice framework:
Domain and process (2nd ed.). American Journal
of Occupational Therapy, 62, 625–683.
8. American Occupational Therapy Association.
(2008). Specialized knowledge and skills in
technology and environmental intervention for
occupational therapy practice. Retrieved March
25, 2011, from http://www.aota.org/practitioners/
official/skills/technology
Karen Majeski, OTR/L, works for Cheshire Public
Schools in Cheshire, Connecticut.
Melissa R. Olson, MS, OTR/L, is in private practice in
assistive technology in Connecticut.
Kimberly Hartmann, PhD, OTR/L, FAOTA, is an associate
professor and chair of the Occupational Therapy
Department at Quinnipiac University in Hamden,
Connecticut.
22 JUNE 20, 2011 • WWW.AOTA.ORG

P r A c T ice PerK s
OT PRACTICE • JUNE 20, 2011
Developing Needs Assessments
for Organizations
QThe local history museum is committed
to promoting equality, inclusion,
and belonging for all and has hired an
occupational therapist as a consultant
on a new inclusion initiative. How
does the occupational therapist conduct
a needs assessment to develop
an occupational profile for an entire
organization?
A
The Occupational Therapy Practice
Framework: Domain and
Process, 2nd Edition states that “all
people need to be able or enabled to
engage in the occupations of need
and choice…to experience equality,
participation, security, health, and
well-being” (p. 625). 1 Even when
the client is an organization, occupational
therapy practitioners strive
to form collaborative partnerships to
understand the client’s functioning
and desires, needs, and priorities. 2
When designing an intervention with
individuals, occupational therapy practitioners
observe clients engaged in
occupations or activities to understand
the transactions between client factors
and performance. In a museum, the
client factors of visiting individuals
are considered in transaction with the
organization. Although occupational
therapy practitioners summarize their
analysis to develop an occupational
profile for the client, our colleagues
in the museum world may view the
analysis as a needs assessment. The
purpose of this particular needs
assessment is to assess the organization’s
current inclusion assets and
barriers and identify additional needs
to support inclusion and participation
for all museum visitors.
At the organizational level, client
factors may include the values and
beliefs of the organization, which may
Ellen S. Cohn
Even when the client is an
organization, occupational
therapy practitioners
strive to form collaborative
partnerships to understand
the client’s functioning
and desires, needs, and
priorities. 2
be explicated in the organization’s
vision statement, goals, code of ethics,
value statement, esprit de corps, or
program strategies. Perhaps there is
an initiative for inclusion as part of
long-range or strategic plans. Thus, in
order to understand the organizations’
culture and commitment to inclusion,
it would be helpful to read any
available documents and observe the
functioning of the organization. For
example, it would be helpful to observe
staff and volunteers interacting with
and explaining exhibits to visitors.
Equally important is understanding
the structure of the organization:
the personnel, their roles and responsibilities,
who reports to whom, how
decisions are made, funding, assets
(both physical and personnel), and
challenges to achieving the organization’s
goals. Perhaps there is an
accessibility coordinator or other key
personnel within the organization who
are committed to inclusion. The activities
and relationships among staff are
influenced by the goals, roles, rules,
and procedures of the organization. It
may be particularly useful to know if
the organization includes individuals
with disabilities as staff, board mem-
bers, volunteers, or to provide feedback
on developing exhibit designs. The
functioning of an organization often is
not reflected in formal organizational
charts, policy, and formal authority.
Thus, understanding the informal
working relationships is also essential.
The needs assessment process is ongoing,
as organizations are dynamic and
constantly changing. Building a trusting
relationship with the personnel committed
to and responsible for inclusion
within the organization is crucial.
Because accessibility leads to inclusion,
accessible environments may be
viewed as organizational assets that
provide a comfortable and welcoming
experience for people with disabilities.
The principles of universal design,
to make the human environment
usable by as many people as possible,
provides a useful framework to think
about the accessibility of the organization.
3 In addition to exhibit accessibility,
the accessibility of buildings and
grounds; design of exhibit captions
and written materials for legibility
and easy comprehension; accessibility
of Web sites for use by people with
hearing, mobility, cognitive, or visual
disabilities; and programs offered by
the museum need to be considered.
Principles of universal design for
learning provide a useful framework
to consider the range of learning
needs among potential visitors of any
museum. 4
An organization’s most important
inclusion asset is its people— staff,
board members, and volunteers.
Accordingly, it is important to consider
whether museum personnel are comfortable
and knowledgeable about how
to involve individuals with disabilities
in their museum-related activities.
Together with museum personnel,
23

training needs should be identified.
Because inclusion is an ongoing process,
the occupational therapy practitioner’s
final recommendation would be to
encourage the museum to create a plan
for ongoing assessment and reassessment,
based on the evolving needs of
the museum visitors and staff. Thus,
developing an occupational profile for an
organization is an ongoing process. n
References
1. American Occupational Therapy Association.
(2008). Occupational therapy practice framework:
Domain and process (2nd ed.). American
Journal of Occupational Therapy, 62, 625–683.
2. American Occupational Therapy Association.
(2009). Occupational therapy’s commitment
to nondiscrimination and inclusion. American
Journal of Occupational Therapy, 63, 819–820.
3. Tokar, S. M. (2003). Keeping all visitors in mind:
Universal design at the Museum of Science
[Electronic Version]. Exhibitionist, Spring,
31–34. Retrieved May 5, 2011, from http://nameaam.org/resources/exhibitionist/back-issuesand-online-archive
4. Blamires, M. (1999). Universal design for learning:
Re-establishing differentiation as part of the inclusion
agenda? Support for Learning, 14, 158–163.
Ellen S. Cohn, ScD, OTR/L, FAOTA, is a clinical professor
at Boston University–College of Health and
Rehabilitation Sciences. She is a member of AOTA’s
Commission on Practice.
Autism:
A Comprehensive Occupational
Therapy Approach, 3rd Edition
By Heather Miller Kuhaneck, MS,
OTR/L, FAOTA, and Renee Watling,
PhD, OTR/L
Order #1213B
AOTA Members: $69
Nonmembers: $98
To order, call 877-404-AOTA or
shop online at http://store.aota.org/
view/?SKU=1213B BK-228
ELECTRONIC MULTITASKING
continued from page 7
technology-support department and
unblocked during lunch.
At the receptionist workstation, Maria
was allowed to access all of the electronic
media, but two strategies were put into
place. One, a timer on the screen indicated
how long Maria’s computer was on
the Internet and would chime at 5 minutes,
thus alerting her to return to receptionist
tasks. This was very effective as
Maria had reported simply “losing track of
time” while surfing. An electronic sign-in
for customers gave a consistent record of
arrivals and departures and allowed Maria
to use electronic media to remind her of
the customers’ names and their business
at the company. Two, to decrease
Maria’s time during breaks, lunch, and
in the bathroom due to typing personal
e-mails, Tweets, and Facebook postings,
the Dragon Dictate Naturally Speaking
application (app) was downloaded onto
her smart phone. This app allowed Maria
to dictate her messages, which were then
converted to text. With a one-tap selection,
she could send her messages to her
friends via e-mail, Twitter, or Facebook.
Thus, she was now more available for
nonvirtual conversations in hallways.
In sum, the work analysis demonstrated
that Maria was attempting to multitask
using electronic media at work, but
these routines led to ineffective use of
time, distractions, and loss of sequential
task completion. Strategies to decrease
the electronic distractions and use of an
electronic tool to more efficiently conduct
personal communications allowed
for Maria to meet both outcome goals.
CONCLUSIONS
The literature indicates that electronic
multitasking is pervasive in young adults
but may represent a shifting in cognitive
skills (exacerbated by technology)
rather than a change in actual functional
routine. This cognitive shifting may lead
to a decrease in efficient work production
in all people, in particular those who may
already have difficulties with attention,
focus, and cognitive shifting. The occupational
therapist’s knowledge and skills in
activity analysis, performance skills, and
performance patterns within contexts can
provide an excellent resource for people
and organizations to analyze and modify
the work domain to identify and decrease
the possible problems of what is typically
labeled as electronic multitasking. n
References
1. Gemmill, E., & Peterson, M. (2006). Technology
use among college students: Implications for
student affairs professionals. NASPA Journal,
43, 280–300.
2. American Occupational Therapy Association.
(2008). Occupational therapy practice framework:
Domain and process (2nd. ed.). American
Journal of Occupational Therapy, 62, 625–683.
3. Veen, W., & Vrakking, B. (2006). Homo zappiens.
Growing up in a digital age. London: Network
Continuum Education.
4. Wallis, C. (2006, March 27). genM: The multitasking
generation. Time Magazine. Retrieved May
5, 2011, from http://www.time.com/time/magazine/article/0,9171,1174696,00.html
5. Kirschner, P. A., & Karpinski, A. C. (2010). Facebook
and academic performance. Computers in
Human Behavior, 26, 1237–1245.
6. Ellis, Y., Daniels, B., & Jauregui, A. (2010). The
effect of multitasking on the grade performance
of business students. Research in Higher Education
Journal, 8, 1–10.
7. Foerde, K., Knowlton, B. J., & Poldrack, R. A.
(2006). Modulation of competing memory systems
by distraction. Proceedings of the Natural
Academy of Sciences of the United States of
America, 103, 11778–11783.
8. Borst, J. P., Taatgen, N. A., & van Rijn, H. (2010).
The problem state: A cognitive bottleneck in
multitasking. Journal of Experimental Psychology:
Learning, Memory, and Cognition, 36,
363–382.
9. Monsell, S. (2003). Task switching. Trends in
Cognitive Sciences, 7, 134–140.
10. Yeung, N., Nystrom, J. E., Aronson, J. A., &
Cohen, J. D. (2006). Between-task competition
and cognitive control in task switching. The
Journal of Neuroscience, 26, 1429–1438.
11. Henry J. Kaiser Family Foundation. (2010,
January). Report: Generation M2: Media in the
lives of 8- to 18-year-olds. Retrieved February
28, 2011, from http://www.kff.org/entmedia/8010.
cfm
12. Ophir, E., Nass, C., & Wagner, A. D. (2009). Cognitive
control in media multitaskers. Proceedings
of the Natural Academy of Sciences of the
United States of America, 106, 15583–15587.
13. Sun, D., Chen, Z., Ma, N., Zhang, X., Fu, X., &
Zhang, D. (2009). Decision-making and prepotent
response inhibition functions in excessive
internet users. CNS Spectrums, 14(2), 75–81.
Kimberly Hartmann, PhD, OTR/L, FAOTA, is an
associate professor and chair of the Department of
Occupational Therapy at Quinnipiac University, in
Hamden, Connecticut.
Barbara Nadeau, MA, OTR/L, CBIST, is an academic
fieldwork coordinator at the Department of Occupational
Therapy at Quinnipiac University.
Martha Sanders, PhD, OTR/L, is an associate professor
of the Department of Occupational Therapy at
Quinnipiac University.
24 JUNE 20, 2011 • WWW.AOTA.ORG

BACKGROUND ILLUSTRATION © WILLIAm CRAIG / ISTOCKPHOTO.COm
Flex-Time or Part-Time Jobs—
Do They Exist?
http://otconnections.aota.org/forums/t/10322.aspx
benjalo posted on 16 May 2011 7:16 PM
I’m a prospective student researching OT and OTA
programs and the job market. I have four children—
two still rather young. Other than the obvious advantage
of a school OT position, are there other opportunities
for OTs and OTAs to work part-time in other settings?
Jaclyn Tarloff replied on 17 May 2011 1:42 AM
You will find home health to be a lot more flexible
than a hospital, where hours are pretty standard
7-4 or 8-5 shifts. Hospitals, do, however, hire a
number of part-time therapists if you want consistent
hours a few days a week. There are also a lot
of new moms in the OT profession, and, therefore, you will
find a ton of OTs work part-time.
meredith replied on 19 May 2011 5:07 AM
There are a lot more jobs out there than you will find advertised.
Find a few places that you would love to work. Research
them. Volunteer for them. Talk with the co-workers.
Find out what they wish they could have. Offer to fill that
need. Where I work, you will hardly ever find an advertised
position. People often get a job right out of school, are hired
here from their fieldwork, and stay until retirement. You can
often create your own position by finding out the need, word
of mouth, and then presenting yourself to the powers that
be as the person to fill that need.
Joanne Bosse de Melgosa replied
on 19 May 2011 6:50 PM
Home health and PRN work are great for flexibility; however,
be careful that you have a mentor who can guide you
during your first 1 to 2 working years. Some larger OT
departments have PRN work where you can learn from
other OTs, and some are willing to hire part-time therapists.
A lot of facilities offer weekend work, which is more
flexible also. Look at the job benefits and how it fits your lifestyle
rather than how much a job pays. You will be better off.
For more of this discussion and to view other posts, go to
www.OTConnections.org. New user? Click on “User’s Guide”
in the upper right hand corner of the Web page.
OT PRACTICE • JUNE 20, 2011
s O ciA l M ediA sPOTligHT
www.aota.org/twitter
AOTAInc: Study shows obesity rising in adults
with arthritis http://ow.ly/52Kqo New fact sheet: OT’s
role in managing arthritis http://ow.ly/52Kuf 25 May
AOTAIncPR: Summer vacation is almost here.
Let kids play! There are benefits. Learn more, http://
ow.ly/526vZ #kids #children #recreation 24 May
dailyskills: #occupationaltherapy as a mind map–
very cool idea http://www.otstudent.info/ 21 May
AOTAInc: Students who receive Occupational Therapy
services are exhibiting art work produced during
their therapy (OT) sessions! http://ow.ly/4Yv5g 20 May
AOTAInc: NPR Interviewed OT Sarina Piergrossi
for “Setting goals, rehabilitating, after brain injury” story
listen (19:23 min mark) http://ow.ly/4YlEM 19 May
AOTAInc: Adding magic to medicine? Kevin is a
magician & assistant professor in OT who teaches how
to spruce rehabilitation efforts http://ow.ly/4Qvvf 9 May
Find us on Facebook
www.aota.org/facebook
American Occupational Therapy Association:
iPads help kids with disabilities
bridge gap... Are you using them in therapy?
What apps? iPads are becoming a successful therapeutic tool
for children with disabilities. http://awe.sm/5LKEM (video).
27 May 10:09 AM
Rebecca Griggs, Jennifer Schmitt Mehring, Carol Smith
and 51 others like this.
Edie Cypcar Klinger: I am a home health OT and there are
some free vision screening apps out there. I use my iPad to
screen some of my patients for vision difficulty/processing
deficits. 27 May 11:12 AM
Journal of Visual Impairment & Blindness (JVIB): [With the]
iPad individuals can download and read JVIB on it whether
they can see or not. Sighted people like that JVIB on the
iPad looks just like the print version, blind people like that the
built-in voiceover application seamlessly reads JVIB aloud to
them. 27 May 12:12 PM
you’ll also find AOTA on www.aota.org/youtube
25

c A leN d A r
To advertise your upcoming event, contact the OT Practice advertising department at
800-877-1383, 301-652-6611, or otpracads@aota.org. Listings are $95 each for 1–10 lines,
$150 for 11–15 lines, per event. Multiple listings may be eligible for discount. Please call for
details. Listings in the Calendar section do not signify AOTA endorsement of content, unless
otherwise specified.
Look for the AOTA Approved Provider Program (APP) logos on continuing education
promotional materials. The APP logo indicates the organization has met
the requirements of the full AOTA APP and can award AOTA CEUs to OT relevant
courses. The APP-C logo indicates that an individual course has met the APP requirements
and has been awarded AOTA CEUs.
June
Online Jun. 25 & Aug. 5
Assessment and Treatment of Children with Selective
Mutism. June 25, 2011 (10 am–12:30 pm EST)
and August 5, 2011 (12 pm–2:30 pm EST), live webinar
hosted by OT Advantage. An introductory course
on assessing and treating children with Sm. This webinar
will delve into the role of the speech-language
pathologist when assessing and treating children
with Sm. Utilizing a co-treatment model and the DIR/
Floortime model, will also be discussed. Through the
use of visual media and case studies, participants
will gain a better understanding of the Stages of
Communication Comfort and how to use those Stages
to develop a systematic treatment plan. Earn 2.5
contact hours. Cost $60 (AOTA member discount offered).
Register at www.otadvantage.com.
July
Minneapolis, MN Jul. 9–19
Lymphedema Management. Certification courses
in Complete Decongestive Therapy (135 hours),
Lymphedema management Seminars (31 hours).
Coursework includes anatomy, physiology, and
pathology of the lymphatic system, basic and advanced
techniques of mLD, and bandaging for
primary/secondary UE and LE lymphedema (incl.
pediatric care) and other conditions. Insurance and
billing issues, certification for compression-garment
fitting included. Certification course meets LANA
requirements. Also in Phoenix, AZ, September
10–20. AOTA Approved Provider. For more information
and additional class dates/locations or to order a
free brochure, please call 800-863-5935 or log on to
www.acols.com.
Salem, MA Jul. 15–17
Working with Special Needs Children: Integrating
Yoga and Other Mind/Body Techniques. For additional
information or to register, go to www.color
meyoga.com or 978-468-YOGA. AOTA Approved
Provider.
August
Jacksonville, FL Aug. 13–16
ADED Annual Conference and Exhibits. Professionals
specializing in the field of Driver Rehabilitation
meet annually for continuing education through
workshops, seminars, and hands-on learning. Earn
contact hours for CDRS renewal and advance your
career in the field of driver rehabilitation. Contact
ADED of 866-672-9466. Visit our Web site at www.
aded.net.
September
Portland, OR Sept. 10–11
Evaluation & Intervention for Visual Processing
Deficits in Adult Acquired Brain Injury, Part I. Faculty:
mary Warren mS, OTR/L, SCLV, FAOTA. This
updated course has the latest evidence-based research.
Participants learn a practical, functional, reimburseable
approach to evaluation, intervention, and
documentation of visual processing deficits in adult
with acquired brain injury from CVA and TBI. Topics
include hemianopsia, visual neglect, eye movement
disorders, and reduced acuity. Also in West Haverstraw,
NY October 29–30 and Fort Worth, TX January
28–29, 2012. Contact: www.visabilities.com or
(888) 752-4364, Fax (205) 823-6657.
October
West Haverstraw, NY Oct. 29–30
Evaluation & Intervention for Visual Processing
Deficits in Adult Acquired Brain Injury, Part I. Faculty:
mary Warren mS, OTR/L, SCLV, FAOTA. This
updated course has the latest evidence-based research.
Participants learn a practical, functional,
reimburseable approach to evaluation, intervention,
and documentation of visual processing deficits in
adult with acquired brain injury from CVA and TBI.
Topics include hemianopsia, visual neglect, eye
movement disorders, and reduced acuity. Also in
Fort Worth, TX January 28–29, 2012. Contact:
www.visabilities.com or (888) 752-4364, Fax (205)
823-6657.
Ongoing
Internet & 2-Day On-Site Training Ongoing
Become an Accessibility and Home Modifications
Consultant. Instructor: Shoshana Shamberg,
OTR/L, mS, FAOTA. Over 22 years specializing
in design/build services, technologies, injury
prevention, and ADA/504 consulting for homes/
jobsites. Start a private practice or add to existing
services. Extensive manual. AOTA APP+NBCOT
CE Registry. Contact: Abilities OT Services, Inc.
410-358-7269 or info@aotss.com. Group, COMBO,
and 2 for 1 discounts. Calendar/info at www.
AOTSS.com. Seminar sponsorships available
nationally.
Online/Interactive Course Ongoing
Driving Rehabilitation: The Analysis of Occupational
Performance in the Context of Driving a
Vehicle. Occupational therapy clients want to know,
“Can I drive?” This online course is designed for
practitioners who need to address driving as part of
the intervention planning, whether for an older adult
with a stroke or a teenager with attention deficits. Understanding
the demands of driving tasks through
activity analysis will better equip the practitioner to
determine if the client is an at-risk driver. The course
is designed to (1) prepare the generalist to articulate
the rational for treatment or referral and (2) build an
essential foundation for the practitioner interested in
considering advanced expertise in driving rehabilitation.
Instructor: Dr. Anne Dickerson, dickersona@
ecu.edu, 252-744-6190. Self-paced with opportunities
to interact with driving experts. Only $100 and
approved for 20 contact hours; 2 CEUs. Link to register:
http://cpeprograms.ecu.edu/CourseStatus.awp?
&course=DRIVER
Become a Member
CONNECTIONS
AOTA’s Online Community
www.otconnections.org
Unlimited CEUs Ongoing
Clinician’s View offers unlimited CEUs at $199
for 1-full year of unlimited access to more than
640 contact hours and more than 90 courses.
Purchase before July 31st and pay only $177.
Use coupon code OTP611. Take as many courses
as you want. Approved for AOTA, IACET, BOC
CEUs. Accepted by NBCOT for PDUs. For more
information, visit www.clinicians-view.com or call
575-526-0012.
AOTA Self-Paced Clinical Course Ongoing
NEW! Occupational Therapy and Home Modification:
Promoting Safety and Supporting Participation.
Edited by margaret Christenson, mPH, OTR/L,
FAOTA, and Carla Chase, EdD, OTR/L, CAPS. This
new SPCC consists of text, exam, and a CD-ROm of
hundreds of photographic and video resources that
provide education on home modification for occupational
therapy professionals. Practitioners who work
with either adults or children will find an overview of
evaluation and intervention, detailed descriptions of
assessment tools, and guidelines for client-centered
practice and occupation-based outcomes. Earn 2
AOTA CEUs (20 NBCOT PDUs/20 contact hours).
Order #3029, AOTA members: $370, Nonmembers:
$470. http://store.aota.org/view/?SKU=3029.
AOTA Self-Paced Clinical Course Ongoing
NEW! Mental Health Promotion, Prevention, and
Intervention With Children and Youth: A Guiding
Framework for Occupational Therapy. Edited by
Susan Bazyk, PhD, OTR/L, FAOTA. This important
new SPCC provides a framework on the role of occupational
therapy in mental health interventions for
children that can be applied in all pediatric practice
settings. The public health approach to occupational
therapy services at all levels puts an emphasis on
helping children develop and maintain positive mental
health psychologically, socially, functionally, and in
the face of adversity. Earn 2 AOTA CEUs (20 NBCOT
PDUs/20 contact hours). Order #3030, AOTA members:
$370, Nonmembers: $470. http://store.aota.
org/view/?SKU=3030.
AOTA Self-Paced Clinical Course Ongoing
Early Childhood: Occupational Therapy Services
for Children Birth to Five. Edited by Barbara E.
Chandler, PhD, OTR/L, FAOTA. This course is an
enlightening journey through occupational therapy
with children at the earliest stage of their lives. Explores
the driving force of federal legislation in occupational
therapy practice and how practitioners
can articulate and demonstrate the profession’s
long-standing expertise in transitioning early childhood
development into occupational engagement
in natural environments. Earn 2 AOTA CEUs (20 NB-
COT PDUs/20 contact hours). Order #3026, AOTA
members: $370, Nonmembers: $470. http://store.
aota.org/view/?SKU=3026
AOTA Self-Paced Clinical Course Ongoing
Occupational Therapy in Mental Health: Considerations
for Advanced Practice. Edited by marian
Kavanaugh Scheinholtz, mS, OT/L. A comprehensive
discussion of recent advances and trends in
mental health practice, including theories, standards
of practice, and evidence as they apply to
occupational therapy. Includes content from sev-
26 JUNE 20, 2011 • WWW.AOTA.ORG

eral federal and non-government entities. Earn 2
AOTA CEUs (20 NBCOT PDUs/20 contact hours).
Order #3027, AOTA members: $370, Nonmembers:
$470. http://store.aota.org/view/?SKU=3027
AOTA Self-Paced Clinical Course Ongoing
Dysphagia Care and Related Feeding Concerns for
Adults, 2nd Edition. Edited by Wendy Avery, mS,
OTR/L. Provides occupational therapists at both the
entry and intermediate skill levels with an up-to-date
resource in dysphagia care, written from an occupational
therapy perspective. Earn 1.5 AOTA CEUs (15
NBCOT PDUs/15 contact hours. Order #3028. AOTA
members: $285, Nonmembers: $385. http://store.
aota.org/view/?SKU=3028
AOTA Self-Paced Clinical Course Ongoing
Collaborating for Student Success: A Guide for
School-Based Occupational Therapy. Edited by
Barbara Hanft, mA, OTR, FAOTA, and Jayne Shepherd,
mS, OTR, FAOTA. Engages school-based occupational
therapists in collaborative practice with
education teams. Identifies the process of initiating
and sustaining changes in practice and influencing
families/education personnel to engage in collaboration
with occupational therapists. Perfect for learning
to use professional knowledge and interpersonal
skills to blend hands-on services for students with
team and system supports for families, educators,
and the school system at large. Earn 2 AOTA CEUs
(20 NBCOT PDUs/20 contact hours). Order #3023,
AOTA members: $370, Nonmembers: $470. http://
store.aota.org/view/?SKU=3023
AOTA Self-Paced Clinical Course Ongoing
Strategies to Advance Gerontology Excellence:
Promoting Best Practice in Occupational Therapy.
Edited by Susan Coppola, mS, OTR/L, BCG, FAOTA;
Sharon J. Elliott, mS, OTR/L, BCG, FAOTA; and Pamela
E. Toto, mS, OTR/L, BCG, FAOTA. Foreword
by: Wendy Wood, PhD, OTR/L, FAOTA. Excellent
resource for gerontology practitioners today to help
sharpen skills and prepare for the spiraling demand
among older adults for occupational therapy services.
Special features include core best practice
methodology with older adults, approaches to and
prevention of occupational problems, health conditions
that affect participation, and practice in crosscutting
and emerging areas. Earn 3 AOTA CEUs (30
NBCOT PDUs/30 contact hours). Order #3024, AOTA
members: $490, Nonmembers: $590. http://store.
aota.org/view/?SKU=3024
AOTA Self-Paced Clinical Course Ongoing
Low Vision: Occupational Therapy Evaluation and
Intervention With Older Adults, Revised Edition,
2008. Edited by mary Warren, mS, OTR/L, SCLV,
FAOTA. Occupational therapy practice in low vision
rehabilitation services has changed significantly
since the first edition of Low Vision. The Revised Edition
helps practitioners maintain professional competency
by supporting the AOTA Specialty Certification
in Low Vision Rehabilitation (SCLV) credentialing process.
Special features include first-edition updates
and revisions, new information on evaluation, lessons
related to psychosocial issues and low vision,
eye conditions that cause low vision in adults, and
basic optics and optical devices. Earn 2 AOTA CEUs
(20 NBCOT PDUs/20 contact hours). Order #3025,
AOTA members: $370, Nonmembers: $470. http://
store.aota.org/view/?SKU=3025
AOTA Self-Paced Clinical Course Ongoing
Neurorehabilitation Self-Paced Clinical Course
Series. Series Senior Editor: Gordon muir Giles,
PhD, DipCOT, OTR/L, FAOTA. This Series includes
4 components—the Core SPCC and 3 Diagnosis-
Specific SPCCs. The Core SPCC is highly recommended
as a prerequisite for the Diagnosis-Specific
courses. Each of the Diagnosis-Specific SPCCs
is based on a case study model supported by
key concepts presented in the Core. Core SPCC:
Core Concepts in Neurorehabilitation: Earn .7
OT PRACTICE • JUNE 20, 2011
c A leN d A r
AOTA CEU (7 NBCOT PDUs/ 7 contact hours).
Order #3019, AOTA members: $130, Nonmembers:
$184. http://store.aota.org/view/?SKU=3019.
Diagnosis-Specific SPCCs: Neurorehabilitation
for Dementia-Related Diseases (Order #3022 http://
store.aota.org/view/?SKU=3022), Neurorehabilitation
for Stroke (Order #3021 http://store.aota.org/
view/?SKU=3021), and Neurorehabilitation for
Traumatic Brain Injury (Order #3020 http://store.
aota.org/view/?SKU=3020). Each: 1 AOTA CEU (10
NBCOT PDUs/10 contact hours), AOTA members:
$185, Nonmembers: $263. Call or shop online to
purchase the Core and/or 1 or more Diagnosis-Specific
SPCCs together for significant savings!
AOTA CEonCDTM Ongoing
NEW! Strategic Evidence-Based Interviewing
in Occupational Therapy. Presented by Renee
R. Taylor, PhD. Begins with an introduction to the
three basic types of interviews most commonly applied
in occupational therapy practice: structured
interviews, semi-structured interviews, and general
clinical interviewing. Through evidence-based
examples of frequently used interview-based assessments
within the occupational therapy literature,
this course will describe a set of norms and
communication strategies that are likely to maximize
success in gathering accurate, relevant, and
detailed information. Earn .2 AOTA CEU (2 NBCOT
PDUs/2 contact hours). Order #4844, AOTA members:
$68, Nonmembers: $97. http://store.aota.org/
view/?SKU=4844
AOTA CEonCD Ongoing
NEW! Skilled Nursing Facilities 101. Christine Kroll,
mS, OTR and Nancy Richman, OTR/L, FAOTA. This
new course is designed to help practitioners better
manage practice within skilled nursing facility settings.
It addresses the importance of documentation,
requirements for different payers, significance of
managing productivity, understanding billing considerations,
and maintaining ethical practice standards.
Earn .3 AOTA CEU (3 mBCOT PDUs/3 contact hours).
Order #4843, AOTA members: $108, Nonmembers:
$154. http://store.aota.org/view/?SKU=4843
ADED Approved AOTA CEonCD Ongoing
NEW! Determining Capacity to Drive for Drivers
with Dementia Using Research, Ethics, and Professional
Reasoning: The Responsibility of All Occupational
Therapists. Linda A. Hunt, PhD, OTR/L,
FAOTA. Emphasizes the role of occupational therapy
in the evidence-based evaluation process and focuses
on the required professional reasoning and ethics
for making final recommendations about the capacity
for older adults with dementia to drive or not. Provides
the multifactor Older Driver with Dementia Evaluation
model (mODEm) to both general practice and driving
specialist occupational therapy practitioners who
work with older driver clients with dementia. Earn .2
AOTA CEU (2 NBCOT PDUs/2 contact hours). Order
#4842, AOTA members: $68, Nonmembers: $97.
http://store.aota.org/view/?SKU=4842
ADED Approved AOTA CEonCDTM Ongoing
Creating Successful Transitions to Community Mobility
Independence for Adolescents: Addressing
the Needs of Students With Cognitive, Social and
Behavioral Limitations. miriam monahan, mS OTR,
CDRS, CDI, and Kimberly Patten, OTL, AmPS certified.
Addresses the critical issue of community mobility
skill development for youth with diagnoses that
challenge cognitive and social skills, such as autism
spectrum and attention deficit disorder. Community
mobility is vast in that it includes mass transportation,
pedestrian travel, and driving, and is essential
for engaging in vocational, social, and educational
opportunities. The course is appropriate for occupational
therapy practitioners practicing in educational
settings and in driver rehabilitation. Earn .7 AOTA
CEU (7 NBCOT PDUs/7 contact hours). Order #4833,
AOTA members: $175, Nonmembers: $250. http://
store.aota.org/view/?SKU=4833
Continuing Education
Assessment and Intervention
Assessment 2-day hands-on & Intervention workshop (1.6 Training CEU)
Two Days 2008 of Conference Hands-On Learning Schedule (1.6 CEU)
San Upcoming Francisco, Locations CA Feb & 29-Mar Dates: 1
Burlington, Texarkana, NC TX Mar. July 14-15 8–9
San Houston, Antonio, TX TX Mar July 28-29 14–15
Minneapolis, McAllen, MN TX August Apr. 4-519–20
Denver, Chicago, CO IL August Apr 11-12 26–27
Manchester, San Antonio, NH TX September Apr 19-20 8–9
Augusta, Charleston, GA September SC Apr 25-26 16–17
Dallas, Tampa, TX FL October May 2-3 14–15
Washington, Manhattan, DC NY October Jul 17-18 21–22
Virginia Orlando, Beach, FL November VA Sep 20-21 3–4
Morganton, NC Sep 25-26
Chicago, For IL 2012 Oct 10-11
Columbia, Dallas, TX SC January Oct 16-17 12–13
Sacramento, CA Oct 24-25
For Orlando, complete FL training Nov schedule 14-15 &
For additional information info and to visit register, visit
www.beckmanoralmotor.com
www.beckmanoralmotor.com
Host Host a Beckman a Beckman Oral Motor Oral Conference Motor Seminar! in 2009!
For Hosting info call (407) 590-4852, or email
Host info (407) 590-4852, or
info@beckmanoralmotor.com
info@beckmanoralmotor.com D-5471
Continuing Education
Treatment2Go’s
Physical Agent Modalities
Occupation based certification course
Only $549.00
for 45 contact hours
Thermal & Electrical Agents
AOTA Approved course
Meets most state requirements
This fantastic interactive movie course
retails at $599.00. Save $50.00 for a limited
time. Use Promo Code: OTPAMS
Order at www.liveconferences.com
Call: 727.341.1674
AOTA APP approved
4.5 CEUs
Treatment2go is a registered trademark of EHT
Continuing Education
D-4410
Atlanta, GA Starting December 1, 2011
Sensory Integration Certification Program by USC/WPS
Course 1: Dec. 1–5 Course 2: Mar. 2–6
Course 3: Jun. 8–12 Course 4: Jul. 27–31
For additional sites and dates, or to register, visit
www.wpspublish.com or call 800-648-8857
D-5150
27

ADED Approved AOTA CEonCD Ongoing
Driving Assessment and Training Techniques: Addressing
the Needs of Students With Cognitive and
Social Limitations Behind the Wheel. miriam monahan,
mS, OTR, CDRS, CDI. Occupational therapy
practitioners in the driver rehabilitation area are challenged
by students with Asperger’s syndrome, nonverbal
learning disabilities, autism, traumatic brain injury,
attention deficit disorders, and lower IQ scores.
This new course is highly visual and creative in addressing
critical issues related to driving assessment
and training. Course highlights include skills deficits
related to these diagnoses, methods and tools that
address driving skills (including video review), assessment
techniques to determine the readiness to
drive, and intervention techniques for developing
specific social and executive function skills necessary
for driving tasks. Earn 1 AOTA CEU (10 NBCOT
PDUs/10 contact hours). Order #4837, AOTA members:
$249, Nonmembers: $355. http://store.aota.
org/view/?SKU=4837
AOTA CEonCD Ongoing
Model of Human Occupation Screening Tool
(MOHOST): Theory, Content, and Purpose. Gary
Kielhofner, DrPH, OTR/L, FAOTA; Lisa Castle, mBA,
OTR/L; Supriya Sen, OTR/L; and Sarah Skinner,
mEd, OTR/L. Occupation-focused practice and
top-down assessment make occupational therapy
unique when assessing and documenting client
services. Unfortunately, therapists often turn to
quicker impairment-oriented or performance-based
assessments. The mOHOST occupation-focused
assessment tool is comprehensive and easy-toadminister
with a wide range of clients at different
functional levels. This new course teaches you how
to use a variety of information from observation, interview,
chart review, and proxy reports to complete
the mOHOST tool. Earn .4 AOTA CEUs (4 NBCOT
PDUs/4 contact hours). Order # 4838, AOTA members:
$125, Nonmembers: $180. http://store.aota.
org/view/?SKU=4838
AOTA CEonCDTM Ongoing
Exploring the Domain and Process of Occupational
Therapy Using the Occupational Therapy
Practice Framework, 2nd Edition. Presented by
Susanne Smith Roley, mS, OTR/L, FAOTA; Janet
V. DeLany, DEd, OTR/L, FAOTA. Explore ways in
which the document supports occupational therapy
practitioners by providing a holistic view of the
profession. Earn .3 AOTA CEU (3 NBCOT PDUs/3
contact hours). Order #4829, AOTA members:
$73, Nonmembers: $103.00. http://store.aota.org/
view/?SKU=4829
AOTA CEonCDTM Ongoing
Sensory Processing Concepts and Applications
in Practice. Winnie Dunn, PhD, OTR, FAOTA. Examines
the core concepts of sensory processing
based on Dunn’s model of Sensory Processing.
The course explores the similarities and differences
between this approach and other sensory
based approaches, examines how to implement
the occupational therapy process, and reviews
evidence to determine how to create best practice
assessment and intervention methods. Case studies
and applications within school-based practice,
and knowledge and practice issues on the horizon
are also discussed. Earn .2 AOTA CEU (2 NBCOT
PDUs/2 contact hours). Order #4834, AOTA members:
$68, Nonmembers: $97. http://store.aota.org/
view/?SKU=4834
AOTA CEonCD Ongoing
Ethics Topics—Organizational Ethics: Occupational
Therapy Practice In a Complex Health
Environment. Lea Cheyney Brandt, OTD, mA,
OTR/L, and member-at-Large, AOTA Ethics Commission.
Explores organizational ethics issues that
may influence the ethical decision making of occupational
therapy practitioners. Participants will
be introduced to strategies that will assist in ad-
c A leN d A r
dressing situations in which occupational therapy
practitioners may be pressured by an organization’s
administration to provide services that are in conflict
with their personal or professional code of ethics.
Earn .1 AOTA CEU (1 NBCOT PDU/1 contact hour).
Order #4841, AOTA members: $45, Nonmembers:
$65. http://store.aota.org/view/?SKU=4841
AOTA CEonCD Ongoing
Ethics Topics—Moral Distress: Surviving Clinical
Chaos. Lea Cheyney Brandt, OTD, mA, OTR/L,
and member-at-Large, AOTA Ethics Commission.
Explores how the complex nature of today’s health
care environment may result in increased moral distress
for occupational therapy practitioners. Offers
coping strategies for reducing negative outcomes
associated with moral distress. Earn .1 AOTA CEU
(1 NBCOT PDU/1 contact hour). Order #4840, AOTA
members: $45, Nonmembers: $65. http://store.aota.
org/view/?SKU=4840
AOTA CEonCD Ongoing
Occupation-Focused Intervention Strategies for
Clients With Fibromyalgia and Fatiguing Conditions.
Renee R. Taylor, PhD. Presents a number of
evidence-based strategies for managing fibromyalgia
and other fatiguing conditions, such as chronic
fatigue syndrome. Learners will become familiar
with interdisciplinary treatment approaches and
how to work best with other professionals treating
these syndromes. Earn .2 AOTA CEU (2 NBCOT
PDUs/2 contact hours). Order #4839, AOTA members:
$68, Nonmembers: $97. http://store.aota.org/
view/?SKU=4838
AOTA CEonCDTM Ongoing
Pain, Fear, and Avoidance: Therapeutic Use of
Self With Difficult Occupational Therapy Populations.
Reneé R. Taylor, PhD. Examines strategies for
managing client pain, fear, and avoidance in occupational
therapy practice. Six distinct modes of interacting
based on the author’s conceptual practice
model teach how to best manage these emotions
and behaviors so that treatment goals can be accomplished.
The model is particularly useful when
therapists are having difficulty engaging clients or
sustaining active participation in therapy. Earn .2
AOTA CEU (2 NBCOT PDUs/2 contact hours). Order
#4836, AOTA members: $68, Nonmembers: $97.
http://store.aota.org/view/?SKU=4836
AOTA CEonCDTM Ongoing
Staying Updated in School-Based Practice. Yvonne
Swinth, PhD, OTR/L, FAOTA, and mary muhlenhaupt,
OTR/L, FAOTA. Provides information and practical
strategies on issues, trends and knowledge related
to providing services for children and youth in public
schools. Topics include IDEA 2004, NCLB, and
Section 504 of the Rehabilitation Act. Ideas and approaches
presented can be implemented individually
or in collaboration with colleagues or members of
a school district team. Earn .15 AOTA CEU (1.5 NB-
COT PDUs/1.5 contact hours). Order #4835, AOTA
members: $51, Nonmembers: $73. http://store.aota.
org/view/?SKU=4835
AOTA CEonCDTM Ongoing
Hand Rehabilitation: A Client-Centered and
Occupation-Based Approach. Presented by Debbie
Amini, mEd, OTR/L, CHT. Describes how to
use the occupation-based intervention to enhance
hand rehabilitation protocols without sacrificing
productivity or detracting from the concurrent client
factor focus. CD-ROm includes mP3 audio file
of the entire course. Earn .2 AOTA CEU (2 NBCOT
PDUs/2 contact hours). Order #4832, AOTA members:
$68, Nonmembers: $97. http://store.aota.org/
view/?SKU=4832
Available From AOTA Ongoing
ASHT Test Preparation. This intermediate-level
course provides a comprehensive overview of all
topics related to upper extremity rehabilitation. There
are twenty-five PowerPoint chapters with over 2,000
slides and sample multiple-choice test questions
accompany each chapter. Earn 30 AOTA approved
contact hours (3 AOTA CEUs/30 NBCOT PDUs).
Order #4850, AOTA members: $300, Nonmembers:
$450. http://store.aota.org/view/?SKU=4850
AOTA/Genesis CEonCDTM Ongoing
Seating and Positioning for Productive Aging: An
Occupation-Based Approach. Presented by Felicia
Chew, mS, OTR, and Vickie Pierman, mSHA, OTR/L.
Reviews seating and positioning from evaluation
to outcome, with a concentration on interventions.
Information reviewed will be applicable to a variety
of settings, including skilled nursing facilities,
home health, rehab centers, assisted living communities,
and others. Primarily addresses manual
wheelchair mobility. Earn .4 AOTA CEU (4 NBCOT
PDUs/4 contact hours). Order #4831, AOTA members:
$97, Nonmembers: $138. http://store.aota.org/
view/?SKU=4831
AOTA CEonCDTM Ongoing
The New IDEA Regulations: What Do They Mean to
Your School-Based and EI Practice? Presented by
Leslie L. Jackson, mEd, OT, and Tim Nanof, mSW.
Understand what the 2004 reauthorization of IDEA
and the new Part B regulations, released in August
2006, mean and what impact they have on your work
as a school-based and early intervention practitioner.
This CE course is an excellent opportunity to update
your knowledge on IDEA. Earn .2 AOTA CEU (2 NB-
COT PDUs/2 contact hours). Order #4825, AOTA
members: $68, Nonmembers: $97. http://store.aota.
org/view/?SKU=4825
AOTA CEonCDTM Ongoing
Occupational Therapy and Transition Services.
Presented by Kristin S. Conaboy, OTR/L; Susan m.
Nochajski, PhD, OTR/L; Sandra Schefkind, mS,
OTR/L; and Judith Schoonover, mEd, OTR/L, ATP.
This course will present an overview of the importance
of addressing transition needs as part of a student’s
IEP and the key role of the occupational therapy
practitioner as a potential collaborative member
of the transition team. It is an excellent opportunity
to update your knowledge about Transition Services
and practice opportunities related to this area of
school-based practice. Earn .1 AOTA CEU (1 NBCOT
PDU/1 contact hour). Order #4828, AOTA members:
$34, Nonmembers: $48.50. http://store.aota.org/
view/?SKU=4828 Set of 3 CE on CDTM ’s: The New
IDEA Regulations, Response to Intervention, and Occupational
Therapy and Transition Services. Order
#4828K, AOTA members: $144.50, Nonmembers:
$206.13. http://store.aota.org/view/?SKU=4828K
AOTA Online Course Ongoing
NEW! Falls Module I—Falls Among Community-
Dwelling Older Adults: Overview, Evaluation, and
Assessments. Presented by Elizabeth W. Peterson,
PhD, OTR/L, FAOTA, and Roberta Newton, PhD, PT,
FGSA. First module in a three-part series of online
continuing education courses on fall prevention. The
content of each module will support occupational
therapists in their efforts to provide evidence-based
fall prevention services to older adults who are at
risk for falling or who seek preventive services. This
course is divided into two sections: Prevalence, Consequences,
and Risk Factors and Approaches to the
Evaluation of Fall Risk. Earn .6 AOTA CEU (6 NBCOT
PDUs/6 contact hours). Order #OL34, AOTA members:
$210, Nonmembers: $299. http://store.aota.
org/view/?SKU=OL34
AOTA Online Course Ongoing
NEW! Falls Module II—Falls Among Older Adults
in the Hospital Setting: Overview, Assessment,
and Strategies to Reduce Fall Risk. Presented by
Roberta Newton, PhD, PT, FGSA and Elizabeth W.
Peterson, PhD, OTR/L, FAOTA. The second module
in a 3-part series on fall prevention, this online course
provides an overview of the problem of falls that occur
in the hospital setting and focuses further on the
28 JUNE 20, 2011 • WWW.AOTA.ORG

identification of older adults at risk for falls, the factors
that contribute to fall risks, and the assessment
strategies that involve occupational therapy expertise.
Earn Earn .45 AOTA CEU (4.5 NBCOT PDUs/4.5
contact hours) AOTA members: $158, Nonmembers:
$225, Nonmembers: $97. http://store.aota.org/
view/?SKU=OL35
AOTA Online Course Ongoing
NEW! Driving and Community Mobility for Older
Adults: Occupational Therapy Roles, Revised.
Susan L. Pierce, OTR/L, SCDCm, CDRS, and Elin
Schold Davis, OTR/L, CDRS. Targeted to occupational
therapy professionals in all settings who work
with older adults. Revised with expanded content
and updated links on research, tools, and resources
to help advance knowledge about instrumental activity
of daily living (IADL) of driving and community
mobility. Earn .6 AOTA CEU (6 NBCOT PDUs/6
contact hours). Order #OL33, AOTA members:
$180, Nonmembers: $255. http://store.aota.org/
view/?SKU=OL33
AOTA Online Course Ongoing
Elective Session 2 (2009): Occupational Therapy
for Infants and Toddlers With Disabilities Under
IDEA 2004, Part C. Presented by mary muhlenhaupt,
OTR/L, FAOTA. An elective session in the Occupational
Therapy in School-Based Practice: Contemporary
Issues and Trends series, this ES2 replaces
the previous “Early Intervention: Service Delivery
Under the IDEA.” The core course is not required as
a prerequisite for this new elective session. Earn .1
AOTA CEU (1 NBCOT PDU/1 contact hour). Order
#OLSB2A. AOTA members: $29.95, Nonmembers:
$41. http://store.aota.org/view/?SKU=OLSB2A
AOTA Online Course Ongoing
Occupational Therapy in Action: Using the Lens
of the Occupational Therapy Practice Framework:
Domain and Process, 2nd Edition. Presented by
Susanne Smith Roley, mS, OTR/L, FAOTA, and Janet
DeLany, DEd, OTR/L, FAOTA. This course focuses
on understanding occupational therapy and
the occupational therapy process as described in
the 2008, second edition of the Framework. This
new course builds on the original Framework course
developed to supplement the first edition of the
Framework in 2002. Earn .6 AOTA CEU (6 NBCOT
PDUs/6 contact hours). Order #OL32, AOTA members:
$180, Nonmembers: $255. http://store.aota.
org/view/?SKU=OL32
AOTA Online Course Ongoing
Understanding the Assistive Technology Process
to Promote School-Based Occupation. Presented
by Beth Goodrich, mS, mEd, OTR, ATP; Lynn Gitlow,
PhD, OTR/L, ATP; and Judith Schooner, mEd, OTR/L,
ATP. The purpose of this course is to provide occupational
therapy practitioners with knowledge of the
AT process as it is delivered in schools, and how
it can assist practitioners in considering the use of
technology to increase student participation in meaningful
school-based occupations. Earn 1 AOTA CEU
(10 NBCOT PDUs/10 contact hours). Order #OL31,
AOTA members: $225, Nonmembers: $320. http://
store.aota.org/view/?SKU=OL31
AOTA Online Course Ongoing
Occupational Therapy in School-Based Practice:
Contemporary Issues and Trends. Edited by Yvonne
Swinth, PhD, OTR/L. Gain an understanding of and
suggestions for service delivery and intervention
strategies in school-based settings based on IDEA,
the No Child Left Behind initiative, the philosophy of
education, and the Occupational Therapy Practice
Framework. The content of the Core Session has
been updated to reflect the changes in the 2004
IDEA amendments. Core session: Service Delivery
in School-Based Practice: Occupational Therapy
Domain and Process. Earn 1 AOTA CEU (10 NBCOT
PDUs/10 contact hours). Order #OLSBC, AOTA members:
$225, Nonmembers: $320. http://store.aota.
OT PRACTICE • JUNE 20, 2011
c A leN d A r
org/view/?SKU=OLSBC Elective sessions: After
completing the Core session, choose supplemental
sessions to further enhance your knowledge for
specific school-based populations, types of settings,
and service delivery issues. Each provides .1 AOTA
CEU (1 NBCOT PDU/1 contact hour), AOTA members:
$22.50, Nonmembers: $32.
AOTA Autism Conference Session Webcast Ongoing
Social Participation and Communication Strategies
for Individuals with Autism across the Lifespan.
Presented by Lisa A. Crabtree, PhD, OTR/L,
and zosia zaks, mEd, CRC. Describes adaptive
strategies and environmental modifications to support
health and participation in life for all individuals
on the autism spectrum through engagement in
occupa tion. Participants will explore the components
of optimal programming for children and adults with
autism, and be ready to implement strategies in a
variety of settings. Earn 2.75 Contact Hours, Order
#WA1002, AOTA members: $124, Nonmembers:
$177. http://store.aota.org/view/?SKU=WA1002
AOTA Autism Conference Session Webcast Ongoing
AOTA and You: Working Together to Promote The
Policy and Practice of Occupational Therapy for
Persons with Autism. Presented by marcy m. Buckner,
JD, AOTA; Sandra Schefkind, mS, OTR/L, AOTA;
and Chuck Willmarth. Outlines AOTA efforts in both
the pol icy and practice of occupational therapy services
for individuals with autism. Includes current
state legislative activity to enact autism re form and
scope of practice and AOTA resources on autism.
Earn 1 Contact Hour. Order #WA1003, AOTA members:
$45, Nonmembers: $64. http://store.aota.org/
view/?SKU=WA1003
AOTA Autism Conference Session Webcast Ongoing
Evidence-based Review of Interventions for Children
with Autism Spectrum Disorders. Presented
by Jane Case-Smith, EdD, OTR/L, FAOTA. Summarizes
the up-to-date re search evidence for interventions
used by occu pational therapy practitioners
with children with ASD. Addresses current research
evidence for sensory integrative, sensory-based,
social skills, behav ioral, relationship-based, and
comprehensive in terventions at different levels of
severity and age groups, and outlines themes that
define elements central to effective intervention.
Earn 1 Contact Hour. Order #WA1004, AOTA members:
$45, Nonmembers: $64. http://store.aota.org/
view/?SKU=WA1004
AOTA Autism Conference Session Webcast Ongoing
You Say ‘Deficit’ I Say ‘Defines Me’: Daring to Celebrate
the Unique Contributions of People on the
Autism Spectrum. Presented by Winnie Dunn, PhD,
OTR, FAOTA. Anyone who has known someone on
the autism spectrum has experienced joy when they
captured the logic that underpins a quirky behavior
or rec ognized the perfect synchrony of a reaction
that reflects the experience. This webcast ex plores
the authentic experience of autism and how it calls
us to change the definition of ourselves as professionals
who support them. Earn 1 Contact Hour. Order
#WA1005, AOTA members: $45, Nonmembers:
$64. http://store.aota.org/view/?SKU=WA1005
AOTA Autism Conference Session Webcast Ongoing
A Family Affair: The Voices of Parents and Individuals
with Autism. Presented by Janet V. DeLany,
DEd, OTR/L FAOTA; Barbara B. Demchick, mS,
OTR/L. Discussion among parents of children with
autism, and youth and adults with autism on life
realities and necessary services for full community
involvement. Topics also include ser vice delivery,
connecting services to family goals and cultural
expectations, fiscal and legislative constraints, and
advocacy and collaboration of oc cupational therapy
practitioners with individuals and families. Earn
1.5 Contact Hours. Order #WA1006, AOTA members:
$68, Nonmembers: $97. http://store.aota.org/
view/?SKU=WA1006
AOTA Autism Conference Session Webcast Ongoing
Professional Collaboration to Maximize Successful
Participation Across the Lifespan. Presented
by Lisa Crabtree, PhD, OTR/L. The needs of individuals
on the autism spectrum require team collaboration
to maximize successful participation in daily life
activities. This webcast pre sentation by professionals
working with individu als with ASD of all ages will
provide par ticipants with practical strategies that
have been implemented in schools, clinics, and the
commu nity. Earn 1.5 Contact Hour. Order #WA1007,
AOTA members: $68, Nonmembers: $97. http://
store.aota.org/view/?SKU=WA1007
AOTA Autism Conference Session Webcast Ongoing
Developing Evidence-Based Interventions in
Early Childhood Aged Children with an ASD
Across Contexts. Presented by Scott Tomchek,
PhD, OTR/L, FAOTA. Assessment and intervention
processes are of ten impacted by social-communication
difficul ties and repetitive behavioral patterns
in young children with an ASD. Practice guidelines
and evidence-based reviews have begun to elucidate
common themes across interventions yielding
fa vorable outcomes. This webcast will present
these evidence-based themes and apply them to
occu pational therapy practice in early childhood
and across contexts. Earn 1.5 Contact Hours. Order
#WA1008, AOTA members: $68, Nonmembers: $97.
http://store.aota.org/view/?SKU=WA1008
AOTA Autism Conference Session Webcast Ongoing
Partnering with Adolescents and Young Adults
with Autism Spectrum Disorders: Challenges and
Opportunities. Presented by Kristie Patten Koenig,
PhD, OTR/L, FAOTA. Adolescents and Young Adults
with ASD generate personal narratives and selfadvocacy
work that highlight life challenges and
opportunities, per spectives that can significantly
inform occupation al therapy practice. This webcast
provides a concep tual model of intervention that
offers an “inside out” perspective of the individual
with ASD and highlights strategies and methods for
improved outcomes. Earn 1.5 Contact Hours. Order
#WA1009, AOTA members: $68, Nonmembers: $97.
http://store.aota.org/view/?SKU=WA1009
AOTA Autism Conference Session Webcast Ongoing
Emerging as Leaders in Autism Research and
Practice. Presented by Roseann C. Schaaf, PhD,
OTR/L, FAOTA. Occupational therapy service is frequently
re quested and utilized by professionals and
parents of children with an ASD, yet it often goes
unrec ognized, under-funded, and under-utilized.
This webcast presentation urges professionals to
become lead ers in autism practice and research by
identifying key areas where OT can meet emerging
needs, such as transitions, evidence-based and
systematic intervention protocols, and clinical trials.
Current research and training examples are also
presented. Earn .75 Contact Hour. Order #WA1010,
AOTA members: $34, Nonmembers: $49. http://
store.aota.org/view/?SKU=WA1010
AOTA Autism Conference Session Webcast Ongoing
Community Partnerships: Panel Presentation by
Autism Society and Easter Seals. Presented by
marguerite Kirst Colston, mA, and Patricia Wright,
PhD. Occupational therapy is a critical component
to early intervention in children with autism, and the
profession is fully engaged in promoting evidencebased
service delivery. Panelists will address challenges
faced by parents, policy and program areas
being pursued, services provided by the Autism
Society, and the capacity being built by Easter
Seals in delivering effective interventions in the field
of autism treatment. Earn 1 Contact Hour. Order
#WA1011, AOTA members: $45, Nonmembers: $64.
http://store.aota.org/view/?SKU=WA1011
AOTA Autism Conference Session Webcast Ongoing
2010 Autism Specialty Conference Webcasts
Set. Presented by experts in the field. AOTA held
29

its first Autism Specialty Conference in December
2010 and drew hundreds of attendees to hear expert
speakers and experience top-level education.
If you were not able to attend, you can choose from
any or all of the 10 selected session Webcasts
that present audio and PowerPointTm presentations
and help participants stay current in practice, evidence,
and policy. Earn up to 13.5 contact hours.
Order #sWA1002–WA1011. Individual Prices. Full
Set Order #WA1000K. http://store.aota.org/view/?
SKU=WA1000K
AOTA Self-Paced Clinical Course Ongoing
The Hand: An Interactive Study for Therapists.
By Judy C. Colditz, OTR/L, CHT, FAOTA. Combines
written coursework with interactive, computerbased
learning to present the anatomical basis and
clinical presentation of problems in the hand and
forearm. Using the CD-ROm The Interactive Hand:
Therapy Edition, explore the multiple layers of complex
anatomy while learning about palpation, examination,
and common disorders. An excellent preparation
tool for the Hand Therapy Certification Exam.
Earn 1.6 CEUs (16 NBCOT PDUs/16 contact hours).
Order #3017, AOTA members: $260, Nonmembers:
$360. http://store.aota.org/view/?SKU=3017
Available From AOTA Ongoing
Physical Agent Modalities: Occupational-Based
Implementation of Electrical Agents (DVD). Available
from AOTA Continuing Education by special
arrangement with Treatment2Go in St. Petersburg,
FL. Presented by Paul Bonzani, mHS, OTR/L, CHT.
This DVD-formatted instructional course helps occupational
therapists integrate electrical agent
modalities as a preparatory intervention in practice
to improve client-centered and occupation-based
outcomes. Evidence that identifies the effectiveness
of each electrical modality intervention is presented
as well as the step-by-step practical application
of each device. Earn 2.5 AOTA CEUs (25 NBCOT
PDUs/25 contact hours). Order #4861, AOTA members/Nonmembers:
$349. http://store.aota.org/view/?
SKU=4861
Available From AOTA Ongoing
Physical Agent Modalities: Occupational-Based
Implementation of Thermal Agents (DVD). Available
from AOTA Continuing Education by special
arrangement with Treatment2Go in St. Petersburg,
FL. Presented by Paul Bonzani, mHS, OTR/L, CHT.
This DVD-formatted instructional course helps occupational
therapists integrate thermal agent modalities
as a preparatory intervention in practice
to improve client-centered and occupation-based
outcomes. Evidence that identifies the effectiveness
of each thermal modality intervention is presented
as well as the step-by-step practical application
of each device. Earn 2 AOTA CEUs (20 NBCOT
PDUs/20 contact hours). Order #4860, AOTA members/Nonmembers:
$299. http://store.aota.org/view/?
SKU=4860
AOTA Conference Session Webcast Ongoing
(available until June 30, 2011)
Medicare 101. Presented by Jennifer Bogenrief,
Esq., and Tim Nanof, mSW. Whether you are a new
therapist beginning your career and or a practitioner
learning a new payment system in a new setting, this
Webcast informs you about resources and strategies
that can lead to successful medicare reimbursement.
Earn .15 AOTA CEU (1.5 NBCOT PDUs/1.5
contact hours). Order #CSC115, AOTA members:
$45, Nonmembers: $64. http://store.aota.org/view/?
SKU=CSC115
AOTA Conference Session Webcast Ongoing
(available until June 30, 2011)
Everyday Ethics: Linking Research, Practice,
and Ethical Decision Making in School-Based
Practice. Presented by Jean Polichino, mS, OTR,
FAOTA, and Kathlyn L. Reed, PhD, OTR, FAOTA,
mLIS. Providers must maintain a focus on students
c A leN d A r
when providing services in public schools. Presenters
draw on the AOTA online Evidence-Based Practice
Resource Directory and AOTA Occupational
Therapy Code of Ethics (2005) to provide guidance
on ethical issues that may also have legal and employment
consequences. Earn .15 AOTA CEU (1.5
NBCOT PDUs/1.5 contact hours). Order #CSC200,
AOTA members: $45, Nonmembers: $64. http://
store.aota.org/view/?SKU=CSC200
AOTA Conference Session Webcast Ongoing
(available until June 30, 2011)
Raising the Bar: Elevating Knowledge in School
Mental Health. Presented by Susan Bazyk, PhD,
OTR/L, FAOTA; Sharon Brandenburger Shasby,
EdD, OTR/L, FAOTA; Donna Downing, mS, OTR/L;
Jennifer Richman, OTR/L; and Sandra Schefkind,
mS, OTR/L. This Webcast provides an overview of
school mental health (SmH) movement and how occupational
therapy helps address mental health and
psychosocial needs of children in schools, including
service within the 3-tiered model of school-wide
SmH using occupation-based practice, positive
behavioral supports (PBS), and social–emotional
learning (SEL). Earn 1.5 AOTA CEUs (1.5 NBCOT
PDUs/1.5 contact hours). Order #CSC303, AOTA
members: $45, Nonmembers: $64. http://storea.
aota.org/view/?SKU=CSC303
AOTA Conference Session Webcast Ongoing
(available until June 30, 2011)
Hemianopsia: Strategies Based on Research and
Clinical Experience That Support Performance in
Daily Occupations. Presented by Timothy Holmes,
OTR/L, COmS. Homonymous hemianopsia is the
most common visual impairment resulting from stroke
or TBI. This short course will provide an update on
what appear to be the most effective interventions
for occupational performance for people with visual
field loss, including research and clinical experience
with scanning techniques, vision restoration therapy,
and optokinetic therapy. Earn 1.5 AOTA CEUs (1.5
NBCOT PDUs/1.5 contact hours). Order #CSC223,
AOTA members: $45, Nonmembers: $64. http://store.
aota.org/view/?SKU=CSC223
AOTA Conference Session Webcast Ongoing
(available until June 30, 2011)
Senior Mobility Choices: National Speakers
Identify Opportunities for Funding, Program
Development, and Education (featuring a tool
for identifying dementia-friendly transportation
options). Presented by Elin Schold Davis OTR/L,
CDRS; Essie Wagner, mA; Lisa Tucker, mA; Nina
m. Silverstein, PhD; and Helen K. Kerschner, PhD.
Occupational therapy programs have an opportunity
to play a proactive role in developing services
that meet community mobility needs for clients.
This session enables learners to identify accessible
options in their communities including those for seniors
with dementia, and explores opportunities for
advocacy, funding, and enhanced mobility service
networks. Earn .3 AOTA CEU (3 NBCOT PDUs/3
contact hours). Order #CWS201, AOTA members:
$79, Nonmembers: $112. http://store.aota.org/view/
?SKU=CWS201
AOTA Conference Session Webcast Ongoing
(available until June 30, 2011)
Paradigm Shift and Innovations in Stroke Rehabilitation.
Presented by Leah S. Dunn, mS,
OTR/L; Valerie Hill Hermann, mS, OTR/L; and Lisa
Finnen, mS, OTR/L. A growing body of evidence
indicates that intense, task-oriented therapy programs
incorporating various technologies are efficacious
in promoting upper-extremity function
post-stroke. This workshop presents an overview of
the technologies for clients with stroke. Research
evidence and pragmatic considerations will also be
discussed. Earn .3 AOTA CEU (3 NBCOT PDUs/3
contact hours). Order #CWS402, AOTA members:
$79, Nonmembers: $112. http://store.aota.org/view/
?SKU=CWS402
AOTA OnLine COUrSe
Understanding the
Assistive Technology
Process To
Promote School-Based
Occupation Outcomes
Presented by:
Beth Goodrich, MS, MEd, OTR, ATP;
Lynn Gitlow, PhD, OTR/L, ATP; and
Judith Schoonover, MEd, OTR/L, ATP
Earn 1 AOTA CEU (10 NBCOT
PDUs/10 contact hours)
Assistive technology (AT) is a
rapidly emerging practice area
for occupational therapy and has
the powerful potential to support
students coping with disabilities as
they strive to meet their learning
needs and enjoy participating in their
school environments.
This outstanding new AOTA
Online Course—
• Delves deep into 4 phases of the AT
service delivery process
• Provides case examples for
experiential learning activities
• Enables matching of technology to
desired school-based outcomes
• Distinguishes occupational therapy
skills on a school-based AT team
• Identifies requirements for federally
funded schools to provide AT.
Register today and help
your students thrive!
Order # OL31
AOTA Members: $225
Nonmembers: $320
Call us at 877-404-AOTA
Shop http://store.aota.org/
view/?SKU=OL31 CE-142
30 JUNE 20, 2011 • WWW.AOTA.ORG

S-5511
South
Midwest
School-Based OTs—IL
Special ed agency seeks licensed full-/part-time OTs for jobs
in the Dundee, Sycamore, Dixon, and Rockford, IL, areas
for the school year beginning August 2011. Competitive salary,
excellent benefits. New grads welcome. Contact Mary
Kolinski, Northwestern Illinois Association, 630-402-2002.
Fax resumes to 630-513-1980 or e-mail mkolinski@thenia.
org. EOE m-5490
Find AOTA
on Facebook
http://www.aota.org/facebook
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http://www.aota.org/twitter
OT PRACTICE • JUNE 20, 2011
e MPl MPl OYMe NT OPPOr TT u N i T ies
Faculty
Faculty Position—Department of Occupational Therapy
Director of Clinical Education
Seton Hall University, School of Health and Medical Sciences, announces a twelvemonth
faculty position for the Fall 2011 in the Department of Occupational Therapy.
Qualifications include eligibility for licensure as an occupational therapist in the State
of New Jersey, minimum of 5 years clinical experience, and teaching experience in an
academic setting. A terminal degree is required. Master’s degree applicants who have
made significant progress toward the completion of a terminal degree and a record
of teaching effectiveness will be seriously considered. Responsibilities include: coordinating
and supervising fieldwork placements, developing additional clinical sites,
providing clinical educator training, teaching, scholarship, and serving on School and
University committees.
Salary and benefits are extremely competitive and include full tuition remission for
spouses and eligible dependents. Resumes will be accepted until the position is filled.
Review of the applications will begin immediately. Interested individuals are required
to submit a cover letter, curriculum vitae, and a statement of teaching philosophy.
Applications must be submitted online at:
https://jobs.shu.edu
After the initial screening, candidates may be subsequently asked to supply additional
materials. Applications will be accepted until the position is filled.
Seton Hall University is committed to programs of equal opportunity and affirmative
action (EEO/AA) to achieve our objectives of creating and supporting a diverse
racial, ethnic, and cultural community. Seton Hall University encourages applications
from individuals who represent a broad spectrum of backgrounds and, in particular,
welcomes applications from women and minority groups.
For further information about the position, contact Thomas Mernar, PhD, OTR,
Search Committee Chair, Thomas.Mernar@shu.edu.
For further information on Seton Hall University, see our web page at www.shu.edu.
F-5491
Northeast
Occupational Therapist
Ivymount School is seeking
a full-time OT to provide
therapeutic services to
students with multiple
disabilities ages 4 to 21.
Graduate of an accredited
OT master’s Program/
MD state license.
N-5439
Apply at www.ivymount.org
West
OCCUPATIONAL THERAPISTS
Anchorage School District Anchorage, Alaska
Join a dynamic team of 30 OT’s!
Full- and part-time opportunities in large,
progressive district. Competitive salary, great
benefits. 6% salary increase and $3,000
signing bonus for 2011-2012 school year.
$2,000 salary supplement for SI or NDT.
Contact Kate Konopasek at
907-742-6121
(Konopasek_Kate@asdk12.org)
or apply online at www.asdk12.org
W-5256
31

32
e MPl OYMe NT OPPOr T u N i T ies
National
associate director (full or Part Time)
institute for the Study of occupation and Health
Serves as a senior program officer for a growing foundation • Assists in creating,
advancing, and evaluating innovative programs to foster research, education,
and public awareness about occupational therapy and everyday living
and health • Forges program partnerships with agencies, institutions, and
organizations, and monitors and interprets social policy • Works with the institute
director and AOTF executive director to stimulate the institute’s size,
visibility, external funding, and impact.
education and experience • Earned doctorate (academic or clinical) • Excellent
grant writing skills • Eligibility for academic faculty appointment • 3 years
experience as a faculty member, or scholar in research, higher education, or
social policy. For a full job description, see www.aotf.org.
This position may be filled as full or part time and does not require relocation
to Bethesda, MD. Offsite working can be arranged for the successful applicant.
Occasional travel may be required to Bethesda or other locations.
Please send cover letter summarizing qualifications and curriculum vitae/
resumé to chair, institute associate director Search committee, aoTf, 4720
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NEW From AOTA Press
Evaluation:
Obtaining and
Interpreting Data,
3rd Edition
Edited by Jim Hinojosa, PhD, OT,
FAOTA; Paula Kramer, PhD, OTR,
FAOTA; and Patricia Crist, PhD,
OTR, FAOTA
Evaluation, which promotes a
greater understanding of the
people whom occupational therapy
serves, is the foundation of
occupational therapy practice
and provides evidence to guide
“best practices”.
This third edition focuses on the
role of the occupational therapist
as an evaluator with assessment
support provided by the occupational
therapy assistant. Chapters
discuss the various aspects
of a comprehensive evaluation,
including screening, evaluation,
reassessment, and reevaluation,
and reaffirm the importance of
understanding people as occupational
beings.
Order #1174C.
AOTA Members: $59
Nonmembers: $84
To order, call 877-404-AOTA, or
shop online at http://store.aota.org/
view/?SKU=1174C
BK-183
JUNE 20, 2011 • WWW.AOTA.ORG

eseA rcH uP d ATe
Upper-Limb Rehabilitation, Meal Preparation
Poststroke, and Sensory Hypersensitivities
Upper-Limb Rehabilitation
for Children With
Hemiplegia
sakzewski and colleagues 1 investigated
whether constraint-induced
movement therapy (CIMT) is more
effective than bimanual training to
improve occupational performance and
participation in children with congenital
hemiplegia. Sixty four children, matched
for age, gender, side of hemiplegia, and
upper-limb function, were randomized
to CIMT or bimanual training in
a day camp (60 hours over 10 days).
Participants were assessed at baseline,
3 weeks, and 26 weeks with the following
measures: Canadian Occupational
Performance Measure (COPM), Assessment
of Life Habits (LIFE-H), Children’s
Assessment of Participation and Enjoyment,
and School Function Assessment.
Both groups improved significantly as
measured by COPM and personal care
LIFE-H domain. Goal-directed upper-limb
rehabilitation (CIMT or bimanual training)
delivered intensively via an activitybased
program resulted in significantly
better occupational performance. n
Meal Preparation
After Stroke
Poole and colleagues 2 examined the
ability to prepare meals following
right or left hemisphere damage
(RHD, LHD) as a result of stroke and
whether cognitive (spatial abilities,
aphasia, limb apraxia) and motor deficits
are associated with meal preparation.
Participants (N=109) included volunteer
right-handed adults with LHD (n=30) or
RHD (n=16) and healthy demographically
matched adults (n=63). Measures
OT PRACTICE • JUNE 20, 2011
Susan H. Lin
of performance were total completion
time, number and type of errors, level
of independence for a meal preparation
task (hot beverage and toast), eating
part of the meal, and cleanup. Compared
with the healthy control group, members
of both stroke groups took significantly
more time to complete the meal preparation
task. The LHD group made more
total errors and showed lower levels of
independence than the other groups,
but individual errors did not significantly
differ between the two stroke groups.
Although the RHD sample was small
and the results should be interpreted
cautiously, poorer ipsilesional motor
performance was associated with longer
completion time in the RHD group, and
poorer contralesional motor performance
and greater aphasia were associated with
less independence in the LHD group. In
conclusion, researchers found impaired
meal preparation after LHD or RHD but
greater overall impairment after LHD. n
Hypersensitivity
in Women
With Fibromyalgia
wilbarger and Cook 3 studied sensory
sensitivities to nonnoxious sensory
stimuli in women with fibromyalgia.
A self-report measure of sensory sensitivity
to stimuli encountered in daily life
was administered to women with fibromyalgia
(n=27); women with rheumatoid
arthritis (n=28); and healthy, pain-free
women (n=28; N=83). The 56-question
sensory measure asked participants to
respond to a 7-point Likert-type scale,
with 1 representing “extremely untrue
of me” and a 7 representing “extremely
true of me.” Higher scores suggest more
sensory sensitivities. An example of an
item is, “I dislike being close to people
who wear perfume or cologne.” Responses
were compared between the three groups
using analysis of variance. Women with
fibromyalgia reported significantly greater
sensory sensitivities to both somatic (e.g.,
tactile) and nonsomatic (e.g., auditory
and olfactory) sensory stimuli compared
with the rheumatoid arthritis and control
group members. The rheumatoid arthritis
and control group did not show significant
difference in sensory sensitivities. The
increased sensory sensitivity in women
with fibromyalgia could be related to more
stress and anxiety, which in turn could
lead to decreased participation in typical
life activities. n
References
1. Sakzewski, L., Ziviani, J., Abbott, D. F., Macdonell,
R. A., Jackson, G. D., & Boyd, R. N. (2011).
Participation outcomes in a randomized trial of 2
models of upper-limb rehabilitation for children
with congenital hemiplegia. Archives of Physical
Medicine and Rehabilitation, 92, 531–539.
2. Poole, J. L., Sadek, J., & Haaland, K. Y. (2011).
Meal preparation abilities after left or right hemisphere
stroke. Archives of Physical Medicine and
Rehabilitation, 92, 590–596.
3. Wilbarger, J. L., & Cook, D. B. (2011). Multisensory
hypersensitivity in women with fibromyalgia:
Implications for well being and intervention.
Archives of Physical Medicine and Rehabilitation,
92, 653–656.
Susan H. Lin, ScD, OTR/L, is the director of research
at AOTA.
Note: To view the abstracts of these
articles, visit Google Scholar http://scholar
.google.com/schhp?hl=en&tab=ws
or PubMed at http://www.ncbi.nlm.nih
.gov/sites/pubmed and type the article title
in the search box, then click on Search.
If you would like your in-press or recently
published research featured in this
column, please contact Susan Lin at
slin@aota.org or 301-652-6611, ext. 2091.
33

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P-5482

SALVADOR BONDOC, OTD, OTR/L, BCPR, CHT
Associate Professor of Occupational Therapy,
Quinnipiac University
Hamden, CT
Holly Alexander, OTR/L, CDRS
Director, Fox Rehabilitation Driving Program,
Fox Rehabilitation
Cherry Hill, NJ
Valerie Hill, MS, OTR/L
Research Occupational Therapist,
Neuromotor Recovery & Rehabilitation Laboratory
University of Cincinnati at The Drake Center
Cincinnati, OH
Education Article
This CE Article was developed in collaboration with
AOTA’s Physical Disabilities Special Interest Section.
ABSTRACT
Outcome measures represent different things for different
fields and areas of practice. In general, we may define outcome
measures as a collective term for tools that measure
the output of a systematic process related to a goal or aim.
In occupational therapy, the intervention process is directed
toward “supporting health and participation in life through
engagement in occupation” (American Occupational Therapy
Association [AOTA], 2008, p. 652). Related to this aim are
interconnected domains of health and occupational performance
made explicit through the Occupational Therapy
Practice Framework: Domain and Process, 2nd Edition
(Framework-II; AOTA, 2008). These domains include healthrelated
quality of life, participation, performance patterns,
performance skills, and client factors. We delineate change in
these domains that are a direct result of occupational therapy
interventions as clinical outcomes, as opposed to system outcomes
that are born out of organizational processes designed
to improve quality and efficiency of service delivery (Bondoc
& Burkhardt, 2004). In this article, we will focus primarily on
the application of clinical outcome measures as an essential
component of evidence-based physical rehabilitation practice.
LEARNING OBJECTIVES
After reading this article, you should be able to:
1. Recognize the significance of outcome measures to physical
rehabilitation practice.
2. Select applied outcome measures used in the domain of
occupational therapy.
Earn .1 AOTA CEU
(one NBCOT PDU/one contact hour)
See page CE-7 for details.
Using Outcome Measures To Improve Occupational
Therapy Practice in Physical Rehabilitation
JUNE 2011 n OT PRACTICE, 16(11) ARTICLE CODE CEA0611
3. Define general clinometric properties of outcome
measures.
4. Identify pragmatic considerations in selecting outcome
measures.
INTRODUCTION
The use of outcome measures has increasingly become a
significant part of physical rehabilitation practice. In this era
of evidence-based health care, many third-party payers are
requiring therapists and facilities to use outcome measures
as a criterion for reimbursement or pre-authorization for
occupational therapy services. Outcome measures are also
used for benchmarking a health care organization’s performance
against a standard. That standard may be against
one’s own best performance, performance during a point in
time (e.g., quarterly performance in the previous year), or
the industry’s gold standard.
An example of a widely used outcome measure for benchmarking
inpatient physical rehabilitation is the Functional
Independence Measure (FIM; Wright, 2000). The FIM is an
18-item assessment tool that measures independence in selfcare,
sphincter control, mobility, locomotion, communication,
and social cognition (Heinemann, Linacre, Wright, Hamilton,
& Granger, 1993) and is the basis for the Inpatient Rehabilitation
Facility–Patient Assessment Instrument (IRF–PAI; UB
Foundation Activities, 2002). Although a global instrument
such as the IRF–PAI is well integrated in physical rehabilitation
settings, there are inherent limitations to the instrument
that may further warrant the use of additional outcome measures.
For instance, the IRF–PAI uses FIM scores and other
patient variables to categorize a patient into a diagnostic
category for the purpose of prospective payment. The FIM as
an outcome measure is known to have a ceiling effect or limited
sensitivity to change as a client progresses to his or her
highest level of function. Finally, the FIM was designed not
to be discipline specific and cannot fully capture the direct
benefits of occupational therapy intervention. With these
limitations in mind, practitioners should consider examining
other tests and measures to document outcomes. By knowing
the outcomes of occupational therapy, practitioners are
able to objectively discern whether interventions are effective
for their clients.
SELECTING AN OUTCOME MEASURE
Selecting the most appropriate outcome measure for incorporation
in physical rehabilitation practice is the crucial first
step; however, it may be the most daunting. Over the past 2
decades, we have seen exponential growth in the scientific
CE-1

AOTA Continuing Education Article
CE Article, exam, and certificate are also available ONLINE.
Register at http://www.aota.org/cea or call toll-free 877-404-AOTA (2682).
literature on various tests and measures that may be useful
in physical rehabilitation practice. Yet even with this growth,
many researchers and clinicians alike find that the available
outcome measures are still inadequate. For now, our challenge
as clinicians lies in selecting from what we already
have. The following questions may give guidance during the
selection process.
n Who is your client?
n What clinical features does your client population share
that you wish to measure?
n Are there established measurement properties in the
outcome measure you are interested in using?
n What are the practical considerations in implementing the
chosen outcome measure?
OUTCOME MEASURES AND THE DOMAIN
OF OCCUPATIONAL THERAPy
Occupational therapy practice in physical rehabilitation is
largely influenced by the biomedical model. As such, we
find that many of the existing measures that occupational
therapy practitioners use in this area are focused on impairment,
including changes in client factors such as range of
motion, grip strength, and attention span. Existing measures
also focus on changes in performance skills such as mobility;
manipulation; and initiating, sequencing, and terminating
tasks. Impairments are significant clinical measures that
demonstrate intervention effectiveness; however, changes at
the impairment level that translate to function or at the level
of activity and participation are more meaningful to clients
and third-party payers. In occupational therapy terms, we
should take stock in a client’s ability to engage in meaningful
activities, demonstrate competence in his or her chosen life
roles, and participate in his or her community.
The outcome measure we choose should be congruent
with the domain of occupational therapy. Two conceptual
frameworks exist that are of significance to occupational
therapy and give support to the use of outcome measures:
the Occupational Therapy Practice Framework: Domain
and Process, 2nd Edition (Framework-II, AOTA, 2008)
and the International Classification of Functioning, Disability
and Health (ICF; World Health Organization, 2011).
The Framework-II provides a discipline-specific framework
of health domains and the occupational therapy process,
whereas the ICF provides a global classification system of
health domains. Furthermore, the ICF provides a conceptual
basis for measurement and policy formations for disability and
health assessment. The Framework-II and the ICF models
are similar in that they both consider the individual—the individual’s
body functions and structures as well as the external
world and its impact on the individual. They also encompass
the activities and level of participation in which the individuals
are able to partake. Furthermore, this overlap in models
provides a nice way in which to evaluate individuals within
occupational therapy and be able to engage in interdisciplinary
cross talk. Both the Framework-II and the ICF can be
used in any practice setting of occupational therapy, including
those within the physical rehabilitation spectrum, from inpatient
acute and subacute care to general outpatient rehabilitation
and specialized centers such as driving rehabilitation,
hand therapy, and low vision clinics. The conceptual foundation
may be the same for all settings; however, you choose the
best tool for your client. The Framework-II and the ICF can
be used in various domains of occupational therapy depending
on your clinical focus and the population you serve.
When choosing an outcome measure, it is important to
consider to whom you are administering the test. Many tools
were designed with specific populations or conditions in
mind. These tools may have been tested for validity within
that population. Tools should be both reliable and valid for
the population you are testing. For example, the Parkinson’s
Disease Questionnaire (PDQ-39; Jenkinson, Fitzpatrick, &
Peto, 1998) and the Stroke Impact Scale (SIS; Duncan et al.,
1999) are quality-of-life measures that were created for their
respective populations and are, therefore, not appropriate for
other populations.
Some tools intended for more general use have not been
specifically tested for a given population; however, it is
important to recognize the risk you are taking by using them.
If the tool has not been validated for your target population,
you have to be cautious about generalizing your outcomes.
The outcome of interest may be based on a specific-body
region or domain of function. For example, the Fugl Meyer
Assessment (FMA) of Motor Recovery (Gladstone, Danells,
& Black, 2002) has components designed to document motor
recovery or changes in motor functions in the upper and
lower extremities of clients with stroke. Like the FMA, the
SIS also has components related to upper and lower extremities,
but when all test domains of the SIS are taken collectively,
the test examines changes in quality of life and activity
and participation.
Subscales or domains allow clinicians to delineate which
areas are improving or responding to interventions. Subscales
share items that revolve within the same construct or
domain of health and functioning. However, it is important
to note that not all outcome measures have multiple components
that specifically measure various aspects of a client’s
health or functioning. In the aforementioned examples, the
PDQ-39 is one measure that provides a singular list without
delineating which items belong to the mobility domain
versus self-care domain and so on.
Even when the outcome measure has been designed and
evaluated for use in a given population with a specific issue
in a given body part or functional domain, it is worthwhile
to investigate the scope of the issue to avoid running into
problems related to test responsiveness. For example, the
FMA, although specific to the stroke population with motor
CE-2 ARTICLE CODE CEA0611
JUNE 2011 n OT PRACTICE, 16(11)

impairments, does not fully discriminate meaningful
changes in the quality of upper extremity motor recovery.
This ceiling effect and other psychometric properties
should be given consideration after determining the population
and domains of concern. At a minimum, outcome
measures should have sound psychometric properties, such
as reliability and validity (Barak & Duncan, 2006), before
using them in practice.
CLINOMETRIC PROPERTIES
Developing a clinical test and measure is a long-term process
that does not end with initial publication of how it was developed,
refined, and further examined for its validity and reliability.
Subsequent studies need to be done to cross validate
the measure across its intended population and its subgroups
or its related domains. Thus, critically appraising an outcome
measure for use in the clinic cannot be easily accomplished
by examining the original or first work. Instead, multiple
studies must be examined and culled for a variety of psychometric
features. At a minimum, we need to find out whether
the test is valid (i.e., whether the assessment measures what
it is supposed to measure), reliable (i.e., whether the results
of the assessment are consistent under various testing
conditions such as different times and different raters), and
capable of detecting meaningful clinical change. There are a
variety of terms associated with the psychometric concepts
of reliability and validity, including:
Content validity—to what extent the assessment measures all
aspects of a given domain (e.g., does the Jebsen’s Hand
Function Test measure all aspects of hand function?)
Construct validity—how consistent are the items in the assessment
are with an established concept (e.g., does the
Canadian Occupational Performance Measure [COPM]
truly capture the essence of occupational performance?)
Concurrent validity—how an assessment stacks against a “gold
standard” measure (e.g., is the Barthel Index a better
instrument than the FIM?)
Predictive validity—how an assessment can predict a subsequent
event (e.g., do the discharge FIM scores accurately
predict community reintegration?)
Inter-rater reliability—whether scores obtained by two or
more testers are similar (e.g., will a nurse score the ADL
items of the FIM in the same manner as an occupational
therapist?)
Intra-rater reliability—how consistently the client will respond
to the same assessment when given on two or more occasions
(e.g., will an occupational therapist yield the same
range-of-motion values on a client with shoulder pain if he
or she repeats the testing an hour later?)
Internal consistency—how various items within an assessment
measure the same domain of function or concept (e.g.,
do all items in the Disability of Arm Shoulder and Hand
[DASH] relate to upper extremity dysfunction?)
JUNE 2011 n OT PRACTICE, 16(11) ARTICLE CODE CEA0611
Earn .1 AOTA CEU (one NBCOT PDU/one contact hour). See page CE-7 for details.
These concepts may be immediately available in the literature
because they are essential in establishing whether the
test or measure is useful to begin with. Upon recognizing that
a test or measure is valid or reliable, it is crucial to determine
whether it is sensitive yet steady enough to capture clinical
change over time. To this end, the following concepts should
be considered:
Minimal detectable change—the least amount of change that
must occur to notice a change in functional ability; this
change does not involve measurement error (Heinemann,
2010; MacDermid & Michlovitz, 2008).
Minimally important clinical difference—the least amount of
change that must occur that is deemed important to the
client (MacDermid & Michlovitz, 2008) and/or the clinician
(Heinemann, 2010).
Ceiling effect—when the measure’s highest score or scoring
range is unable to detect change in a client’s ability.
A converse of this concept is the floor effect, when the
measure’s lowest score is not sensitive enough to assess
low level functioning (Heinemann, 2010).
PRACTICAL CONSIDERATIONS
After considering a variety of population factors (e.g., diagnosis,
complexity, domain of health, function) and psychometric
factors (e.g., reliability, validity, responsiveness to change), a
few more pragmatic issues must be worked out. These issues
include clinical implementation, availability of the measure
(including cost), and the training needs of the user.
Implementation
Outcome measures may be categorized as either clinician
administered (interview- or performance-based) or client
administered (self-report) assessments. There is a general
misconception that clinician-rated, performance-based
measures are superior and more objective than client selfreports
of their impairments, activity limitations, participation
restrictions, and decrement in quality of life. However,
this is not always the case; many client self-report measures
have been found to demonstrate greater levels of test reliability
(MacDermid & Michlovitz, 2008). Another advantage
of self-report measures is that they allow more time for the
clinician to provide interventions, especially when there are
limited visits allowed by the reimburser and the client is
unable to self-pay. Clients can fill out the self-report measure
by themselves or with the assistance of a caregiver outside of
the scheduled therapy time.
Although self-report measures have their merits, clinicianobserved,
performance-based measures are still the best way
to analyze a client’s safety and quality of performance.
Availability
Many outcome measures have been developed over the years
that may be accessed for free. For a listing of these outcome
CE-3

AOTA Continuing Education Article
CE Article, exam, and certificate are also available ONLINE.
Register at http://www.aota.org/cea or call toll-free 877-404-AOTA (2682).
measures, see Web Resources on p. CE-6. In addition, Table 1
on p. CE-5 provides a sampling of outcome measures (most
of which are free) that may be useful to occupational therapy
practitioners. In addition, outcome measures may be freely
obtained through open access journals such as those found
in PubMed Central (www.ncbi.nlm.nih.gov/pmc) and Biomed
Central (www.biomedcentral.com). Personal, one-time use
may be exempt from copyright laws. However, if you plan
to use the open access or free outcome measures multiple
times, direct contact with the authors of the assessment tools
and copyright holders is highly recommended. For instance,
the DASH Outcome Measure (www.dash.iwh.on.ca/conditions
.htm) may be used at no cost by clinicians for treating or
assessing patients or by researchers who are using it only for
noncommercial research. Therefore, keep in mind copyright
laws and your purpose before using an open access test.
Training
Many of the outcome measures that have been recently
developed were designed to be easy to use. Self-report measures
do not require training to capture change; rather, they
require a commitment from the therapist to ensure delivery
of the assessments in a timely manner. Many of the performance-based
measures that are free or open access come
with an administration manual that includes the administration
procedure, literature base, and psychometric studies of
the tool. There are also tests and measures that require users
to receive specialized training to be become certified testers.
Examples of these include the Arnadottir-Occupational
Therapy Neurobehavioral Evaluation (A-ONE; Gardarsdottir
& Kaplan, 2002) and the Assessment of Motor and Process
Skills (AMPS; Fisher, 2002).
CLINICAL REASONING
Selecting the appropriate outcome measure can be difficult.
Occupational therapy practitioners must consider numerous
complexities, including the type, onset, and severity of condition,
and the stage of recovery. Despite these complexities, a
number of strategies can facilitate the selection of functional
outcome measures. Clinical relevance can be optimized by
incorporating the ICF and Framework-II. Additional considerations
include cost of the assessment (many assessments may
be available for free), accessibility (assessments can frequently
be found on public domain Web sites), training (how long,
at what cost, and whether recertification is required), test
implementation (ease of use, clinician vs. self-adminstered),
and the time it takes to administer the test. The following two
examples illustrate clinical reasoning that takes into account
the factors discussed in using outcome measures.
Case Example: JR
JR is a 44-year-old male commercial construction worker
who sustained multi-trauma from a fall from a three-story
high scaffolding. The injuries included a three-part fracture
dislocation of his humerus (status post open reduction internal
fixation), a scaphoid fracture and perilunate dislocation,
multiple nondisplaced rib fractures, and a right stable pelvic
fracture. His insurance authorized an inpatient rehabilitation
facility for intensive therapy for an initial 14 days. His
admission FIM score was 58 out of a possible 126, with greatest
need for assistance in the areas of self-care (7 items),
transfers (3 items), and locomotion (2 items). He received
an intervention of 90 minutes of occupational therapy daily
and 90 minutes of physical therapy for 6 days a week for the
initial 2 weeks after admission. At the 2-week mark, JR was
able to walk 100 feet and transfer with supervision to and
from the toilet and walk-in shower. His self-care scores also
improved from a predominantly maximum assistance level
to a minimum assistance to supervision level using modified
techniques and adaptive equipment. Because JR had the ability
to perform many of his occupations at a supervision level,
the utilization department of JR’s insurance deemed 5 more
days of inpatient care was sufficient for him to be discharged
and able to function at home.
JR had been separated from his wife for 2 years. They
shared custody of two children, 7 and 9 years of age. At the
time of JR’s hospitalization, the children were under the
temporary care of their visiting grandparents, who live out
of state. JR and his kids live in a two-story townhouse in
which the bedrooms are located upstairs, posing a challenge
for both him and his therapists as far as discharge planning.
Fortunately, JR’s occupational therapist had administered
the DASH Outcome Measure and the COPM during the first
week of JR’s admission. The occupational therapist was not
expecting an immediate jump in JR’s self-care scores in the
FIM because of postsurgical orthopedic restrictions. However,
through the DASH and the COPM, the therapist was
able to demonstrate clinically meaningful change in areas not
directly measured by the FIM, including low-impact instrumental
activities of daily living such as light meal preparation,
and low-demand leisure pursuits such as card games
and social activities with his friends and children. At baseline,
JR’s COPM scores were 1.2 for the Performance subscale
and 2.8 for the Satisfaction subscale. At the 2-week reassessment,
these scores improved to 4.5 and 4.8, respectively.
The increase in score was deemed as clinically meaningful in
a related population (Carpenter, Baker, & Tyldesley, 2001).
Meanwhile, the DASH score was at 98 out of the worst possible
score of 100 but improved to 85 at reassessment—a
difference of 13 points. MacDermid and Michlovitz (2008)
suggested that a clinically important difference of 15 points
is a good long-term target goal for the DASH.
Knowing these clinometric properties, JR’s occupational
therapist and the rest of the rehabilitation team success-
continued on page CE-6
CE-4 ARTICLE CODE CEA0611
JUNE 2011 n OT PRACTICE, 16(11)

Table 1. Select Outcome Measures
Name of Test/
Measure
Canadian
Occupational
Performance
Measure
(Law et al., 2005)
Montreal Cognitive
Assessment
(Nasreddine et al.,
2005)
Executive Function
Performance Test
(Baum, Morrison,
Hahn, & Edwards,
2007)
Motor Activity Log
(Uswatte, Taub,
Morris, Vignolo, &
McCulloch, 2005)
Arnadottir Occupational
Therapy
Neurobehavioral
Evaluation
(Gardarsdottir &
Kaplan, 2002)
Motor Assessment
Scale (Carr, Shepherd,
Nordholm, &
Lynne, 1985)
Bristol Activities of
Daily Living Scale
(Bucks, Ashworth,
Wilcock, & Siegfried,
1996)
Dizziness Handicap
Inventory (Jacobson
& Newman, 1990)
Piper Fatigue Scale
(Strohscein et al.,
2003)
The Barthel Index
(Collin, Wade,
Davies, & Horne,
1988)
The Lawton IADL
Scale (Graf, 2007)
Functional Independence
Measure
(Keith, Granger,
Hamilton, &
Sherwin, 1987)
Typical Population
and Setting
Variety of conditions, age
groups, and settings
Adults and older adults with
mild cognitive impairments;
applicable across the rehab
continuum, from acute to
outpatient
Adults with cognitive impairments
due to stroke or multiple
sclerosis; applicable across
the rehab continuum and to
community-dwelling clients
Developed mainly for clients
with upper motor lesions
(e.g., cerebral vascular
accident, traumatic brain
injury) in acute care, inpatient,
outpatient, and home care
Adults and older adults with
neurological impairments
Adults with stroke
Adults and older adults with
dementia; acute care, inpatient,
outpatient, and home care
Adults with symptoms of
dizziness; acute care, inpatient,
outpatient, home care
Adolescents, adults, and older
adults with various conditions;
acute care, inpatient,
outpatient, and home care
Adult, older adults with
various conditions; acute care,
inpatient, outpatient, home care
Older adults with various
conditions; inpatient, and home
care
Adults and older adults with
a variety of conditions across
different settings
JUNE 2011 n OT PRACTICE, 16(11) ARTICLE CODE CEA0611
Earn .1 AOTA CEU (one NBCOT PDU/one contact hour). See page CE-7 for details.
Domain
Framework-II/ICF
Areas of occupation;
satisfaction over
performance
Cognitive performance
skills; mental functions
Cognitive performance
skills during performance
of simple activities of
daily living (ADLs) or
instrumental ADLs (IADLs)
Activity level; amount of
upper extremity use
Cognitive performance
skills during ADLs
Motor performance
including upper extremity
function, gait, and mobility
ADLs, IADLs, play, leisure
and social participation
ADLs, work, play, leisure,
social participation
Rest/sleep, education,
work, leisure, social
participation
ADLs
IADLs
ADLs, self-care, functional
mobility, cognitive performance
EBP Considerations
Test–retest reliability;
internally consistent;
criterion validity;
floor and ceiling effects
not established
Test–retest reliability;
construct and
criterion validity; floor
and ceiling effects not
established
Interrater/intra-rater
reliability; internally
consistent; construct
and criterion validity;
floor and ceiling
effects not established
Interrater/intra-rater
reliability and validity;
floor and ceiling
effects not established
Interrater/intra-rater
reliability and validity,
and responsive to
change
Interrater/intra-rater
reliability and validity,
and responsive to
change
Good test–retest
reliability, face validity,
construct validity,
concurrent validity
High test–retest
reliability, good
internal consistency
Strong test–retest
reliability, high internal
consistency, face
and content validity,
interrater/intra-rater
reliability
Interrater/intra-rater
reliability, high test–
retest reliability
Fair interrater/
intra-rater reliability
Adequate to excellent
interrater/intra-rater
reliability and validity
Pragmatic Considerations
Training
Administration Requirement
Interview;
administration
time could be
lengthy
Paper and pencil
test; brief period
Performance
based; brief
period
Interview; may
be administered
in short or long
format
Performance
based
Performance
based
Caregiver
questionnaire
Self-report
questionnaire
Self-assessment
Performance
based
Performance
based, self-report
Performance
based, nondiscipline
specific
Entry level;
training materials
available for
purchase
Entry level
Entry level
Part of constraintinduced
movement
therapy training
program at University
of Alabama –
Birmingham Taub
Clinic
Postprofessional
Certification
Entry level
Entry level
Entry level
Entry level
Entry level
Entry level
Entry level; interrater
reliability is
improved with
training
Cost and
Access
For purchase at
www.caot.ca
Free at www.
mocatest.org
Free at www.
practicechange
fellows.org/
documents/EFPT.
pdf
May be accessed
through constraintinduced
therapy
training
Part of certification
process
Free at www.
rehabmeasures.org/
PDF%20Library/
Motor%20Assess
ment%20Scale%20
Testing%20Form.
pdf
For purchase at
www.assessment
psychology.com/
resources.htm
Free at www.dizzyfix.
com/dizziness_handi
cap_inventory.asp
Free at www.ntfac
tor.com/survey
Free at www.stroke
center.org/trials/
scales/barthel.pdf
Free at www.
abramsoncenter.
org/pri/documents/
iadl.pdf
For purchase at
www.udsmr.org/
WebModules/FIM/
Fim_About.aspx
CE-5

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Register at http://www.aota.org/cea or call toll-free 877-404-AOTA (2682).
fully appealed to the insurance company for an extension of
inpatient rehabilitation coverage for JR, until he was ready
to perform self-care at modified independence and ambulate
longer distances with a device (a total of 5 weeks). He
returned to the same hospital for outpatient services a few
days after discharge.
CASE ExAMPLE: CM
CM is a 76-year-old female who had sustained a cerebral
vascular accident (CVA) 6 months previously. She was
discharged from inpatient rehabilitation to home 3 months
following the CVA, completed 4 weeks of home health
occupational therapy, and recently completed 8 weeks of
outpatient occupational therapy. Upon initial outpatient
occupational therapy evaluation, CM reported continued difficulties
with feeding and grooming and episodes of dizziness.
CM is cognitively intact and has no deficits with communication;
therefore, the occupational therapist could select
outcome measures that required both client report and were
performance based. Employed by a small outpatient facility
with a small budget, the occupational therapist selected
outcome measures that were available online for no cost,
reliable and valid, and quick to administer. The occupational
therapist completed the Barthel Index and the Dizziness
Handicap Inventory. On initial evaluation, CM scored a 70 out
of 100 on the Barthel Index and a 38 on the Dizziness Handicap
Inventory (31 to 60 indicates a moderate handicap). The
Barthel Index reflected CM’s need for help in cutting food,
dressing, transferring in and out of bed, walking in the house,
and navigating stairs. The Dizziness Handicap Inventory
noted CM has issues of dizziness when looking up, rolling in
bed, rising from a supine position, and completing household
activities of daily living (ADLs). CM reported through the
Dizziness Handicap Inventory that she was afraid of falling
and being alone, and of the perception of being intoxicated.
The occupational therapist developed meaningful goals and
interventions with CM that involved the deficit areas revealed
through the use of the functional outcome measures. Upon
discharge, CM’s score on the Barthel Index improved from 70
to 85 out of 100 and the Dizziness Handicap Inventory score
improved from 38 to 22 (0 to 30 indicates a mild handicap).
At discharge, CM presented with increased ability to cut food
as well as dress and transfer in and out of bed. She reports
feeling less fearful of falling and significantly less dizzy when
rolling in bed, rising from a supine position, and completing
household ADLs. Through the use of these functional
outcome measures, the occupational therapist was able to
document meaningful functional gains and goal attainment.
CONCLUSION
There are many benefits to using outcome measures in
physical rehabilitation practice, including objectively tracking
clinically meaningful progress (e.g., change in skills, change
in performance); justifying reimbursement or pre-authorization
of services; and benchmarking systems performance
for the purpose of improving clinical practices (e.g., quality
assurance, continuous performance improvement). In addition,
benchmarks of performance may be used for marketing
services to potential referral sources and to demonstrate to
third-party payers, legislators, and the public that occupational
therapy works.
Evidence-based practice in occupational therapy has been
considered an amalgam of clinical reasoning, knowledge
about the client and client preferences, and the best available
research evidence (Law, Pollock, & Stewart, 2004). However,
the heart of day-to-day implementation of evidence-based
practice is objectively knowing that the interventions we provide
actually work. For this reason, we need to incorporate
the right outcome measures into our clinical practice. Choosing
the right outcome measures requires time for investigation
and reflection. However, the payoff is significant, for
not only do the right outcome measures lead to clinical and
operational success, they help advance the profession toward
its Centennial Vision goal of being a “powerful, widely recognized,
science-driven, and evidence-based profession with a
globally connected and diverse workforce meeting society’s
occupational needs” (AOTA, 2006). n
WEB RESOURCES
Center for Outcome Measurement in Brain Injury
www.tbims.org/combi/list.html
This Web site is an “online resource for those needing
detailed information and support in regards to outcome
measures for brain injuries.” The site features downloadable
test forms, testing procedures, and psychometric properties
of each measure. The Center for Outcome Measurement
in Brain Injury is a collaborative project coordinated by the
Rehabilitation Research Center at Santa Clara Valley Medical
Center and is funded by the National Institute on Disability
and Rehabilitation Research (NIDRR).
StrokEngine—Assess
www.medicine.mcgill.ca/strokengine-assess/about-en.html
The site was built through a partnership between McGill
University and the Canadian Stroke Network. This link is a
component of a larger Web site on stroke rehabilitation,
StrokEngine, which contains assessments that have been
critically appraised for their psychometric properties.
Hyperlinks or procedures on how to obtain the assessments
are detailed on the site.
REHABILITATION MEASURES DATABASE
www.rehabmeasures.org/default.aspx
This database was developed by the Rehabilitation Institute
of Chicago with funding from the U.S. Department of
Education and NIDRR. The assessments on this site have
CE-6 ARTICLE CODE CEA0611
JUNE 2011 n OT PRACTICE, 16(11)

een critically appraised for various psychometric properties.
Hyperlinks or procedures on how to obtain the assessments
are provided on the site.
REFERENCES
American Occupational Therapy Association. (2006). AOTA’s Centennial Vision
and executive summary. American Journal of Occupational Therapy, 61,
613–614.
American Occupational Therapy Association. (2008). Occupational therapy
practice framework: Domain and process (2nd ed.). American Journal of
Occupational Therapy, 62, 625–683.
Barak, S., & Duncan, P. (2006). Issues in selecting outcome measures to assess
functional recovery after stroke. Neurotherapeutics, 3, 505–524.
Baum, C., Morrison, T., Hahn, M., & Edwards, D. (2007). EFPT Test and Protocol
booklet. Retrieved April 1, 2011, from www.practicechangefellows.org/docu
ments/EFPT.pdf
Bondoc, S., & Burkhardt, A. (2004). Evidence-based practice and outcomes management
in Occupational therapy. OT Practice, 9(20), CE-1–CE-8.
Bucks, R. S., Ashworth, D. L., Wilcock, G. K., & Siegfried, K. (1996). Assessment
of activities of daily living in dementia: Development of the Bristol Activities
of Daily Living Scale. Age and Aging, 25, 113–120.
Carpenter, L., Baker, G. A., & Tyldesley, B. (2001). The use of the Canadian Occupational
Performance Measure as an outcome of a pain management program.
Canadian Journal of Occupational Therapy, 68, 16–22.
Carr, J. H., Shepherd, R. B., Nordholm, L., & Lynne, D. (1985). Investigation of
a new motor assessment scale for stroke patients. Physical Therapy, 65,
175–180.
Collin, C., Wade, D. T., Davies, S., & Horne, V. (1988). The Barthel ADL Index: A
reliability study. International Disability Studies, 10, 61–63.
Duncan, P. W., Wallace, D., Lai, S. M., Johnson, D., Embretson, S., & Laster, L. J.
(1999). The Stroke Impact Scale, version 2.0: Evaluation of reliability, validity,
and sensitivity to change. Stroke, 30, 2131–2140.
Fisher, A.G. (2002). Assessment of motor and process skills. Fort Collins, CO:
Three Star Press.
Gardarsdottir, S., & Kaplan, S. (2002). Validity of the A-One: Performance in
activities of daily living and neurobehavioral impairments of persons with left
and right hemisphere damage. American Journal of Occupational Therapy,
56, 499–508.
Gladstone, D. J., Danells, C. J., & Black, S. E. (2002). The Fugl-Meyer Assessment
of Motor Recovery After Stroke: A critical review of its measurement properties.
Neurorehabilitation and Neural Repair, 16, 232–240.
Graf, C. (2007). The Lawton Instrumental Activity of Daily Living Scale. Try This:
Best Practices in Nursing Care to Older Adults. Retrieved May 16, 2011, from
http://consultgerirn.org/uploads/File/trythis/try_this_23.pdf
Heinemann, A. (2010). The rehabilitation measures database. Retrieved April 25,
2011, from http://www.rehabmeasures.org/Lists/RehabMeasures/Admin.aspx.
Heinemann, A. W., Linacre, J. M., Wright, B. D., Hamilton, B. B., & Granger,
C. (1993). Relationships between impairment and physical disability as
measured by the Functional Independence Measure. Archives of Physical
Medicine and Rehabilitation, 74, 566–73.
Jacobson, G. P., & Newman, C. W. (1990). The development of the Dizziness
Handicap Inventory. Otolaryngology Head and Neck Surgery, 111, 424–427.
Jenkinson, C., Fitzpatrick, R., & Peto, V. (1998). The Parkinson’s Disease Questionnaire:
User manual for the PDQ-39, PDQ-8 and the PDQ summary
index. Oxford, UK: Health Services Research Unit, University of Oxford.
Keith, R. A., Granger, C. V., Hamilton, B. B., & Sherwin, F. S. (1987). The Functional
Independence Measure: A new tool for rehabilitation. Advanced Clinical
Rehabilitation, 1, 6–18.
Law, M., Baptiste, S., Carswell, A., McColl, M. A., Polatajko, H., & Pollock, N.
(2005). Canadian Occupational Performance Measure. Retrieved May 16,
2011, from http://www.caot.ca/copm/index.htm
Law, M ., Pollock, N., & Stewart, D. (2004). Evidence-based occupational therapy:
Concepts and strategies. New Zealand Journal of Occupational Therapy,
51(1), 14–22.
JUNE 2011 n OT PRACTICE, 16(11) ARTICLE CODE CEA0611
Earn .1 AOTA CEU (one NBCOT PDU/one contact hour). See below for details.
Two Ways To Apply for
Continuing Education Credit
A. After reading the article Using Outcome Measures To Improve Occupational
Therapy Practice in Physical Rehabilitation, answer the
questions to the final exam found on p. CE-8 by June 30, 2013.
There are two ways to take the exam:
1. Electronic Exam With Immediate Results and Certificate: Register
to take the exam online and receive your certificate immediately
upon successful completion of the exam. To register to
take the exam online, go to www.aota.org/cea or call toll-free
877-404-2682. Once you are registered you will receive your
personal access information within 2 business days. Then
log on to www.aota-learning.org to take the exam online.
Note: This option comes with a pdf of the article that may be
printed.
2. Answer Card Exam*: Use the Registration and Answer Card
bound into this issue of OT Practice at the beginning of the
article. Using the Registration and Answer Card, complete
Sections A through F and return the card with the appropriate
payment to the address indicated.
B. Continuing education credit will be issued only for a passing
score of at least 75%. Use the electronic exam and you can print
off your official certificate immediately if you achieve a passing
score. If you are submitting a Registration and Answer Card,
you will receive a certificate within 4 weeks of receipt of the
processed card.
C. The electronic exam must be completed by June 30, 2013. The
Registration and Answer Card must be received by June 30,
2013, in order to receive credit for Using Outcome Measures To
Improve Occupational Therapy Practice in Physical Rehabilitation.
* IMPORTANT NOTE: Beginning with articles published after July 1,
2011, only electronic exams will be available. Answer cards will
still be accepted for articles published prior to July 1, 2011.
MacDermid, J., & Michlovitz, S. (2008). Incorporating outcomes measures into
evidence-based practice. In M. Law and J. MacDermid (Eds.), Evidence-based
rehabilitation: A guide to practice (2nd ed). Thorofare, NJ: Slack.
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V.,
Collin I., et al. (2005). The Montreal Cognitive Assessment, MoCA: A brief
screening tool for mild cognitive impairment. Journal of the American Geriatrics
Society, 53, 695-699.
Strohschein, F. J., Kelly, C. G., Clarke, A. G., Westbury, C. F., Shuaib, A., & Chan,
K. M. (2003). Applicability, validity, and reliability of the Piper Fatigue Scale.
American Journal of Physical Medicine and Rehabilitation, 82, 122–129.
UB Foundation Activities. (2002). IRF-PAI training manual. Retrieved April 1,
2011, from https://www.cms.gov/InpatientRehabFacPPS/downloads/
irfpai-manualint.pdf
Uswatte, G., Taub, E., Morris, D., Vignolo, M., & McCulloch, K. (2005). Reliability
and validity of the Upper Extremity Motor Activity Log-14 for measuring realworld
arm use. Stroke, 36, 2493.
World Health Organization. (2011). International classification of functioning,
disability and health (ICF). Retrieved April 25, 2011, from http://www.who.
int/classifications/icf/en
Wright, J. (2000). Introduction to the FIM(TM). The Center for Outcome
Measurement in Brain Injury. Retrieved April 23, 2011, from http://www.tbims.
org/combi/FIM
CE-7

Final Exam CEA0611
AOTA Continuing Education Article
CE Article, exam, and certificate are also available ONLINE.
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Using Outcome Measures To Improve Occupational Therapy
Practice in Physical Rehabilitation • June 20, 2011
Learning Level: Entry
Target Audience: Occupational therapists and occupational
therapy assistants
Content Focus: Category 2: Occupational Therapy Process:
Evaluation;
Category 3: Professional Issues: Contemporary
Issues and Trends
1. Which of the following statements best describes outcome
measures as used in clinical occupational therapy
practice?
A. Outcome measures are assessments that have normative
values.
B. Outcome measures are optional tools that may not be
practical for all settings.
C. Outcome measures are standardized tools designed to
document change in performance over time.
D. An outcome measure must be carefully selected so
that it can comprehensively capture all domains that
are of concern to the therapist.
2. Which of the following are pragmatic considerations
when selecting the proper functional outcome measure?
A. Cost and training required
B. Reliability and validity of measures
C. Responsiveness to change
D. Floor and ceiling effects
3. Incorporating outcome measures in clinical practice
is a useful strategy to increase the likelihood of
reimbursement.
A. True B. False
4. Minimal detectable change refers to:
A. The least amount of change that must occur that is
deemed important to the client and/or the clinician
B. The smallest range of function that an outcome measure
can detect
C. The least amount of change that is detected by the
outcome measure
D. The least amount of change that must occur for the
client or clinician to observe change in a client’s functional
ability
5. Domains or related domains of occupational performance
that may be assessed for change by outcome measures
include each of the following except:
A. Context and environment
B. Performance skills
C. Health-related quality of life
D. Performance patterns
6. For whom are outcome measures relevant?
A. Third-party payers
B. Clients
C. Practitioners
D. All of the above
7. Which of the following is true regarding self-reported
outcome measures?
A. Self-reports are less superior in pyschometric properties
than clinician-observed/administered.
B. Self-reports may be completed initially by a proxy and
then by the actual client in subsequent time periods.
C. Self-reports are reliable, valid, sensitive to change, and
clinically efficient.
D. Self-reports are best used when clinicians want to
determine a client’s safety.
8. Outcome measures that are freely accessible online or
through open-access journals may be freely reproduced
and used in practice without requiring copyright permission
from the author.
A. True B. False
9. If we are interested in knowing whether an outcome
measure score may be reliably used to determine the
likelihood of successful discharge, we need to examine
this particular psychometric property:
A. Test–retest reliability
B. Internal consistency
C. Predictive validity
D. Construct validity
10. When an outcome measure is not able to capture changes
above its maximum score, it is said to have a:
A. Floor effect
B. Minimal detectable change
C. Minimal clinically important difference
D. Ceiling effect
Please use Table 1 on p. CE-5 to help answer the following
questions.
11. Of the following tests and measures, which is
performance-based?
A. Motor Activity Log
B. Barthel Index
C. Bristol Activities of Daily Living Scale
D. Piper Fatigue Scale
12. Which of the following outcome measures can reliably
and validly determine upper extremity functional use in
clients with stroke?
A. Motor Activity Log
B. Canadian Occupational Performance Measure
C. Bristol Activities of Daily Living Scale
D. Executive Function Performance Test
CE-8 ARTICLE CODE CEA0611
JUNE 2011 n OT PRACTICE, 16(11)