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Spring 2006 Research Presentations

Occupational Therapy Department Research
Presentations- Spring 2006

Spring 2006 OT Research Presentations

Title: Current Use of the DIR model to Guide Intervention for Children with Autism
Graduate Student Researchers:
Amy Bower, OTS; Tracy Eiring, OTS; Kayla Riegel, OTS; Crystal Stoltz, OTS
Faculty Chair: Dr. Ellen McLaughlin, Ed.D., OTR/L, BCP
Faculty Reader: Dr. Lalit Shah, Ed.D., OTR/L
This study investigated the use of the Developmental, Individual-difference, Relationship-based (DIR) model by occupational therapists, including its prevalence, perceived effectiveness, and compatibility with other models.
Method. A survey was completed by 91 occupational therapists with a 22.8% response rate. Results. Results of this study determined that 76.5% of therapists surveyed were familiar with the DIR model, and reported it as being one of the primary models used to guide practice. 72.6% of respondents reported the DIR model was effective in guiding intervention. The DIR model was identified as being most compatible with the SI, developmental and cognitive models, respectively.
Conclusion. The DIR model is emerging as a model consistent with its intent regarding the occupational therapy process and compatible with many other approaches.

Title: Differences in Efficiency between the Chubon, FITALY, and ReverseQWERTY Onscreen Keyboard Layouts for Single Digit Typists.
Graduate Student Researchers:
Vanessa Klotz, OTS; Ashley Light, OTS; Angela Sancinella, OTS; Johnna Schickram, OTS
Faculty Chair: Dr. Joseph Cipriani, Ed.D., OTR/L
Faculty Reader: Mr. Denis Anson, M.S., OTR/L, and Dr. Lalitchandra Shah, Ed.D., OTR/L
The purpose of this study was to compare the onscreen layouts of the Chubon, FITALY, and ReverseQWERTY keyboard patterns to discover which of these designs is more efficient for trials to achieve fluency, speed, and accuracy when used by single digit typists. Six subjects were solicited via convenience sample to type on the three alternative keyboard layouts until they achieve fluency. Four out of the six subjects achieved fluency on the FITALY keyboard in fewer trials than the Chubon and ReverseQWERTY. However, four out of the six subjects typed faster on the Chubon keyboard than on the other two keyboards. The results for percent accuracy did not show much difference between the ranges of the keyboards. There was less than a 1% difference for three of the subjects while the other three subjects had less and a 2.5% percent accuracy difference between the keyboards. Due to the results of this study, the researchers were unable to recommend an alternative keyboard layout for single-digit typists. The decision of which alternative keyboard layout to use will be dependent upon the user’s preferences and the occupational therapist’s recommendations.

Title: The Benefit of Handicap Accessibility for Able-Bodied Users of the World Wide Web.
Graduate Student Researchers:
Ronni Marangoni, OTS; Karyn Mills, OTS
Faculty Chair: Dr. Lalit J. Shah, Ed.D, OTR/L
Faculty Reader: Mr. Denis Anson, M.S., OTR/L
The purpose of this study was to identify the benefit of handicap accessibility for able-bodied users of the World Wide Web. This was determined by having 120 individuals complete a multiple choice test using either a conventional or an accessible constructed website using either a graphical, text only or a small screen browser. Instrumentation utilized included computers with web browsers such as Firefox version 1.0.5 (conventional graphical browser), Lynx (text only browser) version 2.8.3, and a small screen browser with a resolution of a Palm T5 screen. The Pennsylvania Bar Association website was used as the medium to develop an accessible website. Participants were asked to fill out a personal reflection questionnaire after completing the test. Using the small screen browser, visitors spent significantly more time on the accessible site but answered significantly more questions correctly and were able to get each correct response significantly more quickly than users of the conventional site. In addition, the accessible site was considered to be significantly easier to use than the conventional site. Using the conventional graphical browser, visitors spent significantly less time on the conventional site were able to answer significantly fewer questions successfully and took substantially longer for each correct response than users of the accessible site. While users of neither site enjoyed using the text-only browser, the accessible site was rated significantly higher in ease of use, more pleasant to use and in the likelihood of being reused by the visitor. These results indicated that using an accessibly designed website is more usable to visitors using a small screen or a text only browser than using a conventionally designed website. The results of this study clearly show that accessible design, even when the look and feel of the site is changed only minimally, had a significant advantage for able-bodied users when using a sub-optimal browser. In the conventional graphical browser, the accessible website was at least as usable as the conventional website. These results suggest that accessible design should not, in fact, be considered as an aspect of accommodation for individuals with disabilities, but as an implementation of universal design.

Title: A Comparison of College Students’ Grasp Patterns and Grasp’s Influence on Speed and Legibility of Handwriting
Graduate Student Researchers:
Tom Doxsee, OTS; Scott Gordon, OTS; Jane Porcaro, OTS
Faculty Chair: Dr. Lalit J. Shah, Ed.D. OTR/L
Faculty Reader: Ms. Molly Mika, M.S., OTR/L
The objective of this study was to determine the impact of college students’ grasp patterns on the speed and legibility of their handwriting. The researcher also attempted to determine if there were proper grasp patterns that allow for efficient handwriting. One hundred and fifty college students ages 18 years or older participated in this study. A writing sample consisting of 382 words was used. Thirty-four letters from this passage were analyzed using Minnesota Hand Writing Assessment for legibility. The Schneck‘s grasp scale was used to identify grasp patterns. The results showed that the dynamic tripod grasp was utilized by 91.3% of the participants in this study. The data analysis showed that the type of grasp had impact on the size and spacing of the letters (correlation was significant at the 0.01 level) but had no impact on alignment, form and legibility of the letters. Although a type of grasp had an impact on the size and spacing of letters, it was not significant enough to demonstrate that one grasp pattern was more effective than the other. According to our research study there did not appear to be any significant relationship between the grasp pattern of college students and their speed and legibility on their handwriting.

Title: Developing and Field Testing the Pain and Functional Performance Assessment for Individuals with Chronic Pain
Graduate Student Researchers:
Carol Beckwith-Cohen, OTS; Stephanie Edwards, OTS; Christine Howe, OTS; Lakeisha Smith, OTS; and Trisha Sugrue, OTS
Faculty Chair: Dr. Grace S. Fisher, Ed.D., OTR/L
Faculty Reader: Dr. Gwen Bartolacci, O.T.D., OTR/L
In order to effectively assess an individual’s ability to function with chronic pain, a comprehensive and structured instrument is needed. In this study, we developed and field tested the Pain and Functional Performance Assessment [PFPA] to aid in evaluation and treatment planning for individuals with chronic pain. The PFPA allows individuals to identify the extent to which their daily occupations have been affected by pain.
Method. The PFPA was developed using the American Occupational Therapy Association Practice Framework as a guide. We administered the PFPA through face to face interviews with a convenience sample of 25 participants who reported having chronic pain. All participants lived independently. To determine the content validity of the PFPA, the participants also completed feedback questionnaires. The PFPA and a separate feedback questionnaire were also given to an expert panel of 17 practicing occupational therapists. Data were analyzed using the Statistical Package for the Social Sciences and a content analysis of responses to open ended questions. Results. The PFPA field test illustrated that basic grooming related tasks were less impacted by chronic pain than activities requiring increased range of motion, strength, and endurance, such as tub/shower transfers, dressing, and sleeping. The majority of participants felt the assessment addressed the important areas of daily life. The occupational therapists also gave positive feedback about the assessment.
Conclusion. Results suggest that the PFPA is an effective tool for helping to determine the extent to which pain affects clients’ everyday activities.

Title: Cougar Home Safety Assessment for Older Adults Version 3.0: Resident Follow Through on Recommendations
Graduate Student Researchers:
Nicole Cardillo, OTS, Silvana Chin, OTS, Erica Derrick, OTS, and Kelda Zepherin, OTS
Faculty Chair: Dr. Grace S. Fisher, Ed.D., OTR/L
Faculty Reader: Dr. Joseph Cipriani, Ed.D., OTR/L
Objective. This study developed the Cougar Home Safety Assessment 3.0, an environmental evaluation tool, by adapting the Cougar 2.0. The purpose of this research was to field test the Cougar3.0 through implementation and analysis of content validity.
Method. Four graduate occupational therapy students assessed the homes of 20 community dwelling older adults aged 65 to 95 for environmental safety hazards. Safety recommendations were provided. 4-6 weeks later a follow up visit was conducted to determine the extent of follow through with the recommendations.
Results. Overall, 195 safety recommendations were given to the 20 participants. The mean number of suggestions given to each older adult was 9.75. The most common hazards found included: lack of fire extinguishers on every level of the home (75%), lack of carbon monoxide detectors on every level of the home (65%), water temperature higher than 120° (50%), and lack of a first aide kit (50%). Follow up visits revealed follow-through on 53.8% of the recommendations given. Content validity was confirmed through feedback on surveys from an expert panel of occupational therapists and participant questionnaires.
Conclusion. The Cougar 3.0 is a valid and easy to use home assessment tool which can identify environmental safety hazards. Older adults have difficulty performing changes to improve their home safety due to financial restraints, feeling the suggestions are not a necessity, not wanting to change old habits, and physical limitations.

Title: An Evidence-Based Practice Review on the Effectiveness of Sensory Integration Intervention and Psychosocial Dysfunction.
Graduate Student Researchers:
Mary Cherney, OTS; Paula Horowski, OTS; Margaret Kieffer, OTS; Elizabeth Perez, OTS; Dawn Welker,OTS
Faculty Chair: Dr. Elizabeth Pfeiffer, Ph.D., OTR/L
Faculty Reader: Dr. Gwen Bartolacci, O.T.D., OTR/L
The purpose of this evidence based practice review was to review research findings that focused on the relationship between sensory integration and psychosocial dysfunction and the effectiveness of sensory integration (SI) treatment interventions on psychosocial functioning. The practice review was completed by the systematic and organized search of all available peer reviewed journal articles that related to the topic of the study. The articles were analyzed with pertinent information collectively organized within a matrix format. Many of the articles reviewed demonstrated a positive relationship between psychosocial behavior and sensory integration. Although the results were inconclusive in regards to the overall effectiveness of sensory integration on psychosocial functioning, many of the articles identified a positive effect. Inconclusive results appeared related to the limited amount of research currently existing that provides scientific evidence of SI interventions. Research is needed to increase public awareness of occupational therapy as a profession, as well as to enhance practitioners’ skill in implementing SI based intervention. Therefore, SI therapy requires more research to further prove its effectiveness, as well as to substantiate evidence-based practice interventions.

Title: Identifying the Health and Social Needs of the Elderly Living in Rural Areas of Northeastern Pennsylvania
Graduate Student Researchers:
Cheryl Bolesta, OTS; Lauren A Sekosky, OTS; Amanda Gaffey, OTS; & Melissa Miskiel, OTS
Faculty Chair: Gwen Bartolacci, O.T.D., OTR/L
Faculty Reader: Dawn Evans, M.S., OTR/L
The purpose of this study was to identify the health and social needs of the elderly living in rural areas of Northeastern Pennsylvania.
Method. The researchers conducted a needs evaluation using qualitative methodologies. Demographic information was obtained using a self-administered questionnaire. Individual semi-structured interviews were conducted using questions based on the Lifestyle Redesign Program (Clark, Azen, Zemke, Jackson, Carlson, & Mandel, 1999), as well as questions created by the researchers and research chair.
Results. Twelve older adults participated in the study. Eight of the twelve participants (66%) did not identify any significant health or social needs. A theme analysis was also done and the following themes were identified: the importance of friends and family, satisfaction with current situation, importance of religion and spirituality, importance of social involvement, and the ability to adapt to changes in their current situations.
Conclusion. Senior apartment buildings in rural areas provide various types of services that may prove to be environments that support successful aging.

Title: The Influence of Gender Norms and Gender Stereotypes on Occupational Leisure Choices among Middle-Age Adults
Graduate Student Researchers:
Jennifer Bottone, OTS, Kimberly Hreha, OTS, Christie Weaver, OTS, Casey Zimmer, OTS
Faculty Chair: Joseph Cipriani, Ed.D, OTR/L
Faculty Reader: Gwen M. Bartolacci, OTD, OTR/L
Abstract: The objective of this study was to (a) explore through life narratives how middle-aged adults’ leisure evolved over time and (b) how perceptions of gender norms and stereotypes have affected the past, present, and possible future occupational leisure choices of a sample of middle-aged adults. Interviews were conducted with eight middle-aged adults and were analyzed by the empirical, phenomenological, psychological method (EPP). The following themes were discovered: leisure as a planned activity; leisure is individually determined; past leisure develops into current leisure; development of new leisure; and gender: past, present, and future. This study found that the effects of gender norms and stereotypes on leisure choices among middle-aged adults are complex and highly variable across participants. It is important for occupational therapists to be aware of the influences of gender norms and stereotypes when planning interventions for clients.