Content Analysis of Qualitative Research on Children and Youth With Autism, 1993-2011: Considerations for Occupational Therapy Services

Exploring the Intensity, Frequency, and Duration of Pediatric Constraint Induced Movement Therapy Published Research: A Content Analysis

Constraint Induced Movement Therapy (CIMT) utilizes a behavioral approach to neurorehabilitation involving constraint of an unaffected upper extremity which forces the use of the affected extremity. There is substantial evidence supporting the effectiveness of CIMT among both children and adults. The purpose of this study was to explore the frequency, intensity, and duration parameters across the published clinical outcomes related to pediatric CIMT (pCIMT) among children and youth populations. A content analysis approach was used to search the following databases Google Scholar, OT seeker, American Occupational Therapy Association special interest section, Medline, EbscoHost, and Cinhal. A total of 141 studies were identified via the initial search, with 51 studies meeting inclusion criteria. The findings revealed that 100% of the studies included restraint of the non-affected upper extremity, 73% incorporated repetitive task-oriented training, but less than half prescribed home practice strategies. Further, only 34% of the studies reviewed included all three components of CIMT. Outpatient hospital clinics and home-based settings were the most utilized settings for research studies. The mean minutes per session was M = 205.53, SD = 164.99. As part of the plan of care, the duration and frequency of therapy both had similar means (~M = 3.60) and standard deviations (~SD = 1.65). There was a significant variance of hours during (SD = 139.54) and outside of therapy (SD = 130.06). The results of this study, together with other emerging evidence, can assist practitioners in prescribing dosages dependent on the setting, the pediatric client, and their current functional status.

Experience of Sleep for Families of Young Adults With Autism Spectrum Disorder

IMPORTANCE

Children with autism spectrum disorder (ASD) may experience sleep difficulties that worsen into adulthood and negatively influence both child and family, yet the experience is not well understood. Understanding the family's experience can inform occupational therapy providers, future research, and practice guidelines.

OBJECTIVE

To examine experiences surrounding sleep for families raising a young adult with ASD (YA-ASD).

DESIGN

Qualitative study in the phenomenological tradition of Moustakas (1994). Experienced researchers analyzed transcripts from in-depth, in-person interviews to triangulate data, distill themes, and construct the essence of family experience. Trustworthiness was established through member checking, audit trails, and epoché diaries that were maintained throughout data analyses.

SETTING

Community setting (large city in the northeastern United States).

PARTICIPANTS

People who self-identified as living in a family arrangement that included a YA-ASD age 15-21 yr, able to verbally participate in English. Families with children diagnosed with developmental disabilities other than ASD were excluded.

RESULTS

Six eligible families identified through volunteer sampling participated. The participants' sociodemographic diversity was limited across household income, education level, and ethnicity. All YA-ASD in this study were limited verbally and unable to contribute. Analyses of interview transcripts revealed five themes that form the essence of the families' experience surrounding sleep.

CONCLUSIONS AND RELEVANCE

Sleep issues for YA-ASD continue into adulthood and affect the entire family because of continuous co-occupation; occupational therapy support is therefore important for families of YA-ASD. The lack of effective evidence-based interventions supporting the YA-ASD population also reveals an area for growth. What This Article Adds: The results indicate the importance of addressing sleep for YA-ASD and their families in occupational therapy practice because of its considerable impact on family life.

Razonamiento clínico en terapia ocupacional. Una revisión narrativa

 Introducción. El razonamiento clínico ordena el procesamiento de la información obtenida durante la evaluación, facilitando tomar decisiones para implementar planes de tratamiento. Esta área es cada vez más relevante para la formación de estudiantes y profesionales de terapia ocupacional. Objetivo. Analizar la literatura sobre razonamiento clínico en terapia ocupacional publicada entre 2009 y 2018. Materiales y métodos. Se realizó una revisión de la literatura en bases de datos, repositorios institucionales, monografías y literatura gris de alcance. Se establecieron criterios de selección para la obtención de documentos que luego se analizaron estableciendo un conjunto de variables que permitieron el análisis de la literatura. Resultados. La literatura sobre razonamiento clínico en el período estudiado fue de 99 publicaciones, más de la mitad que en los 33 años anteriores. El razonamiento clínico en el ámbito docente es el de mayor impacto (41.4%); 52.5% son publicaciones que mejoran la práctica con sus aportes al reforzar el desarrollo de destrezas profesionales y la calidad de las intervenciones. Conclusión. El aumento de la investigación sobre razonamiento clínico en terapia ocupacional dota a esta área de conocimiento y rigor, mejorando así la eficacia de los terapeutas ocupacionales.

Exploring the parameters of intensity, frequency, and duration within the constraint induced movement therapy published research: A content analysis

BACKGROUND

Neurological rehabilitation specialists must determine appropriate dosage, consisting of frequency, intensity, and duration of specified treatments.

OBJECTIVE

The objective of this study was to perform a content analysis of the current literature related to dosage (duration, frequency and intensity) for constraint-induced movement therapy (CIMT) in the adult population.

METHODS

A content analysis was conducted which yielded 62 scholarly articles.

RESULTS

The frequency of CIMT ranged from 1 to 7 days per week with the average frequency being 4.98 days. The duration of CIMT, ranged from 2 to 10 weeks with the average duration 3.14 weeks. All three components of dosage were reported collectively in outcomes studies conducted in inpatient settings and rehabilitation clinics.

CONCLUSIONS

The findings provide a groundwork for evidence based practice for clinician in the application of CIMT dosage with consideration of settings and CIMT components.

Occupational Therapy: Meeting the Needs of Families of People With Autism Spectrum Disorder

Occupational therapy has much to offer to families of people with autism spectrum disorder (ASD). However, people outside the profession may be unaware of occupational therapy's breadth and scope. It is our responsibility and our duty to express the full range of occupational therapy services through research, clinical practice, advocacy, and consumer education. This special issue of the American Journal of Occupational Therapy, with its focus on autism, embarks on this endeavor by highlighting research and theoretical articles that address the various aspects of occupational therapy practice that can help to fully meet the needs of people with ASD and their families.

Contribution of Qualitative Research to Evidence in Practice for People With Autism Spectrum Disorder

Appraising the best available evidence substantiating and informing occupational therapy practice is a commonly expressed obligation for the profession (American Occupational Therapy Association [AOTA], 2007). In this article we argue for the full inclusion of qualitative research, on parity with quantitative research, as a source for evidence of relevant and effective occupational therapy practice, review the limitations of quantitative research, and outline the distinctive contributions of qualitative studies to the practice of occupational therapy for people with autism spectrum disorder (ASD). In addition, we describe the role of qualitative studies in the fulfillment of the Centennial Vision (AOTA, 2007) and recommend three action steps for the profession.