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Spring 2007 Research Activities

Spring 2007 Research Presentations

Title: Text Generation: A Comparison of Dasher Software and WiViK Keyboard with a Chubon Overlay
Graduate Presenters: Christine Swink, OTS; Christine Mancia, OTS; Marissa Maglioli, OTS
Faculty Research Committee Chair: Dr. Joseph Cipriani, Ed.D., OTR/L
Faculty Research Committee Reader: Denis Anson, M.S., OTR/L
Purpose: To compare Dasher software to the WiViK onscreen keyboard with Chubon overlay, as a means of text generation, to determine which input device has better speed and accuracy.
Method: This study used the quantitative paradigm with a single subject alternating treatment (A-B) design. The 7 participants were tested using both methods of text generation and compared against their own performance, with regard to speed and accuracy.
Results: One participant achieved mastery on Dasher, while six participants achieved mastery on WiViK onscreen keyboard with Chubon overlay. All of the participants performed better on WiViK with regard to speed and accuracy.
Conclusion: The WiViK onscreen keyboard with the Chubon overlay shows promise over the Dasher software as a means of text generation.

Title: Who Makes the Grade?: A Study of Dragon Naturally Speaking and Speak-Q Speech Recognition Used With Children
Graduate Presenters: Catherine Dempsey, OTS; Bethany McCullough, OTS; Elizabeth Mistrik, OTS; Amanda Morgan, OTS
Faculty Research Committee Chair: Dr. Joseph Cipriani, Ed.D., OTR/L
Faculty Research Committee Reader: Denis Anson, M.S., OTR/L
The purpose of this study was to compare the performance of school aged children, ages ten to fourteen, for text generation productivity, as measured by words per minute and accuracy, when using two commercially available voice recognition programs: Speak-Q and Dragon Naturally Speaking. Using a single-subject repeated measures design, six participants (three girls and three boys) aged ten through fourteen underwent training on two speech recognition systems. The participants then engaged in a series of 20 minute voice input trials where their words per minute and accuracy were calculated for each of the trials. Results of the study show that Dragon Naturally Speaking out-performs Speak-Q in terms of words per minute produced and number of trials needed for mastery, however, using Speak-Q was found to result in greater accuracy of text generated. The results of the study show promise for the use of speech recognition with children, particularly over the age of twelve.

Title: A Survey of Occupational Therapy Intervention to Improve Handwriting for Children in Pediatric Practice.
Graduate Presenters: Martine Decayette, OTS; Dienna Etienne, OTS; Melissa Lesjack, OTS; Angela Rutty, OTS
Faculty Research Committee Chair: Dr. Lalit Shah, Ed.D., OTR/L
Faculty Research Committee Reader: Dr. Ellen McLaughlin, Ed.D., OTR/L
Handwriting is a significant occupation of school aged children. Efficient and legible handwriting are in particular necessary for success in school, specifically when writing notes or taking a test. Children experiencing handwriting difficulties may be referred for occupational therapy. This study surveyed occupational therapists working in the United States that work in the area of pediatrics to find out the current interventions that are being used to improve handwriting in children. Based on a list of occupational therapists provided by the American Occupational Therapy Association, the researchers mailed a survey of multiple choice and open ended questions. The questions sought to find out what interventions occupational therapists are using to improve handwriting, what are the underlying problem areas related to handwriting deficits, and are there any trends in the interventions used to improve handwriting. Of the 504 surveys sent, 142 surveys were returned. Of these 14 could not be used. The remaining 128 were processed and analyzed. This study found that dysfunction in written communication is the most frequent reason for occupational therapy referral. The most frequently selected problem areas related to the handwriting deficit are motor planning and fine motor/ manipulation skills. The two most common forms of intervention used to treat handwriting difficulties are fine motor and visual motor activities. The most frequently used handwriting program is the "Handwriting Without Tears" program. The results of this study can help occupational therapists understand what other interventions exist and which of those interventions are currently being used.

Title: The Effects of Weighted Vest Versus Pressure Vest Intervention for a Child with Autism
Graduate Student Researchers: Donna Bealla, OTS; Miriam Ludwig, OTS; Kim Reyes, OTS; and Andrea Sheetz, OTS
Faculty Research Committee Chair: Dr. Lalitchandra J. Shah, Ed.D., OTR/L
Faculty Research Committee Reader: Dr. Ellen McLaughlin, Ed.D., OTR/L
Objective. Currently, weighted and pressure vests are being used in pediatric therapy settings with no established protocols. The purpose of this case study was to clarify, compare and contrast the effects of the weighted and pressure vest intervention on a child with autism.
Method. This research studied the behaviors of one child with autism in a single-case A-B-A research design. The researchers videotaped a child to observe/record if there were changes in stereotypical and goal oriented behaviors as a result of wearing a weighted vest or pressure vest during their standard outpatient occupational therapy intervention sessions for six sessions. Key behaviors were determined and counted every 30 seconds of the videos and were subsequently analyzed.
Results. The data was analyzed by adding the stereotypical and goal oriented behaviors of the two vest sessions and calculating the percentage change before and after the vest intervention. There was no change in stereotypical behaviors using the pressure vest intervention, but there was an 86% reduction in stereotypical behaviors for the weighted vest intervention. There was an increase in goal-oriented behavior using the pressure vest of 107%, whereas the weighted vest had a reduction in goal-oriented behaviors of -63%. Comparing the effects of both the pressure vest and weighted vest interventions on one child with autism, the pressure vest intervention showed the most significant increase in goal-oriented behaviors but no change in stereotypical behaviors. The weighted vest reduced the stereotypical behavior, but there was also a reduction in goal-oriented behaviors.
Conclusion. The researchers found only one local therapist using the vest during treatment sessions and therefore recommend that a new survey of occupational therapists be conducted to determine the current practices with weighted vests and pressure vests.

Title: Occupational Therapy- Meeting the Needs of Older Adult Workers?
Graduate Presenters: Karmela Conte, OTS; Missy Gilroy, OTS; Tifany Marvin, OTS; Heather Theysohn, OTS
Faculty Research Committee Co-Chairs: Dawn Evans, M.S., OTR/L and Dr. Grace Fisher, Ed.D., OTR/L
Objective. The purpose of this phenomenological study was to explore and better understand (a) why aging workers continue to work past retirement age, (b) how aware occupational therapists are of the needs of the growing demographic of the aging worker, and (c) potential occupational therapy interventions that can better help this population.
Method. This study was conducted with a mixed method design approach, specifically the parallel/simultaneous design, which consisted of both a qualitative and quantitative investigation. The quantitative portion of the study was based on the numerical data obtained from the surveys and the qualitative portion was based on the phenomenological interviews of the aging worker.
Results. Among the eight interviewees, it was found that they were all in generally good health and many were currently employed, yet were unsure of when they planned to retire. This research study found that the majority of occupational therapists were unaware of growing trends concerning older adult workers, and needed to know more about this population.
Conclusion. There is a growing need for occupational therapists to develop greater knowledge of increasing trends concerning older adult workers. Occupational therapists need to be proactive toward gaining competency in this area and providing the most beneficial intervention possible. Aging workers are prime candidates for occupational therapy. Occupational therapists appear to be overlooking opportunities to meet the needs of this population.

Title: How the Needs of Urban Elderly Differ from Needs of Rural Elderly: OT Interventions to Increase the Quality of Life
Graduate Researchers: Sharon Blackowski, OTS; Josh Kane, OTS; Jackie Henning, OTS
Faculty Research Committee Chair: Dr. Gwen Bartolacci, OTD, OTR/L
Faculty Research Committee Reader: Dawn Evans, M.S., OTR/L
Objective. The purposes of this study were to: (a) identify the health and social needs of the elderly living in urban areas of Northeastern Pennsylvania, (b) compare those needs with the needs of the elderly living in rural communities of Northeastern Pennsylvania, (c) identify any health disparities between the urban and rural populations, and (d) recommend occupational therapy interventions that will help urban older adults remain independent in their community.
Method. This qualitative study interviewed 12 older adults between the ages of 70 and 90. The data collection process included a demographics questionnaire and a semi-structured interview. Following the data collection process, a thematic analysis was used to identify themes.
Results. The three major themes identified were: a) good health and independence are important factors of quality of life, b) the importance of time with family and friends, and c) social engagement in activities at the senior center. Sixty-seven percent of the participants identified good health and independence as important factors that affect quality of life. Ninety-two percent of the participants discussed the importance of spending time with family and friends. In addition, 75% of the participants reported attending to the senior center three or more times a week, where they engaged daily in various activities. Lastly, 75% of the participants did not require different types of health services. Conclusion. The findings of our study show that residents living in urban areas have access to various activities and community resources. This information provides insight to occupational therapy practitioners regarding elderly living in urban areas of Northeastern Pennsylvania.

Title: A Modified Delphi Survey of the Content Validity of the Cougar Home Safety Assessment Version 4.0
Graduate Student Presenters: Holly Civitella, MS, OTR/L; and Vanessa Perez, MS, OTR/L
Faculty Research Committee Chair: Dr. Grace Fisher, Ed.D., OTR/L
Faculty Research Committee Reader: Dr. Joseph Cipriani, Ed.D., OTR/L
Abstract: In this study the Cougar Home Safety Assessment Version 3.0 (Fisher, Cardillo, Chin, Derrick, & Zepherin, 2006) was first expanded to include a disaster preparedness section, resulting in a new and revised instrument called the Cougar Home Safety Assessment Version 4.0 (Cougar 4.0). The purpose of this study was to assess the content validity of the new Cougar 4.0 and obtain suggestions for further refinement of the instrument. Purposive sampling was used to obtain an expert panel of 11 occupational therapists from the United States. A modified Delphi survey research design, consisting of two survey rounds, was utilized to obtain [GF1] feedback from the experts about the content validity of the Cougar 4.0 criteria. The surveys were distributed to the experts via e-mail, with a one month interval between them. Findings were analyzed on an ongoing basis as each survey was returned. The Cougar 4.0 was then revised to include the recommendations from the experts which were most significant, were repeatedly stated, or were judged to be particularly relevant and helpful. In the first round of the survey, 87 percent of the criteria were rated as valid, and 11.8 percent were rated as invalid. Many modifications were made as a result of the first round, including rewording or changing 44 out of the instrument's 77 initial criteria. As a result of the second wave of the survey, nine additional modifications were made in the assessment. The final outcome of the study was the Cougar 4.0 Delphi Survey Final Version.

Title: A Nationwide Survey of the Content Validity of the Cougar Home Safety Assessment Version 4.0
Graduate Student Presenters: Keith Ewonishon, OTS
Faculty Research Committee Chair: Dr. Grace Fisher, Ed.D., OTR/L
Faculty Research Committee Reader: Dr. Ellen McLaughlin, Ed.D., OTR/L
Objective. The Cougar Home Safety Assessment Version 4.0 (Cougar 4.0) is the latest instrument in the Cougar Home Safety Assessment Series. The purpose of this study was to determine the content validity of the Cougar 4.0 from the standpoint of a nationwide sample of occupational therapists. A secondary purpose was to elicit feedback and suggestions from the therapists concerning the construction of the assessment's 77 criteria. Method. A nationwide survey was sent to a random sample of 500 occupational therapists who were members of the American Occupational Therapy Association's Gerontology, Home & Community Health, and Physical Disabilities Special Interest Sections. The surveys requested that the occupational therapists rate each of the Cougar 4.0's 77 criteria either "acceptable" or "not acceptable." They also asked for any comments the therapists wished to offer concerning the content or wording of the criteria.
Results. A return rate of 28.4 percent was obtained, as 142 surveys were returned. Respondents rated the criteria "acceptable" 86.7% of the time. They also offered numerous suggestions for refinement of instrument content.
Conclusion. This study showed that the Cougar 4.0 has high content validity, making it a potentially useful tool for occupational therapists who are concerned about environmental safety. However, future efforts to refine the tool may be warranted.

Title: A Delphi Survey of Face and Content Validity in the Evolution of an Occupation-Based Assessment for Persons with Chronic Pain
Graduate Student Presenters: Diane Bristow, OTS; Lori Jandris, OTS; Ben Mast, OTS; Bruce VanLuvender, OTS
Faculty Research Committee Chair: Dr. Grace Fisher, Ed.D., OTR/L
Faculty Research Committee Reader: Dr. Gwen Bartolacci, OTD, OTR/L
The purpose of this study was to develop a comprehensive occupation-based assessment for people with chronic pain, and to establish its face and content validity. We first revised the Pain and Functional Performance Assessment (PFPA) called the Pain and Functional Performance Assessment (PFPA) which was developed by Fisher, Beckwith-Cohen, et al. (2007) to include concepts from the Paradigm of Life (POL) theory (Fisher, Albright, et al., 2006, p. 19). It was determined that the utilization of this theory base would enhance the instrument's ability to identify the occupational therapy needs of people who have chronic pain. The result of this was the development of the Pain and Functional Performance Assessment- Paradigm of Life (PFPA- POL). This was followed by the use of two waves of a Delphi survey to examine the content validity of the assessment and to make additional revisions. This process resulted in the consequent development of an entirely new assessment called the Occupational Understanding of Challenges - Chronic Pain Questionnaire (OUCH-CPQ).