Debra Cameron

Disability in low-income countries: Issues and implications

This article reports on a study conducted for the CANADIAN INTERNATIONAL DEVELOPMENT AGENCY by THE INTERNATIONAL CENTRE FOR DISABILITY AND REHABILITATION at the University of Toronto. We critically examined the broad literature in the area of disability and development and in this article we identify the key issues which emerged. Most of the data were collected from existing literature in the academic and practice settings and from the publications of key NGOs and governments. We first, examine disability in the context of low-income countries, and then discuss key critical issues: disability and poverty, disability and health, disability and education, disability and gender, disability and children/youth, disability and conflict/natural disasters and disability and human rights. In all these areas we find reports of discrimination, stigmatisation and marginalisation. We conclude that, as we address issues of multi-cultural disability services in developed countries, it is important to bear in mind the various issues that many people with disabilities and their families bring with them as the result of immigrating from a developing country. Although we address these issues within our own countries, we must bear in mind the changes that are occurring due to globalisation.

Global partnerships for international fieldwork in occupational therapy: reflection and innovation.

International fieldwork placements (IFPs) have become very popular among healthcare students including those in occupational therapy programmes. There are many potential benefits that can accrue to the students; however, there are critiques of international placements especially for students going to underserviced areas. The purpose of this paper is to provide a case study/model programme description that critically reflects on six partnerships in three underserviced countries that provide IFPs to students from one Canadian university. The personal opinions of each partner were collected verbally, by email and by a qualitative review of the past 10 years of partnership interaction. Some of the benefits reported by partners include the development of an increased number of sustainable long-term quality placements, orientation materials, student supports and the involvement of university faculty in research and capacity building projects in partner countries. A number of challenges were identified including the need for an expanded formal agreement, more bilateral feedback and examination of supervision models. This paper examines a limited number of partnerships with only one Canadian partner. Direct input of students is not utilized, although feedback given to co-authors by students is reflected. More research is needed on perspectives of partners in IFPs, impact of IFPs on clinical practice in students home countries, impact of IFPS on underserviced areas and effective strategies for debriefing.

Private practice: Benefits, barriers and strategies of providing fieldwork placements

Background. Occupational therapists are entering private practice in ever increasing numbers. In order to gain the skills to practice in this area, students should have the opportunity to experience private practice fieldwork placements. However, the number offered in private practice settings continues to be limited. The purpose of this exploratory qualitative study was to identify the benefits, the barriers, and the strategies associated with providing fieldwork opportunities in private practice. Methods. Data were obtained through semi-structured interviews with six occupational therapists in private practice. Results. Results indicated that participating in fieldwork education affords benefits to the profession of occupational therapy, to the clinician, and to the facility. Potential barriers included student characteristics, cost, time, travel and legalities. Involvement from the university and the private setting were considered necessary for providing and implementing strategies. Clinical Implications. The findings have implications for increasing private practice placements for future students in occupational therapy and other health care professions offering clinical placements as a component of their formal education.

Two case study evaluations of an arts-based social skills intervention for adolescents with childhood brain disorder.

Objective: Arts-based programmes have been shown to be useful for individuals with disturbances in cognitive and behavioural functioning. The current case studies examined the feasibility and effectiveness of a theatre skills training programme to facilitate social skills and participation for adolescents with childhood brain disorder. Methods: A case study approach was used with two adolescent participants. Focus groups were conducted immediately post-intervention, while a battery of quantitative measures were administered pre- and post-treatment, as well as 8 months post-treatment. Results: Perceived and documented improvements in social skills and participation were observed from pre- to post-intervention and at follow-up. Conclusion: Results support the use of an arts-based intervention for youth with brain injuries to facilitate social skills and participation. Findings also highlight the need for more sensitive measures of these skills for youth with childhood brain disorder, who may have impaired awareness of their abilities and/or impairments in memory and language comprehension.

Community integration interventions for youth with acquired brain injuries: A review

Objective: To identify and summarize published literature that examined the effectiveness of social and community integration interventions for children and adolescents with ABI in order to provide recommendations regarding future research on this topic. Methods: A literature review was conducted to identify studies that focused on social and community integration interventions for youth with ABI. Further manual searching of relevant journals with a paediatric rehabilitation focus was also carried out. Results: Currently, limited research has been published evaluating such interventions. The lack of research may stem largely from issues relating to how to measure community integration. Recommendations regarding intervention settings and structure are discussed. Conclusion: Additional studies investigating social and community integration interventions are necessary, including those with measures tailored specifically to community integration, larger samples, as are better controls and recruitment of youth with varying severities of brain injuries.

Effect of Cognitive Intervention on Children with ADHD

ABSTRACT Although not considered a diagnostic criterion in DSM-IV, motor difficulties in children with Attention Deficit Hyperactivity Disorder (ADHD) are commonly reported. Prevalence of co-morbidity of ADHD and Developmental Coordination Disorder is as high as 50%. Cognitive Orientation to daily Occupational Performance (CO-OP) is a problem-solving approach originally developed for children with Developmental Coordination Disorder. In this approach, therapists support children to use cognitive strategies in a process of guided discovery to solve occupational performance problems. A single case experimental design (multiple baselines) was used to examine the influence of a 12-week intervention using CO-OP with six children with ADHD. Outcome measures included the Canadian Occupational Performance Measure (COPM), Goal Attainment Scaling and the Bruininks–Oseretsky Test of Motor Proficiency and Performance (BOTMP). The results of this study demonstrated improvements in both goals and motor performance in the participants due to the intervention. These results provide some support for the use of CO-OP with children with ADHD. Further research into the application of CO-OP with children with ADHD is warranted based on these preliminary positive findings regarding the efficacy of this intervention to address motor-based performance difficulties.

Towards a Critical Occupational Approach to Research

Critical approaches to research are becoming increasingly more prevalent but occupational science and critical approaches have not been explicitly combined into one approach despite the potential to enrich the understanding of the assumptions and ideologies underlying human activity. In this article we outline an approach to research that is mutually informed by occupational and critical social science perspectives. The critical occupational approach we describe can be used to explore the ways in which knowledge is produced through engagement in occupation, who controls knowledge production, the mechanisms of how occupations are taken up, and who stands to gain or lose. We discuss the implications and considerations for generating research purposes and methods and conducting analyses. We then illustrate the use of the approach through a case study. We conclude this article with consideration of the wider uses and implications of a critical occupational approach within health and social research.

Cognitive Orientation to daily Occupational Performance (CO-OP): A New Approach for Children with Cerebral Palsy

ABSTRACT Aims: The results of a small single-case study series suggested that Cognitive Orientation to daily Occupational Performance (CO-OP) may be a successful approach for children with cerebral palsy (CP). Therefore a pilot randomized controlled trial was conducted with the following research questions—is CO-OP a feasible approach to use with children with CP, what are the effects of CO-OP when compared to usual practice, and is a larger study warranted? Methods: 18 children between age 7 and 12 (nine in CO-OP group and nine in Current Usual Practice Approach (CUPA) group) received ten 1-hour sessions of intervention on average once per week at home. Primary outcome measures were the Canadian Occupational Performance Measure and the Performance Quality Rating Scale (PQRS). PQRS assessors were blind to group allocation and timing of assessment. Results: All children in the CO-OP group were able to learn the strategies and achieve their chosen goals, thus demonstrating the feasibility of the approach. Both approaches equally promoted skill acquisition and skill maintenance at follow-up. Effect sizes suggest that CO-OP may show some advantage for transfer and maintenance. Conclusion: Based on these initial findings, further research is warranted.

Which to Choose: Manuscript or Cursive Handwriting? A Review of the Literature

Handwriting is a necessary skill for children to learn during school. Most children in North America learn two formats, manuscript and then cursive. Approximately one-fourth of school children have difficulty producing writing. With success and self-esteem of children negatively impacted by writing challenges, is it necessary for all children to learn both formats? This paper reviewed relevant literature on writing to summarize the history and to discover whether evidence exists to support teaching both forms. The components of complexity of the manuscript and cursive writing are highlighted, the implications are discussed, and future research is suggested.

A critical occupational approach: offering insights on the sport-for-development playing field

The past 15 years have witnessed a proliferation of sport-for-development organizations mobilizing sport activities as a tool for international development. Along with the growth in programmes, an academic analysis of this phenomenon has emerged. However, this body of research has not included an analysis from a critical occupational perspective. This is a conspicuous shortcoming since sport-for-development initiatives are occupation-based programmes. In this paper, we used a critical occupational approach to explore how programme staff and youth participants speak about and understand the use of sport activities in sport-for-development programmes in Lusaka, Zambia. Our findings illuminate the form, function, and meaning of sports in the programmes. Considering the form, function, and meaning together, given that football – which is heavily gendered and segregated – was constructed as the preferential activity for programmes, non-disabled boys were seen as the primary beneficiaries of the programmes.