Jean Deitz

Review of the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2)

The Bruininks-Oseretsky Test of Motor Proficiency (Bruininks, 1978) is a standardized, norm-referenced measure used by physical therapists and occupational therapists in clinic and school practice settings. This test recently was revised and published as the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2; Bruininks & Bruininks, 2005). The BOT-2 is an individually administered measure of fine and gross motor skills of children and youth, 4 through 21 years of age. It is intended for use by practitioners and researchers as a discriminative and evaluative measure to characterize motor performance, specifically in the areas of fine manual control, manual coordination, body coordination, and strength and agility. The BOT-2 has both a Complete Form and a Short Form. This review of the BOT-2 describes its development and psychometric properties; appraises strengths and limitations; and discusses implications for use by physical therapists and occupational therapists.

Sensory Processing, Problem Behavior, Adaptive Behavior, and Cognition in Preschool Children With Autism Spectrum Disorders

OBJECTIVE. This retrospective study explored sensory processing characteristics in preschool-age children with autism spectrum disorders (ASD); the relationships between sensory processing and problem behavior, adaptive behavior, and cognitive function; and the differences in sensory processing between two subgroups (autism and pervasive developmental disorder-not otherwise specified). METHOD. Study measures included the Short Sensory Profile (SSP), Aberrant Behavior Checklist-Community, Vineland Adaptive Behavior Scales, and Mullen Scales of Early Learning. RESULTS. Most of the children with ASD had sensory processing challenges, and a significant relationship was found between SSP total scores and problem behavior scores; however, no significant relationships were found between SSP total scores and adaptive behavior and cognitive functioning. Although all the children had low Vineland scores, approximately one-quarter of the children had typical SSP scores. No significant differences in SSP scores were found between the subgroups. CONCLUSION. The findings highlight the importance of comprehensive evaluations for children with ASD.

The relationship between awake positioning and motor performance among infants who slept supine.

Purpose The purpose of this study was to describe the gross motor development of infants who slept supine and spent different amounts of time in the prone position when awake. Method Thirty infants who were six months old and slept supine were evaluated using the Alberta Infant Motor Scale (AIMS) and then divided into two groups: prone (n = 16) and no prone (n = 14) based on the number of times per day they were placed in prone position while awake. Results The prone group scored higher than the no prone group on the AIMS total scores (U = 36, p = 0.004), total percentile scores (U = 42, p = 0.003), and prone subscale scores (U = 25, p < 0.001). Conclusions Gross motor performance as measured by the AIMS was more advanced in infants who slept supine and had been placed in the prone position when awake than in infants who slept supine but had limited or no experience in the prone position while awake. The influence of awake positioning needs to be considered when interpreting the developmental motor performance of infants who are six months old.

Examining Content Validity through the Use of Content Experts

The most often-used and practical approach to the content validation of occupational therapy assessments involves the use of content experts. Few procedures exist, however, to quantify these judgments. This article briefly reviews the literature on the examination of content validity through the use of expert judgment and describes a method for data collection and analysis with the index of item-objective congruence. This index permits the examination of content validity at the item, subtest, and test levels. Its strengths, as well as concerns regarding its use, are discussed.

The effect of body position on the oxygen saturation of ventilated preterm infants

This study investigated the effects of supine, sidelying, and prone positioning on the oxygen saturation of ventilated preterm infants recovering from respiratory distress syndrome. An alternating-treatments, single-subject design was replicated on infants with gestational ages of 24–29 weeks and birth weights of 640–1360 g. The infants were placed in the three positions in a random sequence each day and oxygen saturations were measured. The median oxygen saturation data were displayed in line graphs by position across nine sessions. Visual analysis suggested that oxygen saturation was highest in prone positioning, with supine and sidelying lower. The results of this study suggest that prone positioning can be used with ventilated preterm infants for whom there is difficulty obtaining and/or maintaining optimal oxygen saturation.

Pediatric power wheelchairs: evaluation of function in the home and school environments

The purpose of this study was to compare the performance of four power wheelchairs when used by children to perform a variety of indoor activities. Eight boys and eight girls performed a series of 11 functional tasks when positioned in each of four different power wheelchairs reflecting different design classes. There were no significant differences for many of the dependent variables. However, the Everaid Turbo was significantly better for functional positioning at a standard kitchen table and at school desks and for accessing objects at different heights. By contrast the Invacare Jaguar was better for straight-line driving speed. Other findings include childrens subjective impressions of the four power wheelchairs.

Functional handwriting performance in school-age children with fetal alcohol spectrum disorders

Handwriting is a critical skill for school success. Children with fetal alcohol spectrum disorders (FASD) often present with fine motor and visual-motor impairments that can affect handwriting performance, yet handwriting skills have not been systematically investigated in this clinical group. This study aimed to comprehensively describe handwriting skills in 20 school-age children with FASD. Children were tested with the Process Assessment of the Learner, 2nd Edition (PAL-II), and the Visuomotor Precision subtest of NEPSY, a developmental neuropsychological assessment. Participants performed below average on PAL-II measures of handwriting legibility and speed and on NEPSY visual-motor precision tasks. In contrast, PAL-II measures of sensorimotor skills were broadly within the average range. Results provide evidence of functional handwriting challenges for children with FASD and suggest diminished visual-motor skills and increased difficulty as task complexity increases. Future research is needed to further describe the prevalence and nature of handwriting challenges in this population.

EFFICACY OF TWO TREATMENT APPROACHES TO REDUCE TONGUE PROTRUSION OF CHILDREN WITH DOWN SYNDROME

Five children with Down syndrome aged between 21 and 31 months, all of whom demonstrated habitual tongue protrusion, were randomly assigned to receive either oral‐motor treatment or behavior modification. Tongue posture of all three children who received oral‐motor treatment improved. For two of these the improvement leveled off after treatment had ended, but the third continued to show improvement. One of the two children receiving behavior modification showed improved tongue posture during treatment and maintained the improvement, but for the second there were insufficient data points to draw firm conclusions. Both forms of treatment appear to be effective, but further study is needed before definite conclusions can be made.

Assistive Technology Programming for a Young Child with Profound Disabilities: A Single-Subject Study

Background and Purpose: The purpose of this study was to use single-subject research methods, combined with social validation procedures, as part of an evaluation/intervention process exploring the effects of adapted switch-operated devices on self-initiated behaviors of a 6-year-old child with profound multiple disabilities. Method: A single-subject withdrawal design with multiple phases, including one alternating treatments phase, was used to investigate the participants ability to perform selective, voluntary motions as indicators of contingency awareness and preferences. Social validity also was assessed. Results: The child demonstrated the ability to use two switch sites to activate adapted switch-operated devices when a preferred stimulus was contingent on a specific motor action, and she demonstrated the ability to communicate preferences as indicated by more frequent switch activations for one consequence than for a second consequence. Social validity results indicated that both the parents and school personnel generally viewed the evaluation/intervention process as positive. Conclusions: Single-subject research methods, combined with social validation procedures, can be used effectively in the evaluation/intervention process for children with profound multiple disabilities.

Performance of Normal Children on the Pediatric Clinical Test of Sensory Interaction for Balance

The purpose of this study was to collect and examine descriptive data on the Pediatric Clinical Test of Sensory Interaction for Balance (P-CTSIB) for children ages 6 to 9 years. To guide decisions regarding grouping of data, hypotheses were tested concerning differences among means for duration of stance for gender and for age. Because results were inconclusive, descriptive data for duration of stance and degrees of sway for each of the six P-CTSIB Feet-Together tests and each of the six P-CTSIB Heel-Toe tests are reported by gender and age category. Recommendations are made for clinical use of this test, and directions for future research are identified.