Navah Z. Ratzon

Personal and environmental pathways to participation in young children with and without mild motor disabilities

OBJECTIVE Participation in everyday activities has a positive influence upon health and well-being and is considered as an outcome measure. According to recent models child participation is the product of the dynamic interaction between health states and both individual and environmental factors. Children with mild developmental disabilities often present decreased participation in everyday activities. The purpose of this study was to explore the extent to which individual and environmental factors explain the participation of young children, with and without mild motor disabilities. METHODS The study population included 58 kindergarten children together with their parents (29 children with mild motor disabilities who were referred to occupational therapy and 29 children without motor disabilities). Both groups of children were matched for: age; gender; age of parents; and socio-economic status (SES). We assessed participation using the Child Participation Questionnaire (intensity, diversity, independence, child enjoyment and parental satisfaction) and we assessed childrens self-efficacy and motor abilities for individual factors. Parental self-efficacy and SES were collected by questionnaires. RESULTS Participation diversity (number of activities) was predicted by child and mother self-efficacy and by SES. Child independence and enjoyment as well as parental satisfaction were predicted by child motor ability but mainly by maternal self-efficacy. Results suggest that the total explained variance is more than double when the environmental variables (parental self-efficacy and SES) are inserted to the participation model. CONCLUSIONS Maternal self-efficacy and SES serve as facilitators to increased participation and well-being of children with mild motor disabilities.

The profile of performance skills and emotional factors in the context of participation among young children with Developmental Coordination Disorder

Participation is a persons involvement in daily activities in a variety of environments, roles and life situations. Children with Developmental Coordination Disorder (DCD) experience difficulties in gaining academic achievements or in their engagement in activity of daily living. Motor difficulties have a negative effect on the ability to participate, as well as on various affective components. Senses of coherence, effort and hope have not yet been assessed, within the context of participation, in children with DCD. The purpose of the present study is to look into the relations between participation and senses of coherence, effort and hope among children with DCD, in comparison to typically developed children. Fifty subjects aged 5-6 years participated in the study, 25 of whom are children diagnosed with DCD, the other 25 being typical children. The DCD diagnosis was established according to the DSM-IV criteria and the M-ABC test. All children completed the coherence questionnaire for children as well as the childrens questionnaire on effort and hope. Parents completed the Children Participation Questionnaire (CPQ), and the Performance Skills Questionnaire (PSQ). Children with DCD had lower performance skills, lower sense of coherence, hope, and effort than their peers. They less enjoy their participation and their parents are less satisfied in comparison to control group. Significant correlations were found between sense of coherence and hope to participation. Process skills were found to be the main predictor for explaining childs participation. While treating children with DCD we have to consider also socio-psychological aspects that may be weakened.

Perceived environmental restrictions for the participation of children with mild developmental disabilities

AIM In light of the International Classification of Functioning, and Health (ICF) model, to assess whether parents of children with mild developmental disabilities perceived various environmental factors as barriers to their childs participation, and whether these factors have a unique contribution to the total explained variance of participation, beyond personal factors. METHODS Seventy-nine kindergarten children (mean age 5.20 ± 0.52 years old) with mild developmental disabilities and their parents participated in the study. Three questionnaires measuring the childs participation, performance skills and environmental factors were completed by the parents. RESULTS Parents perceived environmental factors as slightly restricting to their childs participation. Associations were found between home and education factors and the dimensions of child participation - independence, enjoyment and parental satisfaction. Although parents perceived human environmental factors as more restricting than physical factors at home, regression analysis revealed that the latter was found to affect the child participation dimension of independence beyond the contribution of personal factors. INTERPRETATION These findings are the first, to our knowledge, to support the contribution of environmental factors to the participation of young children with mild developmental disabilities. The results show that environmental factors have significant slight contribution to childs independence in participation beyond other predictors (i.e. personal factors). Therefore, it is recommended to include environmental restrictions measurement in the child evaluation process to facilitate effective intervention programs.

Development and initial validation of the Performance Skills Questionnaire (PSQ).

The objectives of this study was to develop and test the psychometric properties of the Performance Skills Questionnaire (PSQ), addressed to measure performance skills of preschoolers, as reported by their parents. Participants included 231 children ranging in age from 4 to 6 years old, with mild to moderate developmental disabilities and 240 children without disabilities at same age range. Internal consistency, test-retest, construct validity, and divergent and convergent validity were assessed. The PSQ has shown good internal reliability, and temporal stability. Construct validity was supported by factor analysis which yielded 3 factors that explained almost 52% of the total variance. Significant differences were found between known groups. Convergent and divergent validity were supported by significant correlations with Visual-Motor Integration (VMI) test, and the Children Participation Questionnaire (CPQ). The PSQ is a unique tool that measures performance skills based on preschool childrens everyday function. Results provide evidence in support of the PSQ as a reliable and psychometrically sound instrument.

Comparing different short-term service delivery methods of visual-motor treatment for first grade students in mainstream schools

To compare the efficacy of three different short-term service delivery methods on first grade children with soft neurological signs who suffer from visual-motor difficulties. One hundred and forty seven first grade students who scored below the 21st percentile on the Visual-Motor Integration Test (VMI) were recruited from schools and randomly divided into three intervention groups and an additional control group. One group received Direct Treatment Model (DT), the second group received Collaborative-Consultation Treatment Model (CC) and the third group received a Combined Treatment Model (CT). The CC included treatment administered by teachers, after Collaborative-Consultation with an occupational therapist (OT). The CT included the two models (DT, CC), administered simultaneously. Pre- and post-intervention tests were administered to both groups. Students in all three intervention groups made significant gains in comparison to the control group suggesting that all three service delivery methods had the same effect on childrens visual-motor skills. Therapists in school settings who are obliged to be more efficient are encouraged to use the CC or the CT service delivery methods which would enable them to treat more children during the same time-frame, with full confidence that the treatment goals will be achieved as if using the DT.

Reducing musculoskeletal disorders among computer operators: comparison between ergonomics interventions at the workplace.

Typing is associated with musculoskeletal disorders (MSDs) caused by multiple risk factors. This control study aimed to evaluate the efficacy of a workplace intervention for reducing MSDs among computer workers. Sixty-six subjects with and without MSD were assigned consecutively to one of three groups: ergonomics intervention (work site and body posture adjustments, muscle activity training and exercises) accompanied with biofeedback training, the same ergonomics intervention without biofeedback and a control group. Evaluation of MSDs, body posture, psychosocial status, upper extremity (UE) kinematics and muscle surface electromyography were carried out before and after the intervention in the workplace and the motion lab. Our main hypothesis that significant differences in the reduction of MSDs will exist between subjects in the study groups and controls was confirmed (χ2 = 13.3; p = 0.001). Significant changes were found in UE kinematics and posture as well. Both ergonomics interventions effectively reduced MSD and improved body posture. Practitioner Summary: This study aimed to test the efficacy of an individual workplace intervention programme among computer workers by evaluating musculoskeletal disorders (MSDs), body posture, upper extremity kinematics, muscle activity and psychosocial factors were tested. The proposed ergonomics interventions effectively reduced MSDs and improved body posture.

Validity and reliability of upper extremity three-dimensional kinematics during a typing task

Computer use continues to be considered a risk factor for work-related musculoskeletal disorders despite a greater awareness of the risk associated with excessive use, the implementation of safety features and the introduction of extensive interventional programs. Better understanding of risk factors in movement patterns is needed. This study identified the most suitable variable for work-related upper extremity motion analysis as being peak-to-peak range of motion. Assessment was by three-dimensional motion analysis for upper extremity ergonomics. The study was designed to validate and examine the reliability of these parameters in the setting of keyboarding. Sixty-two right-hand dominant participants (non-skilled typists) were recruited. Motion analysis was performed using the Cartesian Optoelectronic Dynamic Anthropometric CX-1 (CODA) system with markers which were attached to the right hand, elbow, wrist and fingers. Range of motion and angular velocity were recorded while the subjects repeatedly typed a predetermined sentence five times. The re-test examination was repeated after an interval of one week. The findings clearly demonstrated discriminative validity in wrist range of motion (p<.01), test-re-test, reliability (.83>ICC>.70) and inter-rater reliability (.95>ICC>.70) for most variables. The CODA system has considerable potential for understanding movement patterns in the upper extremities. These findings can provide the basis for future studies on the efficacy of ergonomic intervention programs.

Reported level of pain of upper extremities related to multi-factorial workloads among office workers during and after work hours.

OBJECTIVES This research compared the level of reported pain between women workers with high workload (main work involved typing) and women workers with low workload (various office work where typing was not the main task). The research examined the relationship between reported pain of upper extremities (UE) and the following variables: physical strain exerted during typing on a computer keyboard, extra-work strain on UE, bio-demographic variables, psychosocial variables, and ergonomic variables. STUDY DESIGN Participants were 60 women who worked in offices, divided into two groups. The index group included women whose main work involved typing (high workload: M=6.16 h of typing per day), and the control group did various office work where typing was not the main task (low workload: M=3.23 h of typing per day). The level of pain, physical strain, and data concerning bio-demographic variables, psychosocial variables and ergonomic variables was assessed by a self-reported questionnaire. RESULTS The results suggested that there was a significant difference between workers with high and low typing workloads. Workers with higher typing load reported higher levels of pain. There was a significant positive correlation between level of reports of pain and levels of physical overload at work, and extra-work strain on UE both among workers with high and low workloads. It was also found that levels of pain correlated significantly with bio-demographic variables (age and number of children) and psychosocial variables (managerial responsibilities) among low workload workers only. CONCLUSIONS The research on pain of UE indicates that pain may be affected by a multi-factorial nature of a work-related environment which includes physical strain exerted during typing on a computer keyboard, extra-work strain on UE, bio-demographic variables and psychosocial variables.

Are Young Adults with Special Needs Ready for the Physical Work Demands

Youth and Adolescents with Special Needs (YASN) face many challenges during transition into employment. Although most of their physical challenges are secondary, yet they call for attention since most of them are hired for blue collar jobs. Functional Capacity Evaluation (FCE) should be adapted to prepare them addressing the physical job-demands, and maintain their jobs effectively and safely. The current pilot study aims to demonstrate the use of standard (FCE) in order to assess performance of basic generic physical activities conducted by YASN, as part of transition to work program. Specifically, it compared subtests of the Physical Work Performance Evaluation of YASN (N = 13) with matched control group (YA) (N = 13). Results revealed slower and reduced performance among YASNs than YA, in basic job demands, like dynamic strength, hand strength, and fine motor skills. Implications and recommendations for research and transition to work practice in the educational setting are discussed.

The validity of the Color Trail Test in the pre-driver assessment of individuals with acquired brain injury

Primary objective: To examine the validity of the Color Trails Test (CTT), a culture- fair analogue of the Trails Test, in the pre-driver assessment of individuals with acquired brain injury (ABI). Research design: Retrospective study. Methods and procedures: 30 participants with ABI completed the CTT and Useful Field of View (UFOV) in a driving rehabilitation clinic. Within the same week an on-road evaluation was conducted by a driving rehabilitation specialist, and a driving instructor. Results: 50% of the participants passed the on-road evaluation and 50% failed. Individuals who passed the on-road test performed the CTT1 and CTT2 faster than those who failed, however the difference between the pass/fail groups was significant only for the CTT1. A correlation analysis between the CTT subtests (CTT1 and CTT2) and the UFOV subtests revealed significant, moderate correlations between these measures. Conclusions: The CTT1 may contribute to the pre-driving screening by rapidly identifying those individuals who are most at risk for unsafe driving behaviors. Further studies are required with a larger representative sample.