PD1 GETTING A GRIP ON PEDIATRIC CONCUSSION: AN EXPLORATORY STUDY ON GRIP STRENGTH IN YOUTH WITH CONCUSSION IN AN ACTIVE REHABILITATION PROGRAM
Students: Zachary McAlpine and Nicole Kelday
Supervisors: Dayna Greenspoon, Nick Reed, and Anne Hunt
Rationale: Neurologic impairment in concussion may prevent typical recruitment and activation of motor neurons needed for muscle strength. Grip strength is an indicator of motor neuron activation, overall strength and physical health. There is a lack of objective measures to measure recovery following concussion. We hypothesized that grip strength may provide a clinically useful measure of recovery following concussion. Objectives: 1) To identify changes in maximal grip strength post intervention, and 2) To explore the relationship between changes in grip strength and changes in symptoms from pre to post intervention. Methods: An interim exploratory analysis was conducted using data from a larger prospective quasi-experimental repeated measures study. Participants were 16 youth ages 13-17 years who completed a six week active rehabilitation intervention. Results: For objective one, a nonparametric paired samples t-test was conducted resulting in a statistically significant median increase in grip strength (0.5Kg/N) from week zero compared to week six p = .021. For objective two, results of Spearman’s Rank Order Correlation found no significant relationship between changes in grip strength and symptoms from pre to post intervention. However, self-reported concussion symptoms were found to be significantly reduced following the six week intervention (p=.021). Conclusion: Maximal grip strength does improve in a six week active rehabilitation program. At this time, the relationship between grip strength and self-reported symptoms is not entirely clear. Grip strength may serve as a cost-effective, reliable, valid, and clinically useful objective measure of recovery for youth with concussion.
PD2 WEIGHT MANAGEMENT NEEDS OF CHILDREN WITH SPINA BIFIDA: A SECONDARY ANALYSIS
Students: Emma Allen and Laura Van Daele
Supervisors: Amy McPherson and Shauna Kingsnorth
Background: Children with spina bifida are at increased risk of developing overweight or obesity, leading to negative health outcomes. Current healthcare systems contain gaps in weight-related services, resulting in unmet needs for this population. Purpose: To determine the needs of children and families around weight management and wellness of a child with a disability. Method: This study is a descriptive qualitative secondary analysis. Semi-structured interviews were conducted using a purposeful sample of children with spina bifida and their parents. A thematic analysis approach was used to inform the findings. Findings: Analysis revealed diverse preferences for weight management services for children with spina bifida. Participants reported a need for enhanced communication, more holistic approach from health care providers, and creative interventions to stimulate motivation for positive change. Implications: Due to their person-centered and novel care initiatives, occupational therapists are well positioned to address unmet needs and should incorporate sensitive communication strategies and healthy lifestyle groups into practice.
PD3 EXPLORING THE NEEDS OF OCCUPATIONAL THERAPISTS IN PEDIATRIC OBESITY: A SECONDARY ANALYSIS
Students: Kylie Holmes and Shannon Bottrell
Supervisors: Amy McPherson and Shauna Kingsnorth
Background: Occupational therapists are well-positioned to address overweight and obesity in children with disabilities. However, many healthcare providers (HCPs), including occupational therapists identify barriers that impede their ability to do so. Purpose: To identify needs of occupational therapists providing care to children with disabilities experiencing overweight or obesity. Method: A descriptive qualitative secondary analysis was conducted using data from semi-structured interviews with six occupational therapists. An inductive thematic analysis was employed. Findings: The following needs were identified: more education and increased level of confidence. Participants suggested webinars as a way to enhance knowledge around weight management, and that more education, increased collaboration with HCPs, more time with clients/families, and increased years of experience would augment occupational therapists’ confidence in weight management. Implications: Occupational therapists require more education and confidence in order to effectively address weight in children with disabilities.
PD6 IDENTIFYING CHILDHOOD OCCUPATIONAL REPERTOIRES ACROSS CULTURES: A QUALITATIVE STUDY
Students: Jessica Stengel and Robin Sommerfeld
Supervisors: Jane Davis and Helen Polatajko
Background: An occupational repertoire, or the set of occupations an individual can perform at a specific point in time, develops over time through interaction between persons and their environment. While unique to each individual, occupational repertoires contain common core occupations, especially in childhood when diversity of occupations is lowest. For pediatric occupational therapists, understanding the commonalities and differences among occupational repertoires allows for their comparison across children to discern possible occupational issues. Aims: The reported study explored the occupational repertoire of children, how occupations developed and influences on occupational development from the perspective of immigrant parents. Methods: A qualitative descriptive design was used with immigrant parents of children ages 2 to 12 years living in Canada. Illustrations from the Occupational Repertoire Development Measure-Parent were used to guide semi-structured interviews with parents. Interview transcripts were coded and categorized. Categories and subcategories were then compared to existing literature. Results: The findings of this study deepen the understanding of not only what children do, but also how and why they do it. In particular, this study applied the Process of Establishing Children’s Occupation (PECO) model to occupational repertoire development and furthered the understanding of the associated reasons for engagement, specifically parent views and values and motivation. Conclusion: This deeper understanding of the influences on the development of children’s occupational repertoires is valuable to pediatric occupational therapists that hope to optimize their ability to evaluate occupational repertoire development and collaborate with families in multicultural contexts.
PD7 EXPLORING PLAY STRUCTURE AND ENGAGEMENT OF CHILDREN WITH ASD
Students: Mikhaela Albarico, Emily Tsing-yee Chai, and Amanda Tong
Supervisor: Sally Lindsay
Aim: This study explored how structured, team-based play compares to unstructured play in affecting the engagement levels of seven- to nine-year-old children with autism spectrum disorder (ASD) in the context of HB FIRST®, an adapted robotics program that has emerging evidence in facilitating social development and cooperative play in children with ASD. Methods: This sequential explanatory mixed methods study analyzed how four children with ASD engaged in two robotics sessions, one earlier and one later on in the program. The sessions involved 30 minutes of unstructured, individual LEGO® building and 90 minutes of structured, collaborative activities. Participant behaviours captured in video recordings were coded using the Revised Individual Child Engagement Record and qualitatively described to reflect participants’ engagement levels. Quantitative data were statistically analyzed using t-tests and qualitative data was analyzed using content analysis. Qualitative results were used to support and explain patterns found in quantitative results. Results: There were statistically significant differences in participants’ passive engagement and active non-engagement between the two play structures in the later session. There were also statistically significant differences in participants’ active engagement and passive engagement between the two play structures when the earlier and later sessions were compared. Although not statistically significant, active engagement was higher in structured play, while passive engagement and both types of non-engagement were higher in unstructured play overall. Conclusions: Play structure has some influence on the engagement levels of children with ASD in the HB FIRST® robotics program. Structured play may encourage more active engagement, while unstructured play may encourage more passive engagement and active non-engagement. Implications for occupational therapy include a better understanding of the physical, material, and social components of play structure that facilitate engagement and a more informed position when advocating for optimal play structure for children with ASD.