Abstract
Gravitational insecurity presents significant challenges throughout the life span. This poster examines performance of typical adults on a standardized assessment of gravitational insecurity originally designed for children, to determine if adaptation to its use was needed for use with adults. Age, self-reported fearfulness to movement, and performance on individual items were all examined as factors potentially impacting use of the assessment with adults.
Primary Author and Speaker: Teresa A. May-Benson
Additional Authors and Speakers: Lenin Grajo
Gravitational insecurity (GI), a sensory modulation problem found in 6-18% of adults and characterized by fear of movement, having feet leave the ground or the head out of upright, is associated with anxiety, and interferes with performance of daily life activities (May-Benson, Faria & Teasdale, 2015). GI presents significant emotional and functional challenges and is often misidentified as anxiety or emotional mental health problems in adults (Coelho & Balaban, 2015). OTs need tools to assess the presence and severity of GI symptoms to provide appropriate intervention and promote functional engagement in desired occupations. This descriptive study examined performance of typical adults on the GI Assessment-Revised, a test developed for children, to determine its appropriateness for adults, adaptations that might be needed, and if it can identify adults with self-reported fear of movement from other typical peers. Adults with reported fear of movement were hypothesized to have significantly lower scores on all aspects of the test. Participants were 51(43 females and 8 males, 18 to 67 years, M = 32.2 years) typically functioning adults recruited as a convenience sample from friends, family, and colleagues of the researchers. Individuals had no known issues related to GI, however, at time of testing, 12 individuals self-reported fear or hesitation to movement experiences, not attributed to any physical limitations, that sometimes interfered with their comfort or completion of activities. They were age/gender matched to other non-fearful participants. 3 OT students were trained to screen, complete the informed consent process and administer the GI Assessment – Revised, a reliable and valid measure with good discriminative validity with children consisting of 8 administered movement tasks scored on a 3-point scale on dimensions of Emotional/Avoidance and Postural Responses. Total possible scores were 48 for Total score, 24 for each dimension, and 6 for each item. Low scores indicate more dysfunction. Pearson correlations were significant for age and Total score (r = -.59, p = .045) and Emotional Responses (r = -.65, p = .022) in the non-fearful group but not the fearful group. Non-fearful adults (n = 38) had near perfect scores: Total, M = 45.9; Emotional, M = 23.2; Postural, M = 22.8 and item scores, M = 5.8 to 6.0. Backward Somersault and Jump off Chair items were lowest at M = 5.1 and 5.2. Fearful adults (n = 12) had lower mean scores with more performance variability than non-fearful adults: Total, M = 43.9; Emotional, M = 22.1; Postural, M = 21.8 and item scores, M = 5.0 to 5.7. Backward Somersault and Jump off Chair were also lowest for this group at M = 5.2 and 5.0. One-tailed paired t-tests tested the directional hypothesis with the matched group of 12 fearful and 12 non-fearful adults. The fearful group had significantly lower scores on Total score (p = .022) and Emotional Responses (p = .070). Postural Responses approached significance at (p = .076). Related-samples Wilcoxon Signed Rank tests found the fearful group had significantly lower scores on Tiltboard Tip, p = .019; Supine on Ball-Active, p = .035; Supine on Ball-Passive, p = .015. Results indicate a larger normative sample and examination of adults with known sensory modulation challenges is necessary. Backward Somersault and Jump off Chair items were most difficulty for all adults and potentially susceptible to physical limitations. As with children, this test identified mild fear of movement in otherwise typical adults with Tiltboard Tip and Supine on Ball items most discriminatory. This study presents preliminary support for use of the GI Assessment-Revised with adults and provides OTs with a formal measure to identify GI at any age to assure appropriate diagnosis and intervention.
May-Benson, T., Faria, W., & Teasdale, A. (2016). Incidence and Patterns of Gravitational Insecurity in Adults and Adolescents. Poster presented at the American Occupational Therapy Association Annual Conference, Chicago, IL, April 9, 2016.
Coelho, C. M., & Balaban, C. D. (2015). Visuo-vestibular contributions to anxiety and fear. Neuroscience & Biobehavioral Reviews, 48, 148-159.