OTJR: Occupational Therapy Journal of Research

People with mild cognitive impairment or dementia in a mild phase who live at home are expected to manage the everyday technology that is common in this context. However, the knowledge of how technology use may interfere with the performance of daily activities is sparse. The purpose of this study was to evaluate whether a new instrument measuring relevance and competence in everyday technology use, the Everyday Technology Use Questionnaire, could generate linear measures of competence in a valid manner when used in a population of 157 older adults with and without cognitive impairment or dementia. The results from this study indicate that the Everyday Technology Use Questionnaire demonstrates acceptable levels of scale validity and person response validity, supporting researchers and clinicians with a tool that generates a valid measure of competence in use of everyday technology for people with mild cognitive impairment or dementia in a mild phase who live at home.

Occupational therapists are interested in clients' performance of activities of daily living in real-life contexts. To maximize the validity of inferences made from assessments, occupational therapists conduct observations in everyday environments: at home, school, and work and in the community. Although these observations in context are arguably more valid, they are potentially less controlled, which affects the reliability of the data obtained. Occupational therapists may wonder about the evidence of reliability when evaluating observational assessments for use or question reliability considerations in developing protocols. This article explores the concept of reliability in the context of observational assessments. We compare two theoretical approaches to reliability; apply the theory to the example of occupational performance, as viewed by occupational therapists; and argue the relevance of internal consistency, observer (rater) reliability, and sample reliability. Finally, the authors examine in-depth factors influencing the sample reliability of observational assessment scores, weighed against the utility of assessments and generalizability of scores.

For occupational therapists working in neonatal intensive care units, the tenuousness of life is part of ordinary daily experience. However, for parents, having a premature infant must feel like a break from their expectations of having a healthy infant and an ordinary family life. Occupational therapists provide opportunities for co-occupation that promote the development of the family and support parents by providing the knowledge that family life is still possible even if the infant has severe disabilities. This article will illustrate how one occupational therapist facilitated extraordinarily ordinary moments of becoming a family for a mother and premature infant through negotiating the meaning of parenting and parenting co-occupations and providing opportunities for parenting co-occupations, which are both important aspects of occupation-based practice implemented in the neonatal intensive care unit.

This study investigated changes in the quality and level of exploratory object play during the transition from infancy to toddlerhood. Sixty “typically developing” infants participated in a longitudinal study that included home visits at 10, 12, and 14 months of age. Play was assessed using the Infants' Play Behaviors with Objects during Semi-structured Tasks (POST) procedure, a 5-minute videotaped procedure that exposes infants to novel objects. Results indicated that higher levels of task-directed behavior were strongly associated with more sophisticated levels of object play. Task-directed play behavior increased significantly with age (F = 8.45, p < .001), as did level of play (e.g., F = 26.69, p < .001). Significant differences in the level of play behavior with different objects suggest that infants as young as 10 months show preferences in the play experiences that they find interesting, engaging, and challenging. These findings have relevance for occupational therapists because they demonstrate the transactional nature of play and the need for facilitating an optimal fit between the child, the environment, and the occupation of play.

A previous study of the Short Child Occupational Profile (SCOPE), an assessment of occupational participation, supported the psychometric soundness of the instrument overall, but pointed to some potential problems in practitioners' use of the SCOPE in practice. Specific revisions were made to the SCOPE to address the rating behaviors of leniency/severity, halo effect, and restriction of range. A many-faceted Rasch model analysis was conducted after 39 practitioners working in eight practice sites learned to administer the SCOPE using a variety of methods and rated 168 clients using the SCOPE (version 2.1). Practitioners exhibited three significantly different levels of leniency/severity, 35 practitioners did not exhibit any halo effects, and the top three rating categories were used 91% of the time. Findings suggest that a variety of methods can be used to learn to administer and rate the SCOPE in an appropriate manner to assess the personal and environmental factors affecting the occupational participation of children.