OTJR: Occupational Therapy Journal of Research

Knowledge of the best uses, limitations, and quality criteria for single subject design (SSD) research has grown over the decades. High-quality SSDs provide replicable results and advance knowledge. Using modern technology, meta-analysis and systematic review methods can be applied to synthesize results of SSDs to provide best evidence on numerous important interventions (e.g., those involving assistive technology). Larger numbers of SSDs are needed.

The Occupational Self Assessment (OSA) was designed to guide collaborative treatment planning and measure client-reported change to document therapy outcomes. This study examined the stability of the OSA and its ability to detect changes in reported Competence and Values. The OSA was administered twice to 112 participants with disabilities 58 to 650 days apart. A Rasch rating scale model was used to analyze the data and determine the stability. Competence and Values items were stable over time. The Competence rating scale was used by participants in the same manner at both administrations. However, the Values rating scale was used differently at time 2; participants were less likely to use the Values rating scale category “More important” at time 2. Thirty-two percent and 49% of participants had significantly different measures at time 2 on Competence and Values scales, respectively. This study lends support for the use of the OSA as a client-reported outcome measure.

Stem cell transplantation is an aggressive therapy for hematological malignancies in which a damaged immune system is essentially destroyed and replaced with healthy stem cells. This article reports the results of semi-structured interviews with 18 survivors of either autologous or allogeneic stem cell transplantation. Participants were interviewed after they had reached 100 days post-transplant and asked to discuss their activities, daily routines, and experiences since being discharged from the hospital. Activity engagement was mentioned by participants as a way to promote health, help reconnect one with his or her pre-transplant identity and lifestyle, and measure progress toward improved stamina. Although many participants reported a gradual resumption of previous routines, some participants described a more complicated process of reconstructing their daily routine in response to changes in their environment or career.

This study described participation, health-related quality of life, and post-traumatic stress disorder (PTSD) in survivors of terrorist attacks and examined the relationships among these outcomes. Participants were 35 survivors of terrorist attacks, an average of 2 years after the injury, with a mean age of 32.1 (± 13.8) years. Most of the participants suffered multiple traumatic injuries. Forty percent to 60% of the sample reported restrictions in participation in the areas of employment, leisure, and homemaking. The patterns of time use indicated a relatively small amount of time devoted to work and more to rest. Survivors who resumed their participation in work and leisure reported high percentages of perceived competence and enjoyment from these occupations. The survivors scored below the norm on the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) scales, indicating low health-related quality of life. A significant moderate correlation in the expected direction was found between the Participation Index total score and the SF-36 total score (r = −.560, p < .01). PTSD was found in 39% of the survivors. No significant difference was found between the group with PTSD versus the group without PTSD on the Participation Index total score (Z = −.481, p = .650); however, subjects without PTSD achieved significantly higher mean scores on the SF-36 total score than those with PTSD (Z = −2.85, p = .003). Further research is required to examine the possible qualitative effect of PTSD on participation in work, leisure, and home management.

The purpose of this study was to examine the interrelations between legibility of handwriting, atomistic factors, handwriting speed, and perceptual-motor body functions. The authors aimed to determine the contribution of these factors in predicting students' handwriting performance during copying and dictation and to assess performance differences under both of these writing conditions. The handwriting performance of 35 third graders with writing difficulties and 35 control subjects was assessed during copying and dictation. The control group performed significantly better on all measures during both copying and dictation. Only overall legibility predicted handwriting performance during copying, whereas both speed and overall legibility predicted handwriting performance during dictation. Only spatial organization significantly predicted overall legibility for both groups and conditions. The findings suggest that handwriting speed and overall legibility are separate constructs and that different components underlie writing during copying and dictation. These results have clinical implications for handwriting evaluation and intervention.