Mental health: How well are occupational therapists equipped for a changed practice environment?

No Abstract

Involvement of Islet-2 in the Slit signaling for axonal branching and defasciculation of the sensory neurons in embryonic zebrafish

In Drosophila melanogaster, Slit acts as a repulsive cue for the growth cones of the commissural axons which express a receptor for Slit, Roundabout (Robo), thus preventing the commissural axons from crossing the midline multiple times. Experiments using explant culture have shown that vertebrate Slit homologues also act repulsively for growth cone navigation and neural migration, and promote branching and elongation of sensory axons. Here, we demonstrate that overexpression of Slit2 in vivo in transgenic zebrafish embryos severely affected the behavior of the commissural reticulospinal neurons (Mauthner neurons), promoted branching of the peripheral axons of the trigeminal sensory ganglion neurons, and induced defasciculation of the medial longitudinal fascicles. In addition, Slit2 overexpression caused defasciculation and deflection of the central axons of the trigeminal sensory ganglion neurons from the hindbrain entry point. The central projection was restored by either functional repression or mutation of Robo2, supporting its role as a receptor mediating the Slit signaling in vertebrate neurons. Furthermore, we demonstrated that Islet-2, a LIM/homeodomain-type transcription factor, is essential for Slit2 to induce axonal branching of the trigeminal sensory ganglion neurons, suggesting that factors functioning downstream of Islet-2 are essential for mediating the Slit signaling for promotion of axonal branching. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

Profile of paediatric occupational therapy practice in Australia

Background: The purpose of the present study was to describe a profile of Australian paediatric occupational therapy practice in terms of theories, assessments and interventions used with the most frequently seen client groups. Methods: An ex post facto survey design was utilised. A purpose-designed survey was mailed to 600 occupational therapists identified by OT Australia as working in paediatrics. Results: The response rate was 55% (n = 330). Respondents in the sample worked chiefly with children with developmental delays, learning disabilities, neurological impairments, and infants/toddlers. Theoretical models used by paediatric clinicians that were common to the most frequently seen client groups focused on sensory integration/multisensory approaches, occupational performance, and client-centred practice. Assessment tools most frequently used were the Test of Visual Motor Integration, Sensory Profile, Bruininks-Oseretsky Test of Motor Proficiency, Handwriting Speed Test, and Motor-Free Visual Perception Test. The most often used treatment methods across the four most frequently seen client groups were parent/caregiver education, sensory integration/stimulation techniques, and managing activities of daily living. Conclusions: Paediatric occupational therapists appeared to draw on a range of theoretical models. With the exception of the Sensory Profile, the assessment and treatment methods most frequently used are not congruent with the most commonly used theoretical models. It is critical that the assessment and treatment methods used are conceptually consistent with the theoretical models that guide practice. Occupational therapists need to examine the evidence and determine whether their clinical practice is grounded in the best contemporary theoretical models, assessments and interventions.

Dynamic occupational therapy cognitive assessment for children: Perceived utility in Australian occupational therapy practice

Background and Aim: The Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch), recently developed in Israel, assesses the cognitive areas: orientation, spatial perception, praxis, visuomotor construction and thinking operations of 6- to 12-year-old children. The dynamic aspect, which incorporates mediation and prompting, has been presented as a valuable clinical feature of this new assessment. This study investigated the cultural suitability, dynamic nature and comprehensiveness of the DOTCA-Ch as a single cognitive assessment for occupational therapy practice in Australia. Methods: Twenty-three paediatric occupational therapists participated in three tutorial and video demonstrations, which were then followed by a group interview. Results and Conclusion: Thematic analysis of transcripts identified four main themes: appropriateness of assessment tasks, language, mediation and clinical utility. Within each theme, the participants raised both positive and negative features. This paper highlights occupational therapists' mixed views on the clinical utility of this assessment in Australia. Limitations of this study and areas for further research are suggested

Interventions for improving self-awareness following acquired brain injury

Accurate self-awareness in clients who have had an acquired brain injury (ABI) has been associated with positive outcomes. However, providing intervention that improves clients' self-awareness is a challenging task for occupational therapists. The present paper provides an overview of the literature regarding models to guide intervention, intervention considerations, descriptions of interventions, and research evidence for interventions. Professionals can draw upon cognitive rehabilitation models and specific models of self-awareness. Facilitatory interventions, such as education, feedback, behaviour therapy and psychotherapy have been recommended to a greater extent than compensatory interventions. The development of interventions for improving self-awareness is at an early stage, and research on the effectiveness of interventions is limited. Future research is required into the effectiveness of interventions to improve clients' self-awareness before structured intervention guidelines can be developed.