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PURPOSE: To translate and cross-culturally adapt The Brachial Assessment Tool (BrAT) into Danish and assess its content validity and reproducibility in adults with traumatic brachial plexus injury (BPI). MATERIAL AND METHODS: Translation followed international guidelines. BrAT(DK) were cognitive tested with 19 adults with traumatic BPI to evaluate cross-cultural understanding, relevance, comprehensiveness and comprehensibility. Content validity and reproducibility were evaluated following the COnsensus-based Standards for the selection of health Measurement INstruments guideline. Participants were recruited from an outpatient hand clinic. Test-retest reliability was assessed using intra-class-correlation coefficient (ICC) and the smallest detectable change (SDC). Internal consistency was evaluated using Cronbach's alpha. RESULTS: Minor cultural differences were observed in the content validity analysis of BrAT(DK). Cognitive testing revealing no significant issues. All participants found the items relevant and important. 63 participants with traumatic BPI were recruited; 49 completed the retest. ICC values for the sub-scales and the total score ranged from 0.91 to 0.95 (95% CI 0.85 to 0.97). Internal consistency ranged from 0.87 to 0.98. SDC ranged from 4.16 to 9.63 for subscales and 16.01 for the total score. CONCLUSION: BrAT(DK) appeared to be content valid and reliabel as a measure of activity limitation in adults with traumatic BPI.

The Brachial Assessment Tool (BrAT) has been cross-cultural translated into DanishBrAT(DK) shows adequate content validity for activity limitation in adults with traumatic brachial plexus injuryBrAT(DK) is a reliable measure, with a smallest detectable change of 16.01 points for the total scaleWe recommend the use of BrAT(DK) in clinical practice to inform goal setting and future interventions and treatment evaluations.

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Purpose: This study presents the use of dry needling (DN) as an intervention to support functional rehabilitation for an adult diagnosed with lateral epicondylosis. Methods: A retrospective, single subject, AB design was implemented. A 50-year-old male with a six-month history of dominant left lateral epicondylosis received traditional interventions for 4 weeks (baseline phase; A) followed by the same interventions with the addition of DN (intervention phase; B). The QuickDASH assessment, numeric rating scale (NRS) for pain, grip strength (elbow flexed and neutral), and Maudsley's test were used as measures of effectiveness along with patient self-report of ability to perform activities of daily living (ADLS), instrumental ADLs, work, and leisure occupations. Results: The patient made minimal progress for the initial 4 weeks of traditional treatment. There were no changes to his initial pain rating of 7/10 on the NRS, left hand grip strength (67 lbs.), or initial QuickDASH score. DN was initiated at week five with a reduction in pain from 7/10 to 2/10 from weeks six to eight. He was discharged at week 12 with no pain, a score of 0/100 on the QuickDASH, non-painful grip of 83 lbs., and a self-report of the ability to perform all ADLs, instrumental ADLs, work, and leisure occupations independently. Conclusions: Dry needling appears to have been an effective intervention when integrated with a holistic approach for an individual with chronic lateral epicondylosis. More research is needed to evaluate dry needling as an intervention to support functional rehabilitation with a larger sample size and randomization.

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BACKGROUND: This study aims to evaluate the feasibility of an occupation-based intervention (OBI) on dexterity and occupational performance for people with multiple sclerosis (MS) and to gather preliminary efficacy data. METHODS: In this feasibility study, 2 women with MS participated in 12 OBI sessions that focused on increasing upper extremity function. The Canadian Occupational Performance Measure, 9-Hole Peg Test, Expanded Disability Status Scale, Montreal Cognitive Assessment, and Fatigue Severity Scale (FSS) were used as outcome measures. The scores of these assessments are reported descriptively. RESULTS: According to preliminary data, both participants demonstrated improvements in dexterity, occupational performance, and occupational performance satisfaction. These data suggest that OBI may be implemented effectively in Iran. CONCLUSIONS: OBI improved the functional use of the participants' upper extremities as well as their occupational performance and satisfaction with their occupational performance in each of the 2 women with MS. This preliminary intervention program should be further tested using randomized controlled trials.

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Fatigue is common, but under-recognized in Parkinson's disease (PD), with limited treatment options. The aim of this study is to explore the experience of people with PD (PwPD) regarding content and delivery of the individual Packer Managing Fatigue program. This mixed-method study (n = 12) was conducted concurrently with a pilot randomized controlled trial. Data were collected using questionnaires, interviews, and focus groups. Five themes emerged: the program is helpful; the program has strengths; areas for improvement; individual online delivery is feasible; and more support from occupational therapist would be helpful. Quantitative findings confirmed feasibility with high ratings on questionnaires and confidence to use learned strategies. The findings inform future implementation of the Packer Managing Fatigue program and contribute to understanding the needs of PwPD. Future studies might explore program's effectiveness as stand-alone treatment or in combination with other approaches. Tailoring fatigue programs to PwPD's unique needs and characteristics of PD fatigue is suggested.

Managing Fatigue in People With Parkinson's DiseasePeople with Parkinson's disease list fatigue as one of their three most disabling symptoms. They describe fatigue as a feeling of extreme tiredness that can make it difficult to perform everyday activities. We explored the perspective of people with Parkinson's disease regarding the individual version of the Packer Managing Fatigue program. The study used video calls and included 12 people with Parkinson's disease. The program proved helpful and feasible for participants. They learned skills to manage their fatigue, such as prioritizing tasks and balancing rest and activity, and were confident in using them. These findings provide preliminary evidence that could be used by occupational therapists to help people with Parkinson's disease manage the negative impact of fatigue on their lives. However, reseaech studies, with more people, are needed to be sure the program is effective.

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BACKGROUND: Motor skills have been linked to executive functions (EFs) in children with developmental coordination disorder (DCD). However, the traits of other neurodevelopmental disorders (NDDs), such as attention-deficit/hyperactivity disorder and autism spectrum disorder, remain overlooked. Therefore, this study explored the association between motor skills, occupational performance, and mental health in older kindergarten children with DCD and other NDDs. Overall, 95 participants aged 5-6 years were included in this study and divided into four groups: DCD traits (DCD-t), DCD-t + NDD traits (DCD-t + NDD-t), NDD-t-only, and typically developing children. Motor skills, EFs, and mental health were assessed using the DCD Questionnaire (DCDQ-J) and Movement Assessment Battery for Children-Second Edition, School Assessment of Motor and Process Skills (S-AMPS), and the Strengths and Difficulties Questionnaire (SDQ), respectively. The DCD-t + NDD-t group exhibited a strong correlation between the S-AMPS motor skill score and the DCDQ-J fine motor skill score (r = 0.88, p < 0.001) and between the total DCDQ-J score and the SDQ Total Difficulties Score (r = -0.94, p < 0.001). The findings indicate that children with DCD-t and NDD-t are more likely to experience EF and mental health problems than those with DCD-t only.

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Functioning is a fundamental dimension across all aspects of life, frequently compromised or reduced in individuals with schizophrenia. However, the lack of a commonly agreed definition of functioning in schizophrenia makes it difficult to apply this concept in clinical practice. In this document, we make a detailed analysis of the literature to identify and define functioning and describe how it can be used in clinical practice today. We performed a preliminary literature search in the MEDLINE database (via PubMed) for articles discussing functioning in schizophrenia. The articles retrieved were then read and discussed by a panel of psychiatrists specialising in schizophrenia. The conclusions reached in this meeting formed the basis for a new exhaustive literature search for the purpose of synthesising the evidence published in the past 5 years. In this article, we show the importance a comprehensive, modern, homogeneous definition of functioning in schizophrenia, propose a definition of functioning, and put forward a series of recommendations for assessing functioning in clinical practice. We also review current unmet needs and highlight the need for a standardised tool for evaluating functioning.

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This study aimed to examine the relationships between the screen time of children with special needs and of their parents with their home participation, occupational performance, and parent-child relationships according to sex and diagnosis. Parents of 150 children with special needs (age range, 4 to 6 years) such as autism spectrum disorder, cerebral palsy, and attention deficit hyperactivity disorder, as well as undiagnosed and developmentally risky children, were included. The Demographic Information Form, Screen Time Usage Form, Parent-Child Relationship Scale, Participation and Environment Measure for Children and Youth, and Short Child Occupational Profile were used for the data collection. There was a significant relationship between the screen time of girls and their parent-child relationships, home participation, and occupational performance. Moreover, we detected a relationship between the screen time of children with autism spectrum disorder and positive parent-child relationships, home participation, and occupational performance. Therapists should account for screen time in their interventions associated with parent-child relationships, home participation, and occupational performance.

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PURPOSE: The present study aimed to compare the effectiveness of Top-down and Bottom-up approaches on levels of the International Classification of Functioning, Disability and Health Framework (ICF), including impairments, activities, and participation. MATERIALS AND METHODS: Thirty-nine chronic stroke survivors were recruited for this single-blinded randomized clinical trial. Participants were assigned to Top-down, Bottom-up interventions, or control group, and received a 6-week intervention. They were assessed before/after treatments and at follow-up (6 weeks later). Impairments were measured through kinematic analysis, Trail Making Tests (TMT), and Fugl-Meyer Assessment (FMA). Activity and participation were evaluated via Box and Block Test, Motor Activity Log (MAL), and Canadian Occupational Performance Measure (COPM), respectively. RESULTS: We found significant improvements in impairment (FMA) and participation (COPM) in all groups, however, COPM scores improved beyond the MCID only in the Top-down, and FMA scores exceeded the MCID in Top-down and Bottom-up groups. Use of the upper limb in daily activities (MAL) enhanced in the Top-down group, although was not clinically significant. CONCLUSION: In most of the outcome measures, no significant difference was observed between groups. It seems that Top-down, Bottom-up, and traditional interventions have relatively comparable effectiveness in chronic stroke survivors. TRIAL REGISTRATION: IRCT20150721023277N2.

Sensory-motor, cognitive, and psychological impairments are the most common consequences of stroke that lead to activity limitations and participation restrictions in stroke survivors.There are various rehabilitation approaches for stroke survivors.Some rehabilitation approaches address underlying impairments (Bottom-up), while others focus on enhancing individuals' ability to participate in meaningful roles (Top-down).Top-down, Bottom-up, and traditional interventions seem to have relatively comparable effectiveness in chronic stroke survivors, and occupational therapists should use their clinical reasoning to select the most appropriate approach for each client.

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The fire service suffers from high rates of cardiovascular disease and poor overall health, and firefighters often suffer fatal and non-fatal injuries while on the job. Most fatal injuries result from sudden cardiac death, while non-fatal injuries are to the musculoskeletal system. Previous works suggest a mechanistic link between several health and performance variables and injury risk. In addition, studies have suggested physical activity and nutrition can improve overall health and occupational performance. This review offers practical applications for exercise via feasible training modalities as well as nutritional recommendations that can positively impact performance on the job. Time-efficient training modalities like high-intensity interval training and feasible modalities such as resistance training offer numerous benefits for firefighters. Also, modifying and supplementing the diet and can be advantageous for health and body composition in the fire service. Firefighters have various schedules, making it difficult for planned exercise and eating while on shift. The practical training and nutritional aspects discussed in this review can be implemented on-shift to improve the overall health and performance in firefighters.

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Illness-induced trauma (IIT) might cause a disruption in an individual's occupational performance. To examine occupational therapy practitioners' (OTPs) perspectives and role in addressing IIT. In this descriptive mixed-methods design, 24 OTPs completed an online survey and 10 OTPs participated in a semi-structured 1:1 interview. Survey questions asked about knowledge regarding IIT. Interviews addressed incorporation of IIT knowledge and trauma-informed care (TIC) into practice. Quantitative results showed most OTPs (64%) did not receive TIC training and believed training was inadequate. Qualitative results indicated three major themes: "Impact on Rehabilitation," "Variety of OT Approaches for IIT," and "Barriers to Providing Trauma-Informed Care." Although OTPs report inconsistencies with incorporating TIC into practice, there are similarities with foundational OT skills and TIC. Findings suggest OTPs utilize a TIC approach to support clients with IIT to process and re-engage in meaningful occupations.

How Occupational Therapists Support Clients Who Have Experienced a Traumatic Event Caused by a Medical ConditionResearchers have shown that some individuals who have been hospitalized and diagnosed with a serious medical condition, also have illness-induced trauma (IIT). They developed symptoms of post-traumatic stress disorder, including mood changes, hyperarousal, and re-experiencing the event. In the criteria to be diagnosed with post-traumatic stress disorder, there are specific events that are considered traumatic and able to receive a diagnosis. IIT is not considered a traumatic event by the diagnosis criteria. Occupational therapy practitioners (OTPs) frequently work with clients who have potentially experienced IIT. This study aimed at learning about the perspective OTPs have while working with individuals who experienced IIT and their role to address this trauma. The researchers recruited 24 OTPs to complete an online survey and 10 OTPs to participate in a 1:1 interview. Survey questions asked the therapists about their knowledge of IIT. Interview questions asked how therapists incorporate knowledge about IIT and intervention strategies to support clients healing from trauma. Survey results showed the majority of OTPs did not receive formal training on ways to support clients processing trauma or believed their training was not enough when working with clients. Interview results indicated three major ideas: IIT has a negative impact on rehabilitation outcomes, there are a variety of approaches that OTPs use to support clients processing their trauma, and there are barriers to supporting clients with IIT. Even though there are inconsistencies to training and incorporating strategies, many of the foundational skills that OTPs are taught in their education align with the principles and approaches to provide supportive care and consideration of trauma. OTPs use these approaches to support clients processing their trauma from medical conditions and events and help re-engage them in meaningful activities.

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Background/aim: The Canadian Occupational Performance Measure (COPM) is a person-centered assessment tool frequently used to identify occupational problems in older individuals and establish goals for geriatric rehabilitation. This study aims to assess the validity and reliability of the Turkish version of COPM (COPM-TR) in older people. Materials and methods: One hundred older people completed the COPM-TR, and 25 of them participated in a retest within two weeks. The convergent construct validity analyses of the COPM-TR included conducting correlation analyses between the COPM-TR and the Functional Independence Measure (FIM) and Lawton Brody Instrumental Activities of Daily Living (Lawton-IADL) scales. The Performance and Satisfaction subscales were subjected to an item analysis for the internal consistency of the COPM-TR. A test-retest analysis was conducted to investigate the reliability. Results: According to convergent construct validity analysis, it was found that there is a moderate correlation between COPM-TR performance and FIM (r = 0.51), and a strong correlation between Lawton IADL (r = 0.62). Similarly, there was a strong correlation between COPM-TR satisfaction and FIM (r = 0.61) and Lawton IADL (r = 0.61). Test-retest reliability was excellent for performance score and good for satisfaction score (ICC values 0.92; 0.78, respectively). COPM-TR showed excellent-high internal consistency (Cronbach's alpha 0.92 for performance and 0.88 for satisfaction). Conclusion: COPM-TR is a valid and reliable tool that can be used to assess occupational performance in older people.

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INTRODUCTION: Distal radius fracture (DRF) is one of the most common upper extremity fractures treated by hand therapists and can lead to chronic physical impairment and reduced occupational performance. This scoping review aimed to reveal what is currently known about occupational performance following DRF and to explore if and how occupational performance is defined and considered in the research. METHODS: This review was guided by the PRISMA-Scoping review and the Joanna Briggs Institute (JBI) guidelines. Relevant databases were searched, and studies that addressed occupation performance in adult participants following DRF were included. The findings were summarised according to the components of occupational performance (person, occupation, and environment), and quality was measured using the Mixed Methods Appraisal Tool. RESULTS: Forty-three articles met the eligibility criteria for inclusion. All of the studies discussed at least two components of occupational performance, while 25 recognised all three. The consideration of occupational performance was dominated by biomechanical issues associated with the person component (i.e. range of motion, strength). There was some acknowledgement of the psychosocial aspects of the person and, to a lesser extent, the environment, as well as the impact of both on return to occupational performance. CONCLUSION: Despite occupational performance being at the core of occupational therapy theory, its consideration within the context of research on DRF appears to be focussed on the person component of occupational performance and on biomechanical issues. Further research is recommended to determine how much this reflects current clinical practice and if a more comprehensive consideration of occupational performance will improve rates of recovery following DRF. CONSUMER AND COMMUNITY INVOLVEMENT: As part of the protocol development for this review, consumers and stakeholders were consulted. They provided feedback on clarity and importance of the research questions. PLAIN LANGUAGE SUMMARY: A distal radius fracture happens when you break the bone on the thumb side of your wrist. This type of injury often occurs when you fall and land on an outstretched hand. It is one of the more common injuries that hand therapists see in their practice. For some people, recovering from this fracture can take a long time and come with a lot of pain, difficulty moving, and emotional stress. These problems can make it hard to do everyday things like driving, cooking, or getting dressed. It can also affect both paid and unpaid work as well as leisure and social activities, making life more difficult for everyone involved. The findings from this review suggest that the current research usually focuses on how the body physically heals from this type of injury, but it does not pay as much attention to the emotional and social impact on healing. Also, it does not always discuss the activities that are important to the person, or the environment where they live, work, and socialise. This may show a gap in the research regarding our full comprehension of recovery from distal radius fractures. Taking a broader view and approach to recovery, considering a person's emotions, social life, environment, and daily activities, could help people recover fully and get back to their previous life routines and roles after this type of injury.

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The study aim was to identify the most problematic self--reported activities of daily living (ADLs). In a retrospective study, 1935 problematic ADLs were reported by 538 clients with 95% experiencing two or more problematic ADLs. Problematic ADLs were assessed by occupational therapists using the Canadian Occupational Performance Measure with walking (67%), household activities (41%), and climbing the stairs (41%) identified as the most prevalent problematic ADLs. Significant but weak associations were found between clinical determinants (e.g. physical, psychosocial) and problematic ADLs. The wide variety of problematic ADLs and the absence of a strong association with clinical determinants emphasizes the need for using individualized interview-based performance measures in clients with asthma.

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The behavioral and psychological symptoms of dementia (BPSD) can be challenging for family caregivers to cope with, leading to distress and fatigue. It is therefore important to offer effective strategies to reduce the impact of BPSD. The HOMESIDE randomized controlled trial (RCT) was testing purposefully developed interventions to improve the quality of life and wellbeing of dyads of people with dementia and family caregivers as a result of reduction of BPSD. HOMESIDE RCT was conducted in Australia, Germany, Norway, Poland and the United Kingdom between 2019 and 2022. The study design was a three-arm parallel-group single-blinded, pragmatic RCT with a sample size of 432 dyads. Dyads were randomly allocated to one of three treatment conditions: Music Intervention plus Standard Care; or Reading Intervention plus Standard Care; or Standard Care only. The Reading Intervention (RI) within the HOMESIDE RCT aimed to evoke shared discussion, reminiscence, meaningful shared experiences and consequently enrich everyday life, interaction and the emotional connection between the caregiver (CG) and carereceiver (CR); as well as to enhance activities of daily living and to promote relaxation or stimulation as appropriate. This paper describes the underlying conceptual framework, the content, and delivery of the Reading Intervention within the HOMESIDE RCT.

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The purpose of this study was to examine the influence of inter-limb leg lean tissue mass (LTM) asymmetry on stair climb (SC) performance in firefighters. Forty-one career firefighters (age = 32.3 ± 8.2 years, body mass = 92.1 ± 18.6 kg, stature = 178.3 ± 7.9 cm) visited the laboratory on one occasion and completed a whole body and leg composition assessment followed by a timed and weighted SC task. Percent body fat (%BF) and leg LTM were determined during a DEXA scan and regional thigh analysis. Asymmetry was assessed by the percent difference between limbs (dominant limb LTM - non-dominant limb LTM)/dominant limb LTM × 100) and a ± 3% cut-off for asymmetry classification. Participants ascended and descended 26 stairs four times as quickly as possible while wearing a weighted (22 kg) vest. Point biserial correlations were used to assess the relationship of inter-limb leg LTM asymmetry and SC performance before and after controlling for age and %BF. Results indicated that inter-limb leg LTM asymmetry was associated with longer SC task time (poorer performance) both before (r = 0.432, P = 0.005) and after (r = 0.502, P = 0.001) controlling for age and %BF. Our findings indicated that inter-limb leg LTM asymmetry negatively impacts firefighter SC performance, which may be improved with appropriate exercise interventions.

This study examined the influence of leg inter-limb lean tissue mass (LTM) asymmetry on SC performance in career firefighters. We found that inter-limb leg LTM asymmetry was associated with reduced SC performance, prior to and after controlling for age and percent body fat. Interventions that mitigate these asymmetries may improve occupational performance.

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BACKGROUND/AIM: Picky eating is a common childhood phenomenon that impacts many families' occupations surrounding mealtimes. Evidence of the effectiveness of Occupational Performance Coaching (OPC) for caregivers of children suggests it may represent a useful occupation-focused intervention for parents of picky eaters. Using an OPC-targeted intervention, this study aims to report preliminary effectiveness, explore the experience of parents' participation, and investigate factors that influence the OPC intervention. METHODS: This study used an explanatory mixed-method design. Parent participants (n = 8) were recruited via purposive sampling and engaged in three sessions of OPC delivered via an online platform between October and December 2022. Standardised assessments were completed before and after OPC and a qualitative semi-structured interview two weeks after the final OPC session. Variables were analysed descriptively, and independent t tests were performed to compare scores on each standardised assessment pre- and post-intervention. Pearson's correlation analyses were conducted to consider associations between resistance to change and the extent of change in each outcome measure. Reflexive thematic analysis was conducted on postintervention interview transcripts. CONSUMER AND COMMUNITY INVOLVEMENT: Consumer invovlement was limited to parents feedback on their experiences of the intervention. RESULTS: Improvements in occupational performance as measured by the COPM change score were statistically significant (p = <0.001). Child eating behaviours, as measured by the CEBQ Food Fussiness subscale change score (p = 0.01) and BPFAS change score (p = 0.02), demonstrated significant improvements. The extent to which parents viewed these behaviours as problematic as measured by the BPFAS problem change score, showed a significant reduction (p = <0.001). Three themes emerged from interviews with parents: small changes beyond nutrition, parents supported as the experts, and what parents value within an intervention. CONCLUSION: Targeted OPC intervention delivered online by an occupational therapist may be an effective intervention for parents of picky eaters. Future studies using randomised controls are required before OPC can be routinely recommended in a clinical setting for the management of picky eating in children.

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An air consumption test (ACT) is a physical ability test used in the fire service. The purpose of this study was to compare demographics and physiological differences between slow versus fast performers on an ACT. 160 career firefighters had air consumption, total task time, body mass index (BMI), peak heart rate (HRpeak), body fat percentage (BF%), and oxygen consumption (VO2peak) measured. K-means clustering was used to dichotomize between slow and fast groups during an ACT. Independent samples t-tests and Cohen's d measures of effect size were used to examine differences between groups. There were no significant differences in groups for age (t = -1.05, p = 0.30, d = 0.17), BMI (t = -1.85, p = 0.07, d = 0.32), or HRpeak (t = 0.99, p = 0.32, d = 0.16). There were significant differences between groups for BF% (t = -3.35, p < 0.01, d = 0.57), relative (t = 3.52, p < 0.01, d = 0.58) and absolute VO2peak (t = 4.29, p < 0.01, d = 0.68), air consumption (t = -4.87, p < 0.01, d = 0.81), and total task time (t = -15.04, p < 0.01, d = 2.58).

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BACKGROUND: People with late effects of polio (LEoP) may need rehabilitation to manage everyday life but knowledge of the benefits of interdisciplinary rehabilitation is limited. OBJECTIVE: To evaluate changes in performance and satisfaction with performance of activities among people with LEoP following interdisciplinary rehabilitation. METHODS: A pre-post retrospective study based on data on 102 participants with LEoP from a rehabilitation clinic. Changes in performance and satisfaction with performance of daily activities before and after interdisciplinary rehabilitation were assessed with the Canadian Occupational Performance Measure (COPM). RESULTS: There were statistically significant increases in the mean performance and mean satisfaction with performance COPM scores from admission to discharge. Twenty-three percent and 19% of the participants, respectively, had improved their performance and satisfaction with performance, 25% and 26% of the participants had no changes, and 19% and 22% of the participants, respectively, rated their performance and satisfaction lower at discharge compared to admission. CONCLUSION: Interdisciplinary rehabilitation can enhance self-rated performance and satisfaction with performance of daily activities among people with LEoP. Future studies of rehabilitation for people with LEoP should use a prospective design and capture the participants' process of change related to their rehabilitation period.

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BACKGROUND: Parent coaching emerges as a preferred approach for enhancing performance and participation of children with developmental disabilities (DD), but limited clinical trials examine its effects on community participation. AIM: To evaluate whether parent coaching, specifically using Occupational Performance Coaching (OPC), enhances community participation among young children with DD. METHOD AND PROCEDURES: A pilot double-blind randomized controlled trial was conducted. Parents of 50 children with DD (31 male, 19 female, mean age 4 years 10 months) were randomly assigned to the OPC group (n = 25) or parent consultation group (n = 25). Each parent received a maximum of eight coaching sessions or consultations. The primary outcome was children's community participation as assessed through parent-report measures at baseline, pre-intervention, post-intervention, and an 8-week follow-up. OUTCOMES AND RESULTS: Both groups showed significant improvements in parent-identified, goal-specific community participation after the intervention (mean difference [MD]=2.26-2.56), and these improvements were sustained during the follow-up. Despite a trend favoring parent coaching, the group difference in the improvements was not evident (MD=0.18-0.28). Both groups displayed positive improvements in children's overall community involvement post-intervention (MD=0.32); however, the time effects were not statistically significant. CONCLUSIONS AND IMPLICATIONS: OPC, by coaching parents, could enhance goal-specific community participation in children with DD, producing effects similar to those achieved through parent consultation.

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INTRODUCTION: Previous research indicates that children with Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) experience sensory reactivity differences that impact occupational performance. The purpose of this study was to determine whether there are differences in sensory reactivity in these children across two different time points; during exacerbation and during remission, using the Sensory Processing Measure (SPM) Home-Form. The study also sought to investigate whether children with PANS experience sensory differences during remission periods, when compared with SPM Home-Form norms. METHODS: A two-period bidirectional case-crossover design was used, and an online assessment was conducted to measure sensory reactivity. Parents of children aged 4.6 to 13.1 years with a diagnosis of PANS were recruited from various sites across Australia, USA, England, Ireland, Scotland, Canada, and New Zealand. The SPM Home-Form was used to measure sensory reactivity at two time points, when PANS was in remission (T-R) and in exacerbation (T-E). Study entry was permitted at either T-E or T-R. Participant exacerbation status was monitored over a maximum 12-month period, and a follow-up SPM Home-Form was sent when a change in exacerbation status was indicated. A linear mixed model was used to assess the difference between SPM Home-Form norm-referenced scores during exacerbation and remission. RESULTS: The study included 82 participants, with 80 providing data at study entry, and 27 providing data at follow-up. Results showed a statistically significant decline in performance across the SPM Home-Form domains of Hearing, Social Participation, Planning and Ideas, and Total Sensory Systems T-scores during exacerbation when compared with remission data. Results also demonstrated atypical sensory reactivity across Vision, Hearing, Touch, Balance and Motion, and Total Sensory Systems domains during periods of remission compared with SPM Home-Form norms. CONCLUSION: This study found that children with PANS experience significant sensory reactivity differences during exacerbation and remission across multiple sensory domains, with a decline in performance during exacerbation. Where there are occupational performance challenges, occupational therapists should consider administering sensory assessments so that effective intervention plans addressing the unique sensory reactivity needs of children with PANS can be developed.

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