A father nevertheless: Self-confident but resigned fathers with children in foster care

This qualitative study aimed to explore the experiences of nine fathers with neurodevelopmental disabilities with children in foster care, including their fathering role, visits and formal and informal support. Systematic text condensation was the analysis method used. The respondents' experience of fatherhood revealed two categories: I accept my situation and I am frustrated. Though self-confident, the fathers expressed ambivalence between acceptance and frustration with their role. The study shows that more should be done to provide adapted support for these vulnerable fathers with children in foster care, although they seldom demand such support. Social workers and professionals from the rehabilitation team within the healthcare service should be aware of gendered settings, specifically norms of masculinity. Increased efforts from the social workers may reduce the risks of detachment in parenthood because engaged and informed fathers are in the children's best interests.

The experiences and the meaning of using MyTime in the preschool context from the perspective of children in need of special support, 5-6 years of age

BACKGROUND

Children in need of special support often display delays in time processing ability, affecting everyday functioning. MyTime is an intervention programme for systematic training of time processing ability. To support preschool children's development of time processing ability and everyday functioning, it is necessary to include their perspectives of the MyTime intervention programme. A previous study shows that MyTime is feasible with children in the preschool setting and shows positive effects on time processing ability for older children in special schools. Yet, there is a lack of knowledge regarding how preschool children experience the intervention programme and how they understand its meaning. The aim of this study was to explore the experiences and the meaning of using MyTime from the perspective of children with informal needs of special support (INS) 5-6 years of age in the preschool context.

METHODS

To explore the children's perspectives, video-recorded interviews with 21 children were analysed hermeneutically. To facilitate the interview situation with the children in need of special support, the Talking Mats© was used. Both body and spoken languages were analysed.

RESULTS

The results reveal children as active participants, willing to share their experiences of using the MyTime intervention in the preschool context. The conceptualization of the children's experiences and expressions uncovers their meaning of using the MyTime intervention as to know and to understand time by doing.

CONCLUSIONS

When children are given the opportunity to use concrete tools to understand and measure time, they experience themselves as active participants involved and engaged in the intervention. They reveal meaningful experiences to be able to manage time that facilitate their everyday functioning and participation in the preschool context.

Evaluation of the group intervention "Let's Get Organized" for improving time management, organisational, and planning skills in people with mild intellectual disability

BACKGROUND

Limited time management skills cause problems in daily life for people with mild intellectual disability (ID) and "Let's Get Organized" (LGO) is a promising manual-based occupational therapy group intervention aiming to support management skills.

AIMS/OBJECTIVES

To evaluate the applicability of the Swedish version of LGO-S by i) exploring enhancements in time management skills, satisfaction with daily occupations, and aspects of executive functioning in people with time-management difficulties and mild ID, and ii) describing clinical experiences of using the LGO-S for people with mild ID.

MATERIAL AND METHODS

Twenty-one adults with mild ID were included. Data were collected pre-/post-intervention and at 3- and 12-month follow-ups with: Swedish version of Assessment of Time Management Skills (ATMS-S), Satisfaction with Daily Occupation (SDO-13), and Weekly Calendar Planning Activity (WCPA-SE). There were few follow-up participants (n = 6-9).

RESULTS

Significant change in time management skills that maintained at 12-months follow-ups. Significant increase in regulation of emotions at 12-month follow-up. Results at 12-months follow-up indicated sustainability in outcomes as measured by ATMS-S. A non-significant positive trend was observed in other outcomes between pre- and post-intervention.

CONCLUSIONS AND SIGNIFICANCE

LGO-S seems applicable for improving skills in time management, organisation and planning also for people with mild ID.

A more active parenting after attending Let's Get Organized - Experiences of parents with ADHD

BACKGROUND

Parenting demands a high degree of attention, planning, and problem-solving, including time management, demands that can be challenging for parents with ADHD. Let's Get Organized (LGO) is an occupational therapy group intervention aiming at developing skills in time management, organisation and planning. There is a need to investigate if LGO may have an impact also on parenting.

AIM

To describe how parents with ADHD experienced the intervention, their time management strategies, parenting and family life after the occupational therapy group intervention LGO.

METHOD

Interviews were performed with 15 parents with ADHD, after completing LGO. Data were analysed using qualitative content analysis.

RESULTS

The findings are described in one overarching main category, Active parenting and better relations within and outside the family through daily time management with three underlying generic categories: Let's Get Organized facilitates empowerment in daily life; The individual and family - both facilitators of and obstacles to implementation of time management strategies; and A changed parenting and family life.

CONCLUSIONS AND SIGNIFICANCE

Participants experienced a positive impact on time management skills after LGO, which generated more active parenting and better predictability in the whole family. LGO can be a valuable intervention for parents with ADHD.

Cross-cultural adaptation of assessments for time-related abilities of Indian older adults and evaluation of their reliability and validity

BACKGROUND

Older adults may have difficulties in daily time management due to age-related or disease-related cognitive impairment. Standardised assessments for time-related abilities are currently unavailable in India.

AIM

The study aimed to adapt the Kit for Assessing Time-processing Ability-Senior (KaTid-Senior) and Time-Self rating, Senior (Time-S Senior) for daily time management of Indian older adults, translate these into an Indian language, and evaluate the reliability and validity of the adapted assessments.

MATERIALS AND METHODS

The two Swedish-origin assessments were reviewed, adapted for linguistic and cultural relevance into English, and translated into Kannada language. Older adults (n = 128) were conveniently selected, assessed with the Montreal Cognitive Assessment, and assigned to age and gender-matched groups: cognitively-impaired and cognitively-normal. Data was then collected with the adapted assessments.

RESULTS

Both adapted assessments demonstrated acceptable reliability (internal consistency) in this sample (α =0.89 - 0.90). The cognitively-impaired group had significantly (p < 0.001) lower scores on the assessments as compared to the cognitively-normal group. There was a strong to moderate correlation between the assessments supporting their convergent validity.

CONCLUSIONS

The adapted assessments are reliable and valid in the Indian context.

SIGNIFICANCE

The study would facilitate contextually-relevant assessment and management of time-related abilities in Indian older adults.

Efficacy of a school-based intervention to influence attitudes about future parenting among Swedish youth with intellectual disability: An RCT study

BACKGROUND

The study aim was to investigate the efficacy of an intervention designed to provide a basis for informed choices about future parenthood to special upper secondary school students with intellectual disabilities.

METHODS

A randomised trial with a waiting list control group was used. In total, 108 special upper secondary school students with mild or moderate intellectual disabilities, age 16-21 years, provided informed consent and participated. The intervention included education using the Parenting Toolkit and a Real Care Baby simulator. The analyses included 91 students (intervention group n = 46, 24F/22M; control group n = 45, 26F/19M).

RESULTS

The result showed that intervention group changed their attitudes to future parenting, from 'do not know' to 'know', significantly more than control group. The intervention increased knowledge levels in the intervention group.

CONCLUSIONS

The intervention group showed increased ability to make informed choices and decisions about parenthood.

Daily time management in dementia: qualitative interviews with persons with dementia and their significant others

BACKGROUND

Persons with dementia encounter time-related problems and significant others often need to provide support in daily time management and use of time assistive technology (AT). Further research has been requested on how time AT for persons with dementia affects the situation of significant others. Moreover, there are a few previous qualitative studies on the experiences of time AT by persons with dementia. This study explores the experiences of persons with dementia and significant others in daily time management and their perceptions on how time AT affects everyday life.

METHOD

Semi-structured interviews with persons with mild to moderate dementia (n = 6) and significant others (n = 9) were conducted three months after receiving prescribed time AT. Interviews were analysed using qualitative content analysis.

RESULTS

A main category "Support by significant others is always part of daily time management", and three categories "Facing new challenges", "Using strategies to handle changes", and "Time assistive technology in daily life" illustrated that significant others provided support for daily time management in all phases of dementia. This support was often embedded in other kinds of support for emerging challenges. Support in time management was needed from an early stage in dementia, and responsibility for time management was gradually transferred to significant others. Time AT could support time orientation and were important for sharing the time management conducted by others but did not enable independent time management.

CONCLUSIONS

Time-related assessments and interventions should be offered at an early stage of dementia to increase the possibility of maintaining daily time management skills. Using time AT to communicate time might increase agency and participation in daily occupations for persons with dementia. Given the central role of significant others for daily time management, the society needs to adequately support persons with dementia lacking support from significant others.

Assessing time processing ability and daily time management in persons with dementia: Psychometric properties of three instruments

INTRODUCTION

Persons with dementia experience time-related problems, but there is a lack of instruments evaluating their time processing ability and daily time management. This study aimed to evaluate the psychometric properties of the instruments KaTid®-Senior measuring time processing ability, and Time-S© Senior and Time-Proxy© measuring daily time management for persons with dementia.

METHODS

Persons with dementia (n = 53) and their significant others (n = 49) participated in the study. Rasch analyses were used to evaluate the instruments' rating scale functioning; internal scale validity; person-response validity; unidimensionality; person-separation reliability; and internal consistency. Versions excluding items with poor fit to the Rasch model were also evaluated.

RESULTS

Overall, the Rasch analyses showed acceptable psychometric properties. All instruments met the criteria for unidimensionality and the reliability was good. More challenging items should be added in KaTid-Senior for better targeting of persons with mild dementia. Person-response validity issues in Time-S Senior need to be addressed.

CONCLUSION

The instruments can validly and reliably be used to assess time processing ability and daily time management in persons with dementia in clinical research and healthcare settings. In turn, this can contribute to the development of methods to compensate for impaired time processing ability and daily time management. The assessments can also increase the possibility of early detection of impaired time processing ability and daily time management, thereby facilitating adequate timing of interventions and enhanced occupational performance.

Feasibility of an intervention to facilitate time and everyday functioning in preschoolers

BACKGROUND

Children in need of special support (INS) often display delays in time-processing ability (TPA) affecting everyday functioning. Typically developing (TD) children are not yet mature to use the information of a clock.

AIM

To investigate the feasibility of an intervention program, MyTime, to facilitate TPA and everyday functioning in pre-school children, including the subjective experiences of pre-school staff and the children.

MATERIALS AND METHODS

The intervention sample consisted of 20 children: 4 INS and 16 TD. Intervention was given daily in 8 weeks with MyTime in the pre-school environment. Data collection procedures were evaluated and children were assessed for TPA pre- and post intervention. Everyday functioning were assessed by teachers, parents and children. Experiences of the intervention were assessed by a group interview with teachers and a Talking Mats© evaluation with children.

RESULTS

MyTime worked well in pre-school and indicated an increase in the children's TPA and everyday functioning. The program was perceived simple to use by teachers and children highlighted the importance to understand the duration of time.

CONCLUSION

The program MyTime was found to be feasible in the pre-school environment. Significance: The assessment and program design can be used to investigate intervention effectiveness in a randomised study.

Evaluation of the "Let's Get Organized" group intervention to improve time management: protocol for a multi-centre randomised controlled trial

BACKGROUND

Time management skills are essential for living in modern society. People with mental or neurodevelopmental disorders typically have cognitive limitations, including affected time management, which might lead to poor occupational balance, low self-efficacy, and poor parental sense of competence. "Let's Get Organized" (LGO) is a recently developed manual-based group intervention to train time management skills. The aim of this trial is to evaluate the efficiency of the Swedish version of LGO (LGO-S) compared to treatment as usual (individual occupational therapy) to improve time management for adults with impaired time management skills due to mental or neurodevelopmental disorders. Furthermore, to evaluate if the intervention is a cost-effective way to improve the quality of life and time management skills of these individuals, we will conduct a health economic evaluation.

METHODS

The trial will have a multi-centre, open, parallel randomised controlled design. A total of 104 adults with cognitive limitations due to mental or neurodevelopmental disorders will be recruited from open psychiatric or habilitation care units. Outcomes will be measured before and after a 10-week intervention, with a follow-up 3 months after completing the intervention. The primary outcome will be self-assessed time management skills. Secondary outcomes will be e.g. self-assessed skills in organisation and planning, regulation of emotions, satisfaction with daily occupations, occupational balance, self-efficacy, and quality-adjusted life years.

DISCUSSION

A recent feasibility study has shown promising results for LGO-S, and a randomised trial will provide robust evidence for the possible efficacy of LGO-S in comparison to treatment as usual.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03654248 . Registered on 20 August 2018.

Psychometric Properties of the Original Version of the Assessment of Time Management Skills

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.

Time management is a key OT intervention component. Valid and reliable instruments are essential for evaluating rehabilitation and OT interventions. The results of this study show that the Assessment of Time Management Skills has good measurement properties and consistent and replicable items and is useful in English-speaking countries. It can provide valid measures of time management skills, organization and planning skills, and regulation of emotion in a general population and presumably also a population with cognitive impairment.

Primary Author and Speaker: Afsaneh Roshanai

Let's Get Organized: A Group Intervention for Improving Time Management—A Pilot Study

Date Presented 04/19/21

The Let's Get Organized Swedish Part 1 pilot study demonstrated feasibility for use in psychiatric and habilitation outpatient services. Participants engaged in a 10-week group module consisting of 1.5-hour sessions per week. Each session had a common structure but a separate theme. The goals were to use an appointment book and cognitive strategies for managing time. This study used OT standardized assessments to measure the intervention results, which were promising.

Primary Author and Speaker: Suzanne Marie White

Contributing Authors: Kerry Ramella, Jyothi Gupta

One-year follow-up after the time management group intervention Let's Get Organized

BACKGROUND

Time management skills are essential to maintain occupations in everyday life. People with neurodevelopmental or mental disorders often experience persistent difficulties with managing time and organizing daily life, consequently, there is a need to establish interventions with sustainable results.

AIM

The aim was to perform a one-year post-intervention follow-up after the intervention Let's Get Organized (LGO-S) for people with neurodevelopmental or mental disorders.

METHODS

The study is a one-year follow-up of a single group pre-test-post-test design. Thirty-eight persons with difficulties in time management due to neurodevelopmental or mental disorders participated. Instruments to collect data were Assessment of Time Management Skills; Weekly Calendar Planning Activity and the Satisfaction with Daily Occupations instrument. Wilcoxons's signed-rank test was used to compare data over time.

RESULTS

There were no significant differences in the participants' outcomes between post-intervention and one-year follow-up in time management skills and regulation of emotions, satisfaction with daily occupations, and global satisfaction. A significant improvement could be seen in the subscale organization and planning at the one-year follow-up compared to post-intervention.

CONCLUSIONS

Improvements in time management skills, organization, and planning, regulation of emotions, and satisfaction with daily occupations after the LGO-S can be maintained in the long term.

A school-based intervention can promote insights into future parenting in students with intellectual disabilities-A Swedish interview study

BACKGROUND

Few studies have focused on how youth with intellectual disability (ID) can be facilitated in reasoning about future parenthood. This study aimed to explore an intervention using the Toolkit "Childrenwhat does it involve?" and the Real-Care-Baby (RCB) simulator among students with ID.

METHOD

Sixteen students with ID who participated in an intervention with 13 educational sessions, with adapted knowledge and a three-day caring session with the RCB simulator, were individually interviewed after the intervention. Qualitative content analysis was used.

RESULTS

Participants reported that the intervention provided important thoughts and insights on future parenting, providing a basis for informed decisions. The ability to be responsible and have autonomy in life and in caring for a future child were described as important.

CONCLUSION

After an intervention, with structured and adapted knowledge and experiences of the RCB simulator, students with ID reported an understanding of the importance of informed decisions about future parenthood.

Occupational performance goals and outcomes of time-related interventions for children with ADHD

BACKGROUND

Children with attention deficit hyperactivity disorder (ADHD) have difficulties with occupational performance, related to difficulties with time-processing ability.

AIMS

To examine the outcome of a multimodal time-related intervention designed to support children aged 9-15 years with ADHD, to achieve their occupational performance goals and improve satisfaction with occupational performance. A further aim was to compare the children's ratings of outcome with their parents' ratings and to analyse the occupational performance goals.

MATERIAL AND METHODS

A pre-post design was used. Participants were 27 children, aged 9-15 years. Children and parents rated occupational performance and satisfaction at baseline and follow-up, after 24 weeks, using the Canadian Occupational Performance Measure (COPM). The intervention consisted of time-skills training and time-assistive devices (TADs). Descriptive and non-parametric statistics were used.

RESULTS

Significant improvements were found in reported performance and satisfaction. Children's were higher than those of their parents. Most goals were about carrying out daily routines, knowing the duration of an activity and knowing what will happen in the near future.

CONCLUSION AND SIGNIFICANCE

The study contributes to knowledge about suitable interventions for children with ADHD who have time-related difficulties. Occupational therapy interventions, including TADs and time-skills training, resulted in significantly improved occupational performance.

Pilot Study of Let’s Get Organized: A Group Intervention for Improving Time Management

Date Presented 03/27/20

The Let’s Get Organized–Swedish Part 1 pilot study shows feasibility for use in psychiatric and habilitation outpatient services. Participants took part in a 10-week manual-based group intervention for 1 ½ hours weekly. Each session has a separate theme, a common structure and goal (to implement use of a calendar), and cognitive strategies for managing time. This study uses OT standardized tools to measure results that were promising and need confirmation in further studies.

Primary Author and Speaker: Suzanne White

Additional Authors and Speakers: Kajsa Lidström Holmqvist, Marie Holmefur

Contributing Authors: Gunnel Janeslätt, Afsaneh Roshanay, Patrik Arvidsson

Lack of time and dependence on significant others: Occupational therapists´ experiences of prescribing time assistive technology for persons with dementia

Background: There is lack of knowledge on how occupational therapists (OTs) assess daily time management (DTM) for persons with dementia (PwDs) and on which aspects affect prescription of time assistive technology (AT).Aim: To explore OTs' experiences of assessing the need for and prescribing time AT for PwDs.Material and methods: Focus group interviews with OTs that prescribe time AT for PwDs analyzed via qualitative content analysis.Results: A main category and four categories were identified. The categories illustrated a complex and time-consuming prescription process, which was facilitated if the PwD was supported by a significant other (SO). Support from a SO was especially important during implementation and follow-up. OTs had to take individual responsibility for staying informed about time AT. Organizational limitations and time constraints were barriers for OTs striving to work according to national prescription guidelines.Conclusions and significance: High demands are made on SO's participation during the prescription process. PwDs with no support from SOs are at risk not receiving or fully benefitting from time AT. To avoid inequalities, specific forms of support need to be developed and targeted at PwDs without SOs to ensure that they have sufficient opportunities to access and use time AT.

Pilot Study of Let's Get Organized: A Group Intervention for Improving Time Management

IMPORTANCE

There is a need for evidence-based occupational therapy interventions to enhance time management in people with time management difficulties.

OBJECTIVE

To pilot test the first part of the Let's Get Organized (LGO) occupational therapy intervention in a Swedish context by exploring enhancements of time management skills, aspects of executive functioning, and satisfaction with daily occupations in people with time management difficulties because of neurodevelopmental or mental disorders.

DESIGN

One-group pretest-posttest design with 3-mo follow-up.

SETTING

Outpatient psychiatric and habilitation settings.

PARTICIPANTS

Fifty-five people with confirmed or suspected mental or neurodevelopmental disorder and self-reported difficulties with time management in daily life.

INTERVENTION

Swedish version of Let's Get Organized (LGO-S) Part 1, with structured training in the use of cognitive assistive techniques and strategies using trial-and-error learning strategies in 10 weekly group sessions of 1.5 hr.

OUTCOMES AND MEASURES

Time management, organization and planning, and emotional regulation were measured with the Swedish version of the Assessment of Time Management Skills (ATMS-S). Executive functioning was measured with the Swedish version of the Weekly Calendar Planning Activity, and satisfaction with daily occupations was assessed with the Satisfaction With Daily Occupations measure.

RESULTS

Participants displayed significantly improved time management, organization and planning skills, and emotional regulation, as well as satisfaction with daily occupations. Aspects of executive functioning were partly improved. ATMS-S results were sustained at 3-mo follow-up.

CONCLUSION AND RELEVANCE

LGO-S Part 1 is a promising intervention for improving time management skills and satisfaction with daily occupations and should be investigated further.

WHAT THIS ARTICLE ADDS

This study shows that LGO-S Part 1 is feasible for use in psychiatric and habilitation outpatient services. The results are promising for improved time management skills, organization and planning skills, and satisfaction with daily occupations and need to be confirmed in further studies.

Intervention in time-processing ability, daily time management and autonomy in children with intellectual disabilities aged 10-17 years - A cluster randomised trial

BACKGROUND/AIM

Difficulties with management of time are frequently observed in children and youth with intellectual disabilities (IDs). The aim of this study was to evaluate a new intervention programme 'My Time' to improve time-processing ability (TPA) in children with IDs aged 10-17 years (n = 61).

METHODS

Cluster randomised and waiting-list control group design was used. Data collection included the Kit for assessment of TPA, the Time-Parent scale and a self-rating of autonomy to assess occupational performance in daily life. The method was implemented over an 8-week period. Effect size (ES) was calculated and an analysis of covariance on the individual level and a two-stage process on the cluster level.

RESULTS

The estimated mean improvement in the KaTid-Child score from baseline (t1) to t2 was significantly higher in the intervention group compared to the waiting-list group, ES Cohen's d = 0.64.

CONCLUSION

The results present first evidence of the effectiveness of a new occupational therapy intervention programme ('My Time') to facilitate TPA in children with mild to moderate IDs. Children with IDs aged 10-17 years could improve their TPA at a measurable pace when given intervention. The method could complement interventions using time-assistive devices. Children with IDs should be identified to guide intervention. Further research is necessary to establish whether using the intervention programme can facilitate the development of TPA in younger children.

An intervention using the Parenting Toolkit "Children-What does it involve?" and the Real-Care-Baby simulator among students with intellectual disability-A feasibility study

BACKGROUND

There is limited knowledge about how young people with intellectual disability can be facilitated in their process of deciding about parenthood. This study aimed to evaluate the feasibility of an upcoming trial to evaluate an intervention using the Toolkit "Children-what does it involve?" and the "Real-Care-Baby" (RCB) simulator among students with intellectual disability.

METHODS

Six students with intellectual disability participated in an intervention with eight educational sessions and a 3-day caring session with the RCB simulator. Data were collected with questionnaires and interviews.

RESULTS

The study showed that it is possible to evaluate an intervention using these instruments among students with intellectual disability in order to provide them with further insights about parenthood.

CONCLUSION

It is feasible to evaluate the Toolkit and the RCB in a cluster-randomized study and that such a study could add to our knowledge about possible intervention strategies regarding reproduction and parenting among students with intellectual disability.

Effectiveness of time-related interventions in children with ADHD aged 9-15 years: a randomized controlled study

Specific problems with time and timing that affect daily routines, homework, school work, and social relations have been recognized in children with ADHD. The primary treatments for children with ADHD do not specifically focus on time-related difficulties. The aim of this randomized controlled study (RCT) was to investigate how multimodal interventions, consisting of training in time-processing ability (TPA) and compensation with time-assistive devices (TAD), affect TPA and daily time management (DTM) in children with ADHD and time difficulties, compared with only educational intervention. Thirty-eight children on stable medication for ADHD in the 9-15-year age range were randomly allocated to an intervention or a control group. The children's TPA was measured with a structured assessment (KaTid), and the children's DTM was rated by a parent questionnaire (Time-Parent scale) and by children's self-reporting (Time-Self-rating). The intervention consisted of time-skill training and compensation with TAD. Data were analysed for differences in TPA and in DTM between the control and intervention groups in the 24-week follow-up. Children in the intervention group increased their TPA significantly (p = 0.019) more compared to the control group. The largest increase was in orientation to time. In addition, the parents in the intervention group rated their children's DTM as significantly (p = 0.01) improved compared with the parents in the control group. According to the children, their DTM was not significantly changed. In conclusion, a multimodal intervention consisting of time-skill training and TAD improved TPA and DTM in children with ADHD aged 9-15 years.

The influence of environment: Experiences of users of myoelectric arm prosthesis-a qualitative study

BACKGROUND

Prostheses are used to varying degrees; however, little is known about how environmental aspects influence this use.

OBJECTIVES

To describe users' experiences of how environmental factors influence their use of a myoelectric arm prosthesis.

STUDY DESIGN

Qualitative and descriptive.

METHODS

A total of 13 patients previously provided with a myoelectric prosthetic hand participated. Their age, sex, deficiency level, etiology, current prosthesis use, and experience varied. Semi-structured interviews were audiotaped, transcribed, and analyzed through inductive content analysis.

RESULTS

Four categories were created from the data: "Prosthesis function," "Other people's attitudes," "Support from family and healthcare," and "Individual's attitude and strategies." The overarching theme, "Various degrees of embodiment lead to different experiences of environmental barriers and facilitators," emerged from differences in individual responses depending on whether the individual was a daily or a non-daily prosthesis user. Environmental facilitators such as support from family and healthcare and good function and fit of the prosthesis seemed to help the embodiment of the prosthesis, leading to daily use. This embodiment seemed to reduce the influence of environmental barriers, for example, climate, attitudes, and technical shortcomings.

CONCLUSION

Embodiment of prostheses seems to reduce the impact of environmental barriers. Support and training may facilitate the embodiment of myoelectric prosthesis use. Clinical relevance For successful prosthetic rehabilitation, environmental factors such as support and information to the patient and their social network about the benefits of prosthesis use are important. Local access to training in myoelectric control gives more people the opportunity to adapt to prosthesis use and experience less environmental barriers.

Daily time management in children with spina bifida

PURPOSE

Spina bifida (SB) often results in a complex disability and can also cause cognitive dysfunction. No previous study has investigated the ability to adapt to time in children with SB. This ability is crucial for an individual's possibility to develop autonomy in life. The purpose of this study was to investigate whether children aged 10-17 with SB have lower time-processing abilities than typically-developing children, and to describe the profile of time-processing in children with SB.

METHOD

Participants comprised a consecutive sample of 21 children (drawn from a geographical cohort of 45) aged 10-17 years (mean: 14 years, SD: 2 years); 13 were boys. The instruments used were KaTid-Y, Time-S, and Time-P.

RESULTS

The children with SB had lower time-processing abilities than typically-developing children (52.4% under -2SD), particularly difficulties to orient to and to estimate objective time, to understand time perspectives and with time planning. They also self-rated low use of strategies to adapt to time. The parents rated their children as having extensive difficulties in daily time management.

CONCLUSIONS

The low time-processing ability found in children with SB is likely to be an important contributing factor to low autonomy and independence.

Assessment of Time Management Skills: Psychometric Properties of the Swedish Version (ATMS–S)

Date Presented 3/31/2017

The Assessment of Time Management Skills–Swedish Version (ATMS–S) is a promising, easily administered self-rating of daily time management. The ATMS–S provides occupational therapists a structured way to assess clients who have reduced time management skills due to higher-level cognitive disorders.

Primary Author and Speaker: Suzanne M. White

Additional Authors and Speakers: Gunnel Janeslätt, Marie Holmefur, Kajsa Lidström-Holmqvist

Drafting standards on cognitive accessibility: a global collaboration

PURPOSE

The International Organization for Standardization (ISO) is working on accessibility of products to support people with cognitive impairment. Working Group 10, within the technical committee 173 (assistive products for persons with disability) was formed in 2014 to draft standards for assistive products that support people with cognitive impairment.

METHOD

This article explains the scope and purpose of the working group and the context for its formation, and describes the plans and process for drafting and publishing new international standards.

RESULTS

The proposed suite of standards is presented, with examples from a draft standard on daily time management. It draws on international research evidence for the effectiveness of assistive products designed to support time management in people with cognitive impairment. Examples of assistive products and their key features are provided based on domains of time as defined in the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY).

CONCLUSIONS

The proposed standards will provide design recommendations for features and functions that increase the accessibility of products used by people with cognitive impairment. They are intended to be used by designers, manufactures, educators and services providers, to facilitate their commitment to inclusion and demonstrate their willingness to work with accessibility regulation. Implications for Rehabilitation New standards based on universal design (UD) principles can guide the design of more user-friendly assistive products for people with cognitive impairment. Greater usability of assistive products, whether mainstream or specially-designed, will make it easier for practitioners to find and introduce assistive solutions to individuals with cognitive impairment. Greater usability of assistive products for daily time management can decrease the need for user training and support and enable participation.

Perception of the influence of environmental factors in the use of electronic planning devices in adults with cognitive disabilities

BACKGROUND

Adults with cognitive disabilities often have difficulties in dealing with the complexity of everyday life. With cognitive assistive technology (e.g. electronic planning devices [EPDs] and individual support), they can bring order to their often chaotic life. Assumptions are that environmental factors influence with non-use of EPDs.

OBJECTIVE

To explore how adults with cognitive disabilities perceive the influence of environmental factors in the use of EPDs.

METHODS

A reference group with experience of use of EPDs assisted the researchers. Twelve adults with cognitive disabilities and experience of using EPDs participated. An interview guide was implemented covering environmental factors according to the International Classification of Functioning, Disability and Health. Qualitative content analysis was applied in the analyses.

RESULTS

Five categories and two themes emerged, which were integrated into a model of facilitating factors influencing the use of EPDs. Measures to prevent or eliminate negative influences of the device use are important to be taken.

CONCLUSIONS

Professionals need more knowledge about EPDs, while users need individual adaption of the EPDs. EPDs need to be user-friendly, manageable and work in any seasons. Implications for Rehabilitation The users should have access to specially trained prescribers. There is a need for development of user-friendly and manageable products to function in any climate. Knowledge is lacking on how to implement the users in all stages of the prescribing process. Prescribers should increase knowledge in the use of EPDs to influence the attitudes of the social environment.

Validity in assessing time processing ability, test equating of KaTid-Child and KaTid-Youth

BACKGROUND

There is a need for instruments with acceptable psychometric properties for measuring time management/time processing ability. KaTid-Child (Swedish: Kit for assessing Time processing ability) was developed for children aged 5-10 years. To meet needs of assessing older children, KaTid-Youth was created. The aim of this study was to investigate the validity of KaTid-Youth.

METHODS

  This study investigates the validity of KaTid-Youth using Rasch models: partial credit and common item equating.

RESULTS

Results indicate that KaTid-Youth has acceptable psychometric properties and seems to measure the same construct as KaTid-Child.

CONCLUSIONS

Indications of gender differences in the sample call for further research. The results indicate that time processing ability can be seen as one construct in which time perception, orientation and management can be operationalized as different levels of complexity in time processing ability. Expressions of time processing ability differ at different ages. Thus, early intervention in time perception and time orientation may be needed to promote time management in later childhood. Professionals need to take time processing ability into consideration when meeting children who risk delayed development of daily time management.

Measurement of time processing ability and daily time management in children with disabilities

BACKGROUND

Improvement is needed in methods for planning and evaluating interventions designed to facilitate daily time management for children with intellectual disability, Asperger syndrome, or other developmental disorders.

OBJECTIVES

The aim of this study was to empirically investigate the hypothesized relation between children's time processing ability (TPA), daily time management, and self-rated autonomy. Such a relationship between daily time management and TPA may support the idea that TPA is important for daily time management and that children with difficulties in TPA might benefit from intervention aimed at improving daily time management.

METHODS

Participants were children aged 6 to 11 years with dysfunctions such as attention-deficit/hyperactivity disorder, autism, or physical or intellectual disabilities (N = 118). TPA was measured with the instrument KaTid. All data were transformed to interval measures using applications of Rasch models and then further analysed with correlation and regression analysis.

RESULTS

The results demonstrate a moderate significant relation between the parents' ratings of daily time management and TPA of the children, and between the self-rating of autonomy and TPA. There was also a significant relation between self-ratings of autonomy and the parents' rating of the children's daily time management. Parents' ratings of their children's daily time management explain 25% of the variation in TPA, age of the children explains 22%, while the child's self-rating of autonomy can explain 9% of the variation in TPA. The three variables together explain 38% of the variation in TPA. The results indicate the viability of the instrument for assessing TPA also in children with disabilities and that the ability measured by KaTid is relevant for daily time management.

CONCLUSIONS

TPA seems to be a factor for children's daily time management that needs to be taken into consideration when planning and evaluating interventions designed to facilitate everyday functioning for children with cognitive impairments. The findings add to the increasing knowledge base about children with time processing difficulties and contribute to better methods aimed at improving these children's daily time management. Further research is needed to examine if there are differences in TPA related to specific diagnosis or other child characteristics.

Development of a new assessment of time processing ability in children, using Rasch analysis

BACKGROUND

Children with disabilities like ADHD, Autism or Intellectual Disabilities may have problems with everyday functioning related to time management and hence there is a need to develop systematic methods for evaluation of the ability to understand and use time information. The purpose of this study was to examine aspects of construct validity of a new instrument, KaTid, for assessing time processing ability (TPA) in children.

METHODS

Data from 144 typically developing, 5-10-years-old typically developing children, were analysed with Rasch analysis. Instruments used were the KaTid, a self-rating scale measuring autonomy in daily routines and a parent scale measuring daily time management.

RESULTS

Fifty-one items in KaTid, initially defined in three subcategories: time perception, time orientation and time management, all demonstrated acceptable goodness-of-fit to a Rasch model, indicating evidence of internal scale validity. Performance of the children on the KaTid also provided evidence for validity in response processes and that it may discriminate among children with different levels of TPA. Relationships between the KaTid measures and the parents' ratings of the child's daily time management indicated further evidence of construct validity.

CONCLUSIONS

The results of this study supports evidence of construct validity in the KaTid when used with typically developing 5-10 years-old children. Further research is needed to evaluate the validity of KaTid in children with known time processing difficulties.