Department of Occupational Therapy
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Item Open Access A neurological approach measuring attentional variations among children with high-functioning autism spectrum disorder, sensory processing difficulties and age-matched peers(Colorado State University. Libraries, 2015) Marshall, Emily A., author; Davies, Patricia, advisor; Gavin, William, committee member; Khetani, Mary, committee member; LaGasse, Ashley Blythe, committee memberChildren with high functioning autism (HFA) and children with sensory processing difficulties (SPD) can have challenges processing auditory stimuli, which may contribute to difficulties with performance of everyday tasks. Few studies assess relationships between neurological measures with behavioral attention measures, yet the benefits of doing so are invaluable in understanding the brain and behavior connections in children who have difficulties processing sensory information. Therefore, this study focuses on examining the impact of neurological auditory processing on performance on tasks that require attention among children with HFA, SPD and typically developing (TD) controls. Participants included 20 children with HFA (mean age = 8.94 ± 2.03 years), 9 children with SPD (mean age = 6.57 ± 1.26 years), and 22 TD gender and age-matched peers (mean age = 8.46 ± 2.39 years). Groups were compared according to behavioral assessment of everyday task performance and a neurological paradigm. The Test of Everyday Attention for Children (TEA-Ch) evaluates a child's attention during tasks that correspond with three subtypes of attention, while the orientation and habituation electroencephalography (EEG) paradigm allows for sensory gating and habituation neural processing measurement and analysis. Based on the TEA-Ch scores, children in with HFA and SPD groups had significant differences with attention demands, especially in the domains of control/shift and sustained attention, when compared to the TD group. On the neurological measures, children with HFA displayed similar sensory gating abilities as compared to TD peers, including a reduction of both N1 and N2 amplitudes from tone 1 to tone 2, while children with SPD showed difficulties with sensory gating of N1 amplitudes only. Habituation analysis revealed significantly larger N2 amplitudes at tone 8 when compared to tone 2 among all groups suggesting that habituation does not occur for N2 amplitude among children in all three groups. A significant interaction occurred between tone and group for N1 amplitudes of children with SPD and the control group suggesting that the children in the control group did not habituate but the children in the SPD group did habituate. Analysis of N1 and N2 amplitude responses to tone 1 in a train without a deviant resulted in no significant differences among all three groups. However, while no differences were found between groups for the first tone, for N1 both HFA and TD groups had significant larger amplitude to the deviant tone in the 5th position, as compared to amplitude of brain response to the tone prior to the deviant. Children with SPD also had significantly larger N1 and N2 amplitudes to the deviant tones in the 4th and 5th positions, when compared to the amplitudes to the tone prior to the deviant. SPD and TD groups had an interaction at N2 amplitudes in the train with the deviant in the 4th positions. The SPD group displayed increased amplitudes at N2 to the deviant while TD decreased N2 amplitudes to the deviant. Regression analysis was conducted to assess relationships between the subtests of the TEA-Ch data and the neurological auditory processing phenomena. For the TD group this analysis revealed a strong relationship between attentional control/shift tasks and N2 amplitudes at tone 1 in the series without a deviant. For children with HFA, there was a significant relationship between attentional control/shift tasks and N1 amplitudes at tone 1 in the train without a deviant. Children with SPD also had a relationship between selective attention measures and N1 amplitudes at tone 1 in the train without a deviant. Results suggest that children with HFA, SPD and TD controls have distinct neuronal profiles related to attention. A better understanding of these group differences may help to elucidate the differential impact of auditory processing capacities on task performance in children with disabilities. This knowledge may inform how occupational therapists select therapeutic approaches, scaffold attention demands, and stimulate the adaptive response during interventions focused toward improving everyday task performance.Item Open Access A picture of traumatic brain injury identification policy in U.S. schools by state(Colorado State University. Libraries, 2015) Mathias, Kelsey, author; Sample, Pat L., advisor; Greene, David, committee member; Daunhauer, Lisa, committee memberThe Individuals with Disabilities Education Improvement Act of 2004 (IDEA, P.L. 108-446) gives definitions for each disability category and general eligibility criteria that apply to all of the disability categories. Each state is allowed by IDEA to have their own definitions for each category, and it is up to the individual states whether they require more specific guidelines for eligibility criteria or if they want to use what is written in the legislation. This study examines the definition and eligibility criteria each of the 50 states in the United States use specifically for the traumatic brain injury (TBI) disability category. In this nation-wide descriptive study, members of the Department of Education for each state were contacted either to verify definitions and eligibility criteria uncovered from existing documentation found through the National Association of State Head Injury Administrators and state Department of Education websites; update the data that were found; or provide data that were missing from the initial search. Results indicated that 45 states fit in the “federal definition category,” and 6 states fit in the “own definition category” for the TBI definitions. For eligibility criteria, 27 states fit in “medical identification,” 11 states fit in “discretion of IEP team,” and 12 states fit in the “no TBI specific criteria” category. Currently, all states identify less than 1% of students receiving special education services as having a TBI, with the exception of Massachusetts (5.11%). The findings of this study demonstrate the discontinuity within the states in the policies and procedures used to determine special education eligibility.Item Open Access A pilot study: inhibition in eating behavior of children through eating in the absence of hunger paradigm and electroencephalography(Colorado State University. Libraries, 2017) Karges, Sunny, author; Davies, Patti, advisor; Gavin, Bill, advisor; Johnson, Susan, committee member; Shomaker, Lauren, committee memberObjective. Eating behaviors contribute to the issue of obesity. The purpose of this research is to determine if there is an association between neural inhibition and behavioral inhibition relating to eating in children (age 4-6 years). Method. Neural inhibition was measured via EEG recordings during go/no-go task using visual food cues. Behavioral inhibition was measured via the amount consumed in free access phase of Eating in the Absence of Hunger (EAH) protocol. Other outcome measures included: Child Feeding Questionnaire (CFQ), a survey developed based on the Picky Eating in Toddlers and Preschoolers Questionnaire, and body mass index (BMI) measurements. Results. This study found a significant correlation between BMI and kcal consumed in free access phase of EAH protocol (p=.006). This study did not find significant correlation between neural inhibition, as measured by N2 amplitude during no-go tasks, and kcal during free access phase. Conclusions. Neural processing of young children possibly varies from that of older children and adults. Further research should be conducted to determine the development of neural processing in children as well as the relationship between development and behavioral inhibition related to eating behaviors.Item Open Access A prospective longitudinal study testing relationships between meaningful activities, basic psychological needs fulfillment, and meaning in life(Colorado State University. Libraries, 2014) Eakman, Aaron M., author; American Occupational Therapy Foundation, publisherThe current study used a prospective longitudinal design to determine whether change in meaningful activity over an 11-month period could help explain change in meaning in life in a sample of 174 undergraduate and graduate students. The Engagement in Meaningful Activities Survey, Basic Psychological Needs Scales (i.e., autonomy, competence, relatedness), and the Meaning in Life Questionnaire were used as indicators of the constructs of meaningful activity, basic psychological needs fulfillment, and meaning and purpose in life. The findings were in support of the study hypotheses and indicated that change in meaningful activity explained both change in basic psychological needs fulfillment (i.e., autonomy, competence, relatedness) and change in meaning in life. Further, this study reports findings consistent with results from cross-sectional studies in support of the hypothesis that change in meaningful activity may influence change in meaning in life through two pathways: a direct path of influence from meaningful activity to meaning in life and an indirect path through change in basic psychological needs fulfillment. The current study contributes to a growing literature implicating subjective evaluations of day-to-day action (or meaningful activity) as a fruitful means for exploring relationships between occupation and well-being.Item Open Access A qualitative study: the influence of occupational therapy for pelvic floor dysfunction on functioning, disability, and health(Colorado State University. Libraries, 2022) Pearce, Delaney M., author; Schmid, Arlene A., advisor; Atler, Karen E., committee member; Fruhauf, Christine A., committee memberIntroduction: Approximately one quarter of all women in the United States experience symptoms of pelvic floor dysfunction (PFD). Occupational therapy (OT) for PFD is a relatively new area of expertise within the field, resulting in limited research on its efficacy. Objectives: Explore the ways in which OT for PFD influences health using the International Classification of Functioning, Disability, and Health (ICF) as a guide. Method: Four participants completed the study. Eligibility criteria included: >18 years old, biologically female, English speaking, self-reported pelvic floor issue, completed OT intervention for PFD within the last two years. Electronic medical records and Pelvic Floor Distress Inventory Questionnaire-10 (PFDI-20) scores prior to and after completing OT intervention for PFD were reviewed, and semi-structured interviews were conducted. Results: Four themes emerged: 1) improved mental health and physiological function, 2) promotion of the mind-body connection, 3) reintroduction of meaning, and 4) relationships with healthcare professionals and sociocultural influences. Each theme is tied to a component of the ICF. Conclusion: OT for PFD has a positive impact on health per the ICF. This may result in better function and participation in everyday life. More research is needed to investigate the generalizability of these findings.Item Open Access A systematic mapping review of animal-assisted therapies for adults with Alzheimer's disease and related dementias: implications for occupational therapy(Colorado State University. Libraries, 2016) Rose, Michelle, author; Wood, Wendy, advisor; Hooper, Barbara, committee member; Bruemmer, Jason, committee memberThe objective of this thesis was to map the current state of knowledge of animal-assisted therapies (AAT) for people with Alzheimer’s disease and related dementias (ADRD) and to derive implications for occupational therapy in addressing dementia-specific quality of life (QoL). This study located 13 peer-reviewed articles related to AAT for adults with ADRD. These articles were written in English, published between 2004-2014, primary sources, and described a health professional as either designing or providing AAT. A data extraction tool was used to record data on the health professionals, participants, interventions, outcomes, and theories. All 13 articles described an outcome related to dementia-specific QoL, hence confirming that the AAT literature addresses QoL for adults with ADRD. Furthermore, 85% of these articles mentioned interventions that were activity-based, thus empathizing that activities, or occupations, may elicit positive outcomes related to QoL. These findings suggest that using animals in therapy may facilitate positive change. These results were also easily “mapped” on to a widely adopted and influential model in occupational therapy, the Person-Environment-Occupation Model. Therefore, incorporating animals into intervention plans in occupational therapy offers a promising avenue for addressing QoL for this population.Item Open Access A systematic mapping review of equine-assisted activities and therapies for children with autism: implications for occupational therapy(Colorado State University. Libraries, 2015) McDaniel, Brittany Caitlin, author; Wood, Wendy, advisor; Hooper, Barbara, committee member; Bruemmer, Jason, committee memberEquine-assisted activities and therapies (EAAT) are often used to promote the health and wellbeing of children with autism. However, the diverse body of literature investigating the effects of EAAT has yet to be systematically synthesized. This study aimed to determine the current state of knowledge pertaining to the use of EAAT for children on the autism spectrum in relation to their ability to participate in everyday occupations where they carry out their lives at home, school, and in the community. A systematic mapping review identified the empirical methods, treatment strategies, theories, and outcomes present in the literature. Database searching and a rigorous process of inclusion and exclusion identified 25 peer-reviewed papers relevant to EAAT for children with autism. Data were extracted from each paper and analyzed in Microsoft Access and Microsoft Excel. Eighty percent (20 papers) of the literature was research, all of which employed quantitative designs. The most commonly studied treatment strategies were therapeutic riding (10 papers) and hippotherapy (4 papers). A variety of theories for why EAAT may be therapeutic were proposed, including the movement of the horse, horse-human interaction, positive reinforcement, social interactions, and sensory processing. A variety of outcomes were studied, including communication, sensory processing, balance, autism severity, behavior, and quality of life. Strengths and gaps of knowledge are identified, leading to recommendations for future practice and research.Item Open Access A theory-driven logic model of equine-assisted psychotherapy for at-risk youth(Colorado State University. Libraries, 2021) Kelly, Erin, author; Wood, Wendy, advisor; Schmid, Arlene A., committee member; Stallones, Lorann, committee memberMental health issues among adolescent and young adult populations are highly prevalent. Mental illness can impact long term success and puts individuals at risk of negative quality of life outcomes. Equine-assisted psychotherapy interventions for at-risk youth are intended to support the development of important life skills and mitigate the risk factors one may be facing. The purpose of this study was to assess an equine-assisted psychotherapy program for at risk youth, the Equine Assisted Life Skills Training (EALST) program, using the structure of a theory-driven logic model. Using a qualitative description approach, I developed a theory-driven logic model to understand the underlying aspects of the EALST program. The aspects included the theoretical assumptions, resources, activities, outputs, outcomes, and impact of the program. I conducted semi-structured interviews with eight program stakeholders, with the questions aimed at explicating stakeholder's conceptualizations of each of these logic model categories. The results of the analysis of these interviews were mapped into a logic model format. This particular type of logic model focused on elucidating the theoretical assumptions of the program stakeholders in order to develop existing program theory. These theoretical assumptions, along with the other aspects of the logic model, will support the program providers in further developing their working theories and more effectively implementing the program. Next steps include identifying measures of hypothesized outcomes in order to test and further refine the identified program theory.Item Embargo Acquiring stakeholder input on the clinical usefulness of measuring outcomes of therapeutic horseback riding(Colorado State University. Libraries, 2023) Brenneman, Moriah, author; Peters, Caiti, advisor; Schmid, Arlene, advisor; Stallones, Lorann, committee memberTherapeutic riding (TR) is a recreational activity which provides mounted and ground-based horsemanship opportunities adapted to the abilities of the participants Click or tap here to enter text.. TR provides physical and psychological benefits to participants with diverse disabilities, including physical, developmental, cognitive, and age-related disabilities, promoting higher quality of life (QoL); however, certified therapeutic riding instructors (CTRIs) and centers are limited in their capacity to implement outcome assessments and report the benefits of their community-based TR programs to a broad audience due to credentialing requirements, time restraints, and limited financial resources. Therefore, the purpose of this study was to identify whether and how TR professionals are currently measuring participant outcomes; benefits and barriers to implementing standardized assessments in TR; and characteristics which would make TR assessments clinically useful in the community TR environment. To address this purpose, we conducted a computer-based survey among TR stakeholders. We identified that while TR professionals measure outcomes among their participants, they typically do not use standardized assessments. Benefits of implementing standardized assessments included bolstering the TR profession, acquiring funding, and communicating about TR services with a broad audience. Barriers to implementing standardized assessments included time, systemic, and expertise constraints. Respondents reported that standardized assessments should be relevant to all age groups and populations who receive TR services. Finally, our respondents reported that for standardized assessments to be clinically useful, they would need to be low-cost (free or $1 – 2 per use), require less than 20 minutes, and available in either paper or computer format. This study revealed that standardized assessments may be a strong support to the TR profession; however, assessments must meet the needs of TR providers in the community.Item Open Access Activity participation and motivation in Down syndrome(Colorado State University. Libraries, 2010) Clader, Emily Jo, author; Daunhauer, Lisa, advisor; Fidler, Deborah J., committee member; Wall, Elizabeth, committee member; Wood, Wendy Hower, committee memberThis paper examines activity participation, motivational style, and daily living skills in the Down syndrome (DS) behavioral phenotype. Children with DS (n = 26) and mixed-etiology intellectual disability (ID, n = 18) ages 5 - 22 participated. The CBCL was used to assess activity participation, the Reiss Profile MR/DD measured motivational style, and the VABS measured daily living skills. Children with DS were more motivated by independence than children with ID (p = .001). In the DS group, sports participation was negatively associated with pain avoidance (r = -.429) and frustration avoidance (r = -.518) but positively associated with daily living skills (r = .452). Daily living skills were negatively associated with curiosity. Though children with DS were motivated by independence, this was not necessarily related to function. Individuals with DS may need heightened tolerance for frustration and even pain to maintain motivation for physical activity. Implications for intervention are discussed.Item Embargo Advancing clarity: exploring professional thinking skills in occupational therapy(Colorado State University. Libraries, 2023) Burke, Hannah K., author; Lane, Shelly J., advisor; Bundy, Anita C., committee member; Sample, Pat L., committee member; Hepburn, Susan, committee member; Spielmann, Virginia, committee memberBackground: Reasoning, reflection and evidence-based practice are three interrelated and essential skills for occupational therapy practice. As threshold concepts in the field, they contribute to development of a sense of professional identity. However, these skills are inconsistently defined and differentiated from one another, leading to difficulties in related communication, education, and research. In this dissertation I sought to advance the profession's understanding of consensus conceptualizations of these essential professional thinking skills and how they are taught. Methods: This dissertation comprises five articles reporting results of two broad studies. In the first study, a scoping review, I explored peer-reviewed occupational therapy literature that included a definition of a term related to reasoning and/or reflection. Along with my research team, I extracted data from each paper on definitions of relevant terms, relationships amongst relevant terms, references used to define relevant terms, and descriptive information about each article. In the second study, I used Delphi methodology to explore nine occupational therapy educators' consensus definitions of, conceptualizations of relationships between, and educational strategies for teaching clinical reasoning, professional reasoning, reflective practice, and evidence-based practice. I then conceptually integrated results of both studies to compare findings between the literature and educators. Findings: Both studies indicate that there is some agreement about main characteristics of each of these skills. They also both suggest that clinical/professional reasoning, reflective practice, and evidence-based practice are related to each other in complex, non-linear ways that warrant further exploration. Findings from the Delphi study additionally indicate that there are key educational strategies that may support development of multiple of these professional thinking skills. Conclusion: This dissertation adds to the body of literature clarifying conceptualizations of necessary professional thinking skills in occupational therapy. Continued explicit consideration of conceptualizations of reasoning, reflection, and evidence-based practice within occupational therapy literature and education will advance communication, measurement, and, ideally, uptake of these skills into practice to support an integrated sense of professional identity.Item Open Access African American parental values and perceptions toward children's playfulness(Colorado State University. Libraries, 1997) Porter, Carolyn A., author; Bundy, Anita C., advisorSince play is the primary occupation of children, and parents have a significant influence in children's lives, it is important to understand the values, beliefs, and childrearing goals of parents in a multicultural society. This study explored the relationship between African American parents' values and beliefs about playfulness and their children's observed playfulness. Forty-seven African American parents from a middle socioeconomic background and their children participated in this study. Observational assessments, the Test of Playfulness (ToP; Bundy, 1997) and the Children's Playfulness Scale (CPS; Barnett, 1990) were used to measure a child's playful approach. Parents completed questionnaires about their children's playfulness (CPS), and their children were observed during free play (ToP). The findings revealed that African American parents shared similar values about playfulness to parents from other cultures. African American parents valued the social and joyful aspects of playfulness highly, whereas items reflecting humor were valued the least. Also, the CPS and ToP are both valid measures of playfulness with African American parents and their children. The results suggested that mothers may be more accurate in judging children's playfulness than fathers. Cultural influences, parental experience, and parents' developmental goals may be contributing factors. Discussion on the significance of the results, recommendations for future research, and a review of African American theoretical conceptions, family characteristics, parental beliefs, and the relationship of play and culture are highlighted.Item Open Access An adapted group yoga intervention: the lived experience of individuals with chronic traumatic brain injury(Colorado State University. Libraries, 2017) Roney, Megan A., author; Schmid, Arlene A., advisor; Sample, Pat L., advisor; Stallones, Lorann, committee memberThe purpose of this qualitative phenomenological study was to explore the experiences of individuals with chronic traumatic brain injury (TBI) who participated in an adapted group yoga intervention. Participants attended one-hour yoga sessions twice a week for eight weeks and described their experiences through focus groups and individual interviews. Data accumulated were analysed using a coding process to generate themes of what experiences occurred, how experiences occurred, and why experiences occurred. Participants described experiencing the yoga intervention as a progression from initially expecting physical benefits from yoga to feeling safe and comfortable in the yoga intervention classes and among fellow participants, and to experiencing physical, emotional, and cognitive changes. Participants stated that these experiences carried over into their daily lives, positively impacting their health maintenance and social participation. Participants attributed their experiences to various structural strategies of the intervention including commonalities among participants, the instructor's dual knowledge of yoga and therapeutic rehabilitation, as well as the adaptability of yoga to their personal needs. Additionally, participant experiences were attributed to a re-conceptualization of what yoga should look and feel like, enhanced body awareness, and feeling supported. The fact that the participants generally expressed beneficial outcomes indicates the need to further research adapted yoga interventions for the population of individuals with chronic TBI.Item Open Access An exploratory study of an equine-assisted intervention for people with dementia living in a residential care facility(Colorado State University. Libraries, 2017) Busselman, Sarah L., author; Wood, Wendy, advisor; Hooper, Barb, committee member; Breummer, Jason, committee memberThere are an estimated 5.3 million Americans diagnosed with Alzheimer's disease or related dementias (Alzheimer's Association, 2015) and the prevalence of dementia is predicted to rise to one million new cases per year. As there is no cure for dementia, health care for people with dementia has begun to incorporate nonpharmacological approaches that aim to improve quality of life. Environmentally based approaches, such as music therapy, aromatherapy, and animal-assisted interventions were found to be effective nonpharmacological interventions for people with dementia (Padilla, 2011b; Wood, Hoesly, Rose, & McLure, in press). Initial evidence produced by Dabelko-Schoeny et al. (2014) indicates that an equine-assisted intervention for people with dementia is feasible and can reduce problematic behaviors. The current mixed methods exploratory case study aimed to investigate: 1) the negative and positive quality of life indicators, and 2) environmental correlates of positive and negative quality of life indicators, specifically occupational opportunities and environmental supports, that are offered during an equine-assisted intervention. The program selected for this study was Riding in the Moment, an equine-assisted intervention for people with dementia. I video recorded observations of four participants during four one-hour sessions of Riding in the Moment. I used the Activity in Context and Time (Wood, 2005) to code quality of life indicators present during eight of the sixteen recorded observations. During the program, I recorded field notes, which were qualitatively analyzed using the Lived Environment Life Quality Model (Wood, Lampe, Logan, Metcalfe, & Hoesly, 2016) to describe the occupational opportunities and physical and social environmental supports. Results revealed that participants with dementia demonstrated more and longer durations of positive quality of life indicators in comparison to negative quality of life indicators during Riding in the Moment. Qualitative findings revealed a number of occupational opportunities offered, such as riding, grooming, and petting the horse. Qualitative findings also revealed various physical and social environmental supports that were critical to supporting engagement. Overall, the Riding in the Moment program was an engaging, equine-assisted intervention that promoted autonomy in an enriched environment.Item Open Access Assessing the immediate impact of a movement tracking-based intervention for unilateral spatial neglect experienced by stroke survivors(Colorado State University. Libraries, 2015) McFarland, Roxie, author; Malcolm, Matt, advisor; Greene, David, committee member; Pasricha, Sudeep, committee memberTo view the abstract, please see the full text of the document.Item Open Access Assessing the impact of a music therapy program on attention in children with autism using behavioral and neurophysiological measures(Colorado State University. Libraries, 2021) Coates, Carolyn, author; Davies, Patricia L., advisor; Merz, Emily, committee member; Stephens, Jaclyn, committee member; LaGasse, Blythe, committee memberChildren with Autism Spectrum Disorders (ASD) are known to have difficulty with auditory sensory processing. Music therapy is a common intervention approach for children with autism to address numerous behavioral and sensory challenges using auditory stimuli. Auditory processing capabilities have also been linked with attention skills and with attentional challenges often observed in children with ASD. This study seeks to understand the differences between children with ASD and their typically developing peers in auditory processing and attention. An additional study goal is to evaluate impacts of a music therapy protocol on those constructs. Baseline measurements were collected for 10 children with ASD using the Test of Everyday Attention in Children (TEA-Ch) and EEG under a sensory registration paradigm. These data were compared to those of age- and sex-matched typically developing peers (n = 10). The children with ASD participated in biweekly music therapy over 5 weeks for a total of 10 sessions and then completed the same assessments during a post-test. The sensory registration paradigm measured passive responses to four auditory tones at two different intensities (50 and 70 dB) and two different frequencies (1 and 3 kHz). The resultant event related potentials (ERPs) were averaged into a waveform for each child at each tone and amplitudes and latencies were calculated for N1, P2, N2 and P3 components. The TEA-Ch resulted in an overall attention score and a score for each of three subdomains of attention: sustained, selective and switching. Results indicated that children with ASD performed more poorly on the TEA-Ch with significantly poorer scores in overall attention, selective attention, and sustained attention. A series of independent sample t-tests on ERP components revealed few significant differences but a trend of increased latency at N1, P2, and N2 in children with ASD for each of the four tones. Children with ASD had lower amplitude of N1 components and greater amplitude P2 components compared with the typically developing children. Following the music therapy intervention, children with ASD improved significantly in selective attention and showed a trend of improvement in switching and total attention compared to pre-testing scores. The music therapy did not result in statistically significant changes in EEG results, but a trend of increased latency was noted for N1, P2, and N2. Amplitude of the P3 component decreased following the music therapy intervention in response to the high and loud tone when age was used as a covariate. Some significant associations were found between the latency of N1, P2, and N2 and sustained and selective attention in response to the 1kHz 70dB tone across all participants at baseline (TD children and children with ASD before music therapy). In conclusion, this study shows that children with ASD have different neural processing of simple auditory tones and reduced performance in multiple domains of attention. The music therapy intervention is a promising approach to improving attention skills. The intervention did not appear to alter neural processing in the expected way of children with ASD performing more like their typically developing peers. Further research at this foundational level of neural processing may help clarify the differences in processing between children with ASD and their typically developing peers and may provide a way of monitoring interventions which seek to alter neural processing to target attentional skills and behaviors.Item Open Access Attentional demands do affect amplitudes of N1 and N2 in the sensory gating paradigm in neurotypical adults and children(Colorado State University. Libraries, 2012) Phelan, Shannon E., author; Davies, Patricia, advisor; Gavin, William, committee member; Cleary, Anne, committee memberPast research has shown that N1 and N2 ERP components may be related to attention; however, few studies have measured N1 and N2 amplitudes when attention was manipulated. In this study, two ERP sensory gating paradigms were used in which attention was manipulated by requiring participants either to focus their attention on the auditory stimuli (FA) or to watch a movie that distracted them from the auditory stimuli (SGM). To examine the relationship of N1 and N2 amplitudes to performance on three types of attention (selective, sustained, and control/switch) all participants completed the Test of Everyday Attention for Children (TEA-Ch). Participants were 23 healthy adults aged 20-30 and 20 typically developing children aged 6-10. Across both groups, N1 amplitude was significantly larger for the FA compared to the SGM paradigm, F(1, 36) = 40.62, p < .001, and for the first click compared to the second, F(1, 36) = 40.62, p < .001. Adults showed larger N1 amplitudes compared to children and group main effect approached but did not reach significance, F(1,36) = 3.211, p = .082. Across both groups, N2 amplitude showed a trend for being larger in the SGM compared to the FA paradigm, F(1, 23) = 3.91, p = .06, and the first click was significantly larger than the second, F(1, 23) = 22.38, p < .001. Adults showed a trend for larger N2 amplitudes compared to children although group main effect did not reach significance, F(1,23) = 1.841, p = .188. For N2, significant interactions for paradigm x group, F(1, 23) = 4.12, p = .05, and click x group, F(1, 23) = 5.21, p = .03 were found. Separate regression analyses controlling for group membership revealed that subtest scores from all subsystems on the TEA-Ch were significant predictors of N1 amplitude for click 2 in the FA paradigm only; selective attention and control/switch attention subtest scores were the strongest predictors. Sustained attention and control/switch attention subtest scores of the TEA-Ch significantly predicted N2 amplitudes for click 1 in the FA paradigm only. The results suggest that N1 amplitude increases when attention is directed towards the task for adults and children alike. Alternatively, N2 amplitude shows a trend for increased amplitude when attention is directed away from the stimuli and children respond differently than adults. N1 has shown that it may represent a more global type of attention while N2 may be related to an ability to dismiss information.Item Open Access Auditory sensory processing in children with sensory processing disorder and autism spectrum disorder(Colorado State University. Libraries, 2016) Pott, Christine Elizabeth, author; Davies, Patricia L., advisor; Gavin, William J., committee member; LaGasse, Blythe, committee memberSensory processing has long been a topic of interest in the field of occupational therapy. This study sought to replicate the results of Davies and Gavin (2007) which examined differences in auditory sensory processing between children with sensory processing disorder (SPD) and typically developing (TD) children as well as expand the results to a sample of children with high functioning autism spectrum disorder (ASD). Additionally, this study sought to relate the neurophysiological measures of sensory processing to a behavioral assessment measuring sensory processing. We hypothesized that the results of Davies and Gavin (2007) would be replicated and expanded to include children with ASD and measures from the Sensory Profile (SP) would relate to the participants' neurological measures of sensory processing. 62 TD children, and 21 children each with SPD and ASD were recruited as part of a convenience sample. Participants’ brainwaves were recorded through electroencephalography (EEG) while they watched a silent movie and listened to a sensory gating paradigm consisting of two paired clicks and a sensory registration paradigm consisting of 4 tones of varied intensity and frequency. From the sensory gating paradigm P50 amplitudes were obtained. From the sensory registration paradigm amplitudes and latencies for N100, P200, N200, and P300 were obtained. Analyses revealed that while the results of Davies and Gavin (2007) were partially replicated, in that sensory gating was able to be significantly predicted from sensory registration the same pattern of sensory hyper and hypo-responsivity was not observed. Results indicate that the Sensory Profile does in part relate to the neurophysiological measures of sensory processing. This study confirmed that auditory sensory processing does differ between children with SPD, children ASD, and TD children. It contributes to occupational therapy's understanding of sensory processing in children and also towards increased understanding of how the SP relates to underlying neurological mechanisms.Item Open Access College veterans' experiences of involvement in cognitive behavioral therapy for insomnia program(Colorado State University. Libraries, 2018) Smith, Jessica, author; Eakman, Aaron, advisor; Atler, Karen, committee member; Hughes, Shannon, committee memberObjective. Despite quantitative research which indicates that cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for chronic insomnia, there is little qualitative research which exists regarding the experiences related to participation and adherence. The purpose of this study was to explore veterans' experiences of adherence to a multicomponent CBT-I program and its impact on occupational engagement. Method. To answer the two research questions:1)What, from the perspective of veteran participants, influenced adherence to a multicomponent CBT-I program? And 2) How is adherence to multicomponent CBT-I experienced in relation to its impacts on occupational engagement? Qualitative data were gathered through the use of semi-structured interviews which were then transcribed and coded via a process of First and Second Cycle coding by three separate researchers. Self-Determination Theory (SDT) was used as a guiding framework to interpret results related to motivation in the current study due to its proven application in behavior change programs such as CBT-I. Results. Qualitative data analysis revealed the presence of three categories that captured the experience of adherence and occupational engagement as a result of participation in a CBT-I program: Extrinsic Forms of Motivation Influenced Adherence, Social Environment can Support or Hinder Adherence and Bidirectional Relationship between Activities and Routines. Extrinsic Forms of Motivation were influenced by the receipt of a reward, emotional responses (i.e. guilt), past experiences and understanding the mechanisms that impact sleep and gaining "tools" as a result of this understanding. An additional motivating factor came from the body itself. As the body's sleep-wake system became entrained as a result of continued adherence, participants experienced the body as motivating. The social environment was determined to be composed of factors within the home and outside of the home. Both people and obligations (such as being a part of a sports team) had the potential to support or hinder adherence to CBT-I components. Additionally, there was evidence that coursework and academic commitments associated with being a college student were important facets of the social environment that influenced participants' ability to adhere. Finally, research revealed that activities and routines played an important role in adherence. The restructuring of activities and the purposeful use of activities as a way to occupy waking time were strategies participants used to support adherence. The development of routines also went on to aid in building sleep drive, which in turn positively impacted adherence. Conclusion. The present study provides novel qualitative data regarding adherence and occupational engagement as a result of participation in CBT-I that can be understood in regards to three categories: Extrinsic forms of motivation influenced adherence, social environment can support or hinder adherence and bidirectional relationship between activities and routines. Designing CBT-I programs which are built on factors that are experienced as supportive has the potential to impact overall adherence and therefore effectiveness, of CBT-I programs.Item Open Access Convergent validity of the engagement in meaningful activities survey in a college sample(Colorado State University. Libraries, 2011) Eakman, Aaron M., author; American Occupational Therapy Foundation, publisherThe Engagement in Meaningful Activities Survey (EMAS) (Goldberg, Brintnell, & Goldberg, 2002) demonstrated sufficient psychometric properties in a sample of 122 adults. The EMAS was found to have adequate test-retest (r = .71) and internal consistency (α = .88) reliability; significant positive correlations between the EMAS and the subscales of the Basic Psychological Needs Scale and the Sources of Meaning Profile and negative zero-order correlations were found with short form versions of the Boredom Proneness Scale and the Depression, Anxiety, and Stress Scales. Step-wise multiple regression analysis results showed the Sources of Meaning Profile, Boredom Proneness Scale, and Competence subscale of the Basic Psychological Needs scale best predicted the EMAS. These results lend additional construct validity evidence in support of the EMAS as a brief measure of meaningful activity participation.