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Girl
Scouts Behind Bars: Serving Time and the Community
...................................................................................................................
During my commute to the office one morning, the above headline
caught my attention. Just the day before, a friend told me
she had agreed to be "Cookie Mom" for her daughter's
Brownie troop, and then asked if I wanted to place an order.
My response was an immediate yes, for several reasons. (1)
I love Thin Mints and Tagalongs. (2) I was a "cookie
Mom, in a past life. (3) I have fond and frustrating memories
of selling cookies both as a Girl Scout (GS) myself and an
assistant to Rachel, my daughter, for several years. On the
web site of the Girl Scouts of the USA, http://www.girlscouts.org
, I learned this annual event began more than eighty years
ago. Perhaps this is only a tradition for American GS troops;
so, I can only say that the level of success in the annual
cookie sale determines the troop's programs for the next year;
so, leaders and scouts work untiringly to sell as many boxes
as possible.
Ordering the cookies triggered fond memories of times shared
with Rachel at GS events and of her satisfaction and pride
with each badge she earned. And, yes, she still has her sash
and vest on which we sewed them. Over the years, I was an
active parent volunteer and then a troop leader. We had few,
if any, discipline problems; so, I certainly cannot say I
have shared the experiences or the skills needed to lead a
group of teenage girls ". . . convicted of murder, drug
dealing, assault and other crimes."
The article was written by Jodi S. Cohen, a Chicago Tribune
reporter, and printed in the Style section of the Washington
Post, Monday, January 5, 2004, page C9. Read the article at
this site http://www.freep.com/news/nw/scouts8_20040108.htm
. Troop 344 meets in the Southern Oaks Girls School, a maximum-security
juvenile facility in Union Grove, Wisconsin. Its Mission statement
from its web site, http://www.wi-doc.com/SOGS.htm
, is:
"Southern Oaks Girls School (SOGS) provides a safe,
secure, and humane environment with innovative treatment and
educational programs designed to change the behaviors of delinquent
girls. The girls are challenged and held accountable for their
behaviors as they receive services and training to prepare
them for their return to the community."
It was an official of the Girl Scouts of Racine County who
introduced the idea of a GS troop at the facility to Patricia
Ogren, the Superintendent, who saw the similarity in the goals
of Southern Oaks and of Girl Scouts: "developing self-potential,
relating to others, developing values and contributing to
society."
Jerry Travis of the National Institute of Justice (NIJ) reiterated
the above mission and goals in his "foreword" to
the 1998 report on a study of programs initiated by local
chapters of several youth organizations, in cooperation with
local police that focused on at-risk youths. Travis wrote,
"National Youth organizations . . . have for generations
enabled young people to engage in wholesome, enjoyable activities
after school, with their peers, in safe places, and under
the supervision of experienced adults. They have also helped
teenagers develop teamwork and leadership skills while participating
in sports, game, crafts, and community activities. "(p.
vii) (Bold added by the author.) The full text of this report,
Kids, Cops, and Communities is published by the NIJ in its
publication Issues & Practices, and available in a pdf
file at http://www.ncjrs.org/pdffiles/169599.pdf
.
Following are a few other national organizations for youth.
Notice similarities in their mission statements to that of
the Girl Scouts and of the Southern Oaks Girls School.
US Youth
Soccer
Welcome to US Youth Soccer The Game for All Kids!® At
US Youth Soccer we provide a fun, safe and healthy game for
ALL KIDS...big kids, little kids, tall kids, short kids, young
kids, older kids...kids who want to play for one season, kids
who want to play for twenty seasons, kids who play strictly
for fun, and kids who want to compete at the highest level
possible. Kids are different, and because they are different
their physical, social and psychological needs are different.
We at US YOUTH SOCCER recognize this and our programs are
aimed at meeting the different needs of ALL KIDS.
Boys & Girls Club of
America
In every community, boys and girls are left to find their
own recreation and companionship in the streets. An increasing
number of children are at home with no adult care or supervision.
Young people need to know that someone cares about them.
Boys & Girls Clubs offer that and more. Club programs
and services promote and enhance the development of boys and
girls by instilling a sense of competence, usefulness, belonging
and influence.
Boys & Girls Clubs are a safe place to learn and grow
-- all while having fun. It is truly The Positive Place for
Kids.
Camp Fire
USA
Camp Fire USA is one of the nation's leading not-for-profit
youth development organizations, currently serving 735,000
children and youth annually. Camp Fire USA, with national
headquarters in Kansas City, Mo., provides all-inclusive,
coeducational programs in hundreds of communities across the
United States. Founded in 1910, Camp Fire USA's outcome-based
programs include youth leadership, self-reliance, after school
groups, camping and environmental education and child care.
Girls Incorporated
Girls Incorporated is a national nonprofit youth organization
dedicated to inspiring all girls to be strong, smart, and
bold. For over 55 years, Girls Inc has provided vital educational
programs to millions of American girls, particularly those
in high-risk, underserved areas. Today, innovative programs
help girls confront subtle societal messages about their value
and potential, and prepare them to lead successful, independent,
and fulfilling lives.
Of course, these are also some of the same objectives occupational
therapy practitioners are working to accomplishing with their
interventions with youths in many settings. From OT SEARCH,
I compiled this list of references on the topic occupational
therapy intervention or assessment with juvenile delinquents
or teen offenders and included a few on activities or occupations
in this age group, as well as the development of competency,
social skills, or autonomy.
Passmore, A. (2003). The occupation of leisure: three typologies
and their influence on mental health in adolescence. OTJR:
Occupation, Participation and Health, 23, 76-83.
In the occupational therapy literature reviewed, limited
empirical research has tested the links between the occupation
of leisure and health. This study examines the influences
of leisure participation on mental health outcomes in adolescents
and investigates the mediating constructs of self-efficacy,
competence, and global self-worth as hypothesized in an a
priori model developed from earlier research. With the use
of a population-based approach, this study surveyed 850 adolescents
aged 12 to 18 years, using a standardized self-report battery.
Structural equation modeling was employed to investigate relationships
and test the goodness-of-fit of the hypothesized model. Results
demonstrate that leisure participation has a significant and
positive relationship with mental health, and positively influences
self-efficacy, competence, and global self-worth. However,
results also show that only selected forms of leisure are
positive influences on adolescent mental health development.
These findings provide evidence to support a theoretical basis
for the relationship between the occupation of leisure and
health, and are discussed in relation to occupational therapy
ideology.
Cunningham, A. (2002). Social skills intervention for teens
with ADHD. OT Practice, 7(20), 10-15.
Although occupational therapy practitioners employed by a
school system provide services through IDEA or Section 504,
this author provides intervention through a pilot program
development project funded by a small grant, allowing her
to address adolescent students' ability to engage in occupation
across many performance areas and contexts.
Gourley, M. (2002). CAREERS: Making a difference one girl
at a time. OT Practice, 7(19), 9-10.
Gonzales, C. (2002). CAREERS: In her own words: Celina's
story. OT Practice, 7(19),
9-10.
Huebner, RA, Emery, LJ & Shordike, A. (2002). The Adolescent
Role Assessment: psychometric properties and theoretical usefulness.
The American Journal of Occupational Therapy, 56, 202-209.
OBJECTIVE: Fostering career adaptability may improve vocational
outcomes for adolescents. This study examined the responses
of adolescents on the Adolescent Role Assessment (ARA) to
explore its usefulness as a measure of career adaptability.
METHOD: The ARA was administered to 101 adolescents 12 to
17 years of age. Descriptive statistics, reliability analysis,
and factor analysis were generated from the ARA scores. Dominant
narrative themes were coded into the six domains of the ARA
and into the domains identified in the factor analysis. RESULTS:
The internal consistency of the ARA was low with few differences
in findings across age. The identified factors-developing
aspirations, self- efficacy, interpersonal competencies, and
autonomy-are consistent with constructs of career adaptability
found in the literature and differentiated low and high scorers.
CONCLUSION: Major changes to the ARA content and scaling or
development of a new assessment of career adaptability using
the factor structure are recommended for clinical and research
applications.
Farnworth, L. (2000). Time use and leisure occupations of
young offenders. The American Journal of Occupational Therapy,
54, 315-325.
Objective. The overall goal of this study was to understand
the time use, including leisure occupations, of a sample of
young offenders in Melbourne, Australia. Method. This study
investigated how 37 probationary young offenders (from 13-18
years of age) spent their wakeful time during 1 week. The
study used a combination of the Experience Sampling Method
and interviewing. Participants were beeped 60 times over 7
days and, each time, they were asked to complete a questionnaire
about the occupations in which they were engaged. Each participant
was interviewed both before and after the Experience Sampling
Method data collection about their everyday lives, including
their leisure occupations. Data were analyzed qualitatively
and quantitatively. Results. The young offenders reported
that they were engaged in leisure occupations, predominantly
passive, 57% of the times beeped, and in personal care occupations
21% of the times beeped. Only 10% of the times beeped did
they report being engaged in productive occupations such as
education or employment. The time spent in passive leisure
occupations was 30% higher than for the average Australian
adolescent. Leaving school and lack of financial and human
resources contributed to the high percentage of engagement
in passive leisure occupations. Conclusion. Findings from
this study help us to understand the relationship between
use of time and social well-being, particularly the nature
of time use of young offenders, and will help to inform occupational
therapy practices with such groups.
Willoughby, C, Polatajko, H, Currado, C, Harris, K &
King, G. (2000). Measuring the self-esteem of adolescents
with mental health problems: Theory meets practice. The Canadian
Journal of Occupational Therapy, 67, 230-238.
Occupational therapists frequently address the self-esteem
of young clients despite little empirical evidence that the
clients have low self- esteem to begin with, and that the
occupational therapy intervention is effective in addressing
self-esteem. This article examines the self-esteem of 39 adolescents
with mental health problems referred to a prevocational programme
in an effort to compare clinical practice with empirical findings.
The Self-Perception Profile for Adolescents and the Importance
Rating Scale for Adolescents are employed to compare the self-esteem
of the adolescents with mental health problems with the normative
sample, prior to (n=39) and upon completion of the pre-vocational
programme (n=14). Results indicate no difference between the
two groups' self-esteem and no change in self-esteem scores
following participation n the pre- vocational programme. Global
self-esteem is significantly correlated with physical appearance
and behavioural conduct (n=39). Competence-importance discrepancy
scores are significantly related to global self-esteem (n=14).
This finding supports the theory that it is the domain of
self-concept which is low and important to the adolescent
which will influence her/her self-esteem. These results are
consistent with previous studies. Possible explanations for
the discrepancy between clinical perceptions and objective
findings are discussed. Implications for practice are presented.
Florey, LL. (1999). Transformations in a summer camp: The
role of occupations. Mental Health Special Interest Section
Quarterly, 22, 2-4.
Parlato, L, Lloyd, C & Bassett, J. (1999). Young occupations
unlimited: an early intervention programme for young people
with psychosis. The British Journal of Occupational Therapy,
62, 113-116.
Early intervention and prevention in psychosis is a relatively
new area of practice for clinicians working in mental health.
An important task for the young person following a psychotic
disorder is the redefinition of self in relation to the disorder
and the development of valued social and vocational roles.
Occupational therapists have developed an early psychosis
intervention programme, known as the Young Occupations Unlimited
programme, which aims to promote health and wellbeing by encouraging
participation in a variety of self-chosen and self-satisfying
occupations.
Henry, AD. (1998). Development of a measure of adolescent
leisure interests. The American Journal of Occupational Therapy,
52, 531-539.
OBJECTIVE: Two studies examined the internal consistency
and test-retest reliability of the Adolescent Leisure Interest
Profile (ALIP), an 86-item measure of adolescent leisure activity
interest, leisure participation, and feelings about leisure.
In addition, leisure activity interests and participation
of adolescents with and without disabilities were described,
and the ability of the ALIP to discriminate among four groups
of adolescents was examined. METHOD: After preliminary item
development, two separate reliability studies of the ALIP
were conducted. The ALIP was administered twice to 88 adolescents
with psychiatric, learning, and physical disabilities and
to 28 adolescents without disabilities. In both studies, the
second administration took place from 7 days to 14 days after
the first. In addition, data from the first administration
in both reliability studies were combined to examine the ability
of the ALIP to discriminate among adolescents with and without
disabilities. RESULTS: Using Cronbach's alpha to estimate
internal consistency and Pearson product-moment correlations
to examine test-retest reliability, acceptable levels of reliability
for total scores derived from the ALIP were found in both
studies. Virtually all test-retest reliability coefficients
for the six total scores exceeded .60 for all participants
except those with learning disabilities. Internal consistency
estimates for a total score of overall level of interest in
the activities exceeded .90 in both studies. Although there
were few differences among the four study groups in terms
of activity leisure interests or participation, there was
some evidence that total scores on the ALIP can discriminate
among adolescents with and without disabilities. CONCLUSION:
The ALIP appears to have good reliability and may be useful
as a clinical and research tool.
Snyder, C, Clark, F, Masunaka-Noriega, M & Young, B.
(1998). Los Angeles street kids: New Occupations for Life
Program. Journal of Occupational Science, 5, 133-139.
In the same sense that health intervention focused on the
daily occupations of the well-elderly can promote successful
ageing, programs aimed at the daily occupations of at-risk
youth may act as a potential deterrent to street gang activity.
In the city of Los Angeles, thousands of young people come
under the influence of gang culture and in turn, lead lifestyles
destructive to themselves and society. This paper begins with
a few statistics which paint a grim picture of the existence
of street gang members and the impact of street gang involvement.
Following, there is a story of one youth's path from immigration
to the United States to his involvement with a street gang
which eventually led to his participation in the New Occupations
for Life Program. This pilot program, developed by the University
of Southern California Department of Occupational Science
and Occupational Therapy, targeted the harmful occupations
for 100 Hispanic and African-American teenagers at risk for
gang involvement. The program provided a safe context for
disestablishing gang allegiances, building community, and
exploring socially acceptable, productive occupations. In
this liminal space, these at-risk youth were given the opportunity
to experience other "modes of being" within the
context of meaningful and enjoyable occupations. Clark and
her colleagues offer their interpretation of this transformative
process and share their optimism about the power of occupation
to change the lives of at-risk youth.
Henry, AD & Coster, WJ. (1997). Competency beliefs and
occupational role behavior among adolescents: Explication
of the personal causation construct. The American Journal
of Occupational Therapy, 51, 267-276.
According to the Model of Human Occupation (MOHO), beliefs
regarding competency can influence whether a person's occupational
role behavior is adaptive or maladaptive. Such beliefs are
considered to be part of a person's sense of "personal
causation". This article reviews some of the theoretical
underpinnings of the personal causation construct. Issues
addressed are the distinction between competency beliefs and
locus of control (another aspect of personal causation according
to the MOHO); the domain-specific nature of competency beliefs;
and, in particular, the evidence for a relationship between
competency beliefs and actual behavior. The article focuses
on competency beliefs and their relationship to three domains
of occupational behavior that have relevance for adolescents:
academic ability, social competence, and physical competence.
Implications for clinical practice with adolescents with psychiatric
disorders are addressed.
Haner, SL. (1996). The role of unconditional positive regard
in the development of adolescent Self-concept and identity
status. The Journal of Occupational Therapy Students, 13-15.
Because adolescence is the development period during which
personal identity status is shaped and achieved, the literature
was reviewed to determine what role unconditional positive
regard (acceptance and respect regardless of the circumstances)
might play in the development of personal identity status.
The review indicates that a positive self-concept may be facilitated
by unconditional positive regard from significant others.
Positive parental attitudes and communication techniques may
encourage self- confidence and an active, positive response
to new and challenging situations.
Henry, AD & Coster, WJ. (1996). Predictors of functional
outcome among adolescents and young adults with psychotic
disorders. The American Journal of Occupational Therapy, 50,
171-181.
Adolescents and young adults who experience the onset of
a psychotic disorder often demonstrate major disruptions in
occupational and social functioning. Yet, certain persons
appear to be at a greater risk for impaired functioning after
an episode than others. This review of the psychiatric research
literature on outcomes in psychotic disorders identifies several
variables predictive of occupational and social functioning
among young persons with both affective and nonaffective psychoses.
Variables predictive of functional outcomes include diagnosis,
symptom severity, duration of onset of symptoms, age of onset
of symptoms, gender, stressful life events, premorbid functioning,
and social supports. A model for conceptualizing the relationships
of these variables to functioning is presented, and the implications
for occupational therapy practice and research are discussed.
Barrows, C. (1996). Clinical interpretation of "Predictors
of Functional Outcome among Adolescents and Young Adults with
Psychotic Disorders". The American Journal of Occupational
Therapy, 50, 182-183.
Bullis, M & Paris, K. (1995). Competitive employment
and service management for adolescents and young adults with
emotional and behavioral disorders. Special Services in the
Schools, 10, 77-96.
Adolescents with emotional and behavioral disorders (EBD)
pose difficult service delivery problems as they display the
types of behaviors that are least tolerated in school, work,
and community settings. This population has (a) the highest
drop-out rate (over 50%) and (b) the highest unemployment
rate (52%) four years after leaving high school of all disability
groups served by special education. Further, there are few
transition programs and interventions with documented long-term
benefit for this population and age group. Given the variety
and severity of the complex problems associated with EBD (e.g.,
poverty, substance abuse, family planning, counseling, criminal
activities, etc.), and the poor transition experiences of
this population, it is imperative that a coordinated system
of vocational training and social support be afforded adolescents
and young adults with EBD to have maximum effect. This article
describes such a service model and summarizes preliminary
data on the effect of the program.
Virikowic, TL. (1993). Perspectives on delinquency and the
Model of Human Occupation. Journal of Occupational Therapy
Students, 7, 30-41.
Adolescents with delinquent behaviors display a multitude
of behavioral patterns that affect several aspects of their
life-styles, including work, school, self-care, and leisure.
A multifactoral and complex interaction of dysfunctional biological,
sociological, and psychological factors has been attributed
to the development of such behaviors. The Model of Human Occupation
provides a framework for occupational therapy assessment and
intervention that addresses the performance skills and underlying
performance components that may be maladaptive or dysfunctional
for the adolescent.
Pape, SB. (1993). Community Resource Group: a new approach
to reintegrate adolescents with their community. Occupational
Therapy Practice, 4(2), 33-38.
This article describes one occupational therapist's experience
in using community professionals to enhance occupational therapy
treatment on an acute care adolescent mental health unit that
includes adolescent substance abuse patients. Community Resource
Group was developed to provide adolescents with substance
abuse and related mental health conditions opportunities to
meet with community professionals to explore a variety of
organizations that promote educational, vocational, and chemical-
free recreational participation after discharge. The unique
element of Community Resource Group was the opportunity it
provided for inpatient adolescents to meet and interact with
the community organization representatives versus solely reading
organization information brochures or "hearing"
of the organization's opportunities and benefits from the
occupational therapist alone.
Gresham, FM & Elliott, SN. (1993). Social Skills intervention
Guide: systematic approaches to social skills training. Special
Services in the Schools, 8(1), 137-158.
Social skills training procedures that can be used in a group
format are described. These procedures are contained in the
Social Skills Intervention Guide (Elliott and Gresham, 1991)
which is a systematic approach to teaching social skills to
children between the ages of 6 and 16 years. A system for
classifying social skills deficits based on acquisition/performance
deficits and presence/absence of interfering problem behaviors
is described. Implementation issues such as selection and
grouping of students, establishing group rules, and monitoring
student progress are also described as well as a means of
monitoring student progress in social skills training groups.
Nelson, DL & Peterson, CQ. (1991). The effects of competitive
vs. cooperative structures on subsequent productivity in boys
with psychosocial disorders. The Occupational Therapy Journal
of Research, 11, 93-105.
The long tradition of experiments that compare the relative
benefits of competition and cooperation is relevant to research
and theory development in occupational therapy. In this study,
three subject groups structured for competition were compared
to three-subject groups structured for cooperation in terms
of subsequent productivity (task accomplishment). Thirty-
six males (18-36 years old) residing in a treatment facility
for non- psychotic psychosocial disorders participated in
both competitive and cooperative dice games after random assignment
to counterbalanced orders. After each dice game, subsequent
group activity was assessed by counting the number of correctly
modeled pieces in a tinker toy task. Results did not support
the hypothesis that a cooperative experience would enhance
subsequent group activity...
Sullivan, M. (1991). Use of the Comprehensive Occupational
Therapy Evaluation Scale in determining occupational therapy
treatment effects on levels of self- esteem and perceived
self-efficacy. Denton, TX: Texas Woman's University. (Master's
thesis)
This study investigates whether changes in the interpersonal
and task behaviors typically targeted and documented in occupational
therapy treatment correspond with levels of self-esteem and
levels of perceived self-efficacy. Six adolescent inpatients
of a private, acute care psychiatric hospital with mean age
of sixteen were selected for study. Occupational therapy treatment
was given through the traditional, task- oriented activity
group utilizing arts and crafts media. Subjects were measured
on interpersonal and task behaviors after each treatment session
with the Comprehensive Occupational Therapy Evaluation Scale
(COTE). Self- esteem was measured every third session of treatment
by subject completion of the Rosenberg Self-Esteem Scale (RSE).
Self-efficacy levels were also measured every third session
by subject completion of an author- constructed self-efficacy
scale. Statistical analysis of variance for repeated measures
and the...
DeForest, D, Watts, JH & Madigan, MJ. (1991). Resonation
in the Model of Human Occupation: a pilot study. Occupational
Therapy in Mental Health, 11(2/3), 57-71.
This pilot study of resonation in the model of human occupation
examines the belief that successful performance of craft activities
will positively influence belief in skill (BIS). Juvenile
delinquents participated in craft activities and interviews
to help answer the question "What is the difference in
the youths' BIS before and after intervention?" Increases
in BIS were significant for: (a) the combination of craft
activities in which the youths participated, and (b) other
performance subsystem activities not specifically practiced
during the study. This offers preliminary support for resonation
since changes in the performance subsystem seemed to have
positively influenced subjects' BIS (volition subsystem).
Future studies are needed to explain how the resonation dynamic
operates.
Lancaster, J & Mitchell, M. (1991). Occupational therapy
treatment goals, objectives, and activities for improving
low Self-esteem in adolescents with behavioral disorders.
Occupational Therapy in Mental Health, 11(2/3), 3-22.
This paper examines the concept of self-esteem: its definitions
and the association between low self-esteem and adolescents
with behavioral disorders. It also provides goals and objectives
for OT intervention based upon the taxonomy in the affective
domain (Krathwohl, Bloom, & Masia, 1964) and suggests
activities integrated into the model of human occupation (Kielhofner,
1985). Finally, a scheme organizing goals, objectives, and
activities is offered to occupational therapists which can
be used in the treatment planning process.
Ebb, EW, Coster, W & Duncombe, L. (1989). Comparison
of normal and psychosocially dysfunctional male adolescents.
Occupational Therapy in Mental Health, 9(2), 53-74.
The purpose of this study was to examine whether variables
defined as critical by the model of human occupation (Kielhofner
& Burke, 1980, 1985), could discriminate normal (n=18),
and psychosocially dysfunctional (n=15), groups of male adolescents.
Discriminant analysis was used to evaluate several variables
simultaneously in order to determine group membership. Measures
used were the following: Locus of Control Scale for Children
(Nowicki & Strickland, 1973), Occupational Questionnaire
(Riopel, 1981), Role Checklist (Oakley, 1982), Modification
of Matsutsuyu's Interest Checklist (1969) and the Adapted
Adolescent Functional Performance Evaluation. Results showed
that the model variables did successfully differentiate between
the normal and psychosocially dysfunctional groups. Further
data analysis indicated that the number of current and future
roles as well as the number of strong interests proved to
be the most valuable variables in this discrimination...
Weissenberg, R & Giladi, N. (1989). Home Economics Day:
a program for disturbed adolescents to promote acquisition
of habits and skills. Occupational Therapy in Mental Health,
9(2), 89-103.
Adolescents hospitalized for mental illnesses have been participating
in a program of therapy which was designed to compensate for
their functional disabilities by a suitable therapeutic milieu.
The program, implemented once a week at Geha Psychiatric Hospital,
is termed Home Economics Day. It revolves around the preparation
and consumption of food as a means for promoting the acquisition
of habits and skills required in daily living, in a setting
of interpersonal relationships. Home Economics Day consists
of a sequence of six phases, including the meal shared by
patients and staff. All patients participating have shown
improvements in motor-action skills (cutting vegetables, eating,
etc.), in their familiarity with kitchen tools and terms,
and in the speed of performing any given task. Improvements
in task-procedure skills varied, in accordance with the level
of cognitive functioning of the individual patient.
Barris, R, Vickie, V & Baron, KB. (1988). A comparison
of psychiatric patients and normal subjects based on the Model
of Human Occupation. The Occupational Therapy Journal of Research,
8, 3-23.
This study examined the empirical validity of the model of
human occupation in psychosocial occupational therapy. A battery
of instruments corresponding to the components of the model
was administered to young adult patients with chronic conditions,
patients with eating disorders, and normal adults and adolescents.
The only variables on which the groups did not differ significantly
were the Fatalism subscale of the Internal- External Scale
and the Future Meaning dimension of the Life Attitude Profile.
A series of comparison regressions using ratings on each of
four roles from the Role Performance Scale as criterion variables
generally was more useful in explaining the performance of
the group with eating disorders and less useful with the young
adult group with chronic conditions. The regressions were
also more useful in explaining social and productive role
performance than in explaining leisure or self-management
role performance. In the most successful model, life purpose,
self- control, existential vacuum, and family environment
explained 46% of the variance in social role performance by
the group with eating disorders. For young adult patients
with chronic conditions, the best model- consisting of existential
vacuum, past roles, self-control, family environment, and
life purpose-accounted for 32% of the variance in performance
of the productive (work or education) role. For the adolescents
hospitalized with psychiatric disorders, skills, family environment,
life purpose, and past roles accounted for 35% of the variance
in social role performance.
Mann, WC & Klyczek, J. (1988). Commentary on "The
A comparison of psychiatric patients and normal subjects based
on the Model of Human Occupation." Occupational Therapy
Journal of Research, 8, 24-31.
Barris, R & Dickie, V. (1988). Response to Commentary
on "A comparison of psychiatric patients and normal subjects
based on the Model of Human Occupation." The Occupational
Therapy Journal of Research, 8, 32-37.
Hardison, J & Llorens, LA. (1988). Structured craft group
activities for adolescent delinquent girls. Occupational Therapy
in Mental Health, 8(3), 101-117.
This was a study of the effects of a craft group for teenage
delinquent girls with suspected vestibular processing difficulties.
The craft group was led by an occupational therapist which
met for two hour sessions lasting six weeks. There were 6
qualified participants but only 3 were available as subjects
for the study due to attrition prior to the pretest. Subjects
were administered the Occupational Therapy Clinical Observation
Evaluation, Bay Area Functional Performance Evaluation, and
the King- Devick Saccadic test for pre- and post testing.
Careful analysis of the craft group process and design indicated
growth individually and collectively.
Agrin, AR. (1987). Occupational therapy with emotionally disturbed
children in a public elementary school. Occupational Therapy
in Mental Health, 7(2), 105-114.
This article describes a model of delivering occupational
therapy services to a class of emotionally disturbed children
in a public elementary school. It was determined that many
of the children were placed in a special class because of
inappropriate social skills. A weekly occupational therapy
program was developed to address the children's lack of age-appropriate
social skills. A task-oriented group was chosen as the format,
with activities selected based upon the level of the children's
group interaction skills. The children exhibited an improvement
in their social skills over the course of the school year.
Gangl, ML. (1987). The effectiveness of an occupational therapy
program for chemically dependent adolescents. Occupational
Therapy in Mental Health, 7(2), 67-88.
This research study, conducted at a residential treatment
center for chemically dependent and emotionally disturbed
youth, was designed to answer the following questions: is
occupational therapy effective in producing behavioral change
in the adolescent chemically dependent population and, if
so, what are the factors producing the change? An assessment
tool was designed and used in conjunction with observations
to determine each resident's behavioral status before and
after involvement in occupational therapy groups. All residents
admitted to Jamestown were involved in a Work Skills Group
(focusing on pre-work skill development) and/or a Relationship
Skills Group (focusing on interpersonal skill development...
Sholle-Martin, S. (1987). Application of the Model of Human
Occupation: assessment in child and adolescent psychiatry.
Occupational Therapy in Mental Health, 7(2), 3-22.
The model of human occupation is proposed to be an effective
basis for occupational therapy assessment in child and adolescent
psychiatry. The theoretical tenets of this model are reviewed
with emphasis on the development of human occupation during
childhood and adolescence. Application of the model is demonstrated
through the presentation of human occupation assessment batteries
currently in use on short-term, diagnostic and research units
for child and adolescent psychiatric inpatients. In addition,
two case studies demonstrate the model's effectiveness in
conceptualizing the occupational functioning of this population.
Baron, KB. (1987). The Model of Human Occupation: a newspaper
treatment group for adolescents with a diagnosis of conduct
disorders. Occupational Therapy in Mental Health, 7(2), 89-104.
The Model of Human Occupation is used as a theoretical framework
to review literature on the diagnosis of conduct disorder
in adolescence. Specific occupational dysfunctions typical
of this population are highlighted. A Newspaper Treatment
Group based on this model is described on three levels of
treatment: exploratory, competence and achievement. The purpose
of this group is to facilitate healthy adaptation in this
population.
Barris, R, Kielhofner, G, Martin, RMB, Gelinas, I, Klement,
M & Schultz, B. (1986). Occupational function and dysfunction
in three groups of adolescents. The Occupational Therapy Journal
of Research, 6, 301-317.
This study examined the characteristics of occupational function
and dysfunction in adolescents with a psychophysiological
illness and compared these adolescents to a group with psychiatric
diagnoses and a group of high school students who were not
being treated for medical or emotional problems. Using the
model of human occupation as a theoretical framework, data
were collected on the status of volition and habituation subsystem
components. Analysis of variance revealed few differences
among the groups; consequently, a discriminant function analysis
was performed to determine whether group differences would
be identified when variables were treated as an aggregate.
The model that was tested accurately discriminated all normal
subjects from the others and accurately classified 7 of the
psychiatric subjects and 9 of the
psychophysiological subjects. This model included the following
variables: locus of control, total rating of competence during
a typical day; total rating of importance of activities during
a typical day; number of not-valued roles; strong interests
in the past ten years; total rating of enjoyment; number of
past roles, and time spent in each of work, play, and daily
living tasks.
Lederer, JM, Kielhofner, G & Watts, JH. (1985). Values,
personal causation and skills of delinquents and nondelinquents.
Occupational Therapy in Mental Health, 5(2), 59-77.
A study exploring the occupational nature of juvenile delinquency
from the perspective of the Model of Human Occupation is presented.
Because of the complex etiology and lack of a coherent occupational
therapy conceptualization of delinquency, this study and literature
review serve as beginning points for further investigation.
Literature is presented on variables in the volition and performance
subsystems, specifically values, internal/external locus of
control and perceptual motor skills. Scott's Personal Values
Scales (1965), the second half of the Role Checklist (Oakley,
1981), the Locus of Control Scale for Children (Nowicki- Strickland,
1973), and the Developmental Test of Visual-Motor Integration
(Beery & Buktenica, 1967) were used to measure the variables
simultaneously in a group of adolescent delinquents and age-matched
non- delinquents to see whether the groups differed. No statistical
differences were found between groups on the variables studied...
Snyder, S. (1985). Comprehensive inpatient treatment for
the young adult patient. Occupational Therapy in Mental Health,
5(2), 47-58.
The young adult chronic patient is one of the most rapidly
growing populations of psychiatric patients in the United
States. These patients often lack internal controls, exhibit
suicidal or assaultive behavior, or suffer from substance
abuse, and they frequently require inpatient care. This paper
describes a comprehensive inpatient program for this population
which emphasizes an integration of psychotherapy, vocational
rehabilitation, socialization, and unit structure. A blend
of psychodynamic and behavioral principles is employed to
assist the young adult in achieving viable adult autonomy.
Smyntek, L, Barris, R & Kielhofner, G. (1985). The Model
of Human Occupation applied to psychosocially functional and
dysfunctional adolescents. Occupational Therapy in Mental
Health, 5(2), 21-39.
This study investigated differences between two groups of
adolescents- those hospitalized with psychosocial problems
and a nonhospitalized group. The model of human occupation
was used as a framework for identifying the dependent variables
of self-esteem, locus of control, feelings of efficacy, interests,
values, roles, and habits. Although expected differences in
personal causation emerged, other findings were more equivocal.
The paper presents a review of the literature on psychosocial
dysfunction in adolescence, organized according to subsystems
of the model. Following a description of the methodology used,
results are presented along with a discussion of their meaning
and limitations of the study.
Blakeney, AB. (1985). Adolescent development: an application
to the Model of Human Occupation. Occupational Therapy in
Health Care, 2(3), 19-40.
Adolescence is a period of development considered by most
to be transitory. It is often viewed as filled with storm,
rebellion, and conflict. Although the profession of occupational
therapy has developed special practice areas and generated
research in the areas of pediatrics and gerontology, little
focus in our literature has been placed on adolescents and
their special needs in development and treatment. This paper
presents an overview of normal development in adolescence.
The model of human occupation is used as structure to organize
research from other fields to provide therapists with useful
guidelines.
Shannon, PD. (1983). The adolescence experience. Occupational
Therapy in Mental Health, 3(2), 73-81.
The behaviors characterizing the adolescent period are examined,
followed by the identification and explanation of the developmental
tasks of adolescence. Each of these tasks is defined as "developmental
continuums" and the element of choice is seen as the
common denominator underlying each of these behavioral continuums.
Finally, the contributions of occupational therapy to adolescent
development and to task mastery in adolescence are presented.
Paulson, CP. (1980). Juvenile delinquency and occupational
choice. The American Journal of Occupational Therapy, 34,
565-571.
Juvenile delinquents and the chronically ill or disabled
share a common role of "nonproductive" members in
a utilitarian society. The exploratory, case method study
described here uses the Occupational Behavior frame of reference
in examining the relationships between the maturational and
occupational choice processes, and how their progression can
be supported or constrained by environmental factors. The
study and its findings then served as a basis for the design
and implementation of a full-time occupational therapy program
at the facility in which the study was conducted.
Zinkus, PW, Gottlieb, MI & Zinkus, CB. (1979). The learning-disabled
juvenile delinquent: a case for early intervention of perceptually
handicapped children. The American Journal of Occupational
Therapy, 33, 180-184.
The relationship between learning disabilities and juvenile
delinquency is examined from an historical perspective as
well as from the author's investigations. The majority of
studies suggest that learning disabilities occur with significant
frequency in delinquent populations. Perceptual disorders
can be a significant cause of academic underachievement and
poor social adaptation among youthful offenders. Preliminary
results of an investigation of the learning-disabled delinquent
confirm that the perceptually handicapped child is at high
risk for developing these behavioral problems. As one of the
first professionals who may be involved in the evaluation
and treatment of the perceptually handicapped child, the occupational
therapist is a key person in effecting early intervention.
Early intervention is considered of prime importance as one
preventive measure of juvenile delinquency.
Black, MM. (1976). Adolescent Role Assessment. The American
Journal of Occupational Therapy, 30, 73-79.
Adolescence is a complex period when children are expected
to shed their dependencies and achieve a level of independence
as adults. Frequently, adult independence is achieved through
the occupational role where individuals recognize personal
assets and liabilities and participate cooperatively in the
society. The decision-making process that guides adolescents
in the search for an occupational role is occupational choice.
This paper traces the development of skills necessary for
the occupational choice process. An instrument is presented
that attempts to identify deficiencies in the occupational
choice process and to provide content for occupational therapy
intervention. Its usefulness in screening deviant adolescents
in order to identify those who may be at high risk in the
occupational choice process is discussed.
Jodrell, RD & Sanson-Fisher, R. (1975). Basic concepts
of behavior therapy: an experiment involving adolescent girls.
The American Journal of Occupational Therapy, 29, 620-624.
This paper attempts to summarize some of the basic principles
and approaches of behavior therapy that occupational therapists
may find useful for application in many areas of practice.
It attempts to do this by describing an experimental application
of the behavioral modification approach within a treatment
unit for disturbed adolescent girls. Two social skills, compliance
and social greeting, are dealt with in this article. These
skills are two of the many behaviors labeled "performance
survival skills" shown in recent studies to be necessary
for successful community adjustment.
Paulson, CP. (1975). Delinquency and occupational choice.
Los Angeles, CA: University of Southern California.
Loveland, CA Little, VL. (1974). Juvenile Correctional System.
The American
Journal of Occupational Therapy, 28, 537-539.
Christiansen, CH & Davidson, DA. (1974). A community
health program with low achieving adolescents. The American
Journal of Occupational Therapy, 28, 346-350.
Peper, BJ & Le Grow, D. (1956). Tutoring for behavioral
delinquents. The American Journal of Occupational Therapy,
10, 147-149.
Barrett, LM. (1953). The scope of occupational therapy in
the remand home. Occupational Therapy, 16, 157-159.
The following are from MEDLINE/PubMed.
Kuo, PH, Yang, HJ, Soong , WT & Chen, WJ. (2002). Substance
use among adolescents in Taiwan: associated personality traits,
incompetence, and behavioral/emotional problems. Drug &
Alcohol Dependence, 67(1), 27-39.
BACKGROUND: Despite that adolescent substance use is increasingly
prevalent throughout the world and leads to increased risk
of progression to illicit drug use, few studies have examined
in detail individual features that are associated with such
use. We aimed to examine personality traits, incompetence,
and behavioral/emotional problems in relation to adolescent
substance use and possible interactions between these factors.
METHODS: Junior high school adolescents (N = 905) randomly
selected from Taipei in 1996 completed a questionnaire consisting
of substance use experience, the Junior Eysenck Personality
Questionnaire (JEPQ), and the Tridimensional Personality Questionnaire
(TPQ). Students' parents (N = 854) were asked to complete
the Child Behavior Checklist. Logistic regression was used
to assess the relationship between substance use and personality
traits or behavioral problems. RESULTS: The most commonly
used substance was liquid substance (alcohol and refreshing
beverage), followed by tobacco and betel nut with an age-related
trend in boys. Associated factors of substance use included
higher Extroversion and lower Lie Scale (as measured in the
JEPQ), higher Novelty Seeking (as measured in the TPQ), poorer
School Competence, and more Delinquent Behavior, Aggressive
Behavior, and Somatic Complaints. The associations remained
unchanged with potential confounders controlled for. CONCLUSIONS:
Adolescents who use substance have specific individual features
that are readily assessable by existing instruments. This
bears important implications for the early intervention of
substance abuse in adolescents. Copyright 2002 Elsevier Science
Ireland Ltd.
McHale, SM, Crouter, AC & Tucker, CJ. (2001). Free- time
activities in middle childhood: links with adjustment in early
adolescence. Child Development, 72(6), 1764-78.
This study assessed links between free-time activities in
middle childhood (hobbies, sports, toys and games, outdoor
play, reading, television viewing, and hanging out) and school
grades, conduct, and depression symptoms both concurrently
and 2 years later, in early adolescence. It also explored
two mechanisms that might underlie activity-adjustment links:
whether the social contexts of children's activities mediate
these links, child effects explain these connections, or both.
Participants were 198 children (M = 10.9 years, SD = .54 years)
in Year 1, and their parents. In home interviews in Years
1 and 3 of the study, mothers rated children's conduct problems,
children reported on their depression symptoms, and information
was collected on school grades from report cards. In seven
evening phone interviews, children reported on the time they
spent in free-time activities during the day of the call and
their companions in each activity. Links were found between
the nature of children's free-time activities and their adjustment.
The social contexts of free-time activities explained activity-adjustment
links to a limited degree; with respect to child effects,
evidence also suggested that better adjusted children became
more involved in adaptive activities over time.
Passmore, A & French, D. (2001). Development and administration
of a measure to assess adolescents' participation in leisure
activities. Adolescence, 36(141), 67-75.
This paper describes the development and administration of
a measure (a self-report questionnaire) to assess the participation
of adolescents in leisure activities. Questionnaire items
were generated through a content analysis of focus group interviews
with 130 young people aged 12 to 18 years. Specifically, the
activities of approximately a thousand adolescents were investigated
through a three-factor leisure typology--achievement, social,
and time-out leisure--together with the leisure parameters
of enjoyment, freedom of choice, and frequency of participation.
Further, leisure engagement was examined based on gender and
age (i.e., changes in activity participation across the adolescent
years). The results are discussed in terms of the practical
and theoretical implications of the relationship between gender
and age in leisure activity participation.
Shanahan, MJ & Flaherty, BP. (2001). Dynamic patterns
of time use in adolescence. Child Development, 72(2), 385-401.
Patterns of time use are tangible representations of individual
identity and the meaning of age groups in the life course.
How do young people allocate their time to multiple domains
of involvement, including the school, workplace, family, and
peer group? Drawing on longitudinal data from the Youth Development
Study (N = 1,010), a person-centered analytic strategy was
used to describe configurations of time use through the high
school years. Over half of the students were engaged in many
domains, although a substantial percentage of students focused
their time on one or two domains outside the school. Students
who were highly engaged in multiple domains tended to remain
so across grade levels, whereas students focused on one or
two domains frequently changed their commitments. Plans for
school, grade point average, future orientations that emphasize
marriage and good citizenship, and gender significantly predicted
time-use patterns. These findings elucidate connections among
school, work, and other contexts through the high school years.
Delle Fave, A & Bassi, M. (2000). The quality of experience
in adolescents' daily lives: developmental perspectives. Genetic,
social, and general psychology monographs, 126(3), 347-367.
The authors analyzed the pattern of experience fluctuation
in adolescents' daily
activities. Italian high school students (N = 120; 16-20 years
of age) were tested with the experience sampling method, a
technique based on on-line sampling of daily life and experience.
A total of 4,794 forms were gathered and analyzed by means
of a model for the study of experience fluctuations. Among
daily activities, studying at home, doing classwork, watching
television, and having structured leisure were selected as
the focus of analysis on the basis of their frequency and
meaning in the adolescents' lives. Results showed that (a)
daily activities have unique experiential profiles, (b) engagement
may be used as an index of long-term commitment to a given
activity, (c) studying at home and doing classwork share this
basic component and can foster behavioral development, (d)
structured leisure can play an edifying role at the short-term
level for a socially integrated transition to adulthood, and
(e) watching television is associated with lack of goals and
engagement and is a source of apathy. The results (a) shed
light on the role of daily life experience in shaping individual
development and (b) provide suggestions for educational and
psychosocial intervention in adolescence.
Mahoney, JL & Stattin, H. (2000). Leisure activities
and adolescent antisocial behavior: the role of structure
and social context. J Adolescence, 23(2), 113-127.
The goal of this study was to understand better how the structure
and social context of adolescent leisure activities relates
to antisocial behavior. A representative sample of 703 14-year-olds
and their parents were assessed concerning adolescent involvement
in community-based leisure activities, peer and adult social
relations, and antisocial behavior. Results showed that participation
in highly structured leisure activities was linked to low
levels of antisocial behavior, while participation in activities
with low structure (i.e. a youth recreation center) was associated
with high levels of antisocial
behavior. Overall the results were similar for boys and girls;
however, the combination of involvement in a low structured
activity and the absence of any highly structured participation
appeared especially problematic for boys' antisocial behavior.
Participants of low structured activities were also characterized
by deviant peer relations, poor parent-child relations, and
they received low support from their activity leader compared
to adolescents engaged in more structured community activities.
Findings are discussed in terms of their implication for prevention
research.
Lifrak, PD, McKay, JR, Rostain, A, Alterman, AI, & O'Brien
CP. (1997). Relationship of perceived competencies, perceived
social support, and gender to substance use in young adolescents.
Journal of the American Academy of Child & Adolescent
Psychiatry, 36(7), 933-40.
OBJECTIVE: This survey study explores the relationship between
area-specific perceived self-competence, perceived social
support, gender, and substance use in young adolescents. METHOD:
Questionnaires were administered to 140 male and 131 female
adolescents attending middle school to assess self-perception
of competencies, social support, and substance use. Correlations
were performed between the predictor variables and the substance
use measures. Hierarchical multiple regressions were also
used to identify potential interactions between gender, perceived
competencies, and perceived social support in the prediction
of specific substances. RESULTS: Higher perceived scholastic
competence was associated with less substance use in both
genders. In boys, more perceived support from teachers, and
to a lesser degree parents, was associated with less substance
use, particularly in those with low scholastic competence.
In girls, social support was unrelated to substance use except
for support from classmates, which was associated with more
cigarette and marijuana use. However, in girls with low scholastic
competence, more support from peers was consistently associated
with more substance use. CONCLUSIONS: The gender differences
in risk factors for early substance use identified in this
study deserve further investigation, in view of their potential
relevance for adolescent substance abuse prevention and early
intervention.
Begg, DJ, Langley, JD, Moffitt, T, & Marshall, SW. (1996).
Sport and delinquency: an examination of the deterrence hypothesis
in a longitudinal study. British Journal of Sports Medicine,
30(4), 335-341.
OBJECTIVE: To determine whether involvement in sporting activity
in mid-adolescence would deter delinquent behaviour in late
adolescence. METHODS: Members of a longitudinal cohort study
were interviewed at ages 15 and 18 years and, among other
topics, were asked questions relating to involvement in physical
activity and delinquent behaviour. Logistic regression models
were used to examine the relation between sports involvement
and delinquency at age 15 years and delinquency at age 18.
RESULTS: After controlling for delinquent behaviour and psychosocial
factors at age 15, females with moderate or high levels of
sporting activity, and males with high levels of sporting
activity, were significantly more likely to be delinquent
at age 18 years than those with
low levels of sporting activity. No significant association
was found between sporting activity and aggressive behaviour,
team sport participation and delinquency, and team sport participation
and aggressive behaviour. CONCLUSIONS: This study did not
support the deterrence hypothesis and showed that high involvement
in sporting activity, but not team sport, was associated with
a subsequent increase in delinquent behaviour.
Chung, H & Elias, M. (1996). Patterns of adolescent involvement
in problem behaviors: relationship to self-efficacy, social
competence, and life events. American Journal of Community
Psychology, 24(6), 771-784.
Using a sample of 556 adolescents from a suburban community,
patterns of various adolescent problem behaviors (e.g., delinquent
behavior, smoking, use of alcohol or drugs) and their links
to self-efficacy, social competence, and life events were
examined. Cluster analysis was conducted to identify four
subgroups of adolescents who showed distinct patterns of problem
behaviors. These clusters were compared on the measures of
self-efficacy, social competence, and life events. Overall
results suggest there are meaningful links between adolescents'
problem behavior patterns and self-efficacy, the amount and
quality of participation in various after school activities,
and life events. For example, a subgroup of adolescents who
showed uniformly low prevalence of all problem behaviors reported
more positive academic self-efficacy, more active participation
in sports and nonsports activities, more positive life events,
and fewer negative events than adolescents who were involved
in multiple problem behaviors. Implications for prevention
and future research on adolescent problem behaviors are discussed.
Edelbrock, C, Rende, R, Plomin, R, & Thompson, LA. (1995).
A twin study of competence and problem behavior in childhood
and early adolescence. Journal of Child Psychology & Psychiatry,
36(5), 775-785.
The Child Behavior Checklist (CBCL) was completed by parents
of 181 pairs of same-sex twins ages 7-15 (mean age = 11.0
years). Correlations between scores on the CBCL scales for
99 pairs of monozygotic twins and 82 pairs of dizygotic twins
indicated significant genetic influences that varied according
to the specific area of competence and problem behavior. Model-fitting
estimates derived from multiple regression analyses indicated
significant genetic influence on competence in school and
on all areas of problem behavior. In addition, significant
shared environmental influence was detected for amount and
quality of participation in activities, quality of social
relationships, performance in school, anxiety/depression,
and delinquent behaviour. Implications for future work on
the mechanisms underlying these effects are discussed.
MacMahon, JR. (1990). The psychological benefits of exercise
and the treatment of delinquent adolescents. Sports Medicine,
9(6), 344-351.
The conviction that athletic participation imparts desirable
educational, social and personal values has been the basis
for including recreational sports in the remedial programme
for juvenile delinquents. More recently, the psychological
benefits of aerobic exercise and increased fitness have been
investigated. Changes following intensive exercise include
reductions in anxiety, tension and depression, and increased
self-esteem. These effects have been variously hypothesised
as due to a sense of increased control or mastery, a meditative
effect or to alterations in neurotransmitter-levels. Delinquent
adolescents comprise a heterogeneous population characterised
by clusters of risk factors, handicapping conditions and psychopathology,
with a prevalence of depression and low self-esteem far exceeding
that of the population at large. Intervention which can benefit
these characteristics may be especially useful in preventive
or therapeutic programmes in this group. While less intensive
recreational play or physically challenging 'Outward Bound'
programmes can be effective in improving social attitudes
and self-esteem, intensive aerobic exercise may produce greater
improvements in self-esteem and depression. Future research
must identify the mechanisms by which exercise confers these
benefits, whether it enhances other areas, such as social
skills or academic performance, and which populations are
benefitted by such programmes.
To return to the story opening this Resource Note, Troop
344, in the Southern Oaks Girls School, sells cookies through
the mail to inmates in other prisons. The project provides
marketing and business experience to the girls, as well as
self-reliance in being able to finance troop activities.
Compiled by Mary Binderman, MLS, Director of Information
Resources, The American Occupational Therapy Foundation, Bethesda,
MD.
January 16, 2004
PLEASE NOTE: In checking the internet for additional information
on the GS troop at the Southern Oaks Girls School through
a couple of search engines, I saw several entries for some
pornographic sites. Check out the brief descriptions of the
sites.
Compiled by Mary Binderman, MSLS
American Occupational Therapy Foundation
Bethesda, MD.
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