This issue of the Scandinavian Journal of Occupational Therapy features papers on two age groups, children and youth on the one hand and older adults on the other. It reflects the increasing international focus of the journal, promoting research conducted in a global context. Thus the issue includes studies from Sweden, Canada, Brazil, Israel and the German-speaking region of Europe. Important conceptual and measurement concerns are raised in several articles, such as the challenges researchers face when translating and using assessments in new contexts and the importance of including measures of user satisfaction. The broadness in scope and research methods is evident and many of the studies included here use mixed methods to reflect the complexity of the phenomena being studied. The contributions aim for a thorough and sophisticated analysis of their respective data.
The first five articles concern children and youth. Previously, numerous studies in this area focused primarily on body function and often reflected the views of parents and professionals. An increasing body of research now gives prominence to the opinions of the children themselves. Increasingly it is also acknowledged how environmental factors – attitudinal, cultural, political and physical – may facilitate or constrain children´s participation and development. Nevertheless, research regarding environmental impacts on children´s engagement in activities has been remarkably sparse, as noted in the article by Bataye Engel-Yeger who compared participation patterns of Jewish and Muslim Israeli children in out-of-school activities. Engel-Yeger emphasizes that we must acknowledge and be sensitive to cultural standards and preferences. Thus environmental opportunities and barriers should be thoroughly considered when interpreting participation patterns, and intervention should focus toward the person’s specific needs, life, and daily context.
The translation and adaptation of assessments for cross-cultural use is widespread. Christina Schulze and colleagues elaborate on issues that arose during the harmonization process in a committee review during the translation of the Pediatric Evaluation Disability Inventory (PEDI) for use in Austria, Germany, and Switzerland. Achieving equivalence between the original and the translated assessment was not unproblematic and the authors discuss important challenges which may arise under such circumstances. Since concepts are influenced by culture, values, and preferences, it is important to consider how these issues may affect practice and research, particularly in international comparisons.
The cost-benefit of specific intervention forms should be thoroughly considered, particularly when the intervention may be somewhat intrusive to clients’ lives and routines. Marisa Mancini and colleagues investigated the perceptions of pre-school children with spastic hemiplegia CP and their caregivers on the Constraint-induced movement therapy (CIMT) protocol and its outcomes. Overall, the perceived benefits of the CIMT seemed to outweigh the difficulties faced by the participants who reported increased use of the affected UE in daily activities and decreased need for assistance following intervention. Nevertheless, several difficulties were reported by the children and their caregivers related to the use of the constraint and to the intensive nature of the training. In particular, the children´s feelings of stress and perceptions of being over-challenged were of concern. It is important to further study how our intervention may affect the lives and experiences of our clients, as can be demonstrated with longitudinal designs focusing on user perspectives.
Handwriting difficulties are common reasons for the referral of students to occupational therapy. In their descriptive mixed-method study, Ingrid Breivik and Helena Hemmingsson explored how adolescents with Asperger’s syndrome experience writing by hand and when using a computerized Assistive Technology Device (ATD) for writing in school. Several advantages when using the ATD were described in addition to participants’ higher scores for performance of and satisfaction with writing. The authors point out that social aspects must be considered when suggesting an ATD, since school staff and peers play an important role in how the device is received.
To date, the increasing number of students with psychosocial difficulties has not received much attention within our field. Vedrana Bolic and colleagues investigated computer use in educational activities by students with ADHD compared with students with physical impairments and students without impairments, as well as students’ perceptions and satisfaction with computer use. The limited access to and use of computers in the classrooms for students with ADHD compared to other students may result in decreased opportunities to develop the digital skills required in a rapidly changing society. The authors suggest that occupational therapists promote strategies for computer use in educational settings in order to develop conditions for equitable computer use among students.
The four remaining papers involve research about older adults from different perspectives. Sakakibara and colleagues examined the measurement properties of the French-Canadian Late Life Function and Disability Instrument (LLFDI-F), using a sample of community-living wheelchair-users, 50 years of age and older. The authors found the participation and activity components of the LLFDI-F to be reliable measures of participation and activity among this particular group. Nevertheless, they point out that caution must be taken when using the activity component among wheelchair-users who have little or no use of their lower extremities. As stressed above, studies on psychometric properties of instruments and cross-cultural issues provide an important base for applicability and decision-making.
Provencher and colleagues used the Assessment of Motor and Process Skills (AMPS) with frail older adults to determine differences between home and clinic cooking task performance and factors associated with a better performance in each environment. The findings may help occupational therapists identify clients for whom home assessments would be important prior to discharge in order to meet their needs at home.
The last two papers address the use of assistive technology (AT) among old adults. The importance of providing assistive devices for the fast growing older population has been emphasized while simultaneously acknowledging individual contexts and preferences, since people may have different needs for and interest in AT for support in their daily activities.
Eva Lindquvist and colleagues explored how persons in the early stages of Alzheimer’s disease became users of AT, and what the use of AT came to mean for these users and their significant others. On the way towards becoming a user of AT, junctures were identified at which significant decisions were made by the participants. The findings suggest that AT can positively affect activity performance of people with Alzheimer’s disease, specifically when the user can identify difficulties and needs and is also motivated and able to make changes to overcome them, given that appropriate support is available.
Marianne Kylberg and colleagues explored experiences of mobility device use among very old single-living men. They used quantitative and qualitative data in an embedded mixed methods design, the findings of which were presented in three narrative stories. These authors highlight that in order to understand individual perspectives on the use of mobility devices and to support active ageing, occupational therapists need to seek information on personal needs and expectations.
After 16 years as the Icelandic associate editor of the SJOT, I am about step down. It has been an interesting time, particularly the last few years when important developments have taken place within occupational therapy – also reflected in the journal´s focus and products. Not only has the quality of the papers grown extensively but the content has expanded and broadened. Increasingly, people’s subjective experiences of engagement in daily occupations are in focus as well as environmental and interactional aspects as conditions for participation in life. In the future I hope to see increased user involvement in our research as well as in the theoretical development of our field. Empirical studies continue to add considerably to our knowledge base. Additionally, I believe it is time for more critical review papers in the journal to reflect the on-going conceptual debate within occupational therapy, highlighting where we were, where we are heading–and why!