American Journal of Recreation TherapyAbstracts
American Journal of Recreation Therapy ®

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American Journal of Recreation Therapy
Winter 2012, Volume 11
, Number 1


Article
From the publisher Remembering Linda Buettner Friend, extraordinary teacher, author, editor and leader
Richard A. DeVito, Jr.
Winter 2012; pages 6-6


Article
Editorial. Linda Lee Buettner, PhD, LRT, CTRS May 13, 1955 to April 26, 2012
Nancy E. Richeson, PhD, CTRS
Winter 2012; pages 7-9

Abstract
DOI: 10.5055/ajrt.2012.0010


Article
Editorial Mentoring our graduate students for a positive change
Linda L. Buettner, PhD, LRT, CTRS
Winter 2012; pages 10-10

Abstract
DOI: 10.5055/ajrt.2012.0011


Article
Evidence supporting exercise interventions for persons in early-stage Alzheimer’s disease
Linda Buettner, PhD, CTRS, LRT; N. E. Richeson; F. Yu,; S. C. Burgener, PhD; K. C. Buckwalter,; E. Beattie; A. L. Bossen; D. M. Fick; S. Fitzsimmons; A. Kolanowski,; K. Rose; J. K. Pringle Specht; I. Testad; S. McKenzie
Winter 2012; pages 11-18

Abstract
The purpose of this article is to grade research evidence supporting exercise-based interventions for persons with early-stage dementias and to report the recommendations of a consensus panel. The search produced 11 databased articles testing the effects of exercise interventions on a variety of outcomes. The body of evidence to support exercise interventions in the prevention and treatment of Alzheimer’s disease is growing and has potential as a treatment modality following translational studies in recreation therapy and other fields. Key words: Alzheimer's, early stage, exercise DOI: 10.5055/ajrt.2012.0012


Article
Therapeutic recreation interventions for need-driven dementia compromised behaviors in community-dwelling elders
Suzanne Fitzsimmons, MS, ARNP; Linda L. Buettner, CTRS, PhD
Winter 2012; pages 19-33

Abstract
This study describes a clinical trial of at-home recreational therapy for community dwelling older adults with dementia and disturbing behaviors. After two weeks of daily, individualized therapeutic recreation interventions (TRIs), results indicated a significant decrease in levels of both passivity and agitation. Biograph data collection was useful in identifying the physiological changes that occurred with each intervention technique. Specific information is included on the time of day each behavior occurred and the most effective interventions, as well as implications for service delivery. Key words: community-based care, dementia, recreational therapy, behavioral Interventions DOI: 10.5055/ajrt.2012.0013


Article
Peace of mind: A pilot community-based program for older adults with memory loss
Linda L. Buettner, PhD, CTRS, FGSA
Winter 2012; pages 34-40

Abstract
This pilot project was established to refine and test the Community of Care continuum for older adults with memory loss. The treatment group (n = 40) received the opportunity to select classes and was compared to the control group (n = 40), members of which simply maintained their normal lifestyles in the community after assessment. A total of 80 participants were tested at baseline, six months, and 12 months. Data were analyzed using repeated-measure analysis of variance to assess the effectiveness of the intervention over time. This allowed for analysis regarding intervention, time, and the interactive effects of time and intervention. The treatment group showed significant positive intervention effects (p < 0.05) for Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), instrumental activities of daily living (IADL), and quality of life. These preliminary findings show great promise for recreation therapists and others using community-based programs for older adults concerned about memory loss. Key words: community-based program, continuum of programs, memory, recreation therapy approaches DOI: 10.5055/ajrt.2012.0014


Article
Content validity, reliability, and treatment outcomes of the Buettner assessment of needs, diagnoses, and interests for recreational therapy in long-term care (BANDI-RT)
Linda L. Buettner, PhD, LRT, CTRS; Nancy Richeson, PhD, CTRS; Peg Connolly, PhD, LRT, CTRS
Winter 2012; pages 41-56

Abstract
This three-phase project evaluated the content validity and test-retest reliability of an assessment tool aligned with the specific content areas of the Minimum Data Set 3.0. In phase I, 54 experts examined the content and made several suggestions for improvement of the tool. In phase II, recreational therapy (RT) students and experienced practitioners pilot tested the “Leisure History and Interest” checklist and interview section of the assessment. A total of 10 categories were found pertinent to interviewing residents about their recreational interests. In the final phase, 15 certified therapeutic recreation specialists tested and retested 45 residents and provided time-limited treatment. The test-retest reliability coefficient for the overall assessment was found to be very high at 0.93. Positive outcomes of RT treatment were found across all domains for the majority of residents. Key words: Buettner assessment, recreation therapy, long-term care DOI: 10.5055/ajrt.2012.0015

American Journal of Recreation Therapy
Spring 2012, Volume 11
, Number 2


Article
Editorial Riding the waves of change
Nancy E. Richeson, PhD, CTRS
Spring 2012; pages 6-6

Abstract
DOI: 10.5055/ajrt.2012.0016


Article
Adults with dementia can appropriately engage in a strengthening exercise program
Sharon D. Rogers, PhD; Shannon E. Jarrott, PhD
Spring 2012; pages 7-15

Abstract
Background/rationale: A group-based exercise program has the potential to promote physical, psychological, and social health of participants. This study intended to document that an exercise intervention, designed for delivery and achievability in dementia care centers, could effectively engage participants with dementia. Methods: An exercise program for residents of two dementia care facilities was designed and implemented. The centers’ activity directors led the programs three times per week for 12 weeks. Using a modified protocol of the Menorah Park Engagement Scale and a quantitative assessment of participants’ accurate performance of exercises, participants’ (n = 17) overall engagement in the prescribed exercise routine were evaluated. Results: Results indicated that nearly all participants were constructively engaged and appropriately performed exercises through the entirety of each session. Conclusions: Individuals with dementia retain the capability to constructively and appropriately participate in a group-based strengthening exercise intervention. The intervention can be readily replicated at facilities serving adults with dementia. Key words: therapeutic activities, environmental press, quality of life, exercise and dementia DOI: 10.5055/ajrt.2012.0017


Article
Assessment in aquatics
Susan J. Grosse, MS
Spring 2012; pages 16-22

Abstract
For assessments performed on land, there are a wide variety of assessment protocols available. However, for assessments performed in aquatics, the selection of assessments is much more limited. This article will provide a brief overview of the available assessments appropriate for the aquatic setting. Assessments discussed will include formally published assessment protocols as well as representative examples of authentic assessments that can be designed by aquatic professionals to meet individual participant needs. Directions will be given for how to design rubrics and examples of how this type of assessment can produce information results that can contribute to progress documentation and goal setting. Key words: aquatics, assessment, therapeutic DOI: 10.5055/ajrt.2012.0018


Article
Effects of recreational therapy for youth in a secured substance abuse treatment program: An exploratory study
Timothy J. Stockhecke, MS; Heewon Yang, PhD, CTRS; Marjorie J. Malkin, EdD, CTRS
Spring 2012; pages 23-31

Abstract
The purpose of the study was to examine if a recreational therapy program decreased substance craving scores among youth at a juvenile detention center. Existing data from three male and three female youths’ craving scores, recorded before and after four recreation therapy interventions per week, were used to obtain the results of the two research questions over an 8-week period. This secured substance abuse treatment program utilized the Craving Identification Management (CIM) model. The craving scores identified by the youth prior to and following all of the recreational therapy activities were analyzed through descriptive statistics to determine the effectiveness of recreation therapy (RT). Results of the research project indicated that recreational therapy may be an effective intervention for lowering the craving scores of youth in a secured substance abuse treatment program. Key words: Craving Identification Management, recreational therapy, substance abuse treatment DOI: 10.5055/ajrt.2012.0019


Article
Professional characteristics of deficiency citations at F-248 in skilled nursing facilities in the United States
Timothy J. Legg, PhD, RN-BC, CNHA, GNP-BC, CTRS, FACHCA; Sharon A. Nazarchuk, PhD, MA, MHA, RN
Spring 2012; pages 32-38

Abstract
In an earlier study, the authors attempted to determine which professional activity group (the certified therapeutic recreation therapist vs certified activity director) received fewer survey deficiencies in the skilled nursing facility. The original study was unable to provide an answer to this question due to low-survey participant response rate. The study was further limited in terms of geographic scope, as it was confined to a single state. The current study replicates that earlier study with an increased sample size and nationwide geographic distribution of participants. Key words: activity professional, long-term care, nursing home, CMS, deficiencies, F-248 DOI: 10.5055/ajrt.2012.0020


Article
Care staff experiences of facilitating person-centered care and resident involvement through the use of individualized music in dementia care
Eva Skrivervik, MHS; Linda L. Buettner, PhD, LRT, CTRS; Ingelin Testad, PhD
Spring 2012; pages 39-46

Abstract
Introduction: To meet the needs of persons with dementia, adequate psychosocial interventions such as individualized music (IM) therapy is needed through resident involvement and person-centered care. Aim: The aim of this study was to explore the experience of care staff working with IM in nursing home residents with dementia. Method: A qualitative, explorative, and descriptive design was used. Semistructured interviews of seven care staff from four nursing homes were carried out. Result: The main findings included improved person-centered care and resident involvement, categorized in the three main themes: (1) IM in care staff-resident relation, (2) IM as a psychosocial intervention for agitation and restlessness, and (3) IM and job satisfaction in care staff. Conclusion: These findings suggest that IM can improve facilitation of person-centered care, thus providing an increased focus on resident involvement. Key words: dementia, individualized music, care staff experiences, resident involvement, individual needs, person-centered care DOI: 10.5055/ajrt.2012.0021

American Journal of Recreation Therapy
Summer 2012, Volume 11
, Number 3


Article
Editorial. Are we ready? A personal reflection
Nancy E. Richeson, PhD, CTRS
Summer 2012; pages 6-6

Abstract
DOI: 10.5055/ajrt.2012.0027


Article
The role of the aquatic professional in the collaboration process
Susan J. Grosse, MS
Summer 2012; pages 7-16

Abstract
The professional in therapeutic recreation has the potential to interact with a variety of other persons who are involved in the life of an individual with a disability. If that individual participates in an aquatic program, one of the persons with whom a therapeutic recreation staff member interacts is the professional in aquatics. To make that interaction as productive as possible, this article will explore several aspects of the interaction between professionals in therapeutic recreation and professionals in aquatics. There are two aspects to the role of the aquatic professional and that professional’s interaction with therapeutic recreation staff participating in the collaboration process when working with individuals with disabilities. The aquatic professionals’ first job is to obtain information that can possibly impact the aquatic participation of the individual with a disability. If the aquatic program is part of a broader therapeutic recreation program, the primary source for that information may be the therapeutic recreation staff. Second and more often overlooked, there is information that the aquatic professional can provide to other individuals, professionals in therapeutic recreation, and caregivers alike, who also interact with the person with a disability. Because of the unique nature of staffing and participation In aquatics, participation in the collaborative process may be difficult. This article explores the specific details of the interactions of the aquatic professional in the collaboration process. Barriers to collaboration are discussed and possible solutions are presented. Key words: aquatics, collaboration, communication DOI: 10.5055/ajrt.2012.0022


Article
Participation incentives among US adult, US youth, and Polish adult wheelchair basketball players
Robert J. Szyman, PhD; Bartosz Molik, PhD
Summer 2012; pages 17-25

Abstract
Wheelchair basketball may be the world’s oldest and most popular team sport for persons with a physical disability. At present, there are at least eight major international tournaments as well as zonal qualifying tournaments for the Paralympic Games and the Men’s and Women’s Gold Cup under the auspices of the International Wheelchair Basketball Federation. There were two purposes of this study. The first was to evaluate the participation motives of Polish wheelchair basketball players and the second was to compare the participation motives of Polish and American wheelchair basketball players. Data for this study were obtained from two sources: men and women who participated on Polish wheelchair basketball teams and data reported in studies by Brasile and Hedrick.1 In general, the results indicate that the incentives for participation in wheelchair basketball across these samples of players are more similar than dissimilar. The groups have similar mean scores and standard deviations for the task-oriented incentives. Future research may address whether American or European wheelchair basketball players have more similar participation motives than players from Africa, Asia, Australia, or South America or that the participants in noncompetitive sports or extreme sports have similar motives. Key words: wheelchair basketball, Paralympic Games, International Wheelchair Basketball Federation, disability sport, sports participation DOI: 10.5055/ajrt.2012.0023


Article
Working with hearing-impaired clients: Techniques to optimize communication
Kari R. Lane, PhD, RN, MOT; M. Kathleen Clark, ARNP, PhD, RN
Summer 2012; pages 26-30

Abstract
The prevalence of hearing impairment in older adult populations is more than 33 percent. It is essential that all therapists understand how to ensure their patients’ speech understanding when a hearing loss is present. This article reviews how to assess hearing loss and identify what types of resources are available for a patient to use while in therapy to ensure speech understanding. Key words: recreational therapy, hearing loss, assistive listening devices, assessment DOI: 10.5055/ajrt.2012.0024


Article
The influence of the Outward Bound Veterans Program on sense of coherence
Marieke Van Puymbroeck, PhD, CTRS; Alan W. Ewert, PhD; Yuan Luo, PhD; Jon Frankel, MS
Summer 2012; pages 31-38

Abstract
Veterans returning from Operations Enduring Freedom, Iraqi Freedom, and New Dawn may experience threats to their mental health and well-being as a result of their military service. The sense of coherence is a concept that is health promoting, and when high, can be protective against negative health consequences of stress. There are few studies that have determined interventions that may enhance the sense of coherence. Therefore, the purpose of this study was to determine the influence of the Outward Bound Veterans Program (OBVP) on the sense of coherence for US veterans. This study examined 246 veterans who attended the OBVP. The OBVP is a program that uses problem-solving tasks and challenges in a land or water-based outdoor setting that become increasingly difficult. The OBVP relies on teamwork and a series of physical and cognitive challenges. After attending the OBVP, there was a significant increase in the sense of coherence for veterans, and this change persisted 1 year following the completion of the program. To our knowledge, this is the first intervention that has demonstrated increased sense of coherence following an intervention and 1 year later. Recreational therapists should consider the sense of coherence as an important variable when working with veterans. Key words: adventure, health promotion, physical activity, recreational therapy, salutogenesis, sense of coherence, veterans DOI: 10.5055/ajrt.2012.0025


Article
Gross motor skills of children with autism
Litresh Williams, MS; Lei Guo, PhD, LRT/CTRS; Shirley Armstrong, PhD; Ardashia Peay, MS
Summer 2012; pages 39-46

Abstract
The purpose of this study was to measure the gross motor skills of children with autism, aged 3-5 years, and to compare their performances with the norms for the Test of Gross Motor Development-2 (TGMD-2). Five participants, three girls and two boys, comprised the sample. The results revealed that differences exist in the gross motor skills of children with autism and without autism. Consistent with trends from the general population, differences were found between boys (n = 2) and girls (n = 3) with the largest differences found in the Gross Motor Development Quotient (GMDQ). Overall fundamental skill delays were demonstrated by four of the participants, placing them in the below average TGMD-2 performance category. The findings from this study support the need for therapeutic recreation specialists to provide appropriate recreational programs to improve the gross motor skills of young children with autism. Key words: gross motor skill, autism, children DOI: 10.5055/ajrt.2012.0026

American Journal of Recreation Therapy
Fall 2012, Volume 11
, Number 4


Article
Editorial. The Alzheimer’s plans: Recreational therapist’s are part of the plan
Nancy E. Richeson, PhD, CTRS
Fall 2012; pages 6-6

Abstract
DOI: 10.5055/ajrt.2012.0028


Article
Community integration/reintegration: A recreational therapy intervention
Tim Passmore, EdD, CTRS/L
Fall 2012; pages 7-13

Abstract
This manuscript addresses the issues surrounding the definitions of community integration and community reintegration. The interventions of community integration and reintegration are outlined and suggested strategies for successful application of both interventions are provided. Key words: community reintegration, community integration, recreational therapy DOI: 10.5055/ajrt.2012.0029


Article
Impact of seated Tai Chi on range of motion as a therapeutic recreation intervention
Suzie W. L. Lane, EdD, CTRS; Sanghee Chun, PhD, CTRS
Fall 2012; pages 14-18

Abstract
Given the large population of older adults and the prevalence of increasing medical costs in the United States, there is a need for alternative means to assist or increase mobility and physical functioning. This study evaluated the efficacy of seated Tai Chi, specifically the number of sessions needed to facilitate an improvement in shoulder mobility. Twenty-eight individuals between the ages 65 and 83 began this program, and 22 completed all nine sessions. This evaluation indicated that shoulder flexion and abduction were significantly increased after six sessions and increased again after three additional sessions. Key words: Tai Chi, shoulder range of motion, recreation therapy, older adults DOI: 10.5055/ajrt.2012.0030


Article
Leisure fitness: A recreation therapy concept design
John R. Mikula, MA, CTRS, CSCS, HFS; Paul Smith, BS, CTRS, HFS
Fall 2012; pages 19-26

Abstract
This article examines the benefits of the recreation therapy intervention leisure fitness and its potential for positively affecting the health and well being of those with chronic health problems. Working within a wide variety of settings, qualified recreation therapists facilitate a leisure-fitness (LF) process to promote endurance, strength, mobility, and psycho-social well being among consumers. This article provides a practical concept design for the development and implementation of a recreation therapy LF program. Key words: recreation therapy, leisure fitness, chronic health problems, physical-fitness DOI: 10.5055/ajrt.2012.0031


Article
Development and evaluation of a family recreation intervention for families with an adolescent with an autism spectrum disorder
Jasmine Townsend, PhD, CTRS; Marieke Van Puymbroeck, PhD, CTRS
Fall 2012; pages 27-37

Abstract
Families with an adolescent with an autism spectrum disorder (ASD) face a variety of barriers in their attempts to participate in recreation activities in their communities, including the fact that few family recreation programs exist for these families. The purpose of this article is to describe the development and evaluation of a family recreation program for families with an adolescent with an ASD. Families participated in an overnight camp experience centered on outdoor recreation activities such as canoeing, fishing, archery, and a challenge course. Parents participated in two leisure education sessions aimed at developing their understanding of family recreation. Results from an importance-performance analysis indicated that parents evaluated the program positively—rating clean facilities, having a fun and relaxing experience, and having a peaceful outdoor experience as highly important aspects of the program that also performed well. Areas for concentration included staff training, specialized instruction, flexibility in programming, and variety in activities, among others. Implications for practice stem from the results of the evaluation and indicate that, as designed, this camp provided an enjoyable family recreation experience for these families, yet areas for improvement remain. Key words: family recreation program development, program evaluation, family recreation involvement, recreational therapy, core and balance framework, autism spectrum disorders DOI: 10.5055/ajrt.2012.0032


Article
The recreational therapy work force: One county’s view
Mary Ann Keogh Hoss, PhD, CTRS, FACHE, FDRT
Fall 2012; pages 38-46

Abstract
The Occupational Outlook Handbook for 2010-2011 edition states a growth rate of approximately 15 percent for recreational therapists throughout the country through 2018. This article explores the growth rate examining one county in one state. Washington State was chosen because data for four therapist types, occupational, physical, recreational, and speech were available to view and compare. Information regarding various aspects of employment for recreational therapists is examined. Estimated occupational employment for 2018 for recreational therapists in Washington State and Spokane County are included with a comparison for occupational employment of physical, occupational, and speech therapists in the same state and county. Both the state and county projections for the growth rate for recreational therapists are above 15 percent. Key words: healthcare workforce, workforce shortage, occupational growth rate, recreational workforce DOI: 10.5055/ajrt.2012.0033