American Journal of Recreation TherapyAbstracts
American Journal of Recreation Therapy ®

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American Journal of Recreation Therapy
Winter 2014, Volume 13
, Number 1


Article
Guest editorial. Access to Inpatient Rehabilitation Therapy Act of 2014 (HR 4755)
Thomas K. Skalko, PhD, LRT/CTRS; Diane Skalko, MS, LRT/CTRS; Richard Williams, EdD, LTR/CTRS
Winter 2014; pages 7-7

Abstract
DOI: 10.5055/ajrt.2014.0060


Article
Benefits of a structured swim program for children diagnosed within the autism spectrum disorder
Jennifer Gaskell, MS, CTRS; Maridith A. Janssen, EdD, RTC/CTRS
Winter 2014; pages 9-16

Abstract
There is a persistent increase in the number of children who are diagnosed with a form of autism. Many therapeutic programs and interventions available have been known to be beneficial for individuals with disabilities. Therapy in the aquatic setting has been useful for the healing purposes of individuals with musculoskeletal or neuromuscular conditions for many years. Clinicians are now beginning to expand the use of aquatic therapy to a new population, which is children with autism, for healing purposes and as an early intervention. A single-subject design was utilized using the Aquatic Behavior Observation Scale (ABOS) to assess and measure behavioral changes for each of the three subjects while participating in an aquatic observation. The ABOS instrument measured the areas of 1) oriented to present; 2) social and communication skills; 3) control of emotions; and 4) responses to stimuli. Levels of responsiveness in each subcategory varied from participant to participant, and observation-by-observation. Data collected from this study suggest that the subjects diagnosed within the autism spectrum were able to demonstrate mild improvements during the application of the intervention. Key words: autism spectrum disorder, aquatic therapy, children, single-subject design, recreation therapy DOI: 10.5055/ajrt.2014.0061


Article
Application of the core areas of environmental health to recreation therapy practices
Dhitinut Ratnapradipa, PhD, MCHES; Alexandra Barger, BA; Heewon Yang, PhD, CTRS
Winter 2014; pages 17-24

Abstract
Because recreation therapists work in a broad range of settings to promote the well-being of individuals, it is important for them to have an understanding of the role of the environment on individuals’ health. Environmental health is a very broad field, encompassing all aspects of the environment and its impacts on social, emotional, and physical health. It can be divided into 11 core areas: air quality (indoor and outdoor), water quality, radiation, food safety, emergency preparedness, healthy housing, infectious diseases and vector control, toxicology, injury prevention, waste and sanitation, and weather and climate change. This informative article discusses six of the 11 environmental health core areas that recreation therapists and their clients might frequently encounter. This article also provides brief guidelines on preventive actions that can be taken by recreation therapists to reduce the potential risks identified. Key words: recreation therapy, environmental health risks, environmental health promotion DOI: 10.5055/ajrt.2014.0062


Article
Regulatory requirements for recreational therapy in nursing homes
Dawn De Vries, DHA, MPA, CTRS
Winter 2014; pages 25-30

Abstract
More recreational therapists than ever are practicing in long-term care and skilled nursing facilities (SNFs). Despite this increase in recreational therapists working in SNFs, there continues to be significant confusion about regulatory requirements, as well as practice and coverage issues. This article intends to provide information on regulatory, coverage, and practice issues related to recreational therapy in nursing homes. Key words: skilled nursing facility, recreational therapy, treatment, activities, regulations DOI: 10.5055/ajrt.2014.0063


Article
Case study. A description of a community-based treatment program designed to address physical health issues associated with severe and persistent mental illness
Ron Tankel, BS, CTRS
Winter 2014; pages 31-35

Abstract
This article describes the ongoing impact of a community-based mental health program to address physical health issues associated with severe and persistent mental illness (SPMI). This program developed over a period of 6 years in response to clients' increased participation and motivation. As participants' level of physical wellness improved, there was a demand for more advanced and varied levels of activity. This article demonstrates that people with SPMI responded positively to a structured and supportive group process for improving physical health and wellness. Key words: severe and persistent mental illness, physical wellness, outpatient mental health treatment DOI: 10.5055/ajrt.2014.0064


Article
Using the Dementia Practice Guidelines in a home setting: A case study
Marianna Stocco; Melissa L. Zahl, PhD, CTRS
Winter 2014; pages 36-44

Abstract
With approximately 70 percent of individuals with dementia living outside skilled care, the need for quality care is imperative. One such indicator for quality of care when working with individuals with dementia is the use of nonpharmacological interventions to treat disturbing behaviors. Disturbing behaviors within dementia are currently classified as passive behaviors or agitation. These behaviors are more about communicating unmet needs. Within recreational therapy, the Dementia Practice Guidelines for Recreational Therapy: Treatment of Neuropsychiatric Behaviors (DPG) provided protocols to assist the practitioner in providing interventions to treat passive behaviors and agitation. This case report used the DPG on a single female living in a family member’s home. Results indicate improvement in passive behaviors, she engaged not only in sessions but also in the home environment. Key words: dementia, Dementia Practice Guidelines, in-home recreational therapy DOI: 10.5055/ajrt.2014.0065


Article
Website review. Promoting Positive Behavioral Health: A Nonpharmacologic Toolkit for Senior Living Communities
Angie Sardina, MS, CTRS
Winter 2014; pages 45-47

Abstract
Promoting Positive Behavioral Health: A Nonpharmacologic Toolkit for Senior Living Communities Available at: http://www.nursinghometoolkit.com/ DOI: 10.5055/ajrt.2014.0066

American Journal of Recreation Therapy
Spring 2014, Volume 13
, Number 2


Article
Editorial. Leaving a legacy: The Linda Buettner Practice Prize
Nancy E. Richeson, PhD, CTRS; Ingelin Testad, PhD, RN; Mĺlfrid Utne
Spring 2014; pages 7-8

Abstract
DOI: 10.5055/ajrt.2014.0067


Article
Name games: The need for our titles and professional philosophies to coincide
David R. Austin, PhD
Spring 2014; pages 9-16

Abstract
The central thesis of the article is that the time has come to end the “name games” that have too long occupied our profession. The two philosophical positions that exist within our profession are presented and it is suggested that neither philosophy endorses the term “therapeutic recreation.” It is further suggested that each philosophical position should adopt a more appropriate title to represent its philosophy and that both should be recognized as unique professions. Key words: therapeutic recreation, recreational therapy, leisure, professional philosophy DOI: 10.5055/ajrt.2014.0068


Article
Effects of a swim program for children with autism spectrum disorder on skills, interest, and participation in swimming
Lisa Mische Lawson, PhD, CTRS; Lauren Foster, OTD, OTR/L; Margaret C. Harrington, MOT, OTR/L; Christy Ann Oxley, MOT, OTR/L
Spring 2014; pages 17-27

Abstract
The purpose of this study was to determine if a sensory-based, learn-to-swim program improved swim skills and increased physical activity of children with autism spectrum disorder (ASD). Forty-two children with ASD (39 male/three female) participated in eight, 30-minute Sensory Supported Swimming© lessons. Researchers tested swim skills at the first and last lessons and parents completed surveys about their children. Results indicated parents felt their children were more physically active both during swim lessons and outside lessons. Children had increased interest in swimming, and parents planned to begin or increase family swimming activities. Swim skills of all children improved, 74 percent improved at least one level. The learn-to-swim program with sensory supports was effective in improving swim skills and increasing physical activity of children with ASD. Key words: disability, physical activity, sensory preferences, recreational therapy, water safety DOI: 10.5055/ajrt.2014.0069


Article
A case study of two recreation programs serving soldiers on Warrior in Transition Units
Andrea Frisch, MS, CTRS; Patricia Ardovino, PhD, CTRS, CPRP
Spring 2014; pages 28-32

Abstract
This case study examined recreation programs on two US military installations serving soldiers who were injured during Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn, and were on Warrior in Transition Units. The recreation programs were the Adaptive Reconditioning program at Schofield Barracks in Hawaii and the Resiliency Through Art program on US Army Garrison in Vicenza, Italy. Data from demographic questionnaires, interviews, and documents were analyzed and revealed three themes: the civilian world, compliance, and masculinity. Key words: wounded warriors, military recreation, soldiers in transition DOI: 10.5055/ajrt.2014.0070


Article
Therapeutic Recreation Empowering Kids: Exploring best practices in transition
Allison Wilder, PhD, CTRS/L; Patricia J. Craig, PhD, CTRS/L; Matthew S. Frye, MS, CTRS/L
Spring 2014; pages 33-48

Abstract
The purpose of this article is to describe the collaborative components of a school and community-based recreation therapy (RT) program designed to support the educational, developmental, and transitional needs of students with disabilities in the K-12 public school system in New Hampshire. The program, Therapeutic Recreation Empowering Kids (TREK), is one of three core service areas of the University of New Hampshire's Northeast Passage, community-based adaptive sport and RT organization. This article focuses on TREK's transition services, which align with many of the recommended best practices in transition. TREK services are delivered in school and community settings by state licensed Certified Therapeutic Recreation Specialists to students with disabilities, in accordance with their individualized education plans. Beginning as early as elementary school, through the use of purposeful RT interventions, community integration, and meaningful inclusion, the TREK therapist facilitates valued transition outcomes. In furtherance of these outcomes, the TREK therapist functions as a critical broker in establishing and maintaining mutually beneficial cross-system collaborative partnerships. The purpose of these partnerships is explored, demonstrating how the TREK program facilitates recreation therapists' ability to successfully partner with K-12 public school personnel, community providers and the families of students, all of which potentiate synergistic partnerships toward accomplishing mutual transition goals. A case example is provided to illustrate ways in which the program impacts those involved and encourages continued collaboration. Key words: transition, recreation therapy, collaboration, best practices, school and community based DOI: 10.5055/ajrt.2014.0071

American Journal of Recreation Therapy
Summer 2014, Volume 13
, Number 3


Article
Editorial - Recreational therapy education
Nancy E. Richeson, PhD, CTRS
Summer 2014; pages 6-6

Abstract
DOI: 10.5055/ajrt.2014.0073


Article
Aquatic activity and emotional experience in adults with severe mental illness
Alysha A. Walter, MS, CTRS; Bryan P. McCormick, PhD, CTRS
Summer 2014; pages 7-12

Abstract
This study examined the relationship of aquatic activity to positive and negative emotion in individuals with a severe mental illness (SMI). Individuals with SMI have been found to experience decreased positive emotions and higher negative emotions as compared to controls. It was hypothesized that aquatic activity participation would be associated with greater positive emotion and lower negative emotion post participation. Eighteen participants with a severe mental illness were recruited from a community mental health center. The study employed a pre-post design with a structured aquatic activity designed for moderate physical exertion. Participants demonstrated statistically significant increase in positive emotion and decrease in negative emotion pre to post activity. The findings of this study provide support for the potential effect of aquatic activities in psychiatric rehabilitation. Key words: severe mental illness, recreational therapy, aquatic activity, positive and negative emotions DOI: 10.5055/ajrt.2014.0074


Article
Recreational therapy services with individuals recovering from spinal cord injury in inpatient rehabilitation: A cost-effectiveness analysis
Brent L. Hawkins, PhD, LRT/CTRS; Richard S. Williams, EdD, LRT/CTRS; Kindal A. Shores, PhD; David P. Loy, PhD, LRT/CTRS; Craig E. Landry, PhD; James L. Barrett, MS, LRT/CTRS
Summer 2014; pages 13-22

Abstract
The purpose of this study was to examine the cost of delivery of inpatient therapeutic services in relation to their influence on change in functional independence (as measured by the Functional Independence Measure [FIM]) of people with spinal cord injuries (SCIs). Participants included adults with SCI (N = 549) who received treatment during inpatient rehabilitation at the study site during a 7-year span. Results from ordinary least squares multiple regression analysis indicated that recreational therapy (RT) significantly predicted both total and motor FIM scores, while occupational therapy (OT) predicted motor FIM change. When costs of service provision and change in motor FIM scores were compared, RT required fewer units of treatment to predict change in motor FIM scores and was less costly per unit than OT. Although not causal, findings provide evidence of the benefits of RT and lend support to the continued use of RT in inpatient rehabilitation programs. Key words: spinal cord injury, Functional Independence Measure, recreational therapy, efficacy research, cost-effectiveness research DOI: 10.5055/ajrt.2014.0075


Article
ICF-based improvements in body structures and function, and activity and participation in chronic stroke following a yoga-based intervention
Marieke Van Puymbroeck, PhD, CTRS, FDRT; Jared Allsop, MS, CTRS; Kristine K. Miller, PhD, PT; Arlene A. Schmid, PhD, OTR
Summer 2014; pages 23-33

Abstract
Purpose: The purpose of this study was to understand the perceived outcomes following a yoga intervention for individuals with chronic stroke, framed within the context of the International Classification of Functioning, Disability, and Health. Method: Twenty-six individuals with chronic stroke participated in one of five focus groups immediately following completion of an 8-week yoga intervention. Results: Primary themes emerged related to body structure and function (with subthemes of improved emotional regulation, increased stability and range of motion, and unexpected improvements in body function), and improvements in activity and participation. The improvements in body function led to participants more fully participating in their lives. Conclusions: While rehabilitation is not typically offered in the chronic poststroke period, the participants in this yoga study perceived changes in body functions, activity, and participation that they associated with the yoga intervention. Larger studies need to quantify these changes to make specific policy recommendations. Key words: yoga, International Classification of Functioning, Disability, and Health, recreational therapy, chronic stroke, rehabilitation DOI: 10.5055/ajrt.2014.0076


Article
Arts-based reminiscence through visual art and narrative analysis: An intergenerational exploration
Emily J. Mills, BA; Lauren S. Seifert, PhD; Clare Murray Adams, MFA
Summer 2014; pages 34-46

Abstract
Objective: To celebrate memory through intergenerational reminiscence that led to the creation of Keepsake Boxes and to the cultivation of lively narratives about them. In Western cultures, adults more than 65 years of age are often subjected to negative and condescending attitudes. Yet they are one of our greatest resources—possessing life experience and wisdom. The current research study sought to oppose ageism and affirm the value of aging adults through reminiscence, expressive art, visual analysis, and narrative analysis. In an intergenerational collaboration, a multimethod and trans-disciplinary approach was used to investigate an arts-based reminiscence activity. With a focus on problem solving, the authors drew upon theory, research, and methods from art, psychology, gerontology, and literary analysis. Dialogic process, narrative analysis, qualitative research techniques, and visual methods were cultivated. All participants took an art class that focused on one of their chosen, significant memories. The researchers used both narrative and visual methods to respond to participants’ artwork and narrative explanations. This project provides an example of the use of multiple methodologies within a trans-disciplinary framework to help engage adults across generations in reminiscence and reflection. It reasserts a positive role of art activities in elder life and of intergenerational collaboration in arts-based research. Key words: art interventions, ABR, eldercare, memory, arts-based activities, elders, intergenerational DOI: 10.5055/ajrt.2014.0077


Article
Book review
Brent L. Hawkins, PhD, LRT/CTRS
Summer 2014; pages 47-48

Abstract
Leisure and Aging: Ulyssean Living in Later Life (5th edition), by Francis A. McGuire, Rosangela K. Boyd, Megan Janke, Begum Aybar-Damali. Sagamore Publishing, 2013, 311 pages. DOI: 10.5055/ajrt.2014.0078

American Journal of Recreation Therapy
Fall 2014, Volume 13
, Number 4


Article
Editorial - Life in an assisted living: A personal perspective
Nancy E. Richeson, PhD, CTRS
Fall 2014; pages 6-6

Abstract
DOI: 10.5055/ajrt.2014.0080


Article
Physical activity levels, mood, and combat-related acquired brain injury: A cross-sectional examination of Operation Iraqi Freedom and Operation Enduring Freedom service members
Julianne M. Hirst, MS, CTRS; Heather Porter, PhD, CTRS
Fall 2014; pages 7-16

Abstract
A significant number of military service members are returning from Operation Iraqi Freedom and Operation Enduring Freedom with acquired brain injuries, and these injuries have been significantly linked with depression symptomology. The primary purpose of this study was to examine the relationship between current levels of participation in leisure-time physical activity (LTPA) and self-reported depressive symptoms in adults with a combat-related acquired brain injury. The study also examined if differences exist in reported levels of LTPA and depressive symptoms between demographic groups and the perceived psychosocial benefits of participation in LTPA for adults with a combat-related acquired brain injury. A cross-sectional survey design using self-reported measures was used; 33 participants completed the survey. Results indicate that there was no significant correlation between current level of participation in LTPA and self-reported depressive symptoms. A diagnosis of post-traumatic stress disorder was the only demographic variable significantly correlated with higher self-reported depressive symptoms. Participants ranked "improved mood" as the highest perceived benefit of LTPA and "decreased anxiety" the lowest. Additionally, the perceived benefits of "improved mood," "decreased anger," and "increased self-esteem" were significantly correlated with lower levels of self-reported depression. Key words: brain injury, military, veterans, depression, leisure-time physical activity DOI: 10.5055/ajrt.2014.0081


Article
Developing a therapeutic recreation identity: A graduate researcher's personal narrative of grant writing and program design
Annalise Doyle, MS, CTRS
Fall 2014; pages 17-27

Abstract
This personal narrative describes the process of a graduate student finding her professional identity as a recreational therapist through the grant writing and research process. The student details her experience of designing and implementing a therapeutic Zumba® program for youth at an afterschool program. The narrative attempts to shed light on the learning processes that occur during the experience and offers advice to other students developing their professional perspective. Key words: deficits vs strengths-based approach, grant writing, personal narrative, program design and implementation, recreational therapy, Zumba® DOI: 10.5055/ajrt.2014.0082


Article
Emergency preparedness of families of children with developmental disabilities: What public health and safety emergency planners need to know
Susan Wolf-Fordham, JD; Carol Curtin, MSW; Melissa Maslin, MEd; Linda Bandini, PhD; Charles D. Hamad, PhD
Fall 2014; pages 28-40

Abstract
Objective: To assess the emergency preparedness knowledge, behaviors, and training needs of families of children with developmental disabilities (DD). Design: An online survey. Participants: A sample of 314 self-selecting US parents/guardians of children with DD, aged birth-21 years. Main outcome measures: 1) Preparedness self-assessment; 2) self-report regarding the extent to which families followed 11 specific preparedness action steps derived from publicly available preparedness guides; and 3) parent training and support needs. Results: Although most participants assessed themselves to be somewhat to moderately well prepared, even those who reported being “very well prepared” had taken fewer than half of 11 recommended action steps. Most participants expressed a need for preparedness support; virtually all the respondents felt that training was either important or very important. Conclusions: Children with disabilities are known to be particularly vulnerable to negative disaster impacts. Overall, parents in this study appeared under-prepared to meet family disaster needs, although they recognized its importance. The results suggest opportunities and methods for public health and safety planning, education and outreach to parents of children with DD who would benefit from targeted training such as information and skill building to develop effective family preparedness plans and connections to local emergency management and responders. Key words: children, developmental disabilities, emergencies, disasters, functional and access needs, emergency planning, emergency preparedness DOI: 10.5055/ajrt.2014.0083


Article
Case study. White water kayaking, positive affect, and perceived self-awareness: A case study of a veteran of the Vietnam era
Kristen Hartman, MS, CTRS; Heather Porter, PhD, CTRS
Fall 2014; pages 41-47

Abstract
Veterans from Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and the Vietnam era have sustained multiple injuries and disabilities as a result of their service, including Traumatic Brain Injury (TBI), Post-Traumatic Stress Disorder (PTSD), and depression. The use of outdoor recreation as a therapeutic modality for civilians with TBI has been found to correlate with greater self-awareness and positive affect, however, scarce literature exists regarding its use and outcomes for veterans. To explore this, a veteran from the Vietnam era reporting a history of depression who is involved with a white water kayaking group completed a series of surveys designed to measure its effect on perceived self-awareness and positive affect. The case study reported that involvement with the white water kayaking group improved his perceived self-awareness. The case study also reported the highest positive affect and lowest negative affect immediately after traveling down the river during a white water kayaking river trip. More research in this area is needed. Key words: outdoor, recreation, recreational therapy, self-awareness, positive affect DOI: 10.5055/ajrt.2014.0084