Occupational Therapy and Arts Therapies
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/25
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Item Development, psychometrics and feasibility of the School Participation Questionnaire: A teacher measure of participation related constructs(Elsevier, 2020-09-19) Maciver, Donald; Tyagi, Vaibhav; Kramer, Jessica; Richmond, Janet; Todorova, Liliya; Romero-Ayuso, Dulce; Nakamura-Thomas, Hiromi; van Hartingsveldt, Margo; Johnston, Lorna; O'Hare, Anne; Forsyth, KirstyBackground We report development of the SPQ (School Participation Questionnaire) a teacher-completed measure of participation related constructs for schools. The SPQ was developed to support participation-related assessment, interventions, and research in the inclusive school context.Item Community‐based participation of children with and without disabilities(Wiley, 2019-11-25) Arakelyan, Stella; Maciver, Donald; Rush, Robert; O'Hare, Anne; Forsyth, KirstyAIM To describe and compare the socio-demographic characteristics and community-based participation of children with and without disabilities.Item Parent focused interventions for older children or adults with ASD and parent wellbeing outcomes: A systematic review with meta-analysis(Elsevier, 2019-09-11) Rutherford, Marion; Singh Roy, Anusua; Rush, Robert; McCartney, Deborah; O'Hare, Anne; Forsyth, KirstyBackground: There is a need for better evidence in relation to parent-focussed interventions for older children (over 7 years) and adults, which are recommended in clinical guidelines.Item Family factors associated with participation of children with disabilities: A systematic review(Wiley, 2019-01-06) Arakelyan, Stella; Maciver, Donald; Rush, Robert; O'Hare, Anne; Forsyth, KirstyAIM: The aim of this review was to synthesise empirical evidence of family factors associated with participation of children with disabilities aged 5-12 years to inform the development of family-centred participation-fostering interventions. METHOD: A systematic search was performed for articles published in English between 2001 and 2017 in MEDLINE, PsycINFO, CINAHL, Scopus and ASSIA following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines (registration no: CRD42017078202). Quality of evidence was appraised using the Research Triangle Institute Item Bank. Family factors associated with participation were identified and assessed using a multistage “semi-quantitative” approach. RESULTS: Thirty studies were included in the review. Four non-modifiable “status” factors consistently associated with participation were parental ethnicity, parental education, family type and family socio-economic status. Six modifiable “process” factors with consistent associations with participation were parental mental and physical health functioning, parental self-efficacy beliefs, parental support, parental time, family preferences and activity orientation. INTERPRETATION: Rehabilitation professionals should direct their focus towards modifiable family factors as primary targets for family-centred interventions. Strategies that can improve families’ access to information, counselling, and community support services are likely to support children’s participation by empowering families and optimizing their health and well-being.Item Implementation of a practice development model to reduce the wait for Autism Spectrum diagnosis in adults(SpringerNature, 2018-03-03) Rutherford, Marion; Forsyth, Kirsty; McKenzie, K.; McClure, Iain; Murray, A.; McCartney, Deborah; Irvine, Lindesay; O'Hare, AnneThis study examined waiting times for diagnostic assessment of Autism Spectrum Disorder in 11 adult services, prior to and following the implementation of a 12 month change program. Methods to support change are reported and a multi-level modelling approach determined the effect of the change program on overall wait times. Results were statistically significant (b = − 0.25, t(136) = − 2.88, p = 0.005). The average time individuals waited for diagnosis across all services reduced from 149.4 days prior to the change program and 119.5 days after it, with an average reduction of 29.9 days overall. This innovative intervention provides a promising framework for service improvement to reduce the wait for diagnostic assessment of ASD in adults across the range of spectrum presentations.Item Factors influencing waiting times for diagnosis of Autism Spectrum Disorder in children and adults(Elsevier, 2015-08-26) McKenzie, Karen; Forsyth, Kirsty; O'Hare, Anne; McClure, Iain; Rutherford, Marion; Murray, Aja; Irvine, LindaAims: To identify the main factors predicting delays in diagnosis for Autism Spectrum Disorder (ASD) at three stages in the diagnostic process: wait for first appointment; assessment duration, and total wait for diagnosis. Method: Data were gathered from 150 case notes (80 child and 70 adult cases) from 16 diagnosing services across Scotland. Results: Having more information pre-assessment was associated with a reduced duration of the diagnostic process for children. This relationship was partially mediated by a reduction in the number of contacts required for diagnosis. In adults, having more factors associated with ASD (increased risk) reduced the wait time from referral to first appointment, but increased the overall duration of the diagnostic process. The latter relationship was partially mediated by an increase in the number of contacts required for diagnosis. Conclusion: Within children's services, increasing the amount of relevant information available pre-assessment is likely to reduce total duration of the assessment process by reducing number of contacts required. Having a high risk of ASD as an adult appears to result in being seen more quickly following referral, but also to increase the number of contacts needed and assessment duration. As a result, it increases and total duration overall. 2015 Elsevier Ltd.Item A national study to investigate the clinical use of standardised instruments in autism spectrum disorder assessment of children and adults in Scotland(Elsevier, 2016-07-07) Rutherford, Marion; McKenzie, Karen; McClure, Iain; Forsyth, Kirsty; O'Hare, Anne; McCartney, Deborah; Finlayson, Ian R.; Scottish GovernmentBackground: There are few large scale studies about the nature and extent of the actual use of standardised assessments for Autism Spectrum Disorder diagnosis in clinical practice. This study compares and contrasts practice in diagnostic services for both adults and children. Method: We conducted an analysis of retrospective case notes from 150 cases (70 adult, 80 children) assessed for Autism Spectrum Disorder by 16 diagnostic services. Results: We found differences between adult and child services in staff training and use of standardised assessment during diagnosis. All child services had staff trained in and regularly using standardised assessments. Most adult services had staff trained in using instruments but only half used them regularly. Administration of standardised ASD assessments was ten times more likely in children than in adults (OR = 10.1; CI = 4.24, 24.0). Child services selected the ADOS as the standardised tool and Adult services selected the DISCO, with very little overlap. Decisions to administer standardised tools were not based on case complexity but rather the same process was applied to all referrals within a service. The three recommended components of assessment (clinical history, clinical observation and contextual information) were included for the majority of cases, although clinical observation was more frequently used with children than with adults. Conclusions: Based on the findings, we suggest a need for a wider range of appropriate assessments for use with adults, particularly those with an intellectual disability and for further research into the reasons behind the choices clinicians make during the assessment process. For child services in Scotland, there is a need for more training in use of current diagnostic interviews. Clinicians did not vary tools used based on complexity, suggesting that this is a notion still to be clearly defined and operationalised in clinical decision making about the use of standardised assessments.Item The relation between practice that is consistent with NICE guideline 142 recommendations and waiting times within Autism Spectrum Disorder diagnostic services(Elsevier, 2016-03-09) McKenzie, Karen; Rutherford, Marion; Forsyth, Kirsty; O'Hare, Anne; McClure, Iain; Murray, Aja L.; Irvine, LindaBackground This study explores the extent to which recommendations from the National Institute of Health and Care Excellence (NICE) 142 guidelines, section 9.2 (relating to identification, assessment and diagnosis) reflected existing routine clinical practice in Autism Spectrum Disorder (ASD) diagnosing services in Scotland; and whether there was a significant relation between routine practice which more closely reflected these recommendations and waiting times. Method A cross-sectional, retrospective case note analysis of recently diagnosed adults, in eight ASD services across Scotland. Results The study found that the existing practice of the participating services was consistent with 14 (maximum number) of the included recommendations in at least half of cases analysed (range 37-70 cases) and was not related to increased total waiting time for diagnosis. Conclusion The results, based only on the included recommendations, suggest that the section 9.2 recommendations can be integrated into clinical practice in Scotland with relative ease and that it is unlikely to have a negative impact on waiting times.Item Improving Efficiency and Quality of the Children's ASD Diagnostic Pathway: Lessons Learned from Practice(SpringerNature, 2017-11-30) Rutherford, Marion; Burns, Morag; Gray, Duncan; Bremner, Lynne; Clegg, Sarah; Russell, Lucy; Smith, Charlie; O'Hare, AnneThe 'autism diagnosis crisis' and long waiting times for assessment are as yet unresolved, leading to undue stress and limiting access to effective support. There is therefore a significant need for evidence to support practitioners in the development of efficient services, delivering acceptable waiting times and effectively meeting guideline standards. This study reports statistically significant reductions in waiting times for autism diagnostic assessment following a children's health service improvement programme. The average wait between referral and first appointment reduced from 14.2 to 10.4 weeks (t(21) = 4.3, p < 0.05) and between referral and diagnosis shared, reduced from 270 to 122.5 days, (t(20) = 5.5, p < 0.05). The proportion of girls identified increased from 5.6 to 2.7:1. Methods reported include: local improvement action planning; evidence based pathways; systematic clinical data gathering and a training plan. This is a highly significant finding for many health services wrestling with the challenges of demand and capacity for autism diagnosis and assessment.Item Why are they waiting? Exploring professional perspectives and developing solutions to delayed diagnosis of autism spectrum disorder in adults and children(Elsevier, 2016-08-05) Rutherford, Marion; McKenzie, K.; Forsyth, Kirsty; McCartney, Deborah; O'Hare, Anne; Iain, McClure; Linda, Irvine; Scottish GovernmentBackground: This paper reports on the development of child and adult Action Plans for Autism Spectrum Disorder to address the problem of delayed diagnosis and lengthy waiting times. Evidence used in the development of action plans was gathered from a sequential mixed methods study to further understand the reasons for the long waiting time and potential solutions. This is the first published investigation, from the perspective of diagnosing professional teams, of the reasons for delays, which also generates solutions. Methods: Ninety five clinicians from 8 child and 8 adult services attended 16 focus groups to explore clinicians' views on a) reducing the wait for diagnosis and b) providing a good quality diagnostic process with good adherence to clinical guidelines. During focus groups, quantitative data were fed back, used to frame discussions and facilitate solution focused action planning with each service. Sixteen local action plans were synthesised to create an ASD Action Plan for children and an ASD Action Plan for adults. Results: Key solutions are proposed to support the reduction of the wait for diagnostic assessment, through reducing non-attendance rates, reducing inappropriate referrals, developing efficient working and communication and improving the effectiveness of care pathways. These are presented in actions plans for use by clinical teams. Conclusion: The first step in addressing the clinical challenge of increased wait for diagnostic assessment of ASD is understanding the complex and multi-factorial reasons for delays. The action plans developed here through systematic enquiry and synthesis may provide clinical diagnostic teams with evidence based guidance on common challenges and solutions to guide future quality improvement programmes. Future research to evaluate whether using Action Plans leads to a reduction in waiting times would be of value.