Browsing by Author "Hepburn, Susan, committee member"
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Item Embargo Advancing clarity: exploring professional thinking skills in occupational therapy(Colorado State University. Libraries, 2023) Burke, Hannah K., author; Lane, Shelly J., advisor; Bundy, Anita C., committee member; Sample, Pat L., committee member; Hepburn, Susan, committee member; Spielmann, Virginia, committee memberBackground: Reasoning, reflection and evidence-based practice are three interrelated and essential skills for occupational therapy practice. As threshold concepts in the field, they contribute to development of a sense of professional identity. However, these skills are inconsistently defined and differentiated from one another, leading to difficulties in related communication, education, and research. In this dissertation I sought to advance the profession's understanding of consensus conceptualizations of these essential professional thinking skills and how they are taught. Methods: This dissertation comprises five articles reporting results of two broad studies. In the first study, a scoping review, I explored peer-reviewed occupational therapy literature that included a definition of a term related to reasoning and/or reflection. Along with my research team, I extracted data from each paper on definitions of relevant terms, relationships amongst relevant terms, references used to define relevant terms, and descriptive information about each article. In the second study, I used Delphi methodology to explore nine occupational therapy educators' consensus definitions of, conceptualizations of relationships between, and educational strategies for teaching clinical reasoning, professional reasoning, reflective practice, and evidence-based practice. I then conceptually integrated results of both studies to compare findings between the literature and educators. Findings: Both studies indicate that there is some agreement about main characteristics of each of these skills. They also both suggest that clinical/professional reasoning, reflective practice, and evidence-based practice are related to each other in complex, non-linear ways that warrant further exploration. Findings from the Delphi study additionally indicate that there are key educational strategies that may support development of multiple of these professional thinking skills. Conclusion: This dissertation adds to the body of literature clarifying conceptualizations of necessary professional thinking skills in occupational therapy. Continued explicit consideration of conceptualizations of reasoning, reflection, and evidence-based practice within occupational therapy literature and education will advance communication, measurement, and, ideally, uptake of these skills into practice to support an integrated sense of professional identity.Item Open Access Comparison between neuroscience- and DIR/Floortime™-informed approaches within music therapy: a descriptive case study(Colorado State University. Libraries, 2021) Shinn, Haley, author; LaGasse, A. Blythe, advisor; Wilhelm, Lindsey, committee member; Hepburn, Susan, committee memberThe purpose of this study was to examine the differences of client and therapist behaviors between a neuroscience-informed approach and a DIR/Floortime™-informed approach for one child involved in music therapy. There are no current studies comparing how the two approaches differently facilitate social skills. The author examined five videos from a neuroscience-informed approach and five videos from a DIR/Floortime™-informed approach and coded seven non-musical social skill behaviors, four musical social skill behaviors, and seven therapist behaviors. The author observed how a music therapist assisted in skill development, responded to and interacted with their client, and utilized the music between approaches and how those changes between approaches affected client social skill behaviors. In the neuroscience approach, there was a higher prevalence of six of the client behaviors and three of the therapist behaviors. In the DIR approach, there was a higher prevalence of five of the client behaviors and four of the therapist behaviors. Descriptive statistics and visual analysis indicated that multiple client behaviors were similar between approaches while the therapist behaviors had more differences between the two approaches. The author discusses why the differences may have been observed and clinical implications for working the client and using each approach within treatment. Further studies are needed to explore these different approaches.Item Open Access Emotioned discourses in K-12 bullying cause, prevention, and response: the affective performativity of bully and victim(Colorado State University. Libraries, 2020) Halboth, Olivia, author; Langstraat, Lisa, advisor; Cloud, Doug, committee member; Hepburn, Susan, committee memberBullying is a serious and exigent public health concern that affects millions of students in K-12 education every year. This thesis employs Critical Emotion Theory to reconceptualize bullying as a discursive issue of social justice, not merely behavioral. The first chapter outlines bullying as an affective issue. The second chapter analyzes ways that shame, disgust, and hate mechanize bullying. Chapter three traces discourses of empathy, pain and regret in public responses to four bullying incidents. Chapter four examines social-emotional learning (SEL) and federal programmatic prevention models, addressing empathy, love, and the absence of emotioned discourses. Finally, conclusions are outlined in chapter five. This inquiry ultimately found that the role emotions play in bullying's cause, prevention, and response are undertheorized on the macro- (emotions as a whole) and micro- (as individual emotions) level. Additionally, a prominent theme throughout each chapter that warrants critical consideration is an emergent pattern of entrenched affective divides between bullying's actors: how bully and victim become divergent, performed roles and how that affective performativity allocates attention and, subsequently, prevention and response resources.Item Open Access Equine-assisted activities and therapies for children with autism spectrum disorders(Colorado State University. Libraries, 2018) Peters, B. Caitlin, author; Wood, Wendy, advisor; Bundy, Anita, committee member; Hepburn, Susan, committee member; Gloeckner, Gene, committee memberObjective: The purpose of this dissertation is to systematically map, and then advance, the state of scientific and theoretical development of equine-assisted activities and therapies (EAATs) for children with autism spectrum disorders (ASD). Method: This dissertation is composed of two studies. The first study was a systematic mapping review of peer-reviewed literature relevant to EAATs for children with ASD. In conjunction with my research team, I gathered peer-reviewed literature pertaining to EAATs for children with ASD, and extracted information from each paper about scientific methods, participants, interventions, theory, and outcomes. Guided by the results of the first study, the second study was a mixed-method investigation of occupational therapy in an equine environment (OTee). The quantitative strand consisted of a multiple-baseline single-case experimental design, investigating the efficacy of OTee on occupational performance, behavior, and social functioning of eight children with ASD. The qualitative strand adopted a generic qualitative research approach; I conducted interviews with two occupational therapists, aimed at elucidating the theoretical rationale guiding OTee for children with ASD. Results: In the systematic mapping review, five types of equine-assisted activities were identified across 25 studies, with reported improvements in behavior, social interaction, and communication. Four types of equine-assisted therapies were identified across eight studies, with reported improvements in motor control and self-care. Different approaches to therapeutic riding and hippotherapy, the most studied interventions, were evident. Theoretical linkages among change mechanisms, intervention designs incorporating horses, and outcomes were rare. Explanatory formal theories and possible change mechanisms were more prevalent. Guided by findings, we propose that a) equine movement, manipulated by a therapist, challenges and improves postural control, and that an equine-assisted activity or therapy can, b) promote engagement, a platform for social development, and c) provide structured support for social interaction and positively reinforce communication. While promising, these three nascent theoretical frameworks merit further critique, testing and refinement. In study 2, children with ASD who received 10 weeks of OTee demonstrated improvements in individualized occupational performance goals, social communication, and social motivation. Some, but not all, participants also demonstrated a decrease in hyperactive and irritable behaviors. Children did not demonstrate significant changes in social cognition, social awareness, or restricted and repetitive behaviors. Occupational therapists portrayed OTee as a holistic intervention that provides children with opportunities to learn and practice a variety of skills within a motivating context where children are purposefully engaged in equine-related occupations. Derived from interview data, a concept map of therapists' clinical reasoning delineates hypothesized mechanisms of change, including the role of the horse, that lead to improvements in the following outcomes: a) cognitive skills, b) motor skills, c) attention and engagement during therapy, d) social interaction, e) communication, f) behavior, and g) safety. Qualitative results elucidated specific mechanisms and intervention components that may have led to improved occupational performance, behavior, and social functioning in the quantitative strand. Conclusion: Peer-reviewed literature pertaining to EAATs for children with ASD is in early stages of scientific and theoretical development. Promising outcomes support continued investigation focused on conceptual development and testing of theoretical frameworks, standardization, appropriateness, and efficacy. One type of EAAT, OTee, is a highly individualized intervention that requires clinical reasoning to incorporate the unique affordances of the equine environment into individualized occupational therapy; when tailored to the individual needs of children with ASD, OTee may improve occupational performance, hyperactivity, irritability, social communication, and social motivation.Item Open Access Examining the efficacy of the empowerment course for young adults with disabilities: training for postsecondary education and employment(Colorado State University. Libraries, 2020) Sjostrand, Rachel L., author; Davies, Patricia L., advisor; Graham, James, committee member; Hepburn, Susan, committee memberObjective. Current secondary transition programs have been less than satisfactory in student outcomes and have not adequately addressed skills necessary to transition into the adult world for students with intellectual disabilities (ID) and autism spectrum disorders (ASD). Individuals with ID and ASD have lower rates of attending postsecondary education, obtaining and maintaining a job, and living independently compared to their peers. The Empowerment Course is a one-year, postsecondary transition program designed to facilitate successful employment and/or educational outcomes for transition aged (18-26) young adults with disabilities. Two occupational therapists (OTs) were the instructors for the course, along with graduate OT students as mentors for participants enrolled in the Empowerment Course. Method. Students who completed the full academic year of the Empowerment Course over the past three years were included in analyses (n = 16). Students and instructors completed questionnaires at the beginning of the fall semester and at the end of the spring semester. A pretest-posttest design was used to assess student's perceived self-efficacy, competence in their job-seeking skills, quality of life, self-advocacy skills, and their ability to set and work towards goals. A series of t-tests were run to analyze the data. Student's attendance for lectures and labs of the Empowerment Course was also examined. Results. Students demonstrated significant improvements in goal attainment, job-seeking skills confidence, and in their self-advocacy skills. On average, student's attendance was greater than 95% for lectures and labs. Conclusions. Results suggest that participation in the Empowerment Course for students with ID and ASD may develop life skills beyond what is taught in high school transition programs. It was feasible to have OTs as instructors for this postsecondary transition program and to facilitate effective results.Item Open Access Foundations of executive function in Down syndrome(Colorado State University. Libraries, 2020) Schworer, Emily, author; Fidler, Deborah, advisor; Daunhauer, Lisa, committee member; Hepburn, Susan, committee member; Knight, Andrew, committee memberThough early features of infant cognition are predictive of executive function (EF) in typically developing (TD) children, there is little information regarding the developmental origins of EF in Down syndrome (DS). The current study compared the performance of infants with DS and TD controls on four foundational EF dimensions: attention shifting, sustained attention, early planning, and processing speed, and examined the relationship between EF foundations at Time 1 and subsequent EF performance at Time 2 (6 months later). Participants were 58 infants with DS, M chronological age = 11.32 months, SD = 3.50; M developmental age = 7.93 months, SD = 2.79, and 48 TD infants, M chronological age = 7.76, SD = 3.22; M developmental age = 7.75 months, SD = 3.52. Results showed that infants with DS shifted their attention more slowly, looked for longer durations at objects, and demonstrated a longer latency to contact objects when compared to TD infants at Time 1. The association between early planning and chronological age differed by group at Time 1 as well. Attention shifting at Time 1 significantly predicted EF performance at Time 2 in the DS group. This study provides evidence that an early atypical presentation of EF precursors is detectable during infancy in DS and is predictive of subsequent EF performance. These findings will facilitate the identification of areas of early cognitive risk in DS and inform future interventions.Item Open Access Occupational therapy in an equine environment: a transactional description of practice(Colorado State University. Libraries, 2018) Bentele, Christof, author; Wood, Wendy, advisor; Pergolotti, Mackenzi, committee member; Hepburn, Susan, committee memberObjective: The purpose of this thesis was to vividly illustrate and comprehensively depict occupational therapy in an equine-environment (OTee) –a novel intervention for children with autism spectrum disorder (ASD)– using a transactional perspective of inquiry. Method: This thesis is comprised of three chapters: an introduction and statement of the problem, a manuscript written for submission to the Journal of Occupational Science and a final chapter reflecting on the thesis process. The study at the center of the manuscript sought to create an account of OTee using methods informed by a transactional perspective. Guided by this theoretical framework, a hermeneutic narrative analysis was chosen to systematically move through almost 40 hours of video data and accompanying field notes. I conducted the narrative analysis in three steps, following a hermeneutic arc: naïve interpretation, structural analysis and comprehensive understanding. Results: Through the process of narrative analysis, I produced a holistic description of OTee that captured a large portion of the entire occupational experience. The results show that OTee takes place across six architectural spaces. There were six categories of actors that played important roles during the intervention. Seventeen distinct occupational opportunities were identified and were organized in a consistent pattern across sessions. Individual differences in the construction of the intervention were found across the children with ASD, typically relevant to the occupational goals or challenges identified by the therapists before the intervention began. A narrative description of OTee was then created, pulling all of the individual components together and relating parts to a great whole. Three segments were identified and used to structure the storytelling, beginning with pre-mounted time, to mounted time and finally to post-mounted time. The roles of the actors are explored during each segment, as well as how they related to the architectural spaces and the other actors over time. Conclusion: Hermeneutic narrative analysis is an effective method for producing a comprehensive description of OTee. As of yet, no study of any equine-assisted activity or therapy has produced a description of practice with as much detail while portraying the entire context as in this study. I argue that this work is consistent with the current literature attempting to adapt a transactional perspective to the study of occupation. Further, the methods I chose are novel and advance our understanding of occupation by illustrating occupational therapy in a way never before available.Item Open Access Parent perspectives of at-home cognitive intervention for preschoolers with Down syndrome(Colorado State University. Libraries, 2023) Walsh, Madison M., author; Fidler, Deborah, advisor; Hepburn, Susan, committee member; Yoder, Jamie, committee memberDown syndrome (DS) is associated with challenges related to cognitive skills, including executive function (EF). Intervention provided during early childhood can support the development of EF, however there are few cognitive interventions designed for young developmental ages. Parent-mediated interventions (PMIs) are emerging as an effective and scalable intervention approach for clinical populations. PMIs require ongoing parent engagement, and therefore, it is critical for a PMI to meet the needs of its intended users. This study used a community-based participatory research (CBPR) framework to (1) understand the daily routines of families of young children with DS and (2) describe parent perceptions of participating in at-home intervention. Participants were 34 caregivers of children 3 – 6 years old with DS living in Italy or the US. Participants responded to questions related to daily tasks they help their children complete and their perceptions of at-home cognitive intervention. Interviews were transcribed and independently coded (inter-rater agreement = .80). Four themes related to daily routines were identified: what parents help with, how parents help, why parents help, and how children respond. Three themes related to parent perceptions of interventions were identified: advantages of parent-led interventions, disadvantages of parent-led interventions, and desires for interventions. Findings suggest that PMIs targeting preschool-aged children with DS should require a short time commitment, blend intervention activities into daily routines, and include other family members. Findings from this study have important implications for the development of novel interventions aimed at supporting families in this population.Item Open Access Parent-child interactions and adaptive behavior in children with Down syndrome(Colorado State University. Libraries, 2018) Howshar, Mackenzie, author; Fidler, Deborah, advisor; Hepburn, Susan, committee member; Knight, Andrew, committee memberAdaptive behavior is essential for the development of independence in individuals with developmental disabilities. Individuals with higher levels of adaptive behavior tend to require less support from caregivers than those with lower levels of adaptive behavior. The current study examined the association between parenting behavior and child adaptive behavior within the context of a parent-child interaction in dyads with and without a child diagnosis of Down syndrome (DS). Findings showed parents of children with DS engaged in significantly more directives than parents of TD children. Additionally, there was a significant negative association between parent directives at Time 1 and child adaptive behavior at Time 2 overall, whereas there was a significant positive association between parent teaching at Time 1 and child adaptive behavior at Time 2 in the DS group. Findings from this study may be useful for informing future parenting interventions.Item Open Access Parental perspectives of occupational therapy in an equine environment for children with autism spectrum disorder: a theoretical qualitative analysis(Colorado State University. Libraries, 2019) Kalmbach, Dorothy, author; Wood, Wendy, advisor; Sample, Pat L., committee member; Hepburn, Susan, committee memberObjective: Children with autism spectrum disorder (ASD) experience difficulties in occupational performance, which can limit the abilities of both the child and family to participate in valued activities and roles. Occupational therapists have provided equine-assisted interventions (EAIs) to children with ASD to address these difficulties with promising results. The purpose of this study was to assess parental perspectives on the appropriateness of a novel EAI, occupational therapy in an equine environment (OTee). Appropriateness includes the psychosocial aspects of the consumer's experience and whether the consumer believes the intervention beneficially addressed their healthcare needs (Evans, 2003). Method: This thesis is comprised of three chapters. The first chapter is an introduction to the study that provides an extensive review of the literature, develops a conceptual framework of appropriateness, and describes research methods. The second chapter is a manuscript written for submission to the journal Occupational Therapy in Healthcare in which I present a condensed version of the complete thesis. I employed qualitative theoretical analysis to analyze parental perspectives on the appropriateness of OTee. Five parents completed semi-structured interviews in which they discussed their child's experience of the service and the influence of their child's participation on their child's and family's daily lives. The third chapter is a reflection on the thesis process in which I additionally consider the contribution of this thesis to the field of occupational therapy and the influence completing this thesis had on me as a scholar and person. Results: Regarding the results of the second chapter, children experienced the service positively due to qualities of the horse and the occupational therapists' ability to integrate tenants of occupational therapy. Prominent areas of carryover to everyday life included an increase in calmness, an increase in social skills, facilitating the parent role, and promoting positive family experiences, among others. The frequency and length of the service, as well as maintenance of effects, concerned the parents. Conclusion: Findings contribute information on the development of a novel approach to occupational therapy intervention that incorporates horses. Next research steps include examining areas of concern and comparing the appropriateness of the service to the appropriateness of occupational therapy in a traditional service context.Item Embargo Personal and contextual influences on Saudi parents' willingness and tolerance for children's risky play(Colorado State University. Libraries, 2024) Alarawi, Rana M., author; Bundy, Anita, advisor; Lane, Shelly, committee member; Hepburn, Susan, committee member; Hickey, Matthew, committee memberObjective: The purpose of this dissertation was to examine personal and environmental factors that influence Saudi parents' willingness to promote, and tolerance of, risk taking in children's play. In this dissertation, I tested a conceptual model that explains the transactions among multiple constructs: factors affecting parental risk willingness, coping efficacy, perceptions of child, and risk tolerance. I also introduced a new tool, the Factors Affecting Tolerance for Risk in Play Scale (FAC-TRiPS) to assess personal, social and cultural factors affecting parental tolerance for risk in play. Lastly, I examined variations between Saudi mothers and fathers in relation to their willingness to allow and tolerate risk in play. Importance: Risky play is defined as "thrilling and exciting forms of physical play that involve uncertainty and a risk of physical injury" (Sandseter, 2010, p.22). Benefits of children's participation in "risky play" are broadly recognized (Barker et al., 2014; Brussoni, Olsen, et al., 2012; Gray et al., 2015; Sandseter, 2007; Sandseter & Kennair, 2011). However, most related research originates in Western countries; none focuses on outdoor play in Eastern countries, including Saudi Arabia. Further, while the literature identifies varying perspectives on risky play among parents, there is limited understanding of parental, social, and cultural contexts shaping and influencing Saudi parents' tolerance of risk in play. Participants: The sample included 90 Saudi parents with children ages 7 to 10 years who were able to read and speak English. Parents of this age group are expected to accept risky play. Method: This cross-sectional, quantitative dissertation encompassed three studies. In the first study, I used moderation analysis to test a conceptual model examining the relationship among factors contributing to parents' willingness to allow risky play and their risk tolerance. I also investigated the moderating effects of parental coping self-efficacy and parents' perceptions of their children's coping ability on the relationships among factors contributing to parents' willingness to allow risky play and their risk tolerance. In the second study, I utilized Rasch analysis to explore evidence for construct validity and internal reliability of data gathered with the FAC-TRiPS. In the third study, I examined gender variations in Saudi parents' willingness to promote, and tolerance for, risk taking in children's play by answering two research questions: (1) Do Saudi mothers and fathers differ systematically on FAC-TRiPS items? and (2) How does the inclusion of gender influence the relationship among factors affecting parental perceptions of tolerance for children's risky play? Results: Findings of the first study showed that play factors contributing to parents' willingness to allow risk (e.g., fear of injury and fear of negative judgment) were negatively correlated with risk tolerance. Additionally, parents' coping self-efficacy significantly moderated the relationships among play factors contributing to parents' willingness to allow risk and their tolerance for encouraging children to engage in risk taking. That is, parents with high self-efficacy were more inclined to perceive less stress in such situations and were more apt to allow their children to engage in risky play. However, parental perceptions of their children's coping ability did not have a moderating effect on the interaction between factors contributing to parents' willingness to allow risky play, and their tolerance for, risky play. In the second study, preliminary analysis suggested that the FAC-TRiPS yielded valid and reliable data measuring factors influencing parents' risk tolerance. Because the instrument in its early stages of development, further research with a larger sample is needed to refine items and enhance the instrument's functionality and precision. In the third study, although parent gender did not significantly predict risk tolerance, Saudi mothers and fathers exhibited systematic differences on three FAC-TRiPS items. Mothers reported more fears surrounding potential negative judgment and repercussions from an authority while fathers were more influenced of Media reports. Within the context of other factors, gender appeared to play a complex and indirect role in determining parents' risk tolerance. Conclusion: This research serves as a useful foundation for understanding the impact of context on parents' willingness to promote children's participation in risky play. Key themes across the three studies indicate that risk tolerance is likely influenced by a multitude of factors including personal, psychological, and cultural factors. This research represents the first to study a sample from Saudi Arabia, contributing an Eastern perspective to the existing body of research on risky play. Nevertheless, its findings invite further exploration into gender, societal, and cultural influences on how parents perceive and approach their children's participation in risky play environments. Additionally, further validation of the FAC-TRiPS and the Risk Tolerance model is needed. Findings of this research lend further support to the critical role of environmental facilitators and barriers on functioning as well as raise a need for creating a culture in which the duty of care is balanced with the dignity of risk in order to enable children of all abilities to participate in playful and age-appropriate risk-taking opportunities.Item Embargo Rasch analysis of the evaluation in Ayres sensory integration (EASI)(Colorado State University. Libraries, 2022) Grady, Patricia, author; Bundy, Anita, advisor; Lane, Shelly, committee member; Hepburn, Susan, committee member; Sharp, Julia, committee memberSensory Integration (SI) refers to the neurological process by which a person takes in sensory information, interprets this information, and uses it to inform movement and goal-directed action (Ayres, 1989). For children with a variety of diagnoses, as well as some children who are otherwise typically developing, SI may be impaired or delayed (Bundy & Lane, 2020a). Occupational therapists and other clinicians who treat children with sensory integration (SI) dysfunction face a dearth of appropriate instruments to evaluate SI function. The Evaluation in Ayres Sensory Integration (EASI; Mailloux et al., 2018) is a novel assessment tool that may allow therapists to evaluate SI in a way that is aligned with SI theory. EASI consists of 21 individual tests that measure constructs of SI. The EASI authors have collected normative data for children across the globe. However, this data must be assessed for validity and reliability before it can be used as the basis for normative scoring on the EASI. In this dissertation, I used Rasch analysis to evaluate data with 19 of the 21 tests. The Rasch model is a latent-trait psychometric model that (1) transforms ordinal-level data to interval-level data and (2) allows users to assess evidence for construct validity (unidimensionality and invariance) and internal reliability (Bond, Yan & Heene, 2020). For each of the 19 tests, I evaluated item fit statistics, rating scale fit statistics, person fit statistics, principal components analysis (PCA) of standardized residuals, differential item functioning (DIF) based on sex, person reliability index and strata. The dataset for this study comprised 2653 children from 51 countries; all data were collected by trained EASI examiners. Overall, results revealed promising evidence for construct validity and internal reliability of data collected using 16 of the19 EASI tests evaluated in this dissertation. However, across many tests, I observed lower-than-desired person fit statistics and reliability. Notably, these results were not far from the desired values. I hypothesized that these findings are the result of the overall high ability level of the normative population. EASI is designed to evaluate children with lower-than-average or poor SI function; therefore, these findings are not unexpected nor are they particularly concerning. Three EASI tests (Proprioception: Force, Proprioception: Joint Position, and Balance) required substantial revision as a result of these analyses; each had threats to construct validity that exceeded my expectations. In this dissertation, I provided potential solutions for these three tests; future studies will evaluate the extent to which these solutions resolve concerns. In conclusion, the normative data form an acceptable basis for creating norm-based scores for clinical interpretation. However, larger studies must be conducted with clinical populations to ensure that the tests can differentiate between children with and without SI dysfunction. Further, future studies should investigate the role of culture, language and other factors on the validity of EASI test scores.Item Open Access The effect of an intensive, outdoor camp on playfulness and adaptability in children(Colorado State University. Libraries, 2021) Deem, Giulia J., author; Lane, Shelly J., advisor; Bundy, Anita C., committee member; Hepburn, Susan, committee memberPlay is the primary occupation of childhood and promotes healthy cognitive, social-emotional, and physical development. Playfulness is the attitude that children bring to play situations. Playfulness can impact a child's play as well as how likely others are to engage with them in play. Adaptability is the ability to functionally adjust to changes in the environment. Both adaptability and playfulness can impact play participation, and both may be improved through play. Children with sensory modulation difficulties and challenging behavior, including children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), may have a harder time engaging in play than their typical peers. These children can show decreased playfulness and adaptability, both of which may be barriers to play. This is unfortunate because children with these challenges may especially benefit from engaging in play and outdoor engagement. The aim of this study was to look at the effect of an outdoor, intensive, five-day camp with occupational therapy supports on the playfulness of children with sensory modulation difficulties and challenging behavior. This study also looked at the relationship between playfulness and adaptability before and after camp. Camp Jabiru is designed and run by occupational therapists, who provide embedded occupational therapy supports to promote participation in a typical summer camp experience. This study used a one group, pre- test and post- test, quasi-experimental design using retrospective data collected before and after camp held April 2019. Participants were 37 overnight campers at Camp Jabiru, 11 females and 26 males, ages 8-12 years. All campers were identified to have sensory modulation difficulties and/or challenging behavior and most had a primary diagnosis of ASD and secondary diagnosis of ADHD. We assessed playfulness using the Test of Playfulness (ToP) on the first and fourth day of camp and assessed adaptability two-three months before and two-three months after camp using the Behavior Assessment System for Children, Second Edition (BASC-2). We found a significant increase in playfulness and adaptability following participation in Camp Jabiru, but a negative relationship between these constructs. Results indicate that children with sensory modulation difficulties and challenging behavior, engaging in this camp model with embedded occupational therapy supports, experienced increased playfulness and to some extent increased adaptability. Additional research is needed to further understand the benefits of an intensive, outdoor camp model with embedded occupational therapy supports as well as the relationship between playfulness and adaptability.Item Open Access The role of socioeconomic status and temperament in preschoolers' emotional competence: direct and interactive effects(Colorado State University. Libraries, 2022) Si, Xinfang, author; Barrett, Karen, advisor; Hepburn, Susan, committee member; Yuma, Paula, committee memberThis study investigated the moderation effects of child temperamental characteristics on the relationship between parental socioeconomic status and child emotional competencies. Children's emotional competencies were conceptualized as emotional understanding, which was measured through puppet assessments (Denham, 1986; Cole et al., 2009). A total of 167 preschoolers (M = 47.24 months; SD = 8.38) and their parents joined the study. Hierarchical multiple regression was used to examine the direct and indirect effects of parental socioeconomic status and child temperament, as well as two key individual factors (age and gender), on children's emotional understanding. The results indicated that the interaction between SES and negative affectivity significantly predicted children's fear situation understanding. Age was a significant predictor of all emotional understandings except anger and shame situation understanding. But gender significantly predicted anger regulation understanding. Implications of these results for future studies on child emotional understanding were discussed.Item Open Access "To boldly go where everyone else has gone before": the road to ADAPT(Colorado State University. Libraries, 2022) Petrie, Gentrice, author; Orsi, Jared, advisor; Carr Childers, Leisl, committee member; Hepburn, Susan, committee memberDuring the 1970s, residents of the newly established Atlantis independent living center used civil disobedience tactics to sway the city to provide accessible transportation services. Their strategies worked, and by 1983, Denver had one of the most accessible public transportation systems in the country. After their success, members of Atlantis decided to expand their cause by founding the activist organization American Disabled for Accessible Public Transportation, now American Disabled for Attendant Programs Today (ADAPT), which not only gave disability activists a national platform to draw attention to the issue of inaccessible transportation, but also gave them the opportunity to integrate disabled individuals into a world that denied them access to mainstream services. This story not only illuminates the success that direct action protest had on influencing public policy on a local scale but highlights how this activism empowered activists and members of the disability community by occupying public spaces, therefore challenging the idea that disabled people are unable to advocate on their own behalf and live independently.Item Open Access What children do on the playground: a Rasch analysis approach to measurement on the playground(Colorado State University. Libraries, 2018) Grady, Patricia, author; Bundy, Anita, advisor; Eakman, Aaron, committee member; Hepburn, Susan, committee memberGiven the many benefits of play and children's right to play, as established by the United Nation's Convention on the Rights of the Child (1990), researchers interested in play have designed a multitude of interventions that aim to support children's engagement in this primary occupation. The school playground is a natural context for these play interventions. Because of the play deficits often associated with autism spectrum disorder (ASD) and intellectual disability (ID), many interventions target these populations. However, review of current literature suggests that researchers are limited by the lack of measurement tools to quantitatively analyze what children do together during a playground session. In this study, I present a Rasch analysis-based measure of what children do on the playground. In this measure, the playground session itself is the unit of analysis – this allows play promoters to compare playground sessions before and after an intervention, under different weather conditions, or with different groups of children. This measure was developed based on observation data collected in the context of a larger study aimed to promote playground play for children with ASD and ID. Through Rasch analysis, I demonstrate preliminary validity and reliability of data collected using this observation-based instrument. The findings of this study suggest that observation-based playground measurement tools can effectively quantify play and non-play sophistication.