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Papers by Jackie Casey
Workshop COTEC-ENOTHE2016Wheelchair Provision Primary to Participation – an Occupational Justice ... more Workshop COTEC-ENOTHE2016Wheelchair Provision Primary to Participation – an Occupational Justice IssueWorkshop Leader: Jackie Casey, Ulster University, j.casey2@ulster.ac.uk Jackie Casey1, Dr Rosie Gowran2, and Dr Rachael McDonald3 1 School of Occupational Therapy, Institute of Nursing and Health Research, Ulster University, N.Ireland. j.casey2@ulster.ac.uk2 Department of Clinical Therapies, Faculty of Education and Health Science, University of Limerick Rosie.Gowran@ul.ie 3CDDHV, Department of Occupational Therapy, Centre for Development Disability Health Victoria, Notting Hill, Australia rachael.mcdonald@monash.eduSummary of the Workshop:Appropriate wheelchair provision for people with mobility impairments is primary to participation as a basic human right, yet there is a dearth of international consensus in assuring individual needs are met. A wheelchair goes beyond a piece of equipment which merely assists participation; it is embodied, addressing all domains of classified funct...
Background • Tilt-in-space (TIS) is used with a wide range of individuals of various ages and con... more Background • Tilt-in-space (TIS) is used with a wide range of individuals of various ages and conditions, and for a variety of activities and purposes1. • TIS is a costly design feature in wheelchairs and therefore clinicians should be confident in the reasons for its prescription2. • There continues to be a dearth of high quality evidence on the benefits of TIS upon the user’s function3. Most research continues to focus upon the therapist or the technical reasons for using TIS as opposed to the occupant’s personal reasons for using it.
Disability and Rehabilitation, 2021
Purpose: This cross-sectional study of 2450 children with cerebral palsy aimed to analyse the pre... more Purpose: This cross-sectional study of 2450 children with cerebral palsy aimed to analyse the prevalence and association of scoliosis, windswept hips, hip and knee contractures. Methods: Logistic regression was used to estimate associations with pain, postural asymmetries, and ability to change position for children at Gross Motor Function Classification System (GMFCS) levels I-V, aged 0-18 years. Results: Most children with a deformity or contracture had postural asymmetries in both sitting and supine positions; 10.5% had scoliosis, 8.7% windswept hips, 6.6% hip flexion and 19.2% knee contractures. Severe postural asymmetries increased the likelihood for scoliosis 9 times, for windswept hips 6 to 9 times, and for hip and knee flexion contractures 7 and 12 times respectively, adjusted for age, sex and GMFCS level. Hip flexion contractures and windswept hips increased the likelihood for pain by 1.5-1.6 times. Conclusion: The likelihood of having scoliosis, windswept hips and flexion contractures in the hips and knees increased if the child had postural asymmetries, and for increased age and higher GMFCS levels. Efforts should focus on preventing postural asymmetries from occurring or progressing, and on increasing the child's ability to change position. Reducing postural asymmetries may also reduce the likelihood of pain. ä IMPLICATIONS FOR REHABILITATION The risk of having scoliosis, windswept hip deformity and flexion contractures in the hips and knees increased if the child had postural asymmetries in sitting or lying. Efforts should focus on preventing or reducing postural asymmetries, and on increasing the child's ability to change position. Reducing postural asymmetries may also reduce the risk of pain.
British Journal of Occupational Therapy, 2016
Introduction Northern Ireland wheelchair guidelines state that wheelchair users who wish to drive... more Introduction Northern Ireland wheelchair guidelines state that wheelchair users who wish to drive their National Health Service provided powered wheelchairs outdoors must complete an electrically powered indoor/outdoor chair test. Within the same guidelines, children in Northern Ireland under the age of 10 years are not permitted to complete this assessment. Research was completed to evaluate how children under 10 years would perform in electrically powered indoor/outdoor chair training and testing under adult supervision. Method A case-study design was utilised with three children aged 7–9 years to evaluate if: (a) these children can complete electrically powered indoor/outdoor chair training/testing safely with adult supervision; (b) the length of time using an electric powered indoor chair correlates with performance on electrically powered indoor chair training/testing; (c) the current Northern Ireland guidelines on age restriction should be re-evaluated so that each child is as...
Journal of Occupational Therapy, Schools, & Early Intervention, 2017
This phenomenological study explored parents' perspectives of Therapeutic Listening (TL) implemen... more This phenomenological study explored parents' perspectives of Therapeutic Listening (TL) implemented as a home program to treat their children with sensory processing difficulties. Ten parents participated in semistructured interviews. Interviews were transcribed verbatim and analyzed thematically. Parents were concerned about their child's anxiety and distress, which they commonly perceived to be reduced with TL. Parents perceived that TL brought a sense of calm to their child, which they linked to improvements in their family life and child's participation in social and daily activities. Parent engagement (problem solving) enabled successful implementation of the program. Findings are discussed in relation to existing literature.
British Journal of Occupational Therapy, 2017
IntroductionChildren with developmental coordination disorder or sensory processing and integrati... more IntroductionChildren with developmental coordination disorder or sensory processing and integration difficulties face challenges to participation in daily living. To date there has been no exploration of the co-occurrence of developmental coordination disorders and sensory processing and integration difficulties.MethodRecords of children meeting Diagnostic and Statistical Manual – V criteria for developmental coordination disorder ( n = 93) age 5 to 12 years were examined. Data on motor skills (Movement Assessment Battery for Children – 2) and sensory processing and integration (Sensory Processing Measure) were interrogated.ResultsOf the total sample, 88% exhibited some or definite differences in sensory processing and integration. No apparent relationship was observed between motor coordination and sensory processing and integration. The full sample showed high rates of some difficulties in social participation, hearing, body awareness, balance and motion, and planning and ideation...
BMC pediatrics, Oct 10, 2016
There is a lack of understanding of the factors that influence independent mobility and participa... more There is a lack of understanding of the factors that influence independent mobility and participation in meaningful activities. The purpose of this study was to analyse physical factors influencing independent use of manual and power wheelchairs in a total population of children with cerebral palsy (CP). A cross-sectional study based on the most recent examination of all children with CP, born 2002-2013, reported into the Swedish cerebral palsy registry (CPUP), from January 2012 to June 2014. There were 2328 children (58 % boys, 42 % girls), aged 0-11 years, at all levels of gross motor function and hand function. Hazard ratios adjusted for age and sex were used to calculate the risk for not being able to self-propel based on Gross Motor Function Classification System (GMFCS) levels, upper extremity range of motion and hand function including Manual Ability Classification System (MACS), House functional classification system, Thumb-in-palm deformity, Zancolli (spasticity of wrist/fi...
This workshop will introduce power mobility use with infants, toddlers and preschool children and... more This workshop will introduce power mobility use with infants, toddlers and preschool children and highlight the benefits and challenges of using power mobility at an early age. The presenters have been involved in publishing three recent articles on use of power mobility with children including an opinion paper, a systematic review of outcomes and a clinical practice considerations paper. Information from these publications will be shared and the evidence supporting the early introduction of power mobility and its impact on children’s development and participation will be highlighted. This will be followed by clinical examples demonstrating the use of different kinds of power mobility devices within different clinical practice settings and different countries around the world. The presenters will highlight their own experiences as well as the experiences of others and will share relevant and practical resources to assist clinicians in educating families and other therapists in the benefits of introducing power mobility with young children.
Introduction- Older people with visual impairment (VI) are much more likely to fall than their fu... more Introduction- Older people with visual impairment (VI) are much more likely to fall than their fully-sighted counterparts (Dhital et al 2010). Age-related macular degeneration (ARMD) is the most common cause of VI in older adults and has been attributed to an increase in falls risk (Szabo et al 2010). This collaborative study, between the Royal National Institute for the Blind (RNIB) and Occupational Therapy (OT) researchers, aimed to establish the effectiveness of an existing service, Eye Care Liaison Officers (ECLOs), in reducing incidence of falls amongst older adults with ARMD.Methods - A randomised control trial study design was used. Ethical approval was obtained through the Office for Research Ethics NI and the Belfast HSC Trust. Consenting participants were 65 years or older, diagnosed with ARMD, cognitively able and attending the out-patient macular clinic. The intervention group (n= 33) received condition-specific falls advice and literature alongside usual ECLO intervention. The control group (n=29) received usual care only. Standardised assessments were used to establish falls risk, confidence and perceived health status. For six months following intervention, all participants completed falls calendars and received monthly telephone calls to establish falls incidence. Data was analysed descriptively. Further statistical analysis is ongoing to determine any differences between control and intervention groups. These results will be fully presented at conference.Impact - Falls are a significant health problem for older people, with 30% of people over 65 years old experiencing a fall (National Institute for Clinical Excellence 2013). In this study, falls were reported by over 60% of all participants, with 75% of these fallers citing two or more falls. A substantial number of reported falls occurred around the home, with falls on steps due to misjudging step distance frequently cited as the cause. Conversations with participants highlighted that they tended not to associate falling with their VI.Conclusions - Preliminary results evidence the high incidence of falls in individuals with ARMD. Full results will be presented showing the falls incidence for each group and the difference, if any, of the enhanced ECLO intervention. Discussion- The implications from this study for future service development are as follows:1. ECLOs are an existing resource within eye clinics working with a high risk falls group. With appropriate falls-specific training, the ECLO is well placed, to give timely, relevant information regarding falls prevention.2. The unexpected high incidence of falls stresses the importance of being visually aware and understanding the link between VI and falls. A need exists for closer working between established falls services and eye care services. This should include clear referral pathways.
Workshop COTEC-ENOTHE2016Wheelchair Provision Primary to Participation – an Occupational Justice ... more Workshop COTEC-ENOTHE2016Wheelchair Provision Primary to Participation – an Occupational Justice IssueWorkshop Leader: Jackie Casey, Ulster University, j.casey2@ulster.ac.uk Jackie Casey1, Dr Rosie Gowran2, and Dr Rachael McDonald3 1 School of Occupational Therapy, Institute of Nursing and Health Research, Ulster University, N.Ireland. j.casey2@ulster.ac.uk2 Department of Clinical Therapies, Faculty of Education and Health Science, University of Limerick Rosie.Gowran@ul.ie 3CDDHV, Department of Occupational Therapy, Centre for Development Disability Health Victoria, Notting Hill, Australia rachael.mcdonald@monash.eduSummary of the Workshop:Appropriate wheelchair provision for people with mobility impairments is primary to participation as a basic human right, yet there is a dearth of international consensus in assuring individual needs are met. A wheelchair goes beyond a piece of equipment which merely assists participation; it is embodied, addressing all domains of classified funct...
Background • Tilt-in-space (TIS) is used with a wide range of individuals of various ages and con... more Background • Tilt-in-space (TIS) is used with a wide range of individuals of various ages and conditions, and for a variety of activities and purposes1. • TIS is a costly design feature in wheelchairs and therefore clinicians should be confident in the reasons for its prescription2. • There continues to be a dearth of high quality evidence on the benefits of TIS upon the user’s function3. Most research continues to focus upon the therapist or the technical reasons for using TIS as opposed to the occupant’s personal reasons for using it.
Disability and Rehabilitation, 2021
Purpose: This cross-sectional study of 2450 children with cerebral palsy aimed to analyse the pre... more Purpose: This cross-sectional study of 2450 children with cerebral palsy aimed to analyse the prevalence and association of scoliosis, windswept hips, hip and knee contractures. Methods: Logistic regression was used to estimate associations with pain, postural asymmetries, and ability to change position for children at Gross Motor Function Classification System (GMFCS) levels I-V, aged 0-18 years. Results: Most children with a deformity or contracture had postural asymmetries in both sitting and supine positions; 10.5% had scoliosis, 8.7% windswept hips, 6.6% hip flexion and 19.2% knee contractures. Severe postural asymmetries increased the likelihood for scoliosis 9 times, for windswept hips 6 to 9 times, and for hip and knee flexion contractures 7 and 12 times respectively, adjusted for age, sex and GMFCS level. Hip flexion contractures and windswept hips increased the likelihood for pain by 1.5-1.6 times. Conclusion: The likelihood of having scoliosis, windswept hips and flexion contractures in the hips and knees increased if the child had postural asymmetries, and for increased age and higher GMFCS levels. Efforts should focus on preventing postural asymmetries from occurring or progressing, and on increasing the child's ability to change position. Reducing postural asymmetries may also reduce the likelihood of pain. ä IMPLICATIONS FOR REHABILITATION The risk of having scoliosis, windswept hip deformity and flexion contractures in the hips and knees increased if the child had postural asymmetries in sitting or lying. Efforts should focus on preventing or reducing postural asymmetries, and on increasing the child's ability to change position. Reducing postural asymmetries may also reduce the risk of pain.
British Journal of Occupational Therapy, 2016
Introduction Northern Ireland wheelchair guidelines state that wheelchair users who wish to drive... more Introduction Northern Ireland wheelchair guidelines state that wheelchair users who wish to drive their National Health Service provided powered wheelchairs outdoors must complete an electrically powered indoor/outdoor chair test. Within the same guidelines, children in Northern Ireland under the age of 10 years are not permitted to complete this assessment. Research was completed to evaluate how children under 10 years would perform in electrically powered indoor/outdoor chair training and testing under adult supervision. Method A case-study design was utilised with three children aged 7–9 years to evaluate if: (a) these children can complete electrically powered indoor/outdoor chair training/testing safely with adult supervision; (b) the length of time using an electric powered indoor chair correlates with performance on electrically powered indoor chair training/testing; (c) the current Northern Ireland guidelines on age restriction should be re-evaluated so that each child is as...
Journal of Occupational Therapy, Schools, & Early Intervention, 2017
This phenomenological study explored parents' perspectives of Therapeutic Listening (TL) implemen... more This phenomenological study explored parents' perspectives of Therapeutic Listening (TL) implemented as a home program to treat their children with sensory processing difficulties. Ten parents participated in semistructured interviews. Interviews were transcribed verbatim and analyzed thematically. Parents were concerned about their child's anxiety and distress, which they commonly perceived to be reduced with TL. Parents perceived that TL brought a sense of calm to their child, which they linked to improvements in their family life and child's participation in social and daily activities. Parent engagement (problem solving) enabled successful implementation of the program. Findings are discussed in relation to existing literature.
British Journal of Occupational Therapy, 2017
IntroductionChildren with developmental coordination disorder or sensory processing and integrati... more IntroductionChildren with developmental coordination disorder or sensory processing and integration difficulties face challenges to participation in daily living. To date there has been no exploration of the co-occurrence of developmental coordination disorders and sensory processing and integration difficulties.MethodRecords of children meeting Diagnostic and Statistical Manual – V criteria for developmental coordination disorder ( n = 93) age 5 to 12 years were examined. Data on motor skills (Movement Assessment Battery for Children – 2) and sensory processing and integration (Sensory Processing Measure) were interrogated.ResultsOf the total sample, 88% exhibited some or definite differences in sensory processing and integration. No apparent relationship was observed between motor coordination and sensory processing and integration. The full sample showed high rates of some difficulties in social participation, hearing, body awareness, balance and motion, and planning and ideation...
BMC pediatrics, Oct 10, 2016
There is a lack of understanding of the factors that influence independent mobility and participa... more There is a lack of understanding of the factors that influence independent mobility and participation in meaningful activities. The purpose of this study was to analyse physical factors influencing independent use of manual and power wheelchairs in a total population of children with cerebral palsy (CP). A cross-sectional study based on the most recent examination of all children with CP, born 2002-2013, reported into the Swedish cerebral palsy registry (CPUP), from January 2012 to June 2014. There were 2328 children (58 % boys, 42 % girls), aged 0-11 years, at all levels of gross motor function and hand function. Hazard ratios adjusted for age and sex were used to calculate the risk for not being able to self-propel based on Gross Motor Function Classification System (GMFCS) levels, upper extremity range of motion and hand function including Manual Ability Classification System (MACS), House functional classification system, Thumb-in-palm deformity, Zancolli (spasticity of wrist/fi...
This workshop will introduce power mobility use with infants, toddlers and preschool children and... more This workshop will introduce power mobility use with infants, toddlers and preschool children and highlight the benefits and challenges of using power mobility at an early age. The presenters have been involved in publishing three recent articles on use of power mobility with children including an opinion paper, a systematic review of outcomes and a clinical practice considerations paper. Information from these publications will be shared and the evidence supporting the early introduction of power mobility and its impact on children’s development and participation will be highlighted. This will be followed by clinical examples demonstrating the use of different kinds of power mobility devices within different clinical practice settings and different countries around the world. The presenters will highlight their own experiences as well as the experiences of others and will share relevant and practical resources to assist clinicians in educating families and other therapists in the benefits of introducing power mobility with young children.
Introduction- Older people with visual impairment (VI) are much more likely to fall than their fu... more Introduction- Older people with visual impairment (VI) are much more likely to fall than their fully-sighted counterparts (Dhital et al 2010). Age-related macular degeneration (ARMD) is the most common cause of VI in older adults and has been attributed to an increase in falls risk (Szabo et al 2010). This collaborative study, between the Royal National Institute for the Blind (RNIB) and Occupational Therapy (OT) researchers, aimed to establish the effectiveness of an existing service, Eye Care Liaison Officers (ECLOs), in reducing incidence of falls amongst older adults with ARMD.Methods - A randomised control trial study design was used. Ethical approval was obtained through the Office for Research Ethics NI and the Belfast HSC Trust. Consenting participants were 65 years or older, diagnosed with ARMD, cognitively able and attending the out-patient macular clinic. The intervention group (n= 33) received condition-specific falls advice and literature alongside usual ECLO intervention. The control group (n=29) received usual care only. Standardised assessments were used to establish falls risk, confidence and perceived health status. For six months following intervention, all participants completed falls calendars and received monthly telephone calls to establish falls incidence. Data was analysed descriptively. Further statistical analysis is ongoing to determine any differences between control and intervention groups. These results will be fully presented at conference.Impact - Falls are a significant health problem for older people, with 30% of people over 65 years old experiencing a fall (National Institute for Clinical Excellence 2013). In this study, falls were reported by over 60% of all participants, with 75% of these fallers citing two or more falls. A substantial number of reported falls occurred around the home, with falls on steps due to misjudging step distance frequently cited as the cause. Conversations with participants highlighted that they tended not to associate falling with their VI.Conclusions - Preliminary results evidence the high incidence of falls in individuals with ARMD. Full results will be presented showing the falls incidence for each group and the difference, if any, of the enhanced ECLO intervention. Discussion- The implications from this study for future service development are as follows:1. ECLOs are an existing resource within eye clinics working with a high risk falls group. With appropriate falls-specific training, the ECLO is well placed, to give timely, relevant information regarding falls prevention.2. The unexpected high incidence of falls stresses the importance of being visually aware and understanding the link between VI and falls. A need exists for closer working between established falls services and eye care services. This should include clear referral pathways.