BURA Collection:

Cognitive Rehabilitation Improves Functional Vision Skills in Children with Cerebral Visual Impairment

2026-01-26T03:01:24Z

Title: Cognitive Rehabilitation Improves Functional Vision Skills in Children with Cerebral Visual Impairment Authors: Celik Turan, Z; Aki, E Abstract: Background/Objectives: Cerebral visual impairment (CVI) is the leading cause of visual disability in children, resulting from damage to the brain’s visual processing pathways. Although ocular structures may be intact, functional vision, the use of vision in daily tasks, is often significantly affected. Cognitive Rehabilitation Therapy (CRT) has shown potential to enhance cognitive functions through neuroplasticity, yet its influence on functional vision remains underexplored. This exploratory pilot study aimed to examine whether CRT could improve functional vision in children with CVI by targeting underlying cognitive deficits. Methods: A single-arm pre–post intervention study was conducted with nine children aged 7–11 years diagnosed with CVI. Participants received 20 individualized CRT sessions over ten weeks, integrating principles from the Model of Visual Functioning. Functional vision was evaluated using the Gazi Functional Vision Assessment Instrument (GFVAI), while cognitive improvements were measured with the Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch) and the Motor-Free Visual Perception Test-4 (MVPT-4). Data were analyzed using Wilcoxon signed-rank tests. Results: Statistically significant improvements were observed in GFVAI domains such as light sensitivity, distant visual field, focusing, maintaining focus, and obstacle avoidance (p < 0.05 to p < 0.01). Qualitative analysis also indicated a shift from low/moderate to good/very good performance in most functional vision categories. Cognitive domains, including visual-motor organization, thinking operations, and spatial perception, showed significant gains. Conclusions: CRT may support improvements in functional vision by enhancing cognitive processes in children with CVI. This therapist-led approach is feasible, adaptable, and holds promise for widespread application in pediatric rehabilitation. Description: Data Availability Statement: Data available on request due to ethical reasons.

Parental Perspectives on Environmental Factors Affecting Participation of Children with Disabilities: A Scoping Review to Inform Inclusive Healthcare and Support Services

2026-01-25T17:28:13Z

Title: Parental Perspectives on Environmental Factors Affecting Participation of Children with Disabilities: A Scoping Review to Inform Inclusive Healthcare and Support Services Authors: Celik Turan, Z; Kayim, A; Engelen, AM; Sezer, KS; Dunford, C; Aki, E Abstract: Background/Objectives: Environmental factors influence the participation of children with disabilities in everyday life. Parents, as primary caregivers, provide insights into how these factors support or hinder participation in health-related, educational, personal and social activities. This scoping review aimed to systematically map the literature on parental perceptions of environmental influences on the participation of their children with disabilities. Methods: The review followed the PRISMA-ScR guidelines and the five-stage framework by Arksey and O’Malley. Searches were conducted in five electronic databases: MEDLINE, CINAHL Plus, PsycINFO, PsycArticles, and OpenDissertations. Eligible studies were published in English, focused on children aged 0–18 with any type of disability, and reported on parental views of how environmental factors influence occupational participation. Data were charted and analyzed using narrative synthesis and vote-counting. Results: Thirty-four studies met the inclusion criteria. Frequently discussed environmental domains included physical, social, and institutional factors, while cultural and economic domains received less attention. Participation was commonly addressed in the contexts of play, education, and social engagement. Most studies used qualitative designs and were conducted in high- and middle-income countries. Standardized tools to assess environmental impacts were rarely employed. Conclusions: This review highlights the need for inclusive, family-centered health and social services that address the full range of environmental influences on participation. Future research and policy should prioritize culturally and economically diverse settings, integrate standardized assessment tools, and recognize parental perspectives as essential for designing equitable pediatric healthcare and rehabilitation services. Description: Data Availability Statement: The original data presented in the study are openly available in Open Science Framework at https://osf.io/fhpbm/?view_only=7019c3911a5b4588894500575ef55e87 (accessed on 19 April 2025).; Acknowledgments: The authors thank Shazia Arif, our academic liaison librarian, for her support in creating the search strategy. During the preparation of this manuscript, the authors used QuillBot Premium (https://quillbot.com/ (accessed on 19 April 2025)) and ChatGPT-4o (https://openai.com/index/hello-gpt-4o/ (accessed on 19 April 2025)) for the purposes of language editing. The authors have reviewed and edited the output and take full responsibility for the content of this publication.

Does a targeted, integrated knowledge translation intervention increase the uptake of evidence-based practice in community children’s occupational therapy settings?

2025-12-16T09:55:35Z

Title: Does a targeted, integrated knowledge translation intervention increase the uptake of evidence-based practice in community children’s occupational therapy settings? Authors: Ferreira, Astrid Mary Abstract: Background: Research shows it can take between 10-20 years for new evidence to be routinely implemented into occupational therapy practice. This ‘knowledge-to-practice gap’ has serious implications on quality of care, particularly in services for children and young people, where early interventions can significantly influence life outcomes. This thesis evaluated the impact of a targeted, integrated knowledge translation intervention on evidence-based practice behaviours of children's occupational therapists working in England’s community-based National Health Services (NHS). Methods: Multiple research designs were used, including a scoping review, qualitative enquiry, intervention development protocol, qualitative process evaluation, a before-andafter study and cross-sectional study. Forty-nine occupational therapists from five sites, including one comparison site, participated. Results: Early findings identified 77 beliefs grouped into seven key determinants influencing evidence-based practice, with self-efficacy, social influence, and attitudes most prominent. An integrated knowledge translation intervention was developed informed by Intervention Mapping and delivered online. The intervention included educational outreach, file auditing and feedback, and the creation of an ‘evidence library’. Data collection included focus groups, file audits, Canadian Occupational Performance Measure scores, and service user length of stay. Thematic analysis and generalised linear mixed-effects models were primarily used to assess impact. Results showed nuanced outcomes at a clinician behaviour level, service user level and an organisational level. Key mechanisms of impact included expert facilitation, reflection, peer learning, multimodal feedback, and strengthened accountability. Conclusion: This research contributes to a growing evidence-base in children’s occupational therapy knowledge translation. It highlights the importance of integrating theory with practical strategies and clinician collaboration. The findings support the use of multifaceted knowledge translation strategies to address therapist behaviour change, that in turn can influence organisational aspects and service user outcomes. Description: This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London

‘Time to spread my wings’ An investigative study exploring the effects of inpatient mental health rehabilitation What is the effect of inpatient mental health rehabilitation on an individual’s functional performance and do changes impact quality of life?

2019-10-29T13:19:41Z

Title: ‘Time to spread my wings’ An investigative study exploring the effects of inpatient mental health rehabilitation What is the effect of inpatient mental health rehabilitation on an individual’s functional performance and do changes impact quality of life? Authors: Dadswell, Rachel Abstract: This mixed methodology, 3-phase study at one NHS rehabilitation unit explores the experiences of 19 participants recruited over a 2 year period. Participants engaged in individual semi-structured interviews, and were invited to complete both the Lancashire Quality of Life Profile and the Assessment of Motor and Process Skills at admission, discharge and follow-up. Not all participants reached the point of discharge in the study period, and a few became too unwell to continue. At the point of follow-up, of the 10 remaining participants one dropped out due to work or educational commitments, three were re-admitted to hospital, and one did not come for appointments as agreed. To illustrate change over time, five participants have been brought to the fore through the use of case studies. The case studies synthesise the quantitative changes in the individual’s quality of life and functional performance with a personal narrative of their experience of their stay in the rehabilitation unit. The findings of the study are rich. Firstly, they highlight the range of losses experienced prior to rehabilitation and the importance of understanding this narrative as part of the recovery journey. Secondly, rehabilitation creates a sense of hope, but not all interactions with staff in the unit were viewed as hopeful. Hope was at its lowest when participants were not included in key decisions. Thirdly, while for some participants occupational performance and quality of life increased over time, for others it decreased. This study indicates tentative links between occupational performance and quality of life. Recommendations include enhancing client involvement in key decisions regarding rehabilitation choices, routine assessment of occupational performance levels, formally expanding rehabilitation into the community and considering grief work alongside more traditional rehabilitation interventions. Areas for further research include exploration of the links between quality of life and occupational performance levels. Description: This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London