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Measuring the self-esteem of adolescents with mental health problems: theory meets practice.

Occupational therapists frequently address the self-esteem of young clients despite little empirical evidence that the clients have low self-esteem to begin with, and that occupational therapy intervention is effective in addressing self-esteem. This article examines the self-esteem of 39 adolescents with mental health problems referred to a pre-vocational programme in an effort to compare clinical practice with empirical findings. The Self-Perception Profile for Adolescents and the Importance Rating Scale for Adolescents are employed to compare the self-esteem of the adolescents with mental health problems with the normative sample, prior to (n = 39) and upon completion of the pre-vocational programme (n = 14). Results indicate no difference between the two groups' self-esteem and no change in self-esteem scores following participation in the pre-vocational programme. Global self-esteem is significantly correlated with physical appearance and behavioural conduct (n = 39). Competence-importance discrepancy scores are significantly related to global self-esteem (n = 14). This finding supports the theory that it is the domain of self-concept which is low and important to the adolescent which will influence his/her self-esteem. These results are consistent with previous studies. Possible explanations for the discrepancy between clinical perceptions and objective findings are discussed. Implications for practice are presented.

Adolescent↗

Reliability and validity of a simple measure for assessing the social skills of people with schizophrenia necessary for seeking and securing a job.

The literature shows that social and vocational impairments are common problems among people with schizophrenia. However, assessment instruments available for measuring social competence of people with schizophrenia in the workplace are limited. This article describes a two-part measure developed and validated based on a model (Tsang & Pearson, 1996) for assessing social skills necessary for seeking and maintaining a job for people with schizophrenia. The measure consists of a 10 item self-administered checklist and a role-play exercise. The self-administered checklist measures clients' perceived competence in handling work-related social situations. The role-play exercise assesses the social skills necessary for job acquisition and maintenance in two simulated situations (participating in a simulated job interview and requesting urgent leave from work). Cronbach alpha coefficients (self-administered checklist: .80 (n = 140); role-play test: .96 (n = 60)) show that both parts had good internal consistency. In addition, correlation coefficients show that the self-administered checklist has acceptable test-retest reliability (.35 to .78), and the role-play exercise has good interrater reliability (.77 to .90). The concurrent validity is also shown to be good for both parts of the measure using the method of contrasted groups. It is suggested that this measure is suitable for use by clinicians, rehabilitation administrators and researchers. Application of the instrument in other countries is discussed. Finally, further research is suggested.

Adult↗

Assessment and intervention with clients with apraxia: contributions from the literature.

Individuals with praxis problems encounter difficulties engaging in occupation, and the occupational therapists who work with these clients are challenged to provide intervention that enables occupational performance. This extensive review of the current literature provides clinicians with information regarding the relevant descriptions and suggested mechanisms of apraxia. Errors noted in performance, different classification systems and the implications of the current knowledge will be discussed. The paper concludes by providing information for clinicians regarding occupational therapy evaluation and intervention strategies for praxis problems.

Apraxias↗

Teaching practice management skills to pediatric residents.

To satisfy the core competencies required by the Pediatric Residency Review Committee, the author describes an educational program for the residents in a large pediatric training program. The course provides a year-long overview of multiple medical management topics. The sessions cover nonclinical subjects usually missed in other educational settings, with particular focus on areas of finance, compliance, personnel management, career advancement, and leadership. The series is currently in its third year, with a positive response from the participants, and demonstrated improvement in resident knowledge of the covered areas.

Adult↗

Simulated and in situ vocational social skills training for youths with learning disabilities.

Social skills training for youth with learning disabilities in transition from school to work is of substantial importance. To examine the generalization of such training to real employment settings, this study used a multiple-baseline design to investigate the effects of 12 measured behaviors (3 behaviors per student) on four high school seniors. An initial simulated social skills package delivered at school led to generalization in 8 of 12 behaviors. Subsequently, in situ training at the work site produced generalization in 4 of 6 behaviors. This two-phase model appears to be a powerful way to promote generalization of behavioral skills.

Adolescent↗

A follow-along study of participants in a longitudinal transition program for youths with mild disabilities.

Descriptive data are presented on the employment patterns of youths with mild disabilities who participated in a transition program with an intensive postsecondary component. Data on employment rates, positive and negative job changes, participation in continuing education, and access to benefit packages are reported for 94 youths who participated in the program over a 4-year period. Program participants had favorable outcomes when compared with a national sample, but they stabilized at an entry level of work participation. Their rates of entry into postsecondary education were also greater than the national sample, but advances were nominal.

Adolescent↗

Transition from school to adulthood: case studies of adults with learning disabilities who dropped out of school.

In-depth, structured interviews were conducted over a 2-year period with four young adults previously identified as having learning disabilities during their school years. All four had dropped out of high school; but overall, they reported that their early withdrawal was an important and affirming choice in their transition from youth to young adulthood. Themes emerging as noteworthy include their lack of involvement in formal vocational assessment, their own individualized education programs, and adult services. The personal stories and experiences cast doubt on the prevailing opinion that school dropouts are "losers" and "failures." In contrast, their stories reveal a serious shortfall in their secondary special education programming and in the overall transition planning process.

Adolescent↗

Vocational education and students with learning disabilities.

This inquiry focuses on the status of nearly 500 students with learning disabilities in 17 state-operated regional vocational-technical schools in a northeastern state. The inquiry addressed four primary concerns: patterns of assessment, career choice, school marks, and attendance. The data indicate that a variety of instruments were used in the assessment process and that the overall grade equivalent levels of attainment ranged between fifth- and seventh-grade levels. Children defined as learning disabled participated in a large number of vocational trade specialties and some 50% or more had school marks indicating that they were passing in these areas. Attendance was high. Many children with learning disabilities successfully perform in competitive vocational education programs designed to produce proficiency at the level of journey person.

Adolescent↗