Older Adults’ Psychosocial Responses to a Fear of Falling: A Scoping Review to Inform Occupational Therapy Practice

Abstract

Falls in older adults are a major health concern, yet the “fear of falling”, a common psychosocial response that can occur post-fall, has seldom been investigated. A scoping review was conducted to identify and map interventions that occupational therapists can use to manage the fear of falling psychosocial response (FoFPR) among older adults. Thirteen electronic databases were searched and 22 studies were retrieved. Cognitive behavioral therapy, guided imagery, and Tai Chi were interventions found to help older adults deal with their FoFPRs. Occupational therapists assisting older adults in this area can play a significant role.     

Attention and language in fragile X

Fragile X syndrome (FXS) is a well-recognized cause of mental retardation and developmental delay in males. Alongside the well-documented clinical characteristics of the condition, recent advances in technology and methodology have begun to define FXS at a number of different levels: genetic, brain structure and function, cognition, and behavior. This article suggests that the FXS phenotype is not merely a juxtaposition of spared and impaired functions but rather may be characterized by an inhibitory control deficit that interferes with the individual's ability to modulate output causing perseverative responding across various skill areas. It is further suggested that an inability to modulate arousal may be at least one cause for the inhibitory control deficit that typifies the FXS phenotype. The approach to understanding atypical development outlined here holds exciting promise for future research in FXS and other developmental disorders.     

Aristotle's Cognitive Science: Belief,Affect and Rationality

I offer a novel interpretation of Aristotle's psychology and notion of rationality, which draws the line between animal and specifically human cognition. Aristotle distinguishes belief (doxa), a form of rational cognition, from imagining (phantasia), which is shared with non‐rational animals. We are, he says, “immediately affected” by beliefs, but respond to imagining “as if we were looking at a picture.” Aristotle's argument has been misunderstood; my interpretation explains and motivates it. Rationality includes a filter that interrupts the pathways between cognition and behavior. This prevents the subject from responding to certain representations. Stress and damage compromise the filter, making the subject respond indiscriminately, as non‐rational animals do. Beliefs are representations that have made it past the filter, which is why they can “affect [us] immediately.” Aristotle's claims express ceteris paribus generalizations, subject to exceptions. No list of provisos could turn them into non‐vacuous universal claims, but this does not rob them of their explanatory power. Aristotle's cognitive science resolves a tension we grapple with today: it accounts for the specialness of human action and thinking within a strictly naturalistic framework. The theory is striking in its insight and explanatory power, instructive in its methodological shortcomings.     

Charting the Developmental Trajectories of Attention and Executive Function in Chinese School-Aged Children

Attention is a complex domain that has reawakened research interest in recent years. There are relatively few studies that have examined age-related changes across different attention subcomponents, such as selection, maintenance, and control, using large samples covering a wide age range. The present study assessed performance in 466 participants in order to identify the ages at which mature performance was reached across differing attention subcomponents. Furthermore, we investigated whether the nature of the attentional demands or task difficulty predicted the age at which stable levels of performance were reached. The results supported the former rather than the latter alternative.     

Fostering social and emotional intelligence: What are the best current strategies in parenting?

This review focuses on parenting practices that are beneficial or antagonistic to the development of emotional and social intelligence in children. We start by reviewing the somewhat nebulous concepts of emotional and social intelligence. This is followed by an examination of the association between well‐known parenting styles such as authoritative, authoritarian, permissive, and directive parenting and various indicators of child emotional and social intelligence. The strategic emotion‐coaching parenting style is also examined for its connections to comparable child outcomes. Parenting practices such as inductive discipline and parental availability also appear to cultivate emotional and social intelligence in children. Finally, overparenting is discussed as a parenting practice that apparently corrupts the development of these traits in emerging adults. We conclude that best practices, where emotional intelligence and social intelligence are the benchmarks, blend parental care and concern with a degree of parental demands on children that are appropriate for their developmental stage.     

Visual attention and academic performance in children with developmental disabilities and behavioural attention deficits

Despite well‐documented attention deficits in children with intellectual and developmental disabilities (IDD), distinctions across types of attention problems and their association with academic attainment has not been fully explored. This study examines visual attention capacities and inattentive/hyperactive behaviours in 77 children aged 4 to 11 years with IDD and elevated behavioural attention difficulties. Children with autism spectrum disorder (ASD; n = 23), Down syndrome (DS; n = 22), and non‐specific intellectual disability (NSID; n = 32) completed computerized visual search and vigilance paradigms. In addition, parents and teachers completed rating scales of inattention and hyperactivity. Concurrent associations between attention abilities and early literacy and numeracy skills were also examined. Children completed measures of receptive vocabulary, phonological abilities and cardinality skills. As expected, the results indicated that all groups had relatively comparable levels of inattentive/hyperactive behaviours as rated by parents and teachers. However, the extent of visual attention deficits varied as a result of group; namely children with DS had poorer visual search and vigilance abilities than children with ASD and NSID. Further, significant associations between visual attention difficulties and poorer literacy and numeracy skills were observed, regardless of group. Collectively the findings demonstrate that in children with IDD who present with homogenous behavioural attention difficulties, at the cognitive level, subtle profiles of attentional problems can be delineated.     

Predictors of the change in self-stigma following a single session of group counseling

One of the major obstacles to seeking psychological help is the stigma associated with counseling and therapy. Self-stigma, the fear of losing self-respect or self-esteem as a result of seeking help, is an important factor in the help-seeking process. In the present study, college students meeting a clinical cutoff for psychological symptoms participated in 1 session of group counseling that either contained therapist self-disclosure or did not. In general, participants reported significantly less self-stigma following the session. Working alliance-bond and session depth significantly predicted the change in self-stigma. Furthermore, self-stigma (as well as bond, depth, psychological symptoms, and being female) predicted the intention to seek help following the session. Self-stigma and session depth also predicted interest in continuing with counseling. The therapist self-disclosure condition, however, had no effect on the change in self-stigma, intentions to seek help, or interest in continuing with group counseling.     

The Geschwind and Galaburda theory of cerebral lateralisation: An empirical evaluation of its assumptions

The relationship between male gender, left-handedness, high visuo-spatial and mathematical skill, speech problems and increased vulnerability to immune disorders was assessed in a large sample of university undergraduates. The only significant finding was a two-way interaction between hand preference and incidence of speech problems, with “pure” left-handers reporting a three-fold increase in the incidence of speech problems compared to mixed left-handers, mixed right-handers and “pure” right-handers. There was no evidence of an interaction among three or more of the variables. These findings are discussed in relation to the influential theory of cerebral lateralisation proposed by Geschwind and Galaburda (1987).     

AN EVALUATION OF ORIENTATION AND ASSESSMENT EFFECTIVENESS IN THE WORK INCENTIVE PROGRAM

The purpose of this study was to evaluate the effectiveness of a Work Incentive (WIN) Orientation and Assessment Program which was designed to (a) assess enrollee attitudes and abilities, and (b) provide enrollee pre-employment test orientation. A sample of 155 WIN enrollees was divided into two groups; the experimental group received two weeks of orientation and assessment. Results were obtained by using two criteria: First, the number of terminations prior to completing the EDP was examined for each group, and second, the total number of referrals to each of three major components was examined. Findings revealed a significantly lower number of terminations among the experimental group, but did not yield any difference in the number of referrals per component. It is suggested that further studies of this type include a more refined measure of enrollee success and satisfaction in various WIN components.