non standardised outcome measures occupational therapy

2013 Sep;35(19):1636-46. doi: 10.3109/09638288.2012.748845. The use of outcome measures to demonstrate changes in patient's functional ability as well as evaluating service effectiveness is crucial for the profession to work in an evidence based practice manner. Skeat, J., Perry, A., Morris, M., Unsworth, C., Duckett, S., Dodd, K., Taylor, N. (2003). Levels of evidence and grades of recommendations. Work, 37(1), 53-64. doi:10.3233/WOR-2010-1056, Kang, D.H., Yoo, E.Y., Chung, B.I., Jing, M.E., Chang, K.Y., Jeon, H.S. La Trobe University, Melbourne. The nature of human function and the complexity of measuring functional outcomes. Carols Individual Treatment Plans: Physiotherapy. Step 6: Decision making in light of the interpretation of test scores. The AMPS manual provides further information regarding detailed steps for AMPS administration, cultural activity considerations, situational circumstances that may impact administration, and additional information needed to properly administer the assessment. Multi-disciplinary team (MDT) half-day clinic assessment process. Topics in Stroke Rehabilitation, 15(4), 351- 364. The AMPS assesses the quality of the persons ADL performance by rating the effort, efficiency, safety, and independence of 16 ADL motor and 20 ADL process skill items. Physical Therapy, 83(3), 224-236. Significant differences between individuals who had a previous stroke (RCVA and LCVA) when compared to non-disabled individuals for IADL performance (p .05), Measurement error accounted for 22% of the differences in subjects ADL ability measures. The application of standardised assessments. impairment (the underlying condition) activity (ability to complete daily activities participation (social participation) wellbeing (emotional health). Physical Therapy, 94(9), 1252-1261. The assignment of numbers for the purposes of assessment. Pleasee-mail us! 1-844-355-ABLE. "This is a useful textbook for occupational therapists and physiotherapists or those studying to become one." 4308 . Fort Collins, CO: Colorado State University, 1996. A qualitative study of clinical decision making in recommending discharge placement from the acute care setting. Thanks for helping us invest in our patients. Self-Care-Participation/ Restriction: Scale 5. doi:10.1371/journal.pone.0147980. OTs use standardized outcome tools in different settings to help inform colleagues and other medical professionals of the complexity of the patients diagnosis and functional level and to aid in safe and effective discharge planning. 1-844-355-ABLE. They felt that standardized outcome measures could be useful and would help them better communicate with stakeholders the rationale supporting their discharge recommendations. They generate numerical data which can be Download Product Flyer is to download PDF in new tab. Robertson, L. & Blaga, L. (2013). Background: Hereditary ataxia syndromes can result in significant speech impairment, a symptom thought to be responsive to treatment. Aldrich, R. M. (2011). The importance of the selection and application of terminology in practice. To continue reading, you must be a member. Standardized outcome measures (SOMs) are tools used for measuring the changes in the patients' performance, function or participation over time. Contact us at rehabmeasures@sralab.org or 312-238-2802. Unsworth, C.A., & Duncombe, D. (2014). AusTOMs for Occupational Therapy. Download Product Flyer is to download PDF in new tab. The Assessment of Motor and Process Skills Applied Cross Culturally to the Japanese. Toll-Free U.S. Therapists select from 12 function-focused scales that match client goals as follows: 1. Once treatment has commenced, the same instrument can be used to determine progress and treatment efficacy. Reflecting on purposes of assessment in your own practice. The nature of human occupation and occupational performance. Phase I = Administration Preparation; Phase II = Occupational therapy interview; Phase III = Observe and implement a performance analysis; Phase IV = Score the AMPS observation, After AMPS administration, the clinician interprets AMPS reports to define and interpret reasons for the person's ineffective ADL performance. Case study: service evaluation - The Development and initial evaluation of a Memory Activity and Self Help (MASH) Group by Karen Innes and Alison Laver Fawcett. Intra class correlation coefficients (ICC). The inter-rater and test-retest reliability of the Self-care and Transfer scales and intra-rater reliability of all scales of the Swedish translation of the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT-S). The American Journal of Occupational Therapy, 64(5), 768-775. doi:10.5014/ajot.2010.09041, Ottenbacher, K. J., Msall, M. E., Lyon, N. R., Duffy, L. C., Granger, C. V., Braun, S. (1997). (2014). Matmari, L., Uyeno, J., & Heck, C. S. (2014). Results: 33 candidate items, amendable to administration acutely after SCI, were developed for against gravity (X=13), gravity minimized (X=2), and gravity eliminated (X . This textbook on assessment and outcome measurement is written for both occupational therapy and physiotherapy students and qualified therapists. *Scores higher than .9 may indicate redundancy in the scale questions. Methods: Functional assessments used by occupational therapists with older adults at risk of activity and participation limitations: A systematic review. (2006). What is important to patients in palliative care? Timing of assessment in the therapy process. Scale 7. The particular challenges to occupational therapy (OT) practitioners working in acute care settings are a limited number of therapy visits and quick discharge. Perry, A., Morris, M., Unsworth, C., Duckett, S., Skeat, J., Dodd, K., Taylor, N. & Riley, K. (2004). The COPM is a standardised measure. Classroom-based assessment: Validation for the School AMPS. International Classification of Impairment, Disability and Handicap. A study to examine the relationship of AMPS to other tests of cognition and function. AusTOMs for Occupational Therapy. sharing sensitive information, make sure youre on a federal Arabic Translation undertaken by Awad, A. Changes from start (goal start, or admission) are compared to scores on discharge (goal end, or discharge). A clear conceptualisation of QOL that incorporates occupational therapy values such as client-centredness and holism is needed to advocate for the profession's role in health care and to encourage the development of suitable outcome measures. Summary of the results other team members assessments. . Unsworth, C.A., & Duncombe, D. (2014). Carolyn Unsworth, Carolyn Unsworth. International Journal of Therapy and Rehabilitation, 12(8), 340-346. Philanthropic support truly drives our mission and vision. Assessment is fundamental to effective occupational therapy practice. Occupational therapy discharge assessment of elderly patients from acute care hospitals. . Shirley Ryan AbilityLab does not provide emergency medical services. Fristedt, S., Elgmark, E. & Unsworth, C.A. The American Journal of Occupational Therapy, 56(2), 210-213. doi:10.5014/ajot.56.2.210, Fioravanti, A. M., Bordignon, C. M., Pettit, S. M., Woodhouse, L. J., & Ansley, B. J. Functional competence of community-dwelling persons with multiple sclerosis using the assessment of motor and process skills. Physiotherapists' perceptions of and experiences with the discharge planning process in acute-care general internal medicine units in Ontario. Therapy Outcome Measures for Allied Health Practitioners in Australia: The AusTOMs. Relationships between cognitive abilities and the process scale and skills of the assessment of motor and process skills (AMPS) in patients with stroke. OT outcome measures are used to determine the value and effectiveness of treatment in therapy. Unsworth, C.A., Bearup, A., & Rickard, K. (2009). Measuring outcomes using the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs - OT):Data description and tool sensitivity. Factors impacting the use of outcome measures were identified as: 1) challenges selecting the appropriate outcome measure; 2) too time consuming for patients to complete and difficult to complete independently; 3) short length of stay; 4) limited time for therapists to complete the evaluation; 5) fast-paced and dynamic environment (different floors, different teams/members); 6) timing problems where patients undergoing tests/procedures were off the floor; 7) and patients were medically unstable at the time of the attempted/scheduled evaluation. International Journal of Health Sciences and Research, 5 (8), 369-376. 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The COPM is an outcome measure designed for use by occupational therapists to assess client outcomes in the areas of self-care, productivity and leisure. This is a dummy description. . Self-care 8. Occupational therapists must be committed to contributing to the evidence base related to the effectiveness of occupational therapy interventions and know how to select and apply valid and. Mobility and function are central factors in discharge decision making for OT. 1 by U.S. News & World Report for 31st Consecutive Year, Community-Ready Upper Extremity Interactive Rehabilitation, Dr. Lieber To Receive AACPDM's Lifetime Achievement Award for Research on Cerebral Palsy, Global Advisory Services Hospital Training & Consulting, Medical Student Education & Residency Program, Bundled Webinars: Spinal Cord Injury (3 Titles), 1 Year Webinar Package - Unlimited Access, Alzheimer's Disease and Progressive Dementia, Making Waves Following a Spinal Cord Injury, Full Circle After a Non-Traumatic Brain Injury, An Unanticipated Head Injury and Incredibly Bright Future. Assessment of motor and process skills. Cross-regional validation of the school version of the Assessment of Motor and Process Skills. By not using standardized outcome measurement tools, the value and benefits of OT services such as ADL and IADL training, patient and caregiver education, and training to use adapted equipment/assistive devices is anecdotal at best. Further research is needed to identify common outcome measures suited for use by OTs in acute inpatient hospital settings. OTs need easy access to information about the clinical utility and psychometric qualities of various measures to help with the appropriate selection and clinical applicability of standardized outcome measurement tools to measure functional outcomes in acute inpatient hospital practice. Unsworth (2004) found scores on several AusTOMs-OT Scales and domains correlated with the EQ-5D: Established through focus groups to develop the 12 scales (Perry 2004) and Unsworth (2005a). By not using standardized outcome measurement tools, the value and benefits of OT services such as ADL and IADL training, patient and caregiver education, and training to use adapted equipment/assistive devices is anecdotal at best. Further research is needed to identify common outcome measures suited for use by OTs in acute inpatient hospital settings. OTs need easy access to information about the clinical utility and psychometric qualities of various measures to help with the appropriate selection and clinical applicability of standardized tools to measure functional outcomes in acute inpatient hospital practice. Occupational Therapy International, 15(4), 253-268. doi: 10.1002/oti.258, Kizony, R. & Katz, N. (2002). Extracurricular and interpersonal life experiences. Version 1.0. There are some limitations to this study. The review was completed by searching six databases using occupational therapy-related and QOL-related terms. Jette, D. U., Grover, L., & Keck, C. P. (2003). Design . World J Clin Cases. An Appropriate Way to Measure the Outcome of Paedi. In this study, a non-standardised assessment tool to measure severity of disability was compared with a standardised tool to assesswhether there were differences in outcomes and what, if any, were the consequences for service entitlement. Pearson product-moment correlation coefficient. "This book provides a comprehensive guide to the background, rationale and utilization of assessment and outcome measurement. Does a short period of rehabilitation in the home setting facilitate functioning after stroke? Chapter 9: Applying models of function to therapy assessment and measurement (Alison Laver Fawcett, PhD DipCOT and David Jelley). The influence of the level of task demand. Download Product Flyer is to download PDF in new tab. Aaronson, N., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A. Duez, N. et al. Chen, Z., & Eng,J.Y. Association of impaired functional status at hospital discharge and subsequent rehospitalization, Journal of Hospital Medicine; 9(5), 277-82. The American Journal of Occupational Therapy, 50(10): 798-806. doi: 10.5014/ajot.50.10.798, Hartman, M., Fisher, A., & Duran, L. (1999). & Fisher, A.G. (2001). 1. measures processes. Quality of life in patients with Alzheimer's disease as reported by patient proxies. PMC Assessment and outcome measurement goals for effective practice. Self-Care and Scale 5 (Transfers) with 7 OTs rating 6 or 3 cases (respectively) with a range of conditions including: spinal cord injury, amputation, schizophrenia, hip replacement, muscle disease, and cancer. Section GG - Medicare Self-Care Measures Reference. Unsworth, C.A., Coulson, M., Swinton, L., Cole, H., & Sarigiannis, M. (2015). Seven articles included a definition of QOL. Chapter 4: Levels of measurement (Alison Laver Fawcett, PhD, DipCOT). In this study, we retrospectively examined and analyzed datasets from OT students level two fieldwork in Summer 2017. Follow us on Facebook @rehaboutcomes and Twitter @rehab_outcomes for more information about the Rehabilitation Measure Database and our other grants at the Center for Rehabilitation Outcomes Research. Scandinavian Journal of Occupational Therapy, 6(3), 111-118. doi:10.1080/110381299443690, Haslam, J., Pepin, G., Bourbonnais, R., & Grignon, S. (2010). Transfers-Participation/ Restriction: Fristedt (2013) as reported above studied interrater and intrarater reliability. Examining reliability data: test examples. AusTOMs for Occupational Therapy. Outcomes of occupational therapy are: Occupational performance Prevention Health and wellness This is a dummy description. What Can We Really Expect from 5G? BMC Health Serv Res. mary nolan nashville, tennessee; simon every annastacia palaszczuk; Projetos. Chapter 12: The Final Case Study: Carol experience of a Chronic Pain Service (Alison Laver Fawcett, PhD DipCOT, Gail Brooke, Dip Phys, Cert in Health Service management, and Heather Shaw, DipCOT). 2014 Apr;61(2):58-66. doi: 10.1111/1440-1630.12080. Shirley Ryan AbilityLab does not provide emergency medical services. Despite the rare incorporation of standardized outcome measures in acute care settings, OT students and therapists were willing to further explore the benefits of the standardized tools. Archives of Physical Medicine and Rehabilitation, 76, 1144-1151. doi: 10.1016/S0003-9993(95)80124-3. Chapter 3: Purposes of assessment and measurement (Alison Laver Fawcett, PhD, DipCOT and Karen Innes, BSc OT, DMS, Cert Counselling). The .gov means its official. A New Ecosystem of Scientific Sharing and What it Would Mean, Preprints and Trust in Peer Review: A Q&A With Alberto Pepe of Authorea, Re-Entering the Classroom in a Time of Trauma and Stress, Cultivating an Inclusive Learning Experience, Wiley "Stay the Course Grant" Winners Tell Their Stories, 4 Things to Consider When Choosing an Online Platform That's Right for You, Determine Your Organizations Digital Skills Level. In January 2018, U.S. News & World Report ranked occupational therapy is 11th of the 100 best jobs for 2018. Criterion approach: Allied health therapists: 1 point (Unsworth, 2015; n=30 (n=25 occupational therapists); Mean Age=71.52 (14.71); Participants most commonly had between 11 and 20 years experience in their respective disciplines (43.3%, n=13), with 30% (n=9) with 10 years experience or less and 20% (n=6) with 2130 years experience. A survey study on 72 OTs working in acute care settings in New Zealand reported similar results that the majority of outcome measures used are non-standardized and include both subjective interview and observations of the patient carrying out functional tasks (Robertson & Blaga, 2014). Standardised measures used in the service. Developing a short form of the Berg Balance Scale for people with stroke. BAYLEY SCALES OF INFANT DEVELOPMENT (BSID) The wide use of this measure is consistent with earlier studies specific to cognitive impairments [ 11] as well as other general occupational therapy assessments [ 12 ]. Epub 2013 Jan 24. The national health policy has strongly recommended the routine use of outcome [1]. Current pressures to document outcomes and demonstrate the efficacy of occupational therapy intervention arise from fiscal restraints as much as from the humanitarian desire to . Your gift of Ability affects everythingwe do every day at Shirley Ryan AbilityLab from the highest-quality clinical care and groundbreaking research to community programs that improve quality of life. descriptive, evaluative, predictive, discriminative) presented. Both studies found that OTs used a wide range of standardized tests but not on a regular basis. Change from admission to discharge for clients, Using Wilcoxon Signed Ranks Test, all significant, p<.001, for mixed client population including: Abu-Awad, Y., Unsworth, C.A., Coulson, M., & Sarigiannis, M. (2014). It begins by defining what is meant by assessment, outcome, evaluation and measurement and discussing the complexity of therapy assessment and measurement, including the challenge of measuring human behaviour and the impact of factors such as task demand and context, including the environment. Scale 7. (1995). Differences between persons with right or left cerebral vascular accident on the Assessment of Motor and Process. doi:10.1080/J148v24n04_03, McNulty, M.C. Without a robust, standardised outcome measure, it is extremely challenging to track . The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The Need for Entrepreneurship in Sustainable Chemistry. OTs role in acute care setting includes but is not limited to facilitating early mobilization, restoring function, preventing further decline, and coordinating care on transition and discharge planning. 1-844-355-ABLE. ; The EORTC Quality of Life Group. Unauthorized use of these marks is strictly prohibited. 2013 Jun;80(3):141-9. doi: 10.1177/0008417413497906. Measurement of QOL has varied in both research and practice. An example Test Critique: The Parenting Stress Index (PSI). Top-down versus bottom-up assessment approach. Even when used, there is significant variability in the use, and scarce research is available on the optimal tool to be used by OTs at acute care settings. The relationship between the Assessment of Motor and Process Skills (AMPS) and the Large Cognitive Level (LACL) test in clients with stroke. 242 7829 47. British Journal of Occupational Therapy, 68(10), 477- 482. Disability and Rehabilitation, 37(11), 997-1003. 2. no feedback given to client. Effect of occupational therapy intervention on the quality of life of HIV positive clients and study of knowledge about HIV on clients and occupational therapists. (1996). The site is secure. 3. adjustments can be graded (harder or easier) To avoid variations in care and show the value of therapy services, ensure your rehabilitation therapists are using standardized outcome measures . You can also join our Rehabilitation Measures Database Networking Group on LinkedIn by . Change data has been published for clients with Diseases of nervous system, circulatory system, musculoskeletal system and Injury/poisoning (Unsworth, 2005b; Abu-Awad, 2014; Chen, 2015). Initial review and summary completed by Amanda Timmer and Carolyn Unsworth. More importantly, therapists questioned applicability of the tools to the acute care setting where they would have to be administered bedside to patients who were often critically ill, vulnerable, or not feeling or performing at their best. Interrater agreement and stability of the functional independence measure for children (WeeFIM): use in children with developmental disabilities. Examples of assessments that use information from a proxy. Analysing your current assessment practice. 36 items (16 ADL motor skill items, 20 ADL process skill items), AMPS can be administered in any task-relevant setting, Jenine Ampudia, OTS, University of Illinois at Chicago, Courtney Heidle, OTS, University of Illinois at Chicago, Johnny Sok, OTS, University of Illinois at Chicago, Jennifer Yi, OTS, University of Illinois at Chicago, Schizophrenia: (Haslam et al., 2010; n = 20; Mean Age = 44.3 (8.49) years), Psychiatric Disorders: (Pan and Fisher, 1994; n = 60; Mean Age = 37.9 (14.9); Sample included diagnosis ofaffective disorders, delusional disorders, schizophrenia, or alcohol hallucinosis), Psychiatric Disorders: (Merritt, 2011; n = 8556; Mean Age = 55.1(17.9) years; Subset of data fromAMPS Project International database), Psychiatric Conditions associated with cognitive impairments: (McNulty & Fisher, 2001; n = 20; Mean Age = 58 (16.05) years), Psychiatric Disorders: (Pan & Fisher, 1994; n = 60; Sample includes diagnosis of affective disorders, delusional disorders, schizophrenia, or alcohol hallucinosis), Stroke: (Bernspang & Fisher, 1995; n =230; Individuals with history of RCVA (n = 71), history of LCVA (n = 76), and nondisabled (n = 83)), Stroke: (Fisher & Bray Jones, 2010 as cited in Poulin et al., 2013; n = 8801; subset of AMPS Project International database; adults with hemispheric stroke), Stroke: (Fisher & Bray Jones, 2010 as cited in Poulin et al., 2013), Stroke (Marom, Jarus & Josman, 2006; n= 30; Individuals in their first week home during stroke recovery), Hemispheric Stroke: (Merritt, 2011;n = 17568;Mean Age = 61.7 (20.6); Subset of AMPS Project International database: Individuals with hemispheric stroke ( n = 8801) and individuals with other neurological conditions ( n = 8767), Stroke:(Dickerson, Reistetter & Trujullo, 2010; n = 46; Mean Age = 71.67 (10.76); Community sample referred for driving assessment), Stroke (Kizony & Katz, 2002; n = 30; Mean Age = 71.3 years; Inpatient acute care, 4-5 weeks Post-Stroke), Stroke: (Bjorkdahl et al., 2006; n = 58; Assessed at discharge, three weeks, three months, and one year after discharge; Swedish sample), Geriatric: (Doble, Fisk, Lewis & Rockwood, 1999; n = 55; Mean Age = 77.9 (7.0) years; Community-dwelling elderly adults), Geriatric: (Fioravanti et al., 2012; n = 54; Mean Age = 80 (8.6) years; Mean Length of Stay = 24 (12) days; Canadian sample in a geriatric and neuro-oncology inpatient rehabilitation unit, Geriatric: (Doble, Fisk, Lewis & Rockwood, 1999), Geriatric with cognitive impairments: (Doble, Fisk, Lewis & Rockwood, 1999; Rockwood, Doble, Fisk, MacPherson, & Lewis as cited in Fisher, 2003), Excellent test-retest reliability: (Motor Scale r = 0.88 - 0.9; Process Scale r = 0.86 - 0.87), Excellent test-retest reliability: (Motor: r = 0.88; Process: r = 0.86), Older adults: (Wales, Clemson, Lannin & Cameron, 2016; Mean Age > 70 years; Analysis of 56 papers with RCT design detailing functional assessments for older adults), Geriatric with Memory Impairments: (Robinson & Fisher, 1996), Older Adults: (Wales, Clemson, Lannin & Cameron, 2016), Geriatric with Memory Impairments: (Robinson & Fisher, 1996; n = 51; Mean Age = 75.4 (9.56) years), Older Adults with Dementia of the Alzheimers Type (DAT) (Hartman, Fisher & Duran, 1999; n = 788; Independent Older Adults ( n = 329, Mean Age = 70.5 (5.9)), Older Adults with minimal DAT ( n = 167, Mean Age = 71.2 (9.7)), Older Adults with moderate DAT ( n = 292, Mean Age = 74.5 (8.4)); Sample selected from AMPS database), Older Adults with Dementia of the Alzheimers Type (DAT) (Hartman, Fisher & Duran, 1999), Geriatric with Alzheimers disease: (Doble, Fisk & Rockwood, 1999; n = 26; Mean Age = 76.8 (6.6) years; Canadian sample), Older Adults with Dementia (Fisher & Jones, 2012; n = 5417), Dementia (Merritt, 2011; n = 2488; subset of AMPS Project International database), School-Aged Children with Identified Disability: (Atchinson, Fisher & Bryze, 1998; n = 54; Mean Age = 4.0 (0.7) years; Students receiving occupational therapy for an identified disability (n = 32) and typically developing students as comparison group (n = 22)), School-Aged Children with Identified Disability or At-Risk: (Munkholm, Berg, Lofgren & Fisher, 2010; n = 984; Age Range 3-13; Students from North America, Australia, New Zealand, United Kingdom and Nordic countries), School-Aged Children with Identified Disability: (Atchinson, Fisher & Bryze, 1998), School-Aged Children: (Fingerhut et. Conclusions: al, 2002; n = 42; Age Range 5 7; Kindergarten students from five public schools), Children with No Known Disabilities: (Peny-Dahlstrand, Gosman-Hedstrom & Krumlinde-Sundholm, 2010), Developmental Delays (Kang et al., 2008; n = 33; Mean Age = 6.1 (1.9) years; Korean sample), Children With or Without Mild Disabilities: (Gantschnig, Page, Nilsson & Fisher, 2013; n = 10,998; Mean Age = 8.7 (3.2) years; Sample selected from the international AMPS database), Excellent significance between two groups in mean ADL process ability measures (p < .001, t = -4.296), Children with No Known Disabilities (Poulson, 1996; n = 162), Goodness of fit; 90% to AMPS-M, 95% to AMPS-P, Children With or Without Mild Disabilities: (Gantschnig, Page, Nilsson & Fisher, 2013), Big Change (Cohens d = 0.81 to 0.98) for 12-15 year olds in ADL motor ability, Big Change (Cohens d = 0.83 to 1.26) for 6-15 year olds in ADL process ability, Children with No Known Disabilities: (Peny-Dahlstrand, Gosman-Hedstrom & Krumlinde-Sundholm, 2012; n = 4613; Age Range 3-15 years; Subset of the AMPS Project International Database, North American (n = 2239) and Nordic (n = 2374) children ), Community Dwelling Adults (Merritt, 2011; n = 38,540, Randomly-selected subset of AMPS Project International database), Mixed Population: (Gantschnig, Page & Fisher, 2012; n = 145489; Mean Age = 54.06 (24.43) years; Sample from the international AMPS database), Mixed Population: (Fisher & Jones, 2012; n = 148158; Age Range = 3 - 103; Sample from international AMPS database), Community-Dwelling: (Goto, Fisher & Mayberry, 1996; n = 10; Mean Age = 28.9 (3.98) years; Mean time living in United States = 12.4 (8.8) months; Japanese sample living in the United States for less than 3 years), Community-Dwelling: (Fisher, Liu, Velozo & Pan, 1992; n = 20; Mean Age = 28.5 (3.32) years; Non-disabled Taiwanese sample living in United States for less than 3 years), Mixed Population: (Fisher & Jones, 2012), Community Dwelling Adults (Merritt, 2011), Mixed Population: (Gantschnig, Page & Fisher, 2012), Multiple Sclerosis: (Doble et al., 1994; n = 44Mean Age = 44.5 (12.3) years, Mean Duration of Self-Reported MS = 19.9 (12.4) years), Atchinson, B., Fisher, A.

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