Diversity, Equity, and Human Rights: An Interview with Janet Njelesani on Educational Opportunity for Children with Disabilities in Zambia

Photo of Janet Njelesani

Janet Njelesani

Janet Njelesani, assistant professor of occupational therapy, researches how social, cultural, and institutional practices impact the education of children and youth with disabilities. Her work is influenced by her experience as an occupational therapist and disability inclusion technical advisor to international governments and United Nations agencies.

Njelesani received Steinhardt’s Global Research Incubator Award in 2017 to carry out a pilot project on school violence against children with disabilities in Lusaka, Zambia in which she is collaborating with the University of Zambia and Ministry of Education. She uses child-centered methodologies, including arts-based research methods,  to engage students with disabilities. Graduate students from both the University of Zambia and NYU Steinhardt are involved in this research process and are learning how to elicit children’s experience through qualitative methods, as well as learning how to build an international research partnership.

A child’s drawing is used to gain insight into her social experience at school.

You are studying violence against children with disabilities in Zambia.  What led you to your research?

Violence at school exists in every country, spanning across cultures, classes, education levels, abilities, incomes, and ethnic origins, and children with disabilities are at a significantly greater risk than their non-disabled peers. Although some one million children are living with disabilities in Zambia and the country is committed to education for all children, little is known about children with disabilities’ school experiences, including the violence that may be perpetuated against them. The experiences of these students are important to understand because violence in schools can not only cause physical harm and psychological distress, but also can affect a child’s ability to learn while in school.  Many students won’t remain in school long enough to reap the benefits of education as parents pull them out for safety reasons.

What are some of the risk factors that children with disabilities face?  

There is a complex interaction of child characteristics (e.g., type of impairment), societal biases (e.g., disability stigma), and other environmental factors (e.g., cultural beliefs and gender norms) that interact to cause greater violence against students with disabilities. Data from recent national school surveys indicated that the prevalence of non-disabled children being bullied by peers was 63% and virtually all (97%) have reported being physically punished by teachers over the past school year. Despite this high incidence of violence against non-disabled children, violence against children with disabilities is even higher in Zambia where there are greater stigmas associated with having a disability and less resources and services available for children with disabilities to succeed at school.

Photo of Janet Njelesani and members of the research team

Janet Njelesani (left) and members of the research team discuss how to adapt research tools to include students with all kinds of disabilities.

You come to your research as an occupational therapist.  How does this influence your point of view?

As an occupational therapy practitioner and scholar, I strive to carry out work that centers on illuminating issues of diversity, equity, and human rights for children and adults with disabilities living in low and middle-income countries. Being an occupational therapist has influenced how I carry out my research in regard to understanding that the participation and rights of persons with disabilities have traditionally been neglected in research and policy. Furthermore, client-centeredness, which assumes that clients are the experts in their lives, is core to the profession of occupational therapy, so I understand the need to partner and collaborate with persons with disabilities, their families, and representative organizations, in order to combine our complementary skills and knowledge to address the rights of persons with disabilities.

What do children reveal in their art work?

Arts-based methods are one of the many tools I use in my research because they can be adapted to meet the diverse needs of children, for example a child who has difficulty communicating may prefer to draw a picture, whereas a child with a vision impairment may prefer telling a story.
Children often reveal in their art what is most important to them, helping us to understand what supports are already in place in their school community and which we can build upon.  They also express their challenges. From an occupational therapy  perspective, this expression has therapeutic value as often they’ve never been given the opportunity to share these experiences before.

Photo of primary school in Lusaka, Zambia

This primary school in Lusaka, Zambia includes children with disabilities.

What interventions will help schools decrease violence against children?  

The Government of Zambia has committed to developing education policy and improving access to quality education for all Zambian children, including those with disabilities. As this study is being carried out in conjunction with researchers from the University of Zambia and policy makers in the Zambian Ministry of Education, findings can be used to inform policy and develop comprehensive and effective violence prevention that are inclusive of all children, including students with disabilities in Zambia.

Read more by Janet Njelesani:  From the day they are born: a qualitative study exploring violence against children with disabilities in West Africa

 

 

 

Grace Kim Publishes Research on Robotics to Improve Hand Function in Stroke Patients

Assistant Professor of Occupational Therapy Grace Kim‘s study Photo of Grace Kim Randomized Trial on the Effects of Attentional Focus on Motor Training of the Upper Extremity Using Robotics With Individuals After Chronic Stroke was recently published in the journal Archives of Physical Medicine and Rehabilitation. The study is also co-authored by NYU Steinhardt’s Mitchell Batavia, Associate Professor in the department of Physical Therapy, and Jim Hinojosa, Professor Emeritus in the department of Occupational Therapy.

The study focused on individuals with stroke and moderate-to-severe arm impairment living in the community. The individuals participated in a four-week arm training protocol on a robotic device in an outpatient clinic.

Highlights of the study include:

•Participants improved on motor outcomes after engaging in high-repetition robotics arm training.

•There were no differences between external focus or internal focus of attention on retention of motor skills after 4 weeks of arm training.

•Individuals with moderate-to-severe arm impairment may not experience the advantages of an external focus during motor training found in healthy individuals.

•Attentional focus is most likely not an active ingredient for retention of trained motor skills for individuals with moderate-to-severe arm impairment.

Introducing the Center of Health and Rehabilitation Research

Photo of Gerald Voelbel PresentingThis fall marked the inception of the yet-to-be official Center of Health and Rehabilitation Research (CoHRR), directed by Gerald Voelbel, Associate Professor of Occupational Therapy and director of the PhD in Rehabilitation Sciences program.

The mission of the CoHRR is to generate and disseminate scientific knowledge to improve human health, functioning, participation, and quality of life among individuals, groups, and communities. The CoHRR fosters interdisciplinary collaboration that furthers basic, applied, and translational health and rehabilitation research.

The CoHRR held it’s Inaugural Research Symposium in September to highlight Steinhardt’s health and rehabilitation researchers. Speakers at the symposium included faculty from Steinhardt’s Music Therapy, Occupational Therapy, Physical Therapy, Communicative Sciences and Disorders, and Nutrition departments. The center also hosted two additional visiting speakers Dr. Juan Carlos Arango Lasprilla of the Biocruces Health Research Center in Bilbao, Spain and Kaitlyn Tona, Au.D. of NYU Langone during the fall semester.

Faculty Achievements: Grants and Publications Summer/Fall 2017

A complete list of achievements by the faculty of the NYU Steinhardt Department of Occupational Therapy.

GRANTS

Kristie Patten Koenig

  • Principal Investigator: “NYU ASD Nest Support Project.” Skaneateles Central School District. 9/1/17-6/30/18. $53,749
  • Principal Investigator: “NYU ASD Nest Support Project.” NYC Department of Education. 7/1/17-6/30/18. $1,555,551
  • Co-Principal Investigator: “Ghanaian Institute for the Future of Teaching and Education (GIFTED) Women’s Fostering Program”. (Co-Principal Investigator). Newman’s Own Foundation. 6/30/17 – 7/1/18 $35,000

Tsu-Hsin Howe

  • 2017: New York University, The Steinhardt School of Education: Faculty Challenge Grant: Cross-Department Collaboration Award

Grace Kim

  • 2017-2018 Co-Principal Investigator: “Using Sensors to Capture Arm Impairment in Individuals with Stroke”. New York University Research Challenge Grant, $14,000
  • 2017-2018 Co-Principal Investigator: “Using Sensors to Capture Arm Impairment in Individuals with Stroke”. Steinhardt Faculty Challenge Grant $10,000

Janet Njelesani

  • 2017-2018 Principal Investigator: Occupational Therapy Research Group on Disability-based Violence. NYU Provost’s Global Research Initiative Award. $10,000.
  • 2017-2018 Principal Investigator: School violence against children with disabilities in Lusaka, Zambia: A pilot study. NYU Steinhardt Global Research Incubator Award. $10,000.

PUBLICATIONS

Tracy Chippendale

  • Chen, S.W. & Chippendale, T. (accepted). The Issue Is: Leisure as ends, not just means in occupational therapy intervention. American Journal of Occupational Therapy.
  • Chippendale, T. (2018). Predicting use of outdoor fall prevention strategies: Considerations for prevention practices. Journal of Applied Gerontology, Early online.
  • Boltz, M., Lee, K. H., Chippendale, T. & Trotta, R. L. (2018). Pre-admission functional decline in hospitalized persons with Dementia: The influence of family caregiver factors. Archives of Gerontology and Geriatrics, Early online.
  • Chippendale, T & Raveis, V. (2017). Knowledge, behavioral practices, and experiences of outdoor fallers: Implications for prevention programs. Archives of Gerontology and Geriatrics, Early online.
  • Chippendale, T., Gentile, P. A. & James, M. K. (2017). Characteristics and outcomes of falls among older adult trauma patients: Considerations for injury prevention programs. Australian Occupational Therapy Journal, Early online.

Patricia Gentile

  • James, M., Saghir, M., Victor, M., Gentile, P.A.  (in press).  Characterization of fall patients: Does age matter?  Journal of Safety Research. https://doi.org/10.1016/j.jsr.2017.12.010                                                                                     
  • Chippendale, T., Gentile, P. A. and James, M. K. (2017). Characteristics and consequences of falls among older adult trauma patients: Considerations for injury prevention programs. Aust Occup Ther J.  https://doi: 10.1111/1440-1630.12380
  • Chippendale, T., Gentile, P. A., James, M. K., and Melnic, G. (2017) Indoor and outdoor falls among older adult trauma patients: A comparison of patient characteristics, associated factors and outcomes. Geriatr Gerontol Int, 17: 905–912. doi: 10.1111/ggi.12800

Yael Goverover

  • Stern, B., Strober, L., DeLuca, J., & Goverover, Y. (Accepted, December 14, 2017).  Subjective Well-being Differs with Age in Multiple Sclerosis: A Brief Report. Rehabilitation Psychology.
  • Goverover, Y., & DeLuca, J. (Accepted, November 21, 2017). Assessing Everyday Life Functional Activity using Actual RealityTM in Persons with MS. Rehabilitation Psychology.
  • Goverover, Y., Sandroff, B., & DeLuca, J. (Accepted, October 13, 2017). Dual-Task of Fine Motor skill and Problem-Solving in   Individuals with Multiple Sclerosis: A pilot study.  Archives of Physical Medicine & Rehabilitation.
  • Goverover Y., Chiaravalloti, N., O’Brien, A., & DeLuca, J. (2017). Evidenced Based Cognitive Rehabilitation for Persons with Multiple Sclerosis: An Updated Review of the Literature from 2007-2016. Archives of Physical Medicine & Rehabilitation. pii: S0003-9993(17)31117-6. doi: 10.1016/j.apmr.2017.07.021. [Epub ahead of print]
  • Costa, S. L., DeLuca, J., Sandroff, B. M., Goverover, Y., & Chiaravalloti, N. D. (Accepted, July 6, 2017). The role of demographic and clinical factors in cognitive functioning of persons with relapsing-remitting and progressive multiple sclerosis. Journal of Imternational Neuropsychology Society.
  • Kalina, J., Hinojosa, J., Strober, L., Bacon, J., Donnelly, S., & Goverover, Y. (Accepted, June 19, 2017). A randomized controlled trial to improve self-efficacy in persons with Multiple Sclerosis: The Community Reintegration for Socially Isolated Patients (CRISP) program. American Journal of Occupational Therapy.
  • Goverover, Y., Chiaravalloti, N.,Genova, H & DeLuca, J. (2017). An RCT to Treat Impaired Learning and Memory in Multiple Sclerosis: The self-GEN Trial. Multiple Sclerosis. 1:1352458517709955. doi: 10.1177/1352458517709955.

Tsu-Hsin Howe

  • Howe, T.-H., Chen, H.-L., Lee, C. C., Chen, Y.-D., & Wang, T.-N. (2017). The Computerized Perceptual Motor Skills Assessment (CPMSA): A new visual perceptual motor skills evaluation tool for children in early elementary grades. Research in Developmental Disability, 69, 30-38. https://doi.org/10.1016/j.ridd.2017.07.010

Grace Kim

  • Kim, GJ, Taub, M., Creelman, C., Cahalan, C., O’Dell, M.W., & Stein, J. (accepted). Hand training utilizing electromyography-triggered robotics for individuals after chronic stroke. American Journal of Occupational Therapy.
  • Kim, G.J., Hinojosa, J., Rao, A., Batavia, M., & O’Dell, M.W. (2017). Randomized trial on the effects of attentional focus on motor training of the upper extremity using robotics with individuals after chronic stroke. Archives of Physical Medicine and Rehabilitation, 97(10), e35. doi: https://doi.org/10.1016/j.apmr.2017.06.005

Janet Njelesani

  • Dean L., Mulamba, C.,  Njelesani J., Mbabazi, P. & Bates I. (in press, 2018). Establishing an international laboratory network for neglected tropical diseases: Understanding existing capacity in five WHO regions. International Journal of Tropical Medicine and Public Health.
  • Njelesani J., Hashemi, G., Cameron, C., Cameron, D., Richard, D., & Parnes, P. (2018). From the day they are born: A qualitative study exploring violence against children with disabilities in West Africa. BMC Public Health; doi: 10.1186/s12889-018-5057-x
  • Hui N., Vickery E., Njelesani J., & Cameron D. (2017). Gendered experiences of inclusive education for children with disabilities in West and East Africa. International Journal of Inclusive Education; doi: 10.1080/13603116.2017.1370740

Anita Perr

  • Koch, KE & Perr, A. (2018). Application of Wheelchair and Seating Standards: From Inside the Test Lab and Beyond. In ML Lange and JL Minkel (eds) Seating and Wheeled Mobility: A Clinical Resource Guide. Thorofare, NJ: Slack.

 

Occupational Therapy Scholar Series: Fall 2017

The Fall 2017 semester brought three expert guest speakers to the department of Occupational Therapy as part of our OT Scholar Series. We were honored to have these insightful researchers visit the department to speak to students, faculty, and staff about current issues in the field.

Dr. Peii Chen, Research Scientist, Kessler Foundation
Topic: Rehabilitation Research on Spatial Neglect

Dr. Peii Chen is a neurorehabilitation scientist at Kessler Foundation. Dr. Chen’s work is mostly focused on spatial neglect. It is a common syndrome following a traumatic brain injury or a stroke. Spatial neglect and its related disorders provide great insights to the understanding of spatial cognition and its underlying neural networks. Symptoms of spatial neglect can be manifested in various ways depending on the impaired sector or reference frame of spatial representation, the affected perceptual modality, or the ability in motor control. There is no single treatment that effectively ameliorates every symptom.  Dr. Chen has been working on developing and refining clinical assessment and treatment tools for patients with spatial neglect, naming the Kessler Foundation Neglect Assessment Process (KF-NAP™) and the Kessler Foundation Prism Adaptation Treatment (KF-PAT™).

Abraham A. Brody, PhD, RN, FPCN, Associate Professor, NYU Rory Meyers College of Nursing, Associate Director, Hartford institute for Geriatric Nursing
Topic: Utilizing Community-Based Participatory Research to Develop Interprofessional Interventions in Caring for Vulnerable Populations

Dr. Brody is an expert in home-based inter-professional care of seriously ill older adults. His program of research focuses on how to improve symptom assessment and management of dementia and other chronic conditions through inter-professional care in community based settings including home health and hospice. He also seeks to understand how effective inter-professional care in these settings effects quality of life, healthcare utilization, and healthcare costs. Dr. Brody is a current Robert Wood Johnson Foundation Nurse Faculty Scholar, a Cambia Healthcare Foundation Sojourns Scholar, and has multiple grants from the NIH, John A. Hartford Foundation, and VA in this area.

Dr. Ji-Hyuk Park, PhD, OT, Chair, Department of Occupational Therapy, College of Health Science, Yonsei University, Republic of Korea
Topic: Therapeutic Effects of Occupation in Neurological Disorders

In occupational therapy, occupation is the therapeutic media used to improve the functional performance of participation and quality of life. Natural motivated behavior, animal model of occupation, increases the levels of neurotrophic factors enhancing neural plasticity. Experience and occupation guide changes in the neural system, as reported by nonscientific evidence in animal and human studies. Experience-dependent plasticity is induced by occupational experiences in human. Therapeutic occupation used for patients with neurological disorder should be a motivated task-oriented activity specified to a target performance skill, highly intensive, and close to a real occupation in everyday life. This kind of therapeutic activity can enhance functional recovery through experience-dependent plasticity in the human brain.

 

Janet Njelesani Awarded Funding from Provost’s Global Research Initiative

Janet Njelesani, assistant professor in the OT department, has received funding of $10,000 from the Provost’s Global Research Initiative to establish a Global Disability-based Violence Research Group for the field of occupational therapy.
Reducing violence against persons with disabilities is a task not just for social and justice services but for the health and rehabilitation sector too. To date occupational therapy has played a limited role in this discourse. The aim is to bring together occupational therapy researchers and have an initial coordination workshop to discuss the feasibility of establishing a Global Disability-based Violence Research Group for the field of occupational therapy that aims to gather, collate, review, and carry out research to help understand, monitor, and alleviate disability-based violence.  The initial workshop will be held in Cape Town, South Africa in May 2018.

 

How Student Strengths Can Help Close the Autism Employment Gap

Twelve years ago, Stephen Shore was visiting Urakawa, a small town in Japan, where he met the mother of a teenage boy with autism. The boy had limited verbal skills, and his mother was worried about what kind of work he might find as an adult.

Shore, an adjunct professor in NYU Steinhardt’s Department of Occupational Therapy, asked her the same question he always asks parents of children with autism: What is it your child likes to do?

The mother said her son liked to spend time in the basement sticking his finger under the faucet and spraying water at high pressure. There could be a number of sensory reasons why the boy enjoyed this, Shore said, including the feeling of pressure on his thumb, the joy of watching water arc across the room, or the sound of water splashing against the wall.

“And that is a gift because it tells us, ‘OK, now we know what he’s interested in: spraying water at high pressure,’” he said. “So that means considering jobs that might involve spraying water at high pressure.”

Focusing on a young person’s interests as a clue to career happiness seems like a given. When a girl shows an interest in animals, she might be encouraged to consider a future career in veterinary sciences. When a boy exhibits an interest in drawing, he may be invited to sign up for art classes. And yet, when children with autism show an interest in a subject, there can be a stigma – many times leading to their interest being labeled “restrictive” or “obsessive.”

“It’s important not to pathologize these strengths,” said Kristie Patten Koenig, an associate professor and department chair for NYU Steinhardt’s Department of Occupational Therapy.

As an example, Koenig said her son, who does not have autism, used to talk a lot about baseball statistics and history, “but we don’t ascribe any weakness to that. We don’t say he’s obsessed or has a ‘restricted interest.’ But for kids who are on the autism spectrum, many people view it as more of a pathology or a deficit versus seeing the potential there, because of the depth of the interest.”

She said removing the pathology from these interests not only eliminates a negative stigma but allows members of the autism community to thrive in situations that capitalize on their strengths. They can be helped mentally and socially, but also occupationally.

Read the full article on our online program OT@NYU‘s blog.

Tracy Chippendale Receives Stroll Safe Grant

Dr. Tracy Chippendale

Assistant Professor of Occupational Therapy Tracy Chippendale recently received a grant from NY Community Trust to conduct a feasibility study for “Stroll Safe”, an outdoor fall prevention program that she developed. The 7-week program, designed for active community dwelling seniors, focuses on safe strategy use to prevent stumbles, trips, slips, and falls outdoors. The purpose of the study is to examine the feasibility of the program and data collection protocol to plan a multisite clinical trial.

The topics addressed in the once a week, 7-week outdoor falls prevention program, for which a treatment manual has been developed, are based on the results of a survey conducted of community dwelling older adults that identified gaps in knowledge and use of prevention strategies, and the related literature. The program includes pre-set modules, however, participants will be able to voice individual concerns and problem-solve solutions during group discussions, and will discuss topics such as self-advocacy regarding reporting problems to the city.

Participants will be asked to keep daily diaries of stumbles, trips, slips, and falls from the time they enroll in the study until two months following the completion of the program. Dr. Chippendale is currently conducting the study.

Faculty Achievements: Grants and Publications 2016-2017

A complete list of achievements by the faculty of the NYU Steinhardt Department of Occupational Therapy.

Grants and Awards:

Tracy Chippendale

“Stroll Safe”: An outdoor fall prevention program. Funder: NY Community Trust. Dates of project:February 2017-February 2018. Role: PI Total budget: $20,000

Janet Njelesani

2017: The landscape of child disability in Rwanda funded by UNICEF. $320,000.

Kristie Patten Koenig

Co-Principal Investigator: “A Comprehensive Program Evaluation of the ASD Nest Program: Student and School Community Impact” (Co-Principal Investigator Cheri Fanscelli, Ph.D.) FAR Fund. Funded for 1/1/17 to 12/31/17. $50,000.

Publications:

Tracy Chippendale

Chippendale, T. & Lee, C-D. (accepted).Characteristics and fall experiences of older adults with and without fear of falling outdoors. Aging & Mental Health.

Chippendale, T., Gentile, P. A. & James, M. K. (accepted). Characteristics and outcomes of falls among older adult trauma patients: Considerations for injury prevention programs. Australian Occupational Therapy Journal.

Yael Goverover

Engel, L., Chui, A., Goverover, Y., &  Dawson, D. (Accepted: 2/3/17). Optimizing activity and participation outcomes for people with self-awareness impairments related to acquired brain injury: An interventions systematic review. Neuropsychological Rehabilitation.

Jim Hinojosa

Hinojosa, J. (In Press). How society’s philosophy has shaped occupational therapy practice for the past 100 years. The Open Journal of Occupational Therapy

Tsu-Hsin Howe

Howe, T.-H., Sheu, C.-F., & Hinojosa, J. Teaching Theory in occupational therapy using a cooperative learning: A mixed method study (Accepted). Journal of Allied Health.

Lee, T.-I., Howe, T.-H., Chen, H.-L., & Wang, T.-N. (2016). Predicting handwriting legibility in Taiwanese elementary school children. American Journal of Occupational Therapy, 70, 7006220020. http://dx.doi.org/10.5014/ajot.2016.016865

Kristie Patten Koenig

Patten Koenig, K. & Hough, L. (published online first January, 2017). Characterization and utilization of preferred interests: A survey of adults on the autism spectrum. Occupational Therapy in Mental Health.

 

OT Speaker Series: Cognitive-Functional Lecture

This semester, we were pleased to welcome Professor Adina Maeir and Dr. Ruthie Traub Bar Ilan of Hebrew University in Jerusalem. Professor Maeir and Dr. Traub Bar Ilan presented their 10 year summary of research and clinical activity of their project Cognitive-Functional (Cog-Fun) Intervention in Occupational Therapy for Individuals with ADHD.

Cog-Fun is an integrated cognitive functional treatment approach designed to address the multifaceted implications of ADHD on the individuals participation in daily occupations.This approach is based on the understanding that the core neurocognitive executive deficits in ADHD interact with psychosocial factors that impact daily functioning and quality of life. The Cog-Fun change mechanisms for improving functioning and quality of life include occupation-based meta-cognitive learning, behavioral learning and environmental adaptation, as well as a positive and empowering therapeutic relationship with clients and their families.

Professor Maeir and Dr. Traub Bar Ilan presented their data as well as showed video interviews with their clients as well as sessions with them to show the impact this treatment approach can have.