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U n i v e r s i t y o f P i t t s b u r g h

FACETSSchool of health and rehabilitation sciences

BUILDING

Spring/Summer 2009

a better child

CONTENTSS p r i n g /S u m m e r

2 0 0 9

F A C E T S S c h o o l o f h e a l t h a n d r e h a b i l i t a t i o n s c i e n c e s

Publisher Clifford e. Brubaker

Executive Editor patty Kummick

Writing and Design Forge Communications

Photography William exler

University of Pittsburgh

FACETS is published by the Office of the Dean, School of Health and rehabilitation Sciences. it is produced twice a year for alumni, students, staff, faculty, and friends of SHrS.

The university of pittsburgh is an affirmative action, equal opportunity institution.

1 From the Dean CliffBrubaker

2 Giving PattyKummick

3 Access Dr.KateSeelman

4 Student News

6 Faculty News

8 Alumni News

9 Department News Calendar of Events

10 Clinical Instructor Profile SpeechTherapyand ThenSome

12 Alumni Profile LifelongAdvocacy

14 Real World CollinThompson

17 Rehabilitation Science and Technology ANewBrandof CareerBuilder

20 Communication Science and Disorders But,CanJohnnyWrite?

24 Health Information Management HealthCareDeliveryinFar AwayPlaces

26 Sports Medicine and Nutrition HelpingKidsEatRight

28 Physical Therapy WhiteMatterDoesMatter

30 Occupational Therapy AssessingIndividualswith High-FunctioningAutism

33 Dialogue AConversationwith CynthiaMiles(PT‘77)

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28 20 14

Practice What You Preach Onthecoverofthefall/winter2008issueofFACETS,weusedaphotothatdepictedtwoseniorshavingagreattimeonatandembicycle,butinadvertentlyignoredtheprincipleswepreachlikewearingahelmetandholdingontothehandlebars.Weapologize.

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F A C E T S S P R I N G / S U M M E R 2 0 0 9 �

F r o m t h e D e a n

Dear Alumni and Friends of SHRS,

Thecurrentclimateofeconomicuncertaintyandyet-to-be-determinedimpact(s)oftheAmerican Recovery and Reinvestment Act of 2009 (ARRA)poseanumberofquestionsforhighereducationinstitutions.Whiletherearedivergentopinionsontheeffectivenessofthecurrent,andperhapsfuture,stimulusprovisionsenactedbyCongress,the“stimulus”increaseinthebudgetsofmajorfederalagenciessuchastheNIHandNSFappeartobodewellforresearch-intensiveuniversities–andparticularlythosewithcomprehensiveHealthScienceprograms.Theseadditionalfundshavecreatedaflurryofactivitiesasprospectiveinvestigatorsprepareapplicationstocompeteforsubstantialadditionalresearchawards.AstheUniversityofPittsburgh,includingSHRSandotherSchoolsoftheHealthSciences,can

beexpectedtocompetefavorably,thereisreasonforoptimismforresearchfundingoverthenexttwoyears.Forecastingfurtherintothefuturewouldseemproblematic,asourcontinuedsuccesseswilllikelybelinkedquitecloselytothegeneralstateandextentofrecoveryofthenationalandworldeconomies.

Forthepresent,applicationsforadmissiontoSHRSprogramscontinuetoberobustwithsubstantialincreasesinexcessofapplicationsreceivedlastyearbytheendofFebruary.Ibelievethatthiscanbeattributedatleastpartiallytothenationalandinternationalrecognitionwehavereceivedforthequalityofourprograms.Evenwiththiscontinuedandgrowingdemand,therisingcostsofeducationcannotbeignoredinthefaceofeconomicdifficultiesthatnowaffectnearlyallfamilies.Ourabilitytocontaincostsandprovidefinancialassistancehasbecomeanincreasinglycriticalconcern.

Inlightoftheincreasingfinancialburdenofeducation,IampleasedtoacknowledgethesuccessofourSHRSAlumniEndowedScholarshipFund.ThisscholarshipfundwasestablishedbytheSHRSAlumniSocietyBoardinrecognitionoftheschool’s35thanniversaryin2005.Ourinitialgoalhasbeenmetandinfacthasbeenexceeded.Asaresultofthesuccessinthiseffortwearenowawardingscholarshipsfromthisfund.StudentsfromallSHRSprogramsareeligibletoapplyandcriteriaincludeacombinationofmeritandneed.AsIamsureyouknow,needforsupportcontinuestogrowandweurgedonorstocontinuetocontributetothisfund.

Iwouldalsoliketotakethisopportunitytodirectyourattentiontoaparticularlyrelevantarticleinthisedition.Dr.CynthiaPuranik,whojoinedthefacultyoftheDepartmentofCommunicationScienceandDisorders,hasestablishedaresearchprogramonthemoreneglectedofthedualityofcommunicationdimensionsintheearlystagesofeducationforchildren.Thisinvestigationtoexploredevelopmentofwritingproficiencyprovidesauniqueandappropriateadditiontotheresearchenterpriseforstudyofcommunicationscience.Itrustthatyouwillfinditbothinstructiveandinteresting.

LetmeconcludebyalsonotingtheeffortsoffacultyinourDepartmentofRehabilitationScienceandTechnology(RST)intheiroutreacheffortstoprovideopportunitiesforResearchExperiencesforUndergraduatesonQualityofLifeTechnologies.ThearticleonRSTactivitiesalsoincludestheTech-Linkoutreachprogramthatbringstogetherminoritystudents,studentswithdisabilities,andothermiddleschoolstudentstoprovideeducationalandtrainingexperiencestopromoteinterestinSTEMactivitiesviaa10-weekroboticstrainingprogramthatculminateswiththeannualFIRST Lego Leaguecompetition.

ThankyouforyourcontinuedsupportofSHRSanditsprograms!

[email protected]

“Our ability to contain

costs and provide financial

assistance has become an

increasingly critical concern.”

� F A C E T S S P R I N G / S U M M E R 2 0 0 9

giving

[email protected],PA15260

PattyKummickDirectorofDevelopment

Lastfall,whenstudentswerebusyapplyingforvariousSHRSscholarshipsandawards,

theschoolquietlyrealizedamilestone.The2008-2009schoolyearmarkedthedistributionofthefirstawardsfromtheSHRSAlumniEndowedScholarshipFund,whichwascreated

in2005tocommemoratetheschool’s35thanniversary.Becauseofgenerousandon-goingsupportfromalumni,faculty,staff,andfriends,thefundprovidedthreetop-performingstudentswithscholarshipassistance.(ForalistingofallSHRSawardrecipients,seepage5.)

It’sexcitingtorealizethatthisfundgrewfromacommunaleffort…gifts,bothsmallandlarge,fromsomanyofyou.Yourreasonsforgiving,I’msure,werevariedandpersonal.Perhapsyouwantedtomakecollegelifealittleeasierforonewhomayfollowasimilarcareerpathasyours.Ormaybeyougavebecauseyou’reproudoftheeducationandclinicalexperienceyoureceivedwhileastudentatPitt.Ormaybeyourecognizehowvaluableyoureducationhasbeenandyouwanttoseeothersbenefitfromourexceptionalschool.

Whateverthereason,weappreciateyourcommitmentanddedicationtoyourAlmaMaterandencourageyoutocontinuesupportingtheschooloraparticularprogramordepartmentasyouareable.

Ifyourinterestlieswithinaparticularprogramordepartment,youcandirectyourgifttothatprogram.Oryoucandesignateyourgifttoanumberofexistingmulti-donorfunds(i.e.AudreyHolland,Matthews/Rubin,andEmeritusfundsinCSD;AnthonyDelitto,VickiGreenMemorial,andDTWatsonfundsinPT;ThomasJ.O’ConnorMemorialFundinRST;TimKerinMemorialandSportsMedicineStudentResourcefundsinAT/SM).Oryoumaycontinuesupportingtheschool-wideSHRSAlumniFund.

Ofcourse,theopportunityalwaysexistsforyoutoestablishyourownnamedfund.Eveninchallengingeconomictimes,optionsforcharitablegivingexist.Iwouldbehappytodiscusstheseoptionswithyouorassistyouinthestraightforward,painlessprocessthatenablesyoutocreatealastinglegacyofyourownhereatSHRSandatPitt.

Here’stoaprosperousandfruitfulSpringforallofus!

Sincerely,

PASCASIODELIVERSLECTURE

Students,faculty,andstaffweretreatedtoaonce-in-a-lifetimeexperienceonFriday,March20.AttheinvitationofSHRSstudents,Dr.AnnePascasio,foundingdean,presentedalecturetitled“HerStory:AHistoryofSHRS”toastanding-room-onlycrowd.PascasioreflectedonhertimeatD.T.Watson(asastudentandinstructor),hereducationatPitt,andhertenureasthefirstdeanforwhatisnowtheSchoolofHealthandRehabilitationSciences.It’saremarkabletaleofonewoman’sstrength,intelligence,intuition,determination,andboundlessenergy.

Attheveryheartofthelecturewasasenseofprideforwhattheschoolusedtobeandwhattheschoolhasbecome.Theaudiencewalkedawaywithagreaterappreciationoftheschool’sheritageandagreaterunderstandingoftheaccomplishments,challenges,andopportunitiesthatserveasthebackboneofSHRS.

ManythankstoDr.Pascasioforacceptingthestudents’invitationandforbeinghergracious,givingself.AndkudostostudentsRachelBlaskoandLeanneGanterforsuggestingtheforumandorganizingtheevent.

Dean Cliff Brubaker (left) and Dr. Anne Pascasio (right) thank Rehabilitation Science seniors Leanne Ganter and Rachel Blasko for organizing the “Her Story: A History of SHRS” lecture.

To view the lecture, go to www.shrs.pitt.edu and click on “Alumni” on the left, then click on “MediaSite” on the right. Click on the “SHRS Public Presentations” file and go to “Her Story” under presentations.


It is estimated that there are over 20 million deaf and hard-of-hearing children and adults in the United States. I am one of them. However, unlike other physical disabilities, ours is virtually invisible. Unfortunately, this invisibility seems to extend to government and the health care community as well. For example, deaf people have not been counted in the U.S. Census since 1930. The last known count was privately conducted by the National Association of the Deaf in 1971. Even the most essential assistive technology – a hearing aid – is not paid for by most government and private insurers. Recently, I paid $6,800 for new hearing technology – totally out-of-pocket. Many insurers view the devices as cosmetic. The ability to hear and communicate is not deemed a medical necessity.

Ray and Jennifer Spellman confronted this reality 11 years ago, when their then six-month-old son Andrew was diagnosed with deafness. I’ve asked them to share their experience.

Andrewwasoursecondchild.Hewasahappybaby,alertandalwayssmiling.Atthetime,newbornswerenotscreenedfordeafness,soitwasnotuntilhewas

sixmonthsoldthatwefirstsuspectedaproblem.Andonlythen,itwasbecauseofourdog.Andrewwouldalwaysturnhisheadtowarduswhenwewalkedintheroom.Weknownowthathefeltourvibration.Butonedaywhenwewereplayingwithhimwenoticedthathedidn’treactwhenthedogbarked.Thatwasour“aha”moment.

Thatrealizationsetusoffonweeksoftesting,retesting,andconsultation.Onespecialistintimatedthattherewasprobablymoreinvolvedthandeafness.Retardation,hesuggested,wasalsoapossibility.Anotherphysicianinsistedonamedical“fix”–acochlearimplant.Whileultimately,Andrewdidhavetheprocedure,atthetime,noonecouldexplaintouswhysurgerywastheonlyanswer.Andbecausewehadnoexperiencewithdeafness–nooneineitherimmediatefamilyhadanyhearingproblems–wehadnoideawheretoturnforanswers,andnoadvocatestopointusintherightdirection.Wewereonourown.

Throughtrial,error,andtenacity,weidentifiedresourcesandpiecedtogetherasupportsystem.Welearnedtosign,andtaughtothersaswell.SpeechandhearingprofessionalssuppliedbytheAlleghenyIntermediateUnitcametoourhometoworkwithAndrewonhiscommunicationsskills.Itwasoneoftheseprofessionalswhoalertedusthatstartingatagethree,AndrewwouldneedtobeginattendingclassesattheWesternPennsylvaniaSchoolfortheDeaf(WPSD).WeweretolditwasouronlyoptionifwewantedAndrewtohaveaccesstospecialservicesuntilage18.

WhilewewerenotopposedtoAndrewattendingtheWPSD,wewereconcernedaboutthedistancebetweenMoonTownship,wherewelive,andEdgewood,wheretheschoolwaslocated.Bothofusworked,ourolderdaughterwasinschool,and

anotherbabywasontheway.Bustransportationwasouronlyoption.Butwhowantstoentrusttheirthree-year-oldtoastrangerforanalmost50-mileroundtripcommutefivedaysaweek?Athree-year-oldwhocan’ttalkandcan’thear.

Ourconcernwasjustified.Withinashorttime,wereceivedatelephonecallfromthepolice.Oursonwasintheircustody.ThebusdriverhadtakenAndrewtoanearbybarwhosenamewassimilartoourstreetname.HeaskedacompletestrangerifshewastheretopickupAndrew.Fortunately,thestrangerwastheowneroftheestablishment,andshecalledthepolice.Oursoncamethroughtheincidentunscathed;however,thisexperienceignitedanotherfight–thistimeforsafe,reliabletransportation.Itwasabattlethatplayedoutinthemediaandultimatelywaswonthroughapainstakingfightwiththeschooldistrict.

AndrewcontinuedatWPSDuntilthethirdgrade.WhileitwasanexcellentschoolandprovidedAndrewwithasolidcommunicationsfoundation,wefeltthatifheweretoreachhisfullacademicpotential,heneededtobeinadifferentsetting.OurfirstchoicewasaprivateChristianschoolthatourthreeotherchildrenattended.Hereagain,weweretold“no”–notifweexpectedthestatetopaythecostofaninterpreterandothersupportprofessionals.Itdidn’tmatterthatwecoulddemonstratethatcostsattheChristianschoolwouldbelower,orthattherewasvalueinkeepingourchildrentogetherinthesameschool.Churchandstate,weweretold,hadtoremainseparate.Fundingforserviceswasavailableonlyinthepublicschools.Noexceptions.

Ultimately,wemovedAndrewandourotherchildrenintoapublicschoolsetting.We’velearnedtheinsandoutsofcreatingadetailedindividualizededucationplan,andalotmoreaboutourrights.Andrewnowhasacommittedteamofspeechandlanguageprofessionals,andisthrivinginhisnewenvironment.Nextyear,heentersthemiddleschool,andalreadytheelementaryschoolprincipalisadvocatingforhimtoensurehecontinuestoreceivethebestpossiblesupport.We’reoptimisticabouthisfuture.

Butwouldtheoutcomehavebeenthesamehadwenotbeensowillingtofightforhisrights?Weknewnothingabouthisdisability,theprosandconsofthevarioustreatmentoptions,ortherulesandregulationsthatgovernsupportservices.Wehadtolearnaswewent.Werefusedtotake“no”forananswer.Yet“no”wastheanswerweheardmostoftenfrompeoplewhoeitherdidn’tknow,ordidn’tcare.

Parentingachildwithahearingdisabilityisachallenge.Butthedifficultiesarecompoundedwhenyou’reforcedtobecomeafull-timeadvocateaswell.Whathappenstothosechildrenwhoseparentsorcaregiverscan’t–orwon’t—dobattle?Wecanonlywonder.

ACCESSGivinggiving

Access

DR. KATE SEELMAN


Student NewsJoe Olson,graduatestudentintheDepartmentofRehabilitationScienceandTechnology,washonoredatthe4thAnnualCelebrationofInnovationonOct.6.Olsonworkedwithasmallteamofresearcherswhodevelopedawheelchairconvoysystemthatallowsmultiplepeopleinchairstosafelymoveatonetime.Thetechnology,whichwonanInnovatorAward,waslicensedtoacompanyinOctober2007.TheCelebrationofInnovationwashostedbytheUniversity’sOfficeoftheProvostandtheOfficeofTechnologyManagement.JoiningOlson(secondfromright)are(lefttoright)Dr.ArthurLevine,seniorvicechancellorforHealthSciences,JamesV.Maher,provostandseniorvicechancellor,andChancellorMarkA.Nordenberg.

Kimberly MeighandApril Scott,doctoralstudentsintheDepartmentofCommunicationScienceandDisorders,wereawardedthe2008NewCenturyScholarsDoctoralScholarshipsfromtheAmericanSpeech-Language-HearingFoundation.Theywereamong20doctoralcandidatestoreceivetheawardbecauseoftheircommitmenttoattainingtheresearchdoctoraldegreeandworkinginahighereducationacademiccommunityinthefieldofCSDintheUnitedStates.

Rhona Galera,CScDstudentintheDepartmentofCommunicationScienceandDisorders,receivedthe2008GraduateStudentScholarshipfromtheAmericanSpeech-Language-HearingFoundation.Theaward,oneofsevenawardedannually,recognizesgraduateordoctoralstudentswho

demonstrateoutstandingacademicachievement.

Lisa Guttertag Lederer,agraduatestudentintheDepartmentofCommunicationScienceandDisorders,receivedtheAmericanSpeech-Language-HearingAssociationSpecialInterestDivision2StudentResearchTravelFellowship.Shewasrecognizedforoutstandingstudentresearchinneurophysiologyandneurogenicspeechandlanguagedisorders.

Lindsay Diethorn,AuDstudentintheDepartmentofCommunicationScienceandDisorders,receivedthePennsylvaniaAcademyofAudiologyStudentScholarshipfor2008.Thisstatecompetitionawardsstudentsforoutstandingachievementinaudiology.

Veronica Umeasiegbu,amaster’scandidateintheDepartmentofRehabilitationScienceandTechnology’sRehabilitationCounselingprogram,spent10weeksasaninternwiththeWorldHealthOrganization.Duringherinternship,VeronicafoundasponsorandspearheadedasuccessfulfundraisingeffortamongherinternclasstosendasetofessentialclinicaltextstoacommunityhealthcenterinherhomecountryofNigeriathroughWHO’sBlueTrunkLibraryprogram.ShealsowonanessaycontestforUNinternsonimplementationoftheMilleniumDevelopmentGoalsandpresentedaprojectproposalatapaneldiscussionduringtheDialogueonGlobalGovernance.

Alexandra Jefferds,graduatestudentintheDepartmentofRehabilitationScienceandTechnology,recentlyself-publishedherfirstscience-fictionnovel.“EarlierHeaven”addressesmanyreal-worldthemesandservesasavehicleforJefferdstoexpandupononeofherlife’spassions–helpingpeoplewithdisabilities(theheroineisayounggirlwithadisability).

Steve Gaul,astudentintheAthleticTrainingprogram,becamethesecondPittathletictrainingstudentinthelast

S t u d e n t N e w s

threeyearstoparticipateinavictoriousSuperBowlcelebrationfollowingthePittsburghSteelersdramatic27–23winovertheArizonaCardinalsonFeb.3.Stevespenttheentire2008seasonwiththeSteelerscompletingoneofhisclinicaleducationexperiencesaspartoftheathletictrainingstaff.HealsotookpartintheSteelersvictoryparadefollowingtheteam’sreturntoPittsburgh.

Bailee Miller,astudentintheAthleticTrainingprogram,wasselectedasoneofthreeathletictrainingstudentsfromPennsylvaniatoparticipateinthefirstiLeadConferenceinWashington,DC.Theprogram,sponsoredbytheNationalAthleticTrainers’Association,promotesstudentleadershipdevelopmentandoffersopportunitiestoattendworkshopsandmeetingsaswellasspendingadayonCapitolHillmeetingwithlegislatorstodiscussandpromotetheprofessionofathletictraining.

Michelle Petraglia,master’sstudentintheDepartmentofCommunicationScienceandDisorders,wasselectedbytheCSDfacultytoreceiveastudenthonorsawardfromtheSouthwestPennsylvaniaSpeechandHearingAssociation(SWPSHA).TheawardwaspresentedattheSWPSHAHonorsmeetinginMarch.

Rhona Galera,adoctoralstudentintheclinicalscienceinspeechlanguagepathologyprogram,participatedinamedicalmissioninQuito,Ecuador,attheNuevaTierraHospitalthroughFacesofTomorrow.Galeraworkedasateamwithpediatricians,dentists,surgeons,socialworkers,andtranslatorstoaidechildrenwithcleftlipandcleftpalatedeformitiesandtheirfamilies.

Melissa Stauffer,MOTstudent,wasawardedtheGreekRoomCommitteeScholarshipfromtheUniversityofPittsburghNationalityRooms.ItwillsupportherparticipationintheExperientialLearningInternational’sPrograminGreece.


�008-�009 SHRS Scholarship and award recipientsThe following is a listing of SHRS scholarships and awards granted to students during the 2008-2009 academic year.

Wikar Kadhim,MOTstudent,wasawardedtheFredC.BruhnsMemorialAwardfromtheUniversityofPittsburghNationalityRooms.ItwillsupporthisparticipationintheExperientialLearningInternational’sPrograminJordan.

Michelle AndersonandStephanie Young,MOTstudents,andDrs. Ketki Raina,assistantprofessorandDenise Chisholm,associateprofessor,presentedPromotingOccupationalTherapyThroughInternationalExperientialLearningatthe31stAnnualPennsylvaniaOccupationalTherapyAssociationConference.YoungandRainaalsopresentedTheCulturalImpactonDisabilityinTanzanianChildren.

Michelle Anderson,Benjamin Gross,andWikar Kadhim,MOTstudents,wereselectedas2008–2009JewishHealthcareFoundationJonasSalkFellows.

Betsy Boyce,Alisha Cousins,Cortney DiVito,Caitlin Feeney,Ellen Malinoski,Shelley McCauley,Renee McDade,Amanda Miller,Angela Pasquarelli,Sarah Petrus,Lori Sopko,Anne Marie Sweeney,Carla Tcruz,andJeanna Thomas,MOTstudents,wereinductedintotheBetaTauChapterofPiThetaEpsilon,thenationalhonorsocietyforoccupationaltherapystudents.

Natalie D’Angelo,Benjamin Gross,Shelley McCauley,Amanda Miller,andSarah Petrus,MOTstudents,andYu Yun Huang,MSstudent,representedtheDepartmentofOccupationalTherapyattheNationalDisabilityDayeventandprovidedassistancetostudentswithdisabilities.

Betsy Boyce,Benjamin Gross,andCaitlin Feeney,MOTstudents,presentedOccupationalTherapyasaCareerto

9th–12thgradestudentsattheSchooltoCareerDaysponsoredbytheOaklandPlanningandDevelopmentCorps.BoyceandGrossalsopresentedahands-onworkshop,OccupationalTherapyasaCareerto10th–12thgradestudentsatCareerConnectionsCharterHighSchoolofPittsburgh.

Andi Saptono,doctoralcandidateintheDepartmentofHealthInformationManagement,presentedaninstructionalcourseonTelerehabilitation:AViableMethodWheelchairPrescriptionatthe25thInternationalSeatingSymposiuminOrlando,Fla.,inMarch.SaptonowillalsopresentUserRoles,Needs,andInformationManagementFeaturesinTelerehabilitationattheAmericanTelemedicineAssociation14thAnnualInternationalMeetingandExpositioninLasVegasinApril.

Bruce Baker Travel Award (school-wide) GustavoAlmeida(PT) KearaChestney(HIM) MariaDietrich(CSD) CaitlinFeeney(OT) AmandaGillespie(CSD) PatrickLambert(EM) PalmaLiberto(HIM) DanielleMaloney(RS) MichaelMorgan(RS) AnaSouza(RST) PauloTeixeira(PT) MatthewWeaver(EM)

Anne Pascasio Scholarship (school-wide) SarahChunko(PT) ShelleyMcCauley(OT) AlyssaMeisenhelter(RS)

SHRS Alumni Endowed Scholarship (school-wide) AlexandraJefferds(RST) KaHeiKarenLau(CDN) SvenLynch(PT)

UPMC Scholarship (school-wide) MeghanJablonski(CSD) SarahPetrus(OT) KristinRobb(CDN)

Mildred Wood Student Resource Award (school-wide) SuzanneAdjogah(CSD) TessaUtz(CSD) MohamedHagahmed(EM) MarkMurphy(EM)

AVADA Book Award (CSD) GregoryGenna JeniferPowers MeganHannonVargo

Bruce Baker Student Training Award (CSD) ThomasKovacs

Emeritus Award (CSD) KathleenHodges

Lisa Levy Memorial Award (CSD) InbalVellucci

Dorothy Bradley Brown Scholarships (PT) ChristaBauer JeffersonHolm JillianKosinski JessicaMiller KristinOrenchuk

Pat Croce Scholarship (PT) TimothyZelch

Joseph M. David/David PT & Sports Medicine Center Scholarship (PT) LauraFawcett

Victoria Green Memorial Resource Award (PT) SamanthaWaller

Patti Leahy Memorial Award (PT) ZabrinaLanger

Pearl Cricco Mann Scholarship (PT) RalphHoerner

Alice Chagnot Oulette Scholarship (PT) WilliamBuchala

Paul and Judy Rockar Scholarship (PT) ChristinDonofrio

D.T. Watson Scholarship (PT) AndreaWysochansky

Rory A. Cooper/Dion Johnson Student Award (RST) SaraSibenaller

Sean and Stephanie Shimada Student Award (RST) HyunwookKa

Freddie Fu Athletic Training Scholarship (SMN) StephenGaul KimberlyStoner DougZaruta

Freddie Fu Sports Medicine Graduate Research Award (SMN) Yung-ChienChu AnthonyHouse Hung-ChunHuang

Tim Kerin Athletic Training Scholarship (SMN) JenniferLucy


F a c u l t y N e w s

Faculty News

Dr. Sajeesh Kumar,assistantprofessor,iscoordinatingallresearchinitiativesoftheCenterforTelehealth,aninformalgroupofpeersinvolvedintelemedicineservicesatPittandUPMC.

Dr. Leming Zhou,assistantprofessor,presentedaposter,“SPARK – A Systems Biology Framework for Agent-Based Biomedical Modeling,”attheComputationalCellBiologyMeetinginMarchatColdSpringHarborLab,NY.

Occupational Therapy

Dr. Denise Chisholmwaspromotedtoassociateprofessor.

Mary Lou Leibold,assistantprofessor,authoredtwochaptersofthenewlyinitiatedAmericanOccupationalTherapyAssociation’sFieldworkEducatorCertificateProgram.

Joanne BairdandLeibold,assistantprofessors,wereselectedasoneof15teamsnationwidetoparticipateinathree-dayTrain-the-TrainerInstituteandwill,inturn,providemultipletwo-dayworkshops,locallyandregionally,foroccupationaltherapypractitionerswhosupervisestudentsduringfieldwork.The

SHRSwelcomesthefollowingnewfacultytoitsranks:

Joanne Merante BairdhasjoinedtheDepartmentofOccupationalTherapyasanassistantprofessor.SheisalsoresponsibletotheCentersforRehabServices(CRS)astheoccupationaltherapycoordinatorofclinicaleducationandprofessionaldevelopment.Inthisrole,shewilloverseeplacementofoccupationaltherapystudentsfromavarietyofacademicprogramsatCRSclinicalsites.BairdreceivedherBachelorofArtsdegreeinOTatPittandherMasterofArtsinOTfromtheUniversityofSouthernCalifornia.Shehasclinicalexperiencefromacrossthehealthcarecontinuumincludingacuteandinpatientrehabilitationaswellascommunity-basedoutpatientandskillednursingcare.SheisthePennsylvaniaOccupationalTherapyAssociationDistrictIIsecretary.

Dr. Sajeesh KumarhasjoinedtheDepartmentofHealthInformationManagementasanassistantprofessor.KumarreceivedhisdoctorateinTelemedicinefromtheUniversityofWesternAustralia,andhisresearchinterestsarerelatedtothedesignanddevelopmentoftelemedicinetechnology,ruralandremotehealthcareservice,andassessmentofmedicaltechnology.PriortocomingtoPittsburgh,KumarconductedresearchandserviceactivitiesinAustralia,Singapore,theNetherlands,Seychelles,UnitedArabEmirates,andIndia.Healsorecentlyeditedthefirstbooksonteleradiologyandtelepathology(publishedbySpringer).Heiscontinuinghisinnovativeresearchintelemedicineande-healthatSHRS.

Communication Science and Disorders

Dr. Katya Hill,associateprofessor,receivedtheDepartmentoftheArmyCertificateofAppreciationforhercontributiontotheeducationofstaffatWalterReedArmyMedicalCenter.HillwasalsoapresenteratiCREATe’s3rdInternationalConventioninSingapore.Whilethere,sheconsultedonAACservicedeliveryandresearchneedsatvariousspecialschoolsandrehabilitationorganizations.

Dr. Sheila Pratt,associateprofessor,wasnamedaFellowoftheAmericanSpeech-Language-HearingAssociation,recognizingheroutstandingprofessionalandscientificachievementsinthefield.ShealsoreceivedtheASHAEditors’AwardfortheAmerican Journal of Audiology.

Dr. Scott Yaruss,associateprofessor,wasnamedthe2008Speech-LanguagePathologistoftheYearbytheNationalStutteringAssociation.

Health Information Management

Dr. Mervat Abdelhak,chairandassociateprofessor,presentedrecentlyatasymposiumbytheInternationalUniversityofHealthandWelfareinTokyo.Thesymposiumaddressedformaleducationaswellasworkforceissuesforhealthinformationandcancerregistry.

Abdelhakwasalsoinvitedtopresentthekeynoteaddress,“Advances in e-HIM: From Vision to Reality”ataconferenceinSaudiArabiainMarch.Duringhervisit,shealsoevaluatedtheHealthInformaticsgraduateprogramatKingSaudBinAbdulazizUniversityofHealthSciencesandconsultedwithotheracademicinstitutionswithinterestinhealthinformation.

Dr. Abdelhak, front row, second from left, is joined by the dean of the International University and the chair of the Health Information Management program and representatives from the Japan Hospital Association.


twoalsopresentedatthePennsylvaniaOccupationalTherapyAssociationandthePittsburghFieldworkCouncil’sConferenceforOccupationalTherapyPractitioners.Also,BairdisrepresentingtheAmericanOccupationalTherapyAssociationontheShortTermAlternativesforTherapyServices(STATS)ContractProjectadministeredbytheComputerSciencesCorporation(CSC)andfundedbytheCentersforMedicareandMedicaidServices.

Drs. Ketki Raina,assistantprofessor,Joan Rogers,professor,TerenceStarz,professor,andAmalie Andrew,researchoccupationaltherapist,presentedPatients’ Perceptions of the Meaning of the FIQ Activity ItemsattheAmericanCollegeofRheumatology/AssociationofRheumatologyHealthProfessionals2008AnnualScientificMeeting.

Dr. Elizabeth Skidmore,assistantprofessor,wasinvitedtopresentatalkonLife After Stroke: Long-term Issues for Stroke Survivorsatthe4thAnnualAcuteStrokeManagementConference.ShealsopresentedDeveloping Clinical Practice Guidelines for RehabilitationatthePennsylvaniaAssociationofRehabilitationFacilitiesAnnualConference.

Dr. Nancy Baker,assistantprofessor,andMOTstudentAbby SipppresentedThe Association Between Impairments Due to Rheumatoid Arthritis and Typing SkillsattheAmericanCollegeofRheumatology/AssociationofRheumatologyHealthProfessionals2008AnnualScientificMeeting.BakeralsopresentedObservational Studies of Non-Pharmacologic Interventions: Methods to Measure PerformanceattheACRClinicalResearchConference:SessionI:MethodsforNon-PharmacologicInterventions.

Drs. Denise Chisholm,associateprofessor,Margo Holm,professor,Ketki Raina,assistantprofessor,Joan Rogers,professor,Elizabeth Skidmore,assistantprofessor,Min-Mei Shih,postdoctoralassociate,Joanne Bairdassistantprofessor,andSHRSalumnaeDrs. Razan HamedandSana Abu-Dahab

presentedpeer-reviewedpapersatthe31stAnnualPennsylvaniaOccupationalTherapyAssociationConference.

Rehabilitation Science and Technology

Al Condeluci,adjunctfaculty,servedasguesteditorofthelatesteditionoftheJournal of Vocational Rehabilitation.

AspartofanationalcampaignorganizedbytheVeteransAdministration,VACanteenService,andGeneralMills,Cheerios®releasedacerealboxfeaturingseveralveteranathletesfromthe28thNationalVeteransWheelchairGamesincludingDr. Rory Cooper,distinguishedprofessorandchair.Coopersignedcerealboxesand“sportsherocards”atvariousVACanteenServiceStoresinthePittsburghareaaspartofthecampaign.

Cooper,anArmyveteran,alsocompetedthispastfallinthe33rdMarineCorpMarathon,finishingfourth.CooperwascloselyfollowedbyaMarineheteamedupwithandthetwofoughtinfriendlyinter-servicerivalryastheyclimbedthehilltotheIwoJimaMemorialinWashington,DC.

Deborah L. Endres,instructor,receivedaPostsecondaryEducationProgramsNetwork(PEPNet)granttosupportherattendanceatthe“AddressingNeedsofStudentsLabeledDeafandLowFunctioningAt-RiskorDeafblind”heldinHoustonlastfall.PEPNet’sgoalinthissupportwastoexplorethedevelopmentofaprogrambasedupontheCognitiveSkillsEnhancementProgramdevelopedandimplementedbyRSTfacultyandstudentsincooperationwiththeHiramG.AndrewsCenter,Johnstown,Pa.

Dr. Katherine Seelman, associatedeanofdisabilityprograms,professor,DepartmentofRehabilitationScienceandTechnology,wasnamedtotheCommunityAdvisoryBoardofWQED,thepublicbroadcastingentityinPittsburgh.Theboardreviewsprogramminggoalsestablished,theservicesprovided,andthesignificantpolicydecisionsrenderedbytheWQEDCorporation.

Sports Medicine and Nutrition

Dr. Kevin Conley,assistantprofessorandprogramdirector,AthleticTrainingEducationProgram,wasnamedtheassistantdeanforundergraduatestudiesfortheSchoolofHealthandRehabilitationSciences.

Judy Dodd,adjunctassistantprofessor,ClinicalDieteticsandNutrition,wasnamedtotheAmericanDieteticAssociationBoardofDirectorsasthechairmanoftheADAFoundation.ShewasalsoelectedtotheAdagioHealth(formerlyFamilyHealthCouncil)BoardofDirectors.

GeneralMillsissupporting

militaryfamiliesandfeaturing

goldmedalwinnersofthe2009

NationalVeteransWheelchair

Games,includingDr.Rory

Cooper,chair,Departmentof

RehabilitationScienceand

Technology,onspecialedition

Cheeriosboxes.Theywillbesold

inmilitarymarketsandVeterans

CanteenServiceretailoutlets.

8 F A C E T S S P R I N G / S U M M E R 2 0 0 9

Emergency Medicine

Turki Alhamid(EM’04)isaparamedicfortheRoyalClinic/King’sPalaceinRiyadh,SaudiArabia.HeisalsopartoftheKingAbdullahMedicalTeamestablishinganon-emergencymedicaltransportprogram.AlhamidmetwithDeanCliffBrubakerduringthedean’striptotheKingdominNovember.

Health Information Management

Meagan Sampogna(HIM’00)waspromotedtodirectorofclientsolutionsandimplementationfortheReimbursementAccessServicesDivisionofMcKessonSpecialty.ThenewpositioninvolvedrelocatingtoScottsdale,Ariz.Previously,Sampognaservedasdirectorofpharmacyoperationsanddirectorofstrategyandprogramdevelopmentforthecompany.

Meredith Flack(HIM’08)acceptedapositionasimplementationspecialistwithMcKessonProviderTechnologies,Alpharetta,Ga.

Julie Rudolph(HIM’08)hasacceptedthepositionofimplementationspecialistwithNextGenHealthcareInformationSystems,Horsham,Pa.

Sarah Smith(HIM’08)recentlyacceptedthepositionofmedicalrecordscoordinatorwithPrecisionTherapeutics,Pittsburgh,Pa.

Dr. Bakheet Aldosari(HIM’00,’03)waspromotedtochairmanoftheDepartmentofHealthInformaticsintheCollegeofPublicHealthandHealthInformaticsatKingSaudBinAbdulazizUniversityforHealthSciences,Riyadh,SaudiArabia.InNovember2008,AldosarimetwithDean

Alumni NewsCliffBrubakerduringthedean’svisittoRiyadhandassistedinmeetingswithSaudieducators.

HIMalumnijoinedfacultyandguestsatareceptionheldinconjunctionwiththeAHIMAConferenceinSeattle,Wash.,inOctober.GatheringforaClassof1981reunionphotowere(lefttoright)Barbara Rosen Knight (HIM’81),Jill Sell-Kruse(HIM’81),Dr. Mervat Abdelhak(HIM’73,SIS’81),HIMchairandassociateprofessor;Denise Dunyak(HIM’81)andMark Dietz,AHIMAdirector.

Jill Sell-Kruse(HIM’81),codingcompliancecoordinatorforMemorialHealthSystem,ColoradoSprings,Co.,isa2008ACEmemberofAHIMAandisaroutinepresenterfortheSouthernColoradoHealthInformationManagementAssociation.She’salsotheproudmotherofthreechildren(twoincollege).

Physical Therapy

Charlotte Carey(PT’65),acompetitiveballroomdancer,competedintherecentAmerica’sBallroomChallengeandplaced1st(worldchampion)inAmericanSmoothStyleWorldPro-Aminthesenior(60andolder)level,and2ndintheAmericanSmooth“C”level(50andover).Sheandherpartneralsotook2ndplaceintheInternationalStandardWorldPro-Amintheseniorleveland5thplaceintheStandard“C”level.

Dr. Ahmad Alghadir,(PT’02,’06)ischairandassistantprofessor,DepartmentofRehabilitationSciencesintheCollegeofAppliedMedicalSciencesatKing

SaudUniversity,Riyadh,SaudiArabia.HeisalsoservingaspresidentoftheSaudiPhysiotherapyAssociation(SPTA).AlghadirprovidedDr.TonyDelitto,chairandprofessor,DepartmentofPhysicalTherapy,atourofSPTAheadquartersduringDelitto’srecentvisittoRiyadhinNovember.

Rehabilitation Science and Technology

Maggie Casteel(RST’07)contributedachapterinarecentlypublishedbookondeafness,ACCESS – Multiple Avenues for Deaf People.Casteelprovidedadescriptionofthelatestinnovativehearingassistivetechnology.ShealsocontributestoHearing Loss Magazine,distributedtomembersofHearingLossAssociationofAmerica.Casteel,withhermaster’sdegreeinrehabilitationcounseling,servesasavocationalrehabilitationcounselorwiththeVA.

Athletic Training

Ryan Grove(AT’93,’96),triathloncompetitor,performedhispersonalbestinthe2008IronmanAustriainKlagenfurt,Austria,recordinga10-hour17-minutetimeinthegruelingtriathlon.GrovecompetesinatleastfourOlympicdistance,Half-Ironman,andIronmanDistanceraceseachyear.NextupistheKineticHalf-IronmaninLakeAnna,Va.Inaddition,Grove,athletictrainerforthePittsburghSteelers,witnessedhissecondSuperBowlwinandvictoryparadewiththeNFLteamthispastFebruary.

A l u m n i N e w s

F A C E T S S P R I N G / S U M M E R 2 0 0 9 9

Alumnus Named Legacy Laureate

Dr. David Perrin(AT’85),picturedwithChancellorMark A. Nordenberg,wasnamedaUniversityofPittsburghLegacyLaureatelastOctober.Recognizedforhisoutstandingpersonalandprofessionalaccomplishments,Perrinwasamong12honoreesfor2008.

Renownedinthefieldofsportsmedicineandathletictraining,PerrinreceivedhisdoctorateinExercisePhysiologyfromtheUniversityofPittsburghin1985.Hecurrentlyservicesasprovostandvicechancellorofacademicaffairs,andaprofessorofExerciseandSportsScienceattheUniversityofNorthCarolinaatGreensboro.

AsamemberoftheNationalAthleticTrainingAssociation(NATA)ProfessionalEducationCommittee,Perrinhelpedestablishaccreditationguidelinesforbothundergraduateandgraduateathletictrainingprograms.Hehaspublishedover130researcharticlesandtextbookchapters.PerrinisarecipientofNATA’sMostDistinguishedAthleticTrainerAwardandisamemberoftheNATAHallofFame.HewasnamedtheSHRSSportsMedicine/AthleticTrainingDistinguishedAlumnusin2005.

Calendar of Eventsa p r i lSaturday, April 18, 2009Health Sciences Alumni Reception, Phoenix, Ariz.

TheSchoolsoftheHealthScienceswillhostanalumnireceptionattheUniversityClubPhoenix,10a.m.–2p.m.PleaseRSVPto412-647-8983.

April 23 – 26, 2009AOTA 89th Annual Conference, Houston, Texas

j u n eJune 17 – 20, 2009NATA �009 Annual Meeting, San Antonio, Texas

TheAthleticTrainingandSportsMedicineprogramswillhostawelcomereceptionfortheiralumni.Date,timeandplaceTBA.Sponsored in part by the SHRS Alumni Society.

June 23 – 27, 2009RESNA Annual Conference, New Orleans, La.

TheDepartmentofRehabilitationScienceandTechnologywillhostanalumnieventcoincidingwiththeconference.DetailsTBA.Sponsored in part by the SHRS Alumni Society.

o c t o b e rOctober 5 – 7, 2009AHIMA Annual Meeting, Grapevine, Texas

TheDepartmentofHealthInformationManagementwillhostareceptionforHIMalumni,Monday,October5,6–7:30p.m..LocationTBA.Sponsored in part by the SHRS Alumni Society.

Tuesday, October 13, 2009Fifteenth Annual Endowed Scully Visiting Lecture Program

Detailstofollow

October 30 – 31, 2009��nd Annual Pennsylvania Occupational Therapy Association Conference,StationSquareSheratonHotel,Pittsburgh,Pa.

Ezine Anyone?Everyday,virtuallyallofusreceiveane-mailnewsletterorotherelectroniccommunication.AtSHRS,weareexploringwaystomakeourinformationmoreappropriatefortheon-lineworld.That’swhywe’reconsideringanEzineversionofFACETS,oneyoucanbrowsetoyourheart’scontent,justlikethehard-copyversion.

Pleasedropusalineat:facets@shrs.pitt.eduandletusknowwhatyouthinkaboutanEzineversion.Andwhileyou’reatit,byallmeansgiveusyourfeedbackonthiscurrentissueofFACETS.

We’dlovetohearfromyou.

�0 F A C E T S S P R I N G / S U M M E R 2 0 0 9

C l i n i c a l I n s t r u c t o r P r o f i l e

Clinicaleducation–thehands-onlearningthatoccurswhenstudentsleavetheclassroomandpracticetheircraftintherealworld–isavaluablepartofstudents’

learningexperienceatSHRS.Notonlydoesitensurethatstudentsareputtingtheirlearningintopractice,ithelpsstudentsweighwhatexperiencesandenvironmentstheyvaluemost,smoothingtheirtransitionintoacareer.

TheDepartmentofCommunicationScienceandDisorders’(CSD)16-weekclinicalpracticumsallowstudentstoputthemselvesintheshoesoftheclinician,learningtheintricaciesofprevention,screening,evaluation,andtreatment.Notonlyaretheyalearninggroundforclinicalcompetenciesandcoreclinicalskills,theyalsoallowstudentstogettoknowthefundamentalsbehindclinicaldecision-making–thetrue“whys”aswellasthe“hows”oftheirfuturejobs.

JenniferBlack,a2003master’slevelgraduateofCSD,completedherclinicalpracticumlikesomanyotherswhileatSHRS.“ItwasthetypeofexperienceIneededtoreallyunderstandwhereIcouldbestputmyskillstouse,”shesaysofthepracticum.“Iexperiencedawiderangeofsettingsinashortamountoftime,workingwithadultsandchildren.TherewasnobetterwayformetohoneinonwhereIwouldfitbestoverthelong-term.Itwasoneofthemostvaluablecomponentsofmyeducation.”

Speech Therapy and Then SomeRecent Graduate Takes the Reins as Clinical Instructor

C l i n i c a l I n s t r u c t o r P r o f i l e

F A C E T S S P R I N G / S U M M E R 2 0 0 9 ��

growth.“Theirconfidenceisreallyelevatedknowingthatsomanypeopleareinvolvedintheirpersonalgrowth.It’sunspoken,butitsthere.Mystudentsreallyfeelgoodaboutalltheattentiontheygetaspartofthepracticum.”

Butthegoodfeelingsarefarfromone-sided.

“Thebondsthatthegraduatestudentsformwiththechildreninmycaseloadareverystrong.Duringthelastdayoftherapy,it’softenmySHRSstudentswhoaremoreupsetaboutendingthepracticumandmovingonthanarethechildren.It’snotablehowclosethegraduatestudentsbecomewithmystudents.It’sthespecialpartoftheprogramthatcangounnoticedbut,inreality,itiswhereagoodpartofpersonalgrowthoccurs.Graduatestudentscanreallyrecognizethevalueoftheirworkwhenit’stimeforthemtomoveon.”

Turning the Tables

Itwasn’tthatlongagothatBlackwasthestudentwithother,moreexperienced,speechtherapistsasmentors.Butnow,justsixyearsafterhavinggraduatedfromtheUniversityofPittsburgh,Blackisintheroleoftutorandhermentees,first-yeargraduatestudentsinCSD,arelearningthenuancesofbeingspeechtherapists.

BlackisjustoneofmanyprofessionalswhoparticipateasclinicalinstructorsforSHRS.SheworksasaspeechtherapistforK-5atHighlandsSchoolDistrictinNatronaHeights,Pa.,givinghertimetomorethan60CSDstudentseachsemester.

Interestingly,itwastheclinicalpracticumitselfthatsetBlackonhercurrentcareercourse.Whileshewasconfidentinthefactthatshehadchosentherightprofession,shewasabithazywhilestillastudentaboutwhatworkingenvironmentwouldsuitherbest.Hervisionforthefuturebecameclearerafterherfirststeadydoseofhelpingchildren.

“IneverthoughtIwouldbeworkingwithchildren,”sheexplains,“ButoneofmylastexperiencesinthepracticumwasinearlyinterventioninthePittsburghPublicSchools.Itwasanamazingexperience–reallylife-changingforme.Ifellinlove.”

Aftergraduation,Blacktookajobalmostimmediatelyworkingwithkidsand,whileshedescribestheexperienceasabigchangeinitially,itdidn’ttakelongforhertofindacomfortablegroove.“TheworkismoreenrichingthanIwouldhaveeverimagined,butatfirstitwasabigchange,”sheconcedes.“Workingwithchildreninaschoolenvironmentcanbechallenging.”

Winning Hearts and Minds

Aspartoftheprogram,graduatestudentscometoworkwithBlackonedayeachweekpersemester.Themaindutyofbothmentorandmenteeistoprovidetherapyandguidancetothechildrenwithwhomtheywork.Buttherelationshipsthatdevelopandthetrustthatevolvesbetweentherapist,graduatestudent,andchildcanprovidelong-lastinglessonsinandofthemselves.

“Ideveloplong-termrelationshipswithmyyoungstudentsastheirprimaryspeechtherapist,buttheadditionofagraduatestudentclinicianintothemixleadstoextraopportunitiesfordevelopmentbothwiththechildrenandwithmygradstudents,”shenotes.“Anywayyoulookatit,it’sawin-winforeveryoneinvolved.”

Sheaddsthatherstudentsalsobenefitfromhavingtwopeople,notjustone,showinterestintheirprogressand

�� F A C E T S S P R I N G / S U M M E R 2 0 0 9

A l u m n i P r o f i l e

Itisn’tsurprisingthatthroughoutthepast40yearsthepeoplewhohavemadethebiggeststridesin

disabilityresearchandrightshavebeenpeoplewithdisabilitiesthemselves.UntiltheAmericanswithDisabilitiesActwassignedintolawin1990,theU.S.hadalessthanstellartrackrecordofaddressingtherightsofthisgroup.Andithasonlybeenwithinthelast25yearsthatfunding,research,andacademicinstructionintodisabilitieshavecometogethertomakesignificantheadwayinaddressingproblemsanddiscoveringsolutions.

Ittookearlypioneerstobeginshapingthedisciplinesthatwenowknowasoccupationaltherapy,rehabilitationscienceandtechnology,andrehabilitationcounseling.Notonlydoyoungfieldsneedscientistsandresearchers,theyalsoneedadvocatesanddevotededucators–peopletopushtheboundariesofthecurrentknowledgeandbegintrainingthenextgenerationofleaders.Inthefieldofrehabilitationcounseling,Dr.RobertChubon,anearlyalumnusoftherehabilitationcounselingprogramatPitt,isoneofthoseleaders.

An Early Start

Chubonbecamedisabledatarelativelyearlyageafterafreaktrampolineaccidentlefthimwithaspinalcordinjuryinhissenioryearofhighschool.Theyearwas1954andlittlewasknownabouthowtotreatspinalcordinjuries.ButChubonslowlyovercamethechallengesitposed.Ittooknearly10years.

Heremembers,“Iwentfromanathletic16-year-oldwithaNavyROTCscholarshipnearlyinhandtosomeonestrugglingwiththechallengesofadisability.Whilethetreatmentformyspinalcordinjurywasbetterthanitwouldhavebeen10yearsbefore,duelargelytotheadvancesthatcameoutof

Lifelong AdvocacyPittAlumnusDr.RobertChubonaShiningExampleofEducationandAdvocacyatWork


WorldWarII,itwasstillalongroad.Atthatage,emotionally,itwasanightmare;butintheendImadeit.”

MuchofhisinitialrehabilitationwasaccomplishedattheKesslerInstituteforRehabilitationinWestOrange,NJ,andtheWoodrowWilsonRehabilitationCenterinFishersville,Va.,pioneersintherehabilitationfield.However,therealbreakthroughoccurredin1960atSt.FrancisMedicalCenter’sDepartmentofRehabilitationMedicineinPittsburgh.

Hewasunabletofinishhissenioryearinthemonthsfollowinghisinjurybecause,inthosedays,Chubonwasconsideredtoodisabledtobenefitfromevenhomeboundinstruction.Despitethelackofahighschooldiploma,hisrehabtherapists–whobynowhadbecomehisadvocates–urgedhimtoapplytoPitt.“Tosaytheytreatedmelikefamilyisanunderstatement.”HisSATscoresandsolidhighschoolgradeswonhimacceptance.WiththesupportandencouragementfromtheSt.FrancisandPittstaffs,hestartedatPittinthefallof1961.

TheschoolingwentwellforChubon,despitehislimitedabilitytowrite.But,hesayshestudiedrelentlesslyandreliedonin-classfocusandagoodmemory.Thefirsttwoyearswereastruggle,havingtocopewiththephysicalbarriersandadeficienthighschooleducation,buthewasabletoraisehisgradestoalevelacceptableforadmissiontograduateschool.Thebiggestchallenge,heexplains,wasgettingtoclass.

“TherewerenoaccessibleentrancesorelevatorsinmanyofthebuildingsatPittinthosedaysandcertainlynoramps.Soforexample,Ihadtorelyonthefootballteamtogetmeupanddownthedormsteps.Atthattime,Iwasthefirstresidentialstudentina

recognitionandpraiseforakeyboardingsystemheinventedforpeoplewithdisabilities.Chubonreorganizedthekeysonastandardcomputerkeyboardsothatthemostfrequentlytypedlettersarearrangedclosetothemiddleofthekeyboard,makingiteasierforpeoplewithlimitedfingerdexterityorforthosewhouseatypingstickashedoes.Healsohasgainedinternationalrecognitionforhisworkintheareaofqualityoflifeassessment.Andhismostcurrentpassion,asanauthorandplaywright,hasbeenconsuminghiminretirement.He’swrittennumerousplaysandshortstoriesandisworkingonanInternetWeb-basedmemoir.

Butintheend,hislife’sworkhasbeeninhelpingpeoplewithdisabilitiestolivebetterlives–andeducatingbothprofessionalsandthepublicatlargetodothesameforothers.

Hislongroadtowardfullrehabilitationasayoungpersonshapedhimasamanandshapedhimasateacher.“AdaptingtomydisabilitywasachallengeandI’vecommittedmywholelifetohelpingothersinthesamewaythatIwashelped,withcompassionandwithatotalcommitmenttounderstandingthechallenge,whileatthesametimechallengingtheindividual,”heexplains.

HealsocreditstheopportunityhewasgivenatPittformakingallthedifferenceinhislifeandhiscareer.Withoutit,headmits,hispathcouldhavebeenquitedifferent.

“I’vealwaysbeendeeplyindebtedtotheUniversityofPittsburghfortheeducationandtheopportunity,andI’vedonemybestthroughoutmylifetoextendthatopportunitytootherswithdisabilities.Intheend,that’swhatcountsthemost.IhavebeenbothproudofandgratefulfortheleadershipPittdemonstratedbyacceptingme.”

wheelchairtohaveeverattendedPittsoyoucanimaginehowthatsituationmademefeel.Iwaswellawarethatmysuccessorfailurewoulddetermineifotherswithdisabilitieslikeminewouldfollow.”

Byhisjunioryear,theUniversityhadbuiltthreewheelchair-accessibledormsandbythetimehegraduated,13residentialstudentsusingwheelchairswereattendingPitt.

Experience that Counts

ChuboncontinuedontoearnaMaster’sdegreefromPittinrehabilitationcounselingandbeganworkingwithpeoplewithdisabilitiesatSt.FrancisMedicalCenter.Withintwoyears,hebecametheadministratoroftheRehabilitationMedicineDepartmentwhereheusedhisbackgroundandexperiencetorefineandexpandtheprogram.AsaresultofguestlecturingatPitt,hewaspersuadedtobecomeafull-timeeducatorandearnedadoctoratefromPittin1979.In1980,Chubonandhiswife,Sandra(NURS’66,GSPH‘69),movedtoColumbia,S.C.,wherehewasaneducator-researcherattheUniversityofSouthCarolinaSchoolofMedicineforthenext21years.

Chubonhaswrittenawell-knowntextbookonrehabcounselingentitled“TheSocialandPsychologicalFoundationsofRehabilitation,”andhasauthoreddozensofpeer-reviewedarticlesonthesubject.Healsohasreceivedwide

“I was well aware that my success or failure would determine if

others with disabilities like mine would follow.”


R e a l W o r l d

Nowinthehomestretchtowardgraduation,ThompsoniscompletingfieldworkatTheChildren’s

Institute.HerpreviousexperiencesattheWesternPennsylvaniaSchoolforBlindChildrenaffirmedherloveofworkinginpediatrics,whichcontinueswithherassignmentattheChildren’sInstitute.AdditionalexperienceshaveincludedworkingwithstrokepatientsandthosewithspinalcordinjuriesonanoutpatientbasisatUPMCSouthsideCentersforRehabServices(CRS).

Onthisday,sheisworkingwithColton,atwo-year-oldwhowasbornwithArnold-ChiariMalformation,acompressionofthespinalcordorbrainstem.This

real WorldThe


congenitalanomalyconsistsofelongatedpeg-likecerebellartonsilsthataredisplacedintotheuppercervicalcanal.Oneofthesymptomsofthediseaseisdifficultyswallowingordysphagia.

“Coltonhasdifficultyeatingandwasseverelyundernourished,”saysThompson.“Ratherthaninsertingafeedingtube,hewasadmittedtotheFunctionalFeedingProgramaboutamonthago.Weintroducehimtoavarietyoffoods,differenttextures,inanefforttogethimtoeatmoreandgainweight.”AsanexampleofsomeofColton’seatingissues,shenoteshehaslatedumpingsyndrome,sohedoesn’tfeelhungry.Onamorepersonalnote,hedoesn’tliketogetmessysopuddingdidn’tappealtohim,

althoughnow,afterparticipatingintheFunctionalFeedingProgram,hedelightsinpushingitaroundhisplate.

“OneofthefirstthingsIdidwithColtonwastomakefunnyfacesoutofthefood.We’vealsoaddedpastatotherepertoirebecauseithasadifferenttexture,”sheimparts.Playingwithfoodisonewaytohelpmakeeatingfun,somethingthatisoftenmissingforchildrenwitheatingdisorders.

TheChildren’sInstitutetakesanintegratedteamapproachwithpatientslikeColton.BeforehearrivedforhisrehabilitationsessionwithThompson,Coltonhadbreakfastwithhismotherandabehavioralpsychologist,whohelps

thefamilyunderstandColton’stherapysotheycancontinuewithitwhenhegoeshome.“Childrencanfallbacktotheiroldeatinghabitsoncetheyleavetherapy,soit’simportantthatweteachColton’smothertoreinforcewhathe’slearnedonceshe’sbackinthedriver’sseat,”saysLesliePaat,anoccupationaltherapistattheChildren’sInstituteandaco-supervisorandmentortoThompson.

Colton’smealshavebeenprescribedbytheteamclinicaldietician,whomakessurehisdailynutritionalandcaloricintakeareoptimal.Coltonalsoseesaspeech-languagetherapistandtheentireteamworksunderthedirectionofapediatrician.

real WorldTheWhen Collin Thompson was a sophomore at Juniata College in Huntington, Pa.,

a friend suggested she might make a great occupational therapist. Thompson did

some investigation and volunteer work and decided the profession was right for her.


AnothersideeffectofArnold-Chiariisataxia,thelackofcoordinationandunsteadiness.Unlikeaveragekidswholovetoswing,spin,andtwirl,Coltondoesnotlikethesesensations.TohelpColtonfeelmorecomfortablewiththesemotionsThompsonputshiminaswing,“Wewanthimtofeelcomfortableintheswingandhelpimprovehisvestibularmovement,”shenotes.

AspartofThompson’sfieldwork,shehasdevisedanewtwistforFunctionalFoodTherapy,PlayPicnic.SheremarksthatPlayPicnicisbasedonearlierEuropeanworkdesignedtomakechildrencomfortablewithfood.“The‘picnic’lastsaboutanhourandistotallydirectedbythekids,mostofwhomaretwo-year-olds–withadultsupervisionofcourse,”shesmiles.“It’sanythinggoesfor60minutes.Theycanthrowthefood,theycaneatthefood,theycanplaywiththefood,thesky’sthelimit.”

ButThompson’sfieldworkattheChildren’sInstitutehasn’tallrevolvedaroundtheFunctionalFeedingProgram.“I’vehadtheopportunitytoworkwithyoungpatientswithbraininjuries,burns,tumors,andthoseintheRND(reflexneurovasculardystrophypain)program.”

Beforegraduation,ThompsonhasonefinalfieldworkassignmentatUPMCPresbyterianHospitalinacutecare.“I’mlookingforwardtotheexperiencebecauseitwillbesomuchdifferentfrommycurrentfieldwork.”ButcountonThompsontoendupinpediatrics.“Ireallyfindworkingwithchildrenincrediblyrewarding.”

R e a l W o r l d

“They can throw the

food, they can eat

the food, they can

play with the food,

the sky’s the limit.”


Therearesomecareersevenyoungchildrendreamabout:adoctor,ateacher,amusician,

oractor.Theseareprofessionsweareexposedtofromearlyinlife.Schoolorscoutscanbroadenourhorizons.Literatureandfilmexposeustothelegionsofpossibilitiesavailable.Thesky’sthelimit.

Butworkingtohelppeoplewithdisabilitiesisn’tgenerallyatthetopofthelist.Unlessyouhavefamilyorfriendswithdisabilities,chancesareit’snotevenontheradarscreen.Sohowdostudentsdiscovercareersinrehabilitationscienceandtechnology?

Almostsinceitsinceptionin1994,theDepartmentofRehabilitationScienceandTechnology(RST)hasoffered

undergraduatestudentstheabilitytotestdrivethedisciplinethroughaseriesofinternshipsandundergraduateresearchprograms.“TheResearchExperienceforUndergraduates(REU)beganasaninformal

programtoexposestudentstothesubject,”saysMary

Goldberg,educationandoutreachcoordinator

fortheQuality

ofLifeTechnology(QoLT)CenterandtheUniversityofPittsburghDepartmentofRehabilitationScienceandTechnology.GoldbergisalsoresponsibleforthefacilitationoftheREU,anoffspringoftheAmericanStudentPlacementsinRehabilitationEngineers(ASPIRE)ProgramwithgrantfundingfromtheNationalScienceFoundation.StudentscometoREUfromavarietyofdisciplines.

“Theymaybestudentsinengineering,rehabilitationscience,physicaltherapy,oroccupationaltherapy,”Goldbergnotes.

Studentsinthe2009programwillhaveanopportunitytochooseamongseveralresearchprojectsincludinginvestigatingtransfertechniquestominimizeshoulderjoint-loadinginwheeledmobilityusers,buildingandtestingasmartcontrollerforelectricalpoweredwheelchairs,orthedevelopmentofaVirtualJobCoachforveteranswithtraumaticbraininjury.

“Ithinkit’simportantforstudentstoworkonissuesthatarerealandwhoseoutcomesmightreallymakeadifferencetoapersonwithadisability,”statesDr.DanDing,assistantprofessorofRSTandarehabilitationscientistattheHumanEngineeringResearchLaboratories(HERL).Aspartoftheprogram,participantsalsovisittheCenterforAssistiveTechnologywheretheyinteractwithclients.

“Thestudentssaidtheyappreciatedtheexperienceofinteractingwiththeendusers,somethingtheywouldneverhavetheopportunitytododuringtheirundergraduateyears.”

R e h a b i l i t a t i o n S c i e n c e a n d T e c h n o l o g y

A New BrANd of CAreer Builder


Theyoungresearchersworkhard,puttingin40-hourworkweeksrunningfromlateMaythroughAugust.“Studentsreceivetravelexpenses,astipend,andhousingintheuniversitydorms,”Goldbergpointsout.

“Attheendofthesummer,weholdaresearchsymposiumwithbothinternshipprogramssostudentscanshowcasetheirresearchinpostersandmakepresentations,”Dingnotes,indicatingthatthisyear,theyplanto

extendinvitationstotheadvisorsfromthestudents’homeuniversities.“IfthestudentcomesfromtheUniversityofFlorida,forexample,wewouldinvitethatstudent’sadvisororclosefacultymentorsotheywouldgettoseefirsthandtheworkthatthestudentsaredoing.”Shenotesthatstrengtheningrelationshipswithfacultyaroundthecountryisalsoimportantfortheprogram.

Goldbergsaysallstudentsarerequiredtowriteatechnicalpaperbasedontheirresearchexperience.Theyarealsoencouragedtosubmittheirworktoaconferenceoftheirchoice,suchastheRehabilitationEngineeringandAssistiveTechnologySocietyofNorthAmerica(RESNA).“Iftheirpapergetsaccepted,weunderwritetheirattendanceattheconference.”

GoldberghasbeenusingmoderntechnologylikeFacebooktodeterminehowpreviousparticipantshaveincorporatedtheirexperiencesintotheirprofessionaloreducationallives.“Nearly60percentofthestudents

who‘graduated’fromREUwentontograduateschool,32percentofwhompursuedadvancedpractitionerdegreessuchasphysicaltherapy,occupationaltherapy,ormedicine.”Shealsonotesthatherresearchindicatesthatnearly30percentworkinafieldrelatedtoassistivetechnology.

TheREUprogramhasbecomemorepopularasstudentsbecomemorefamiliarwithit.“Overthepastthreeyears,we’vereceivedmorethan100applications,whichistriplewhatweusedtoget,”saysDing,“Sowearedefinitelymoreselective.”Goldbergadds,“Wejustpassedthedeadlineforthe2009programandreceivedmorethan175applications.”

Encouraging STEM Studies

ProgramsliketheREUrelyonundergraduateswithaloveofscienceandtechnology,althoughtheymaynotstartoutthatway.Manystudentsarechallengedbyscience,technology,engineering,andmath,knownasSTEMsubjects.Butimagineyou’reamiddleorhighschoolstudentwiththeadditionalchallengescausedbyaphysical,visual,orhearingdisability.STEMsubjectsmayseemevenfartheroutofreach.EnterTech-Link,whosemissionistoencouragestudentswithdisabilitiestoconsidercareersintechnology.SondraBalouris,RSTinstructor,isfounderandexecutivedirectoroftheprogram.“Wethinkthatitisfundamentallyimportantforyoungpeoplewithdisabilitiestobeabletolivefunctionalandindependentlives,andcareersintechnologyandthesciencescanputthemonthatroad.”

“Nearly 60 percent of the students who ‘graduated’

from REU went on to graduate school, 32 percent of whom pursued advanced practitioner degrees such as

physical therapy, occupational therapy, or medicine.”

R e h a b i l i t a t i o n S c i e n c e a n d T e c h n o l o g y

F A C E T S S P R I N G / S U M M E R 2 0 0 9 �9

“OnewaytoincreasediversityamongSTEMprofessionalsistoactivelyrecruitstudentswithdisabilitiesatayoungage.Tech-Link’sfallroboticscampengagesmiddleschool-agedchildrenwithdisabilitiestojointeamswiththeirnon-disabledpeers,”Balouriscomments.

The10-weekTech-LinkprogramculminateswiththeregionalFIRSTLegoLeagueCompetition,inwhichmorethan1,000studentsfromaroundtheareacompete.Fittingly,theeventishostedbyCarnegieMellon’sNationalRoboticsInstitute.TheFIRSTLegoLeagueisaglobalroboticsprogramthatignitesanenthusiasmfordiscovery,science,andtechnologyinkidsagesnineto14,or16outsideoftheU.S.andCanada.

Eachyear,world-wide,athemeisselectedandparticipantsconstructandprogramrobotstofitthetheme.

Tech-Linkcompetitorsgoanextrastepinthattheyconductaresearchprojectrelevanttothetheme.“Oneyear,thethemewasOceanOdyssey,andthestudentsinvestigatedbeachaccessibilityforpeopleusingwheelchairs,”saysGoldberg.

Balourispointsoutthat,moreandmore,Tech-LinkstudentsarematriculatingintotheREU.“WebelievethisdemonstratesthatifyoucanexposestudentsearlytoSTEMsubjects–andmakethemfunandapplicable–theycanbecomeenthusiasticlearners.”

“We think that it is fundamentally important

for young people with disabilities to be able to live functional and independent

lives, and careers in technology and the sciences can put them on that road.”

Tech-Linkstudentsalso‘shadow’professionalsinthesciencesandhaveinternedwithorganizationsandcompaniesincludingHERL,Highmark,andtheNationalWeatherService.

OnestudentwithcerebralpalsywhoparticipatedinTech-Linkisgoingontoengineeringschool.“Hermothersaidthatifitwerenotforthisexperience,shewouldn’thavehadtheinterestinengineeringthatshedoes,andshe’snowbeenacceptedtoanumberofengineeringprograms,”saysDing.ThatsamestudentsubmittedapostertoaQoLTcompetitionandherentrywon.Another“six-yearveteran”ofTech-LinkwillcompletehisfirstyearofengineeringatCarnegieMellonUniversitythisMay.


Beingliterateinmodernsocietymeansbeingabletoreadandwrite.Yet,“TherehasbeensomuchattentionpaidtohelpingchildrenreadthatIthinkwehaveallbutignoredtheoriginsofgoodwriting,”saysDr.Cynthia

S.Puranik,assistantprofessor,DepartmentofCommunicationScienceandDisorders.AccordingtotheNationalAssessmentofEducationalProgress(NAEP),75percentofschool-agestudentsonlyachievepartialmasteryofgrade-levelwriting,andjustonepercentwriteataproficientlevel.

“Justaswecanpredictwhichchildrenareatriskforreadingdisabilities,weshouldbeabletospotthestudentforwhomwritingmaybeachallenge.”AndthatiswhatPuranik’sresearchisdesignedtoaddress.Thankstoa$1.1milliongrantfromtheNationalCenterforEducationResearch,Puranikwillsoonbeginassessingpreschoolchildren,agesthreetofiveyears.Theywillberepresentativeofthenationwithrespecttoage,gender,andethnicity,andwillincludechildrenfromdifferenttypesofpreschoolsandfamilysocioeconomicbackgrounds.Puranik’sresearchisdesignedtoestablishcriteriaforassessingchildren’swrittenlanguage.Hercurrentstudiesfollowalineofresearchsheinitiatedatthe

FloridaCenterforReadingResearch,FloridaStateUniversity,whichwassupported

byapostdoctoralfellowshipfromtheInstituteofEducationScience,

USDepartmentofEducation.

C o m m u n i c a t i o n S c i e n c e a n d D i s o r d e r s

WRITE?JohnnyBut, Can


“IwasoriginallylookingatolderchildrenwhenIrealizedthattheoriginsofwritinginyoungchildrenhavenotbeenstudiedthatintensely.Mostoftheresearchthathadbeenconductedhasbeenmoreobservationalorcasestudy-basedbutnotsomethingthathasbeenquantified,”Puranikcontinues.

Puraniknotesthatchildrenenterschoolhavinghaddifferentqualitativeandquantitativeencounterswithprintthroughtheirexperiencesathome.Shealsoindicatesthatitiswellknownthatchildrenlivinginpovertyaredisproportionatelymorelikelytobereferredforspecialservicessuchasspeechandlanguagetherapyorlearningdisabilityclassesduetopoorreadingandwritingskillsandacademicperformance.

“Perhapsthesechildrencomefromhomeswherenoadultreadsanewspaper,receivesapersonalletter,orreadsbooksoutloud,”notesPuranik,whoindicatesthatthesechildrenenterkindergartenclassroomswithlowlevelsofemergentliteracyskillsintheareasoflanguage,phonologicalprocessing,andprintknowledge.“Unfortunately,thesechildrenmayalsoattendpreschoolsthatdon’tprovideoptimalsupportforthedevelopmentofliteracyskills.”

When Does Writing Begin?

Virtuallyeveryparentofayoungchildhasturnedtherefrigeratorintoamuseum,adornedwiththelatestartcreatedbyabuddingvanGoghorWarhol.Theseseeminglymeaninglessscribblesareanearlyprecursortothewrittenword.Doyourememberthefirsttimeyouwrotesomethinglegible?Probablynot,butchancesareitwasyourname–oratleastthefirstletterofyourname.Researchindicatesthatthisisthecasebecauseone’snameisimportanttodevelopingasenseofselfandfeelingsofcontrol.

“Thisdemonstratesagainwhyparentsorcaregiversaresoimportanttoemergentliteracy,”statesPuranik.

Parentsattachmeaningtothespokenwordandthat’showchildrenlearntotalk.Similarly,parents,caregivers,andteachersattachmeaningtoearlyscribblesandthat’safirststepinlearningtowrite.Butit’smorecomplicatedthanthat.“Youhavetorememberthatwritingalsohasamotoriccomponenttoit,soaskingathree-year-oldtowritehisorhernamemightnotbereasonable,”shepointsout.

Justaschildrendonotbegintotalkbyspeakingincomplexutterances,childrendonotbeginwritingincompletesentences.Similartothedevelopmentoforallanguage,theacquisitionofwritingskillprogressesinstages.Aschildren’swritingdevelops,certainfeaturesaremanifestintheirwrittenoutput.Thesewritingfeaturescanbegroupedintouniversalandlanguagespecificfeatures.Universalfeaturesofwritingincludelinearity(writingunits/marksareorganizedinstraightlines),discretenessorsegmentation,andlackoficonicity(writingunitsareabstract)thatalllanguagesshare.Language-specificfeaturesofwritingincludedirectionality–lefttoright–symbolshapes,andspacingbetweenwords.

Forexample,inEnglishwewritefromlefttoright,butinArabiconewritesfromrighttoleft.“Linearityisafeaturethatislearnedearly,whichchildrenseemtopickupfromwatchingadultswriteorfromnoticingtheorientationofprint,”shepointsout.“Segmentation,understandingthatwritingissomehowmadeupofdiscreteseparateunits,comesabitlater.Researchsuggeststhatchildrenbegindisplayingsomeknowledgeoftheuniversalproperties

ofwritingasearlyasagethree,andbyfour,mostchildrenhavewrittenoutputthatislinearanddiscrete,”saysPuranik.Butsheaddsthatit’snotreallywritingasweconventionallyknowit,butratherscribblescontainingmade-upletters.

Inherearlierresearchresults,Puranikexplains,“Ourresultspointmoretowardalinearprogressionoflearning;developmentofwritingtakesplaceinsequentialsteps.Earlyfeaturesaremasteredfirst,andtheseearlyfeatures,inturn,contributetotheacquisitionoflaterdevelopingskills.Asappliedtowriting,whatthismeansisthatchildrenwilldemonstratetheuniversalfeaturesofwritingbeforetheydemonstrateknowledgeofthelanguage-specificcharacteristicsoftheirwritingsystem.”

Numerous Gaps Remain

Puraniknotesthatalthoughpreviousresearchonemergentwritinghasbeeninstrumentalintheidentificationofearlywritingbehaviorsinyoungchildren,numerousgapsremaininourcurrentunderstandingaboutearlywriting.“First,thereisnocommontheoryofhowwritingdevelops,”saysPuranik.“Whetherthewritingofveryyoungchildrenshowssuperordinatefeatures,ordinatefeaturesorbothhasnotbeenthesubjectofthoroughinvestigations.”

Shecontinues,“Second,withafewexceptions,studiesexaminingearlywritinghavegenerallyinvolvedasmallnumberofparticipantsfromselectsocio-economicgroupsorhavebeendescriptivecasestudies.”

Andfinally,Puraniknotesthatamajorshortcominginresearchonemergentwritingisthelackofconsensusonhowitshouldbemeasuredandquantified.PuranikpointstotheNationalEarlyLiteracyPanel,whichidentified10studiesonwriting.“Butnostudyusedasimilarscoringsystemandasaresult,eachchild’sscorevarieddependingonthecriterionusedforaparticularstudy.”

…75 percent of school-age students only achieve partial

mastery of grade-level writing, and just one percent

write at a proficient level.

WRITE?JohnnyBut, Can


C o m m u n i c a t i o n S c i e n c e a n d D i s o r d e r s

CSDGrantProvidesStudentScholarshipsTheDepartmentofCommunicationScienceandDisorders(CSD)hasbeenawardeda$600,000grantfromtheU.S.DepartmentofEducation(DOE)toprovidescholarshipstoqualifiedstudentsenrolledintheDoctorofAudiology(AuD)program.StudentscurrentlybeingrecruitedfortheFall2009-2010termmayreceivescholarshipsthatwillcoverthemajorityoftuitioncostsoverthethreepre-externschoolyears.Severalstudentscurrently

enrolledintheAuDprogramarebeingselectedtoreceivesupport.

TheDOEprogramisintendedtobringincreasedattentiontothegrowingnationwideneedforpractitionersofpediatricandeducational(“ped-ed”)audiology.Selectionofawardeesfavorsstudentsofhighscholasticachievement,strongundergraduateCSDbackgrounds,andanexpressedcareergoalofjoiningtheranksofaudiologistsworkinginthesefields.

AccordingtoDr.JohnDurrant,professorandvicechairofCSDandprojectdirector,studentswillbeeducatedunderanintensifiedplanthataimstomeetgeneralaudiology

competenciesandprovideapediatric/educationalaudiologyemphasis.“Studentswillreceiveped-edenhanceddidacticstudy,clinicalpracticum,clinicalresearch,specialconferences,and,ultimately,pediatricand/oreducationalexternshipplacement.”

“Studentswillalsobecomepartnerswithfaculty,workingtogethertofocuseffortsandresourcesacrossspecialtiesonthisimportantareaoftheaudiologist’spractice,”hepointsout.Theprogramwillalsostrivetobringtogetheraudiologists,speech-languagepathologists,andeducatorstoincreaseattentiontolinksacrossauditoryprocessing,speech-language,andliteracydevelopment.

Consequently,comparisonsamongstudiesaredifficultandgeneralizationoffindingsisalmostimpossible.

Inhercurrentresearch,PuranikisbuildingonherworkattheFloridaCenterforReadingResearch.“Inthecurrenttestinganddevelopmentstage,we’relookingatwhatskillsareimportanttowriting.Howdochildrenlearntherearedifferentkindsofprintandthatprintservesdifferentfunctions?Howdotheycometothepointofrecognizingsymbolsandprint?Ithink

that’soneaspectofit.Andthenthere’sthephysicalactofwriting,andfinallybeingabletoputwordstogetherandmakeacoherentsentence.”

Home Environment Key

Justaswithreading,youngchildrenwhohaveparents,caregivers,oroldersiblingsactivelyinvolvedwiththeiremergentliteracyappeartodobetterthanthosewhodonot.“Wedon’treallyknowwhatspecifichomeliteracybehaviorsmightberesponsibleforthegrowthofwriting,”

saysPuranik.“Butit’ssafetosaythatwhenchildrenareallowedtoexplorewithwritingutensils,whenparentsactivelyengageachildin‘writing’projects,thekidsdobetter.Wedon’tknowspecificallywhatismoreimportant;isitthatparentsactuallymaketheirchildrenwrite,teachthemthelettersofthealphabet,playgameswithsounds,orisitjustsufficientthattheypointtowordsinabook.”

Youngchildrenmimicwhattheyseetheirparentsdoingorsomethingthey’veseenontelevision.Theymightpretendtocreateashoppinglistoransweratoytelephoneandtakeamessage.Puranikpointsoutthatveryyoungchildren,aroundtwo-and-a-half,justknowtheyneedtofillinanemptyspaceonpaper,andit’susuallywithscribbles.Butparentshelpchildreninotherways.“Ababypointsandsayssomethingundecipherable,butthemothersays‘hewantshisbottle.’Childrenlearnfromthemeaningsthatadultsassigntowhattheysay.Theylearnspokenlanguagelikethat,andtheyactuallylearnwrittenlanguagethesameway.Adultsgivemeaningtotheirearlyscribbles.”


Theacademiccoordinatoroftheproject,entitled“PreparationofAudiologiststoServeChildrenwithAuditoryDisorders,”isDr.DeborahMoncrieff,assistantprofessor.ShenotesthatthegrantsubmissionwastheconcertedeffortoftheentireaudiologyfacultyandstronglysupportedbytheCSDfacultyatlarge.ThisisthefirstgrantofitstypetobeawardedtoCSD.

Durrantnotesthat,althoughagreatdealofsuccessfulresearchhasbeenconductedtodevelopuniversalnewbornhearingscreeningandearlyinterventionofhearingimpairments,theAuDdegreehasbeenstronglydrivenbyadvancesinthe

diagnosisandtreatmentofhearingproblemsinadults,especiallyintheagingpopulation.Technicaladvancesandinformationgrowthhavesimilarlygreatlybenefitedthediagnosisandtreatmentofchildren,evenyounginfants,yet,accordingtoDurrant,thegrowthrateofaudiologistsgoingintopediatricandeducationalaudiologyisratherflat.

“Encouragingstudentstopursueped-edwillhelpensureacontinuingpooloftrainedprofessionals.”

Puranikrelatesthestoryofateacherwhotellsheryoungstudentstowritetheirnamesandonelittlegirlbecameexcitedandproudthatshehadwrittenhernametellingtheteacher,“Look,thatsaysmyname!”“Anuntrainedpersonmightwonderwhatthefussisallaboutbecauseallthechildhadwasawavylineonthepaper.However,theteachermadethoseearlyattemptsatwritingmeaningfulandattachedsignificancetoawavyline.Ithinkitwasanexampleofunderstandingbythelittlegirlthatwhatshewritesactuallycarriesmeaning.”

On-line Environment Creating Shifts

Thereisnoquestionthatthecomputerhasrevolutionizedourlivesinagoodway.Butitmayhavealsoledtoadeclineinourhandwritingskills.“Today,kidsarealreadytypingandspendingalotoftimeonthecomputeratayoungageandwedon’tunderstandthelongterminfluenceofverylittlewritingonpenmanshipandwriting.Thereisagoodamountofresearchthatshowshavinghandwritingfluidtyandspeed,notpenmanship,isactuallyaveryimportantcomponentofwritingandcomposing,”Puranikcautions.

Thereisalsothequestionofthe‘new’languagebeingcreatedbyanoverabundanceoftextmessaging,whichhasledtodeteriorationinspellingskills.Furthermore,“Wehavealreadybecomereliantonthespell-checkingfeatureonourcomputers.EvenIoftenhavetroublespellingwords.IknowIcantypeawordthatcloselyresemblesthetargetwordandthecomputerwill

dotherestforme.Idon’twanttoimaginetheimpactofthisonthecurrentgeneration,”Puranikconcludes.


H e a l t h I n f o r m a t i o n M a n a g e m e n t

Itissaidthatnecessityisthemotherofinvention.Sometimesthisclichéevenhelpsplotthecoursewetakein

life.That’swhathappenedtoDr.SajeeshKumar,assistantprofessor,DepartmentofHealthInformationManagement.AsayoungboyinruralIndia,Kumar’sgrandfatherwasworkinginthefieldswhenanaccidentcausedaseriouseyeinjury.Whilethegeneralpractitionerdidhisbest,bythetimetheytraveledtothecitytoconsultaneyespecialist,Kumar’sgrandfatherhadlosthiseyesight.

“Ithought,whyshouldwehavetogotothecity?Whydidwehavetowaitforhoursandhoursandhoursintheclinic?”saysKumar.Ashegrewolder,herealizedthatwhenNeilArmstrongwalkedonthemoonin1969,NASAscientistswereabletomonitorhisheartratefrom250,000milesaway.“Telemedicineisn’tnew;wejustneededtoadaptittothevariousmedicaldisciplines.”

SobeganKumar’seducationalsojourn,firstwithadegreeinvisionsciencefromtheMedicalResearchFoundation

inIndia,toamaster’sinmedicalinformaticsfromErasmusUniversityinTheNetherlands,andfinallyadoctorateintelemedicinefromtheUniversityofWesternAustralia.

“Telemedicineusestelecommunicationstodeliverhealthcare,oftenovergreatdistances,withpotentialcostsavings,particularlyinremoteandruralareas.Itisamulti-disciplinaryundertakingrequiringexpertisefromthetelecommunications,healthcare,andinformationtechnologysectors,”Kumarexplains.“However,therearealsoconcernsaboutliability,confidentiality,andotherpolicyandregulatoryissues.”Sothedisciplineisworkingtoadoptsoundpoliciesandstrategicplansthatguaranteetheprovisionofhigh-quality,sustained,andintegratedhealthcareservices.

AndKumarhasstudiedthepracticalitiesoftelemedicinearoundtheworld.NomoreprofoundanexampleofwhereitissuccessfullybeingusedistheRepublicofSeychelles,anarchipelagoof115

islands1,000mileseastofAfricaintheIndianOcean.Thetotalnumberofinhabitantsintheislandchainisjust82,300.

ThereisoneprimaryhospitalinthecapitalofVictoria,someprivateclinics,andcommunityhealthcentersonjustfouroftheislands,makingregularmedicalcareandscreeningsfortheaverageresidentverydifficult.Patientsneedtobetransportedbyboattothemainislandforspecialistcare.Therefore,theSeychellesrepresentedanenormousopportunitytodemonstratetheimportanceoftelemedicine.

“Withmypersonalinterestinvision-relateddiseases,Ifocusedonglaucoma,thesecondleadingcauseofblindnesstodayafterdiabeticretinopathy.

“IwantedtodofurtherinvestigationoftelemedicineandIfoundWesternAustraliatobeideal,”Kumarpointsout.WesternAustraliaisthesecondlargestsubnationalentityintheworld–almostamillionsquaremiles–yethasapopulationofjust2.1million.


Asanexample,hepointstothenortherntownofKununurra,withjust3,700inhabitants,some1,900milesfromthecapitalofPerth.Kununurraistoosmalltosupportitsownhospital,yettooremoteforcitizenstoregularlytraveltohealthcarefacilitiesinthecapital.

Traditionally,ophthalmologistsandothermedicalpersonnelwouldtraveltofar-flungsectionsofWesternAustraliaonceortwiceayear.Butthiswasanexpensiveundertaking,Kumarpointsout,oftencosting$8,000perweek.

Buttheideaoftele-ophthalmologywasappealingtotheAustralianDepartmentofHealth.“Web-basedeyecaremakesincrediblesense,”saysKumar,notingthatitincreasesefficiency,resultsindigital,qualityimages,andnewertechnologyhasmitigatedband-widthproblems.

“Wecantrainnon-professionals,includingretirees,tooperatetheequipment,whichisveryuserfriendly.”Imagestakenwithnew,portabledevicesarestoredonalaptopandthenuploadedtoacentralizedserver.Whenapatientisscreened,ane-mailisautomaticallysenttoanophthalmologistwhocanprovidethepatientwithadiagnosiswithin24hours.

Kumarcommentsthatearlyintheprocess,aroundtheyear2000,therewassomeconcernaboutpatientconfidentiality.“Buttoday,wehaveexcellentfirewallsandsecuresystemsthatinsureallinformationisprotected.”

The Evolution of Medicine

Telemedicineisjustthenextstepinamedicalcaresystemthathasevolvedoverthelastcentury.“Therehasbeenashiftinmedicalcaredelivery–awayfromthehospitalsandintothecommunity.”Infact,$155millionfromtheAmericanRecoveryandReinvestmentAct(ARRA)hasbeenreleasedtoestablishmorethan5,500communityhealthcentersacrossthenation.

“Peoplenowwantqualityhealthcareintheirneighborhoods,orevenintheirhomes,”saysKumar.“Theyasktheirphysicianforcertaintreatmentormedications.ThereisextensiveinformationavailableontheInternetandpatientsarebecomingmuchmoresavvyabouttheircare.

“Ithinktheshiftinthecurrentcenturywillbetowardevenearlierdiagnosisandpreventionratherthantreatingthedisease,”hecontinues.Continuingadvancesingenotypingcouldallowmoreindividualizedtreatment.“Butatthesametime,thepopulationisaging,andtherewillbemoremorbidityandmultiplediseasestotreat.IwitnessedthisinSingapore,wherepatientsrequiredmorespecializedcare.Themedicalestablishmentisadjustingtothenewparadigm.”

Andofcourse,patientswithmultiplediseasesareagreaterchallengetomanage.“Electronicmedicalrecordsarethewayofthefuture.Changeisalwaysdifficult,butintheend,costswillbereduced,medicalerrorswillbereduced.”Thefederalgovernmentrecognizestheimportanceofelectronicrecords.TheARRAincludes$19.2billiontojumpstartthetaskofEMRexpansion,andPresidentObama’sproposedbudgetallocates$76.8billionover10yearstocontinuetheprocess.

Astelemedicinebecomesmorecommon,theimportanceofelectronichealthrecordswillgrow.Theaccessibilityofup-to-dateinformationondiagnosisandmedications,forexample,willbeparamounttosuccess.Justasimportantly,therecordswillbeupdatedquicklyandeasily,ensuringthatthenexthealthcareprofessionalwillhaveaccesstothenewdata.Kumaralsopointstoagreenbenefittoelectronicmedicalrecords,“Thinkofthetreesthatwe’llsavebyswitchingfrompaperrecords.”

Hetakesitastepfurther,“Offercarboncreditsforpeoplewhousetelemedicine.Thehealthcareindustryisalreadyoneofthebiggestusersofenergyinthiscountry.Ifwecaneliminatetheneedforpatientstodrivetoseetheirphysiciansorhealthcareprofessionals,wecanimprovehealthcaredeliveryandhelpsaveourresources.”

“Electronic medical records are the way of the future. Change is

always difficult, but in the end, costs will be

reduced, medical errors will be reduced.”


Nodoubtatsomepointinyourlife,momadmonished“Don’tplaywithyourfood!”Behonest,aservingofpeas

scatteredaroundtheplatejustmighthavebeenmissed.

ButforJudithL.Dodd,adjunctassistantprofessor,DepartmentofSportsMedicineandNutrition,andsomeofherstudents,playingwithfoodislearningaboutfood–withaservingofnutritionontheside.DuringMarch,NationalNutritionMonth,Doddandthestudentstooktheir“foodplay”totheChildren’sMuseumofPittsburghforwhatthemuseumdubbed,“GetMoving,GetHealthy!”TheactivitywaspartoftheWeCan!series,promotinghealthy,physicallyactiveplay,sponsoredbyUPMCHealthPlanandtheGiantEagleChildDevelopmentSeries.

“TheChildren’sMuseumisagreatplacetoconductthiskindofactivity,”saysDodd.“Theyhaveayoungclientelewhoaregenerallyaccompaniedbyparentsorcaregivers,whichisgreatforexposingthewholefamilytogoodnutritionandhealth.”Shefurthernotesthatparentstaketheirchildrentothemuseumbecausetheyareinterestedinaneducationalexperiencesothekidsaregenerallypredisposedtolearning.

Doddandherstudentsseealotofhome-schooledchildrenandschoolgroups,aswell.

“Wealwaysbringhulahoopsandjumpropesbecausewewanttohighlighthowimportantitisforkidstobeactive,”Doddcontinues.Theyalsoofferinteractivegamesthathelpchildrenlearnaboutfoodsandthefoodpyramid.Commonitemslikeapplesareplacedinabagandchildrenhavetoidentifythemjustbytouch.Thekidsaregivenclues,‘it’safruit,it’savegetable,’whichvarydependingontheirage.

Andhowdothechildrendo?“Surprisinglywell,”Doddreports,“Althoughtheyfrequentlycan’tidentifyarealcarrot,whichisnottoosurprisingsincemostkidstodayeatshort-cutcarrots.”Therearealsotheoccasionalunfortunateerrors,likemistakinghealthylow-fatmozzarellasticksforbeefjerky.

“Weliketogetadiscussiongoingaboutfoodandnutrition.Onegamechildrenseemtoenjoyisfishingforfood,”shepointsout.Oncethey’ve‘caught’thefood,theyhavetoplaceitinitsfoodgrouporidentifywhereitlandsonthefoodpyramid.

ForDodd’sgraduatestudents,thisispartofthecourseSupervisedPracticeintheCommunity,whichplacesstudentsinsettingsthatspanthelifecycle.“It’sanopportunityforthestudentstoseethatthesearegoodvenuestotakenutritioneducationandtowatchtheinteractionwiththeparents,who,ofcoursedon’twanttheirchildrentofail.”Itcouldproveembarrassingforaparentifhisorherchildcan’tidentifyacommon,healthyfood.

S p o r t s M e d i c i n e a n d N u t r i t i o n

Nutritional Knowledge Decreasing

Despitethefactthatmorepeople,includingyoungchildren,areobese,ourknowledgeofgoodeatinghabitsseemstobeonthedecline.Evenchildren’sknowledgeofactualfoodandwhereitcomesfromisonthedecline.“Forsomekids,theythinkafruitcomesinalittleplasticcontainerthatyoudrinkwithastraworyoufindpeasinthesupermarketinacanorthefreezer,”lamentsDodd.“Andlemonjuicecomesfromasqueezebottle.”

Shealsonotesthatwehavegivenpeoplepermissionnottocook.“Inmyestimate,weareonthethirdgenerationoffoodilliterates.Wegaveuphomeeconomicsinschools.Wegaveuptheideaofhomecooking.ThefingerthatactivatesthemicrowaveisthesameoneweusefortheTVremoteand,forsomepeople,that’sprobablythemostexercisetheygetinaday.”ButDoddandhercolleaguesandstudentsaretryingtoreversethetrend.

Helping Kids Eat Right

“…they frequently can’t identify a real carrot, which is not too surprising since

most kids today eat short-cut carrots.”


Theyareoutinthecommunity,notjustinmuseums,butinschoolsandevengrocerystorestryingtospreadtheimportanceofgoodnutritionforchildren.“Thiscoursetakesthestudentsintovariouscommunitysettings,”shenotes,includingchildcarecenters,seniorcenters,aWICprogram.Theyarerequiredtogotocertaincoreplaces,butatthesametime,studentshavetheoptionofvolunteeringatcertaineventsandlocations.”

ShecitesstudentsupportofacollaborativeresearchprojectdesignedbyCarnegieMellonUniversitySchoolofDesignandUPMCSaintMargaretFamilyHealthCenterscalledFitWits™.Createdtohelpprimarilyinnercitykidsandtheirfamiliesachievehealthylifestyles,FitWitsincludesfuncharacterslikeElvisPretzley,MontyandJack,andSunnyYoketohelpchildrenlearnaboutthedifferencebetweenhealthyandnot-so-healthyfoods.

AspartofNutritionMonthawareness,participantswereinvitedtotheShadysideMarketDistrictsupermarketforascavengerhunttotrackdowntheFitWitsandtheNitWits,includingtheFryGirls,LollyParton,andChipandtheLittleDipperCrew.

“WeofferedthesamegamesandactivitiesaswedidattheChildren’sMuseum,”saysDodd.“Wealsocloseddownthecafé,whichdidn’tendearustotheseniorcommunitywhoconsiderithome.”

BecausemostofthekidsinvolvedintheprogramalreadyhadtheadvantageoftheirFitWitseducation,theywerefairlyknowledgeableabouthealthyfoodsandtheimportanceofactivity.

Don’t Overlook an Opportunity

BookscanhelpeventheyoungestchildrenlearntheABCsofnutrition,Doddpointsout.Andsheandherstudentshaveheldstoryhoursatlocallibrariesandsupermarkets,evendevelopinglessonplanssurroundingbookslikeGreen Eggs and Ham and

The Berenstain Bears and Too Much Junk Food.

Helping Kids Eat Right

“GreenEggsandHamisagreatwaytoteachkidsabouttryingnewfoods,”accordingtothelessonplanthatcomescompletewitharecipe.

Butsheacknowledgesthatit’softentheparentswhomakefooddecisionsfortheirchildrenwithlittleornoinput.“Aparentmightsay‘Oh,theywon’tlikethatfood’wheninfact,theylikeitverymuchoncethey’vehadachancetosampleit,”declaresDodd.

Inall,Doddismorethansatisfiedwiththecommunity-basedactivitiesinwhichsheandherstudentsparticipate.“There’ssomuchmorewecoulddobuttherejustaren’tenoughentrypointsandpeopletogetthejobdone.Wellnessisacommoditythatisn’treimbursedandtheassumptioniseverybodyknowshowtoeatandeverybodyknowsgoodnutrition.Weknowthat’sjustnotso,andtheresearchprovesit,”Doddconcludes.


P h y s i c a l T h e r a p y

Agingaffectsusalldifferently.Dependingonlifestyle,diet,andgenetics,theagingprocess

canvarygreatly.Inthesameway,ourbrainchangesasweageandhasprofoundeffectsonmood,memory,andmotorfunction.Whiletherehasbeenagreatdealofresearchinrecentyearsonthechangesinthebrainoftheelderly,inmanyways,wehaveyettoconnectallthedots.

Dr.PatrickSparto,associateprofessor,DepartmentofPhysicalTherapy,hasbeeninterestedinthecorrelationbetweenchangesinthebrainintheelderlyandthelossofbalance,posture,andmobilityforseveralyears.Herecentlybeganpreparingstudieshewillconductaspartofanewfour-year$800,000NationalInstitutesofHealth(NIH)grant.Hisprimaryfocusisonthestudyofthedegenerationinwhitematterpathwaysofthebrain.

Spartoinitiallybecameinterestedinthebrainwhileworkingatabalancedisordersclinic.Aftertreatingawiderangeofolderadults,includingthosewithexcellentstrengthandsensation,itoccurredtohimthatthecentralnervoussystemhadtoberesponsibleforaslow-downinmotorskillsaspeopleage.Ashetookacloserlook,hefeltsurethesechangesweredirectlyrelatedtothebrain.AsSpartobegantoexaminetheissuemoreclosely,hehonedinonwhitematterastherootcause;specifically,hehypothesizedthataswhitematterdegeneratesasweagesodoesourbalanceandabilitytowalk.

Brain Anatomy �0�

TotrulyunderstandthepotentialimpactofSpartoandhisteam’sresearch,it’simportanttofirstknowthephysiology.

Greymatterisamajorcomponentofthecentralnervoussystem,consistingofnervecellbodies,glialcells,capillaries,andshortnervecellextensions/processes–axonsanddendrites.Itsfunctionistoroutesensoryormotorstimulustointer-neuronsofthecentralnervoussystem,thepartofthenervoussystemthatconsistsofthebrainandthespinalcord,inordertocreatearesponsetothestimulusthroughchemicalsynapseactivity.Graymatterstructuresprocessinformationoriginatinginthesensoryorgansorinothergraymatterregions.Putsimply,explainsSparto,thegreymatterofthebrainiswheretheactionhappens.

Greymatterisalsoveryinvolvedinregionsofthebrainthatmanage

musclecontrol,sensoryperceptionslikesightandhearing,aswellasmemory,emotions,andspeech.

Whitematter,ontheotherhand,iscomposedofbundlesofaxons,andistheconnectorbetweenvariousgreymatterareas,carryingnerveimpulsesbetweentheseareas.SaysSparto,“Whenonepartofthebraincommunicateswithanotherpart,thatmessageisdirectedalongapathwaywhich,inessence,isthewhitematterinourbrain.”

Usingacommonanalogy,Spartosaysthatifourbrainwerelikenedtoacomputernetwork,thegreymatter

White Matter Does Matter

F A C E T S S P R I N G / S U M M E R 2 0 0 9 �9

evaluatedbasedontheirperformance.TheneachwillbegivenanMRItoexaminethequalityofthewhitematterinthebrain.“We’rehopingthatacloselookatmobilityandbalancetestingcomparedtowhitematterchangeswillleadtosomestrongerconclusionsabouttheconnectionbetweenthewhitematterlossandlossofmobility,”hesays.

Whilethestudyisstillalongwayfromcompletion,Spartofeelsthattheconnectionsbetweenmobilityandwhitematterlossaretoostrongtoignore.Inaddition,hebelievesitisimportanttounderstandtherelationshipbecauseitmayimpacttherehabilitationprocess.Forinstance,otherstudieshaveshownthatwhitematterdegenerationaffectslearning–acriticalcomponentforanyrehabilitation.

Ultimately,helpingpeopletomaintainmotorskillsandbalancelongerwillpreventinjuries–keepingthemoutofthehealthcaresystemandsavingmoney.Butbeyondthis,there’sthemoreobviousmotivation:helpingolderpeopleeverywhereleadmorehealthyandproductivelives.

wouldbetheindividualcomputerswhilethewhitematterrepresentsthenetworkcablesconnectingthecomputerstogether.

ItisthewhitematterthatisofparticularinteresttoSparto.

Dissecting the Problem

Agingcanleadtodegradationofthewhitematterinthebrain.Asthepathwaysthatconnectthegreymatterareaserode,theyleadtothereductionofahostoffunctions,includingcognition,moodregulation,andmostnotablytoSparto,balance,walking,andothermotorskillsdealingwithmobility.

“Weknowthatalossordegradationofgraymatterleadstoanumber

ofconditions,includingdementia,Alzheimer’sdisease,and

Parkinson’sdisease,anditseemsclearthat

White Matter Does Matter

similarneurologicalfunctionsalsoarespawnedbyalossofwhitematter.Butthespecificsremainunclear,”heposits.

PerhapsthemostcommondiseasethataffectswhitematterisMultipleSclerosis(MS).Inthisdevastatingdisease,whichusuallyoccursinyoungadulthoodtomiddleage,whitematterisdestroyedbyinflammationandmotorskillsdecreaseovertime.Thewhitematterdegenerationthatoccursinolderadultsisadifferentdiseaseprocess.Itisthoughttobecausedbyareductioninbloodflowtocertainareasofthebrain,inasimilarwaythatcloggedarteriesreducebloodflowtotheheartandextremities.

Spartocontinues,“Gettingtothebottomofhowwhitematterlossaffectsusremainsoneofthebigmysteriesofthebrain–especiallyasit’stiedtoaging.”

Spartoandhisteamwillrecruit,meet,andworkwith120adultsovertheageof70.Therearenospecificcriteriaeachpersonmustmeettoqualifyforthestudyotherthanage.Spartosays,“Theonlycriterionisthateachpersoncanstillmoveaboutinthecommunity–it’sprettyinclusive.”MostoftherecruitmenthasbeendonethroughtheUniversityofPittsburghClaudeD.PepperOlderAmericansIndependenceCenter,butSpartoandtheteamhavealsobeenrecruitingparticipantsinthecommunity.

Eachindividualwillbeguidedthroughaseriesofbalanceandphysicaltherapy-relatedskillactivitiesand

Getting to the bottom of how white matter loss affects

us remains one of the big mysteries of the brain –

especially as it’s tied to aging.


O c c u p a t i o n a l T h e r a p y

Therearemorethan1,700internationalstudentsenrolledattheUniversityofPittsburgh.Theycomefromdeveloping

nationsandmembercountriesoftheG8,representingeverycontinentandregionoftheworld.SomecomefromwealthyfamilieswhorecognizethatanAmericanuniversityeducationisessentialtoadvanceinaglobaleconomy.OthershavebeensingledoutbytheirgovernmentstocometotheU.S.andlearnscience,medicine,engineering,andotherdisciplinessotheycanreturnhomeandaidtheircountriesandfellowcitizens.

SuchwasthecasewithDr.SanaAbu-Dahab,currentlychairandassistantprofessorofoccupationaltherapy(OT)ontheFacultyofRehabilitationSciencesattheUniversityofJordaninAmman.AfterreceivingherundergraduatedegreefromJordan,shewastappedtotravelabroadtostudypediatricoccupationaltherapy.ItbecameherchargetostudythelatestmethodsforOTsworkingwithchildrenwithautism.Globally,onein166childrenisbornwithautism,andinJordan,diagnosisofautismisontherise.IntheU.S.,itisestimatedthatonein150childrenisbornwithautism.

Autismisadevelopmentaldisordercharacterizedbyqualitativeimpairmentsinsocializationandcommunication,andbyrepetitiveandrestrictedpatternsofbehavior.Itistheresultofdisturbancesinthedevelopmentofbrainconnections.Rarecaseshavebeenassociatedwithabnormalitiesingenesthatcodefortheformationormaintenanceofcontactsbetweenbraincells.Somecasesaretheresultofotherneurologic,metabolic,genetic,orinfectiousdiseases.Thecauseofmostcasesthoughisnotyetknown.

SobeganAbu-Dahab’sventureintoSHRSandtheDepartmentofOccupationalTherapy,whereshefirstearnedamaster’sdegree.“WhenitcametimeforSanatobeginherPhDdissertation,weaskedDr.NancyMinshewifshewouldserveonthecommittee,”saysDr.MargoHolm,

Assessing Individuals with High-Functioning

Autism


professoranddirector,Post-ProfessionalEducationinOT.Minshew,aninternationalauthorityonautismresearchandtreatment,isdirectoroftheNIH-fundedAutismCenterofExcellenceattheUniversityofPittsburgh–CarnegieMellonUniversity.

“Sanacameforwardwithfourdifferentproposalsforherdissertation,whichwereallexcellent.Butgiventhetimeframe,webelievedtheywereunworkable,”saysMinshew.

HolmandAbu-Dahabsuggestedasecondarydataanalysis,usingMinshew’sexistingresearchdatabases.HolmpointsoutthateverypersoninthedatabasehasundergoneanAutismDiagnosticInterviewandanAutismDiagnosticObservationSchedule.“Bothofthesetoolsareusedtoensurethatthere’sstandardizationacrossresearchsites,andthatthere’sreliabilityandvalidityinthediagnosis,”saysMinshew.Inaddition,eachindividualhasanIQscoregreaterthan80,classifyingthemashigh-functioning.

Usingthedatabases,Abu-Dahabsetouttoexploremotor,sensory-perceptual,andexecutivefunctioningskillsinindividualswithhigh-functioningautism(IHFA).“Executivefunctionsallowustoanticipateoutcomesandadapttochangingsituations.Theabilitytoformconceptsandthinkabstractlyareoftenconsideredcomponentsofexecutivefunction,”accordingtoMinshew.

Three’s a Charm

Abu-Dahabconductedthreestudies:inthefirst,sheexaminedsimplemotorskills,suchasgripstrengthandtheFingerTappingTest,andcomplexmotorskills,asmeasuredbytheGroovedPegboardtest.ThedataincludedIHFAandIQ-matchedtypicallydevelopingindividuals(TDI),ranginginagefrom5to21yearsold.Simplesensory-perceptualskillsandcomplexsensory-perceptualskillswerealsoexaminedwithinthesametwogroups.

SaysAbu-Dahab,“TheIHFAwerefoundtobesignificantlyimpaired,whencomparedtoTDI,onallmotormeasuresacrosstheagecontinuumwithoneexception:thespeedoftappingrevealednodifferencesbetweenthetwogroupsatayoungage(8–9yearsold),”butforolderIHFA(14–15yearsold)theimpairmentsweresignificant.

“Inchildrenfrom5to8yearsold,thestudyfoundthatgripstrengthwassignificantlyweakerthantheirtypicallydevelopingpeers,whichhasnotbeenreportedintheliteratureanywhere,”Holmpointsout.

Minshewstatesthatthegripstrengthdifferencesthatweredemonstratedprovideadditionalevidencethatthebasalgangliamightbeinvolvedinorresponsibleforsomeofthemotorsymptomsofautism.“Sana’sresearchdocumentedthemotorproblems,sensoryproblems,andofcourse,thewidelyknownexecutivefunctioningproblems.Thepresenceofmotorandsensoryabnormalitiesmeansthatwhat’sdifferentaboutthebrainofapersonwithautismhastobemuchbroaderthanjustthesocial,language,andcommunicationsystems.Wenowhavetoaddressmotorandsensoryskills.”

Inhersecondinvestigation,Abu-Dahabdevelopedastatisticalmodelthatexplainedrelationshipsamongfactorsthatpredictedorwereassociatedwithgoodandpoorcomplexfine-motorskillsorskilledmotormovements(psychomotorspeed,hand-eyecoordination,andmanipulativedexterity),asmeasuredbytheGroovedPegboardtest.

Assessing Individuals with High-Functioning

AutismGlobally, one in 166

children is born with autism, and in Jordan, diagnosis of

autism is on the rise.


O c c u p a t i o n a l T h e r a p y

TherewereseveralfactorsthatplayedanimportantroleincomplexfinemotorskillsintheIHFAmodel,suchaseducationallevel,memory,attention,andvisual-spatialskills.“ButintheTDImodel,age,finemotorskillsofthenon-dominanthand,memory,andproblem-solvingskillsweretheinfluencingfactors,”saysAbu-Dahab.ThismeansthatIHFAmayneedtorelyonstructuredexperiences,suchasschool,toacquirethecomplexfinemotorskillsthataresimplyorautomaticallyacquiredwithageinatypicallydevelopingindividual,”shecontinues.

Herthirdinvestigationalsodevelopedastatisticalmodeltodelineaterelationshipsamongfactorspredictinggoodandpoorexecutivefunctioningskills,asmeasuredbytheWisconsinCardSortingTest.SaysAbu-Dahab,“Ingeneral,wefoundsimilarfactorspredictedperformance:complexlanguage/conceptformationandmemorywereimportantfactorsinbothofthemodels,oneforIHFAandoneforTDI.However,theorderofimportanceofeachfactorforcontributingtogoodexecutivefunctioningskillswasnotthesameforIHFAandTDI.“

Findings May Alter Interventions

“ThesefindingsareofsignificantclinicalimportanceforguidingassessmentandinterventionplanningforIHFA,”Abu-Dahabcontinues.“Whilememory

skillsappeartoenhancethecapacityofexecutivefunctionskills,theirinfluenceforIHFAseemstobesecondarytocomplexlanguage/conceptformationskillsthatareusuallychallengingforhigh-functioningindividualswithautism.”

“WeusedtobelievethatrotelearningwasappropriateforcomplexmotorskilldevelopmentforIHFA”interjectsHolm.“Letterslikeb,d,p,qaresimilar,sowewouldhavethechildrenpracticecopyingthemoverandoveragain.”

GivenAbu-Dahab’sfindings,therapistsneedtofocusonattentionandproblem-solvinginadditiontopracticingcomplexmotorskills.“Forexample,therapistsneedtohavethechildfocusonthebandthepinisolation,andpointoutthatbotharemadeofcirclesandlines,butask‘howdoesthebdifferfromthep?’”shecontinues.

“IthinkthatSana’sworksuggeststherearemanyreasonsIHFAhavedifficultywithcomplexmotorskills,andthemodelsshedevelopedprovideguidancefortherapists–whichskillstofocusonfirst,andhowtobuildonthoseskills.It

encouragestherapiststothinkoutsidetheboxanddeterminewhytheycan’twriteletters,andofferafunctionalanalysisofbehavior,”Holmmaintains.

Minshewoffers,”Ithinkit’sveryimportantthattheoccupationaltherapist,whocanbetheentrypointintothehealthcaresystem,isn’tjustconfinedtoevaluatingandworkingwiththemotorsystemorthesensorysystem,butseesthatinrelationtoalltheotherimpairments.Theyneedtohaveaholisticviewofthechild,totacklemorethanonechallengeatatime.”

Insummary,Abu-Dahab’sfindingssupporttheimportanceofmotorandsensoryskillsintheassessmentandinterventionofindividualswithautismofallages.Herresultsprovideguidanceabouthowtointerveneinatieredapproachtobuildskillsinthemotorandsensoryareasinconnectionwithbuildingskillsinlanguageandproblemsolving.“Sana’sresearchandreturntoJordanexemplifyhowthetrainingofonepersoninanareaofneed–inthiscaseautismassessmentandintervention–canintroduceimprovementstotheentirehealthsystemofacountry,”Holmasserts.

A Conversation withCynthia Miles

Cynthia Miles

Cindy Miles is a 1977 graduate of SHRP, now SHRS, with a degree in physical therapy. Today, she directs a successful pediatric therapy practice in the Lehigh Valley. She is Board Certified by the American Board of Physical Therapy Specialties as a Pediatric Clinical Specialist, and serves on the executive committee for the Section on Pediatrics of the American Physical Therapy Association (APTA).


After you received your PT education,

what were your career plans?

Myinitialinterestwasinpediatricsandsports

medicine,soItookapositionatanacutecare

hospitalthinkingthatwastheplaceforme,

anditwas.Ashiftinmypersonallifeledme

tofindmoreflexibleemploymentsoIjoined

UnitedCerebralPalsy(UCP)ofNortheastern

Pennsylvania.ItwasthenIdiscoveredapassion

forworkingwithchildrenofallabilities.After

severalyears,Idecidedtostrikeoutonmy

own,offeringprivatephysicaltherapy.In1993,

weopenedafacilitywedesignedandbuilt.The

growthofthepracticehasbeenveryrewarding.

You now offer a full range of therapies

and other programs. How did that come

about?

Webeganaddingservicestoaccommodate

ourclients.Amotherrequestedspeech

therapyforherchild,soIcalledonaformer

colleaguetoprovidetheservice.Theaddition

ofanoccupationaltherapistfollowedsuit.

Weexpandedtoprovideearlyintervention

forinfantsandtoddlers,engaginganearly

childhoodeducationteacher.Wesawaneed

forfitnessprogramstoencouragechildren

toparticipateincardioandstrengthening

activities.Therapeuticaquaticswasthenext

logicalstep,sowebuiltapool.

How many clients are you currently

serving?

Wecurrentlyserveabout275clientsin300

visitsperweek,whichislowforaprivate

practiceofoursize.Withtheexceptionof

swimming,eachchildisseenone-on-onefor

anhoureachsession.Atraditionaltherapy

practicecouldbecoordinatingasmanyas

fourpatientsinthattime.Childrenofall

abilitiesrequireindividualizedtherapy.

Please describe the children you see in

your practice.

Ourprimaryfocusischildren,birththrough

youngadult,includingyoungathleteswith

sportsinjuriesandchildrenofallabilities

forfitnessprograms.Westrivetobuildon

eachindividual’sstrengthsotheycanachieve

maximumability.Weprovideanaccessiblearea

whereindividualscanworkindependentlyon

theirperformanceincludingmusclestrength,

cardioendurance,functionalability,and

mobility.WhenIlectureonfitness,mymantra

is‘FitforLife.’Ibelievethatphysicaltherapists

canprovidetrainingandfitnessfortheir

challengedclientsandencouragechildrenof

allabilitestobeactive.Parentsareamongtheir

children’sbestadvocates.Thetherapistjust

needstoprovidethetoolsandencouragement

tofindactivitiesthatinteresttheirwholefamily.

Tell us about Fun & Fitness Day,

celebrating its 10th anniversary.

Afewyoungboyschallengedmetorunina

raceatthelocalUCP;butwhenthatracewas

cancelled,westagedourown.Wesecured

alocalparkandprovidedadayfulloffitness

andfunforourclientsandfamilies.Thatyear,

wehadabout50childrenparticipateandseven

sponsors.Lastfall,wehadmorethan250

participants,40volunteers,and30sponsors.

It’sevolvedintoagreatfamilyevent.

The Lehigh Valley seems to be very

supportive of children with disabilities.

In2006,alocalfatherwantedtostarta

MiracleLeague–baseballplayedona

rubberizedfieldsothatALLchildrencan

play.Hepitchedtheideatoagroupoflocal

donors,andwithinfivemonths,theyprepared

a$750,000complexforopeningday.They

cametousforassistanceinfieldingteams.Our

staffandvolunteerscontinuetoparticipateas

“angelsintheoutfield,”andIjoinedtheboard.

WebeganachapterofAmTryke,asubsidiary

ofAMBUCS,anorganizationdedicatedto

creatingmobilityandindependenceforpeople

withdisabilities.AmTrykesaretherapeutic

tricyclesdesignedforkidsunabletoride

traditionalbikes.Ourgoalistoraise$12,000

topurchase20bikesbyJune.Westartedthe

ballrolling,butwe’returningtheleadership

overtothecommunity.CamelotHouseand

DreamComeTruearetwootherorganizations

herethatsupportchildrenwithdisabilities.

Are there ‘alumni’ of yours who still stay

in contact?

Absolutely,therearemanywhostayintouch,

somehavecomebackandvolunteered.One

youngman,bornwithoutbilateralfemurs,went

ontowintwogoldmedals,onesilverandone

bronzeinswimmingattheParalympicsin

Atlanta,Barcelona,andAthens.Hecameback

lastfalltosharehisexperiences.He’sjustone

ofthereasonsIlovemyjob.

What are you doing to help the profession and future therapists?

Weacceptinternsfromacrossthecountry,

andvolunteersfromcollegesandhighschools

throughoutthearea.It’sawin-winforeveryone.

Wearealsoplanningaresidencyforphysical

therapygraduates.Personally,I’mseekinga

doctorateinpediatricphysicaltherapyandhope

tocontributetomuch-neededresearch.I’m

pleasedtoplayaroleinhelpingfuturetherapists

andchildrenandtheirfamilies,andIamgrateful

formyeducationandtheopportunitytohave

attendedtheSHRSphysicaltherapyprogram!

Cindy Miles with associate Andrew Sutphin (PT ‘05)

university of pittsburgh School of Health and rehabilitation Sciences 4031 Forbes Tower pittsburgh, pennsylvania 15260

Change Service requested nonprofit Org. u.S. postage

pAiD pittsburgh, pA permit no. 511

www.giveto.pitt.edu

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