20Q: An Expert in Developmental Coordination Disorder

Sharon Cermak, 20Q- An Expert in Developmental Coordination Disorder

Sharon Cermak is a distinguished researcher, scholar, and professor. She is renowned for her expertise in sensory processing, autism, and Dyspraxia/Developmental Coordination Disorder. She co-edited a leading text, “Developmental Coordination Disorders,” and served as a member of an NIH Task Force on Childhood Motor Disorders. Dr. Cermak was selected by the American Occupational Therapy Association as one of the 100 most influential occupational therapists. She has received numerous awards for her significant work in sensory processing and developmental effects of deprivation in institutionalized and post-institutionalized children in Romania. On a personal level, I have known Sharon Cermak for many years beginning in 1970 when she was one of my graduate students at Boston University. This is where we collaborated on her first manuscript published by the American Journal of Occupational Therapy. Currently, Sharon is on the editorial board of the Annals of International Occupational Therapy. 

 

 

Franklin Stein, PhD, OTR/L, FAOTA

Contributing Editor

Salute to OT Leaders Series

20Q- An Expert in Developmental Coordination Disorder

Sharon Cermak

EdD, OTR/L, FAOTA

Research

1.  Let's start this interview with your research. Tell me how you define Developmental Coordination Disorder (DCD) and dyspraxia.

Developmental Coordination Disorder (DCD) is a diagnosis in the Diagnostic and Statistical Manual (DSM-5).  In children with DCD, the acquisition and execution of motor skills are substantially below chronological age and opportunity. The motor impairment significantly interferes with ADL, impacts academic/school productivity, prevocational and vocational activities, leisure and play.  The onset is in the early developmental period. DCD is not explained by an intellectual deficit (ID), visual impairment or neurological or neuromuscular condition (cerebral palsy, muscular dystrophy). Attention deficit hyperactive disorders and autism spectrum disorders may also be present.

The definition of dyspraxia is highly similar to DCD. It refers to an impairment in the ability to plan skilled nonhabitual movements. As such, it is a disorder of new as opposed to habitual motor response strategies. It involves difficulty relating the sequences of actions to each other.  According to Ayres, dyspraxia reflects challenges in formulating a plan of action; however, it is more than just motor planning. Key features of both DCD and dyspraxia include difficulty learning new motor skills and performing these skills in everyday tasks in the home, school, and play environments. Distinctions between DCD and dyspraxia are not uniformly clear, and while some feel the terms should be considered the same and used interchangeably, there is an international consensus among most researchers in using the term DCD.  However, when occupational therapists use a sensory integration framework, the basis for dyspraxia is believed to be difficulty in somatosensory discrimination which interferes with the development of an adequate body scheme and negatively influences motor planning. This is not the case with DCD in which the underlying mechanisms may be highly varied. Although there is broad agreement that the motor behavior of children with DCD/dyspraxia is qualitatively inferior, a deeper understanding of the difficulties with motor behavior is still lacking although neuroimaging studies are increasing our understanding of this disorder.

2. Describe how your research has contributed to helping children with disabilities.

For the last eight years, since coming to USC, I have done research helping promote healthy oral care in children with autism spectrum disorder (ASD) by reducing sensory sensitivities. Children with ASD have well-documented difficulties with sensory processing. The dental clinic is an environment with many sensory challenges including noxious smells, high-pitched sounds, touch, and bright lights. As such, it is reasonable to believe that dental care may be difficult for children with ASD. In our early work, we conducted surveys with parents and conducted focus groups with dentists and with parents to discover the extent of oral care challenges and their relation to sensory issues. We documented that parents perceive that oral care in the home and at the dentist is a major challenge for their children. Parents further reported that their children’s sensory issues were exacerbated at the dental office, with resulting behavioral problems. These findings formed the basis for our completed pilot and a feasibility study which concluded that modifying the sensory characteristics at the dental office reduced the children’s anxiety and negative behavioral responses, thus enhancing oral care for children with ASD. Our current randomized controlled trial, funded by NIH National Institute of Dental and Craniofacial Research, involves 220 children with ASD between the ages of 6- and 12-years and examines the efficacy of adapting the sensory environment to enhance oral care. We also plan to examine moderating and mediating characteristics. This research has the potential to revolutionize oral care for children with ASD as well as for those with other disabilities, with sensory sensitivities, and with dental anxiety. We have just received funding to examine these issues in children with Down syndrome.

Another area of my research is in sensory processing disorders in children and adults and their impact on the quality of life and activities of daily living. I initially examined sensory processing in children in orphanages in Romania who experienced severe deprivation. I extended this research to individuals (children and adults) who are typical but who show sensory over-responsivity, as well as to children with ASD who often show sensory processing challenges. Findings showed that “typical” adults with sensory sensitivities showed greater psychological distress than individuals who did not evidence sensory symptoms. Further, individuals with ASD showed greater sensory sensitivities and these sensory concerns had an impact on numerous activities of daily living including oral care and feeding and mealtime behaviors.  Sensory sensitivities impacted the quality of life in both typical populations and populations with individuals with ASD.  

I also have engaged in research in health promotion and physical activity in children with autism and children with Developmental Coordination Disorder. I investigated physical activity, participation, fitness, and obesity in individuals funded by two federal grants, one with DCD and one with ASD, resulting in multiple publications. Our research with children with motor coordination disorders showed a cyclical relationship such that children with DCD were less active and more sedentary and participated less than children with average motor skills.  Because they participated less, they had decreased physical fitness which likely further reduced their interest in and ability to participate in physical activity.  As such, as a group, a higher percentage of children with DCD were overweight and showed an increased risk of obesity.  Similarly, reduced participation was seen in children with ASD.

3. What was your experience in Romania working in orphanages?

My work in orphanages in Romania started in 1992. A colleague of mine, an eye surgeon, had been doing volunteer eye surgery in Romania. Michael Jackson was about to go to Romania for his Heal the World tour.  He heard about my colleague's work and asked him to come again and be videotaped for fundraising.  My colleague who is married to an occupational therapist suggested that an interdisciplinary team of developmental specialists also come and work directly with children in the orphanage. My colleague’s wife was unable to attend because she was giving a presentation in Australia so my colleague called and asked me to join the team which was leaving in four days. To show what a small world this is, my colleague was Dr. Bill Whalen who is married to Dr. Lucy Miller. Of course, I went to Romania, and in addition to working with children in an orphanage for 500 children from birth to three years old (Orphanage #1 in Bucharest), I got to go to Michael Jackon’s concert. I fell in love with both the children in Romania and Michael Jackson’s music. 

Since then, I have volunteered in Romania more than 20 times. Over the years, I saw many changes in Romania. When I started volunteering in an orphanage in Buzau, most of the children in the orphanage were delayed because of poor conditions but did not have identified disabilities.  However, I saw the long-term devastating effects of living in an orphanage and its negative effect on physical, social, and psychological development including attachment, language, sensory processing, and other areas. Several years after we started in Romania, the country instituted a foster care system and put healthy children under age 2 in foster care. However, children with disabilities continued to be placed in orphanages. As such, the orphanages in which we were working became “rehabilitation centers” with young children with a variety of disabilities including autism, cerebral palsy, Down syndrome, and hyperactivity.  Although the facility was referred to as a rehabilitation center, the ratio of staff to children did not change, and the staff did not change, remaining underfunded and understaffed, and inadequately trained to work with this new population. Our major focus changed to include training in working with children with disabilities including proper positioning, feeding, oral care, and sensory processing.

In addition to work with children in Romania, I have also collaborated with Dr. Laurie Miller at the International Adoption Clinic, Floating Hospital, Tufts New England Medical Center, on enhancing research capacity in developing countries regarding brain development. Our work focused on children in Russian orphanages and examined several factors including how children spend their time and the prevalence of fetal alcohol syndrome. 

4. Tell us about your experience as a visiting professor.

I have been a visiting professor in two different countries: Israel and Australia. 

Israel. My husband and I both received Fulbright awards to go to Israel in 1991. This was the year of the scud missile attacks and the U.S. State Department told us we could not go so we went in 1992. I was there for the first graduating post-professional master’s degree class at the Hebrew University of Jerusalem. Several years later, I did another sabbatical at the Hebrew University in 2008, and I recently completed a sabbatical at Ono Academic College in 2016.  I made many close relationships both professionally and personally with Drs. Noomi Katz, Shula Parush, Tamar Weiss, Tami Bar-Shalita, Adina Maeir, Eynat Gal, Ayelet Ben-Sasson, and others, and I continue to collaborate with many of these individuals and their students. I am extremely impressed with the quality (and quantity) of research of graduate students and faculty in occupational therapy in Israel. 

In Israel as part of my sabbatical in 2008, I worked with Dr. Michele Shapiro on an autism dental study conducted at Beit Issie Shapiro. This was the basis for my research on sensory adapted environments which informed my research at the University of Southern California. 

I also worked on a handwriting assessment, “Here’s How I Write” (HHIW), with Debbie Gevir and Sarina Goldstand. This assessment was originally developed in Israel in Hebrew by Gevir and Goldstand.  Dr. Julie Bissel and I worked with the Israeli authors to develop the assessment for English speakers. HHIW is a unique assessment in which the student assesses his or her own handwriting and becomes an active participant in setting goals for improvement. HHIW consists of a picture card interview in which a child is presented with 24 cards, one at a time sampling various aspect of handwriting. There are nineteen items relate to specific performance factors such as staying on the lines, letter formation, letter, and word spacing. Two items involve the child's feelings about writing (affective items), including "I like to write," and "I feel that I write well," and three items related to physical factors contributing to writing including body posture and stabilizing the page with the non-writing hand. HHIW targets children in second through fifth grade who need Response to Intervention (RtI) Tier 2 and Tier 3 intervention, or those referred for occupational therapy assessment for consideration of a related service as a result of handwriting difficulties. It is a criterion-referenced handwriting assessment, with standardized administration procedures. The manual includes case studies involving school children and includes many intervention strategies directly related to the specific handwriting problems revealed by the student's self-assessment that can be used in the classroom. Research that substantiates the validity of the self-assessment approach and the relationship to the educational requirements of public law and RtI is presented supporting evidence-based practice. 

Additionally, while on sabbatical at Ono Academic College (2016), I collaborated with colleagues in Israel to examine the effectiveness of a six-month employment training program for young adults with high functioning autism known as Roim Rachok (translated to Looking Ahead). This is a collaborative program run by the occupational therapy department at Ono Academic College and the Israeli army. The first three months of the program is held in a civilian framework in Ono Academic College where participants learn a profession and essential work and daily living skills. During the next three months, they are provisionally assigned to an IDF (Israeli Defense Force) unit where they work as civilians, to gain experience. After the trial period, participants may join the IDF as volunteers during which time they contribute their special skills to the IDF while accruing professional experience. After discharge, they may continue working in the same field or develop in other scientific and academic directions. The program began in 2013 with the first training course for reading and interpreting aerial and satellite photography. It was based on the recognition that some individuals with ASD have exceptional strengths visually and have the ability to focus on details that this work requires. Since 2015, numerous training opportunities have been implemented. I had the opportunity to interview many individuals in the program. Many talked about the stigma associated with ASD, wanting to contribute to their country, and issues related to “being, belonging and becoming”. As part of my time in Israel, I explored the feasibility of bringing a similar model to the US.

Australia. I completed a sabbatical in Australia at the University of Western Australia in Perth in 1999 in the Department of Human Movement Sciences. I worked closely with Dr. Dawn Larkin, a movement scientist. Together, we edited one of the first interdisciplinary scholarly books on Developmental Coordination Disorder, titled as such and co-edited by Cermak and Larkin (2002). This work introduced me to interdisciplinary colleagues and expanded my view of dyspraxia from one that was primarily from a sensory integration perspective to one that drew upon numerous theoretical frameworks from multiple disciplines.

6. How do you foresee the future of occupational therapy in your specialty area?

I believe there is increasing recognition of sensory integration as both a way of interpreting child behavior, assessing factors contributing to function and as an intervention. There is tremendous interest in sensory integration throughout the world. The incorporation of sensory hyporeactivity and hyperreactivity as part of the diagnostic criteria for the diagnosis of ASD has increased interest in sensory processing by many disciplines including psychology, neuroscience, and others.

I also believe that in the future there will be an increased focus on health and wellness in individuals with a disability.  My interest in this relates to the relationship between obesity, physical activity, and occupation participation.

7. How would you summarize your major achievements in occupational therapy thus far?

I have had highly fulfilling experiences during my tenures at Boston University and at the University of Southern California. One of my major accomplishments was in 1979 where I worked with Dr. Anne Henderson and colleagues in developing one of the first doctoral programs in occupational therapy. 

Some of my awards of which I am most proud include inclusion in the list of the 100 occupational therapists who have made significant contributions to the profession, being a charter member in the AOTF Academy of Research, The AOTF Jean Ayres' Award, and a Fulbright award that enabled me to do research in Israel.

A major accomplishment has been the mentoring of graduate students. This has been a highlight of my career. I am very proud of the many students I have taught and advised who have become leaders in the profession both within the United States and internationally. Many of the students I mentored have made significant contributions in occupational therapy through research and teaching. These include notably: Wendy Coster, Anne Fisher, Anita Bundy, Theresa May Benson, Joan Toglia, Debbie Marr, Elizabeth Murray, Ayelet Ben-Sasson (Israel), Eynat Gal (Israel), Keh Chung Lin (Taiwan), Mei-Hui Tseng (Taiwan), Livia Magalhaes (Brazil), Lucy Miller, Susanne Roley, Jane Koomar, Marie Anzalone, Lisa Daunhauer, Tami-Bar Shalita (Isreal), and Leah Stein Duker, to name a few. I have served as a mentor for more than 40 post-doctoral fellows and PhD students who in turn have made significant contributions to the occupational therapy and occupational science knowledge base.  I am still very active in publishing research in conjunction with several of my former graduate students. 

I have contributed to a better understanding of the characteristics of clinical populations served by occupational therapists.  My early research focused on cognitive and perceptual problems in individuals with stroke.  Other populations include dyspraxia/DCD, children with ASD, children in or adopted from institutions, and children with ADHD.  Content areas include sensory processing including nosology of sensory processing disorders and terminology related to sensory integration and sensory processing; assessment such as handwriting and cross-cultural adaptations of different assessments; daily activities including oral care and eating; and physical activity and fitness and health disparities.

History

8.  Where did you grow up and where did you go to primary school?

I was born in Brooklyn, New York near Ebbets Field where the Brooklyn Dodgers played. My father was the owner with his two brothers of clothing stores in the Williamsburg section of Brooklyn. My mother was a housewife and helped occasionally in the store. I have one sibling a brother 4 years younger than I who became an engineer. During my childhood, we moved several times. When I was four years old we moved to Jackson Heights in Queens, from seven to twelve years old we lived in Whitestone, New York and later we lived in North Woodmere, Long Island where I went to Hewlett high school.

9. How did you become interested in occupational therapy?

During high school, I did volunteer work in summer camps for children with disabilities and in nursing homes. When I was a senior, I told the guidance counselor that I wanted to work with individuals with special needs, but I did not want to be a classroom teacher.  The school counselor recommended that based on vocational tests and interests that I would be a good candidate for becoming either an occupational or physical therapist. I looked at the curriculum for each of the two professions.  Physical therapy required swimming; occupational therapy did not.  So, I became an occupational therapist.

10. Where did you obtain your professional degree in occupational therapy and how did your education shape your occupational therapy career?

I decided to go to Ohio State University for my bachelor’s degree since I was familiar with Columbus, Ohio. I had family in Columbus and I wanted to be independent and be in a different environment from New York. This turned out to be the right decision since I enjoyed Ohio State and the independence it afforded me. The occupational therapy program was small with only 15 students in my graduating class. It provided me with an excellent education.  I graduated from Ohio State University in 1969 with a bachelor’s degree in occupational therapy.

11. Who were your mentors?

Primarily, the mentors at Ohio State were the Chair at that time, Barbara Locher, and two of my professors, Kay Grant and Marian Ross. When I graduated from Ohio State, I was positive that I was going to specialize in mental health. I enjoyed the courses and remember Gail Fidler’s book (1954), "Introduction to Psychiatric Occupational Therapy." The book impressed me very much. I also had worked at Creedmore State Psychiatric Hospital in Queens, NY during the summer between my sophomore and junior years. I worked in a locked ward that was an insulin shock therapy unit directed by Dr. Peter Laqueur. Dr. Laqueur, known as the Father of Multiple Family Group Therapy, started multiple family group therapy at Creedmore State, and I was privileged to be able to participate in the family meetings as a “recorder."  It was an amazing learning experience.  While in school, I also became familiar with Jean Ayres and her pioneering work in sensory integration. My interest in pediatrics and developmental disabilities started with my fieldwork at Children’s Hospital in Columbus, Ohio and continued with excitement about Dr. Jean Ayres research and pioneering work in sensory integration.
 

12. What was your first position in occupational therapy?

In 1968 while I was still an undergraduate at Ohio State, I attended an occupational therapy conference in Kentucky. At the conference, I met with Anne Henderson who encouraged me to consider a graduate degree in occupational therapy at Boston University. However, I still needed experience as an occupational therapist before I would be eligible for admission to the occupational therapy master’s degree program. At this time, I met my future husband Laird Cermak who was a doctoral student in psychology. We married in 1969. He had a position in the Psychology Department at Tuft’s University in Boston, so I moved to Boston and I obtained a position as an occupational therapist at Mattapan Chronic Disease Hospital in Boston. Although I still wanted to work in mental health, I wanted to keep options open. Because I felt less comfortable in rehabilitation, I took my first job in that area because I understood, that as a new graduate, I would not need to know everything. 

13. What was your experience at Mattapan Chronic Disease Hospital?

I worked for one year at Mattapan Chronic Disease Hospital. The hospital included a rehabilitation program for patients with neurological conditions. I worked mostly with patients who had experienced a severe stroke. I was extremely interested in cognitive-perceptual impairments and unilateral neglect and used assessments such as the Draw a Person, Draw a Clock, and Draw a House tests. We used motor skateboards for increasing motor skills, and ADL training in dressing, grooming and feeding. I remember color coding parts of clothing to help the patient with dressing. We also did endurance training in a standing table for individuals who had broken their hip. We used crafts such as sanding boards and working in woodcraft. We also used cooking as a therapeutic activity. My first patient taught me how to bake a pie.  Rehabilitation at that time was quite different from what it is now. Patients typically stayed in rehabilitation for two months and I often saw patients twice a day. Typically, my caseload was 5-6 patients. 

14. What was your experience in the master’s program at Boston University (BU)?

I entered the advanced master’s degree program in occupational therapy with the encouragement of Dr. Anne Henderson. It was an interdisciplinary master’s degree with OT, PT, and Nutrition. The graduate students were very close, and to this day I am still good friends with fellow students, Andrea Larson (OT) and Rhona Lebner (PT) and with several of my professors. I attended the graduate program from 1970-72 directed by Dr. Nancy Watts a prominent physical therapist. The graduate program was fully funded with grants from the Maternal and Child Health Bureau (MCHB) so that I did not have to pay tuition and I also received a stipend. At that time, Dr. Willie West, an occupational therapist at MCHB, was a strong supporter of the graduate program at BU. Most of the faculty had doctoral degrees and were actively engaged in research. As such, the program had a strong emphasis on research and every student was required to complete a research thesis. It was a rigorous education and students were in small seminar-like classes in their specialty. My primary mentors in the graduate program were Anne Henderson, Shirley Stockmeyer and Frank Stein. Each of these professors helped me in my career and specialty area. After receiving my master’s degree at Boston University, I obtained a position at Youville Hospital in Cambridge, Massachusetts in 1972. 

15. What was your experience at Youville Hospital?

I worked as a staff occupational therapist at Youville Hospital from 1972 to 1975. I worked mainly with post-stroke patients who were receiving rehabilitation. I often saw patients in collaborative treatment with a co-worker usually a physical therapist. The treatment was very intensive, and we got to know the patients as well as their families. It was a very positive experience for me. During the time I was at Youville Hospital, they started a pediatric program so I also worked with children who had a diagnosis of cerebral palsy, and those with other physical disabilities. During this time at Youville, I was invited by Boston University to present guest lectures on perceptual deficits with patients who were recovering from a stroke. The initial teaching experience was very stressful, and I spent many hours preparing lectures. After a while, the anxiety in teaching abated and I began to enjoy the experience. In 1975 I was offered a full-time position at BU, with one-half clinical supervisor position and half teaching. One of the instructors, Irene Allard, had received an early intervention grant from the federal government. In the other half of the position, I taught a course on sensory integration and perceptual deficits.  One of my first students was Lucy Miller.  She was amazing, even then.
 

16. What was your experience at Boston University?

I taught at Boston University for more than 30 years, 1975 to 2008. During the first three years (1975-1978), I was the supervisor on Irene Allard’s early intervention grant, and I worked with children from low-income families in daycare centers in Roxbury, Chelsea, and Jamaica Plain and mentored a group of occupational therapy students who were on a nontraditional fieldwork experience (two days per week for the year). The focus was on promoting development in young children. I enjoyed my work very much and I had the opportunity to work with teachers on helping the students with gross motor and fine motor skills as well as challenges in self-regulation.
 

17. When did you publish your first manuscript? What was the experience like?

I published my first manuscript in The American Journal of Occupational Therapy. The title of the manuscript was, "Hyperactive Children and an Activity Group Therapy Model." The research for this manuscript came out of a graduate class in group therapy taught by Frank Stein at Boston University. The children attended a program at Kennedy Memorial Children’s Hospital that served as a clinical laboratory for the graduate students. We had the opportunity to work with the students while they were in this activity group. The purpose of the intervention in the group was to help the children develop internal controls through self-regulation. There were five graduate students in the class. Each one of the students had an opportunity to lead the group while the professor and the other graduate students served as observers. After the group, we critiqued the progress of the children and gave feedback to the graduate student who led the group. Creative media such as art, ceramics, and play were used in the activity group therapy. The experience in the project was positive as well as the experience in writing up the results with the professor and fellow student.  To this day, I still find it exciting when an article gets accepted for publication and when people request a copy of an article. 

Cermak, S., Stein, F., & Abelson, C. (1973). Hyperactive children and an activity group therapy model. American Journal of Occupational Therapy, 26, 311-315.

18. You became a full-time faculty Assistant Professor at Boston University in 1978.  Describe the courses you taught and the research projects that you initiated. 

The first course I taught was "Sensory Integration and Perceptual Deficits" which examined assessments and interventions for adults and children. I initially co-taught the course with Dr. Anne Henderson. I also taught a course in tests and measurements that analyzed the psychometric properties of different assessments used in occupational therapy. I also taught a unit on sensory integration assessment (using Sensory Integration and Praxis Tests) that was part of SIPT Certification. At that time SIPT certification involved three courses: Theory, Tests and Measurements, and the administration and interpretation of these tests. I taught all three courses. I taught mostly at the post-professional Master of Science level.  Research was required for all master’s degree students and one of my favorite activities was mentoring students in research. When the PhD program was developed at Boston University in 1979, I also taught courses in that program. For example, I taught a doctoral seminar on dyspraxia and a course on mechanisms of change.

One of the benefits of being a faculty member at a University is the ability to take courses without paying tuition.  I loved learning so I started taking a course each semester, primarily in developmental psychology and special education. A few years into this, I realized I had completed half of the required coursework for a doctoral degree so I applied into an EdD program in Special Education, and a few years later received my doctoral degree.

Summary

19. What do you see as the major issues in healthcare that are impacting clinical practice in occupational therapy?

The occupational therapy doctorate (OTD) entry level is a significant issue in the profession. There currently is a debate as to whether occupational therapy should move to an OTD entry level. Personally, I strongly support the OTD as an entry level and do not think the profession has a choice. I believe we must make the switch. Occupational therapy is a complex profession demanding advanced education. Other professions such as physical therapy recognize this and have already made the change. Unless we want OT departments subsumed under OT/PT and headed by PT, we must remain competitive.

Other professional issues include occupational therapy as an autonomous profession, parity in billing Medicare and Medicaid as far as mental health issues, and the question of how short stays in rehabilitation hospitals and clinics are affecting practice. 

20. How would you summarize your research in general?

I have published more than 200 papers including journal articles, book chapters, and others. The major research topics in my publications include sensory integration and sensory processing including the effects of early deprivation, dyspraxia/Developmental Coordination Disorder (DCD), and ASD. This includes including physical activity, fitness, and risk for obesity in these populations, feeding Issues (food selectivity and sensory sensitivity) and oral care in children with ASD, and more recently, research on neuroimaging related to motor and social factors in ASD and DCD. I am currently working with colleagues in Israel on a meta-analysis examining sensory processing in children with ASD.

In closing, at the end of this course, the reader will be able to discuss how the author defines developmental coordination disorders. Additionally, the reader will be able to describe how sensory symptoms can trigger anxiety in children with autism, impact participation in daily occupations, and how occupational therapists can help set up the environment, like in dentistry. Lastly, the reader will be able to explain how physical activity and fitness relate to children with poor motor coordination. 

Here are some example publications on a variety of topics. They are separated by categories. I hope these are helpful to you. I want to thank you for your time and interest today.

Examples of Publications

ASD.

Oral care and ASD

Stein Duker, L. I., Florindez, L.I., Como, D., Tran, C.F., Henwood, B.F., Polido, J.C., & Cermak, S.A. (2019). Strategies for success: A qualitative study of caregiver and dentist approaches to improving oral care experiences for children with autism. Pediatric Dentistry, 41(1), 4E-12E.  PMID: 30803480; PMCID:PMC6391730

Duker, L.S., Henwood, B.F., Bluthenthal, R.N., Juhlin, E., Polido, J., & Cermak, S.A. (2017). Parents' perceptions of dental care challenges in male children with autism spectrum disorder: An initial qualitative exploration. Research in Autism Spectrum Disorders, 39, 63-72.

Cermak, S., Stein, L., Williams, M., Dawson, M., Lane, C., & Polido, J. (2015). Sensory adapted dental environments to enhance oral care for children with autism spectrum disorders: A randomized controlled pilot study  Journal of Autism and Developmental Disorders. 45(9), 2876-2888. E-pubDOI 10.1007/s10803-015-2450-5; PMID: 25931290

Neurobiology

Kilroy, E., Cermak, S.A., & Aziz-Zadeh, L. (2019). A review of functional and structural neurobiology of the Action Observation Network in Autism Spectrum Disorder and Developmental Coordination Disorder.  Brain Sciences, 9, 75; doi 10.3390/brainsci9040075

Physical activity, fitness, and participation.

DCD

Cermak, S.A., Katz, N., Weintraub, N. Steinhart, S., Raz-Silbiger, S., Munoz, M.,  &  Lifshitz, N.  (2015). Participation in physical activity, fitness, and risk for obesity in children with Developmental Coordination Disorder: A cross cultural study.  Occupational Therapy International. DOI: 10.1002/oti.1393 

ASD

Jozkowski, A.C., & Cermak, S. (2019). Moderating effect of social interaction on enjoyment and perception of physical activity in young adults with autism spectrum disorders. International Journal of Developmental Disabilities. https://doi.org/10.1080/20473869.2019.1567091

Bandini, L., Gleason, J., Curtin, C., Lividini, K., Anderson, S.E., Cermak, S., Maslin, M., & Must, A.  (2013). Comparison of physical activity between children with autism spectrum disorders and typically developing children. Autism 17(1), 44-54.(doi: 10.1177/1362361312437416) 

Sensory processing.

Cermak, S., & May-Benson, T. (in press).  Developmental dyspraxia.  In A. Bundy and S. Lane (Eds).  Sensory integration: Theory and practice. Philadelphia: FA Davis. 

Kilroy, E., Aziz-Zadeh, L., & Cermak, S.A.(2019). Ayres theories of autism and sensory integration revisited: What contemporary neuroscience has to say. Brain Sciences, 9, 68. doi:10.3390/brainsci9030068

ASD and Food selectivity.

Christol, L.T., Bandini, L.G., Must, A., Phillips, S., Cermak, S., & Curtin, C. (2017).  Sensory sensitivity and food selectivity in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, DOI 10.1007/s10803-017-3340-9

Zobel-Lachiusa, J., Andrianopoulos, M.V., Mailloux, Z., & Cermak, S. A. (2015). Sensory differences and mealtime behavior in children with autism. American Journal of Occupational Therapy, 69(5), 6905185050 PMID: 26379266;  doi: 10.5014/ajot.2015.016790 

Cermak, S.A.., Curtin, C., & Bandini, L. (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association, 110, 238-246. (doi:10.1016/j.jada.2009.10.032)

Handwriting.

Goldstand, S., Gevir, D., Cermak, S.A, & Bissell, J.  (2013).  Here’s How I Write: A Child’s Self-Assessment and Goal-Setting Tool: Improving Handwriting Abilities in School-Aged Children. Framingham, MA: Therapro.

Cermak, S., & Bissell, J.  (2014). Content and construct validity of Here’s How I Write (HHIW): A child’s self-assessment and goal setting tool.  American Journal of Occupational Therapy, 68(3), 296-306. http://dx.doi.org/10.5014/ ajot.2014.010637

Health disparities.

Como, D.H., Duker, L.I.S., Polido, J.C., & Cermak, S.A. (2016). The persistence of oral health disparities for African American children: A scoping review. International Journal of Environmental Research and Public Health, 16, 710. Doi:10.3390/ljerph16050710.