Interventions Within the Scope of Occupational Therapy Practice to Improve Activities of Daily Living, Rest, and Sleep for Children Ages 0-5 Years and Their Families: A Systematic Review.

Abstract

Research studies supporting occupational therapy interventions to address feeding, toileting, and sleep can be applied to practice in early intervention and preschool settings to improve the outcomes of young children and their families. To examine the effectiveness of interventions within the scope of occupational therapy practice to improve activities of daily living, rest, and sleep for children ages 0-5 yr and their families. Five databases (MEDLINE, PsycINFO, CINAHL, OTseeker, ERIC) and Evidence-Based Medicine Reviews, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, and Database of Abstracts of Reviews of Effectiveness were searched for studies published between January 2000 and March 2017. Inclusion criteria were Levels I-III evidence, being within occupational therapy's scope of practice, including participants with a mean age younger than 6 yr, and addressing self-care, activities of daily living, and rest and sleep. Forty articles were appraised, and three themes emerged: interventions to address feeding and eating, interventions to address toileting, and interventions to address rest and sleep. Additional subthemes of behavioral approaches, parent and caregiver education, and contextual intervention were revealed. Occupational therapy practitioners should consider the use of interventions with moderate or strong evidence as described in this review. Limitations include risk of bias and limited evidence for several interventions. This article provides a broader perspective on evidence-based practice by examining studies within the scope of occupational therapy practice published outside of current occupational therapy publications. The review includes studies from nutrition, nursing, and psychology, which address interdisciplinary care, family coaching and education, and behavioral approaches within the professional scope of occupational therapy to improve the functional performance, routines, and quality of life for young children and their caregivers.