Abstract

Purpose The purpose of this paper is to feedback the results of a survey of paediatric occupational therapists completed by the Paediatric Advisory Group (PAG) regarding perceptions and practices of the assessment of need (AON) process. This survey was completed to gather feedback from occupational therapists about the impact of the AON process on paediatric occupational therapy practice in Ireland. Design/methodology/approach A questionnaire was developed by the authors, who were on the PAG committee, to specifically gather quantitative and qualitative information about the AON. A snowball sampling method was utilised. The results were grouped into themes related to the practices and recommendations from occupational therapists nationally. Findings Surveys were returned from 98 paediatric occupational therapists with a wide national geographical spread with the majority working in the HSE. The amount of time spent on AON assessments, as well as the length of reports, varied nationally. The process of how assessments were completed (unidisciplinary or multidisciplinary) and whether a diagnosis was provided was inconsistent. Concerns were raised about the negative ethical impact of the AON on service provision and intervention and the need for further training of staff along with more frequent assessment reviews. The respondents also highlighted concerns about the increasing age of the AON criteria, with no increase in resources, and they provided suggestions for improvements for the future. Research limitations/implications The survey was sent to all AOTI and PAG members via gatekeepers and then forwarded to others, resulting in a snowball sampling technique; however, this does not represent all paediatric occupational therapists nationally as membership in these groups is voluntary. Practical implications The concerns and inequities raised in the survey regarding occupational therapy practices of completing the AON process need to be shared with relevant stakeholders both at the occupational therapy management level and in the HSE and Department of Health/Disability. The PAG will continue to highlight these concerns from their members to relevant parties and by disseminating findings in articles such as this. Social implications Ethical concerns were raised by some members about the equity of access to interventions as a result of the AON process. The social implication of this for families and children is pertinent, particularly in the context of the increased age in the AON criteria without any increase in resources. Originality/value The PAG aims to support paediatric occupational therapists nationally and the committee often gathers feedback from members regarding concerns which affect day-to-day practice in paediatric OT. Sharing of this information with IJOT readers helps to highlight the challenges faced by paediatric occupational therapists nationally.

Highlights

  • Occupational therapists working in paediatrics aim to work with children with a variety of diagnoses to provide assessments, interventions and follow-up services (Case-Smith et al, 2000)

  • In Ireland, the Disability Act (2005) dictates that children are entitled to an assessment of need (AON) if they meet certain criteria; anecdotally, members of the Paediatric Advisory Group (PAG) have highlighted various concerns relating to this practice

  • Background to the AON Under Part 2 of the Disability Act (Government of Ireland, 2005), children under five years with a disability are entitled to an independent assessment of their health and educational needs arising from their disability, an assessment report and a statement of the services they will receive

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Summary

Introduction

Occupational therapists working in paediatrics aim to work with children with a variety of diagnoses to provide assessments, interventions and follow-up services (Case-Smith et al, 2000). In Ireland, the Disability Act (2005) dictates that children are entitled to an assessment of need (AON) if they meet certain criteria; anecdotally, members of the Paediatric Advisory Group (PAG) (a subcommittee of the Association of Occupational Therapists Ireland [AOTI]) have highlighted various concerns relating to this practice. To investigate how the AON is being utilised across Ireland, the PAG completed a survey with occupational therapists working in Ireland to gather feedback about current practice. The survey aimed to highlight how the AON is being completed by occupational therapists nationally and to highlight any discrepancies or concerns raised by occupational therapists working in paediatrics. The report highlighted a variation in the number of applications for the AON and the number of assessments completed within the statutory timeframes in different local health office areas (NDA, 2011)

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