Occupational Engagement Research Articles

Having a Voice: Resident Perceptions of Supervision, Decision-Making and Patient Care Ownership

ObjectiveHeightened resident supervision due to patient safety concerns is increasingly common in pediatrics and may leave residents with fewer opportunities for independent decision-making, a diminished sense of autonomy, and decreased engagement. This may ultimately threaten their development into competent clinicians. Understanding how pediatric residents experience supervision’s influence on their involvement in decision-making, engagement in patient care, and learning is crucial to safeguard their transition to independent practice. In relation to supervision, our research investigated: 1) how residents navigated their involvement with clinical decision-making and 2) how opportunities to make clinical decisions influenced their engagement in patient care and learning. MethodsFrom 2019–2020, we recruited 38 pediatric residents from three different programs for a qualitative interview-based study. Through a constructivist stance, we explored clinical decision-making experiences and performed thematic analysis using an iterative and inductive process. ResultsWe identified three themes: 1) Residents perceived having autonomy when they had space to make independent decisions, regardless of supervisor’s presence; 2) Patient care ownership resulted from having a voice in a variety of contributions to patient care; and 3) Supervisors’ behaviors modulated patient care ownership and thereby residents’ sense of feeling heard, their engagement in patient care, and their learning. ConclusionsOur results suggest that focusing on patient care ownership may better fit with current learning environments than aiming for independence and autonomy. They provide insight on how, in the pediatric learning climate of enhanced supervision, supervisors can preserve resident engagement in patient care and learning by augmenting patient care ownership and ensuring residents have a voice.

Climate Change and Occupational Therapy: Meeting the Urgent Need for Adaptation, Mitigation, and Resilience

Climate change may be the most pressing existential threat to human health and wellbeing in the twenty first century. In this paper, the authors provide context and critique on barriers to climate action in the United States and other high-income countries, including the profit-driven approach to health, consumerism, and the climate change countermovement. The reciprocal connections between occupational engagement and climate damage are examined from a lens of collective and irresponsible occupations and subsequent accountability. The authors propose the United Nations’ Sustainable Development Goals as a basis for recommendations occupational therapy practitioners could implement within the priorities of adaptation, mitigation, and resilience.

Guidelines for Contributors to AJOT.

The American Journal of Occupational Therapy (AJOT) is the official journal of the American Occupational Therapy Association (AOTA). The primary mission of AJOT is to publish peer-reviewed research examining the effectiveness and efficacy of occupational therapy practice so that occupational therapy professionals can make informed, evidence-based decisions about best practice. In addition, the journal aims to publish (1) research documenting the reliability and validity of occupational therapy instruments; (2) studies demonstrating a relationship between occupational engagement and the facilitation of community participation and health; and (3) articles that provide a forum for scholars to debate professional issues that affect education, practice, and research. This Guidelines for Contributors to AJOT is also available at the American Journal of Occupational Therapy manuscript submission website, ScholarOne (go to https://mc04.manuscriptcentral.com/ajot and click "Instructions & Forms" in the upper right). These guidelines are published annually in a supplement to the journal; any changes implemented in the interim are published to the Author Guidelines page on the AJOT website (go to https://research.aota.org/ajot/pages/authorguidelines).

Development of a Multi-site Curriculum for Inequities in Newborn Care (CINC) Informed by Pediatric Resident and Community Engagement.

Inequities in health care are a well-identified contributor to adverse outcomes in neonates of vulnerable populations. 1 2022 March of Dimes Report Card. Accessed March 8, 2023. 〈https://www.marchofdimes.org/report-card〉 Google Scholar , 2 Warren M.D. Hirai A.H. Lee V. Accelerating Upstream Together: Achieving Infant Health Equity in the United States by 2030. Pediatrics. Published online January. 2022; 3e2021052800https://doi.org/10.1542/peds.2021-052800 Crossref Scopus (2) Google Scholar , 3 Sigurdson K. Morton C. Mitchell B. Profit J. Disparities in NICU quality of care: a qualitative study of family and clinician accounts. Journal of Perinatology. 2018; 38: 600-607https://doi.org/10.1038/s41372-018-0057-3 Crossref PubMed Scopus (61) Google Scholar Societal and institutional inequities rooted within implicit biases and racism result in variable quality of care in the nursery, such as differences in time spent skin-to-skin with infants, clinical resource allocation based on racial background, and a lack of motivation to establish a therapeutic alliance with families who have differing social and cultural needs. 3 Sigurdson K. Morton C. Mitchell B. Profit J. Disparities in NICU quality of care: a qualitative study of family and clinician accounts. Journal of Perinatology. 2018; 38: 600-607https://doi.org/10.1038/s41372-018-0057-3 Crossref PubMed Scopus (61) Google Scholar Most significantly, this inequitable care results in the increased mortality of non-Hispanic black and Hispanic infants as compared to infants of non-Hispanic white backgrounds. 4 National Vital Statistics Reports Volume 69, Number 7 July 16, 2020, Infant Mortality in the United States, 2018 : Data From the Period Linked Birth/Infant Death File. Google Scholar In light of these inequities, the Academic Pediatrics Association (APA) implemented initiatives rooted in active anti-racism to dismantle oppressive power structures across pediatric organizations. 5 Cohen A. et al. Changing Who Has a Seat and Voice at the Table: How the Academic Pediatric Association is Responding to Systemic Racism. Academic Pediatrics. 2022; 22: 352-355https://doi.org/10.1016/j.acap.2022.01.002 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar This urgent commitment to action is further supported by the Association of Pediatric Program Directors (APPD) which maintains that anti-racism involves actively dismantling racism in all that we do. 6 Blankenburg B. et al. Dismantling Racism: Association of Pediatric Program Directors’ Commitment to Action. Academic Pediatrics. 2020; 20: 1051-1053https://doi.org/10.1016/j.acap.2020.08.017 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar Focus groups of trainees at 4 Bay Area academic medical centers explored gaps in education on newborn health inequities to best understand how to support providers in actively practicing anti-racism in clinical care. Trainees spotlight inequities in their rotations, but feel helpless to address them given a lack of action-based tools, education on inequities, protected time for reflection, and faculty role-modeling. 7 Hume P. , Bowers K. , Robertson L. , et al. Residents’ Perspectives on Neonatal Health Inequities to Guide an Innovative Curriculum. Poster Presentation presented at: APPD; March 2023; Atlanta, Georgia. Google Scholar Given these highlighted gaps, we sought to provide our pediatrics faculty and trainees with action-oriented education to address inequities.

Integration of occupant voting systems and smart home platforms for collecting thermal feedback in indoor environments

The assessment of indoor thermal comfort is increasingly shifting from statistical to personalized models and therefore there is a growing interest in collecting feedback on occupants’ perceptions and preferences. Occupant Voting Systems (OVS) are emerging as a widely used tool in Post Occupancy Evaluations (POE) but the level of occupants’ interaction with these data collection devices, their scientific accuracy, and the integration of feedback data with building management systems, especially in residential buildings, still need to be further explored. This paper presents a study conducted on five dwellings, located in Italy, where smart home switches were used as feedback buttons to collect the thermal sensation of the occupants. These buttons were integrated into an open-source smart home platform, MOQA. The developed system is described in its technical features, highlighting the amount of information collected, the response rate and its interoperability with smart home systems. The results show that OVSs still have limitations in terms of occupant engagement and it is still rather complicated to correlate ratings with environmental variables. However, an easier integration, here described, with smart home systems would partially overcome these problems, turning the OVS into a useful tool for both users and research purposes.

Leisure and social occupational choice within nursing home facilities in Ireland: Residents perspectives

Background National standards for nursing homes in Ireland require that residents are offered a choice of recreational and stimulating activities to meet their needs and preferences. Aims/Objectives To investigate residents’ perceptions of leisure and social occupational choice in nursing homes in Ireland to determine if occupational choice is facilitated. Materials and method Qualitative-descriptive design – nursing home residents completed two semi-structured interviews that explored their experiences of leisure and social occupational engagement. Results Two overarching themes with six associated sub-themes emerged. From residents’ perspectives, social and leisure occupational choice was dependent on: Environmental factors (nursing homes’ Cultural, Social, Physical, and Temporal Environments) and Personal factors (residents’ Health Status and Personal Attitudes). Conclusion The cultural environment had the most significant influence on residents’ leisure and social occupational choice, highlighting the importance of person-centred care within nursing homes, to promote occupational choice. Resident’s health status was also identified as a contributing factor. Significance Occupational therapists could play a critical role in supporting the leisure and social occupational choices of nursing home residents by developing residents’ skills, educating staff and adapting tasks and the environment to limit/reduce occupational deprivation.

An Easily Implemented, Inexpensive, Useful Novel Surgical Intern Wellness Initiative

Determine whether use of reflective questions asked on a twice monthly basis is a useful addition to our intern wellness curriculum, with a goal of longitudinal development. Prior studies have demonstrated the use of reflection in processing educational experiences toward professional growth at both the medical student and resident level. During the first year, every 2 weeks, the 13 interns were asked and answered 2 reflective prompts by email. Their responses went to a single faculty member and were then blinded for analysis. The second year of the program, prompts were discussed by participants in a closed group setting. Participation was voluntary. The questions fell into 6 major categories: role expectations, role assessment, role affirmation, role reflection, emotional self-assessment, work-life integration, and boundaries. Thematic analysis of the responses was performed using an inductive approach by 2 independent expert reviewers. Brown General Surgery Residency Program, academic years 2021 to 2022 and 2022 to 2023. Use of reflective questions is a valuable tool as part of an intern wellness curriculum and can be easily implemented. It is inexpensive, does not require a huge time commitment, and is easily adaptable to a program's specific needs. It encourages developing surgeons to recognize and share in their emotions as they encounter the new and stressful experiences inherent in residency and may help to prevent burnout. Sustained participation through the year and robust responses suggest good resident engagement and acceptance of the program.

Effects of burnout and work engagement in the relationship between self-efficacy and safety behaviours-A chained mediation modelling analysis.

To explore the current situation, influencing factors and pathways of safety behaviour of nurses in tumour specialized hospitals, in order to provide a theoretical basis for managers to manage and train nurses, improve their safety behaviour level and ensure medical safety. An anonymous cross-sectional survey. A total of 2147 nurses from Grade A cancer hospitals in 15 provinces of China were selected by a convenient sampling method. Questionnaires were collected through the Questionnaire Star platform. Nurses' safety behaviour was measured using the nurse Safety Behaviour Scale, Self-efficacy by the General Self-efficacy Scale, and nurses' occupational burnout was measured by the occupational Burnout Scale, and work engagement through the the Work Engagement Scale. Structural equation modelling was used to test the relationship among nurses' safety behaviour, general self-efficacy, occupational burnout and work engagement. SPSS25.0 software was used to test the relationship among the safety behaviour of nurses, general self-efficacy, occupational burnout and work engagement. The total score of safety behaviour of nurses was 55.45 ± 6.879, the total score of general self-efficacy was 31.39 ± 5.729, the total score of occupational burnout was 44.99 ± 26.587, and the total score of work engagement was 38.48 ± 13.433; the scores of the Nurse Safety Behaviour Scale, Self-Efficacy Scale, and Work Engagement Scale were positively correlated (all p < .001); the occupational burnout scale was negatively correlated with the scores of self-efficacy scale, work engagement scale and nurse safety behaviour scale (all p < .001); Structural equation model analysis shows that self-efficacy and work engagement have a direct positive impact on nurse safety behaviour(β = .103, β = .096, all p < .001); Occupational burnout has a direct negative impact on self-efficacy, work engagement and nurse safety behaviour(β = -.371, β = -.413, β = -.328 all p < .001). Bootstrap analysis showed that occupational burnout and job involvement had a significant chain mediating effect between self-efficacy and the safety behaviour of nurses (95% CI: 0.148-0.21). The total effect of self-efficacy on the safety behaviour of nurses was 0.283 (p < .001, 95% CI: 0.225-0.301), the direct effect was 0.096 (p < .001, 95% CI: 0.042-0.15), and the indirect effect was 0.179 (p < .001, 95% CI: 0.085-0.215), The mediating effect accounted for 63.3% of the total effect size. Occupational burnout and work engagement play a partial mediating role between self-efficacy and nurse safety behaviour. It is necessary to strengthen training on nurse safety culture awareness, improve the nurse self-efficacy and work engagement, reduce nurse occupational burnout, and thereby improve the level of nurses' safety behaviour.

Telehealth interventions in occupational therapy with older adults: Results from a scoping review targeting better health promotion.

Telehealth interventions have the potential to enhance access to care and improve efficiency while reducing the burden on patients. Although telehealth interventions are well accepted and adopted in physical therapy, their usage in occupational therapy for older adults is less common, and limited information exists regarding their setting and context. To provide an inventory and synthesis of telehealth interventions in occupational therapy for older adults. For published studies on telehealth-based occupational therapy interventions in older adults between 2000 and 2022, six databases were reviewed. Data extraction and analysis were guided by the taxonomies developed by Tulu, McColl and Law and informed by the Canadian Model of Occupational Performance and Engagement. Twenty-three studies on telehealth interventions in occupational therapy for older adults were identified, mostly from North American authors (n = 11; 47.8%) and randomised clinical trials (n = 9; 39.1%). Most participants had a health problem (n = 20; 87.0%), mainly stroke (n = 9; 39.1%). Interventions focussed primarily on symptom management education (n = 12; 52.2%) of community-dwelling adults with health conditions, using videoconferencing systems or applications (n = 14; 60.7%). Interventions were delivered from the healthcare centre (n = 6; 26.1%) to the person's home (n = 18; 78.3%) synchronously (n = 19; 82.6%). About one third (n = 8; 34.8%) of the studies specified the therapist's location. Published studies on telehealth interventions in occupational therapy with older adults have mainly focussed on the synchronous training and education of participants using videoconferencing systems or applications. According to these studies, the scope of interventions is limited and could be expanded, for example, through occupational development and environmental modification. To better understand and describe best practices in the use of telehealth in occupational therapy, future studies should provide more details about the interventions performed, the technology used and the environmental settings of the therapist.

Nurturing the next generation of pediatric physician scientists: the Padova Physician Scientist Research Training for pediatric residents

Less than 2% of physicians complete a research training (PhD) after the residency with a declining trend in those pursuing a clinical scientist pathway in pediatrics. The exposure to research methodology during the clinical training may play a role in engaging the next generations of pediatric physician scientist. Herein, we describe the experience of the Padova Physician Scientist Research Training (PPSRT) of the pediatric residency program at the University of Padova. The PPSRT was addressed to residents attending PGY2 to PGY4 of the pediatric program and consisted of two cores: a general one including in person or virtual lectures about research methodology in pediatrics including design of a clinical trial, writing of a scientific paper and statistical methods, and a subspecialties core for the discussion of research challenges in each area and the scientific writing activities. The perceived barriers to a research training and an evaluation of the program were assessed by an anonymized questionnaire. Sixty-four out 150 residents registered for the research training with 62/64 completing the two cores. The major perceived barrier to research during clinical training was the absence of protected time (89%) followed by the lack of specific funds (37%). The group activities lead to the publication of 24 papers. Conclusion: This is the first experience in the Italian pediatric training of a dedicated research program within the frame of postgraduate medical education. Our report highlights the need for protected time to promote research interest and nurture a new generation of physician scientists.What is Known:• Training to medical research is not part of residency program.• The declining trend of physician scientists might be reverted by early exposure to research methodology and challenges during residency.What is New:• An early exposure to research training during pediatric residency increases the research engagement of pediatric residents.• The lack of protected time for research is perceived as the major barrier to research training during residency.

JAVA Memory Care program: Facilitating social and occupational engagement for older adults living with advanced dementia.

Residents in aged care homes often report lack of life purpose and meaning and limited opportunities to contribute to their community. The JAVA Memory Care program is designed to facilitate engagement for older adults with advanced dementia. This study explored whether JAVA Memory Care engaged such adults meaningfully, on social and occupational levels, within one Australian residential care home. A mixed method design guided this exploration. Trained staff facilitated six JAVA groups over 2 months. Three sources of data were utilised. Observational data (qualitative and quantitative) were obtained using a narratively enhanced Assessment Tool for Social and Occupational Engagement (ATOSE). The other two data sources were qualitative and analysed thematically: reflections by the lead JAVA facilitator and data generated by a research discussion group. The quantitative data comprised 564 ATOSE behaviour markers. Participants were categorised as being engaged in 93% of these markers. Two of the three qualitative themes focused on the collective and self-expressive nature of participant engagement. The third theme focused on practicalities such as time pressures, facilitator training, resident selection, and resource preparation. For residents, the groups provided a context for relating meaningfully to others. The JAVA program achieved a high level of engagement. However, it was a time intensive intervention and required a person-centred philosophy, appropriate staff training, organisational support, and a suitable quiet space. The program had positive benefits, but practical issues identified needed to be considered before implementation.

Evaluating the Environmental Footprint: BPE Framework for Sustainable and Energy-Efficient Residential Buildings in India

In the context of enhancing building performance assessment, this study introduces the BPE (Building Performance Evaluation) framework and explores its application through a residential complex in India. An expert evaluation of the questionnaire is carried out to investigate the main element and obstacles to the execution of BPE. The framework, designed to scrutinize five parameters, initially assesses design aspects, including building form, orientation, and aesthetics. Findings reveal that the building design lacks efficient circulation, storage facilities, and satisfactory spatial allocation. Building energy monitoring, essential for comprehensive analysis, faces limitations due to insufficient data availability, emphasizing the need for thorough planning. Thermal comfort analysis, based on temperature and humidity measurements, unveils significant fluctuations beyond comfort thresholds. Expert surveys and occupant feedback further expose reduced utilization of natural ventilation, high air conditioner adoption rates, and adaptive behaviours. The framework's insights prompt opportunities for improvement, yet validation requires broader application across diverse buildings. The study's academic survey emphasizes the importance of integrating BPE in industries with government policies. Field observations highlight challenges in space utilization, material selection, and occupant engagement. This study's findings underscore the BPE-RBPI framework's potential to refine performance assessment, sustainable and energy efficient to foster industry confidence, and drive holistic improvements in India's building sector.

Recommendations for initiating and engaging local energy communities in alignment with justice principles – evidence from seven European citizen engagement processes

Background The promotion of local energy communities is highlighted as a solution to accelerate the transition towards a more decentralised, decarbonised and just energy system. EU policies are actively trying to strengthen the role of local energy communities as vital actors in the energy system. These developments open up a space for energy communities across Europe that are initiated, supported and/or strengthened from actors outside of the community. Such approaches have received limited attention by academic literature. The perspective of energy justice can serve as a normative framework to assess how the engagement of local residents and stakeholders in energy communities should take place. This paper points out injustices in seven different community engagement trajectories that took place as part of the Horizon project Lightness. Methods Relevant data was collected over the course of more than two years of field work, including interviews with residents and engagement leaders, workshops and site visits. A framework based on justice principles called The Voicer model was applied to analyse the data and pinpoint injustices. Results Based on these findings it provides ten recommendations for engaging residents and other local stakeholders in a just manner in local energy communities (LECs). These recommendations address among others the competences required for engaging residents in community-building, the importance of accessible communication and how to deal with the complexity of multi-stakeholder involvement. Conclusions The pathways for just engagement shown in this paper are limited in scope and would benefit from application in contexts with different legal, economic and governance configurations. Doing so can provide engagement practitioners with tangible tools to let diverse groups of residents enjoy the benefits that a just energy transition has in offer.

Perspectives on Promotion of Quality of Life for Individuals Recovering from Substance Abuse: Priority for Occupational Therapy Programmes

The prevalence of substance abuse in South Africa is growing fast, impacting negatively on quality of life. Individuals abusing substances present with impaired occupational functioning, which warrants occupational therapy intervention. Meaningful engagement in occupations contribute to well-being and quality of life of an individual. It is important for the occupational therapist to be aware of the enhancers of quality of life for the intervention programme of persons living with substance use issues. The barriers of quality of life need to be addressed in the programme in order to guard against relapse. A holistic approach to the intervention of substance abuse is of paramount importance.

Occupational adaptation for adults living with advanced cancer: A phenomenological longitudinal study.

People living with advanced cancer want to continue participating in their valued occupations amid cancer progression. However, increasing dependence and bodily deterioration challenge a person's ability to do so, thus requiring adaptation to how they engage in their occupations. Theoretical frameworks on the process of occupational adaptation often do not address the implications of progressive functional decline. A longitudinal phenomenological design was used to understand the lived experience of occupational engagement for working-aged adults living with advanced cancer. A semi-structured interview series explored participants' experience of occupational engagement and how this changed over time. Data were analysed thematically and mapped against the Model of Human Occupation (MOHO). Eight adults (40-64 years old) participated in 33 interviews over 19 months. Three themes were constructed from the data: ongoing adaptation through doing, the significance of volition in adaptation, and everyday life is contingent on my environment. Study findings demonstrate that the process of adaptation occurs through occupational engagement, is motivated by volition, and is affected by the environment. Volition and the environment play a more central role in occupational adaptation than occupational competency for the advanced cancer cohort. Study findings further MOHO's theoretical conceptualisation of occupational adaptation by identifying the centrality of volition and the environment in the process of adaptation. For people living with advanced cancer, disease progression results in unremitting functional decline, thus rendering competency an unstable and untenable construct. Rather, this paper argues that occupational adaptation is facilitated by volition (i.e., the motivation behind the doing) and the environment, thus fostering a sense of identity and meaning at the end of life. Occupational therapists' awareness of the significance of volition and the environment can thus foster continued occupational engagement and meaning at the end of life for people living with advanced cancer.

The impact of the COVID-19 pandemic on children's occupations.

The COVID-19 pandemic changed the daily lives and limited everyday activities of children worldwide. To document the impact of the COVID-19 pandemic on children's occupations, the associated factors, and the impact on children's health, wellbeing, and development. A narrative review was conducted by searching four databases (Scopus, MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews). A total of 35 articles met the inclusion criteria. Out of the 34 articles, 23 were relevant to the impact of the COVID-19 pandemic on occupations related to leisure (n = 17), productivity (n = 11), and self-care (n = 9). Ten articles highlighted specific factors that had been linked to changes in occupational engagement and child behavior. Ten articles focused on the impact of occupational disruption during COVID-19 on health, wellbeing, and general development. The COVID-19 pandemic seems to have had a negative impact on children's occupations, while the restrictions were still in effect. Further research is needed to establish reliable conclusions.

Early Resident Support for a Mega-Event: Evidence from the 2032 Brisbane Summer Olympic Games

With fewer willing hosts, mega-events face uncertainty. From stakeholder and core/periphery perspectives, dystopic outcomes are occurring because mega-event elites benefit far more than peripheral stakeholders, including host city residents. To overcome the current crisis of confidence in mega-events and enable procommunity ideals of stakeholder theory, we identify levels of host community support for the 2032 Brisbane Olympic Games in the early preevent stage, when proactive planning interventions are still possible. Two thirds of 897 surveyed host city respondents supported the Brisbane Games in our 2022 study, but this support is "soft." Specifically, cluster analysis reveals an event-loyal inner periphery of "enthused legacy optimists" and "enthused immersives" who can be targeted for early personal engagement and recruitment of other residents, especially the large middle periphery of "skeptics." A passively opposed outer periphery of "neutral negatives" and "naysayers" was also identified that may resist recruitment but is unlikely to disrupt preparation or hosting.

The older adult: physical activity considerations and learning to age in place

PurposeThe purpose of this study is to investigate the transfer of learning among older adults and the importance of physical activity (PA) related to aging in place.Design/methodology/approachA mixed-methods approach examined 10 older adults aged 65–88, who were receiving occupational therapy and contemplating aging in place. Semistructured interviews determined participants' perceptions of aging in place and PA. Accelerometers assessed levels of PA over 14 days.FindingsInterviews revealed that most participants were aware of the importance of PA but did not specify PA as being a primary contributor to continued independence with aging. Accelerometer data revealed that, on average, 96.7% of the day is spent in sedentary behavior.Practical implicationsHealth-care professionals may ask the question, “What will my patient do with the information he or she has learned?” This study was useful to increase understanding of older adults’ learning, lifestyles and effects on aging independently.Social implicationsAs older adults have true expectations of requirements for successful aging in place, realistic levels of PA and transfer of learning could improve the intended outcome of aging independently.Originality/valuePA is often an overlooked factor for occupational engagement and aging in place and is novel to investigate in combination with interviews.

Enriching Resident Engagement During Whiteboard Mini-Talks.

Enriching Resident Engagement During Whiteboard Mini-Talks.

'Having the dog as part of our family gives us hope': Experiences of the impact of assistance dogs on the occupational engagement of children with autism and their families.

Autism is a developmental disorder characterised by changes in social, communication, and behavioural performance. Assistance dogs can support children with autism to engage in everyday occupations. Despite more children being partnered with assistance dogs, there is limited research regarding the impact of assistance dogs on the occupational engagement of children with autism and their families, and further research is needed to fully understand the impact of this type of support within the Australian context. To explore caregiver-reported experiences of an assistance dog on the occupational engagement of children with autism and their families. Using a qualitative approach, semi-structured interviews were undertaken with six caregivers of seven children with autism, who each had an assistance dog. Interviews ranged from 45 to 60 minutes in duration. Data were transcribed verbatim and thematically analysed. Trustworthiness was maximised through independent recruitment, research team discussions, member checking, and a researcher reflective journal. Three themes were identified: participation in everyday occupations prior to and after partnering with an assistance dog, increased engagement in everyday occupations, and impact of the assistance dog on the family unit. Assistance dogs were reported to progress children from community 'isolation' to 'freedom'. Participants reported the dog increased children's capacities through positively influencing completion of routines, increasing independence, and improving therapy engagement. Assistance dogs were viewed as supporting the whole family's occupational engagement. Some challenges were identified with the introduction of the assistance dog to thefamily unit, and with animal maintenance costs and time demands, public access rights, and limited government funding. This research identifies benefits and challenges for children who partner with autism assistance dogs. It provides insights to inform assistance animal referral, assessment, and support of assistance dogs in Australia for children with autism and occupational therapists working with them.