Occupational Therapy Interventions For Children Research Articles

Key elements of Goal-Directed Training for children with cerebral palsy: A qualitative content analysis

Background: Goal-directed training is an evidence-based occupational therapy intervention for children with cerebral palsy targeting motor performance and goal attainment. There is variability and limited description on goal-directed training delivery within the studies who found it a successful intervention. The aim of this study was to establish the who, what, why and how of goal directed training according to practicing occupational therapists. Methods: Occupational therapists currently delivering goal-directed training to children with cerebral palsy were recruited. Qualitative data were collected from structured, open-ended interviews and analysed through content analysis. Themes and consensus answers were elicited and mapped to the Template for Intervention Description and Replication checklist. Results: Four key elements were identified as essential for goal-directed training: goal setting, task analysis, active intervention and evaluation. Within each area, occupational therapists provided rich descriptions of what these elements looked like in practice. Despite having a clear understanding of goal-directed training, some barriers to implementation were identified. Conclusion: Occupational therapists identified key elements and barriers to implementing goal-directed training in their practice. It is recommended that further support and training is provided to ensure that occupational therapists deliver goal-directed training with high fidelity.

Characterizing Occupational Therapy Intervention for Children on the Autism Spectrum.

Occupational therapy is one of the most used interventions for children on the autism spectrum. There is a critical need to develop an operationalized list of key treatment components of usual-care occupational therapy practice for children on the autism spectrum. To identify and develop consensus on definitions and examples of key treatment components of usual-care occupational therapy for children on the autism spectrum, ages 6 to 13 yr. We conducted a Delphi study to obtain feedback from a panel of experts. Electronic survey. 17 occupational therapy panelists with expertise in autism intervention. Panelists rated the definition and example of each treatment component and provided feedback through multiple rounds of survey. On the basis of the panelists' feedback on Delphi Round 1, the criteria rating form was revised to include four questions for the definition and example of each treatment component. Through four Delphi rounds of consensus building, we developed an operationalized list of 20 treatment components with definitions and examples that incorporated elements of usual-care occupational therapy intervention for children on the autism spectrum. This operationalized list of treatment components serves as a foundational framework to improve education, practice, and research of occupational therapy intervention for children on the autism spectrum. Plain-Language Summary: This study identified and developed consensus on definitions and examples of key treatment components used in usual-care outpatient occupational therapy for children on the autism spectrum. Through four rounds of consensus building with 17 occupational therapy experts in autism, we identified 20 key treatment components central to occupational therapy practice. Our results have the potential to serve as a framework to improve education, practice, and clinical research in autism.

Long-Term Impact of an Occupational Therapy Intervention for Children With Challenges in Sensory Processing and Integration.

Research is limited regarding parent-caregiver perspectives of occupational therapy (OT) intervention for children with challenges in sensory processing and integration and whether changes immediately following OT intervention are sustained over time. To evaluate whether changes in identified goals are maintained following OT intervention and to determine what aspects of OT intervention parents-caregivers perceive to be most valuable. A mixed-methods research design. A large midwestern pediatric hospital, with follow-up telephone interviews with parents-caregivers. Sixteen children with sensory challenges and their parents-caregivers. Children participated in 1-hr OT intervention sessions, 3 days per wk, for 6 to 7 wk. Parents-caregivers of children who completed OT intervention were interviewed via the telephone 6 to 12 mo after the intervention. The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) were used to determine whether changes were made and sustained over time. Qualitative data on caregiver perceptions of OT intervention were collected via open-ended questions during phone interviews. COPM and GAS scores before intervention were statistically significant compared with scores immediately following intervention and at 6- to 12-mo follow-up. Five themes emerged from the qualitative data. Children with sensory challenges made significant changes related to occupational performance following OT intervention, and goal achievement was sustained over time. Parents-caregivers valued many aspects of the OT program, including the increased frequency of therapy services, the occupational therapist's advanced knowledge and skills, and the education and information provided during the program. Plain-Language Summary: This study supports the results of previous studies on OT intervention for children with challenges in sensory processing and integration. The study also adds to the body of knowledge that shows that changes and progress toward goals that result from skilled OT intervention can be sustained over time. The study showed that children participating in OT intervention made statistically significant changes while receiving OT services and maintained progress after intervention ended; however, the children did not continue to make significant progress toward goals once skilled OT services ended. Parents and caregivers of children with sensory challenges reported that they found OT intervention to be beneficial. Other important factors influencing the effectiveness of OT intervention that were identified by parents-caregivers included the education provided by the occupational therapist, the increased frequency of therapy services, and the increased knowledge and skills of the occupational therapists who provided the intervention.

Effectiveness of School-Based Occupational Therapy Interventions on School Skills and Abilities Among Children with Attention Deficit Hyperactivity and Autism Spectrum Disorders: Systematic Review

ABSTRACT This systematic review aimed to synthesize the best available research evidence regarding the effectiveness of school-based occupational therapy interventions on school skills and abilities among children with ADHD (attention deficit hyperactivity disorder) and ASD (autism spectrum disorder). The review was conducted according to JBI (Joanna Briggs Institute) guidelines . A three-step search strategy was conducted from five electronic databases (CINAHL, PubMed, OTDBASE, Google Scholar, and Oula-Finna) in January 2022. This review considered randomized and quasi-randomized studies that evaluated school-based occupational therapy interventions for children on school skills and abilities, specifically outcomes of social interaction and process skills, and cognitive abilities. This review includes thirteen studies with a total sample size of 375 participants. Results are divided into two categories: school-based occupational interventions for children with ADHD (three studies) and school-based occupational interventions for children with ASD (ten studies). Results from school-based occupational therapy intervention studies for children and adolescents with ADHD indicate that this group of students benefits from manualized interventions that focus on social interaction skills, process skills, and cognitive abilities. Positive responses to these outcomes were found when using interventions concerning mindfulness, weighted vests, and executive function training programs. Results from school-based occupational therapy intervention studies for children and adolescents with ASD emphasize using interventions that affect social interaction skills.

Parents as Adult Learners in Occupational Therapy for Children With Sensory Challenges: A Scoping Review.

Parent training is an essential part of occupational therapy intervention for children with sensory processing and sensory integration (SP-SI) challenges, and parents' learning needs should be considered. To identify the extent to which adult learning needs are considered in occupational therapy literature addressing parent training as a part of intervention for children with SP-SI challenges. Searches were performed of the following databases: MEDLINE, PsycINFO, CINAHL, Web of Science, EMBASE, and ERIC. The date range was limited to 1990 to 2019 to capture literature focused on family-centered care. Using Arksey and O'Malley's framework for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist, the following criteria were used to guide the literature searches: population (parents and families of children with SP-SI challenges), intervention (parent training), outcomes (parent learning needs), and concept (parents as adult learners). Searches produced 133 peer-reviewed articles, and 5 met the criteria for inclusion. Qualitative thematic analysis, including stakeholder interviews, revealed two themes: (1) Parents focus on children's needs, not their own, and (2) parents benefit from connection with peers and learn through shared experiences. Parent training is an essential component of occupational therapy; however, there is limited occupational therapy evidence examining parents' learning needs, specifically parents of children with SP-SI challenges. Future studies should investigate parents' learning needs in relation to occupational therapy intervention for families of children with SP-SI challenges. What This Article Adds: Parents' learning needs are both rarely considered in the occupational therapy literature and important for best practice in pediatric therapy for children with SP-SI challenges. The results of this scoping review point to the need for further investigation of parent training programs specifically examining parents as adult learners.

Association Between Sensory Features and High-Order Repetitive and Restricted Behaviors and Interests Among Children With Autism Spectrum Disorder.

Children diagnosed with autism spectrum disorder (ASD) are often referred to occupational therapy practitioners so their sensory features and their repetitive and restricted behaviors and interests (RRBIs) can be addressed. RRBIs include an insistence on sameness, narrow interests, rigid routines, and rituals. However, there is a paucity of knowledge concerning the association between sensory features-across patterns, modalities, and contexts-and high-order RRBIs among children with ASD who are cognitively able. To examine the association between sensory features across sensory patterns, modalities, and contexts and high-order RRBIs in children with ASD. Correlational clinical study based on parent questionnaire responses. General education system in Israel. Parents of 39 cognitively able school-age children with ASD (ages 6-10 yr; 34 boys and 5 girls), recruited by means of convenience sampling. High-order RRBIs were assessed with relevant subscales from the Repetitive Behavior Scale-Revised (RBS-R), and sensory features across patterns, modalities, and contexts were examined with the Sensory Experiences Questionnaire, Version 2.1. The study hypotheses were formulated before data were collected. Significant correlations were observed between the high-order RRBIs of children with ASD and their sensory features across patterns, sensory modalities, and contexts. Fifty-one percent of the total RBS-R scores were predicted by sensory hyperresponsiveness, and an additional 11% were predicted by sensory-seeking behaviors. The hypotheses concerning the association between sensory features and high-order RRBIs were confirmed. The findings enhance occupational therapy practitioners' understanding of this association and may assist in the planning of more efficient interventions. What This Article Adds: The findings enhance clinical knowledge concerning the association between sensory features and high-order RRBIs and may lay a better foundation for occupational therapy interventions for children with ASD and their families.

Exploration of a Short-term Learning Community Focused on Evidence-based Occupational Therapy Interventions for Children and Youth with Autism

Continuing education (CE) for occupational therapists typically takes place in workshops, seminars, or webinars with little support for practice change after the event concludes. Continuing education that occurs over an extended time with opportunities for social learning and competence assessment may improve knowledge translation. This study explored how pediatric occupational therapists who participated in a short-term, online learning community acquired new knowledge about evidence-based interventions from learning activities and how they applied this new knowledge to practice. Weekly modules with facilitated discussions, competency self-assessment, and peer-reviewed journal article readings occurred over a six-week period. An exploratory design included content analysis of participants’ online discussion postings, goal-setting activities, reflections, and a researcher-developed evaluation survey. Of the 19 participants who completed the evaluation survey, 17 participants indicated that the case simulation helped to assess their competence and that readings on evidence-based interventions obtained from ProQuestTM were helpful. All participants (n = 19) agreed that the learning community enriched their understanding of how to work with children and youth with autism spectrum disorder and they planned to apply new knowledge to their practice. Qualitative data analysis yielded two themes: becoming evidence-based and integrating evidence into practice. A community of occupational therapists with shared interests who participated in socially mediated learning opportunities with multiple educational components increased understanding and application of evidence-based interventions. Future research should investigate the relationship between engagement in a short-term learning community and application of evidence-based interventions with follow-up.

Choosing Performance-Based Outcome Measures of Daily Living Skills and Socialization for Clinical Trials in Autistic Children.

Robust and psychometrically sound performance-based outcome measures are needed for clinical trials of occupational therapy interventions for children with autism. To demonstrate a systematic approach for choosing psychometrically sound performance-based outcome measures of daily living skills and socialization for use in clinical trials of occupational therapy interventions for children with autism. Rapid literature review to identify appropriate measures for studies with this population followed by quality indicator ratings and a nominal group process. University. Four experts in autism and pediatric outcome measurement. Outcomes and Measures: Twenty-one outcome measures of daily living skills and socialization were identified and reviewed. Seven measures met the inclusion criteria. The Assessment of Motor and Process Skills and the Evaluation of Social Interaction-Second Edition, received the highest ratings and group consensus. Several other measures were also scored highly. Careful assessment of psychometric properties is an important component of choosing outcome measures for a clinical trial, but burden of assessment and study objectives are important considerations. What This Article Adds: This project demonstrates use of a systematic process for choosing outcome measures for a planned clinical trial.

Occupational Therapy Interventions for Children and Youth Ages 5 to 21 Years

Abstract Evidence Connection articles provide a clinical application of practice guidelines developed in conjunction with the American Occupational Therapy Association’s (AOTA’s) Evidence-Based Practice Program. Each article in the series summarizes the evidence from the published reviews on a given topic and presents an application of the evidence to a related clinical case. The articles illustrate how the research evidence from the practice guidelines can be used to inform and guide clinical decision making. In this Evidence Connection article, we describe a case report of a child receiving occupational therapy services and summarize the evaluation and intervention processes for supporting sleep, activities of daily living, and social participation. The practice guideline on this topic was published in the July/August 2020 issue of the American Journal of Occupational Therapy (Cahill & Beisbier, 2020).

Occupational therapy interventions in child and adolescent mental health to increase participation: A mixed methods systematic review

Introduction Mental health disorders and low levels of mental well-being can have a lasting effect on life satisfaction and contribution to society for children and adolescents, yet the effectiveness of occupational therapy interventions is unknown. Methods A mixed methods systematic review was conducted including studies with children and adolescents aged 5–16 years, who had mental health difficulties, that evaluated occupational therapy interventions and focused on participation in everyday occupations as an outcome. Results The nine included studies were generally very low quality. The results could not be pooled due to heterogeneity. For children with Asperger’s syndrome, the Cognitive Orientation to Daily Occupational Performance intervention had clinically significant improvements on occupational performance and social skills. For children with attention deficit hyperactivity disorder, the Ultimate Guide to Play, Language and Friendship intervention improved playfulness and the Cognitive–Functional intervention had a statistically significant improvement on occupational performance and behaviour. Conclusion One intervention used by occupational therapists with children with Asperger’s syndrome and two interventions used with children with attention deficit hyperactivity disorder had some evidence of effect. No evidence was identified for the effectiveness of occupational therapy interventions for children and adolescents with other common mental health conditions.

Сучасні підходи до ерготерапії дітей з розладами аутистичного спектра

The purpose of the study is to determine the current provisions on occupational therapy interventions for children with ASD, features of their practical implementation and effectiveness based on the analysis of research data. Materials and methods. This work is the result of the analysis of scientific and methodological developments on the practical implementation of occupational therapy interventions in terms of timing and scope, complexity and role of the family; comparison of research results, which are devoted to the study of the effectiveness of behavioral therapy and SI, as the main interventions of occupational therapists. Results. Early rehabilitation of a child with ASD contributes to the formation of the necessary skills in everyday life and communication. To date, the largest evidence base has been accumulated by intervention programs, which are based on the principles of improving parent-child relations and are aimed at developing social and communication skills. Occupational therapy in ASD is aimed at overcoming motor anxiety, disorders of large and fine motor skills, coordination of movements and ability to learn, speech. SI-based occupational therapy is used to improve the processing of sensory information, improve the efficiency of "registration" and modulation of the senses, as well as help in the formation of simple adaptive responses. The effectiveness of sensory and motor interventions is manifested in positive changes in the social interaction of children, purposeful play and normalization of sensitivity. Sensory interventions of occupational therapists can reduce maladaptive behavior, hyperactivity, as well as inhibit self-stimulation, stereotyped movements and improve attention. Researchers recommend that occupational therapists combine sensory interventions with functional tasks that help the child's practice in achieving the goal of the activity. Conclusions. There is a large number of approaches and techniques used in occupational therapy for children with ASD. Given the lack of evidence to determine the most effective of them, it should be noted that additional research is needed to address this issue

The Role of Occupational Therapy with Children with Attention Deficit Hyperactivity Disorder (ADHD): A Canadian National Survey

ABSTRACT Children with Attention Deficit Hyperactivity Disorder (ADHD), a neurobehavioral disorder prevalent in childhood, demonstrate a persistent pattern of inattention and hyperactive and/or impulsive behavior that is more severe than their typically developing peers. Much of this challenging behavior is observed in the classroom. However, current literature on ADHD for school-aged children largely examines issues of clinical diagnosis and pharmacological management. Consequently, the associated challenges in functional limitations and participation restrictions that these children demonstrate have not been well examined. Fortunately, as members of the school-based team, occupational therapists are uniquely suited to address this important perspective. Therefore, the purpose of this study was to 1) identify the scope of occupational therapy (OT) practices in assessment, intervention and service delivery with children/youth with ADHD across Canada, 2) indicate potential research and practice gaps, and 3) discuss future implications with respect to OT intervention for children with ADHD. A bilingual national survey was created based on a comprehensive literature review and consultation with experts in pediatrics and knowledge translation. The survey link was sent to pediatric occupational therapists across Canada through mailing lists obtained from national and provincial organizations. A total of 172 surveys were completed (response rate = 10%). The majority of respondents reported that children with ADHD comprised 26–75% of their caseloads. More than 90% of respondents reported using OT interventions to address skills related to impairments (sensory processing), activity (fine motor function), and participation (school functioning) in their treatment of children with attentional disorders. OTs frequently reported using sensory-based principles to address the behavioral symptoms of children with ADHD. The most common form of service delivery was individualized sessions, followed by consultation. Potential gaps and implications at the research, practice and organizational levels are discussed to further support the role of OT with school-aged children with ADHD.

Activity- and Occupation-Based Interventions to Support Mental Health, Positive Behavior, and Social Participation for Children and Youth: A Systematic Review.

Children and youth are often challenged to maintain well-being, positive behavior, and social participation. To identify evidence for occupational therapy interventions for children and youth with and at risk for mental health concerns. Articles published in English-language peer-reviewed journals between January 2010 and March 2017 identified through searches of MEDLINE, PsycINFO, CINAHL, ERIC, OTseeker, and Cochrane databases. : The methodology in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to complete the review. Of 5,310 articles screened by title and abstract, 357 were retrieved for full-text review, and 62 met inclusion criteria. Articles describing interventions that were activity or occupation based were included. Conference proceedings, non-peer reviewed publications, dissertations, theses, and presentations were excluded. Of the 62 studies included in the review, 20 (32%) were Level I studies, 22 (36%) were Level II studies, and 20 (32%) were Level III studies. Articles were categorized by type: outdoor camps, video and computer games, productive occupations and life skills, meditation, animal-assisted interventions, creative arts, play, sports, and yoga. Moderate to strong evidence supports the use of yoga and sports. Moderate-strength evidence supports the use of play and creative arts. Evidence for the use of animal-assisted interventions, meditation, video and computer games, and productive occupations was of low strength. Substantial evidence exists to support the use of activity- and occupation-based interventions to address the mental health, behavioral, and social participation concerns of children and youth. Occupational therapy practitioners should match the desired outcome of therapy with the appropriate intervention to provide the best and most effective services to their clients. This review provides additional support for the use of activity- and occupation-based interventions (i.e., those that involve active participation) to improve the behavior, social participation, and mental health of children and youth.

Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review.

IntroductionPaediatric occupational therapy seeks to improve children's engagement and participation in life roles. A wide variety of intervention approaches exist. Our aim was to summarise the best‐available intervention evidence for children with disabilities, to assist families and therapists choose effective care.MethodsWe conducted a systematic review (SR) using the Cochrane methodology, and reported findings according to PRISMA. CINAHL, Cochrane Library, MEDLINE, OTSeeker, PEDro, PsycINFO were searched. Two independent reviewers: (i) determined whether studies met inclusion: SR or randomised controlled trial (RCT); an occupational therapy intervention for children with a disability; (ii) categorised interventions based on name, core components and diagnostic population; (iii) rated quality of evidence and determined the strength of recommendation using GRADE criteria; and (iv) made recommendations using the Evidence Alert Traffic Light System.Results129 articles met inclusion (n = 75 (58%) SRs; n = 54 (42%)) RCTs, measuring the effectiveness of 52 interventions, across 22 diagnoses, enabling analysis of 135 intervention indications. Thirty percent of the indications assessed (n = 40/135) were graded ‘do it’ (Green Go); 56% (75/135) ‘probably do it’ (Yellow Measure); 10% (n = 14/135) ‘probably don't do it’ (Yellow Measure); and 4% (n = 6/135) ‘don't do it’ (Red Stop). Green lights were: Behavioural Interventions; Bimanual; Coaching; Cognitive Cog‐Fun & CAPS; CO‐OP; CIMT; CIMT plus Bimanual; Context‐Focused; Ditto; Early Intervention (ABA, Developmental Care); Family Centred Care; Feeding interventions; Goal Directed Training; Handwriting Task‐Specific Practice; Home Programs; Joint Attention; Mental Health Interventions; occupational therapy after toxin; Kinesiotape; Pain Management; Parent Education; PECS; Positioning; Pressure Care; Social Skills Training; Treadmill Training and Weight Loss ‘Mighty Moves’.ConclusionEvidence supports 40 intervention indications, with the greatest number at the activities‐level of the International Classification of Function. Yellow light interventions should be accompanied by a sensitive outcome measure to monitor progress and red light interventions could be discontinued because effective alternatives existed.

Defining Occupational Therapy Interventions for Children with Fine Motor and Handwriting Difficulties

ABSTRACTFine motor deficits are often correlated with poor handwriting which can impact a variety of academic-related tasks. Occupational therapists (OTs) frequently provide interventions for the remediation of handwriting difficulties. Evidence exists to provide information as to the most effective forms of interventions used by occupational therapists. However, what OTs do within a treatment session has yet to be defined and studied for effectiveness. This study provides an initial feasibility study to examine the method of text mining to explore and define the interventions used by occupational therapists in the treatment of fine motor skills as related to handwriting difficulties. Researchers performed a retrospective review of 157 participants’ narrative treatment notes using text mining. Data were categorized into treatment interventions based on five previously identified treatment categories. Pre and posttest fine motor scores were examined to determine change. Specific handwriting outcomes were not gathered at this time. Results revealed three primary treatment interventions for the treatment of handwriting difficulties multisensory and motor approaches. A significant change in pretest and posttest scores was indicated. Overall, therapists in this setting utilized evidence-based interventions that demonstrated significant changes in fine motor skills. The study exhibited limitations in the single site sample and size of the sample and no direct assessment of handwriting outcomes. Future research would expand the study to additional sites and further explore relationships between interventions and outcomes.

An integrative review of assessments used in occupational therapy interventions for children with cerebral palsy

Introduction: Children with cerebral palsy (CP) experience a wide range of deficits and symptoms. When undergoing occupational therapy (OT) interventions, it is essential that the OT select assessments that can accurately reflect the outcome measures of the targeted domains. Objective: To identify the assessment tools most frequently reported in research studies as measures for OT interventions when treating children with CP. Method: Pubmed and Ovid databases were systematically searched by using key terms “cerebral palsy,” “assessments,” and “occupational therapy”. Assessment tools were explored and extracted from articles contingent on the following inclusion criteria: (1) children birth to 18 years diagnosed with cerebral palsy; (2) use of assessment(s) as a measure of OT intervention; (3) published in English between 2007 and 2017. In the preliminary search, Pubmed yielded 151 records and Ovid yielded 571. Out of these, only 76 met the inclusion criteria. From the remaining 76 articles, a total of 88 assessment tools were retrieved and included in this literature review. Results: Ten assessments were found to be of importance based on frequency of use. The Assisting Hand Assessment (AHA) and Pediatric Evaluation of Disability Inventory (PEDI) were the most commonly used. Conclusion: This study helps to determine which assessments are frequently used in OT practice with children with CP. The findings of this study play an important role in addressing the challenge of assessment selection faced by occupational therapists and provide a basis for future research to expand on with regards to treating children with CP.

A Retrospective Pre-Post Treatment Study of Occupational Therapy Intervention for Children with Sensory Processing Challenges

A Retrospective Pre-Post Treatment Study of Occupational Therapy Intervention for Children with Sensory Processing Challenges

Occupational Therapy Interventions for Children with Attention Deficit Hyperactivity Disorder: A Systematic Review

ABSTRACTThis systematic review examined evidence published 2005–2015 for occupational therapy interventions for children with Attention Deficit Hyperactivity Disorder (ADHD). We identified 590 abstracts with 17 full-text articles eligible for review. Fourteen articles were included in the final analysis with two level I studies, two level II studies, eight level III studies, and two level IV studies. Occupational therapy interventions focused on play, sensory, motor, and cognitive skills. While the interventions yielded good results, there were limitations in study design, interventions, and outcome measures. Future research should include larger sample size, randomization, control groups, and interventions that can be replicated.

Goal Attainment Scaling and Multi-Component Occupational Therapy Intervention for Children with Hemiplegia

Goal Attainment Scaling and Multi-Component Occupational Therapy Intervention for Children with Hemiplegia

Ingredients and change processes in occupational therapy for children: a grounded theory study

Background: There is limited evidence about the effectiveness of occupational therapy interventions for participation outcomes in children with coordination difficulties. Developing theory about the interventions, i.e. their ingredients and change processes, is the first step to advance the evidence base.Aim: To develop theory about the key ingredients of occupational therapy interventions for children with coordination difficulties and the processes through which change in participation might happen.Material and methods: Grounded theory methodology, as described by Kathy Charmaz, was used to develop the theory. Children and parents participated in semi-structured interviews to share their experiences of occupational therapy and processes of change. Data collection and analysis were completed concurrently using constant comparison methods.Results: Five key ingredients of interventions were described: performing activities and tasks; achieving; carer support; helping and supporting the child; and labelling. Ingredients related to participation by changing children’s mastery experience, increasing capability beliefs and sense of control. Parents’ knowledge, skills, positive emotions, sense of empowerment and capability beliefs also related to children’s participation.Conclusion and significance: The results identify intervention ingredients and change pathways within occupational therapy to increase participation. It is unclear how explicitly and often therapists consider and make use of these ingredients and pathway.