Occupational Therapy Services For Children Research Articles

The experiences of occupational therapists supporting children with self-regulation needs: A qualitative descriptive study.

Occupational therapists support children with self-regulation needs to engage in meaningful occupations at home, school, and in the community. However, little is known about how Australian practitioners perceive their role working with children with self-regulation needs in the Australian healthcare context. Therefore, we explored the contemporary practice experiences of Australian occupational therapists working with children 4-12 years referred for self-regulation support, to better understand elements constituting efficacious service delivery to enhance occupational engagement. A qualitative descriptive design, underpinned by constructivism and relativism, was implemented to address the research aim. Occupational therapists were recruited online to participate in audio-recorded focus groups and interviews. The audio recordings were anonymised, transcribed verbatim, and analysed through reflexive thematic analysis. No consumers were involved in the study design or analysis. Four themes were generated, encapsulating the experience of 13 occupational therapists working with children with self-regulation needs: (1) navigating the complexities of self-regulation, (2) intervening to support the child and surrounding systems, (3) bringing the occupational therapy perspective to the self-regulation puzzle, and (4) working within an evolving practice context. Themes 1-3 describe specific processes that all occurred within the context of Theme 4. Overall, participants detailed successful practice to support children with self-regulation needs to participate in meaningful occupations that required person-centredness, collaboration, coaching, and adaptability of therapists responding to different stakeholder demands. Self-regulation is a complex area of practice, and occupational therapists have a key role in supporting occupational engagement by balancing the child's needs with those of family, other stakeholders, and funding bodies. Findings support occupational therapists and decision-makers advocating for the unique role of occupational therapy in supporting self-regulation in childhood as part of a collaborative, multi-disciplinary approach. Specific consideration must also be given to ways that current funding schemes in Australia enable occupational therapy services for children with self-regulation needs. Controlling emotions and behaviours is sometimes called 'self-regulation'. Some children find this hard and need help from an occupational therapist, who knows a lot about the body and the systems within it. A lot of occupational therapists in Australia help children with their self-regulation. There is not much known about how these therapists see their role in working with these children. We wanted to understand what it is like for occupational therapists who help children, between 4 and 12 years old, with their self-regulation. We interviewed 13 occupational therapists from across Australia and analysed what they said. The data showed four main points: (1) understanding the challenges of self-regulation, (2) helping the child and their environment, (3) using an occupational therapy approach to solve self-regulation issues, and (4) working in a changing practice environment. The therapists described how important it is to focus on the child, work together with many people like caregivers and teachers, and being flexible. They talked about how they balance the needs of the child, family, and funding bodies, which could sometimes be tricky. The study shows the things that therapists are doing when working with children who need help with their self-regulation and the things that therapists find hard working in this space. The results of the study can be used by people who advocate for services that help children and by people who make decisions about Australia's healthcare. One way the study can be used is to think about how current funding schemes do or do not allow different people and professions to work together to support children's self-regulation. Even though there were some limitations, such as a low response rate due to the stress of the COVID-19 pandemic, we did interview therapists from different parts of Australia who work in different settings to each other.

Occupational therapy services for children with Autism Spectrum Disorder on the primary healthcare platform

INTRODUCTION: The diagnosis of Autism Spectrum Disorder (ASD) is complex. In a low middle income country, like South Africa, early recognition of ASD rarely occurs on the primary health care (PHC) platform.To mitigate late diagnosis of ASD, which has a poorer prognosis, the purpose of this study was to identify the knowledge and clinical competencies required by inexperienced occupational therapists to improve early detection of and service delivery for children with ASD at the PHC level METHODS: A descriptive qualitative design explored the perceptions of occupational therapy experts as to the required knowledge and clinical competencies necessary for inexperienced occupational therapists to deliver services to children with ASD on the PHC platform. Thematic inductive analysis was used to analyse the data FINDINGS: Two themes emerged: Theme one: the perceived critical knowledge for early identification, assessment and treatment of children with ASD.Theme two: the clinical competencies required forassessment and effective treatment of children with ASD on the PHC level CONCLUSION: This study identified the perceived knowledge and clinical competencies needed to improve early identification and service community-based delivery for children with ASD on the PHC platform by early career occupational therapists IMPLICATIONS FOR PRACTICE ■ This study provides critical knowledge and clinical competencies to occupational therapists to facilitate effective therapeutic services to children with ASD on the PHC platform. ■ The study identified appropriate screening, assessment and intervention that could assist occupational therapy service planners to reduce the gap of service delivery for children with ASD within the concept of UHC provision on a community-based level in SA. ■ Faculty at tertiary educational institutions may utilise the findings in order to adapt curriculums to better prepare inexperienced occupational therapists with working with children with ASD on the community-based level.

Occupational therapists’ Perspectives of Using Telehealth for Youth with Autism Amidst the COVID-19 Pandemic in the UK: A Pilot Qualitative Study

ABSTRACT The COVID-19 national emergency led to a surging demand for telehealth expansion within pediatric occupational therapy. Despite the growing literature on telehealth as a response to COVID-19, few studies explore the use of telehealth for children and young people with autism spectrum disorder (ASD). This pilot study aimed to understand the experiences of occupational therapists adapting to a virtual delivery service model amidst COVID-19 to support youth with ASD. The researchers used a qualitative research design. Semi-structured, video-based interviews were used to collect data. Interviews were analyzed using thematic analysis. This study included 3 UK registered occupational therapists. Four themes emerged from the data: 1. “Telehealth is Reducing Social Anxiety” 2. “Parents End Up Becoming Your Therapy Assistants” 3. “Nothing Will Replace Face to Face for Assessments” 4. “You Definitely Have to Be More Creative.” The themes report that telehealth can reduce social anxiety, increase skill transferability, and improve family involvement. Participants indicated that shorter sessions, movement-based interventions, planning and adapting to home-based resources were strategies that overcame the limitations of virtual therapy. The findings contrast with some previous research that found that telehealth may inhibit engagement and may strain the therapeutic rapport. This study supports existing literature that telehealth can enhance engagement, family involvement and generalization of skills. Findings from this study support the use of telehealth to deliver occupational therapy services for children and young people with ASD, but it is recommended that telehealth should not be a one size fits all service delivery model. Further larger-scale research is needed to confirm the study findings and to explore the family and young person’s perspectives of using telehealth.

Assessing children to identify developmental coordination disorder: A survey of occupational therapists in Australia.

Developmental coordination disorder (DCD), a prevalent neurodevelopmental disorder with motor and psychosocial consequences, can significantly impact children's quality of life. In Australia, most children with diagnosed/suspected DCD have received occupational therapy services, more so than any other health service. As such, occupational therapists are key in identification and treatment and require a sound knowledge of diagnostic criteria and the best evidence for practice. This study explored current occupational therapy services for children with DCD. Areas for development are identified to improve the identification of, and subsequent intervention for, children with DCD. In this cross-sectional study, an online survey was completed in September and October 2020 by 175 occupational therapists working in Australia. Although all therapists worked with children who met the criteria for DCD diagnosis, 70% worked with children with no specific diagnosis and 50% worked with children with outdated diagnostic labels. Australian occupational therapists used similar models/frameworks (commonly a multisensory/sensory processing approach) to guide practice with children with DCD, regardless of therapist characteristics, practice setting (clinic/community, rural/urban), how therapy is funded, or the state where the therapists completed their training/currently practiced. Although assessment practices did not differ significantly, therapists with greater years of paediatric practice and those who studied and/or practiced in Western Australia were more likely to assess to identify DCD. Half of the therapists did not assess to identify DCD; however, 60% of assessing therapists reported best practice methods in assessment for DCD, indicating emerging best practices in the Australian context. The findings from this study suggest that small adaptations to current occupational therapy practice may enhance the early identification of children with DCD in Australia. The existing gaps in evidence to practice must be addressed to improve current Australian practice and increase access to appropriate services and ultimately improve the quality of life for children with DCD.

Defining and measuring the occupational performance of children

ABSTRACTOccupational performance assessments of children are essential for guiding occupational therapy intervention and for measuring the effectiveness of occupational therapy services for children. A review of relevant research and of occupational performance assessments designed for children was conducted to determine and describe how the occupational performance of children has been conceptualized and measured. The results indicated that more consistency with the ways in which occupational performance is being conceptualized by occupational scientists and within the occupational therapy profession is needed. A conceptual model for understanding and defining occupational performance was proposed and described. This model may be useful for assisting researchers in the development of new instruments for measuring occupational performance. In addition, how the model may be used by occupational therapists to describe what they refer to as occupational performance and to guide their evaluations of children are discussed.

Graphomotor skills in children with prenatal alcohol exposure and fetal alcohol spectrum disorder: A population-based study in remote Australia.

Few studies have examined graphomotor skills in children with prenatal alcohol exposure (PAE) or fetal alcohol spectrum disorder (FASD). Graphomotor skills were assessed in 108 predominantly Australian Aboriginal children aged 7.5-9.6years in remote Western Australia using clinical observations (pencil grasp; writing pressure) and standardised assessment tools (the Evaluation Tool of Children's Handwriting; and the Miller Function and Participation Scales - The Draw-a-Kid Game). Skills were compared between children (i) without PAE, (ii) PAE but not FASD and (iii) FASD. Most children used a transitional pencil grasp and exerted heavy handwriting pressure (83.3% and 30.6% of the cohort). The percentage of letters (M=62.9%) and words (M=73.3%) written legibly was low. Children with FASD were more likely than children without PAE to use a cross-thumb grasp (P= 0.027), apply heavy writing pressure (P=0.036), be unable to write a sentence (P=0.041) and show poorer word legibility (P=0.041). There were no significant differences between groups for drawing outcomes, although some children with FASD drew pictures that appeared delayed for their age. There were no significant differences between children without PAE and those with PAE but who were not diagnosed with FASD. Overall, graphomotor skills were poor in this cohort, but children with FASD performed significantly worse than children without PAE. Findings suggest the need for improved occupational therapy services for children in remote regions and evaluation of graphomotor skills in children with PAE.

Factors Associated with Comfort Level of School-Based Occupational Therapists in Providing Low-Vision Services

ABSTRACTThis study identified factors associated with the comfort level of school-based occupational therapists in providing services to children with visual impairments. Sixty-one school-based occupational therapists completed an on-line survey. Fifty-four percent of respondents were comfortable or somewhat comfortable when choosing assessments and 84% were comfortable or somewhat comfortable in providing occupational therapy services for children with visual impairments. Multivariable linear regression analyses indicated years of professional experience, history of a caseload of children with visual impairments, and training received in treating children with visual impairments from continuing education were uniquely and significantly associated with the respondents’ comfort level. Though not included in the final model, collaboration with other low vision service providers (e.g., teachers, optometrists, ophthalmologists, and orientation/mobility specialists) was also significantly associated with respondents’ comfort level in the univariate analysis. Findings provide an initial direction and strategies to improve occupational therapists’ comfort level in providing services to children with visual impairments in school settings.

Malaysian occupational therapists’ practices with children and adolescents with autism spectrum disorder

Introduction Occupational therapy is one of the health care professions that provides assessments and interventions for children and adolescents with autism spectrum disorder. However, to date, there is no information available regarding occupational therapy practices in Malaysia for this population. The purpose of this study is to describe the occupational therapy services for children and adolescents with autism spectrum disorder in Malaysia, including the perceived training needs of practitioners. Method We surveyed the registered members of the Malaysian Occupational Therapy Association using a mailed questionnaire. Results A response rate of 15.5% was obtained. The majority of the responses were from those working in hospital settings who had less than 5 years’ experience working as occupational therapists with children and adolescents with autism spectrum disorder. The theories, assessments, interventions, and training that related to respondents’ practices mainly revolved around sensory-based approaches. Encouragingly, more than 70% of the respondents claimed that they performed assessments of daily living activities in their service. Client-centred practice was a further feature of occupational therapist respondents involved in this study. Conclusion Future study is needed, especially to engage more respondents and thereby produce more generalizable results and an in-depth exploration of the continuing education needs of occupational therapists in Malaysia.

Relationship between Children’s Physical Self-Concepts, Activity Preferences, and Occupational Participation

Participation in leisure and play occupations is viewed as a key outcome for occupational therapy services for children. Our aim was to investigate whether children’s physical self-concepts are predictive of their activity preferences and occupational participation. A group of 38 typically developing Australian children ages 10 to 14 years completed the Physical Self-Description Questionnaire-Short form (PSDQ-S) and the Children’s Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE/PAC). Correlation and linear regression analyses were completed to determine predictive relationships existed between the constructs measured by the PSDQ-S and the CAPE/PAC. The PSDQ-S Sport subscale was the only statistically significant predictor of the CAPE Overall Diversity score (beta = .37, p < .05) explaining 14% of its total variance. The PSDQ-S Self-Esteem subscale was the only statistically significant predictor of the CAPE Overall Enjoyment subscale, accounting for 12.6% of its total variance (beta = .50, p < .05). The PSDQ-S Coordination subscale explained 11.1 % of the CAPE Overall With Whom subscale (beta = .33, p < .05). This study provides evidence that sub-domains of children’s physical self-concepts are potential predictors of components of children’s activity preferences and occupational participation.

Evidence‐based practice in occupational therapy services for children with autism spectrum disorders in Victoria, Australia

The current practice of occupational therapy services provided for children with autism spectrum disorders in Victoria, Australia was investigated - specifically, practice in terms of the theories, assessments and intervention strategies utilised. Identification of professional development needs was also explored. The purpose was to identify how occupational therapy practice may have changed over the last decade and to explore what additional developments are required in the field. A self-administered survey was mailed to 322 registered members of Occupational Therapy Australia Limited, Victoria Branch. A valid response rate of 20.5% was obtained. The majority of the participants worked in private practice, and had between one and five years of work experience. Theories, assessments and interventions that are associated with or based on, sensory integration and/or processing approaches are highly utilised by the participants in their service delivery with children with autism spectrum disorders. Participants indicated that they felt they needed training and courses around sensory integration. We concluded that there were few changes in occupational therapy practice related to the selection of theoretical models, assessments and interventions by the participants in this study over the last decade. It is essential for occupational therapists not to neglect the goals of providing occupation-based interventions to children with autism spectrum disorders by focusing only on sensory-based approaches. An urgent need for occupation-based approaches to working with children with autism spectrum disorders and their families is required.

Time use, parenting practice and conduct problems in four- to five-year-old Australian children

Conduct problems (CoP) represent one of the most common mental health issues manifesting in childhood, with the potential to influence the developmental trajectory of children negatively. Early identification of children at risk of developing CoP is a key strategy to their effective management. Evidence suggests that parenting practices are important contributors to CoP; however, these practices can also interact with the activities in which children engage and these have not yet been addressed in combination. A cross-sectional study of a nationally representative sample of 4936 four- to five-year-old children from Wave 1 of the Longitudinal Study of Australian Children was undertaken to examine the relationship between CoP, parenting practices and time use. All children were at a lower risk of CoP if they were exposed to less hostile and consistent parenting practices and if they did not have sleep problems as reported by their parents. However, boys were more vulnerable if they had fathers who had not undertaken tertiary education, and spent more time in risk-oriented physical activities. Parenting practices are affirmed as a significant independent predictor of risk for developing CoP. The nature of activities in which children engaged, particularly boys, also has the potential to influence the manifestation of CoP. Occupational therapy services for children with CoP are best provided in the context of family-centred practice and should incorporate an examination of daily time use.

Community-Based Occupational Therapy Services for Children: A Quebec Survey on Service Delivery

ABSTRACT.Community-based occupational therapy (OT) services are intended to promote social integration and minimize disability. The objective of this study was to describe community-based OT services for children in the province of Quebec, Canada. Specific aims included (a) to determine the proportion of Centres Locaux de Services Communautaires (CLSCs) that provide OT services to children, (b) to describe the nature of the services offered, and (c) to identify factors that are associated with the availability of these services. Surveys were sent to all CLSCs where at least one OT was employed. The response rate was 80%. Only 12% of CLSCs offered OT services to children on a regular basis (≥ 1 day/week). Home adaptations were the most frequent service offered, whereas health promotion was rarely addressed. Perceived obstacles to servicing children included prioritization of services to the elderly, limited funding, and shortage of OTs. CLSCs in rural areas and those with a psychologist had significantly more dedicated OT time spent for services to children. The findings suggest that community-based OT services for children in Quebec are poorly developed, which may negatively impact upon timely access to specialized rehabilitation services and may increase activity limitations and family burden.

Intensity of Therapy Services: What are the Considerations?

Research on intensity of therapy services is limited and perspectives often vary considerably among families, therapists, administrators, policy makers, and health insurers. In this commentary, the authors share their perspectives on intensity of physical therapy and/or occupational therapy services for children with developmental conditions. Five considerations are discussed: episode of therapy, readiness for activity and participation, method of service delivery, the distinction between intensity of therapy and practice of activity in natural environments, and the link between skill level and method of service delivery. We conclude that for children with developmental considerations, method of service delivery and intensity of therapy may differ for each episode of therapy based on contextual factors including child and family priorities and goals. In most situations, more than one method of service delivery can and should occur simultaneously.

The Psychosocial Deficits of Children with Regulatory Disorders

This article addresses the need to provide occupational therapy services for children with regulatory disorders who also have concomitant psychosocial deficits. The psychosocial deficits of children with regulatory disorders have commonly received less therapeutic attention than the child's sensorimotor problems. This article describes how occupational therapists can identify and treat the psychosocial deficits of children with regulatory disorders to enhance the child's functional performance in the home and school settings. Suggestions are provided regarding how therapists can work with both the parents and teachers of children with regulatory disorders, to enhance a greater understanding of the child's experience and needs. A case study follows that offers an example of therapeutic work with parents and children.

Occupational Therapy Services for Children and Youth Under the Individuals With Disabilities Education Act

Book Review| Online July 01 1999 Occupational Therapy Services for Children and Youth Under the Individuals With Disabilities Education Act Occupational Therapy Services for Children and Youth Under the Individuals With Disabilities Education Act. American Occupational Therapy Association ( 1997). American Occupational Therapy Association, 4720 Montgomery Lane, PO Box 31220, Bethesda, MD 20824-1220. 240 pp.; $40.00 (members); $50.00 (nonmembers). ISBN: 1-56900-069-7 Sharon Brandenburger-Shasby, MEd, OTR/L, BCP Sharon Brandenburger-Shasby, MEd, OTR/L, BCP Search for other works by this author on: This Site PubMed Google Scholar Author & Article Information Online ISSN: 1943-7676 Print ISSN: 0272-9490 Copyright © 1999 by the American Occupational Therapy Association, Inc.1999 The American Journal of Occupational Therapy, 1999, Vol. 53(4), 410–411. https://doi.org/10.5014/ajot.53.4.410b Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Sharon Brandenburger-Shasby; Occupational Therapy Services for Children and Youth Under the Individuals With Disabilities Education Act. Am J Occup Ther July/August 1999, Vol. 53(4), 410–411. doi: https://doi.org/10.5014/ajot.53.4.410b Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentThe American Journal of Occupational Therapy Search Advanced Search This content is only available via PDF. Copyright © 1999 by the American Occupational Therapy Association, Inc.1999 Article PDF first page preview Close Modal You do not currently have access to this content.

Medical and Educational Collaboration for Therapy Services: The Oregon Experience

In 1994, the Oregon Health Plan challenged the delivery of physical therapy and occupational therapy services for children with special health needs by transferring Medicaid recipients to managed care. Primary care physicians and managed care plans attempting to provide appropriate services requested assistance. The authors coordinated a statewide collaborative effort to examine existing services, to clarify the complementary roles of medically based and educationally based therapy services, to advocate for best practice, and to publish a comprehensive document detailing guidelines for medically based outpatient therapy services. They describe a process that attempts to balance fiscally responsible utilization of therapy resources with advocacy for appropriate therapy services.