Pediatric Occupational Therapists Research Articles

Barriers to Pediatric Occupational Therapists' Research Utilization in Australia, the United Kingdom, and Taiwan

Evidence-based practice and research utilization enable health professionals to provide care based on high-quality research evidence; however, various research barriers have been documented. The aim of this study was to examine the perceived barriers to research utilization of pediatric occupational therapists in Australia, the United Kingdom, and Taiwan. Questionnaires were received from 696 participants (response rate, 56.6%) who completed the Barriers to Research Utilization Scale. The combined sample and participants from the United Kingdom and Taiwan perceived the greatest barriers within the organization, whereas in Australia communication was the largest barrier. To reduce barriers, pediatric occupational therapists may require support within their organization, such as additional time for research activities, and opportunities for professional development regarding obtaining, critiquing, and evaluating research.

Occupational Therapists Views and Beliefs Regarding the Risks and Benefits of Childhood Vaccinations

ABSTRACTThis study presents findings from an exploratory study of occupational therapists’ views and beliefs regarding childhood vaccination safety and vaccination requirements for day care and school attendance. One-on-one, semi-structured telephone interviews were conducted over a six-week period with 25 pediatric occupational therapists across the United States. Participants expressed ideas similar to those found in surveys of parent vaccination attitudes and beliefs, as well as the need to extend the vaccination schedule to prevent overloading a child's immune system. Differences among participants were most clearly seen when comparing those with post-entry-level training to those with only an entry-level degree. The results appear to support the idea that lack of clear communication of public health concepts extends to healthcare professionals as well as consumers.

Information Used by an Expert Paediatric Occupational Therapist When Making Clinical Decisions

Occupational therapists use a range of types and sources of information when making clinical decisions. It is unclear how this information is integrated. This paper describes an exploratory qualitative case study that identified the types and sources of information accessed by one experienced paediatric therapist and how this information was combined and prioritised when making clinical decisions. . Data were collected using observations of therapy sessions, key informant interviews, and semi-structured interviews. Data were analysed thematically. To inform clinical decisions, the participant prioritised information about each child in his or her context when making decisions. Other types of information from text books and journals, professional development activities and professional and personal experience, expanded her unique body of knowledge over time. Re-conceptualisation of how information use supports clinical decision making and expands a therapist's unique body of knowledge over time can support client-centred practice in occupational therapy.

Professional and organizational commitment in paediatric occupational therapists: the influence of practice setting

The professional and organizational commitment of paediatric occupational therapists working in two distinct practice settings, schools and medically based settings, was investigated. A web-based survey program was used to administer a questionnaire to occupational therapists employed in New York, New Jersey and Connecticut. The study employed social identity theory as a guiding perspective in understanding therapists' professional and organizational commitment. One hundred and fifty-seven paediatric therapists responded to the Professional Commitment Questionnaire and the Organizational Commitment Questionnaire to gauge their commitment to both the profession and their employing organizations. Results indicated that paediatric therapists, regardless of employment setting, have high professional commitment. Paediatric occupational therapists employed in medically based settings indicated statistically significant higher organizational commitment than their school-based counterparts. For therapists that work in school settings, the presence of a professional cohort did not influence professional commitment scores. As the study employed a web-based survey methodology, only individuals who were members of associations and had access to a computer and the Internet were able to participate. Further study might include widening the participant pool as well as adding additional instruments to explore both professional and organizational commitment on a more national scale.

Survey of Paediatric Occupational Therapists' Understanding of Developmental Coordination Disorder, Joint Hypermobility Syndrome and Attention Deficit Hyperactivity Disorder

Evidence suggests that developmental coordination disorder (DCD) co-occurs with attention deficit hyperactivity disorder (ADHD) and joint hypermobility syndrome (JHS). Paediatric occupational therapists working with children with DCD need to consider the impact of co-occurring conditions on the children they assess and treat. A survey investigating the knowledge base and understanding relating to these conditions was conducted. The results showed that therapists (n = 225, response rate 23%) have an understanding of DCD; however, a more detailed knowledge of ADHD and JHS would allow them to consider the impact of the overlapping nature of these conditions. This highlights a training need to ensure understanding of these conditions and appropriate management.

Research Knowledge, Attitudes, Practices and Barriers among Paediatric Occupational Therapists in the United Kingdom

Evidence-based practice and research utilisation are promoted to enable clients to receive the most current care; however, there is limited research evaluating the use of these approaches within the occupational therapy profession. This study aimed to investigate the knowledge, attitudes, practices and barriers to evidence-based practice and research utilisation of a group of paediatric occupational therapists in the United Kingdom. Questionnaires were received from 145 participants (response rate 30%), who completed the Research Knowledge, Attitudes and Practices of Research Survey (KAP Survey), the Edmonton Research Orientation Survey (EROS) and the Barriers to Research Utilisation Scale (BARRIERS). The results indicated that the respondents held positive attitudes towards research and were willing to access new information and implement research findings to guide clinical practice. However, they were less confident in their research knowledge and practices, and perceived multiple barriers associated with the organisation, accessibility and quality of research. The respondents reported limited engagement in conducting research studies; however, the majority of the sample reported implementing the findings of research in their clinical practice to some extent. Additional research education and support within organisations would be beneficial to ensure that children and families are receiving occupational therapy services that are based on sound research evidence.

Perspectives Regarding Occupational Therapy Practice with Children and Families

This article gives a brief description of Ireland's demographics and its national health service, the Health Services Executive (HSE). It highlights how economic and social changes within the country and the development of the HSE affected pediatric occupational therapy service provision. It gives an overview of the settings in which pediatric occupational therapists work, which include community health services, non-governmental agencies, acute hospitals, and schools. The role of special interest groups in developing policies and services is described. Pediatric occupational therapy practice is discussed, referencing some advantages and challenges that are faced by therapists in their striving for client-centeredness and occupation-focused services provision. The most used assessments are listed and the most dominant frames of reference discussed. It concludes by highlighting continuing professional education in pediatric occupational therapy and research activity, which is increasing in Ireland.

Knowledge, attitudes, practices and barriers of pediatric occupational therapists to evidence-based practice and research utilization

Knowledge about the use of evidence-based practice and research utilization continues to develop and expand within the occupational therapy field. The aim of this study was to investigate and compare the perceived knowledge, attitudes, practices, barriers and orientation to evidence-based practice and research utilization of a group of pediatric occupational therapists from Australia, the United Kingdom, and Taiwan. Questionnaires were received from 696 participants (response rate 56.58%) who completed the Research Knowledge, Attitudes and Practices of Research Survey (KAP Survey), the Barriers to Research Utilization Scale (BARRIERS), and the Edmonton Research Orientation Survey (EROS). The results indicated pediatric occupational therapists held positive attitudes towards evidence-based practice but were less confident in their research knowledge and practices. The greatest barriers to research utilization were associated with the “Organization”, with participants rating some engagement in research conduct and utilization. Similarities and differences were noted between countries regarding various aspects of evidence-based practice and utilization. Findings also indicated that evidence-based practice and research utilization in the context of pediatric occupational therapy practice vary from one country to another and that these issues are impacted by both personal and workplace related issues.

Predictors of Research Utilization among Pediatric Occupational Therapists

Evidence-based practice and research utilization activities by clinicians enable clients to receive the best, most current health care available. This study investigated the factors predicting pediatric occupational therapists' attitudes toward evidence-based practice and research utilization in Australia, the United Kingdom, and Taiwan. Questionnaires were received from 696 participants (response rate = 56.58%) who completed the Edmonton Research Orientation Survey (EROS), the Research Knowledge, Attitudes and Practices of Research Survey (KAP Survey), and the Barriers to Research Utilization Scale (BARRIERS). The results of the multiple linear regression analysis indicated the strongest predictor of research utilization was “level of academic occupational therapy qualification,” which was found to be predictive of all of the EROS subscales. The second EROS subscale, “research involvement,” had the largest number of predictive factors. To increase research utilization among pediatric occupational therapists, it is important to be mindful of which aspects of research require improvement so that strategies with the greatest impact and influence can be implemented.

Paediatric Occupational Therapists' Reflections on Meaning in Professional Practice: A Phenomenological Study

The construct of meaning plays an important role in the theories and models that inform occupational therapy; yet little research has examined the construct of meaning within the professional practices of occupational therapists. The purpose of this research is to gain a deeper understanding of the meanings occupational therapists identify within their professional practice occupations. A phenomenological methodology was adopted for this study. Eight paediatric occupational therapists participated in in-depth, semi-structured interviews, which were tape-recorded, transcribed, and analyzed. Seven major themes were identified: Relating to clients as human beings, making a positive difference, working as a team, permission to have fun, congruency of values, support in the workplace, and artistry of practice. The study contributes to knowledge about accounts of meaning in the working lives of paediatric occupational therapists and highlights potential implications for therapists, clients, teams, organizations, and for the profession.

Entwicklungsbedingte Koordinationsstörung (Developmental coordination disorder DCD): ein Update aus der englischsprachigen Fachliteratur

Although every paediatric occupational therapist would recognise a child with gross- or fine- motor coordination difficulties, the term Developmental Coordination Disorder (DCD) is less well-known in German-speaking countries. Often trivialised, DCD is a disorder with long-term consequences for the child and his/her family. This article aims to (1) present the results of a literature review of international studies on DCD to which German–language therapists might not otherwise have access, (2) describe the impact of the condition on the child’s development and participation in meaningful life roles, and (3) indicate where more research is needed.

OBJECTIVE VS. SUBJECTIVE: THE CHALLENGE OF CLEAR DOCUMENTATION OF RANGE OF MOTION

To the editors of Physiotherapy Canada: After reading the editorial “Objective versus Subjective: Kudzu Terminology” in the Spring 2008 edition of Physiotherapy Canada, we were inspired to share a recent experience with so-called “objective” measurement. At the Winnipeg Children's Hospital, physiotherapists (PTs) and occupational therapists (OTs) work closely together on the Hand and Rheumatology Services. While reviewing our patient documentation practices, we learned that the OTs used a system of recording joint range of motion (ROM) that differed from the practice the PTs were using. After discussing the merits and limitations of both methods, we decided to survey our departmental colleagues regarding whether a standard or preferred method of recording ROM existed in their clinical practice. Interestingly, we found within our Pediatric PT and OT departments that plus (+) and minus (−) signs were used to denote both limitation of extension and joint hyperextension; however, there was no agreement among us regarding which sign should be used to denote each clinical finding! Intrigued, we decided to explore this documentation discordance outside of our department. We consulted textbooks,1–4 emailed PT and OT colleagues across the country, consulted with faculty members at the University of Manitoba, examined the American Society of Hand Therapy guidelines,5 and reviewed protocols from two large multi-centre studies.6,7 We undertook this exercise in an attempt to facilitate consistent and reliable measurement and recording of ROM within our hospital.

Using all the available evidence: perceptions of paediatric occupational therapists about how to increase evidence-based practice

This study aimed to (i) explore occupational therapy practitioners' perceptions of the scope and sources of evidence that they use in clinical decision-making; and (ii) identify strategies and resources that would increase the use of evidence in a paediatric clinical service. An action research methodology was applied to systematically explore participants' experiences of using evidence in practice and to democratically develop ways of increasing evidence-based practice. A series of six focus groups were conducted with nine occupational therapists, whose clinical experience ranged from 5 to 24 years. All participants had completed or were undertaking research qualifications. A systematic process of data coding was used whereby data were coded, categorised, analysed thematically and summaries developed. Rigour was maintained through triangulation (i.e. multiple data sources and occasions of data collection), and consultation and interpretation by two researchers. Participants identified two distinct sources of evidence they use in clinical practice: research-based and practice-based. They identified features of each source that they valued but also described barriers to the utilisation of each. Participants proposed strategies to increase the value of each source of evidence in their clinical practice. Strategies included appraising the clinical relevance and utility of research-based evidence, and developing standards and systematic processes to increase the credibility of practice-based evidence. Participants in this study perceived that although it is necessary to use all the available evidence in practice settings, there are currently barriers to using both research-based and practice-based evidence. In particular, the study indicates that there is need for the development of a structured model with processes and standards to guide practitioners in the collection, trial, evaluation and dissemination of practice-generated evidence. Further research is needed to explore the extent to which valid evidence can be generated from individual client programs by examining therapists' strategies for goal attainment in practice settings.

Book Reviews: Building Blocks for Learning, Occupational Therapy Approaches: practical strategies for the inclusion of special needs in primary school – By Jill Jenkinson, Tessa Hyde and Saffia Ahmad

Book Reviews: Building Blocks for Learning, Occupational Therapy Approaches: practical strategies for the inclusion of special needs in primary school – By Jill Jenkinson, Tessa Hyde and Saffia Ahmad

Comparing probable case identification of developmental coordination disorder using the short form of the Bruininks‐Oseretsky Test of Motor Proficiency and the Movement ABC

Aim Despite its widespread current use in research and its potential for future application, the validity of the short form of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP-SF) when administered by trained lay assessors is not known. This paper reports the results of case identification using the Movement Assessment Battery for Children (M-ABC) in a group of children scoring below the sixth percentile on the BOTMP-SF. Methods The BOTMP-SF was administered by trained research assistants to 2058 children. In total, 24 of 128 children aged 10 (n = 10), 11 (n = 10) or 12 (n = 4) scoring below the sixth percentile were randomly selected for further assessment by a paediatric occupational therapist using the M-ABC and the Kaufman Brief Intelligence Test. Results Twenty-one of 24 children positive for motor co-ordination problems on the BOTMP-SF scored below the 15th percentile of the M-ABC, a positive predictive value (PPV) of 0.88 [95% confidence interval (CI) = 0.69 to 0.96]. Fifteen of these children were below the fifth percentile (PPV = 0.63; 95% CI = 0.43 to 0.79). Conclusions The BOTMP-SF seems to be a reasonable alternative to case identification when clinical assessment with the M-ABC is not feasible. Further research is needed to examine the sensitivity and specificity of the short form when used for this purpose.

Management of Children with Attention Deficit/Hyperactivity Disorder and Learning Disabilities: A Survey of Paediatric Occupational Therapists in the United Kingdom

Attention deficit/hyperactivity disorder (ADHD) is a common complex neuropsychiatric disorder frequently overlapping with learning disabilities (LD) in children with average and above intelligence (Biederman et al 1991). The complex needs of these children could be better addressed in a multidisciplinary context (Foy & Earls 2005) within which paediatric occupational therapists may have a significant role. The aim of this study was to identify the interventions used by occupational therapists in the United Kingdom with these children and explore the rationale for their use. The purpose was to provide baseline data to inform multidisciplinary team approaches for the management of these children. A survey, based on postal questionnaires, was conducted among 100 paediatric occupational therapists in the United Kingdom. The effective rate of response was 42%. Both qualitative and quantitative data were gathered and analysed. The findings suggested that therapists tended to use more than one method/ approach in the rehabilitation of these children. The sensory integration approach and the perceptual-motor training were more popular among therapists. A variety of other approaches, used on an individual needs basis, were reportedly used. Future studies to test the effectiveness of reported practices with children with both ADHD and LD are recommended.

To Provide or Not to Provide Treatment? That is the Question

It is generally accepted that whether or not a client receives occupational therapy should be based on the client's needs not on the therapist that the client sees. However, in the United Kingdom there is little evidence to show that treatment provision is similar between therapists or even that therapists share a common rationale for providing treatment. This research investigated paediatric occupational therapists' beliefs about and intentions to provide treatment for children with coordination difficulties. Ten paediatric occupational therapists were recruited from two National Health Service Scotland Health Boards. The data were collected at one time point. Intentions and beliefs about treatment provision were explored and measured both at general and at case (situation-specific) levels. Quantitative and qualitative data were collected concurrently. Statistical and thematic approaches to analysis were applied. The findings showed that the therapists shared similar general intentions and beliefs about providing treatment. However, the situation-specific intentions to provide treatment varied considerably between the therapists. The situation-specific intentions were characterised by consideration of the client's individual circumstances and a variation in the interpretations made about the information available. The beliefs that possibly contributed to the variation in the situation-specific intentions were also identified. This research informs the occupational therapy profession about issues related to the expectation that treatment provision is similar between therapists.

Use of Assessment Methods in Paediatrics: The Practice of Private Occupational Therapists

This study is part of a larger research project investigating the assessment practices of paediatric occupational therapists in independent practice in the United Kingdom. The focus of this paper is the identification of the assessment methods used and the factors influencing respondents' satisfaction with them. The research design was a cross-sectional descriptive survey using a postal questionnaire as the data collection tool.Out of 89 questionnaires sent, 66 (74%) were returned and 48 (54%) were deemed usable. The findings demonstrated that the respondents used a combination of assessment methods, with interviewing being used by all of them. The majority of the respondents were satisfied with the methods that they used. The most frequently mentioned factors influencing the respondents' satisfaction level were issues concerning standardised tests and the quality and quantity of the information gathered about the client.The implications for clinical practitioners include the benefits of using a combination of assessment methods and their selection after extensive clinical reasoning. Moreover, the use of interviewing is stressed and its multiple purposes are pointed out.

Development of a multidisciplinary consultation in pediatric rheumatology in Switzerland with a link to daily life of the patient

Methods We established a multidisciplinary network in the French part of Switzerland, within and outside the hospital, with pediatric rheumatologists, nurses, physical therapists and occupational therapists. The patients are seen by the different members of the team according to their needs, and after consent of the physician, patient and parents. The nurses are providing a link between the consultation and the daily life of the child (family, home, school). With the different members of the team, we evaluated the needs of the patients and the goals of the network.

Ergotherapeutische Betätigungsziele in der Pädiatrie - welche Faktoren beeinflussen deren Vereinbarung in Deutschland?

INTRODUCTION: In the course of professionalisation of occupational therapy in Germany, the orientation on occupation is regarded as a chance for the profession to establish its position in the health system. However functional concepts of treatment and goals of body functions are mainly employed in occupational practice. It is the aim of this paper to analyse possible factors which are influencing the occupational orientation within the therapeutic goal agreement of the paediatric occupational therapy. METHOD: Within the framework of a qualitative research six paediatric occupational therapists who were familiar with the occupational orientation were interviewed. The interviews were analysed with the help of deductive, theory-orientated categories by means of a qualitative content-analysis according to Mayring with the technique of content structuring. RESULTS: The identified possible factors of influence are to be found in the basic social conditions of therapist and client. They cover legislation, job politics, interdisciplinary cooperation, therapeutic understanding of one’s role and therapeutic knowledge, person-related factors of the therapist, child- and family-related factors and change in circumstances. CONCLUSION: Occupational oriented goals are influenced by a number of factors, which have an effect on the relation of therapist and client. This results in consequences in job politics and affects each therapist in respect of its professional experience and each client concerning its environment and community.