Scope Of Occupational Therapy Practice Research Articles

Occupational therapy scope of practice in the rehabilitation of adults experiencing persistent post-concussion symptoms following traumatic brain injury: a scoping review protocol.

The objective of the review is to identify, categorize, and examine literature describing occupational therapy scope of practice in the rehabilitation of adults experiencing persistent post-concussion symptoms (PPCS). PPCS are symptoms experienced by adults a minimum of 2 to 4 weeks after a traumatic brain injury (TBI), and include vestibular, neuropsychiatric, visual, and cognitive issues. Enduring PPCS may result in disability, affecting a person's independence and/or participation in daily activities. Despite growing recognition of the role occupational therapy can offer in TBI rehabilitation, evidence is limited regarding the scope of practice occupational therapists have in the rehabilitation of adults experiencing PPCS. Literature that includes adults (aged 18 to 65 years) experiencing PPCS that describes the occupational therapy scope of practice in concussion programs will be considered for inclusion in this review. Sources reporting on participants aged under 18 years, classified with non-persistent symptoms, and receiving care in acute health care settings will be excluded. Non-English publications or gray literature from civil society or disabled persons organizations or other representative bodies in the field of brain injury will also be excluded. The scoping review will follow the JBI methodology for scoping reviews. Five electronic databases will be searched for literature published between 2013 and the present: MEDLINE, Embase, Emcare, PsycINFO, and CINAHL. Two reviewers will independently conduct title and abstract screening of the results and, upon consensus, independently screen full texts to confirm final sources for inclusion. Any disagreements will be resolved by discussion with a third reviewer. Data will be extracted from included sources and we will then map occupational therapy scope of practice (inclusive of assessments and interventions) against the World Health Organization's International Classification of Functioning One-Level Classification. Results will be presented in tabular or narrative format. Open Science Framework osf.io/qxgzj.

Occupational Therapy’s Role within the Middle and High School Settings in the United States

ABSTRACT There is a need for occupational therapy (OT) in the middle and high school settings, yet the role practitioners (OTPs) play in these settings is not clearly defined. School-based OT is in alignment with the Occupational Therapy Practice Framework (OTPF) which recognizes health is supported and maintained when clients are able to engage in their home, school, workplace, and community (American Occupational Therapy Association, 2020). OTPs serving students in the middle and high school settings ensure successful engagement while at school by addressing not only the occupations specific to education but also by addressing the factors that disrupt or empower these occupations American Occupational Therapy Association (2020). Evidence suggests OTPs are struggling to provide relevant service due to limited clarity of their role . A scoping review was conducted to describe the role of American-based OT in the middle and high school settings, identify barriers that affect practitioners, and provide practitioners with information about the role of the OT. Researchers utilized Preferred Reporting Items for Systematic Reviews and Meta Analyses-Scoping Review extension guidelines. Inclusion criteria included were articles published in English, peer-reviewed journals, within the past twenty years and within the scope of OT practice. A total of 1,107 records were identified of which 24 articles were included. Three themes emerged: 1. specific interventions used in middle and high school settings such as transition readiness, social participation, fine motor/handwriting, assistive technology, literacy participation, and life skills; 2. barriers to service delivery; 3. and the need for advocacy. More research is needed to develop conclusive evidence relating to the current practices of occupational therapy in the middle and high school settings.

Occupations and balance during the transition to motherhood with a lifetime chronic illness: A scoping review examining cystic fibrosis, asthma, and Type-1 diabetes.

Throughout the transition to motherhood, changes are experienced across a woman's physical, mental, social, and occupational self. Maternal chronic illness adds the complexity of increased healthcare needs and navigating a high-risk, medicalised pregnancy, birth, and post-natal period. Literature concerning motherhood transitions in chronic illness generally focusses on the mother's medical health and pregnancy outcomes; little is known about the impacts on women's occupations, balance, and quality of life. Understanding these issues may help support women in a more tailored and holistic way. This scoping review aims to gather, analyse, and synthesise existing empirical research on occupational engagement and occupational balance as they impact on wellbeing and quality of life in women with a lifetime chronic illness before and during pregnancy and in early motherhood. The review follows the nine-stage framework described in the Joanna Briggs Institute Manual for Evidence Synthesis (2020). Five databases were searched: Embase, Medline, PsycINFO, CINAHL, Scopus, and OT Seeker. Data were extracted and examined via content analysis, described in narrative synthesis, summarised into a conceptual framework, and tabulated. A total of 8,655 papers were discovered on initial search. Following title and abstract screening, 220 full-text studies were assessed for eligibility, and 46 papers were finally included. Analysis generated four major themes: The Disrupted Transition Journey; Adaptation, Compromise and Choice; Outcomes; and Drawing on What's Available. The themes were conceptualised into a framework to explain how women sought to balance motherhood and illness-related occupations. Adequate access to information, social support, expert care, and financial resources improved both quality of life and healthcare compliance. Findings of this scoping review deepen the understanding of occupational balance during the transition to motherhood in the context of lifetime chronic illness. Healthcare providers and supportive family and friends can use this knowledge to adapt their approach to assisting women with chronic illness on the motherhood journey. These findings may also inform further inquiry into the scope of occupational therapy practice with this population.

Predictors of Participation Difficulties in Autistic Children.

Participation in meaningful occupations supports quality of life and health. Because quality of life is lower in autistic children than in children without this diagnosis, it is important to consider aspects contributing to the participation difficulties this population experiences. To identify predictors of participation difficulties in a large data set from autistic children to inform professionals about potential intervention targets. Retrospective cross-sectional design using a large data set with multivariate regression models for home life, friendships, classroom learning, and leisure activities. 2011 Survey of Pathways to Diagnosis and Services data set. Parents or caregivers of 834 autistic children with co-occurring intellectual disability (ID) and 227 autistic children with no ID. The strongest participation predictors within the scope of occupational therapy practice were sensory processing, emotional regulation, behavioral variables, and social variables. Our results are consistent with those of smaller previous studies and indicate the importance of addressing these areas in occupational therapy intervention in line with client priorities. Focusing interventions with autistic children on sensory processing, emotional regulation, behavioral skills, and social skills to address their underlying neurological processing can support their increased participation in home life, friendships, classroom learning, and leisure activities. What This Article Adds: Our findings support a focus in occupational therapy interventions on sensory processing and social skills to increase activity participation in autistic children with and without ID. Emotional regulation and behavioral skills can be supported by interventions that target cognitive flexibility. Positionality Statement: This article uses the identity-first language autistic people. This nonableist language describes their strengths and abilities and is a conscious decision. This language is favored by autistic communities and self-advocates and has been adopted by health care professionals and researchers (Bottema-Beutel etal., 2021; Kenny etal., 2016).

Occupational Therapy to Improve Activities of Daily Living of People With Parkinson's Disease.

Evidence Connection articles are offered by the American Occupational Therapy Association's Evidence-Based Practice Program to inform and assist occupational therapy practitioners in methods that translate findings from the literature into usable knowledge for daily practice. These articles can guide professional reasoning and help practitioners operationalize findings from systematic reviews into practical strategies that can improve patient outcomes and support evidence-based practice. This Evidence Connection article is based on findings from a systematic review of interventions within the scope of occupational therapy practice to improve performance with activities of daily living (ADLs) for adults with Parkinson's disease (Doucet etal., 2021). In this article, we present a case study of an older adult with Parkinson's disease. We discuss suggested evaluation tools and intervention strategies that might be used as part of occupational therapy to address limitations and meet his desired needs for improved participation in ADLs. A client-centered, evidence-based plan was constructed for this case.

Implementation of occupational therapy within early intervention in psychosis services: Results from a national survey.

Occupational therapy plays an important role in fostering community participation in areas such as education, employment, leisure, and social relationships, yet its added value within early intervention in psychosis services, especially in the United States, remains poorly understood. The purpose of this research was to conduct a national survey of early intervention in psychosis programs to: (1) understand the role and unique contributions of occupational therapists to early intervention teams, and (2) identify barriers and supports to the implementation of occupational therapy services within these programs. Fifty-one senior leaders from U.S.-based early intervention in psychosis programs participated in the national survey. The survey consisted of a series of closed and open-ended questions related to program staffing, the presence of specific services that fall within the occupational therapy scope of practice, and implementation barriers and supports. Despite there being strong interest in employing occupational therapists, a small proportion of programs (31%) reported having them on staff. Occupational therapists supported clients across multiple life areas and were significantly more likely than other team members to promote daily living activities (e.g., cooking) and to address sensory processing needs and challenges. Implementation was influenced by environmental/organizational and staff factors; the primary barrier was funding. Findings support the role occupational therapists may play in facilitating the community participation of clients of early intervention services, but significant barriers to implementation of occupational therapy services remain. Additional research is needed to further identify the impact of occupational therapy services within the early intervention model.

Interventions to Improve Social Participation, Work, and Leisure Among Adults Poststroke: A Systematic Review.

Sustaining a stroke frequently leads to difficulties in returning to work, leisure, and social participation. These outcomes are important for occupational therapy practitioners to address. To determine the current evidence for the effectiveness of interventions within the scope of occupational therapy practice to improve social participation, work, and leisure among adults poststroke. MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases. Primary inclusion criteria were peer-reviewed journal articles published between January 1, 2009, and December 31, 2019, within the scope of occupational therapy that evaluated an intervention to address work, leisure, or social participation poststroke (levels of evidence ranged from Level 1b to Level 2b). Reviewers assessed records for inclusion, quality, and validity following Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Forty-seven articles met the inclusion criteria. Forty-four articles related to social participation were categorized as follows: occupation-based approaches, metacognitive strategy training, education and training approaches, impairment-based approaches, and enriched environment approaches. Three articles related to work and 3 articles related to leisure were not further categorized (2 articles were each included in two categories). Seventeen Level 1b and 30 Level 2b articles were included. The strength of evidence to support occupational therapy interventions for social participation, work, and leisure outcomes is predominantly low. Occupational therapy interventions may improve work, leisure, and social participation outcomes poststroke, with the strongest evidence existing for client education, upper extremity training, and cognitive training for improving social participation. What This Article Adds: Occupational therapy practitioners may use the available literature along with clinical reasoning to improve work, leisure, and social participation outcomes among clients poststroke. Additional research is required to build stronger evidence to support clinical decision making in stroke rehabilitation in these areas.

Caregiver Coaching in Early Intervention: A Scoping Review.

Best practice guidelines and legal mandates have deemed parent engagement an essential component of early intervention (EI). Parent coaching is an intervention and a model of service delivery used in occupational therapy practice that is designed to integrate parents into the therapy session. To examine the current definitions of coaching and the ways in which U.S. occupational therapy practitioners are using coaching models in EI. We systematically searched 11 databases-CINAHL Complete, CINAHL with full text, Education Research Complete, ERIC, PsycARTICLES, PsycINFO, Teacher Reference Center, Academic Search Premier, Academic Search Complete, Socindex with full text, and Social Work Abstracts-for articles published from 2000 through 2020. A total of 178 articles were retrieved, and 60 underwent full-text review. The final review included 16 studies of varying designs in which occupational therapy was one of the interventions and in which various definitions of coaching and models were used. The concepts inherent in coaching models were consistent across studies. There was little emphasis on the efficacy of coaching models as related to goal attainment. Coaching is a viable intervention in EI. Studies are needed to assess the efficacy of the parent coaching model in achieving child and family outcomes and the training needed to provide the intervention appropriately. What This Article Adds: This scoping review explores existing research on coaching interventions and models used by occupational therapists in EI. Findings indicate that this is an area of opportunity because the model of parent coaching strongly aligns with the professional scope of occupational therapy practice.

Occupational therapy in Australian residential aged care facilities: A systematic mapping review.

Australia's population is ageing, resulting in more older adults living in residential aged care facilities. Occupational therapy scope of practice in Australian residential aged care facilities is significantly influenced by the government funding instrument. As the current government funding instrument is administratively inefficient, insufficiently discriminates between residents' care needs and provides perverse incentives, a new funding model is set to be implemented. This creates an opportunity for a review of the current evidence base to support the lobbying of national associations to shape occupational therapy practice. The research question that guided this systematic mapping review was as follows: What is the current state of scholarship about occupational therapy in Australian residential aged care facilities? A search of four databases (CINAHL, Medline, Embase and Scopus) was conducted and 1,617 papers were identified. All papers were screened through a two-phase process: (i) title and abstract review and (ii) full text review, using pre-determined inclusion and exclusion criteria to identify papers relevant to this review. A data extraction tool was designed in Microsoft Excel® and was used to extract data from the included papers. Twelve Australian articles were published between 1986 and 2020, most frequently authored by an occupational therapist. Included articles were classified into four groups: articles including occupational therapists as participants, articles about occupational therapy practice, articles exploring an occupational perspective of residents and articles with limited exploration of occupational therapy. This review identified that there is a dearth of Australian occupational therapy literature. This creates challenges for occupational therapists seeking evidence to guide their practice to optimise resident health and well-being and for national associations seeking to lobby for the profession. Consequently, there is a crucial need to develop the evidence base to support the profession within this practice setting and, ultimately, residents.

Occupational therapy for cognitive impairment in stroke patients.

Occupational therapy for cognitive impairment in stroke patients.

Interventions for Instrumental Activities of Daily Living Among Adults With Multiple Sclerosis: A Systematic Review.

Occupational therapy practitioners need updated information about interventions that may improve or maintain functional changes in instrumental activity of daily living (IADL) engagement caused by multiple sclerosis (MS). To conduct a narrative synthesis of updated evidence on interventions within the scope of occupational therapy to improve or maintain performance of and participation in IADLs among adults with MS. CINAHL, MEDLINE in PubMed, Cochrane, OTseeker, and PsycINFO. Study Selection and Data Collection: This systematic review followed the Cochrane Collaboration methodology and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting a systematic review. Inclusion criteria were Level 1 or 2 evidence, published in English, published from January 2011 to December 2018, intervention within the occupational therapy scope of practice, and at least one IADL outcome measure. Nineteen randomized controlled trials (including pilot and feasibility trials) and 1 preintervention-postintervention study met inclusion criteria. Results of this review show strong strength of evidence for coaching interventions in addressing physical activity (PA) routines and moderate support in addressing medication routines. Moderate strength of evidence was found with mixed results for interventions involving coaching plus prescribed PA in improving PA participation. This systematic review supports occupational therapy practitioners addressing PA and medication health management and maintenance IADLs through the use of coaching interventions when treating people with MS. Other IADLs were addressed by the articles in this review but require more evidence to make clinical recommendations. What This Article Adds: Occupational therapy practitioners' skills in promoting habits and routines paired with utilization of evidence-supported coaching interventions can support independence with health management and reduce the negative impact of MS on daily activity participation.

Occupational therapy service provision in adult intensive care units in Australia: A survey of workload practices, interventions and barriers.

IntroductionOccupational therapy practice within intensive care units (ICUs) is limited with respect to published research evidence and guidelines regarding scope of practice. An understanding of the current level of service provision, feasibility of services in ICUs and training and development needs of occupational therapists is required to enable consistent best practice and promote the occupational therapy profile. This study aimed to explore occupational therapy practice within ICUs in Australia including the barriers and enablers to practice perceived by occupational therapists.MethodsIn this cross‐sectional study, a national customised online survey was completed by registered occupational therapists who provide services in intensive care settings in Australia. Recruitment was from July to September 2019 through Occupational Therapy Australia and other professional networks and interest groups.ResultsThe survey was completed by 43 respondents. The majority were experienced therapists from Queensland with greater than 10‐years post‐qualification and working in a tertiary hospital setting. The most common length of time spent working in the ICU was 0–2 h per week. Formal and informal self‐care measures, cognitive screens and physical outcome measures were commonly used. Bed‐based grooming retraining, pressure care management, functional upper limb retraining and passive ranging were the most frequent interventions provided on a daily basis. Perceived barriers to occupational therapy service provision in ICU included lack of funding for staffing, competing workload demands, lack of occupational therapy role delineation and scope of practice and lack of published evidence and training.ConclusionOccupational therapy services in intensive care settings in Australia are limited. Published practice guidelines, further research, applications for service funding and ongoing education of the ICU multidisciplinary team regarding the scope of occupational therapy practice are recommended to promote the development of occupational therapy services in ICU.

Interventions for Instrumental Activities of Daily Living in Adults With Multiple Sclerosis

AbstractEvidence Connection articles provide examples of how evidence from systematic reviews developed in conjunction with the American Occupational Therapy Association’s Evidence-Based Practice Project can be directly translated into clinical practice. These articles present a summary of the topic and case studies that demonstrate how the evidence from these reviews can inform clinical decision making. This Evidence Connection article includes findings from a systematic review of interventions within the scope of occupational therapy practice that improve or maintain performance of or participation in instrumental activities of daily living for people living with multiple sclerosis.

Sleep in the Intensive Care Unit (ICU): An Overlooked Opportunity for Occupational Therapists to Fill a Gap in Health Care Service

Sleep hygiene is well-established in the scope of occupational therapy practice; however, this occupation is rarely addressed in the intensive care unit (ICU). The majority of health care practitioners believe patients experience reduced sleep quality in the ICU, which can negatively impact patient outcomes. Through a review of the literature, this paper identifies common factors that negatively influence sleep quality and duration and proposes evidence-based interventions to improve patients’ sleep. Factors that influence sleep and fall in the domain of occupational therapy practice include the environment, psychosocial elements, and patient care. Occupational therapists can use interventions, such as orienting patients during the day, creating sleep-promoting routines, and educating patients on the use of adaptive equipment (earplugs, eye masks, or sound machines for relaxing music). Role confusion and a lack of prioritization of sleep have led to the occupation of rest and sleep not being addressed. This paper will suggest implications for the future of the profession that includes establishing leadership positions on a multidisciplinary team to improve patients’ sleep.

Potential occupational therapy scope of practice in the work-to-retirement transition in Australia.

Retirement, being a major life event and a focus of healthy ageing in society, creates the opportunity for occupational therapists to support people transitioning from work to retirement. Little is known about the scope of practice of occupational therapy in the work-to-retirement transition. The aim of this study was to, in Australia, (1) explore the potential scope of practice and factors influencing the potential scope of practice of occupational therapy in the work-to-retirement transition and (2) map findings to occupational therapy theoretical frameworks to assist in articulating scope of practice. A qualitative study (thematic analysis as an independent approach within a qualitative descriptive methodology) was undertaken using semi-structured interviews with Australian occupational therapists. Australian occupational therapists (n = 14) were interviewed. Four themes were identified which related to the potential scope of occupational therapy practice in the work-to-retirement transition: finding meaningful occupation; modifying lifestyles and homes for better living; work engagement; and application of occupational therapy skills. Six themes were identified which related to contextual factors influencing the potential scope of occupational therapy practice in the work-to-retirement transition: right time; valuing our expertise; promoting occupation(al therapy); finding the money; life, work and retirement longevity; and social responsibility. The work-to-retirement transition can be incorporated into other practice areas or can be a unique practice area allowing for a more targeted service. The frameworks of who, what, when, and where and enablement skills assist in articulating occupational therapy scope of practice in the work-to-retirement transition. A number of contextual factors can be barriers and/or facilitators to occupational therapy practice. More clearly articulating occupational therapy practice in the work-to-retirement transition will enable the profession to promote their scope of practice assisting in obtaining professional and public recognition and overcoming barriers such as funding to enable provision of services within this area.

Occupational Therapy Interventions to Address Depressive and Anxiety Symptoms in the Physical Disability Inpatient Rehabilitation Setting: A Systematic Review.

Depressive and anxiety symptoms across physical disability inpatient rehabilitation (IPR) patient groups are well documented and negatively affect functional recovery. The strategies within the occupational therapy scope of practice to address these symptoms in IPR are unclear. To determine what interventions within the occupational therapy scope of practice have been used to address depressive and anxiety symptoms in IPR and to determine intervention efficacy. Nine databases for all publication years were searched (PubMed, Scopus, Embase, Web of Science, PsycINFO, Cochrane Library, AgeLine, OTseeker, and CINAHL). Study Selection and Data Collection: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for abstracting data and assessing quality. Included articles were peer reviewed, based in the United States, in English, controlled clinical trials or randomized controlled trials, in the IPR setting, and within the occupational therapy scope of practice. Two reviewers independently screened articles, with disagreements resolved by consensus. Five of 8,082 articles met inclusion criteria. Diagnoses included stroke (n = 1), traumatic brain injury (n = 1), spinal cord injury (n = 1), and musculoskeletal conditions (n = 2). Results are discussed among four categories: study design and outcome variables, intervention type, intervention intensity, and intervention efficacy. Limited, moderate-quality evidence exists within the occupational therapy scope of practice for addressing depressive and anxiety symptoms in the physical disability IPR setting. Interventions primarily included cognitive and behavioral strategies. Further research among diverse patient populations is needed to support occupational therapy practitioners in facilitating client participation and functioning. What This Article Adds: This systematic review provides an evaluation of the evidence within the occupational therapy scope of practice to address depressive and anxiety symptoms within the physical disability IPR setting. This research can support occupational therapy practitioners to comprehensively address physical and mental health for participation in IPR.

Effective interventions within the scope of occupational therapy practice to address participation for adults with aphasia: A systematic review

Introduction Occupational therapists work with clients with impaired communication to re-engage in valued occupations. This systematic review seeks to answer the question: What are effective interventions within the scope of occupational therapy practice to address participation for adults with aphasia? Method A systematic review of the literature was completed using PubMed, PsychInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Database of Systematic Reviews, and OT Seeker databases. Intervention studies within the scope of occupational therapy practice with a participation outcome, and published in peer reviewed journals from 2000 to 2019, were included. The quality of each study was assessed using the Mixed Methods Appraisal Tool. Findings Thirteen articles fit the inclusion criteria. Categories of interventions that emerged from the data include community-based groups, individually tailored programs, adaptation/presentation of materials, interprofessional interventions, and psychoeducation. Conclusion There is evidence to support the use of interventions within the scope of occupational therapy practice to increase participation for people with aphasia. Specifically, the use of community-based groups and adaptation of materials are effective to facilitate participation. Most of the studies were pre-post one group design; however, they demonstrated positive results for participation outcomes. More research is needed on people with aphasia that focuses on participation in meaningful occupations.

Assistance dogs in occupational therapy practice: A survey of Australian occupational therapists' experiences and recommendations.

Assistance dogs perform multiple tasks to support people with disabilities and bring various benefits. Occupational therapists play a key role in assessing or referring clients for assistive technology, which includes assistance dogs. However, little is known about Australian occupational therapists' experiences with assistance dogs and how they perceive their roles in this area of practice. A cross-sectional online survey was developed and distributed nationally to Australian occupational therapists to glean their experiences and perceptions of assistance dogs and their recommendations to support future practice. A total of 220 completed surveys were received with all perceiving assistance dogs as beneficial for clients with disabilities. Over 60% agreed it was within their scope to assess or refer clients for assistance dogs, but more than two thirds had not had the occasion to do so and/or lacked relevant education and training. Common difficulties experienced in the referral or assessment process include challenges with accessing and navigating funding, lack of resources and/or assistance dogs, and perceived insufficient evidence to support the use of assistance dogs. Findings indicate that occupational therapists' lack experience and knowledge of assistance dogs although they perceive assistance dogs as within the scope of occupational therapy practice. This study highlights a need for increasing professional development opportunities for occupational therapists regarding assistance dogs, including assessment and referral processes. This will be steadily more important given the increasing profile and expanding application of assistance dogs, and funding organisation requests for occupational therapists in assessing clients for assistance dogs.

Occupational Therapy Scope of Practice.

The Occupational Therapy Scope of Practice is an updated position statement from the American Occupational Therapy Association that defines the scope of practice in occupational therapy and provides a model definition of occupational therapy to promote uniform standards and professional mobility across state occupational therapy statutes and regulations. It is intended to serve as a resource for consumers, health care providers, educators, the community, funding agencies, payers, referral sources, and policymakers.

Systematic Review of Occupational Therapy Interventions to Enhance Cognitive Development in Children 0–5 Years: Part 2, At-Risk Due to Environmental Factors and Promoting Cognitive Development

ABSTRACT Aim: This article is the second part of a systematic review updates and broadens a previous systematic review (Frolek Clark & Schlabach, 2010) to examine the evidence for of interventions within the scope of occupational therapy practice to enhance cognitive and pre-academic development in young children with or without at-risk factors. This article is Part 2 of the review and will focus on interventions for children at-risk from environmental factors and interventions that promoting cognitive development in children ages birth to 5 years. Part 1 is published separately and focuses on children with specific diagnoses. Methods: A systematic search of studies published from 2010 to 2020 using MEDLINE, PsycINFO, CINAHL, ERIC, OTseeker, and Cochrane was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Twenty-seven studies met the inclusion criteria and were critically appraised: 19 Level I, 6 Level II, and 2 Level III evidence (Part 2). Two themes are discussed within this paper (Part 2): Children At-Risk of Cognitive Delays due to Environmental Factors, and Promoting Cognitive Development. Strong strength of evidence exists for cognitive and executive functioning training programs, literacy programs, and parent interactions focused on child’s needs. Strong strength of evidence indicates explicit Tier II interventions assist preschool children in learning early literacy skills (e.g., print knowledge, letter names, letter sounds). Moderate strength of evidence supports using movement or play to enhance cognitive and executive functions in preschoolers. Conclusions: Occupational therapy practitioners working in home and preschool programs can use these evidence-based interventions to enhance cognitive development, executive functions, and pre-academic functions performance for young children with or without risk factors. Part 1 of the review also appears in this issue.