Search

Introduction: Increasingly, autistic adolescents and adults are accessing occupational therapy. However, limited evidence exists on the type of supports that are important to them. Examining the patterns of supports valued by autistic adolescents and adults will inform the design of occupational therapy services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important., Methods: This study involved two anonymous online surveys. Survey one involved 54 items and was distributed to caregivers of autistic adolescents and/or adults. Survey two included 41 items and was distributed to self-reporting autistic adults. Surveys sought closed and open-ended responses about the support needs of autistic individuals living in Australia. Quantitative data were analysed as counts and frequencies of responses, whereas short-answer responses were analysed through content analysis., Community and Consumer Involvement: There was no consumer or community involvement in the completion of this project., Results: A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Quantitative data from both autistic adolescents' and adults' closed-answer responses showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Content analysis of open-ended responses, performed separately for each participant group, revealed six categories: employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance., Conclusion: Results highlight that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy practice. Differences between the priorities of autistic individuals and their caregivers highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs., Plain Language Summary: Increasingly, autistic adolescents and adults are accessing occupational therapy services. However, limited information exists regarding the type of supports that are important to them. Understanding what supports are valued by autistic adolescents and adults will support occupational therapists deliver effective and individualised services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important to them. This study involved two anonymous online surveys. Survey one was completed by caregivers of autistic adolescents and/or adults. Survey two was completed by self-reporting autistic adults. Surveys included both open-ended and closed-answer responses to better understand the support needs of autistic individuals living in Australia. A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Closed-answer response questions from both the caregivers and self-reporting autistic adolescents and adults showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Open-ended response questions revealed six main priorities including, employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance. This study found that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy. Further, participant responses highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs., (© 2024 Occupational Therapy Australia.)

Aim: To explore the lived experiences of adolescents with fetal alcohol spectrum disorder (FASD) to understand: the ways in which their challenges influence daily functioning; and the personal assets and external resources that facilitate participation., Method: Semi-structured interviews were conducted with four adolescents (one identified as non-binary, one male, and two female) with FASD aged 13 to 15 years. A photo elicitation approach facilitated participation, whereby adolescents first took photographs of their daily activities and environments. Photographs were subsequently used to generate discussion during the interviews. Data analysis involved using interpretative phenomenological analysis to generate themes., Results: Two superordinate themes and three subthemes relating to participants' lived experiences emerged from the interviews: (1) 'anxiety challenges participation' (subthemes [i] 'need for external support'; [ii] 'the power of positive relationships'; and [iii] 'talents and interests facilitate participation') and (2) 'importance of a unique identity'., Interpretation: Findings illustrated the barriers adolescents experienced regarding their daily functioning and independence. Additionally, incorporating strengths into daily activities appeared to reduce anxiety and improve participation, and adolescents desired for their unique characteristics to be recognized and appreciated. To support adolescents with FASD, service providers should consider incorporating strengths-based approaches and an explicit focus on facilitating the development of positive self-identities., What This Paper Adds: Anxiety often prevented adolescents' independent participation in social activities, requiring caregiver assistance. Strengths (e.g. talents, positive relationships) facilitated adolescents' participation and reduced their anxiety. Clinicians and researchers should consider strengths-based approaches to interventions targeting participation. Interventions for adolescents with fetal alcohol spectrum disorder could focus on developing a positive self-identity., (© 2022 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.)

Introduction: The Student Practice Evaluation Form - Revised Edition (SPEF-R) was used across Australian universities from 2008 to 2020 to assess occupational therapy student performance on practice placement. Evolution of practice contexts, placement models and professional competency standards prompted updating of the tool. This paper describes the second and final action research cycle in the development of the SPEF-R2., Methods: Cycle 2 included three phases: (a) piloting of the SPEF-R2 and post-pilot survey to determine utility and applicability; (b) post-pilot focus groups/interviews; and (c) final amendments for publication and launch. Quantitative data were summarised descriptively, and qualitative data were analysed using qualitative content analysis and reported using illustrative quotes., Results: In Phase 1, 23 participants piloted the SPEF-R2 and completed a post-pilot survey. Results indicated participants found the SPEF-R2 relevant to a range of traditional and contemporary settings, easy to understand and an improvement over the previous version of the tool. Most participants found it more concise and less repetitive than the SPEF-R. Participants particularly valued additions regarding culturally responsive practice, student health and well-being and reflective practice. In Phase 2, five post-pilot focus groups/interviews were held, gathering a deeper understanding of its utility. Discussion highlighted desire for an additional core item within the self-management domain (Domain Two). Increased confidence in rating and provision of feedback on student performance were also evident. Reflection on findings led to final amendments and publication of the SPEF-R2., Conclusion: Extensive consultation with the occupational therapy community informed the development of the SPEF-R2, reflecting contemporary practice and meeting the expectations of Australian occupational therapists. Action research was an effective approach to the development of the SPEF-R2. Use of the manual and training website and support from universities are paramount if practice educators are to use the tool effectively., (© 2022 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Introduction: Appropriate evaluation of health services for First Australians demands culturally responsive goal setting tools that can be used by inter-professional teams. The Australian Therapy Outcome Measure for Indigenous Clients (ATOMIC) is a purpose-designed tool for measuring therapy outcomes for First Australians. The aim of this study was to establish the clinical utility of the ATOMIC by investigating its alignment with the practice perspectives of an inter-professional First Australian health service., Methods: Using action research cycles, 12 occupational therapists and 8 speech pathologists applied two successive versions of the ATOMIC in practice. Focus group feedback after use of the first version (ATOMICv1) prompted adaptations to the tool (ATOMICv2). Therapists participated in four focus groups, two after using ATOMICv1 and two after using ATOMICv2. Focus group transcripts were analysed inductively using a qualitative description approach., Results: Challenges in setting SMART goals early in therapy and defining specific measurement increments in ATOMICv1 led to therapists favouring skill-based goals that were easier to measure rather than broader daily life goals, thereby impacting on occupation- and client-centred practice. ATOMICv2 allowed goal setting at any point in therapy, evaluated goals using visual analogue scales, and gathered evidence for rating goal achievement throughout the therapy process. Therapists found the ATOMICv2 to be a culturally responsive tool that aligned with practice perspectives by foregrounding relationship building, facilitating clinical reasoning, documenting daily life changes, and providing integrated inter-professional care., Conclusion: The ATOMIC demonstrated good clinical utility in an inter-professional service for First Australian children. It aligned with a culturally responsive practice perspective and captured goal achievement in daily life contexts. Further research is needed to gain client perspectives across the lifespan and to investigate its application by other health professions., (© 2021 Occupational Therapy Australia.)

Introduction: Evidence-based practice (EBP) is a critical framework for supporting clinical decision-making that has been increasingly promoted in occupational therapy over the last 20 years. Discipline-specific EBP frameworks and resources have emerged, primarily created by scholars from developed countries. However, EBP has received limited attention in literature published in developing and non-English speaking countries. This study aimed to explore Chilean occupational therapists' perceptions of EBP, factors influencing the adoption of EBP and sources of information used to inform clinical decision-making., Methods: A cross-sectional online survey of Chilean occupational therapists included socio-demographic information, closed questions using a fivepoint Likert scale and open-ended questions. Numerical data were summarised using frequencies and percentages. Cross-tabulations explored relationships between variables. Narrative data from openended responses were analysed deductively using content analysis., Results: Complete surveys were returned by 192 Chilean respondents. The majority of participants (68.3%) defined EBP as the use of research knowledge only and perceived EBP as useful and important. The most significant barriers to the application of research knowledge included: lack of time (68.2%), an emerging research culture (67.7%) and restricted access to scientific literature (56.8%). Additionally, Chilean occupational therapists did not feel confident finding, appraising and integrating research evidence. Of the four sources of knowledge used in EBP, participants predominantly relied on clinical observations of clients (99.5%), their clinical expertise (89.1%), and discussions with the multidisciplinary team (78.1%) and other occupational therapists (40.1%), to inform clinical decision-making., Conclusion: Language barriers, lack of time, scarcity of locally produced research, and an emergent research culture within Chile impede occupational therapists' ability to implement EBP. The adoption of EBP can facilitate access to contemporary occupational therapy knowledge powerfully guide clinical reasoning, and build local research capacity. Building research partnerships and collaborations with the international scientific community are crucial to the global achievement of EBP., (© 2020 Occupational Therapy Australia.)

Introduction: Newly graduated occupational therapists face well-documented difficulties as they embark on professional practice. Occupational therapy departments need to ensure that new graduates conduct their roles appropriately while developing experience and building clinical and professional skills. This study aimed to explore the experiences of new graduates at a major Australian metropolitan hospital occupational therapy department, the support provided to them and their perceptions of this support., Methods: The research design was Interpretive Description. Semi-structured interviews of approximately 60 min were undertaken with seven occupational therapists, their team leader and the Departmental Head. The two research questions were as follows: What were the graduates' experiences of their first year in practice? What support was provided to graduates and what were their perceptions of this?, Results: New graduates perceived the transition to practice as overwhelming, particularly regarding their caseload responsibility. During the first few months, work tasks took them longer and they felt stressed and anxious. They received a range of support and education, both inter-professional and discipline specific. Their occupational therapy team leader and clinical senior provided tailored support, guidance and reassurance. Guided questioning facilitated development of new graduates' clinical reasoning and professional skills. Reflection helped them to identify and address learning goals relating to occupational therapy professional competencies. New graduates valued having a consistent caseload and a supportive workplace was highly valued., Conclusion: New graduates initially feel overwhelmed by being responsible for their decisions. However, they can benefit from tailored supervision and guided questioning to help develop clinical reasoning and professional skills, formal and informal support from experienced occupational therapists and their inter-professional teams and time to increase skill with their caseload. Engagement in a professional community of practice is important., (© 2020 Occupational Therapy Australia.)

Introduction: The Student Practice Evaluation Form-Revised Edition (SPEF-R) is used by all Australian universities to assess the capability and performance of occupational therapy students on block practice placements. The occupational therapy landscape in Australia has evolved significantly since the SPEF-R was developed. This study aimed to review the SPEF-R and develop a revised edition, the SPEF-R2., Methods: The first cycle of an action research process involved four phases: (a) mapping the SPEF-R to the Australian Occupational Therapy Competency Standards 2018 (AOTCS); (b) development of the SPEF-R2; (c) national consultation through an online survey with clinicians, university staff and students; and (d) reflection and further amendments., Results: In phase 1, good alignment was found between the AOTCS 2018 and the SPEF-R. In phase 2, the SPEF-R2 was developed to further enhance alignment, including expanded content related to culturally responsive practice, reflective practice and clinical/professional reasoning, resulting in two items being added to the tool. Further wording adjustments were made to improve clarity, reduce duplication and improve relevance to the contemporary occupational therapy landscape. In phase 3, survey results indicated that the SPEF-R2 was well received overall, with most participants viewing it as an improvement on the SPEF-R. Cultural content and reflective practice additions in particular received positive feedback. Concerns were raised by some participants, including perceived repetition, the length of the tool and time required for completion, and addressed by further amendments in phase 4. Three items were removed or consolidated elsewhere, and three items became core items., Conclusion: The Australian occupational therapy community considers the SPEF-R2 to be a timely and much-needed development. Piloting of the SPEF-R2 and final revisions prior to release are planned for subsequent action cycles and amendments will be made to the online platform and associated training resources., (© 2020 Occupational Therapy Australia.)

Occupational therapists implicitly rely on tacit knowledge to inform the strategies they use to engage children and parents in a therapy session., Objective: To identify strategies occupational therapists use in a therapy session to engage children and parents., Methods: A qualitative approach was employed using interpretive description methodology. This involved seven therapy session observations with six occupational therapists (involving child, parent and therapist) and a key informant interview with the therapist after each session. Thematic analysis was undertaken., Results: Two themes emerged. (a) 'Engaging the child' included 'building a connection', 'attending to feelings', 'thoughts and behaviours', 'structuring or designing the session', 'giving choice and respecting their choice', 'use of self', 'helping the child feel success' and 'helping the child understand and explore'. (b) 'Engaging the parent' included 'connecting', 'listening', 'explaining', 'demonstrating anddiscussing', 'including the parent and valuing their input' and 'collaborating'., Conclusions: The strategies therapists used to engage children and families can be mapped with autonomy, relatedness- and competence-supportive strategies of Self-Determination Theory. Therapist attunement and responsiveness to the child as well as collaboration with the parent were strategies that represented all aspects of SDT., (© 2020 Occupational Therapy Australia.)

Aim: Participation in leisure has known health benefits. Children and young people (CYP) with physical disabilities demonstrate reduced participation in leisure. To facilitate their meaningful participation, one must understand what leisure means to CYP. The aim of this study was to systematically synthesize evidence from qualitative studies on the meaning of leisure for CYP with physical disabilities., Methods: CINAHL, MEDLINE, AMED, EMBASE, PsycINFO, and ERIC were searched periodically from January 2012 until May 2013. Qualitative studies reporting the views of CYP (0-18y) with physical disabilities on leisure participation were included. The analysis involved thematic syntheses, double coding, and established quality appraisal procedures., Results: Twelve studies met inclusion criteria, addressing the leisure experiences of 146 CYP with disabilities. Four themes core to the meaning of leisure for these CYP were (1) 'fun': the enjoyment and pleasure experienced from leisure; (2) 'freedom' of choice and from constraints; (3) 'fulfilment': discovering, developing, and displaying potential; and (4) 'friendship': social connectedness and belonging., Interpretation: The identified themes resonate with the psychological needs outlined by self-determination theory: fun relates to satisfaction and intrinsic motivation; freedom relates to 'autonomy'; fulfilment relates to a belief in 'competence'; and friendship resonates with 'relatedness'. Social context had an impact on all of these themes, indicating that this is an important target for leisure participation interventions., (© 2015 Mac Keith Press.)

Background/aim: The Student Practice Evaluation Form-Revised Edition (SPEF-R) is widely used in Australian universities to evaluate occupational therapy students' performance in practice education. Reliable completion of the SPEF-R by practice educators is critical for students and universities from a quality assurance perspective. This study used standardised video vignettes to examine the inter-rater and test-retest reliability of practice educators when completing the SPEF-R., Methods: Nine vignettes were developed with three levels of student performance (below expectations, adequate-to-proficient, and outstanding) for each of three scenarios which depicted a multidisciplinary team meeting, a supervision session, and a home visit respectively. Seventy-five occupational therapy practice educators viewed the vignettes and completed an online survey to rate student performance in each vignette using five selected SPEF-R items and using the five-point rating scale. Twenty of these practice educators completed the rating process twice for test-retest reliability purposes. Percentage agreement, t-tests and Rasch Measurement Model were used for analysis., Results: Practice educators exhibited consistent ratings on most of the SPEF-R items, except for rating adequate-to-proficient student performance on three items for inter-rater reliability and eight items for test-retest reliability. Rasch analysis found that the majority of practice educators (96-98.7%) exhibited consistency in their use of the SPEF-R rating scales. Practice educators also demonstrated satisfactory test-retest agreement of severity/leniency in rating student performance in the multidisciplinary team meeting scenario., Conclusion: The study findings suggest that the SPEF-R could be used reliably and interpreted consistently by practice educators with diverse backgrounds and levels of experience., (© 2014 Occupational Therapy Australia.)

Background/aim: The reliable evaluation of occupational therapy students completing practice education placements along with provision of appropriate feedback is critical for both students and for universities from a quality assurance perspective. This study describes the development of a comment bank for use with an online version of the Student Practice Evaluation Form-Revised Edition (SPEF-R Online) and investigates its reliability., Methods: A preliminary bank of 109 individual comments (based on previous students' placement performance) was developed via five stages. These comments reflected all 11 SPEF-R domains. A purpose-designed online survey was used to examine the reliability of the comment bank. A total of 37 practice educators returned surveys, 31 of which were fully completed. Participants were asked to rate each individual comment using the five-point SPEF-R rating scale., Results: One hundred and two of 109 comments demonstrated satisfactory agreement with their respective default ratings that were determined by the development team. At each domain level, the intra-class correlation coefficients (ranging between 0.86 and 0.96) also demonstrated good to excellent inter-rater reliability. There were only seven items that required rewording prior to inclusion in the final SPEF-R Online comment bank., Conclusion: The development of the SPEF-R Online comment bank offers a source of reliable comments (consistent with the SPEF-R rating scale across different domains) and aims to assist practice educators in providing reliable and timely feedback to students in a user-friendly manner., (© 2014 Occupational Therapy Australia.)

Background/aim: Occupational therapy educators are challenged to provide students with practical experiences which prepare them for ever changing health-care contexts on graduation. Role-emerging placements have been widely used internationally to help meet this challenge, but research into the learning experiences of students during these innovative placements is limited. This research investigated the enablers and barriers to learning from the perspectives of students on such placements from two European universities., Methods: Two separate qualitative studies tracked 10 final year students. Interviews explored their learning experiences prior to, during and after an eight- or 10-week role-emerging placement in a range of settings., Results: Four themes emerged, which were (1) adapting to less doing, more thinking and planning; (2) understanding the complexity of collaboration and making it work; (3) emotional extremes; and (4) realising and using the occupational therapy perspective., Conclusions: These placements presented a 'roller coaster' of authentic learning experiences which created the opportunity for students to use occupation in practice and develop skills for collaborative working in an interprofessional environment. Whereas students viewed their role-emerging placement experiences positively, challenges included the emotional responses of students and placement pace. Findings suggest the need for supportive student placement experiences in both established and role-emerging areas to prepare students for a range of opportunities in an uncertain future., (© 2013 Occupational Therapy Australia.)

Background: Adolescents from refugee backgrounds experience challenges participating in their new school environments. This study aimed to describe and discuss the development of an occupational therapy program to facilitate school participation of high school students from refugee backgrounds., Methods: Three cycles of action research were used to develop a program over 18 months in collaboration with two high schools. Data were collected from four occupational therapists, seven school staff members and two school principals using in-depth interviews, questionnaires and review of documents., Results: The program changed significantly over the three cycles from a focus on individual task mastery in the classroom environment to development of social competence through an activity-based group program., Conclusions: Building capacity for social competence helped create better alignment between the roles of occupational therapist and teacher within the school context and was perceived to contribute to refugee students' overall availability for learning in their new environments. Action research is useful in collaboratively developing programs in emerging areas of practice., (© 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.)

Background/aim: Research to date has not fully explored how occupational therapists provide intervention for children with learning difficulties in their day-to-day practice. The purpose of this study was to provide an in-depth description of the approaches and techniques used and how they are applied and combined to meet the complex and multifaceted needs of these children., Methods: In-depth interviews and short questionnaires were completed by seven occupational therapists who had provided intervention to children with learning difficulties. Observations of therapy sessions were also conducted. Thematic analysis gained insight into the approaches and techniques therapists used and how these were applied in practice., Results: Therapists use a wide range of approaches in various combinations because they feel that these best meet the needs of individual children. Sensory-based and cognitive approaches were most frequently drawn from and combined with other approaches such as visual information analysis, biomechanical and psychosocial approaches added for particular purposes. Approaches were usually combined simultaneously within an activity or session., Conclusions: Therapists create their own 'multimodel' approach in order to best meet the needs of their clients. They are able to articulate the theoretical basis behind these choices, although lack of clarity exists about the frames of reference being used.