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Introduction: Picky eating is a complex phenomenon, impacting family routines and relationships. Occupational therapists often work with picky eaters and their families, yet little is understood about the occupational therapy process and reasoning in this context. This study was guided by the following research question: How do Australian occupational therapists choose and deliver interventions for children with picky eating and their families? Method: This qualitative interpretive descriptive study used in-depth semi-structured online interviews with 10 Australian-based occupational therapists working with children who are picky eaters. Data was analysed inductively following a thematic analysis process, and emergent themes were identified. Findings: Participants indicated that they used a complex reasoning process, with 'Tailoring Occupational Therapy for Picky Eating' emerging as the central finding. Key factors underpinning these tailored interventions were finding the why; addressing the why; and practising within context. Conclusion: To our knowledge, this is the first qualitative study to investigate occupational therapists' reasoning processes when working with families impacted by picky eating. Occupational therapists described the complexity of picky eating, and the subsequent reasoning to find suitable interventions. Findings may guide occupational therapists' clinical practice when working with children with picky eating and their families. [ABSTRACT FROM AUTHOR]

Introduction: Autism spectrum disorder (ASD) is a sensory processing, social communication, and occupational performance disorder. Sensory diets can have positive effects on these fields. Current research compared the effectiveness of the sensory diet program with and without teleoccupational therapy on sensory processing patterns, social competency and occupational performance in children with ASD. Materials and Methods: The study sample comprised 32 children with ASD 4-10 years old. They were placed in the control and intervention groups. The number of sessions for both groups was 20 30-minute sessions administered over 8 weeks. Through photos, videos, and explanations, sensory problems were described in both groups, the mother presented and implemented activities and environmental adaptations, and the therapist supervised the implementation. This study used three tools--sensory profile 2, social responsive scale 2 and Canadian occupational performance measure. Results: According to the sensory profile 2, social responsiveness scale, and Canadian occupational performance measure, processing in the areas of auditory, visual, touch, movement, body position, oral, conduct, social-emotional, attentional, sensory seeking, sensory avoiding, sensory sensitive, low registration, social awareness, social cognition, social communication, social motivation, limited interests, repetitive behaviors, and occupational performance in both groups have a significant difference (P<0.05). Conclusion: It seems that providing a sensory diet program through teleoccupational therapy on sensory processing patterns, social competency, and occupational performance is applicable, as well as face-to-face occupational therapy in children with ASD. [ABSTRACT FROM AUTHOR]

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

Background: We aimed to examine the psychosocial interventions used by occupational therapists in managing pediatric TBI, and to identify unique psychosocial needs in this population. Methods: The scoping review was guided by Arksey and O'Malley's framework. Four databases were searched for relevant studies namely: Embase (Elsevier), Medline (PubMed), Cochrane Library, and PsycNet. Included studies were studies written in English reporting on psychosocial interventions for pediatric TBI by occupational therapists and/or the psychosocial needs of children with TBI. Results: The search identified 13 relevant studies published from 2006 to 2020. Multiple psychosocial interventions were pinpointed in these studies, but only cognitive rehabilitation was found to significantly improve participants' performances. Social and emotional difficulties were the most common psychosocial needs reported in the studies. Conclusions: This scoping review revealed knowledge gaps in the long-term outcomes of psychosocial treatments for pediatric TBI by occupational therapists. Most studies were conducted in a small population and tools for measuring outcomes were inconsistent. Replication of included studies in larger samples and with a longer follow-up duration is required. [ABSTRACT FROM AUTHOR]

Background. Research suggests praxis and sensory integration contributes to handwriting legibility in primary students. However, little research has demonstrated performance-based measures of praxis and its relationship to handwriting legibility. This study examined performance-based praxis skills of third and fourth grade students with and without handwriting difficulties (HD). Method: Handwriting legibility and praxis were examined in 33 third and fourth grade students at a local primary school using the Handwriting Legibility Scale and five praxis tests from the Evaluation in Ayres Sensory Integration. Participants were categorized into two groups based on their handwriting legibility scores: students with HD (n = 6) and students without HD (n = 27). Mann-Whitney U and effect size r was calculated to compare the two groups. Results: Students with HD had significantly lower scores on three areas of praxis (positions, sequences, and ocular praxis); pAreas without significant differences include ideation and following directions. Conclusion: Overall, preliminary data support a relationship between praxis and handwriting legibility, which supports the need to evaluate praxis skills to inform occupational therapy interventions for students with handwriting difficulties. [ABSTRACT FROM AUTHOR]

AbstractOccupational therapy’s whole-person approach is well-suited to address the complex needs of children and youth with fetal alcohol spectrum disorder (FASD). However, literature regarding best practices for occupational therapy practitioners working with this population is lacking. This article delineates the role and scope of occupational therapy practice for children and youth with FASD, focusing on holistic and strengths-based approaches. The value of occupational therapy practice is illustrated through application of the person-environment-occupation-performance model and case examples at key developmental stages. Understanding occupational therapy’s scope of practice will support the growth of the profession’s role and facilitate successful participation of children with FASD in everyday life. [ABSTRACT FROM AUTHOR]

Introduction: Autistic children commonly receive simultaneous services from various health‐care and other professionals, including occupational therapy, throughout their journey of diagnosis and consequent therapeutic support. Current best practice guidelines for supporting autistic youth emphasise the importance of interprofessional collaboration. Despite this, collaboration among health‐care professionals does not always occur, and little is understood about clinicians' experiences of collaborative care. The aim of this study was to explore Australian paediatric occupational therapists' experiences of interprofessional collaboration and their perception of factors influencing collaboration when supporting autistic children. Methods: This study employed an exploratory qualitative descriptive design. Semi‐structured interviews were conducted with 13 Australian paediatric occupational therapists involved in service provision to autistic children. Questions explored clinicians' experiences and perceptions of interprofessional collaboration. Reflexive thematic analysis was used to inductively analyse data. Consumer and Community Consultation: This study was conceptualised and conducted by a team of researchers with a range of personal and professional experiences with the autistic community. The research design was strongly informed by the Autism CRC'S research guidelines. Findings: Three themes were generated highlighting factors that influence collaboration between occupational therapists and other professionals. The first emphasised that 'clinicians' capacity to collaborate' at both organisational and individual levels was understood to be greatly influenced by funding structures. The second emphasised that 'relationships are key to collaboration' with these often established through shared workplaces or clients. The third, 'shared perceptions make collaboration easier' described how shared perceptions of collaboration, the occupational therapy role, and autism‐related frames of reference were perceived to influence interprofessional collaboration. Conclusion: Findings indicate that, while occupational therapists perceive interprofessional collaboration as valuable in the support of autistic children, there are barriers to effective collaboration, particularly in the context of a marketised service delivery model. PLAIN LANGUAGE SUMMARY: This study looked at how Australian occupational therapists work with other professionals to support autistic children. Even though it is recommended that professionals work together to support autistic children and their families, this does not always happen. In this study, researchers interviewed 13 occupational therapists and asked what it is like working with other professionals, what is helpful, and what makes working together difficult. From these interviews, it was found that many things affect how well occupational therapists can work with other health professionals and teachers to support autistic children. Factors like funding and workplace rules affect how professionals work together. Having someone take on the role of leader and having good relationships between professionals made it easier to work together. It was also helpful when occupational therapists and other professionals shared similar ideas on how to support autistic children. The study could be improved if it had gathered more information about the occupational therapists' education and what they have learnt about working with other professionals. Overall, the therapists in this study believed that working together to support autistic children and their families was important, but that there are many challenges to making this happen. More research on this topic would be helpful. [ABSTRACT FROM AUTHOR]

Introduction Methods Consumer and Community Involvement Results Conclusion PLAIN LANGUAGE SUMMARY Paediatric occupational therapists assess and provide intervention for children presenting with sensory processing challenges that impact their daily occupational performance. Interoception, the ability to sense internal body signals, is an emerging practice area, yet it remains unclear how and why paediatric clinicians are applying interoception and related concepts in practice.A scoping review was conducted to report on the current body of published literature related to interoception and its application to paediatric occupational therapy practice. A comprehensive search of 10 electronic databases and related grey literature was conducted. Title and abstract screening were completed prior to full‐text review of evidence. The PRISMA‐ScR Checklist and the Crowe Critical Appraisal Tool were used to support a systematic scoping review process and increase robust extraction and appraisal of data. Narrative synthesis was used to analyse and synthesise data.No consumer and community involvement.A total of 18 articles were included in this review, including original research articles (n = 8), published books (n = 4), theses/dissertations (n = 3), opinion pieces (n = 2), and one government document. Narrative synthesis analysis identified six themes: (1) occupational therapy principles relevant to interoception, (2) what is interoception?, (3) assessment of interoception, (4) clinical application of interoception, (5) clinical populations receiving interoception‐based intervention, and (6) relationships between interoception and other performance components. Findings indicated that paediatric occupational therapists are integrating interoception concepts alongside occupational therapy principles to inform assessment and intervention processes. Several assessments and interventions are utilised to support children; however, evidence to strengthen use is lacking. Further, there are limited occupation‐based assessments and intervention programs to address interoception deficits in children.Findings from this scoping review contribute to the emerging body of empirical evidence related to interoception and paediatric occupational therapy practice. These findings provide an informed basis for practice and research by occupational therapists in this area.Interoception allows us to feel what is going on inside our body and helps us to notice how our body might be feeling (e.g. if our stomach grumbles, we might feel hungry; if our heart is beating very fast, we might feel scared; if we are sweating, our body is feeling overheated). Some children may present with problems recognising interoceptive feelings in their bodies. Therefore, occupational therapists can help children learn about their own interoception related to their bodies. This is a new topic for therapists, and they need to know more about it so that they best help children and their families. There is not a lot of information about how to use interoception in occupational therapy practice, and we wanted to know what information already exists about interoception and occupational therapy. This review provides a summary of the current knowledge that is available and summarises it. Some information about interoception and how it relates to occupational therapy services with children was found, but more research knowledge about this topic is needed. [ABSTRACT FROM AUTHOR]

Aim: Trauma-informed care (TIC) is a strengths-based organizational approach which recognizes the prevalence and impact of trauma on an individual's neurological, sensorimotor, and emotional responses and development. There is limited research on pediatric occupational therapy providers' (OTPs) and physical therapy providers' (PTPs) perceptions on incorporating TIC into their practice. This pilot study aims to describe the confidence, attitudes, barriers, and education of pediatric OTPs and PTPs regarding TIC. Method: OTPs and PTPs (n = 87) working in pediatric settings in the U.S. completed an electronic survey regarding their perceptions of TIC. Results: OTPs reported higher confidence in TIC compared to PTPs. Most participants reported favorable attitudes toward TIC, yet no statistical significance was identified between the two professions' overall attitudes toward TIC. Collectively, participants reported lack of time and training as barriers. There was a statistically significant difference between how the two professions rated competency, training, and concern over clients' retraumatization. There was significant association between years of professional experience and TIC education. Conclusion: Preliminary findings indicate an overall agreement of OTPs and PTPs with principles of TIC and common barriers to TIC practice. There are implications to further integrate opportunities for TIC training into foundational education and professional practice. [ABSTRACT FROM AUTHOR]

Introduction: Children with acquired brain injury (ABI) are at risk for poor therapeutic engagement due to cognitive impairment, affect lability, pain, and fatigue. Animal‐assisted therapy (AAT) has the potential to improve patient engagement in rehabilitation therapies; however, the feasibility of integrating AAT into the rigorous therapy schedule of inpatient clinical care or its reception by patients, families, and staff is unknown. Objective: To examine the feasibility and acceptability of incorporating dogs into physical therapy and occupational therapy sessions with pediatric patients being treated on an inpatient rehabilitation unit for acquired brain injury. Design: A feasibility study of AAT within the context of a within‐subjects crossover study. Setting: Pediatric inpatient rehabilitation unit. Participants: Sixteen patients, aged 7–28 years (mean = 13.6 years, standard deviation [SD] = 5.2 years; 50% male), being treated on the inpatient rehabilitation unit following ABI. Intervention: AAT – the integration of dogs into inpatient physical therapy and occupational therapy sessions. Main Outcome Measures: Feasibility measures: enrollment rate, the proportion of AAT sessions a dog attended, adverse events, instances where therapist or handler ended session early, patient animal closeness, and utilization of dog in session. Satisfaction measures: parent satisfaction questionnaires and therapist feedback. Results: Feasibility was supported by high enrollment rate (88.9%) and dog attendance rate of 93%–95%; 84.3% of sessions used the dog in multiple ways and patients reported a high level of closeness with the dog in session, indicating that the dogs were integrated in meaningful ways. No adverse events were noted, therapists reported that intervention was convenient, and clinical care was not negatively impacted. A high level of satisfaction was reported by families and therapists. Conclusions: Findings suggest that AAT is feasible and acceptable, and it may be a valuable tool for therapists working with patients with ABI on an inpatient rehabilitation unit. [ABSTRACT FROM AUTHOR]

Diffusion-weighted magnetic resonance imaging (DMRI) is a potential tool to assess changes in brain connectivity and microstructure resulting from physical and occupational therapy in young children with cerebral palsy. This works was carried out to assess whether DMRI can detect changes after 36 weeks of physical and occupational therapy in the microstructure and connectivity of the brains of children with cerebral palsy and determine whether imaging findings correlate with changes in clinical measures of motor function. Five children underwent anatomical MRI and DMRI and evaluations of motor function skills at baseline and after 36 weeks of intensive or once-weekly physical and occupational Perception-Action Approach therapies. Diffusion tensor imaging and constrained spherical deconvolution methods were used to calculate fractional anisotropy (FA) and fiber orientation distribution functions (fODFs), respectively. The fODFs were used to generate tractograms of the cerebrospinal tract (CST). After 36 weeks of physical and occupational therapy, all children showed increases in motor function. No changes were observed in anatomical MRI before and after therapy but CST tractography did show small differences indicating possible altered microstructure and connectivity in the brain. FA values along the CSTs, however, showed no significant changes. Reliable longitudinal DMRI can be employed in toddler-aged children with CP and DMRI has the potential to monitor neuroplastic changes in white matter microstructure. However, there is a high variability between subjects and clinical improvements were not always correlated with measures of FA along the CST. [ABSTRACT FROM AUTHOR]

(1) Background: Obstetric brachial plexus palsy (OBPP) is an unpredictable and unpreventable neurological injury, caused by shoulder dystocia during birth, that affects the brachial plexus and leads to motor and sensory deficits in the child's upper extremity. The limited literature on early therapeutic assessment of newborns with OBPP highlights a gap in specialized care that, if filled, could enhance decision-making and support timely treatment. The objective of this paper is to analyze the therapeutic intervention techniques used at an early stage and their functional impact, from the occupational therapy discipline in the treatment of the upper extremity in babies and children with OBPP. (2) Method: Systematic review design and meta-analysis. A systematic review is a comprehensive analysis of existing research on a specific topic, using rigorous methods to identify, evaluate, and synthesize studies. Meta-analysis, often part of a systematic review, combines results from multiple studies to identify overall trends and enhance reliability, providing a clearer summary of evidence. Articles that included pediatric patients (from birth to 12 years of age) with a diagnosis of OBPP were reviewed. The results of the techniques used were analyzed according to each study, with the scale or method of assessment considered by the study for the presentation of data. The articles were assessed for methodological quality using the "PEDro Validity Scale". (3) Results: A total of 2190 articles were found, with 108 analyzed and 22 fully meeting this study's standards. Fourteen had a quantitative design, while the others included clinical guidelines. The most statistically reliable intervention techniques were CIMT (constraint-induced movement therapy) and splinting (dynamic and static), with second-tier techniques like joint manipulation, NMES, early infant management education, and serial casting used when needed. This study focused on children from birth to eight years old, with assessment tools primarily measuring upper limb range of motion, external rotation, supination, and impairment levels, though bimanual activity assessment was less common. (4) Conclusions: The early implementation of the techniques that provide us with the most data are CIMT, splinting, NMES, and joint manipulation linked to health education for families. In second place, we have the use of TB infiltrations and serial casts, when the treatment of the previous techniques fails in some cases. [ABSTRACT FROM AUTHOR]

Introduction: In childhood intervention, parent–therapist collaboration is central to the family‐centred approach. Despite long‐standing discussion in occupational therapy literature, the field faces challenges, including inconsistent terminology and difficulties in translating theory into practice. This paper represents the first part of a comprehensive scoping review study aimed at developing foundational concepts for collaborative practices with parents in occupational therapy for children. Therefore, this paper focusses on mapping existing practices, types, and approaches articulated in the literature. Methods: We searched English‐language sources published worldwide from 1998 to 2022 discussing collaborative practices with parents in occupational therapy for children aged 0–10 with any diagnosis, including multidisciplinary practices. Seven databases were searched. Data from peer‐reviewed indexed literature, theses and dissertations, and book chapters were extracted and analysed through basic numerical and descriptive analyses before being synthesised into similar categories. The Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic reviews and Meta‐Analysis—extension for Scoping Reviews were used. Results: The scoping review yielded 299 papers. Parent–therapist collaboration was prominent in clinics, family homes, schools, and hospitals, particularly during therapy implementation, goal setting, and planning. Most reported practice types included 'interventions with parent engagement', 'parent‐directed interventions', and 'parent education'. 'Family‐centred', 'occupational‐focussed', and 'client–therapist collaborative' approaches were frequently mentioned. There were inconsistencies in the terms used to describe collaborative practice characteristics. Conclusion: Over the past 24 years, the collaborative practice literature has expanded and evolved, with parent–therapist collaboration observed across various occupational therapy settings. Inconsistencies in this collaboration across different therapeutic stages were revealed, which could impact intervention success and sustainability. Further research is needed to explore parent–therapist collaboration mechanisms within and across stages. This scoping review also underscores the need for a common framework to guide practice and research. PLAIN LANGUAGE SUMMARY: This literature review explores how occupational therapists and parents work together in childhood intervention. Collaboration is essential for understanding and meeting children's needs within their family and community settings. However, occupational therapists and parents face challenges in applying family‐centred practices and using a common language to bridge theory with practice. To address these challenges, we examined 299 papers published between 1998 and 2022 to understand how collaborative practices with parents have been described in the literature. Our review revealed that therapists and parents collaborate across various settings, such as clinics, schools, homes, and hospitals, mainly during therapy sessions, goal setting, and planning interventions. Collaborative practices take different forms. For instance, therapists often encourage parents to actively engage and take the lead in therapy, requiring therapists to recognise and respect parents' priorities and learning preferences. They often develop strategies together to support the child within family routines. While we found several studies on therapist–parent collaboration, the review outlined inconsistencies in how this practice was described and applied, which could affect its success. Therefore, more research is needed to understand the best ways in which collaboration can occur at each stage of therapy. The need for a core guideline for collaborative practice with parents in occupational therapy was also observed. While therapist–parent collaboration is used in occupational therapy for children, there is a clear need to minimise inconsistencies and gaps found in the literature, as well as to ensure a common language to promote intervention quality and success. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the initial content validity and clinical utility of Mealtime Screening for School (MEALSS), a new screening tool that measures mealtime participation in students with intellectual and developmental disabilities 5 to 10 years of age. Methods: To determine the content validity of MEALSS, the researchers recruited five participants identified as pediatric occupational therapists and/or feeding experts to review the MEALSS. Item level content validity index (I-CVI) and scale level validity (S-CVI) were calculated, as well as modified kappa indices to reduce the probability of chance agreement. MEALSS was then revised based on feedback from the content experts. To determine the clinical utility of MEALSS, 20 school-based occupational therapists were recruited to assess the clinical usage of the revised version of the tool. The responses were thematized and analyzed. Results: Content experts rated 17 out of the 18 MEALSS items essential in assessing mealtime participation in the school setting. The majority of the clinician participants indicated a favorable response to the clinical utility of the tool, ease of use, and accuracy in identifying and measuring mealtime challenges in the school setting. Conclusion: The study provided useful perspectives on how the tool can be further improved to measure mealtime participation in school-aged children. [ABSTRACT FROM AUTHOR]

Objective: Management of emergency care Background: Pediatric burn injuries are a global health concern, particularly in infants and toddlers, who face increased risks owing to their higher water content. Despite substantial medical treatment, the mortality rates remain challenging, especially in severe cases. This study explored non-surgical interventions for pediatric burn injuries, aiming to enhance care and alleviate the burden on affected children. Case Report: A 16-month-old boy with 30% mixed second- and third-degree burns presented with a scald injury. Initial measures included dressing and analgesia. The Plastic Surgery team led the treatment. Upon admission, the patient experienced convulsions due to hyponatremia in the burn unit and was subsequently transferred to the Pediatric Intensive Care Unit (PICU). Burn care management included the use of hyaluronic acid and occupational therapy. Scheduled dressing changes, including the use of glycerin-based dressings, resulted in satisfactory wound healing. Split skin grafting from the right thigh was performed to prevent elbow joint contracture. Preventive measures against hypertrophic scarring were also implemented. The patient was discharged after follow-up appointments. Consent for publication of case details and photographs was obtained from the patient's father. Conclusions: The presented non-surgical approach, incorporating hyaluronic acid, Bactigras, Elasto-Gel, and a multidisciplinary team, can effectively treat mixed partial- and full-thickness burn injuries in pediatric populations. Splitthickness grafts may be required in functional areas. Therefore, a comprehensive management strategy that considers tissue damage, electrolyte balance, and infection is crucial. This report underscores the importance of meticulous assessment and correction of overall patient condition, especially in pediatric cases of electrolyte imbalance. [ABSTRACT FROM AUTHOR]

Background: Assessment tools are essential in occupational therapy for providing client-centered care, clinical decision-making, evidence-based documentation, and defining expected outcomes. This study investigated available occupational therapy assessment tools for children and adolescents in Iran. Methods: A comprehensive search was conducted in MEDLINE, PubMed Central, Web of Science, Embase, Scopus, SID, Magiran, and Google Scholar from their inception until May 24, 2022. Two reviewers screened records and applied inclusion criteria focused on peer-reviewed articles in English or Persian, covering children and adolescents aged 0-18 years old in Iran. The methodological quality of each study and the evidence quality of each measurement tool was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias Checklist, and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Results: A review of 66 articles published between 2010 and 2021, identified 51 assessment tools. The majority of tools (70.7%) targeted typically developing children and those with cerebral palsy, with limited options for adolescents (n=5) and infants (n=1). These tools primarily focused on assessing body functions (47.06%), particularly sensory-motor functions. While numerous tools demonstrated good reliability (66.67%) and significant content validity (31.37%), there was a paucity of high- quality evidence supporting other psychometric properties. Conclusion: This study identified 51 occupational therapy assessment tools for Iranian children and adolescents. However, the present research identified some concerning trends, such as lack of tools available for specific populations, an overreliance on translated tools, and a predominant focus on body functions. Moreover, there were concerns about the methodological quality of studies using these tools. [ABSTRACT FROM AUTHOR]

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

Importance: Care partners' involvement is a key feature of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach that can enhance rehabilitation outcomes and promote the generalization and transfer of strategies and skills to everyday life. Gaining insight into care partners' experience with their child's CO-OP intervention is critical to understanding how to enhance care partners' involvement. Objective: To gain insight into the experience of care partners whose child with acquired brain injury (ABI) participated in CO-OP intervention. Method: A qualitative descriptive research design was used. Semistructured interviews were conducted at three time points (immediate postintervention and at 2 and 6 mo postintervention). Setting: Two rehabilitation centers. Participants: Thirteen care partners of 12 children or youth with severe ABI. Results: Three themes emerged from the analysis of 33 interviews: (1) The child is an active agent in their therapy, (2) the care partner is the keystone who helps solidify the elements of CO-OP, and (3) CO-OP mastery requires time and practice, and its use evolves over time. Conclusions and Relevance: These themes highlight the progressive nature of proficiency in CO-OP for both care partners and children. This was evident not only in the children's improvement in task performance, but also in their ability to problem solve. Care partners' role in supporting the CO-OP approach also unfolds over time as their confidence in their child's problem-solving abilities, and in their own ability to adequately provide guidance, increases. Engagement seems to be central in facilitating this progression for both children and their care partners. Plain-Language Summary: This is the first study to provide insights into the involvement of care partners in the Cognitive Orientation to daily Occupational Performance (CO-OP) approach for children and youth with executive function deficits after acquired brain injury. This is also the first study to explore the evolution of care partners' experiences over time. Involving care partners is a key feature of the CO-OP. Understanding care partners' experiences with their child's CO-OP intervention can improve a child's rehabilitation outcomes. The study found that care partners' role in supporting their child's CO-OP approach improved over time as their confidence in their child's problem-solving abilities increased. The care partners' own ability to adequately provide guidance to their child also increased over time. Engagement seems to be central in facilitating this progression for both children and their care partners. It is hoped that occupational therapists will consider the findings of this study to better support care partners in implementing the CO-OP approach with their child in their real-life context. Care partners' role in supporting their child's engagement with the Cognitive Orientation to daily Occupational Performance (CO-OP) occupational therapy approach improved over time as their confidence in their child's problem-solving abilities increased. [ABSTRACT FROM AUTHOR]

Allied Health Professionals (AHP) are integrated members of the multidisciplinary Functional Neurological Disorder (FND) care team and include physical therapy, occupational therapy and speech therapy. The objective of this survey study is to determine factors impacting AHPs interest and confidence treating pediatric patients with FND in the United States. An 11-question survey was developed by pediatric AHPs at St. Louis Children's Hospital and distributed over an 8-month period via pediatric interhospital listserv; as well as American Occupational Therapy Association and American Physical Therapy Association community boards. Respondents were required to be licensed AHPs working in a pediatric setting. In total, 239 respondents from 32 hospitals across 18 states participated in this study. Respondents were 110 physical therapists, 92 occupational therapists and 37 speech therapists. For AHPs with 0-5 years clinical experience, 40% reported to be neutral to extremely not interested in FND, with 49.5% reporting neutral to extremely not confident treating FND. For AHPs with 6+ years of clinical experience, 48.6% reported neutral to extremely not interested in FND and 45.8% reported neutral to extremely not confident in treating FND. AHPs with more general clinical experience report higher levels of confidence and lower levels of interest treating pediatric FND compared to those earlier in their career, regardless of AHP type. Non-clinical exposure did not have a significant impact on confidence treating FND. Though, experiential exposure was observed to correlate with highest levels of confidence at 75.8%, regardless of years of experience. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the self-reported stress levels of pediatric occupational therapists, examine specific work factors and determine if demographic factors predict occupational stress. A cross-sectional survey design study, using voluntary response sampling, was conducted. The survey included demographics, the Workplace Stress Scale, and the Stress Index. The sample included 289 pediatric occupational therapists. Using descriptive analysis, a one-sample t-test, and multiple linear regressions, results indicated that pediatric occupational therapists had significantly higher stress levels than the validating sample of the Workplace Stress Scale. Self-reported work factors included too much work to do in a limited time and lack of time to plan or evaluate treatments. No demographic factors predicted work stress, while several work factors did. Occupational stress exists in pediatric occupational therapy work settings, especially in settings where high productivity is self-reported. [ABSTRACT FROM AUTHOR]

The purpose of this scoping review was to provide further insight into the stress and the stressors experienced by pediatric occupational therapists in the work environment. Using the Arksey and O'Malley framework, the search was conducted in eight databases, nine electronic journals, and eight gray literature sources to identify articles related to stress and stressors of pediatric occupational therapists. Review selection and characterization were performed by two independent reviewers. Twelve articles published from 2011 to 2020 were identified and varied in terms of purpose, population, and results although the articles all shared similar methodologies and outcome measures. Only 25% of the articles (3/12) addressed pediatric occupational therapy stress and stressors directly while the remaining addressed occupational stress, but with varying levels of attention to pediatric occupational therapists. Stress and stressors experienced by pediatric occupational therapists have been studied to a limited extent. Occupational stress is associated with increased burnout, decreased health, and decreased job satisfaction and performance. Several knowledge gaps have been identified, as well as priorities for future research into pediatric occupational therapists and occupational stress. [ABSTRACT FROM AUTHOR]

Background: Many challenges exist in promoting inclusion in childcare settings. Adequate support from specialized professionals is necessary to create inclusive childcare settings. Understanding which services are being delivered by specialized professionals in childcare contexts is an important first step. The aim of this study was to (1) describe the services currently being delivered by specialized professionals in childcare settings in Quebec (Canada) and (2) seek childcare administrators' perspectives on their preferred services. Methods: An online province‐wide descriptive survey was conducted with childcare administrators (n = 344). Questions focused on 11 service delivery dimensions (e.g. professionals involved, children served). Descriptive statistics were calculated. Results: Childcare settings received services from a median of two specialized professionals (IQR [1–4]). Most services were delivered by early childhood special educators (61.3%), speech‐language pathologists (57.6%), psycho‐educators (43.6%) and occupational therapists (43.3%). Childcare administrators identified these four services as being particularly supportive. Professionals delivered a median of 0.4 h of service per week in each childcare setting (IQR [0.1–3.0]). A high percentage (91.2%) of administrators reported unmet needs for professional support in at least one developmental domain, with a high percentage (57.3%) of administrators identifying needs in the socio‐emotional domain. Most (63.3%) expressed a desire to prioritize services for children without an established diagnosis but identified by early childhood educators as having needs for professional support. Most administrators (71.4%) also preferred in‐context services. Conclusions: Childcare administrators perceive an important role for specialized professionals in supporting inclusion in their settings. Recommendations emerging are based on the four main professional service needs identified: (1) increasing the intensity and stability of services; (2) providing services for undiagnosed children identified by early childhood educators as having unmet needs; (3) ensuring that services encompassing all developmental domains with a focus on the socio‐emotional domain; and (4) prioritizing of in‐context services. [ABSTRACT FROM AUTHOR]

Difficulties with self-care skills are frequently observed in children with developmental delays. Given the scarcity of robust evidence backing self-care interventions for this group, this scoping review is designed to aggregate existing literature on the implementation of such interventions. Therefore, this scoping review aims to collate literature on the nature of self-care intervention implementation to increase understanding of the current practice and inform future research directions. This scoping review endeavoured to explore the body of literature concerning the existence of self-care interventions and their implementation strategies in children who have developmental delays. Relevant studies were identified by searching through the following databases: Web of Science (W0S), Scopus, ASEAN Citation Index (ACI), CINAHL EBSCO and PubMed. Six types of interventions using various approaches were identified. Occupational therapists mainly manage intervention providers with multidisciplinary co-facilitator and parents' involvement. Whilst session information varied, some evidence suggests that at least 30 min per session, minimum once per week up to twice per week, ranging from 10 to 23 sessions, may be sufficient. Intervention plans should be tailored to each child's unique needs, taking into account the variety of available interventions. Collaboration among occupational therapists, parents, educators and health professionals in home programmes enhances self-care intervention outcomes. These results are set to inform future research and practice, paving the way for enhanced support and improved outcomes for children with developmental delays. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of cranial deformities, including nonsynostotic plagiocephaly, has been increasing, especially since the “Back to Sleep” campaign. Treatment of these deformities can use a cranial remolding orthosis or helmet. However, inconsistencies in results of studies of cranial remolding orthoses have made it increasingly more difficult for providers to accurately make recommendations for individuals with nonsynostotic plagiocephaly. Therefore, the purpose of this study was to assess the effectiveness of cranial remolding orthoses effective in treating nonsynostotic plagiocephaly by reducing cranial vault asymmetry (CVA) and to assess whether age and severity impact length and success of treatment. Materials and Methods: A retrospective analysis of patient files from September 2019–September 2020 was conducted. Paired samples of initial average and discharge average CVA measures and severity ratings were compared. Regression analyses were used to assess the relationship between all factors and severity rating at discharge. Results: A total of 106 infants (73 male, 33 female) were included in final analyses. Results indicated a significant difference between initial and discharge CVA and severity rating as a result of cranial remolding orthosis treatment. It was found that CVA at initial evaluation significantly predicted CVA at discharge (β = 0.73, P = 0.000) and severity at discharge (β = 0.52, P = 0.000), but all other variables were not significant predictors. Conclusions: The cranial remolding orthosis is an effective treatment in the correction of nonsynostotic plagiocephaly when used by a certified practitioner. In addition, this study found that treatment led to significant improvement regardless of age or initial severity. [ABSTRACT FROM AUTHOR]

Importance: Clinicians and researchers can leverage clinical documentation of therapy services for quality improvement and research purposes. However, documentation is often institution specific and may not adequately capture the dose of therapy delivered, thus limiting collaboration. Objective: To implement documentation of pediatric occupational and physical therapy dose from one institution to another institution. Dose documentation includes the frequency, intensity, time, and type of interventions delivered (FITT Epic® Flowsheet) at each session. Design: Prospective time-series quality improvement study. Setting: Two large urban pediatric hospitals. Participants: Occupational and physical therapy staff members. Intervention: Staff training and feedback loops utilizing existing groups. Outcomes and Measures: The process measure (number of available staff trained and using the FITT Epic Flowsheet over time) and the outcome measure (percentage of FITT Epic Flowsheets used for treatment visits each month) were analyzed using a statistical process control chart. The balancing measure (percentage of notes closed before 7 p.m. on the same day as the encounter) was analyzed using mean per month across three time periods. Results: Fifty-seven staff members (68%) attended formal training. On average, clinicians documented 90% of sessions using the FITT Epic Flowsheet after implementation. There was no change observed in the balancing measure. Conclusions and Relevance: Documentation of dose was spread from one institution to another. Shared documentation will facilitate future collaboration for quality improvement and research purposes. Occupational therapy practitioners and leaders should consider implementing documentation with common dose elements. Plain-Language Summary: Occupational therapy documentation is often institution specific and may not adequately capture the dose of therapy (frequency, intensity, time) or types of interventions that were delivered, thus limiting opportunities for collaboration between institutions. This article adds to the literature on administrative supports for clinical and quality improvement research by illustrating a specific example of how documentation of dose can be shared from one institution to another. The data show that clinicians at one institution started using a new style of documentation using the FITT Epic® Flowsheet and shared discrete dose elements with another institution, creating new opportunities for collaboration. Shared documentation can facilitate future collaboration for quality improvement and research purposes. This article adds to the literature on administrative supports for clinical and quality improvement research by illustrating a specific example of how documentation of dose can be shared from one institution to another. [ABSTRACT FROM AUTHOR]

Importance: Although play and positive caregiving strategies have been associated with child well-being, little is known about the relationship between play type and strategies used by caregivers in early childhood. Objective: To investigate whether a relationship exists between play type and positive caregiving strategies. Design: Exploratory correlational nonexperimental design. Setting: Early childhood center. Participants: A convenience sample that included 60 observations of 14 caregivers during a therapeutic playgroup with 14 children with and without disabilities ages 15 mo to 3 yr (4 fathers, 3 mothers, 1 nanny, and 6 female early childhood teachers; age range = 30–39 yr). The caregivers were Black (n = 1; 7.1%), Hispanic (n = 5; 35.7%), and White (n = 8; 57.1%). Outcomes and Measures: Positive caregiving strategies were scored using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes. Results: Results revealed no significant correlations between play type and positive caregiving strategy. There was a positive, significant correlation between caregiving strategies (affection, responsiveness, encouragement, teaching, and total; rpbs =.767–.970, n = 58, p =.001). The play type and caregiver type variables did not predict total positive caregiving strategies, F(2, 57) = 2.147, p =.126. One variable, caregiver type, added statistical significance to the prediction (p =.045). Conclusions and Relevance: The findings show no relationship between play type and positive caregiving strategy. Consideration of the types of caregivers participating in a therapeutic playgroup and their roles and use of positive strategies during play is worthy of further investigation. Plain-Language Summary: This study explored how parent and teacher caregivers supported children (both with and without disabilities) during a therapeutic playgroup at an early childhood center. Therapeutic playgroups are a special type of group play in which a trained professional helps guide play activities to support participation. The researchers wanted to see whether there was a connection between the type of play the children engaged in and how the adult caregivers interacted with them. The surprising finding was that there was no link between play type and how caregivers interacted. However, the caregivers often used positive strategies with the children, regardless of the play activity. Interestingly, type of caregiver (parent, teacher) seemed to make a slight difference in how they interacted with the children during playtime. Overall, this study suggests that more research is needed to understand how the types of play activities and objects might influence caregiver interactions during group play. This study explored how parent and teacher caregivers supported children (both with and without disabilities) during a therapeutic playgroup at an early childhood center. [ABSTRACT FROM AUTHOR]

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

AbstractThe purpose of this qualitative constructivist grounded theory study was to develop a model to explain potential mechanisms of change in the nature-based pediatric occupational therapy process, based on analysis of the perspectives of occupational therapy practitioners currently engaging in nature-based practice with children. Using 27 photos and interview data from 22 participants the Ecology of Change in Outdoor Therapy (ECO-Therapy) Model was developed. The model suggests mechanisms of change in nature-based pediatric occupational therapy may involve six iterative phases: Longing for Freedom, Embarking on Adventure, Dancing with Nature, Claiming Self-Agency, Braving Real-Life Challenges, and Growing Adaptive Capacity. The practitioner and child experiencing these phases throughout the nature-based occupational therapy process may lead to improved participation and performance in the child’s daily life. [ABSTRACT FROM AUTHOR]

Background: Entrustable Professional Activities (EPA)-based assessment is easily and intuitively used in evaluating the learning outcomes of competency-based medical education (CBME). This study aimed to develop an EPA for occupational therapy focused on providing health education and consultation (TP-EPA3) and examine its validity. Methods: Nineteen occupational therapists who had completed online training on the EQual rubric evaluation participated in this study. An expert committee identified six core EPAs for pediatric occupational therapy. TP-EPA3 was developed following the EPA template and refined through consensus meetings. The EQual rubric, a 14-item, five-point criterion-based anchor system, encompassing discrete units of work (DU), entrustable, essential, and important tasks of the profession (EEIT), and curricular role (CR), was used to evaluate the quality of TP-EPA3. Overall scores below 4.07, or scores for DU, EEIT, and CR domains below 4.17. 4.00, and 4.00, respectively, indicate the need for modifications. Results: The TP-EPA3 demonstrated good validity, surpassing the required cut-off score with an average overall EQual score of 4.21 (SD = 0.41). Specific domain scores for DU, EEIT, and CR were 3.90 (SD = 0.69), 4.46 (SD = 0.44), and 4.42 (SD = 0.45), respectively. Subsequent revisions clarified observation contexts, enhancing specificity and focus. Further validation of the revised TP-EPA3 and a thorough examination of its reliability and validity are needed. Conclusion: The successful validation of TP-EPA3 suggests its potential as a valid assessment tool in occupational therapy education, offering a structured approach for developing competency in providing health education and consultation. This process model for EPA development and validation can guide occupational therapists in creating tailored EPAs for diverse specialties and settings. [ABSTRACT FROM AUTHOR]

Background: Intensive manual therapy is important for improving lifelong upper limb motor outcomes for infants and toddlers with cerebral palsy. This play-based therapy is delivered by caregivers who are coached by occupational therapists. However, access to this therapy is very limited for Canadian children with cerebral palsy younger than two years old. This project aims to first identify barriers and facilitators and then design implementation strategies to support early intensive manual therapy delivery for infants and toddlers with cerebral palsy across Canada. Methods: A mixed-methods sequential explanatory design will be used with four consecutive phases. The updated Consolidated Framework for Implementation Research will guide the study. Quantitative data will be collected from a survey in Phase One. Participants will be recruited from three groups: (1) Caregivers of children with cerebral palsy six years old and younger who are eligible for manual therapy; (2) occupational therapists who treat children with cerebral palsy; and (3) healthcare administrators or people responsible for managing pediatric occupational therapy programs. In Phase Two, quantitative data from the survey will be used to map to implementation strategies known to be effective at addressing the identified modifiable barriers and facilitators. Phase Three will collect qualitative data from semi-structured interviews for the purpose of explaining Phase One quantitative findings in greater depth, and for understanding the appropriateness of strategies identified in Phase Two. The participant recruitment strategy and interview guide content for Phase Three will be informed by results of Phase One. Phase Four will use a modified nominal group technique to refine and prioritize an implementation strategy toolbox. Results will be widely disseminated to knowledge users to provide them with tailorable strategies to increase delivery of early intensive manual interventions. Discussion: This study will provide a comprehensive understanding of the barriers and facilitators to implementation of early intensive manual therapy for young children with cerebral palsy in Canada. A toolbox of evidence-based and tailorable implementation strategies will be disseminated nationally to support uptake of early intensive manual therapy into clinical practice for young children with cerebral palsy. [ABSTRACT FROM AUTHOR]

This Perspectives paper advances understanding of coaching in pediatric rehabilitation. We compare three coaching approaches designed for pediatric rehabilitation: Coping with and Caring for Infants with Special Needs (COPCA), Occupational Performance Coaching (OPC), and Solution-Focused Coaching in Pediatric Rehabilitation (SFC-peds). Our objectives are to contrast the theory underpinning the approaches, discuss the evidence for outcomes and hypothesized mechanisms of change, consider the necessary mindsets of effective coaches, and propose directions for research and practice. The coaching approaches have different theoretical bases and are designed for specific contexts, yet are similar in their mechanisms of change and intended outcomes. There is growing evidence of important effects of coaching on coachees' goal achievement, empowerment, and capacity building. Studies indicate that stakeholders value coaching, and provide a preliminary understanding of the mechanisms, including engagement and self-efficacy, by which coaching approaches support clients' self-directed and sustained change. Open, curious, and client-centered practitioner mindsets are fundamental to effective coaching. Coaching is a distinctive group of relational, goal-oriented, and evidence-based approaches that support goal achievement and empowerment. These approaches reflect and advance an ongoing paradigm shift in pediatric rehabilitation—a movement from therapist-as-expert approaches to those that build empowerment and capacity. Coaching is a distinctive group of theory-based approaches that support clients' goal achievement and empowerment, and build capacity Coaching practitioners are collaborative facilitators who assist clients and families with their own discovery of solutions that fit their everyday contexts The evidence suggests that coaching triggers engagement and self-efficacy, which are the mechanisms by which changes in longer-term outcomes occur Open, curious, and client/family-centered practitioner mindsets are fundamental to effective coaching [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to evaluate the impact of a standardized vision screen guideline on occupational therapy vision screens in a pediatric inpatient rehabilitation unit. METHODS: Charts of patients admitted to a pediatric inpatient rehabilitation before guideline implementation (n = 47) versus charts after implementation (n = 47) were randomly, retrospectively reviewed to explore differences in visual skills screened and use of standardized assessments. RESULTS: Significant improvements (p < = 0.05) were found in the number of visual skills screened (p = 0.034), use of standardized assessments (p = 0.005), and screening of the specific visual skills of accommodative amplitude (p = 0.05), suppression (p = 0.015), and double vision (p < 0.001). CONCLUSION: Implementation of a standardized vision screen guideline improved the frequency of vision screens during occupational therapy evaluations in a pediatric inpatient rehabilitation unit. The use of standardized assessments may also improve the quality of vision screens by encouraging staff to complete more comprehensive vision screens, including screening more visual skills, and by prompting use of standardized assessments, which can improve accuracy of screening procedures. [ABSTRACT FROM AUTHOR]

While research into mindfulness practices is on the rise across populations, there is evidence to suggest that clinical practice has outpaced the literature with regard to mindfulness in pediatric rehabilitation. The aim of this study was to explore the perceptions of occupational therapists who opt to incorporate mindfulness into their clinical practices with children and youth. Hermeneutic phenomenology was the methodology of the study. The theoretical framework employed a Heideggerian-informed phenomenology of practice. Eight occupational therapists practicing in Canada and the United States participated in 90–120 min semi-structured interviews that elicited first-hand accounts of mindfulness in pediatric occupational therapy practice. Interviews were transcribed verbatim and analyzed using Finlay's four-step approach. Six salient themes were identified in the data: drawing from personal practice, enhancing participation, fostering healthy habits, adapting for children, keeping it playful, and doing with. The findings of this study offer insights for therapists who are considering incorporating mindfulness into their practices with children and youth. Further, this research highlights a number of research priorities that require further inquiry. Mindfulness is growing in popularity and may support occupational engagement in children and youth receiving rehabilitation services. Mindfulness practices may support rehabilitation providers in approaching their work with children and youth from a critical perspective. Further development of the child- and youth-centred mindfulness approaches may be warranted to enhance engagement and appropriateness for a range of ages and conditions. [ABSTRACT FROM AUTHOR]

Animal-assisted therapy has gained increased attention in occupational therapy. Yet there remains minimal education opportunities available. In addition to supporting student learning, student-led clinics have the potential to provide a valuable, cost-effective health service to the community. This study aimed to explore the potential benefits to the children clients participating in a student-led, canine-assisted occupational therapy pediatric clinic from the perspectives of the students and parents. Semi-structured interviews were conducted with nine occupational therapy students, and five parents to describe their experience. Transcripts were analyzed using inductive thematic analysis. Participants emphasized how the presence of the therapy dog supported child engagement within the therapy session. Ways in which participants believed the therapy dog influenced the children's engagement were described within three themes. The first highlighted the importance of the relationship between the children and the therapy dog. The second described how this relationship facilitated a sense of safety within the sessions. The third captured how this sense of safety supported the children's participation within their meaningful occupations. Parents and students involved in the canine-assisted occupational therapy clinic perceived that canine-assisted therapy was supportive of child engagement in therapy. [ABSTRACT FROM AUTHOR]

To adapt the Wheelchair Use Confidence Scale for Manual Wheelchair Users, French-Canadian Version (WheelCon-M-F) into a paediatric version (WheelCon-M-F-P) and to evaluate its validity. A three-phase process was conducted: (1) item adaptation using secondary analysis of focus group data; (2) item refinement using a think-aloud process; and (3) preliminary validation of the WheelCon-M-F-P (i.e. internal consistency, test-retest reliability, standard error of measurement, smallest real difference, ceiling and floor effects, limits of agreement, and relations with other variables). Phase 1: The sample consisted of occupational therapists (n = 9), paediatric manual wheelchair users (PMWUs) (n = 12), and parents of PMWUs (n = 2). Of the 65 WheelCon-M-F items, 35 were removed, 25 modified and 6 were added for the WheelCon-M-F-P. Phase 2: 4 PMWUs helped refine 14 and remove 3 items. Phase 3: 22 PMWUs participated. Cronbach's alpha, test-retest reliability, standard error of measurement, and smallest real difference were 0.846, 0.818, 3.05, and 8.45 respectively. No ceiling or floor effects were demonstrated. Pearson correlations between the WheelCon-M-F-P and the Wheelchair Skills Test Questionnaire (capacity, confidence, and performance), and the Child Occupational Self-Assessment were 0.688, 0.711, 0.584, and 0.687 respectively. This study provides preliminary evidence of a valid and reliable WheelCon-M-F-P. The Wheelchair Use Confidence Scale for Manual Wheelchair Users, French-Canadian Version (WheelCon-M-F-P) is an outcome measure that can be used clinically with pediatric manual wheelchair users. The WheelCon-M-F-P can help identify modifiable factors associated with wheelchair confidence. Identifying modifiable factors associated with wheelchair confidence can help guide clinicians in establishing a targeted intervention for their pediatric clients. Establishing a targeted intervention can help improve self-efficacy for wheelchair use and social participation of pediatric wheelchair users. [ABSTRACT FROM AUTHOR]

This paper describes an example of collaborative course development, in which occupational therapy faculty members designed a two-course sequence for teaching content related to occupational therapy with children and youth. They used a backward course design approach and performance-based learning objectives to create alignment between Accreditation Council for Occupational Therapy Education (ACOTE) standards, course assignments and instructional content. The authors present examples from their course design, along with evidence-based resources to guide educators working on developing new courses or revising existing courses. Outcomes achieved from four years of teaching and refining the developed courses are also described. [ABSTRACT FROM AUTHOR]

Objective The implementation of early rehabilitation programs based on evidence to improve the movement abilities of preterm infants is of particular importance. The evidence about rehabilitation interventions in improving the motor development of preterm infants is diverse and scattered and there is heterogeneity in the type, dose and time of therapeutic interventions. Therefore, the purpose of this review study is to identify the types of rehabilitation interventions (occupational therapy and physiotherapy) in improving the motor skills of infants hospitalized in the intensive care unit. Materials & Methods This is a scoping review study. Research studies and indexed in scientific databases including were available in PubMed/Web of Science/Scopus or retrieved by Google Scholar search engine were searched and reviewed. Inclusion criteria included the report of studies in English and Persian papers published from 2000 to 2023 that were mainly focused and the main subject of early rehabilitation intervention studies (occupational therapy and physiotherapy) on the development of neuromotor skills of preterm infants in the neonatal intensive care unit. After selecting the keywords and organized search, the found articles were matched with the entry criteria and finally considered studies were selected. Results Among the reviewed studies, 15 studies met the inclusion criteria. Among the available studies, 7 studies related to multi-modal interventions and 2 studies related to multi-sensory intervention .2 studies related to neuro-developmental interventions. 2 studies related to interventions implemented by parents--administered. 2 studies related to interventions supporting play exploration and early developmental intervention. Conclusion Based on the findings of this research and the meetings held with experts in this field, we were able to organize early rehabilitation interventions for motor skills of preterm infants in 4 groups: 1) multimodal and multisensory interventions 2) neurodevelopmental interventions 3) parentsadministered interventions 4) supporting play exploration and early developmental intervention to categorize. In this way, all types of therapeutic interventions in improving motor skills of infants were identified. Most of the studies included interventions that were performed in a short period of time and reported short-term effects on motor improvement. Only the supportive play exploration intervention continued after discharge and bridged the gap of early NICU-to-home interventions and reported improved motor development in the short- and long-term (6, 12 months). [ABSTRACT FROM AUTHOR]

This study aimed to examine the effectiveness of an interprofessional telehealth course developed based on a collaborative needs assessment of professionals working in community-based child-development units. Ninety-six pediatric therapists, including psychologists, social workers, speech-language pathologists, physiotherapists, and occupational therapists, participated in a 10-week, 30-hour online training on best practices in telehealth delivered according to adult learning theory guidelines. Participants reported their telehealth competencies before and after the training using a questionnaire developed for the study. Repeated paired t-tests showed significant increases with high effect sizes in participants' knowledge, attitudes, emotions, and willingness to use telehealth in their practices. However, at follow-up, the implementation rates remained low. Online learning tailored to learners' needs can change knowledge, attitudes, and willingness to incorporate telehealth into routine care. Collaboration among regulators, foundations, professional associations, and clients attuned to health care's changing needs is essential to providing solutions and boosting the quality of rehabilitation services. However, providing knowledge alone is not enough: Sustainable implementation planning is essential for knowledge translation. Telehealth can enhance access to rehabilitation services, but providers require training to promote knowledge, attitudes, and willingness to incorporate telehealth into routine care. Effective training should be based on collaboration among all stakeholders, from needs assessment and content development to implementation and devising a plan to translate sustainable knowledge into rehabilitation. Training courses should combine content on best practices with a delivery approach based on adult learning principles. To translate knowledge into practice, the course must be a part of a sustainable implementation plan at the workplace. [ABSTRACT FROM AUTHOR]

Interdisciplinary collaboration between health and education professionals is one of the principles of inclusive education. This study aimed to describe the practices and service delivery by pediatric occupational therapists (OTs) in schools in Spain. Data came from a convenience sample of pediatric OTs recruited through Spanish professional colleges and associations for a web-based survey, mixed-method research study. Thirty-five respondents were excluded because they didn't meet the eligibility criteria. Ninety-two responses were obtained for data analysis. Twenty-nine OTs (31.5%) work in schools (school-OTs), and sixty-three participants (68.5%) don't work there but collaborate with schools (non-school OTs). Participants support students with and without a medical diagnosis. Services provided by OTs external to the educational system are mainly funded by families or only partially covered. Findings show that most participants use standardized assessments and apply several intervention approaches. They believe there are barriers to the collaboration and implementation of occupational therapy services in schools. This preliminary study shows a need for changes in Spain's State and Regional Education legislation and provides recommendations to improve school service delivery. Pediatric OTs are encouraged to reflect on and identify opportunities for changes to enhance school-based occupational therapy practice in Spain. [ABSTRACT FROM AUTHOR]

Background/aim: Occupational therapists use different models and measurements for assessing children with attention-deficit/hyperactivity disorder (ADHD). One of those measurements is the Child Occupational Self-Assessment. In this study, concurrent validity of the Child Occupational Self-Assessment with Pediatric Quality of Life was tested in children with ADHD. Methods: A correlational study was conducted. The Child Occupational Self-Assessment and Pediatric Quality of Life were filled by 128 children with ADHD aged between 8 and 11 years. Findings: The results indicated that in competency subscale the highest correlation coefficient was for the total score of Pediatric Quality of Life (r = 0.56, p < 0.01) and the lowest was for social performance (r = −0.44, p < 0.01). The highest and lowest correlation coefficient in value subscale were for the total score (r = −0.46, p < 0.01) and emotional performance of Pediatric Quality of Life (r = −0.34, p < 0.01), respectively. Conclusions: The Child Occupational Self-Assessment has an acceptable concurrent validity with Pediatric Quality of Life. It can be a suitable measurement for assessing of children with ADHD. [ABSTRACT FROM AUTHOR]

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Background: Autism is a developmental disorder characterised by changes in social, communication, and behavioural performance. Assistance dogs can support children with autism to engage in everyday occupations. Despite more children being partnered with assistance dogs, there is limited research regarding the impact of assistance dogs on the occupational engagement of children with autism and their families, and further research is needed to fully understand the impact of this type of support within the Australian context. Objectives: To explore caregiver‐reported experiences of an assistance dog on the occupational engagement of children with autism and their families. Method: Using a qualitative approach, semi‐structured interviews were undertaken with six caregivers of seven children with autism, who each had an assistance dog. Interviews ranged from 45 to 60 minutes in duration. Data were transcribed verbatim and thematically analysed. Trustworthiness was maximised through independent recruitment, research team discussions, member checking, and a researcher reflective journal. Findings: Three themes were identified: participation in everyday occupations prior to and after partnering with an assistance dog, increased engagement in everyday occupations, and impact of the assistance dog on the family unit. Assistance dogs were reported to progress children from community 'isolation' to 'freedom'. Participants reported the dog increased children's capacities through positively influencing completion of routines, increasing independence, and improving therapy engagement. Assistance dogs were viewed as supporting the whole family's occupational engagement. Some challenges were identified with the introduction of the assistance dog to the family unit, and with animal maintenance costs and time demands, public access rights, and limited government funding. Conclusion: This research identifies benefits and challenges for children who partner with autism assistance dogs. It provides insights to inform assistance animal referral, assessment, and support of assistance dogs in Australia for children with autism and occupational therapists working with them. [ABSTRACT FROM AUTHOR]

Objective: Children with Attention Deficit Hyperactivity Disorder (ADHD) are often referred to Equine-Assisted Services (EAS) for therapy despite lack of validated protocols in the field. This paper reports the development and validation of ASTride (ADHD Skills Therapy): a protocol of Equine-Assisted Occupational Therapy (EAOT) intervention for children aged 6-12 with ADHD. The intervention addresses deficits in cognitive-emotional functions and participation. Method: Phase one of the intervention development includes theoretical framework and core content based on an in-depth review of existing literature. Subsequently, the intervention protocol was revised by a panel of experts. Phase two includes a pilot study, during which five children diagnosed with ADHD (mean age= 10.40 year, SD 2.966) participated in a 12-week EAOT intervention according to the suggested protocol, with pre- and post-assessments conducted. Results: Statistically significant improvements were found in executive functions, as reflected in the Behavioral Regulation Index (BRI) total score. Additionally, hope perception and everyday performance improved following the intervention. Conclusions: Results support the feasibility of ASTride intervention protocol for the improvement of cognitive and emotional functions as well as everyday performance. [ABSTRACT FROM AUTHOR]

Background: The purpose of this case study was to explore the effects of a school-based occupational therapy on children's attention, school adaptation, sensory processing, and motor function for children in special classes in elementary school in Korea. Case presentation: The subjects of this study were a 7-year-old boy with autism spectrum disorder and a 9-year-old girl with intellectual disability. The school-based occupational therapy program consisted of 10 sessions and was conducted once a week for an hour and a half. The program consisted of classroom activities, use of school facilities, emotional management, and activities based on sensory integration, and was conducted as individual and group programs according to sessions. As a result of the study, all improved when the pre- and post-scores of the two children's attention assessment, school adjustment scale, sensory processing evaluation tool for the children in school and BOT-2-SF were compared. Conclusions: Although the results from two cases cannot be generalized, the findings suggest the school-based occupational therapy program may help a positive effect on the school life of children with disabilities. Further investigation is necessary. [ABSTRACT FROM AUTHOR]

Our purpose was to explore the scope of nature-based interventions used in pediatric occupational therapy and identify gaps in existing literature. This scoping review was guided by Arksey and O'Malley's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) framework. We searched CINAHL, PubMed, PsycINFO, Web of Science, Embase, MEDLine, and gray literature, and we hand-searched included articles' references. We included studies published through June, 2021 that were in English, described a service provided by occupational therapists, with a population with at least 50% of participants ages 0–21 years, with nature as a primary context and treatment modality. Studies were excluded if they only described animal-assisted therapies or human-made structures. A total of 12 articles (two reporting quasi-experimental studies; 10 gray literature) met inclusion criteria. Articles described a variety of interventions, but there was a lack of rigor in included articles and no clear conceptualization of nature-based pediatric occupational therapy. Despite practitioner interest in the topic, there are two primary gaps in the literature: lack of a clear conceptualization of nature-based practices for occupational therapy and lack of articulation of the unique contribution of occupational therapy to nature-based practices. [ABSTRACT FROM AUTHOR]

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