Ability Partners have sourced the journal article, Effectiveness of paediatric occupational therapy for children with disabilities, to inform clinical practice for an existing case. Our NDIS client was diagnosed with ASD, ADHD, SPD and ODD, and has impairments with developing independence, regulating senses and emotions and life skills.
Paediatric Occupational Therapy (OT)
A child’s life roles include:
- Developing personal independence
- Becoming productive
- Participating in play or leisure pursuits
Inability to participate in these roles due to health, disability or skill deficits can result in marginalisation, social isolation and lowered self-esteem.
40 different interventions received a strong recommendation for use, indicating high-quality evidence base with more benefits than harms. In general, these interventions focused on top-down approaches which are focused on collaborative, strengths-based approaches rather than bottom-up approaches which focus on the disability and deficits.
Methodology Review:
- Systematic review – Level 7
- Information reviewed came from existing SR’s and appraised RCT’s
- 9 different databases searched, literature from 2014-2018 increasing validity
- Studies only involving atypical development were included
- GRADE framework was used to eliminate studies of low quality
- 12 articles were ultimately included, spanning 52 interventions across 22 diagnoses and 135 intervention outcome indicator
Limitations
Though the best quality evidence was reviewed, this limited the ability to include other forms of intervention and reporting bias could be a factor. There was no direct information and training on specific interventions either.
What does this mean?
Parent partnership with OT (family-centred care) is preferred to achieve outcomes. In terms of activity-based interventions that a Paediatric OT helps to deliver, the following list from top down offers greater capacity building:
- Bimanual training (CP)
- CIMT
- Co-op
- Goal-directed training
- Social-skills training
The process of effective paediatric OT follows,
- Beginning with the goal
- Practicing of activity in natural environment
- Intense repetition to activity plasticity
- Scaffolded practice – Scaffolding is the process of breaking an activity into manageable units. The Paediatric OT provided decreasing levels of support as the child grasps new concepts and builds their capacity.
Occupational Therapy for children
If you have a participant who needs support with developing independence or regulating senses and emotions, get in touch today!
Our Occupational Therapists will focus on your child’s strengths and work in a family-centred way. Make a referral now.
Journal Article
Novak, I & Honan, I 2019, ‘Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review’, Australian Occupational Therapy Journal, vol. 66, pp. 258-273, https://doi.org/10.1111/1440-1630.12573.
