Students with intellectual and developmental disabilities (IDD) have been found to participate less in school-based activities.
This study aimed to examine the effectiveness of a combined in-service and collaborative consultation intervention model for enhancing classroom participation of students with IDD.
The Collaborative Consultation for Participation of Students With IDD (Co-PID) program involved a multidisciplinary team (an occupational therapist and 17 teachers) as well as 35 students and was compared to an in-service program (20 teachers and 34 students). Students were 8 to 20 years old. The programs aimed to enhance three classroom participation components: communicating, choosing, and initiating.
The Co-PID was found to significantly improve students’ participation in all areas, whereas the participation of the students in the in-service group decreased.
A school-based multidisciplinary intervention program for students with IDD, combining in-service and collaborative consultation (e.g., Co-PID), may assist in enhancing classroom participation among students with IDD.
The idea of empowerment permeates the occupational therapy literature yet has received little critical reflection from occupational therapy’s theorists.
This paper aims to explore the concept of empowerment and highlight a recent definition that resonates with occupational therapists’ core values.
Empowerment is generally understood to be a process of bestowing power and giving ability to someone deficient in both. However, a new definition provides a framework for understanding how empowerment might enhance people’s capabilities.
The World Bank’s depiction of empowerment fits well with occupational therapists’ beliefs in the importance of the ability and opportunity to "do," providing a framework for action. This framework focuses on people’s capabilities: their freedom—or opportunity—to choose what they wish to do and to be and their ability to act on these wishes. Moreover, the World Bank’s assertion that empowered people have freedom of both choice and action suggests empowerment is a relevant concept for occupational therapists.
There is a need for a conceptual practice model that explicates ecological complexities involved in using occupation to optimize the quality of life of institutionalized people with dementia.
This study aimed to prepare the Lived Environment Life Quality Model, a dementia-specific conceptual practice model of occupational therapy in institutional facilities, for publication and application to practice.
Interviews and focus groups with six expert occupational therapists were subjected to qualitative content analysis to confirm, disconfirm, and further develop the model.
The model’s lived-environment domain as the focus of assessment and intervention was extensively confirmed, and its quality-of-life domain as the focus of intervention goals and outcomes was both confirmed and further developed.
As confirmed in this study, the Lived Environment Life Quality Model is a client-centred, ecologically valid, and occupation-focused guide to optimizing quality of life of institutionalized adults with dementia in present moments and progressively over time.
Although the idea of occupational injustice pervades the occupational therapy literature, there has been little scholarly debate concerning this construct or the parameters of the five identified forms of occupational injustice.
The aims of this paper are to highlight conceptual confusions, foreground some inherent questions that have been neither acknowledged nor addressed, and question the theoretical and practical utility of five manifestations of occupational injustice.
Few theorists have contributed to the occupational injustice literature. Significant definitional confusion exists concerning the five forms of occupational injustice with some forms described as subsets of others. The inherent problems of judging occupational injustice have not been addressed.
If occupational injustice were understood as a violation of occupational rights—human rights to achieve well-being through occupation—many of the problems of identifying a situation of occupational justice or injustice would be resolved. Using the capabilities approach to human rights would facilitate this endeavour.
Occupational justice is cited throughout the occupational science and occupational therapy literatures despite little scholarly attention either to its definition or to how situations of occupational justice are identifiable.
This paper aims to contribute a critique of occupational justice, explore the concepts of justice and (occupational) rights, and support a capabilities approach to inform rights-based occupational therapy practices.
No clear definition of occupational justice or differentiation from social justice exists despite the longevity of the concept, and theorists frequently confuse the concepts of justice and rights. A rights-based focus provides an unambiguous mandate for occupational therapists, with the capabilities approach offering a cross-disciplinary framework to inform rights-based practices.
The concept of occupational rights is consistent with the rights-based focus advocated by the disabled people’s movement, articulated by the United Nations’ Convention on the Rights of Persons With Disabilities, and affirmed by the World Federation of Occupational Therapists’ position on the centrality of occupation to health, well-being, and human rights.
Currently, Canada and the United States are the only two countries that mandate entry to the occupational therapy profession at the master’s level. There was a recommendation considered by the American Occupational Therapy Association that by 2025 all education programs would move to the clinical doctorate level. In August 2015, the Accreditation Council for Occupational Therapy Education made the formal decision that for now, the entry-level qualification for occupational therapists in the United States will remain at both the master’s and clinical doctorate levels.
This article presents an overview of the types of doctorates available, the pros and cons of moving to the clinical doctorate, and some potential questions that will need to be considered.
Is the next step in the educational progression of occupational therapy in Canada the entry-level clinical doctorate? What are the potential implications for the profession, our clients, and funders?
Further discourse and investigation of this issue is needed.
The Cognitive Orientation to daily Occupational Performance (CO-OP) approach—now trademarked as the CO-OPApproach—was introduced in the literature in 2001 as an intervention to improve real-world performance in children with developmental coordination disorder. CO-OP has since appeared in numerous publications and has seen adoption with various populations. No compilation of the CO-OP literature is available.
The purpose of this scoping review was to examine the extent (number) and nature (features and characteristics) of the literature on CO-OP.
Using the scoping review methodology outlined by Arksey and O’Malley, 10 online databases were searched for materials discussing CO-OP. Materials found were reviewed by two reviewers, independently. Articles were categorized according to identified study characteristics.
In all, 94 documents were found, including 27 research articles examining application and adaptations of CO-OP with eight populations. In all cases, the approach was deemed useful; however, in many cases, adaptations to the CO-OP protocol were recommended.
CO-OP has been applied with a number of populations. There is now sufficient research to warrant a systematic review of the research literature.
Evidence supports validity of the Personal Care Participation Assessment and Resource Tool (PC-PART), but clinical utility remains unverified.
This study aimed to investigate occupational therapists’ perceptions about the PC-PART’s clinical utility for inpatient rehabilitation.
Using mixed methods, occupational therapists who had used the PC-PART as part of a research study in an inpatient rehabilitation setting completed a questionnaire (n = 9) and participated in a focus group (n = 6) to explore their perspectives about its clinical utility. Quantitative data were summarized and qualitative data analyzed using inductive thematic analysis.
Quantitative data highlighted both positive and negative aspects of the PC-PART’s clinical utility. Five themes emerged from the qualitative data: nature of information gathered; familiarity with the instrument; perceived time and effort; item phrasing, interpretation, and presentation; and external influences on clinical use.
The PC-PART was perceived to support gathering of clinically useful information, helpful to intervention and discharge planning. Recommendations for improving some item phrasing, operational definitions, and instructions were identified. Although standardized assessments were valued, use in routine practice was challenging, requiring a knowledge translation strategy.
Participation in occupations is a basic human right. Although people with schizophrenia commonly experience restrictions in participation, there is a paucity of research in this area.
This study aimed to compare the participation patterns of people with schizophrenia to people without mental illness (control group).
A total of 140 people of similar age and sex completed the Adults Subjective Assessment of Participation and provided demographic and health-related data.
People with schizophrenia tend to participate in fewer activities and to participate alone. However, they participate with similar intensity as those in the control group.
The participation patterns of people with schizophrenia are both unique and similar to those of the general population. The differences in participation raise concerns due to signs of restriction and social exclusion. However, it appears that people with schizophrenia benefit from occupation and community-based services that promote and support participation with others in diverse activities.
Increasingly, community development is recognized as an important process for occupational therapy practice. However, occupational therapists working in community development report feeling unprepared.
This study aimed to identify the knowledge, skills, and experiences that occupational therapists need for practice in community development.
Using the Delphi technique, the researchers developed statements from the Round 1 (n = 8) responses of occupational therapists involved in community development practice or scholarship. Rounds 2 (n = 14) and 3 (n = 12) sought to establish consensus among the occupational therapists on the areas of focus.
Participants rated the importance of 64 statements grouped into 11 domains. After three rounds, researchers eliminated six statements by analyzing the median, interquartile range, and percentage of agreement. Participants reached consensus on 58 statements.
Many of the competencies identified were relevant to all areas of practice, while others were specific to community development, suggesting a need for specialized education and training in this area. The results provide information that can be used to enhance the preparation of occupational therapists for practice in community development.
Foundational to the occupational therapy profession is the belief that engagement in occupation is health promoting; however, this belief fails to account for occupational engagement that may be risky or illness producing. Consensus regarding the nature of the relationship between occupation and health has yet to be achieved.
The purpose of this study is to provide a comprehensive description of how the relationship between occupation and health and well-being is discussed within the occupational therapy and occupational science literature.
The methodological framework outlined by Arksey and O’Malley served as the basis for this scoping review of the occupational therapy and occupational science literature.
One hundred and twelve articles were identified as meeting the criteria for inclusion. The dominant discourse portrays the relationship between occupation and health as positive.
The broader literature suggests that occupational engagement can have both positive and negative effects on health and well-being. As such, the reconceptualization of the relationship between occupation and health and well-being is warranted to enable occupational therapists to practise in a more client-centred manner.
Values are evident in health ethics literature; however, it is seldom clear how they are visible in practice.
The aim of this study was to illuminate how values inform occupational therapists’ decision making in practice.
Fifteen New Zealand community occupational therapists completed this embedded experimental mixed-methods study. A pre-deliberation questionnaire was completed prior to deliberation of a case study using web-based values transparency software, the Values Exchange, followed by a post-deliberation questionnaire. Categorical data were analyzed using non-parametric statistics. Written responses to open questions were thematically analyzed.
Most participants disagreed with the proposed action for the case. Degrees of divergence, concern for dignity and risk, and values-based reasoning were found, revealing how ethical deliberation was values based.
Recognition and transparency of the values inherent in practice-based decision making is possible and desirable in promoting sound ethical reasoning.
For many working-age cancer survivors, return to work represents a quality-of-life indicator. However, there is currently a lack of resources to assist survivors with navigating this process.
As a first step toward informing resources to address this gap, 10 female survivors’ return-to-work experiences were explored.
Photovoice methods were combined with interviews. Photographs and text were analyzed to identify key themes.
Return to work was psychosocially motivated. Survivors independently decided if they would take leave and, if so, when they would return to work. Successful work reintegration was characterized as respectful, collaborative, and customized to each survivor’s ongoing limitations and variable recovery.
The findings underscore a holistic, client-centred, and collaborative approach to successful return to work with cancer survivors. Occupational therapists, with their vocational rehabilitation knowledge and responsive practice philosophy, are well positioned to address this gap in survivorship support.
Many occupational therapy programs have augmented curricula to provide students with opportunities to engage in international fieldwork placements (IFPs). However, limited research exists exploring the perceived influence that IFPs may have on future occupational therapy roles and characteristics.
The purpose of this study is to explore how Canadian occupational therapists who participated in IFPs as students perceive the influence of their IFP experience on their subsequent practice.
Semi-structured interviews were conducted with 20 occupational therapists who participated in IFPs as occupational therapy students. The interview guide was developed based on the Profile of Occupational Therapy Practice in Canada and relevant literature. A directed content analysis was used in conjunction with the DEPICT model of data analysis to guide the analysis process and summarize the results.
Participants described how IFPs nurtured the development of six skills, or active ingredients, which supported the development of competence in occupational therapy roles. IFPs were also perceived as providing a competitive edge.
This study suggests that IFPs shape the development of competence in key practice skills and occupational therapy roles.
The concept "everyday" appears unchallenged and problematic when applied to people who experience disrupted lives through illness or disability.
This study draws upon social and philosophical theory to review the relevance of the concept "everyday" when applied to contemporary occupational therapy and the lives of individuals who experience biographical disruption.
A literature review guided by a scoping framework was undertaken followed by a critical analysis drawing on Bauman to determine the frequency and meaning of the concept "everyday" used in the occupational therapy and occupational science literature.
Definitions of the "everyday" are used infrequently despite recurrent use of the concept. A large proportion of literature reviewed in this manuscript does not acknowledge or discuss the philosophical and sociological influences that contribute to an understanding of the "everyday," leaving the reader to make her or his own interpretations.
Reconceptualizing lived "everyday" experience within the contextual "here and now" provides a postmodern "episodic" lens for occupational therapists working with individuals who experience biographical disruption.
The similarities between health promotion and occupational therapy have been recognized. Both are based on perspectives that share a goal of enabling individuals and populations to improve control over their health. Consequently, it is logical that the principles of health promotion complement the practice of occupational therapy.
This paper highlights the affinity between occupational therapy and health promotion, and discusses ways in which health promotion principles can be incorporated into occupational therapy practice.
Some Canadian occupational therapists may be unaware of the current discourse in health promotion and, thus, may not be incorporating its principles into practice. Steps are warranted to expand the current knowledge and practice of therapists to include health promotion, with specific attention to providing services for the population.
Incorporating health promotion principles into occupational therapy perspectives will facilitate the implementation of the domains of practice within the occupational therapy profile. This paper highlights how the principles of health promotion can impact practice at the individual and community level.
Background: The Canadian Model of Occupational Performance and Engagement depicts individuals embedded within cultural environments that afford occupational possibilities. Culture pertains not solely to ethnicity or race but to any dimension of diversity, including class, gender, sexual orientation, and ability. Purpose. This paper highlights specific dimensions of cultural diversity and their relationships to occupational engagement and well-being. Key issues. Cultural variations constitute the basis for a socially constructed hierarchy of traits that significantly determine occupational opportunities and impact mental health and well-being. Cultural humility is an approach to redressing power imbalances in client-therapist relationships by incorporating critical self-evaluation and recognizing that cultural differences lie not within clients but within client-therapist relationships. Implications. It is proposed that theoretical relevance would be enhanced if culturally diverse perspectives were incorporated into theories of occupation. Cultural humility is advocated as an approach to theoretical development and in efforts to counter professional Eurocentrism, ethnocentrism, and intellectual colonialism.
Background. Theory is important to the growth and evolution of occupational therapy. However, use of theory remains challenging for many therapists. Purpose. The aim was to develop a process that occupational therapists could apply to advance theory in practice. Method. Based on a review of the literature and using a qualitative instrumental case study design, 18 student occupational therapists and eight fieldwork educators completed online modules on the theory advancement concepts generated from the literature, wrote journals, and/or participated in online discussions during fieldwork. Following fieldwork, educators were interviewed and students participated in focus groups exploring their experiences. Directed content analysis was used to analyze the data. Findings. Based on the data collected, we developed the Theory Advancement Process (TAP). The TAP is composed of four primary contexts, a climate of collaborative relationships with four key elements, and four essential processes. Implications. The TAP presents a collaborative process for students, faculty, and therapists to work together to advance the use of theory in practice.
Background. Increasingly recognized as an important factor in the performance of complex, goal-directed tasks, executive functioning is understood in different ways across disciplines.Purpose. The aim was to explore the ways in which executive functioning is conceptualized, discussed, described, and implied in the occupational therapy literature.Method. A scoping review of the occupational therapy literature was conducted following Levac, Colquhoun, and O’Brien’s (2010) recommended methodology.Results. Executive functioning is described both as a set of performance component skills or processes and as the executive occupational performance inherent in complex occupations. Executive functioning is implicit in occupational performance and engagement, and some health conditions seem to be commonly associated with impaired executive functioning. Assessing executive functioning requires dynamic occupation- and performance-based assessment. Interventions targeting executive functioning are grounded in metacognitive approaches.Conclusion. Executive functioning is a complex construct that is conceptualized with considerable variance within the occupational therapy literature, creating barriers to effective service delivery.
Background. The Canadian occupational therapy profession has proclaimed its allegiance to client-centred practice for three decades. However, official definitions of client-centred practice have been inconsistent, and its defining features, underlying assumptions, and power relations have been subjected to little critical reflection.Purpose.The aim was to reflect critically on Canadian conceptions of client-centred practice and its core values.Key issues. Definitions of client-centred practice have evolved and changed, suggesting that the occupational therapy profession in Canada may have abandoned those values that originally underpinned its vision of client-centred practice by electing to focus on the enabling skills of therapists. However, evidence suggests that clients value those qualities of client-centred practice that underpinned the profession’s original vision.Implications. This paper proposes a renewed focus on respect—respect for clients; respect for clients’ strengths, experience, and knowledge; respect for clients’ moral right to make choices concerning their lives—and on fostering respectful, supportive relationships with clients.
Background: Enhancing occupational therapy practice requires critical examination of assessment tools and the conclusions being drawn from their use. When working with cognitively impaired older individuals, judgments about occupational competence are often informed by an assessment of cognitive competence. Purpose: The Cognitive Competency Test (CCT) is a frequently used measure in Canada to inform predictions of occupational competence. However, there is an absence of published evidence that addresses its validity. Methods: To appraise validity of the CCT, a retrospective chart review (n = 107) of CCT reports for inpatient and outpatient clients with cognitive impairment was conducted. Data were subjected to exploratory factor analyses to examine the factor structure, and the measure was compared with commonly used clinical variables reflecting cognitive and occupational competence. Findings: Results suggest that the CCT measures a unitary construct and provide some support for its predictive capacity. Implications: CCT scores can add incremental validity to cognitive screens, such as the Mini Mental State Exam, when evaluating occupational competence.