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Volume 76, Number 1
From the Editor
Extending an invitation for discussion and debate
Sacred texts: A sceptical exploration of the assumptions underpinning theories of occupation
Karen Whalley Hammell
Background. Occupational therapists share some basic assumptions about occupation that are rarely challenged and are held to be true. These assumptions underpin our theories of human occupation. Purpose. To probe some of the core assumptions that inform current occupational therapy theory and to determine whether these are culturally specific or have supporting evidence. Key issues. Evidence suggests that some of occupational therapy’s entrenched assumptions reflect specific rather than universal perspectives; that many meaningful occupations cannot be categorized as self-care, productivity or leisure; that the concept of leisure is an ableist, class-bound, and culturally specific concept; that current models of occupation overlook activities motivated by connections to others; that productivity is not universally perceived to be central to life's meaning nor universally experienced as a positive contributor to health; and that independence is not universally prized. Implications. Occupational therapy’s theories of occupation would benefit from a sound evidence base derived from diverse cultural perspectives.
Occupational therapy theory , Models, Critical thinking , Culture , Post-colonial theory
Exploring a cognitive intervention for children with pervasive developmental disorder
Shanon Phelan, Laura Steinke, Angela Mandich
Background. Pervasive developmental disorders (PDD) affect approximately 3–4% of the childhood population. PDD pervades every aspect of a child’s life, having significant adverse effects on occupational performance. Purpose. This study investigates a new treatment approach to treating children with PDD, the Cognitive Orientation to Occupational Performance (CO-OP). CO-OP emphasizes problem-solving strategies and guided discovery of child- and task-specific strategies. Method. Three goals were established in collaboration with the parents and the child. Pre- and post-measures of parents’ perceptions of child performance were identified using the Canadian Occupational Performance Measure (COPM). Repeated measures were taken using clinical observations, video analysis, and the Performance Quality Rating Scale (PQRS). Findings. Improved COPM ratings of performance and satisfaction were observed, and these results were paralleled by improved PQRS scores. Practice Implications. Self-report and observer report together provide preliminary evidence of the effectiveness of the CO-OP approach with children who have PDD supporting the use of CO-OP and suggesting further investigation.
Pervasive developmental disorders, Motor skills, Cognitive intervention
A reflection on motor learning theory in pediatric occupational therapy practice
Jill G. Zwicker, Susan R. Harris
Background. Theory provides a guide to clinical practice. To date, the most prevalent theories in pediatric occupational therapy practice are sensory integration and neurodevelopmental treatment. Purpose. The purpose of this paper is to present a brief overview and reflection on motor learning theories as well as a summary of motor learning principles that can be used in pediatric practice. Key Issues. Over the past two decades, motor learning theory has been applied in adult occupational therapy practice, but it has been slow to gain popularity in pediatrics. Implications. Although therapists may be tacitly applying motor learning principles in practice, conscious and deliberate application of these principles to a variety of pediatric populations is required to determine if motor learning theory provides a viable and effective contribution to evidence-based, occupational therapy pediatric practice. Further research comparing motor learning interventions to other dominant interventions in pediatric occupational therapy is warranted.
Motor learning, Theory, Pediatric practice, Occupational therapy
Factors predicting applicant outcomes in occupational therapy education
Rosemary Lysaght, Catherine Donnelly, Michelle Villeneuve
Background. Student selection for health science programs is a complex process designed to identify individuals who are most likely to succeed academically and professionally. There is limited evidence supporting specific admission criteria beyond the pre-admission GPA, and no strong evidence substantiating the need for specific academic prerequisites. Purpose. This study examined the predictive value of selected pre-admissions criteria relative to student outcomes in a master of occupational therapy program. Methods. The study involved analysis of data for 129 students admitted to a new master in occupational therapy program. Findings. Results show strong support for the pre-admission academic average as a selection criterion and limited support for referee ratings. No evidence was found linking pre-admission coursework to subsequent performance in courses of similar content. Implications. Results provide evidence upon which to ground admissions decisions, and point to the need for further examination of the value of extensive pre-admission course requirements.
Student selection, Student retention, Health sciences education
Hunter-gatherers and the behavioural ecology of human occupation
Mark J. Hudson, Mami Aoyama
Background. Despite growing interest in indigenous peoples within occupational therapy in Canada and elsewhere, there has been little consideration of hunter-gathering—an occupation that retains great material and symbolic significance for many indigenous groups. Purpose. A preliminary analysis of occupational behaviour amongst hunter-gatherers was conducted to aid understanding of the nature and evolution of human occupations and inform policy in indigenous occupational therapy. Methods. Human behavioural ecology was used to analyze four aspects of hunter-gatherer occupations: occupational diversification, the sexual “division of labour,” the long dependence of juveniles on adult provisioning, and active foraging by postmenopausal women. Findings. It was concluded that many occupational adaptations of human foragers can be related to life-history traits, namely slow maturation, long lifespans, weaning before independent feeding, and postmenopausal longevity. Implications. Further research will help understand how our hunter-gatherer heritage has affected the evolution of occupational behaviour and to develop program designs using foraging occupations.
Hunter-gatherers, Indigenous occupational therapy, Human behavioural ecology, Occupational diversification, Program design
How interdisciplinary pediatric practitioners choose assessments
Jessica Kramer, Patricia Bowyer, Jane O’Brien, Gary Kielhofner, Vanessa Maziero-Barbosa
Background. The assessment process affects the direction and quality of the services children and youth with disabilities receive. However, little is known about how practitioners choose tools and strategies to assess clients. Purpose. To identify processes practitioners use to gather information and choose methods of assessment in pediatric practice. Methods. Three focus groups were held with teams of interdisciplinary pediatric practitioners. Key themes were identified. Findings. Two primary themes emerged: “Things practitioners want to know” and “Choosing what and how to assess.” Practitioners began the assessment process wanting to gather information about children and their environment. Practitioners then used the initial information to decide what and how to further assess as described by three subthemes: “fitting” the child, balancing formal and informal information, and professional context. Implications. Practitioners generally made individualized assessment choices for each child based on the initial information they gathered and then used a balance of formal and informal assessments. However, they were more likely to formally assess children at the level of body structures and function rather than participation, and continued to rely upon such standardized assessments to meet reimbursement and policy requirements.
Clinical reasoning, Pediatric assessment, Participation assessment