Occupation-Centred Practice with Children
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Notes on Contributors xi
Foreword xv
Preface xvii
Acknowledgements xix
1 Introduction to Occupation?]centred Practice for Children 1
Sylvia Rodger and Ann Kennedy?]Behr
Introduction 1
Re?]affirming occupation: The core of occupational therapy 5
External influences impacting occupational therapy practice 6
International Classification of Functioning, Disability and Health (ICF) 8
United Nations' declarations 9
The evolution of occupational therapy practice with children 11
Changing views of child development and maturation 11
Emerging views about occupational development 13
Re?]focusing occupational therapy with children 14
Conclusion 15
References 16
2 Becoming an Occupation?]centred Practitioner 21
Sylvia Rodger and Ann Kennedy?]Behr
Introduction 21
Theoretical underpinnings of occupational therapy with children 22
Occupation?]centred and performance?]component focused approaches to practice with children 23
Characteristics of occupation?]centred practice for children 28
Focus on occupational performance and participation throughout the process 30
Conclusion 39
References 40
3 Child and Family?]centred Service Provision 45
Sylvia Rodger and Deb Keen
Introduction 45
Defining the client: Who and how many? 46
Client?]centred practice 46
Child?]centred practice 48
Family?]centred practice and service provision 49
Family?]centred practice, family?]centred services and family?]centred care 51
Becoming a child?] and/or family?]centred practitioner 52
Developing family?]centred services 55
Outcomes of family?]centred practice and family?]centred services and their measurement 61
The extended family and community 64
Conclusion 65
References 66
4 Cultural Influences and Occupation-centred Practice with Children and Families 73
Alison Nelson, Chrisdell McLaren, Tara Lewis and Michael K. Iwama
Introduction 73
Culture and the occupations of the child 74
Culturally responsive occupational therapy 75
The child's and family's stories are central 76
Getting connected 77
Being connected 78
Staying connected 80
Building connections 82
Case studies 82
Making the invisible visible 88
Conclusion 88
References 89
5 Occupational Goal Setting with Children and Families 91
Nancy Pollock, Cheryl Missiuna and Judy Jones
Introduction 91
Giving children and families a voice 92
Goal setting and motivation 93
Goal setting and outcomes 94
Tools to facilitate goal setting with children and families 94
Summary 102
Goal setting contributes to outcome measurement 102
Case studies: Goal setting with children and parents 103
Conclusion 106
References 106
6 Occupational Transitions for Children and Young People 111
Sok Mui Lim and Fiona Jones
Introduction 111
Definition of transition using a life course perspective 112
Transition from home to early childcare centres 112
Transition from early childhood care to primary school 116
School readiness 118
Transition to secondary school 121
Tips for transition to secondary school 125
Transition to post?]school options 127
Conclusion 129
References 129
7 Assessing Children's Occupations and Participation 133
Chi?]Wen Chien and Ted Brown
Introduction 133
Bottom?]up or top?]down approaches to assessment? 135
Occupation?] and Participation?]Centred Assessment with Children (OP?]CAC) framework 137
Implementation of Occupation?] and Participation?]Centred Assessment with Children (OP?]CAC) framework: Assessment in action 138
Occupation?] and Participation?]Centred Assessment with Children (OP?]CAC) framework: Tools 141
Conclusion 159
References 159
8 Cognitive Orientation for Daily Occupational Performance (CO?]OP): An Occupation?]centred Intervention 165
Sylvia Rodger and Helene Polatajko
Introduction 165
CO?]OP: A brief overview 166
CO?]OP Approach: An occupation?]centred intervention 169
Review of handwriting intervention 183
Conclusion 183
References 184
9 Perceive, Recall, Plan and Perform (PRPP): Occupation?]centred Task Analysis and Intervention System 189
Christine Chapparo
Introduction 189
Information processing, cognitive strategy use and occupational performance 190
The Perceive, Recall, Plan and Perceive (PRPP) System of Task Analysis and intervention 192
Using the PRPP system of task analysis and intervention: David 196
'Perceive': Observing and prompting sensory processing strategies during task performance 198
'Recall': Observing strategies used for storage and retrieval of information during task performance 199
'Plan': Processing information for organizing and problem?]solving 201
Conclusion 205
References 206
10 Occupational Performance Coaching (OPC): Enabling Caregivers' and Children's Occupational Performance 209
Fiona Graham, Sylvia Rodger and Ann Kennedy?]Behr
Introduction 209
Theoretical and philosophical basis 210
Three enabling domains 211
Research about OPC 228
Conclusion 229
References 229
11 Occupation?]centred Intervention in the School Setting 233
Elizabeth Hinder and Jill Ashburner
Understanding the occupations of the school student 235
Educationally relevant occupational therapy in schools 236
Ways of working in schools 238
Planning educational programmes for diverse learners 238
Occupation?]centred information gathering in educational settings 240
Occupation?]centred programme planning and intervention in schools 244
Collaboration in service delivery 245
Conclusion 249
References 250
12 Occupation?]centred Practice: When the Classroom Is Your Client 257
Karina Dancza, Cheryl Missiuna and Nancy Pollock
Introduction 257
Practicalities of implementing occupation-centred classroom-based practice 259
Partnering for Change: A description of the model 269
Conclusion 275
Acknowledgements 275
References 278
13 Enablement of Children's Leisure Participation 289
Anne A. Poulsen and Jenny Ziviani
Introduction 289
Outcomes of leisure engagement 291
Engaging and Coaching for Health - Child: Model of leisure coaching 292
Step One: Creating successful engagements 294
Step Two: Coaching to promote personal growth 298
Conclusion 308
References 308
14 The Arts and Children's Occupational Opportunities 311
Dido Green and Jenny Ziviani
Introduction 311
The affordances of the arts 312
Overview of arts in children's health care 312
Role of creativity and the performing arts within childhood play: Identity, imitation and imagination 313
Skill acquisition and empowerment 316
Motivation and motivationally enhanced learning 317
Self?]reflection, feedback and competition 318
Emerging evidence for creative performing arts in therapies for children 320
Conclusion 323
References 324
15 Using Animals to Support Children's Occupational Engagement 329
Anja Junkers and Ann Kennedy?]Behr
Introduction 329
AAT as an enabler of occupational engagement 331
Theory in AAT 332
Attachment patterns, secure child-therapist relationships, and the effects of human-animal interaction 332
Physiological stress response 333
Understanding the individual meaning of engagement in human-animal interaction 334
Methods of AAT 335
AAT to support an increase in desired social behaviours/attention in social interaction 336
Using AAT to facilitate social interaction and positive social attention 337
Assisting participation in meaningful activities 339
Decision?]making in AAT 341
Conclusion 344
References 345
16 Decision?]making for Occupation?]centred Practice with Children 349
Jodie Copley, Sally Bennett and Merrill Turpin
Introduction 349
Decision?]making and information sources 350
Information from clients, families and their contexts 351
Information about the practice context 356
Information from empirical research 357
Information from clinical experience 360
Integrating information given alternatives and uncertainties 361
Shared decision?]making 365
Conclusion 367
References 368
Appendix 1 Assessments Referred to Throughout the Book 373
Index 377
Chapter 1
Introduction to Occupation-centred Practice for Children
Sylvia Rodger and Ann Kennedy-Behr
If we don't stand up for children, then we don't stand for much.
Marian Wright Edelman
Preliminary questions
- Why a book on occupation-centred practice for children?
- Think about your childhood: what did you most like doing?
- Think about your childhood: what did you least like doing?
- What were the environments that you engaged in (e.g. home, park, school, neighbourhood)? How did they afford opportunities for occupation?
- Did you play sports, learn an instrument or go to clubs or organised activities?
- How might your childhood be different to those of children today?
- How might living in the city vs country, suburb vs. high rise impact on children's occupations?
Introduction
The primary aim of this chapter is to set the scene for this book and in doing so to fulfil the following objectives:
- Briefly describe the resurgence of occupation within the occupational therapy profession.
- Outline some global trends that have occurred in parallel with the refocusing of the profession.
- Describe some of the challenges to traditional developmental theory that has historically informed occupational therapy practice with children, as well as emerging views and theories of occupational development that have the potential to better inform our practice with children and their families.
- Identify the impact of these professional and global trends on occupational therapy practice with children.
Children engage in many social and occupational roles every day. They are variously grandchildren, children, nieces/nephews, siblings, friends, peers and playmates. In addition, they are school or kindergarten students, players or self-carers/maintainers, albeit they are developing independence and autonomy in these latter roles (Rodger, 2010; Rodger and Ziviani, 2006). Healthy active children engage in occupations relevant to these roles all the time: they play, dress, eat, manage their personal care needs, engage in household chores and schoolwork tasks and extra-curricular activities, such as soccer, ballet, scouts, tae kwon do and playing musical instruments. Children engage in these occupations in a range of environments, such as with their families at home, friends at school and in their communities (e.g. church, neighbourhoods, local parks, sports clubs) (Rodger and Ziviani, 2006).
The children's artwork in Figure 1.1 and Figure 1.2 illustrates the daily occupations of two boys, one growing up in metropolitan Brisbane, Australia and the other in a village in East Timor. Figure 1.1 illustrates the boy's daily life with family, friends and his occupations of schoolwork, playing sports, ball games, listening to music and the importance of school. By contrast, Figure 1.2 illustrates the outdoor environment in which this Timorese boy lives, his home, the hills, his village and his role in tending crops. These drawings demonstrate some of the many cultural differences in children's occupations and daily lives.
Figure 1.1 Daily life and occupations of a boy aged 11 years in metropolitan Brisbane.
Source: Courtesy of Thomas Beirne (2008).
Figure 1.2 Daily life and occupations of a boy aged 15 years in East Timorese village.
Source: Courtesy of Jorge do Rosario (2008).
Typically, occupational therapists come into contact with children when there are concerns about their occupational performance (e.g. ability to engage fully in their roles, issues with performance of tasks or activities associated with various occupations, or environmental hindrances to their performance and participation). However, it has been proposed (Rodger and Ziviani, 2006) that as a profession we also have a role in advocating for children's place and rights in society, their need for health-promoting occupations and for safe, supportive, healthy environments that can optimise their occupational performance and participation. This may be through supporting campaigns promoting healthy lifestyle choices such as: having smoking banned in children's playgrounds, lobbying for traffic calming and pedestrian footpaths/pavements to enable safe walking to school, advocating for more green spaces, such as parks, and raising awareness about excessive involvement in virtual environments (e.g. computers and handheld games) which may lead to decreased engagement in physical activity and social isolation. In recent times, issues of children's health and well-being in detention centres have been raised in Australia, and elsewhere in conflict zones and refugee camps. From an occupational perspective, these environments lead to significant occupational deprivation for detainees, and impact negatively on children's development and mental health (Australian Human Rights Commission, 2014). In essence, occupational deprivation is caused by the lack of access to the typical activities, routines and objects (toys, books, games, outdoor recreation spaces) that support children's development and skill acquisition due to the restrictive institutional environment of detention centres.
There are many advocacy and professional groups whose websites provide information for parents about children's health and well-being issues such as the American Academy of Pediatrics (http://www2.aap.org/obesity/community_advocacy.html?technology=2) and Play Australia, which promotes the value of children's play (https://www.playaustralia.org.au/).
In addition, we have a role as individuals, health professionals and occupational therapists to advocate for children whose lives are deprived of health-giving occupations and safe environments as a result of war, natural disasters, dislocation, social disadvantage, poverty or neglect/abuse, for example the World Federation of Occupational Therapists Position Statement on Human Rights (WFOT, 2006) and the Occupational Opportunities for Refugees and Asylum Seekers (OOFRAS, 2016). The WFOT (2006, p. 1) Position Statement declares occupation a human right. Specifically it espouses a series of principles:
- People have the right to participate in a range of occupations that enable them to flourish, fulfil their potential and experience satisfaction in a way consistent with their culture and beliefs.
- People have the right to be supported to participate in occupation, through engaging in occupation, to become valued members of their family, community and society.
- People have the right to choose for themselves, to be free from pressure, force or coercion, in participating in occupations that may threaten safety, survival and health, and those occupations that are de-humanising, degrading or illegal.
- The right to occupation encompasses civic, educative, productive, social, creative, spiritual and restorative occupations.
- At a societal level the right to occupation is underpinned by the valuing of each person's unique contribution to the valued and meaningful occupations of society and is ensured by equitable access to participation regardless of difference.
- Abuses to the right to occupation may take the form of economic, social or physical exclusion through attitudinal or physical barriers, or through control of access to necessary knowledge, skills, and resources, or venues where occupation takes place.
- Global conditions that threaten the right to occupation include poverty, disease, social discrimination, displacement, natural and man-made disasters, and armed conflict.
While this book focuses primarily on the occupational therapy practitioner engaging with children and their families at an individual, group or family level, it also addresses occupation-centred practice in school environments (Chapter 11) and in the context of community-based leisure pursuits (Chapter 13). The broader benefits of occupational engagement for children who are deprived of occupations is not specifically addressed; however, readers are encouraged to consider the opportunities they may have for advocacy and engagement at a societal and political level in instances where children experience poor health (Spencer, 2008) or occupational deprivation, alienation and injustice (Kronenberg et al., 2005; Whiteford and Wright St-Clair, 2005).
Re-affirming occupation: The core of occupational therapy
Over the past several decades, there has been a major focus within occupational therapy on the provision of client-centred services, with its counterparts in child- and family-centred practice. Emanating from Canada, the emphasis on guidelines for enabling occupation- and client-centred practice has spread throughout the occupational therapy profession internationally (CAOT, 1991; Sumsion, 1996). This is discussed at length in Chapters 2 and 3.
There has also been a resurgence of interest in occupation at the core of occupational therapy. This occurred in response to critical reflection by a number of occupational therapy theorists and researchers (e.g. Clark, 1993; Fisher, 1998; Kielhofner, 2007; Molineux, 2004; Pierce, 2001; Yerxa, 1998). This has led to the reclamation of occupation as the defining feature of our profession and practice focused on occupation, its meaning for individuals, its importance for health...
