Occupational Therapy Interventions for Children Ages Birth-5 Years.

Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's (AOTA's) Evidence-Based Practice Project. This article presents a case example of a young child with autism spectrum disorder who receives occupational therapy evaluation and intervention in natural environments (home and child care center). Systematic review findings supporting enhancement of key life occupations through interventions to develop cognitive, motor, social-emotional, and self-care skills for young children were published in AOTA's Occupational Therapy Practice Guidelines for Early Childhood: Birth-5 Years (Frolek Clark & Kingsley, 2020) and the March/April 2020 issue of the American Journal of Occupational Therapy (Gronski & Doherty, 2020; Kingsley et al., 2020; Tanner et al., 2020). Each article in the Evidence Connection series applies evidence from the published reviews on a topic to a related case. These articles are designed to promote application of the evidence to practice.

Occupational Therapy Practice Guidelines for Early Childhood: Birth-5 Years.

IMPORTANCE: This Practice Guideline provides stakeholders with a condensed summary of a large number of effectiveness studies. It is a valuable tool for facilitating decision making related to occupational therapy interventions for children ages birth-5 yr. OBJECTIVE: Early childhood (birth-5 yr) is a critical period in which the foundation of key life occupations is developed (e.g., eating, dressing, play, learning, social participation, rest and sleep, and chores). The development of cognitive, motor, social-emotional, and self-care skills is important to support these occupations. This Practice Guideline synthesizes recent systematic reviews (SRs) on these areas of development to promote decision making for and high-quality interventions with this population. METHOD: Four SRs related to cognition, mental health, motor function, and ADLs analyzed studies published from 2010 to 2017 retrieved from six electronic databases (MEDLINE, PsycINFO, CINAHL, ERIC, OTseeker, and Cochrane). RESULTS: A total of 196 articles were included in the SRs, which served as a guide to final clinical recommendations. Case studies describe translation and application to practice. CONCLUSION: and Recommendations: A variety of interventions within the domain of occupational therapy were found to support the development of cognitive, social-emotional, motor, and self-care skills. Although some of these interventions are typically implemented by occupational therapy practitioners, others can be implemented by parents after training or by teams working in preschool settings. These findings should be used to inform evidence-based practice provided by occupational therapy practitioners working in various early childhood settings. WHAT THIS ARTICLE ADDS: This Practice Guideline gives occupational therapy practitioners clear information about which interventions will be effective for specific outcomes. Better intervention choices mean better outcomes for young children and their families.

Occupational Therapy Interventions for Children and Youth With Challenges in Sensory Integration and Sensory Processing: A Clinic-Based Practice Case Example.

Evidence Connection articles provide case examples of how practice decisions may be informed by findings of systematic reviews sponsored by the American Occupational Therapy Association (AOTA) Evidence-Based Practice (EBP) Project. This Evidence Connection article describes a case report of a child with a diagnosis of autism spectrum disorder who has difficulties in function and participation related to challenges in sensory integration. This article is the first in a two-part series, and it focuses on occupational therapy provided to the child by a clinic-based therapist in collaboration with the child's school-based occupational therapist. Part 2 in this series will describe the same child's intervention by the school-based therapist. Intervention decisions are informed by findings of systematic reviews of intervention effectiveness that were part of an AOTA EBP Project addressing occupational therapy interventions for children and youth with challenges in sensory integration and sensory processing.

Occupational Therapy Interventions for Children and Youth With Challenges in Sensory Integration and Sensory Processing: A School-Based Practice Case Example.

Evidence Connection articles provide case examples of how practice decisions may be informed by findings of systematic reviews sponsored by the American Occupational Therapy Association Evidence-Based Practice Project. This Evidence Connection article is the second article in a two-part series. The first article described a case report of occupational therapy provided to a child with a diagnosis of autism spectrum disorder and challenges in sensory integration in a clinic setting (Parham et al., 2019). This article describes the same child's occupational therapy service delivery by the occupational therapist working in the school setting.

Effectiveness of Cognitive and Occupation-Based Interventions for Children With Challenges in Sensory Processing and Integration: A Systematic Review.

This systematic review examines the evidence for the effectiveness of cognitive and occupation-based interventions to improve self-regulation in children and youth who have challenges in processing and integrating sensory information. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guided the methodology. Five studies identified through a comprehensive database search met the inclusion criteria and were separated into categories of cognitive and occupation-based interventions. Articles that did not specifically measure sensory integration (SI) or processing challenges were omitted. Synthesis of the articles suggests that self-regulation (e.g., sensory processing, emotional regulation, executive functioning, social function) improved with cognitive and occupation-based interventions. Because the number of studies that measured sensory processing or SI challenges was limited, researchers are encouraged to include these measures in future research to understand the impact of a broader range of cognitive and occupation-based interventions.

Providing occupational therapy using sensory integration theory and methods in school-based practice.

AOTA recognizes SI as one of several theories and methods used by occupational therapists and occupational therapy assistants working with children in public and private schools. Regardless of the theories and methods utilized, occupational therapy practitioners work within the framework of occupational therapy toward the desired outcome of health and participation through engagement in occupations that allow participation in a child's daily life (AOTA, 2008). When children demonstrate sensory-related deficits that interfere with their ability to access the general education curriculum, occupational therapy using a sensory integrative approach is appropriate.

Guidelines for supervision, roles, and responsibilities during the delivery of occupational therapy services.

These guidelines about supervision, roles, and responsibilities are to assist in the appropriate utilization of occupational therapists, occupational therapy assistants, and occupational therapy aides and in the appropriate and effective provision of occupational therapy services. It is expected that occupational therapy services are delivered in accordance with applicable state and federal regulations, relevant workplace policies, the Occupational Therapy Code of Ethics (AOTA, 2005), and continuing competency and professional development guidelines.

Applying sensory integration framework in educationally related occupational therapy practice (2003 statement).

Based on the educational team recommendations, occupational therapists and occupational therapy assistants working in educationally related settings provide services to students who are eligible for Section 504 or special education under IDEA and need occupational therapy to benefit from their education program. It is the occupational therapist's responsibility to develop an intervention plan based on the student's needs and the therapist's professional knowledge base. The occupational therapist chooses and applies any frame of reference within the domain and process of occupational therapy. Regardless of the frame of reference utilized, the desired outcome of occupational therapy services is always engagement in occupations that allows participation in a student's daily life. When students demonstrate deficits in sensory integration that contribute to a significant and documented discrepancy in their skills within their educational program, the use of a sensory integrative approach may be one frame of reference for, intervention chosen by the occupational therapist.

Guidelines for supervision, roles, and responsibilities during the delivery of occupational therapy services (2004).

These guidelines about supervision, roles, and responsibilities are to assist in the appropriate utilization of occupational therapy personnel and in the appropriate and effective provision of occupational therapy services. All personnel are expected to meet applicable state and federal regulations, adhere to relevant workplace policies and the Occupational Therapy Code of Ethics (AOTA, 2000), and participate in ongoing professional development activities to maintain continuing competency.