Pediatric Occupational Therapy Process PDF

The OT Process in Pediatrics Chapter 1  Students will:  be introduced to fundamental concepts related to pediatric occupational therapy practice.  become familiar with key factors that are integral to being an excellent pediatric...

The OT Process in Pediatrics Chapter 1  Students will:  be introduced to fundamental concepts related to pediatric occupational therapy practice.  become familiar with key factors that are integral to being an excellent pediatric OT (developing cultural sensitivity, providing child-centered/family-centered services, utilizing top-down assessments, using EBP, Objectives building therapeutic relationships, and providing the just-right challenge to clients).  develop a basic understanding of: environmental modifications, service delivery models, how therapists work toward inclusion, and advantages of utilizing natural environments. https://sacredheart.edu/media/shu-media/occupational-therapy/Heather_Kuhaneck_500x500.jpg Photo link source https://www.une.edu/sites/default/files/styles/portrait/public/portraits/obrien_2 019.jpg?itok=fwEw1UJ- Photo link source Sacred Heart University Heather Kuhaneck PhD, OTR/L FAOTA Fairfield, CT University of new England Jane Clifford O’Brien PhD, OTR/L, FAOTA Portland, ME Editors Pediatric OT Practice  Largest single area of practice (NBCOT, 2018)  20% of OTs  15% of those work in schools Who is a child?  Typically B-18yr  Individuals with Disabilities Act (IDEA) 2004 states special education services end at 21yrs  AOTA B-21yrs  “occupation denotes personalized and meaningful engagement in daily life events by a specific client” (p. 7, AOTA, OTPF 4th, 2020). OT and Occupations “occupations refer to the everyday activities that people do as individuals, in families, and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do” (WFOT, 2012 quoted p. 7, AOTA, OTPF 4th, 2020). 3 Occupations in the 1990’s Wor ADL k Play 9 Occupations 2022 Educati Play Leisure ADLs on Social Health Participatio Work IADLs Sleep/Rest Manageme n nt Don’t Forget to “Leap & Swish”  Family-Centered 1 Strength-Based 2 Essential Concepts Cultural Sensitivity 3 Therapeutic Use of 4 Self   Core Concepts  Respectful  Appreciation  Family/professional collaboration Family-  What do parents want from an OT provider? Centered 1. Care 2. This Photo by Unknown Author is 3. licensed under CC BY-NC 4. 5. 6.  This Photo by Unknown Author is licensed under CC BY-SA-NC  What are benefits?  Strength Focus Strength- Based  Religion, Country, Region, SES, Gender, Age, Ethnicity, Race, etc. Cultural  What is culture?  Don’t Guess Awareness  Culture impacts occupations &  What are the benefits of striving to be culturally Sensitivity sensitive as an OT?  How is pediatric health This Photo by Unknown Author is licensed under CC BY-SA-NC  1. Developmental different from adult health?  2. Dependency  3. Differential Epidemiology  4. Demographic  5. Dollars What makes a culturally sensitive therapist?  Demonstrates understanding  Embraces diversity  Participates in traditions  Asks about routines, traditions, priorities  Integrates intervention into cultural practicies   What is therapeutic use of self? “planned use of [a therapist's] personality, perceptions, and judgments as part of the Therapeutic therapeutic process” (p. 285, Punwar & Peloquim, 2000; Taylor, Lee, Keilhofner, & Ketkar, 2009) Use of Self &  How do you build trust? Relationship  1. Building  2.  3.  4.  5.  Occupational Profile Top-Down Bottom-up Assessment types The OT Referral Theory Evaluati Context Process on is Key For evaluation and treatment Pediatric OT Intervention Essential Concepts   Social Justice  IDEA 2005: requires service to children as possible with children who do not have disabilities. LRE  Services for infants and toddlers in the “natural Inclusion environment”  How can treatment support inclusion?   Choice Preferred  Collaboration Occupations  Engaging & Client- Centered  CO-OP example of this treatment approach Create “Just- Right challenge” This Photo by Unknown Author is licensed under CC BY  Matches child’s interests and skills Modify/Adapt  Reasonable challenge Activities  Engage/Motivate  What are the benefits?   Requires Collaboration Modify/  Work to increase: comfort, safety, accessibility, sensory modulation supports, etc. Adapt  Assistive Technology (AT): low and high-tech Environmen This Photo by Unknown Author is licensed under CC BY-NC t to Enable Access & Participation Evidence-  “The conscientious, explicit and judicious use of current best evidence Based in making decisions about the care of Practice individual patients.” (Sackett et al., 1996) (EBP)  5 Use & Evaluate Appraise for 4 applicability to your practice EBP Steps 3 Appraise for: validity, impact, meaningfulness 2 Search databases for evidence 1 Create question   EBP is based on research EBP  Benefits of using AOTA EBP Guidelines and Clinical Use Guidelines  Improved outcomes Documente  Represents synthesis of research  d Effective  Grade recommendations Provides input of multiple experts, consensus Intervention  Illuminate what dx or type of intervention they support s  EBP works best when decisions reflect clinician experience, family priorities, and research evidence Educate & Advocate for Others  Consulting/Coaching  Education/Advocacy  Interprofessional Teamwork (see Competency Engage in Domains, p. 11) Competent  Clients & Professionals Interprofessio nal Practice   Multiple ways to practice skill Plan  Natural environment Intervention  Educate (caregivers, teachers, support people) s that  Based on: Generalize  Collaboration with child and family  Collaborate when establishing goals, home programs Across must be partnership  Focus to achieve goals, supporting caregivers Environmen implementing  Evaluate outcomes ts   Direct Service  Indirect Delivery  In Education Setting: “push-in” or “pull-out”, Direct and Indirect (consulting, advocating, RTI, etc.), block Models scheduling, co-teaching  Fluid service delivery How is Pediatric Practice Different from Adult Practice?  Specific laws related to pediatric services  Provide services in schools  Funding services (CHIP, Medicaid)  Developmental stages  Caregivers  Navigate differing goals/views of client vs. caregivers  Have to figure out what a child wants in ways that may not be as big a challenge with adults  Greater focus on play and education  Kids can say “NO” in ways that are different from adults   OTs provide child-centered/family-centered services that are meaningful, appropriate, motivating, and the “just right challenge”  OTs must be culturally sensitive and aware  Use top-down and bottom-up assessment, incorporate Summary EBP in practice  OTs advocate and provide treatment using a variety of service models  King, G., & Chiarello, L. ( 2014). Family-centered care for children with cerebral palsy: Conceptual and practical considerations to advance care and practice. Journal of Child Neurology, 29(8), 1046-1054. O'Brien. C., & Kuhaneck, H. (2020). Case-Smith’s occupational therapy for children and adolescents. St. Louis: Elsevier. NBCOT. (2018). Practice analysis of the occupational therapist registered. https://www.nbcot.org/-/media/NBCOT/PDFs/2017-Practice- Analysis-Executive- under CC BY-NC-ND This Photo by Unknown Author is licensed Sources OTR.ashx?la=en Punwar, J., & Peloquim, M. (2000). Occupational therapy: Principles and practice. Philadelphia: Lippincott. Ridgway, J. L., et al. (2017). Conceptualising paediatric health disparities: A metanarrative systematic review and unified conceptual framework. BMJ Open, 7(8), e015456. Taylor, R. R., Lee, S. W., Kielhofner, G., & Ketkar, M. (2009). Therapeutic use of self: A nationwide survey of practitioners’ attitudes and experiences. The American journal of Occupational Therapy, 63(2), 198.