1
|
Lage CR, Wright S, Monteiro RGDS, Aragão L, Boshoff K. Collaborative practice with parents in occupational therapy for children: A scoping review. Aust Occup Ther J 2024; 71:833-850. [PMID: 38923569 DOI: 10.1111/1440-1630.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/20/2024] [Accepted: 05/18/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION In childhood intervention, parent-therapist collaboration is central to the family-centred approach. Despite long-standing discussion in occupational therapy literature, the field faces challenges, including inconsistent terminology and difficulties in translating theory into practice. This paper represents the first part of a comprehensive scoping review study aimed at developing foundational concepts for collaborative practices with parents in occupational therapy for children. Therefore, this paper focusses on mapping existing practices, types, and approaches articulated in the literature. METHODS We searched English-language sources published worldwide from 1998 to 2022 discussing collaborative practices with parents in occupational therapy for children aged 0-10 with any diagnosis, including multidisciplinary practices. Seven databases were searched. Data from peer-reviewed indexed literature, theses and dissertations, and book chapters were extracted and analysed through basic numerical and descriptive analyses before being synthesised into similar categories. The Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic reviews and Meta-Analysis-extension for Scoping Reviews were used. RESULTS The scoping review yielded 299 papers. Parent-therapist collaboration was prominent in clinics, family homes, schools, and hospitals, particularly during therapy implementation, goal setting, and planning. Most reported practice types included 'interventions with parent engagement', 'parent-directed interventions', and 'parent education'. 'Family-centred', 'occupational-focussed', and 'client-therapist collaborative' approaches were frequently mentioned. There were inconsistencies in the terms used to describe collaborative practice characteristics. CONCLUSION Over the past 24 years, the collaborative practice literature has expanded and evolved, with parent-therapist collaboration observed across various occupational therapy settings. Inconsistencies in this collaboration across different therapeutic stages were revealed, which could impact intervention success and sustainability. Further research is needed to explore parent-therapist collaboration mechanisms within and across stages. This scoping review also underscores the need for a common framework to guide practice and research. PLAIN LANGUAGE SUMMARY This literature review explores how occupational therapists and parents work together in childhood intervention. Collaboration is essential for understanding and meeting children's needs within their family and community settings. However, occupational therapists and parents face challenges in applying family-centred practices and using a common language to bridge theory with practice. To address these challenges, we examined 299 papers published between 1998 and 2022 to understand how collaborative practices with parents have been described in the literature. Our review revealed that therapists and parents collaborate across various settings, such as clinics, schools, homes, and hospitals, mainly during therapy sessions, goal setting, and planning interventions. Collaborative practices take different forms. For instance, therapists often encourage parents to actively engage and take the lead in therapy, requiring therapists to recognise and respect parents' priorities and learning preferences. They often develop strategies together to support the child within family routines. While we found several studies on therapist-parent collaboration, the review outlined inconsistencies in how this practice was described and applied, which could affect its success. Therefore, more research is needed to understand the best ways in which collaboration can occur at each stage of therapy. The need for a core guideline for collaborative practice with parents in occupational therapy was also observed. While therapist-parent collaboration is used in occupational therapy for children, there is a clear need to minimise inconsistencies and gaps found in the literature, as well as to ensure a common language to promote intervention quality and success.
Collapse
Affiliation(s)
- Carla R Lage
- Allied Health and Human Performance, Occupational Therapy Program, University of South Australia, Adelaide, South Australia, Australia
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Shelley Wright
- Allied Health and Human Performance, Occupational Therapy Program, University of South Australia, Adelaide, South Australia, Australia
| | - Rafaelle G de S Monteiro
- Department of Applied Social Sciences, Technological University of the Shannon: Midlands Midwest, Limerick, Ireland
| | - Luisa Aragão
- Department of Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Kobie Boshoff
- Allied Health and Human Performance, Occupational Therapy Program, University of South Australia, Adelaide, South Australia, Australia
- Innovation, Implementation and Clinical Translation in Health (IIMPACT), Adelaide, South Australia, Australia
| |
Collapse
|
2
|
Albaum CS, Sellitto T, Vashi N, Bohr Y, Weiss JA. Treatment Engagement as a Predictor of Therapy Outcome Following Cognitive Behaviour Therapy for Autistic Children. J Autism Dev Disord 2024; 54:3575-3586. [PMID: 37642867 PMCID: PMC11461639 DOI: 10.1007/s10803-023-06083-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Active engagement in one's therapy is a key contributor to successful outcomes. Research on child engagement in cognitive behaviour therapy (CBT) has largely focused on youth without autism. This longitudinal study examined multiple indicators of child engagement in relation to outcomes for autistic children who took part in CBT for emotion regulation. METHOD Data were collected from 60 autistic children who were between 8 and 13 years of age (86.7% male; Mage = 9.58 years, SD = 1.44 years; 75% White). Indicators of child engagement included independent observer ratings of in-session involvement, as measured by the Child Involvement Rating Scale, and therapist ratings of the therapeutic relationship and homework completion using single-item measures. Indicators of engagement were measured at early (i.e., first third), middle (i.e., mid third), and late (i.e., final third) stages of treatment. Parent-reported emotion regulation was the primary treatment outcome, as measured by the Emotion Regulation Checklist. RESULTS After controlling for pre-treatment scores, in-session involvement significantly predicted some aspects of post-treatment emotion regulation, whereas therapeutic relationship and homework completion did not. CONCLUSIONS Child in-session involvement throughout therapy may be particularly relevant for treatment change. Addressing issues related to in-session involvement early in treatment may help to promote therapeutic success for autistic children.
Collapse
Affiliation(s)
- Carly S Albaum
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Teresa Sellitto
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Nisha Vashi
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Yvonne Bohr
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| |
Collapse
|
3
|
Chan-Víquez D, Fernández-Huertas H, Montserrat-Gonzalez C, Khan A, Fehlings D, Munce S, Wright FV, Biddiss E. Feasibility of a home-based home videogaming intervention with a family-centered approach for children with cerebral palsy: a randomized multiple baseline single-case experimental design. J Neuroeng Rehabil 2024; 21:151. [PMID: 39227911 PMCID: PMC11373410 DOI: 10.1186/s12984-024-01446-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 08/13/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Worldwide, children with cerebral palsy (CP) living in underserved communities face barriers to accessing motor therapy services. This study assessed the implementation and effectiveness of an 8-week, upper limb (UL) home-based intervention with a movement-tracking videogame (Bootle Blast) in Costa Rican children with CP. METHODS Children established a weekly playtime goal and two UL activities of daily living (ADLs) that they would like to improve on. A multiple-baseline, single-case experimental design, was used with the Performance Quality Rating Scale (PQRS) as the repeated measure to track changes in performance of the selected ADLs between the baseline (usual care) and intervention (Bootle Blast) phases. The Canadian Occupational Performance Measure (COPM), the Box and Blocks Test (BBT) and the Children's Hand-Use Experience Questionnaire (CHEQ) were collected before and after the intervention. Technical barriers were documented during weekly video calls with a monitoring therapist. Treatment effect size, slope changes and percentage of non-overlapping data were identified for the PQRS. Descriptive statistics summarized results for the BBT, CHEQ, videogame logs (e.g., playtime) and technical barriers. RESULTS Fifteen children participated and 13 completed the intervention. Both participants who dropped out did so after completing baseline assessments, but before experiencing Bootle Blast. Children's mean active playtime (i.e., mini-games targeting the UL) across the 8-weeks was 377 min, while mean total time spent engaging with Bootle Blast (active + passive play time [e.g., time navigating menus, reviewing rewards]) was 728 min. In total, eight technical issues (from five children) were reported, and all but three were resolved within 48 h. Partial effectiveness was associated with the intervention. Specifically, 85% of participants improved on the PQRS and 69% achieved clinically important improvements ≥ 2 points in performance on the COPM. Children improved by 1.8 blocks on average on the BBT, while on the CHEQ, five children had a clinically important increase of 10% of the total number of UL activities performed with both hands. CONCLUSION Bootle Blast is a feasible and effective option to facilitate access and engage children with cerebral palsy in UL home rehabilitation. Trial registration Trial registration number: NCT05403567.
Collapse
Affiliation(s)
- Daniela Chan-Víquez
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | | | | | - Ajmal Khan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Darcy Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Sarah Munce
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - F Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Elaine Biddiss
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada.
| |
Collapse
|
4
|
King G, Phoenix M, VanderKaay S, Pinto M. Seeing the light versus being in the dark: parent, child, and service providers' use of metaphors to express system complexity, therapy engagement, and personal experiences of adaptation. Disabil Rehabil 2024; 46:4176-4186. [PMID: 37807674 DOI: 10.1080/09638288.2023.2266372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 09/20/2023] [Accepted: 09/29/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE To describe parent, child, and service providers' use of metaphors to communicate the meaning of participation in life and therapy engagement in the field of childhood disability. METHODS Metaphors concerning participation and engagement were extracted from 59 qualitative articles recommended by a group of experts in pediatric rehabilitation. A systematic process of metaphor analysis was used, involving identification of source and target domains, categorization into target-source groupings, and interpretation. RESULTS 209 metaphors were identified and categorized into seven target-source groupings. These seven groupings reflected environmental, interpersonal, and personal domains of experience: (a) the service system and life context, (b) the interpersonal therapy context, and (c) personal aspects. Together, the groupings expressed experiences concerning service system complexity, therapy engagement, and personal experiences of adaptation. Speakers used several metaphor dichotomies to express different experiences (e.g., open vs closed doors to opportunities). CONCLUSIONS When service providers pay attention to clients' use of metaphors, this can lead to a deeper, more evocative understanding of the meaning of their participation and engagement experiences. Service providers can use metaphors generated by clients to communicate their understanding to clients, thereby creating a common ground for collaboration and assisting clients to interpret their experiences in different ways.
Collapse
Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Michelle Phoenix
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- School of Rehabilitation Science and CanChild, McMaster University, Hamilton, Canada
| | - Sandra VanderKaay
- School of Rehabilitation Science and CanChild, McMaster University, Hamilton, Canada
| | - Madhu Pinto
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| |
Collapse
|
5
|
King G, Chiarello LA, McLarnon MJW, Einarson KM, Pinto M. Reliability and validity of a measure of service providers' perceptions of child and parent engagement in pediatric rehabilitation therapy sessions. Child Care Health Dev 2024; 50:e13319. [PMID: 39090032 DOI: 10.1111/cch.13319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 01/11/2024] [Accepted: 07/19/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND There is growing interest in client engagement in pediatric rehabilitation. This article investigated the psychometric properties of a measure of service providers' perceptions of the affective, cognitive and behavioural engagement of both children with disabilities and their parents in pediatric rehabilitation therapy sessions. METHODS Test-retest reliability of the Pediatric Rehabilitation Intervention Measure of Engagement-Service Provider version (PRIME-SP) was examined using engagement ratings made by 60 service providers for 77 children and 73 parents. Construct validity was examined using the known-group validity technique, utilizing service providers' ratings of the engagement of parents and their children attending the same session with the service provider. We hypothesized that there would be significantly different, yet moderately correlated engagement ratings for children and their parents. RESULTS There was evidence of moderate test-retest reliability for the child ratings, indicative of dynamicity across occasions, but also a degree of consistency, as aligned with our expectations. Service providers' ratings of parent and child engagement were not significantly correlated and paired t-tests indicated significantly higher engagement scores for parents than children. CONCLUSIONS The study provides preliminary evidence to support the reliability and validity of the PRIME-SP as a tool for service providers to document, reflect on and monitor child and/or parent engagement.
Collapse
Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Lisa A Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Kathleen M Einarson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Madhu Pinto
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| |
Collapse
|
6
|
Karni-Visel Y, Baum N, Schertz M. Understanding autism and its treatment: The child's perspective. Soc Sci Med 2024; 354:117066. [PMID: 38943777 DOI: 10.1016/j.socscimed.2024.117066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/31/2024] [Accepted: 06/20/2024] [Indexed: 07/01/2024]
Abstract
INTRODUCTION While parents' and professionals' perceptions regarding children with autism spectrum disorder (ASD) have been studied extensively, limited data regarding the perspectives of children with ASD on their needs and the challenges they face are available. The study aimed to examine how children with ASD understand their condition and the aims of the interventions they undergo. METHODS Nineteen children and adolescents (ages 5.7-14.2 years) formally diagnosed with ASD, with borderline to high intelligence (range 70-140), and able to converse verbally were interviewed in person at a child development clinic. A qualitative approach was used to capture children's perceptions of their strengths and challenges and their understanding of a novel ASD treatment. The interview included direct and projective open-ended questions on each topic. Interpretive content analysis was used to evaluate the children's answers. Medical data were extracted from medical records. The children's parents completed questionnaires on their children's disability levels, awareness of ASD diagnosis, and sociodemographic details. FINDINGS Children spoke of their embodied sensations and feelings and discussed "normality" vs. "disability." They varied in their awareness of their diagnosis/symptoms, and only one boy named his diagnosis and described its consequences in detail. Most children lacked an understanding of the educational and therapeutic aspects of the goals set for them. DISCUSSION AND CONCLUSIONS Children with ASD are aware of their unique emotional and behavioral challenges. Nevertheless, they are frequently excluded from the process of patient information provision and lack an understanding of the goals of interventions. Findings suggest the need to explore developmentally and emotionally adaptive ways to involve children with ASD in discussions of their condition and possible interventions.
Collapse
Affiliation(s)
- Yael Karni-Visel
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel.
| | - Nehami Baum
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | - Mitchell Schertz
- Child Development and Pediatric Neurology Service, Meuhedet Health Services, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
7
|
Aewerdieck LM, Martin RA, Graham FP, Hay-Smith J. Exploring In-Session Engagement in Equine-Assisted Services for Children and Youth Experiencing Disability: A Scoping Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024. [PMID: 38976484 DOI: 10.1089/jicm.2024.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Aims: The purpose of this review was to identify and describe the evidence about children and youth engagement during equine-assisted services (EAS). Methods: Five databases (Scopus, Web of Science, PsycINFO, CINAHL, and MEDLINE) were systematically searched. Included studies reported research about EAS conducted in children and youth and presented findings about in-session engagement or associated concepts such as motivation, involvement, and participation. Extracted data (study type, equine intervention, population, and the studies' key focus) were summarized descriptively, followed by inductive content analysis of the main mechanisms proposed to influence engagement. Results: In total, 30 studies were identified; however, only three centered on rider engagement as the primary focus of research. Other publications addressed in-session engagement within service descriptions or results and discussion sections. Three mechanisms that influence engagement within EAS were derived: (1) the unique EAS landscape, (2) the horse-child relationship and (3) the provider-child relationship. The literature primarily referred to horses as the most important factor influencing child and youth engagement in EAS sessions. Little attention was given to the influence of service providers', parents', or child preferences on engagement. Conclusions: The child/youth-parent-provider relational triad and specific strategies to improve rider engagement within EAS sessions warrants further investigation.
Collapse
Affiliation(s)
- Lena M Aewerdieck
- Department of Medicine, Rehabilitation Teaching and Research Unit, University of Otago Wellington, Wellington South, New Zealand
| | - Rachelle A Martin
- Department of Medicine, Rehabilitation Teaching and Research Unit, University of Otago Wellington, Wellington South, New Zealand
| | - Fiona P Graham
- Department of Medicine, Rehabilitation Teaching and Research Unit, University of Otago Wellington, Wellington South, New Zealand
| | - Jean Hay-Smith
- Department of Medicine, Rehabilitation Teaching and Research Unit, University of Otago Wellington, Wellington South, New Zealand
| |
Collapse
|
8
|
Harniess PA, Basu AP, Bezemer J, Gibbs D. How do parents frame their engagement experience in early intervention? A grounded theory study. Disabil Rehabil 2024; 46:3067-3076. [PMID: 37652081 DOI: 10.1080/09638288.2023.2242788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE Parent and therapist engagement and partnership are critical in early intervention physiotherapy and occupational therapy for infants with cerebral palsy to improve outcomes. The main aim of this study was to understand how parents perceive their engagement experience in early intervention over time. METHODS Grounded theory methodology was used. Twenty parents of diverse backgrounds participated in 22 interviews (including some repeated longitudinally) to reflect on their engagement experience within the context of early intervention community services provided in the UK NHS. RESULTS The findings highlight how parents' perspectives of their engagement in EI change according to critical circumstances, including their preceding neonatal trauma, the at-risk CP label, firmer diagnosis of CP and their child's response to intervention. We theorise that this disrupted transition experience to parenthood becomes part of parental framing (or sense-making) of their engagement in EI. Overlapping frames of uncertainty, pursuit and transformation capture and explain nuances in parents' engagement patterns within EI over time. CONCLUSION This theorising has implications for early intervention therapists in how they engage in the lives of families and partner with parents to support healthier parental transition, wellbeing and subsequent improved infant outcomes.
Collapse
Affiliation(s)
- Phillip Antony Harniess
- Institute of Education, UCL, London, UK
- Community Paediatric Physiotherapy, Guys' and St Thomas' NHS Foundation Trust, London, UK
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter, Exeter, UK
| | - Anna Purna Basu
- University of Newcastle Population Health Sciences Institute, Callaghan, UK
- Paediatric Neurology, Great North Childrens Hospital, Newcastle upon Tyne, UK
| | | | - Deanna Gibbs
- Barts Health NHS Trust, London, UK
- Clinical Research for Neonates and Children, Queen Mary University, London, UK
| |
Collapse
|
9
|
Chan-Víquez D, Fernández-Huertas H, Chacón-Vargas F, Montserrat-Gonzalez C, Fehlings D, Munce S, Virginia Wright F, Biddiss E. Family expectations and demand for home-based videogaming therapy in children with cerebral palsy in Costa Rica: a mixed methods study. Disabil Rehabil 2024:1-12. [PMID: 38946018 DOI: 10.1080/09638288.2024.2362952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 05/28/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE To understand the expectations and demand for a movement-tracking videogame (Bootle Blast) for home-based, upper limb (UL) rehabilitation among Costa Rican children with cerebral palsy (CP). METHODS Data were collected via telephone screening (demand) and child-parent dyads Zoom interviews (expectations). Descriptive statistics and data transformation were used to report on demand success criteria (i.e., recruitment rate, having an appropriate screen and space to play, setting a weekly play time goal (PTG) ≥45 min, identifying one UL therapy goal). The DEPICT model for collaborative qualitative analysis was used in the thematic analysis of interview data. RESULTS Fifteen dyads participated (1.6 ± 1 recruited/month). All had a flat-screen TV in a suitable location to play, were able to set a UL therapy goal, and established PTGs ranging from 45-120 min per week. Identified themes were: 1) Socio-cultural factors heighten demand, 2) Feelings of hope prevail for the intervention, and 3) Collaborative goal setting supports realistic expectations for Bootle Blast. CONCLUSIONS Dyads had positive and realistic expectations about implementing the proposed videogaming intervention. This study provides insights on tailoring a family-centered, therapy gaming intervention to improve access to motor rehabilitation for children with CP in rural/remote settings and low-middle income countries.
Collapse
Affiliation(s)
- Daniela Chan-Víquez
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | | | | | | | - Darcy Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Sarah Munce
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - F Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Elaine Biddiss
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| |
Collapse
|
10
|
Granlund M, Imms C. Participation as a means-implications for intervention reasoning. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1399818. [PMID: 38994330 PMCID: PMC11236800 DOI: 10.3389/fresc.2024.1399818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/06/2024] [Indexed: 07/13/2024]
Abstract
Introduction The increased focus among researchers and professionals on participation as an explicit intervention outcome has prompted a paradigm shift in both thought and practice. However, much research centers on altering participation outcomes in specific life situations and stages. This discussion paper considers "participation as a means" in pediatric rehabilitation and special education interventions, emphasizing its role in achieving lasting outcomes. Method This paper uses a Venn diagram approach to consider relations between three core concepts-participation, intervention, and outcomes-and their intersection. The paper's central theme revolves around the intersection of these concepts, wherein participation serves as a means to achieve enduring participation outcomes within the realms of rehabilitation and special education. The discussion is supported by contemporary empirical work and from literature identified in two recent scoping reviews focusing on the intervention process. Results Achieving enduring participation outcomes through participation in the intervention process necessitates creating a learning experience, with children and families actively participating in every step: identifying participation issues, seeking explanations, prioritizing intervention goals, selecting methods, implementing interventions, and evaluating the process and outcomes. Discussion This structured approach supports professionals and researchers to foster the skills and capacity required for lasting participation outcomes for children with impairments.
Collapse
Affiliation(s)
- Mats Granlund
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Christine Imms
- Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
11
|
Gellatly R, Boustani M, Nair P, Mahajan R, Jambhale A, Sahu R, Chodankar B, Krishna M, Malik K, Mathur S, Becker K, Michelson D, Patel V, Chorpita B. Adolescent engagement in a stepped care, transdiagnostic mental health intervention delivered in Indian schools. DISCOVER PSYCHOLOGY 2024; 4:43. [PMID: 38686018 PMCID: PMC11057193 DOI: 10.1007/s44202-024-00154-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/12/2024] [Indexed: 05/02/2024]
Abstract
Given the relationship between poor engagement and worse treatment outcomes, improving engagement has been the focus of attention in recent years. Engagement is a particular challenge among minoritized and otherwise challenged youth, such as those from socioeconomically disadvantaged groups, including youth in low- and middle-income countries (LMICs), where they face lower levels of access to resources, including mental health treatment. The present study describes engagement challenges that arose in an uncontrolled pre-post evaluation of a school-based, modular, multi-problem, stepped-care intervention delivered in urban Indian communities. Specifically, the study aimed to (1) characterize barriers and facilitators of youth treatment engagement; and (2) evaluate treatment acceptability and fit of treatment from the youth perspective. Youth participants completed semi-structured interviews, which were transcribed and coded using thematic analysis. Participants described numerous facilitators to engagement (e.g., positive therapeutic relationship) and reported high overall satisfaction with the intervention, while also identifying barriers to engagement (e.g., concerns about confidentiality) and offering suggestions to increase fit and acceptability (e.g., more visually appealing treatment materials). Findings highlight ways in which engagement can be enhanced and implementation supports improved to maximize treatment effectiveness among minoritized and disadvantaged youth in LMICs. Supplementary Information The online version contains supplementary material available at 10.1007/s44202-024-00154-1.
Collapse
Affiliation(s)
- Resham Gellatly
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
| | | | | | | | | | | | | | | | - Kanika Malik
- PRIDE Project, Sangath, New Delhi India
- Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonipat, Haryana India
| | | | - Kimberly Becker
- Department of Psychology, University of South Carolina, Columbia, SC USA
| | - Daniel Michelson
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Vikram Patel
- PRIDE Project, Sangath, New Delhi India
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA USA
| | - Bruce Chorpita
- Department of Psychology, University of California, Los Angeles, CA USA
| |
Collapse
|
12
|
Lebrault H, Martini R, Manolov R, Chavanne C, Krasny-Pacini A, Chevignard M. Cognitive Orientation to daily Occupational Performance to improve occupational performance goals for children with executive function deficits after acquired brain injury. Dev Med Child Neurol 2024; 66:501-513. [PMID: 37792283 DOI: 10.1111/dmcn.15759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 10/05/2023]
Abstract
AIM To determine the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach in improving the occupational performance goals of children and young people with executive function deficits after acquired brain injury (ABI) (e.g. etiologies such as stroke, encephalitis, brain tumor, and traumatic brain injury). METHOD A replicated single-case experimental study using a randomized multiple baseline design across participants and goals was used. Three clusters of four participants (12 participants, nine males and three females, aged 8-16 years) were included. The intervention consisted of 14 individual CO-OP sessions. Each participant chose four goals; three goals were trained during the intervention sessions and a fourth goal served as the control. The Goal Attainment Scale (GAS) was used as a repeated measure to determine goal achievement while the Canadian Occupational Performance Measure (COPM) was used to identify the perceived goal achievement of children, young people, and their parents. RESULTS For 26 of the 35 trained goals, the intervention led to statistically significant improvements in the GAS. Perceived occupational performance and satisfaction improved significantly for the trained goals (30 out of 35 goals for the COPM performance and satisfaction of participants; 26 out 31 goals for the COPM performance of parents; 24 out of 31 goals for the COPM satisfaction of parents) and were maintained at the follow-up. Almost all COPM control goal results were significant, but these changes were not supported by the GAS measures or the statistical analysis. INTERPRETATION The generally positive results of this study provide evidence of the benefits of using the CO-OP approach with this population.
Collapse
Affiliation(s)
- Hélène Lebrault
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint-Maurice Hospitals, Saint-Maurice, France
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
- Sorbonne Université, GRC 24, Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
| | - Rose Martini
- Occupational Therapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Rumen Manolov
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Céline Chavanne
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint-Maurice Hospitals, Saint-Maurice, France
| | - Agata Krasny-Pacini
- Pôle de Médecine Physique et de Réadaptation, Institut Universitaire de Réadaptation Clemenceau (IURC), Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Unité INSERM 1114 Neuropsychologie Cognitive et Physiopathologie De La Schizophrenie, Département De Psychiatrie, University of Strasbourg, Strasbourg, France
| | - Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint-Maurice Hospitals, Saint-Maurice, France
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
- Sorbonne Université, GRC 24, Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
| |
Collapse
|
13
|
Moon DJ, Nichols CB, Zhang Y, Cruce A, Haran H, Sgourakis A, Lee H, Johnson-Motoyama M. Engagement Measures in Maltreatment Prevention Studies: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1551-1567. [PMID: 37626470 DOI: 10.1177/15248380231188070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
Prevention services can promote public health by building protective factors and reducing maltreatment risk. Yet, engaging caregivers in prevention services presents a unique set of challenges. Measurement studies are important first steps to increase the knowledge of caregiver engagement in prevention services. The purpose of this scoping review was to investigate how family engagement has been measured and operationalized in the studies of maltreatment prevention/positive parenting programs. The review examined quantitative and mixed methods studies conducted in the U.S., which measured multiple dimensions of client engagement, including behavioral, attitudinal, and relational domains. A total of 88 studies selected from PubMed, CINAHL, ERIC, PsycINFO, Social Work Abstracts, Academic Search Premier, and Web of Science were included in this review. Results indicated that studies examine engagement constructs in all three domains of engagement with a primary focus on behavioral engagement. The attitudinal and relational engagement was mostly assessed through general satisfaction surveys, and a limited number of studies utilized validated measures to assess those constructs. While most studies reported acceptable internal reliabilities, only two studies reported other dimensions of psychometric qualities. Only one validated measure was found, which assessed client perceptions of provider cultural competence. More measurement studies are needed to further incorporate multiple dimensions of engagement into the studies of maltreatment prevention programs, which can inform the effort to develop tailored implementation strategies to fully engage various groups of parents in maltreatment prevention programs.
Collapse
|
14
|
Petrevska M, Wright FV, Khan A, Munce S, Fehlings D, Biddiss E. Evaluating the impact of movement tracking feedback on engagement with home exercise programmes of children with cerebral palsy using a new therapy app: a protocol for a mixed-methods single-case experimental design with alternating treatments. BMJ Open 2024; 14:e082761. [PMID: 38503423 PMCID: PMC10952875 DOI: 10.1136/bmjopen-2023-082761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/26/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Children with cerebral palsy (CP) are prescribed home exercise programmes (HEPs) to increase the frequency of movement practice, yet adherence to HEPs can be low. This paper outlines the protocol for a single-case experimental design (SCED) with alternating treatments, using a new home therapy exercise application, Bootle Boot Camp (BBCamp), offered with and without movement tracking feedback. This study will explore the impact of feedback on engagement, movement quality, lower limb function and family experiences to help understand how technology-supported HEPs should be translated and the added value, if any, of movement tracking technology. METHODS AND ANALYSIS In this explanatory sequential mixed-methods study using a SCED, 16 children with CP (aged 6-12 years, Gross Motor Function Classification System levels I-II) will set lower limb goals and be prescribed an individualised HEP by their physiotherapist to complete using BBCamp on their home television equipped with a three-dimensional camera-computer system. Children will complete four weekly exercise sessions over 6 weeks. Children will be randomised to 1 of 16 alternating treatment schedules where BBCamp will provide or withhold feedback during the first 4 weeks. The version of BBCamp that results in the most therapeutic benefit will be continued for 2 final weeks. Goals will be re-evaluated and families interviewed. The primary outcome is adherence (proportion of prescribed exercise repetitions attempted) as a measure of behavioural engagement. Secondary outcomes are affective and cognitive engagement (smiley face ratings), exercise fidelity, lower limb function, goal achievement and participant experiences. SCED data will be analysed using visual and statistical methods. Quantitative and qualitative data will be integrated using joint displays. ETHICS AND DISSEMINATION Ethical approval was obtained from the Research Ethics Boards at Bloorview Research Institute and the University of Toronto. Results will be distributed through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER NCT05998239; pre-results.
Collapse
Affiliation(s)
- Marina Petrevska
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - F Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ajmal Khan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Sarah Munce
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Darcy Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Elaine Biddiss
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
15
|
Moeller MP, Gale E, Szarkowski A, Smith T, Birdsey BC, Moodie STF, Carr G, Stredler-Brown A, Yoshinaga-Itano C, Holzinger D. Family-Centered Early Intervention Deaf/Hard of Hearing (FCEI-DHH): Foundation Principles. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024; 29:SI53-SI63. [PMID: 38422441 DOI: 10.1093/deafed/enad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 03/02/2024]
Abstract
This article is the fifth in a series of eight articles that comprise a special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. The 10 FCEI-DHH Principles are organized conceptually into three sections (a) Foundation Principles, (b) Support Principles, and (c) Structure Principles. Collectively, they describe the essential Principles that guide FCEI for children who are DHH and their families. This article describes the Foundation Principles (Principles 1 and Principle 2). The Foundation Principles emphasize the essential elements of ensuring that families with children who are DHH can access early intervention (EI) and other appropriate supports, as well as highlight the need for provision of EI that is family-centered. Implementation of these FCEI-DHH Principles is intended to improve the lives and the outcomes of children who are DHH and their families around the globe.
Collapse
Affiliation(s)
- Mary Pat Moeller
- Center for Childhood Deafness, Language & Learning, Boys Town National Research Hospital, Omaha, NE, United States
| | - Elaine Gale
- School of Education, Deaf and Hard-of-Hearing Program, Hunter College, City University of New York, New York, NY, United States
| | - Amy Szarkowski
- The Institute, Children's Center for Communication/Beverly School for the Deaf, Beverly, MA, United States
- Institute for Community Inclusion, University of Massachusetts Boston, Boston, MA, United States
| | | | - Bianca C Birdsey
- Global Coalition of Parents of Children who are Deaf or Hard of Hearing (GPODHH), Durban, South Africa
| | - Sheila T F Moodie
- Health Sciences, School of Communication Sciences & Disorders, Western University, London, ON, Canada
| | - Gwen Carr
- Early Hearing Detection and Intervention and Family Centered Practice, London, United Kingdom
| | - Arlene Stredler-Brown
- Colorado Early Hearing Detection and Intervention Program, Colorado Department of Human Services, Denver, CO, United States
| | | | - Daniel Holzinger
- Institute of Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria
| |
Collapse
|
16
|
Kohler BE, Baque E, Sandler CX, Jones T, Terranova CO, Brookes DSK, Hassall T, Bradford NK, Trost SG. Goal-directed therapeutic exercise for paediatric posterior fossa brain tumour survivors: a qualitative analysis of experiences. Support Care Cancer 2024; 32:125. [PMID: 38252320 PMCID: PMC10803389 DOI: 10.1007/s00520-024-08327-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
PURPOSE To explore child and parent experiences of a 12-week goal-directed therapeutic exercise intervention in paediatric posterior fossa brain tumours survivors and to identify features of the program that influenced program adherence and acceptability. METHODS Eleven interviews were conducted; five parent-child dyads (mothers = 83%) and one parent only (mean child age = 10.6 ± 3.0 years; 83% male). Posterior fossa brain tumour survivors, who participated in a weekly goal-directed exercise program for 12 weeks, completed semi-structured interviews to discuss their experience of the program. An inductive content analysis was undertaken. Interviews were transcribed, imported into NVivo and independently coded by two reviewers. Code and content categories were iteratively discussed and refined. RESULTS Five content categories were generated: (1) perceived improvements, (2) program logistics, (3) activity selection, (4) connection with the therapist and (5) options for technology. All participants valued the tailored exercise program and described improvements in movement competence. Children and their parents discussed preferring home- and community-based locations and favoured face-to-face delivery. Occasionally, parents reported difficulty completing the home program due to low child motivation or family time restrictions. Multiple families suggested an interactive digital application would be an effective delivery channel for the supplemental home-based program. CONCLUSION A goal-directed exercise program delivered at home and in community-based locations was considered valuable and helpful for improving movement competence in paediatric survivors of posterior fossa brain tumour. TRIAL REGISTRATION ACTRN12619000841178 June 12, 2019.
Collapse
Affiliation(s)
- Brooke E Kohler
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | - Emmah Baque
- School of Health Sciences and Social Work, Griffith University, Nathan, Australia
| | - Carolina X Sandler
- Sport and Exercise Science, School of Health Sciences, Western Sydney University, Sydney, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Taryn Jones
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | - Caroline O Terranova
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | - Denise S K Brookes
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
| | | | - Natalie K Bradford
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT) Brisbane, Brisbane, Australia
- Cancer and Palliative Care Outcomes Centre, at Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Australia
| | - Stewart G Trost
- Children's Health Queensland, Brisbane, Australia.
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.
| |
Collapse
|
17
|
van der Helm GHPP, Roest JJ, Dekker AL, van Miert VSL, Kuiper CHZ, Stams GJJM. Group Climate in Residential Youth Care: Development and Validation of the Group Climate Instrument-Revised. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2024:306624X231219984. [PMID: 38229466 DOI: 10.1177/0306624x231219984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Group climate in residential youth care is considered to be essential for treatment of youth and young adults. Various instruments exist to measure quality of living group climate, but some are lengthy, use complicated wording, which make them difficult to fill out by youth and individuals with a mild intellectual disability. The present study describes the development and rationale for the Group Climate Instrument-Revised (GCI-R). Construct validity and reliability of the GCI-R were examined by means of Confirmatory Factor Analysis (CFA) in a two-step validation process using a construction sample (n = 190 youth, representing 41 groups) and a validation sample (n = 207 youth, representing 42 groups). Results indicated a good fit of a five-factor model (Support, Growth, Physical Environment, Peer interactions, and Repression). Reliability of the scales was good. These findings indicate that the GCI-R can be used as a parsimonious, valid, and reliable instrument to assess perceptions of group climate in youth. Recommendations for future research and practice are suggested.
Collapse
Affiliation(s)
- G H P Peer van der Helm
- University of Applied Sciences Leiden, The Netherlands
- University of Amsterdam, The Netherlands
| | - Jesse J Roest
- University of Applied Sciences Leiden, The Netherlands
| | | | | | - Chris H Z Kuiper
- University of Applied Sciences Leiden, The Netherlands
- University of Amsterdam, The Netherlands
| | | |
Collapse
|
18
|
Antoniadou M, Granlund M, Andersson AK. Strategies Used by Professionals in Pediatric Rehabilitation to Engage the Child in the Intervention Process: A Scoping Review. Phys Occup Ther Pediatr 2024; 44:461-488. [PMID: 38213190 DOI: 10.1080/01942638.2023.2290038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/25/2023] [Indexed: 01/13/2024]
Abstract
AIM To investigate strategies used by professionals in pediatric rehabilitation to engage children in every step of the intervention process, including assessment, goal setting, planning and implementation of the intervention, and results evaluation. METHODS A scoping literature review was conducted, and seven databases were searched, including CINAHL and MEDLINE, ProQuest Central, PsycINFO, Social Science Premium Collection, PubMed, and Web of Science. A citation search of included articles was completed. Predetermined criteria, quality standards, and PIO framework guided the selection process. Results were presented in relation to Self-Determination Theory (SDT) and the contextual model of therapeutic change. RESULTS In total, 20 studies were included in the review. Pediatric professionals reported that therapeutic use of self and their own engagement in the intervention facilitated the establishment of a supportive relationship. Providing clear explanations about their role and therapy rationale developed positive expectations. By making the child feel successful within-session and outside-session activities, professionals enhanced child mastery. Professionals' strategies were abstractly described. CONCLUSIONS Further research is needed to investigate strategies that are effective in the different steps of the intervention. More observational, longitudinal studies are required to capture fluctuations in in-session engagement.
Collapse
Affiliation(s)
- Marianna Antoniadou
- CHILD, School of Education and Communication, Jönköping University, Jönköping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
| | - Mats Granlund
- CHILD, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Mental Health, Norway University of Natural Science and Technology, Trondheim, Norway
| | | |
Collapse
|
19
|
Retamal-Walter F, Waite M, Scarinci N. Exploring engagement in telepractice early intervention for young children with developmental disability and their families: a qualitative systematic review. Disabil Rehabil Assist Technol 2023; 18:1508-1521. [PMID: 35287526 DOI: 10.1080/17483107.2022.2048098] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This review aimed to (1) describe the nature of engagement in telepractice early intervention (EI) for families of young children with developmental disabilities; and (2) identify major barriers and facilitators for developing and maintaining engagement via telepractice. METHODS A qualitative systematic review was conducted, searching systematically across six databases (i.e., PUBMED, CINAHL, PsycINFO, Web of Science, EMBASE, and Scopus). The search identified 14 studies which met the inclusion criteria of peer-reviewed studies exploring EI professionals', families', managers', or service's views of engagement in telepractice EI using qualitative methodologies. The studies were appraised using the Critical Appraisal Skills Programme and data were analysed using thematic synthesis. RESULTS The synthesised data were grouped into four main themes reflecting the nuances of engagement in telepractice EI: (1) children and family engagement is facilitated and enhanced during telepractice interaction; (2) engagement may enhance therapy outcomes through telepractice multidisciplinary collaboration and communication; (3) there are challenges to engagement in the telepractice environment; and (4) preparation in telepractice can improve the development of engagement. CONCLUSION This review provides a comprehensive characterisation of engagement and describes a set of conceptual recommendations for establishing and maintaining engagement when using telepractice in EI.IMPLICATIONS FOR REHABILITATIONBuilding and maintaining engagement with families of young children with developmental disability/delay through telepractice is feasible.Despite some similarities between in-person and telepractice engagement, there are certain unique features of telepractice engagement that professionals and families may need to consider while providing/receiving early intervention services remotely.Preparation and training on how to engage in telepractice is recommended for professionals and families of young children with developmental disability/delay.Understanding how professionals and families engage with one another during telepractice interactions may improve targeted child and family intervention outcomes.
Collapse
Affiliation(s)
- Felipe Retamal-Walter
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Monique Waite
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
20
|
Tierney-Hendricks C, Miller J, Lopez RP, Conger S, Vallila-Rohter S. 'It's been an extraordinary journey': Experience of engagement from the perspectives of people with post-stroke aphasia. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:2008-2021. [PMID: 37300434 DOI: 10.1111/1460-6984.12911] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/11/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Engagement is recognized as an important factor in aphasia treatment response and outcomes, yet gaps remain in our understanding of engagement and practices that promote engagement from the client perspective. AIMS The purpose of this phenomenological study was to explore how clients with aphasia experience engagement during their inpatient aphasia rehabilitation. METHODS & PROCEDURES An interpretative phenomenological analysis approach guided the study design and analysis. Data were collected through in-depth interviews with nine clients with aphasia, recruited through purposive sampling, during their inpatient rehabilitation admission. Analysis was completed using a variety of analytic techniques including coding, memoing, triangulation between coders and team discussion. OUTCOMES & RESULTS The analysis revealed that for clients with aphasia in the acute phrase of recovery, the rehabilitation process resembles travelling on a journey through a foreign land. Successful engagement in the journey was accomplished when one had a therapist who served as a trusted guide and was able to be a friend, invested, adaptable, a co-creator, encouraging and dependable. CONCLUSIONS & IMPLICATIONS Engagement is a dynamic, multifaceted and person-centred process involving the client, provider and rehabilitation context. Findings from this work have implications for measuring engagement, training student clinicians to be skilled facilitators in engaging their clients and implementing person-centred practices that promote engagement within clinical settings. WHAT THIS PAPER ADDS What is already known on the subject Engagement is recognized as an important factor in rehabilitation treatment response and outcomes. Prior literature suggests that the therapist plays a critical role in facilitating engagement within the client-provider relationship. Communication impairments associated with aphasia may negatively impact a client's ability to develop interpersonal connections and participate in the rehabilitation process. There is a dearth of research directly exploring the topic of engagement in aphasia rehabilitation, particularly from the perspective of clients with aphasia. Capturing the client perspective can provide novel insights regarding practices to foster and maintain engagement in aphasia rehabilitation. What this paper adds to existing knowledge This interpretative phenomenological study revealed that for individuals with aphasia in the acute phase of recovery, the rehabilitation process resembles travelling on a sudden and foreign journey. Successful engagement in the journey was accomplished when one had a therapist who served as a 'trusted guide' and was able to be a friend, invested, adaptable, a co-creator, encouraging and dependable. Through the client experience, engagement is seen as a dynamic, multifaceted and person-centred process involving the client, provider and rehabilitation context. What are the potential or actual clinical implications of this work? The current study highlights the complexity and nuance of engagement within the rehabilitation context, which has implications for measuring engagement, training student clinicians to be skilled in engaging their clients and implementing person-centred practices that promote engagement within clinical settings. It is necessary to recognize that client and provider interactions (and thus engagement) are embedded in and influenced by the broader healthcare system. With this in mind, a patient-centred approach to engagement in aphasia care delivery cannot be achieved through individual efforts only and may require prioritization and action at the systems level. Future work is needed to explore barriers and facilitators to enacting engagement practices, in order to develop and test strategies to support practice change.
Collapse
Affiliation(s)
- Carla Tierney-Hendricks
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Jennifer Miller
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
- Speech Therapy Department, Sheltering Arms Institute, Richmond, VA, USA
| | - Ruth Palan Lopez
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
| | - Sarah Conger
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
| | - Sofia Vallila-Rohter
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
| |
Collapse
|
21
|
Kahlon E, Wachspress B, Berger I, Maeir A, Mazor-Karsenty T. A qualitative study on parents of autistic adolescents' experience of OT-ParentShip: A family-centred intervention. Aust Occup Ther J 2023; 70:627-640. [PMID: 37392163 DOI: 10.1111/1440-1630.12892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND OT-ParentShip intervention addresses the needs of autistic adolescents and the physical and emotional burden associated with parental caregiving. AIM This article describes the qualitative findings of a mixed-method, single-group, pre-test-post-test pilot study to determine whether this intervention has adequate potential for further, large-scale testing. METHOD The qualitative study sought to understand 14 parents' (N = 4 couples, N = 6 mothers) experiences in the intervention, examine their satisfaction, and receive their suggestions for improvement, using a grounded approach, with the aim of conceptualising a theoretical understanding of the data gathered. RESULTS A total of five key themes and 14 sub-themes describe parents' experiences. The key themes that were identified were parent-therapist relationship, parent-adolescent relationship, reframing, benefit for family, and parental resilience. Emerging themes shed light on the therapeutic components and change mechanisms of the intervention. CONCLUSION Self-determination theory was found to be an adequate theoretical framework to map these components and help in understanding their contribution to treatment outcomes. OT-Parentship directly enforces parents' basic psychological needs, who, in turn, support their adolescent child's need for relatedness, competence, and autonomy. An occupational therapy intervention that satisfies these basic needs has the potential to lead to therapeutic alliance and internalisation of goals, thus increasing therapy engagement and outcomes.
Collapse
Affiliation(s)
- Einav Kahlon
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Batel Wachspress
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Itai Berger
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Neurology Service, Pediatric Division, Assuta-Ashdod University Hospital, Ashdod, Israel
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Adina Maeir
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tal Mazor-Karsenty
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
22
|
Albaum CS, Vashi N, Bohr Y, Weiss JA. A Systematic Review of Therapeutic Process Factors in Mental Health Treatment for Autistic Youth. Clin Child Fam Psychol Rev 2023; 26:212-241. [PMID: 35999330 PMCID: PMC9879813 DOI: 10.1007/s10567-022-00409-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 01/31/2023]
Abstract
Understanding the role of therapeutic process factors in treatment change may prove useful for discerning why some autistic youth benefit from psychosocial interventions that target emotional and psychological aspects of mental health, while others do not. The aim of the current study was to synthesize what is currently known about therapeutic process factors in mental health treatment of emotional and psychological challenges for autistic youth, regarding how process factors have been measured in past research, and the relation between process factors and treatment outcome. A systematic review of the literature was conducted to narratively synthesize all articles published up until June 2021. Methodological quality of included studies was appraised. Twenty-five studies met inclusion criteria. Process factors assessed across studies included relational factors; treatment expectations, readiness, and satisfaction; and treatment engagement from youth and their parents. Process-outcome associations were reported for a limited number of constructs. There is a limited, albeit growing, body of high-quality research evaluating the role of process factors in the treatment of mental health issues for autistic youth. Future research should continue to examine process factors in relation to treatment outcome, and validate measures to accurately capture process-related constructs in mental health treatment for this population. Greater understanding of therapy processes can lead to developing evidence-informed strategies that clinicians can implement to promote positive expectations, relationships, and engagement.
Collapse
Affiliation(s)
- Carly S Albaum
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Nisha Vashi
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Yvonne Bohr
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| |
Collapse
|
23
|
Becker KD, Chorpita BF. Future Directions in Youth and Family Treatment Engagement: Finishing the Bridge Between Science and Service. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:284-309. [PMID: 36787342 DOI: 10.1080/15374416.2023.2169926] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The field has spent more than 50 years investing in the quality of youth mental healthcare, with intervention science yielding roughly 1,300 efficacious treatments. In the latter half of this period, concurrent efforts in implementation science have developed effective methods for supporting front-line service organizations and therapists to begin to bridge the science to service gap. However, many youths and families still do not benefit fully from these strategic investments due to low treatment engagement: nearly half of youths in need of services pursue them, and among those who do, roughly another half terminate prematurely. The negative impact of low engagement is substantial, and is disproportionally and inequitably so for many. We contend that to build a robust and "finished" bridge connecting science and service, the field must go beyond its two historical foci of designing interventions and preparing therapists to deliver them, to include an intentional focus on the youths and families who participate in these interventions and who work with those therapists. In this paper, we highlight the significance of treatment engagement in youth mental healthcare and discuss the current state of the literature related to four priorities: conceptualization, theory, measurement, and interventions. Next, we offer an example from our own program of research as one illustration for advancing these priorities. Finally, we propose recommendations to act on these priorities.
Collapse
|
24
|
Xu Z, Smit E. Using a complexity science approach to evaluate the effectiveness of just-in-time adaptive interventions: A meta-analysis. Digit Health 2023; 9:20552076231183543. [PMID: 37521518 PMCID: PMC10373115 DOI: 10.1177/20552076231183543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/05/2023] [Indexed: 08/01/2023] Open
Abstract
Objective Just-in-time adaptive interventions (JITAIs), which allow individuals to receive the right amount of tailored support at the right time and place, hold enormous potential for promoting behavior change. However, research on JITAIs' implementation and evaluation is still in its early stages, and more empirical evidence is needed. This meta-analysis took a complexity science approach to evaluate the effectiveness of JITAIs that promote healthy behaviors and assess whether key design principles can increase JITAIs' impacts. Methods We searched five databases for English-language papers. Study eligibility required that interventions objectively measured health outcomes, had a control condition or pre-post-test design, and were conducted in the real-world setting. We included randomized and non-randomized trials. Data extraction encompassed interventions' features, methodologies, theoretical foundations, and delivery modes. RoB 2 and ROBINS-I were used to assess risk of bias. Results The final analysis included 21 effect sizes with 592 participants. All included studies used pre- and post-test design. A three-level random meta-analytic model revealed a medium effect of JITAIs on objective behavior change (g = 0.77 (95% confidence interval (CI); 0.32 to 1.22), p < 0.001). The summary effect was robust to bias. Moderator analysis indicated that design principles, such as theoretical foundations, targeted behaviors, and passive or active assessments, did not moderate JITAIs' effects. Passive assessments were more likely than a combination of passive and active assessments to relate to higher intervention retention rates. Conclusions This review demonstrated some evidence for the efficacy of JITAIs. However, high-quality randomized trials and data on non-adherence are needed.
Collapse
Affiliation(s)
- Zhan Xu
- School of Communication, Northern Arizona University, Flagstaff, AZ, USA
| | - Eline Smit
- University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
25
|
Collins A, D'Cruz K, Jackman A, Anderson V, Jenkin T, Scheinberg A, Muscara F, Knight S. Engaging children and adolescents with acquired brain injury and their families in goal setting: The family perspective. Neuropsychol Rehabil 2023; 33:1-23. [PMID: 34538207 DOI: 10.1080/09602011.2021.1977154] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study explored the experiences of goal setting in paediatric rehabilitation from the perspectives of children and adolescents with acquired brain injury (ABI) and their parents in paediatric rehabilitation. Using a qualitative research design, 15 semi-structured interviews were conducted with 13 parents and 8 young people with ABI aged between 9 and 18 years who were engaged in outpatient rehabilitation. Interview transcripts were analysed using constructivist grounded theory methods. Two main themes and several sub-themes emerged: Experiences of goal setting: The role of professionals; The role of the young person; and The role of the parents. Working as a team: Understanding each other and building trust; Communicating, sharing knowledge and different perspectives; and Being flexible. These themes reflect parent's and young people's experience of goal setting during paediatric rehabilitation for ABI and suggest clinicians play an important role in educating young people and their families about goal setting in the outpatient rehabilitation context. Young people and their parents also perceive the focus of outpatient rehabilitation as working collaboratively with clinicians to gain knowledge to manage the consequences of ABI. Our findings emphasize the importance of the therapeutic consumer-clinician relationship and the need to actively engage young people in goal setting.
Collapse
Affiliation(s)
- Alana Collins
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | | | - Angie Jackman
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Vicki Anderson
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.,Psychology Service, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Taylor Jenkin
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Adam Scheinberg
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Victorian Paediatric Rehabilitation Service, Royal Children's Hospital, Melbourne, Australia
| | - Frank Muscara
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Psychology Service, Royal Children's Hospital, Melbourne, Australia
| | - Sarah Knight
- Department of Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Victorian Paediatric Rehabilitation Service, Royal Children's Hospital, Melbourne, Australia
| |
Collapse
|
26
|
Jenkin T, Anderson VA, D'Cruz K, Scheinberg A, Knight S. Family-centred service in paediatric acquired brain injury rehabilitation: Bridging the gaps. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1085967. [PMID: 36619530 PMCID: PMC9816340 DOI: 10.3389/fresc.2022.1085967] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
Background Children and adolescents who sustain an acquired brain injury (ABI) can experience acute and ongoing difficulties in a range of cognitive and functional domains, and their families often experience significant life changes and challenges. Family-centred service is therefore considered best practice in paediatric ABI rehabilitation. Despite widespread acceptance of family-centred service in this context, recent literature indicates that family needs are often unrecognised and unmet following paediatric ABI. Although family-centred service was introduced in the field of developmental disability over five decades ago, there remains a lack of clarity about how this approach is implemented in practice. Additionally, limited literature has discussed the implementation of family-centred service in paediatric ABI rehabilitation despite key differences between ABI and developmental disability, including nature and timing of onset, rehabilitation foci, and impacts on families. Aims In this review, we aim to: (i) outline common sequelae of paediatric ABI with a focus on family outcomes; (ii) summarise paediatric rehabilitation and highlight opportunities for family support and involvement; (iii) discuss and synthesise literature across paediatric ABI rehabilitation and family-centred service to highlight gaps in knowledge and practice; and (v) identify clinical implications and future research directions. Conclusions There is a clear need for greater clarity and consensus regarding the implementation of family-centred service in paediatric ABI rehabilitation. This review highlights the importance of providing professional development opportunities for clinicians to increase competency in practising in a family-centred manner, and opportunities to actively involve, empower and support families within rehabilitation. This review also emphasises the importance of services implementing relevant supports to address family needs where possible and developing clear referral pathways so that families can access further support elsewhere when needed.
Collapse
Affiliation(s)
- Taylor Jenkin
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Vicki A. Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
- Brain and Mind, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Psychology Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Kate D'Cruz
- Summer Foundation, Melbourne, VIC, Australia
| | - Adam Scheinberg
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sarah Knight
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| |
Collapse
|
27
|
King G. Central yet overlooked: engaged and person-centred listening in rehabilitation and healthcare conversations. Disabil Rehabil 2022; 44:7664-7676. [PMID: 34647516 DOI: 10.1080/09638288.2021.1982026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Listening in healthcare practice is often overlooked. This article addresses the misconception that listening in rehabilitation and healthcare is a simple skill, and proposes a conceptual framework of effective listening in healthcare conversations, based on conceptualizations, attributes, and outcomes associated with listening. METHOD A critical review was conducted, encompassing literature on listening in everyday and healthcare conversations. Articles were retrieved through database and hand searching. RESULTS Although various types of listening have been proposed, they share common attributes, including being attentive, emotionally involved, and non-judgmental. A conceptual framework is proposed in which listening in healthcare is seen as a relational process fostered by the 'engaged and person-centred listener', leading to relational outcomes (e.g., mutual engagement, collaboration) and client-specific outcomes. Listening in healthcare conversations can be difficult due to situational conditions and the level of self-regulation required. CONCLUSIONS Effective listening in healthcare differs from everyday listening with respect to its attributes, intentionality, and challenges. In healthcare, listening is essential to mutual engagement and other relational outcomes that mobilize the client towards pursuing goals. There is a need for greater understanding of the centrality and challenges to effective listening in healthcare conversations. Implications for rehabilitation practice are discussed.Implications for RehabilitationListening in rehabilitation conversations is a core skill or advanced competency-not a 'soft' skill with little effect on client outcomes.Effective listening is essential to mutual understanding, engagement, relationship building, and collaboration, which mobilize the client towards pursing goals in rehabilitation.Listening effectively in rehabilitation conversations involves deliberately adopting a person-centred perspective.Effective rehabilitation professionals have several listening intentions in mind in addition to understanding, including engaging the other person in the therapy session, building relationship, and collaborating.Rehabilitation professionals can deliberately adopt the intention to be an "engaged and person-centred listener" who is with and for the client.
Collapse
Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| |
Collapse
|
28
|
Perpetuini D, Russo EF, Cardone D, Palmieri R, Filippini C, Tritto M, Pellicano F, De Santis GP, Pellegrino R, Calabrò RS, Filoni S, Merla A. Psychophysiological Assessment of Children with Cerebral Palsy during Robotic-Assisted Gait Training through Infrared Imaging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15224. [PMID: 36429941 PMCID: PMC9690262 DOI: 10.3390/ijerph192215224] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Cerebral palsy (CP) is a non-progressive neurologic pathology representing a leading cause of spasticity and concerning gait impairments in children. Robotic-assisted gait training (RAGT) is widely employed to treat this pathology to improve children's gait pattern. Importantly, the effectiveness of the therapy is strictly related to the engagement of the patient in the rehabilitation process, which depends on his/her psychophysiological state. The aim of the study is to evaluate the psychophysiological condition of children with CP during RAGT through infrared thermography (IRT), which was acquired during three sessions in one month. A repeated measure ANOVA was performed (i.e., mean value, standard deviation, and sample entropy) extracted from the temperature time course collected over the nose and corrugator, which are known to be indicative of the psychophysiological state of the individual. Concerning the corrugator, significant differences were found for the sample entropy (F (1.477, 5.907) = 6.888; p = 0.033) and for the mean value (F (1.425, 5.7) = 5.88; p = 0.047). Regarding the nose tip, the sample entropy showed significant differences (F (1.134, 4.536) = 11.5; p = 0.041). The findings from this study suggests that this approach can be used to evaluate in a contactless manner the psychophysiological condition of the children with CP during RAGT, allowing to monitor their engagement to the therapy, increasing the benefits of the treatment.
Collapse
Affiliation(s)
- David Perpetuini
- Department of Neuroscience and Imaging, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Daniela Cardone
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
| | - Roberta Palmieri
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Institute of Child Neuropsychiatry, University of Bari, 70121 Bari, Italy
| | - Chiara Filippini
- Department of Neuroscience and Imaging, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Federica Pellicano
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Grazia Pia De Santis
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland
| | | | - Serena Filoni
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Arcangelo Merla
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
- ITAB, Institute for Advanced Biomedical Technologies, 66100 Chieti, Italy
| |
Collapse
|
29
|
Ramadurai R, Beckham E, McHugh RK, Björgvinsson T, Beard C. Operationalizing Engagement With an Interpretation Bias Smartphone App Intervention: Case Series. JMIR Ment Health 2022; 9:e33545. [PMID: 35976196 PMCID: PMC9434389 DOI: 10.2196/33545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 02/28/2022] [Accepted: 06/20/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Engagement with mental health smartphone apps is an understudied but critical construct to understand in the pursuit of improved efficacy. OBJECTIVE This study aimed to examine engagement as a multidimensional construct for a novel app called HabitWorks. HabitWorks delivers a personalized interpretation bias intervention and includes various strategies to enhance engagement such as human support, personalization, and self-monitoring. METHODS We examined app use in a pilot study (n=31) and identified 5 patterns of behavioral engagement: consistently low, drop-off, adherent, high diary, and superuser. RESULTS We present a series of cases (5/31, 16%) from this trial to illustrate the patterns of behavioral engagement and cognitive and affective engagement for each case. With rich participant-level data, we emphasize the diverse engagement patterns and the necessity of studying engagement as a heterogeneous and multifaceted construct. CONCLUSIONS Our thorough idiographic exploration of engagement with HabitWorks provides an example of how to operationalize engagement for other mental health apps.
Collapse
Affiliation(s)
- Ramya Ramadurai
- Department of Psychology, American University, Washington, DC, United States
| | - Erin Beckham
- Cognition and Affect Research and Education Lab, McLean Hospital, Belmont, MA, United States
| | - R Kathryn McHugh
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, Harvard Medical School, Belmont, MA, United States
| | - Thröstur Björgvinsson
- Behavioral Health Partial Hospital Program, McLean Hospital, Harvard Medical School, Belmont, MA, United States
| | - Courtney Beard
- Cognition and Affect Research and Education Lab, McLean Hospital, Belmont, MA, United States
| |
Collapse
|
30
|
Goodwin BM, Olney CM, Ferguson JE, Hansen AH, Eddy B, Goldish G, Morrow MM, Vos-Draper TL. Visualization of user interactions with a pressure mapping mobile application for wheelchair users at risk for pressure injuries. Assist Technol 2022; 34:444-453. [PMID: 33395558 PMCID: PMC8433259 DOI: 10.1080/10400435.2020.1862938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Pressure injuries for individuals with spinal cord injuries (SCI) are correlated with mortality and are a leading cause for rehospitalizations. The Assisted Weight Shift (AW-Shift©) is a mobile pressure mapping application designed to provide users with a live map view and reminders to perform weight shifts. Novel visualization techniques were used to understand daily distributions of user interaction wit h AW-Shift©. The date and time of system interactions were recorded for six participants with SCI over 7 days (five males/one female, five manual users/one power user, 55.3 ± 17.3 years old, 10.6 ± 6.5 years since injury). Circular frequency plots were created to visualize the time and frequency participants brought the app to the foreground of their phone and received alerts and reminders to complete weight shifts. While some participants used the system regularly throughout the day, others primarily used it before 8am; highlighting the system's importance for regular spot checks and morning wheelchair setup. Participant adherence to weight shift reminders was low suggesting the live pressure map may be more useful. Circular frequency plots can be used by clinicians to more easily review large amounts of patient data. Future work will investigate raw pressure mat data and create a closed-loop weight shift detection algorithm.
Collapse
Affiliation(s)
- Brianna M. Goodwin
- Division of Health Care Policy and Research, Department of Health Sciences Research Mayo Clinic, Rochester, Minnesota, USA,Kern Center for the Science of Health Care Delivery, Rochester, Minnesota, USA
| | - Christine M. Olney
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA,College of Design, University of Minnesota, Minneapolis, Minnesota, USA
| | - John E. Ferguson
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA,Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Andrew H. Hansen
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA,Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Byron Eddy
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA,Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gary Goldish
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA,Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Melissa M. Morrow
- Division of Health Care Policy and Research, Department of Health Sciences Research Mayo Clinic, Rochester, Minnesota, USA,Kern Center for the Science of Health Care Delivery, Rochester, Minnesota, USA
| | - Tamara L. Vos-Draper
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA,Center for Allied Health Professions, Program in Occupational Therapy, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
31
|
Kaelin VC, Valizadeh M, Salgado Z, Sim JG, Anaby D, Boyd AD, Parde N, Khetani MA. Capturing and Operationalizing Participation in Pediatric Re/Habilitation Research Using Artificial Intelligence: A Scoping Review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3. [PMID: 35919375 PMCID: PMC9340801 DOI: 10.3389/fresc.2022.855240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background There is increased interest in using artificial intelligence (AI) to provide participation-focused pediatric re/habilitation. Existing reviews on the use of AI in participation-focused pediatric re/habilitation focus on interventions and do not screen articles based on their definition of participation. AI-based assessments may help reduce provider burden and can support operationalization of the construct under investigation. To extend knowledge of the landscape on AI use in participation-focused pediatric re/habilitation, a scoping review on AI-based participation-focused assessments is needed. Objective To understand how the construct of participation is captured and operationalized in pediatric re/habilitation using AI. Methods We conducted a scoping review of literature published in Pubmed, PsycInfo, ERIC, CINAHL, IEEE Xplore, ACM Digital Library, ProQuest Dissertation and Theses, ACL Anthology, AAAI Digital Library, and Google Scholar. Documents were screened by 2–3 independent researchers following a systematic procedure and using the following inclusion criteria: (1) focuses on capturing participation using AI; (2) includes data on children and/or youth with a congenital or acquired disability; and (3) published in English. Data from included studies were extracted [e.g., demographics, type(s) of AI used], summarized, and sorted into categories of participation-related constructs. Results Twenty one out of 3,406 documents were included. Included assessment approaches mainly captured participation through annotated observations (n = 20; 95%), were administered in person (n = 17; 81%), and applied machine learning (n = 20; 95%) and computer vision (n = 13; 62%). None integrated the child or youth perspective and only one included the caregiver perspective. All assessment approaches captured behavioral involvement, and none captured emotional or cognitive involvement or attendance. Additionally, 24% (n = 5) of the assessment approaches captured participation-related constructs like activity competencies and 57% (n = 12) captured aspects not included in contemporary frameworks of participation. Conclusions Main gaps for future research include lack of: (1) research reporting on common demographic factors and including samples representing the population of children and youth with a congenital or acquired disability; (2) AI-based participation assessment approaches integrating the child or youth perspective; (3) remotely administered AI-based assessment approaches capturing both child or youth attendance and involvement; and (4) AI-based assessment approaches aligning with contemporary definitions of participation.
Collapse
Affiliation(s)
- Vera C. Kaelin
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
| | - Mina Valizadeh
- Computer Science, University of Illinois at Chicago, Chicago, IL, United States
- Natural Language Processing Laboratory, University of Illinois at Chicago, Chicago, IL, United States
| | - Zurisadai Salgado
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
| | - Julia G. Sim
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Andrew D. Boyd
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Physical Therapy, University of Illinois at Chicago, Chicago, IL, United States
| | - Natalie Parde
- Computer Science, University of Illinois at Chicago, Chicago, IL, United States
- Natural Language Processing Laboratory, University of Illinois at Chicago, Chicago, IL, United States
- Natalie Parde
| | - Mary A. Khetani
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States
- *Correspondence: Mary A. Khetani
| |
Collapse
|
32
|
McQuillin SD, Hagler MA, Werntz A, Rhodes JE. Paraprofessional Youth Mentoring: A Framework for Integrating Youth Mentoring with Helping Institutions and Professions. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 69:201-220. [PMID: 34318526 DOI: 10.1002/ajcp.12546] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The demand for child mental health services, including those provided by psychologists, counselors, and social workers, exceeds the supply. This trend is expected to continue or worsen unless there are substantial structural changes in how mental health services are provided. We propose a framework for paraprofessional youth mentors, defined as a subgroup of professionally supervised, non-expert volunteer or paid mentors to whom aspects of professional helping tasks are delegated. Our proposal is aligned with historical and modern solutions to scaling mental health services, and this framework could simultaneously increase the number of youth receiving evidence-based mental health services and reduce the burden on existing systems of care. The framework defines three plausible tasks for paraprofessional mentors: (1) reducing barriers to mental health service, (2) increasing engagement in services, and (3) providing direct services. The safety and effectiveness of these task-shifting efforts will hinge on competency-based training and evaluation, supervision by professionals, and documentation of services rendered, all of which the field of youth mentoring currently lacks. We describe several requisite scientific, institutional, and regulatory advances that will be necessary to realize this variant of youth mentoring for a subgroup of youth who are presenting for assistance with mental health problems.
Collapse
Affiliation(s)
- Samuel D McQuillin
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Matthew A Hagler
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Alexandra Werntz
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Jean E Rhodes
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
| |
Collapse
|
33
|
King G, Keenan S. Solution-Focused Coaching for Friendship in Pediatric Rehabilitation: A Case Study of Goal Attainment, Client Engagement, and Coach Stances. Phys Occup Ther Pediatr 2022; 42:154-171. [PMID: 34266361 DOI: 10.1080/01942638.2021.1947435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIMS To examine goal attainment, engagement, and the stances used by coaches providing a solution-focused coaching intervention (SFC-peds) for young people with cerebral palsy pursuing friendship goals. METHODS The case study involved two clients with cerebral palsy (a young child and his mother, and a youth) and their service providers. An interpretive descriptive approach was used to analyze quantitative and qualitative data. Friendship goal attainment was assessed by the Canadian Occupational Performance Measure and goal attainment scaling, and client engagement was assessed using the Pediatric Rehabilitation Intervention Measure of Engagement-Service Provider version. Information from post-intervention client interviews was used to identify coach stances and relationships with client engagement. RESULTS Participants met their friendship goals and were considered to be highly engaged by their coaches. Four coach stances were identified: Respectful Inquiry, a Strengths Presupposition, Implementation Curiosity, and Inspiring Commitment. These stances, and aligned tactics, engaged clients on affective, cognitive, and behavioral levels, and impacted the client's stance toward their goal. CONCLUSIONS SFC-peds appears to be an effective and engaging approach for young people with disabilities working on friendship goals. The findings illustrate how the coach's stances and tactics engage clients, thus impacting the client's own stances toward change.
Collapse
Affiliation(s)
- Gillian King
- Bloorview Research Institute and Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Sarah Keenan
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| |
Collapse
|
34
|
Hawes DJ, Dadds MR. Practitioner Review: Parenting interventions for child conduct problems: reconceptualising resistance to change. J Child Psychol Psychiatry 2021; 62:1166-1174. [PMID: 33543502 DOI: 10.1111/jcpp.13378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2020] [Indexed: 11/30/2022]
Abstract
Parenting interventions based on social learning theory have received extensive empirical support in the treatment of child conduct problems; yet, they fail to produce lasting gains in as many as a third of cases. Perspectives on these poor outcomes have been informed by numerous lines of research, and practitioner recommendations for improving such outcomes have often emphasized processes related to clinical engagement. In this Practitioner Review, we examine recent theory and evidence pertaining to these processes, including emerging research into the therapeutic relationship across face-to-face and eHealth treatment modalities, and the clinical engagement of both mothers and fathers. The concept of resistance to change is examined in light of these developments, and it is argued that the process of overcoming such resistance can be characterized as one of reflective practice. A novel process model based on this perspective is presented, comprising practical clinical strategies that are designed to be initiated from the earliest contacts with a family and build on one another across treatment.
Collapse
Affiliation(s)
- David J Hawes
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Mark R Dadds
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
35
|
Chiappini EA, Parrish C, Reynolds E, McGuire JF. Overcoming barriers in cognitive-behavioral therapy for youth anxiety and obsessive-compulsive disorder: Addressing parent behaviors. Bull Menninger Clin 2021; 85:231-253. [PMID: 34468212 DOI: 10.1521/bumc.2021.85.3.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Exposure-based cognitive-behavioral therapy (CBT) is a well-established treatment for anxiety disorders and obsessive-compulsive disorder (OCD) in youth. Although a majority of youth respond to CBT, a substantial portion remain symptomatic and/or experience a return of symptoms after completing a course of treatment. This highlights the need for further improvements to this evidence-based treatment. Given that parent behaviors can negatively influence treatment, addressing parental behaviors in CBT serves as a novel and promising treatment target to improve youth's therapeutic outcomes. The authors review three common parent behaviors that influence anxiety and treatment outcomes: family accommodation, parent anxious behaviors, and management of disruptive behaviors. The authors then discuss each behavior, its effect on anxiety/OCD and treatment, and how to address the behavior within the context of CBT. In doing so, therapeutic learning can be optimized to improve CBT outcomes for youth with anxiety disorders and/or OCD.
Collapse
Affiliation(s)
- Erika A Chiappini
- Postdoctoral Scholar, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Carisa Parrish
- Associate Professor, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Elizabeth Reynolds
- Associate Professor, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Joseph F McGuire
- Assistant Professor, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, Maryland
| |
Collapse
|
36
|
Wong Chung R, Willemen A, Voorman J, Ketelaar M, Becher J, Schuengel C. Professionals' motivation to support parental self-management regarding children with physical disability in Dutch rehabilitation services: 'Please mind your gap'. Child Care Health Dev 2021; 47:685-696. [PMID: 34014585 PMCID: PMC8453492 DOI: 10.1111/cch.12883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 01/05/2021] [Accepted: 05/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Professionals in child healthcare increasingly endorse the support of self-management in paediatric rehabilitation services for children with physical disability. Less understood though are their views regarding the role of the children's parents, as well as their own role in supporting parents. This study aimed to investigate the motivation of rehabilitation professionals to support self-management of parents regarding their child with physical disability, professionals' beliefs about parental self-management, and the perceptions underlying their motivation. METHODS A mixed-methods strategy was followed using a survey among rehabilitation professionals (n = 175) and consecutive semi-structured interviews (n = 16). Associations between autonomous (intrinsic) versus controlled (extrinsic) motivation and beliefs on parental self-management were tested. For deeper understanding of their motivation, directed content analysis was used to address key themes in the qualitative data extracts. RESULTS Professionals reported autonomous motivation for parental self-management support more often than controlled motivation (t[174] = 29.95, p < .001). Autonomous motivation was associated with the beliefs about the importance of parental self-management (r = .29, p < .001). Approximately 90% of the professionals believed that parents should have an active role, though less than 10% considered it important that parents also are independent actors and initiative takers in the rehabilitation process. Interviews revealed that individual professionals struggled with striking a balance between keeping control and 'giving away responsibility' to parents. A 'professional-like' attitude was expected of parents with 'involvement' and 'commitment' as essential preconditions. Furthermore, professionals expressed the need for additional coaching skills to support parental self-management. CONCLUSION Professionals were predominantly autonomously motivated to support self-management of parents. However, the dilemmas in giving or taking responsibilities within the partnership with parents may limit their effectiveness in empowering parents. Reflection on the potential gaps between professionals' motivation, beliefs and actual behaviour might be crucial to support parental self-management.
Collapse
Affiliation(s)
- Ruud Wong Chung
- Merem Medical RehabilitationAlmereThe Netherlands,Amsterdam Public Health research institute and Department of Educational and Family studies, Faculty of Behavioural and Movement SciencesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Agnes Willemen
- Amsterdam Public Health research institute and Department of Educational and Family studies, Faculty of Behavioural and Movement SciencesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Jeanine Voorman
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain CentreUniversity Medical Centre Utrecht and De Hoogstraat Rehabilitation UtrechtUtrechtThe Netherlands,Department of Rehabilitation, Physical Therapy Science & Sports, Wilhelmina Children's HospitalUniversity Medical Centre UtrechtUtrechtThe Netherlands
| | - Marjolijn Ketelaar
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain CentreUniversity Medical Centre Utrecht and De Hoogstraat Rehabilitation UtrechtUtrechtThe Netherlands
| | - Jules Becher
- Amsterdam Movement Sciences and Department of Rehabilitation MedicineAmsterdam UMC, VU Medical Centre, Amsterdam Movement SciencesAmsterdamThe Netherlands
| | - Carlo Schuengel
- Amsterdam Public Health research institute and Department of Educational and Family studies, Faculty of Behavioural and Movement SciencesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| |
Collapse
|
37
|
Maré L, van Staden W, Hassim J. Primary caregivers' perspectives of the disruptive behaviour of their children attending Weskoppies Psychiatric Hospital, South Africa. J Child Adolesc Ment Health 2021; 33:17-31. [PMID: 35670521 DOI: 10.2989/17280583.2022.2058952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
While practitioners might engage caregivers on their understandings of the disruptive behavioural disorders of their children, their perspectives are yet to be examined in a qualitative study. This study explored perspectives of primary caregivers on the disruptive behaviour of children who attended the child unit of Weskoppies Psychiatric Hospital, in South Africa. Qualitative methods were used in a case study design. Nineteen participants were purposively sampled. The participants were interviewed using individual in-depth, semi-structured interviews. Data were analysed using typological and bracketed grounded theory methods. Both methods revealed these themes: confusion, emotional build-up towards a meltdown; loss of others; spiritual and cultural (dis)connectedness; behaviour of others towards the children; something being wrong medically; behavioural difficulties when "I want my way"; emotional turmoil of caregivers; and corrective responses. Differences yielded by the analytic methods were a yearning for a better future, and the perspective that trauma had impacted the child's behaviour. These findings suggest that practitioners may anticipate and support caregivers in their experiences of emotional turmoil, uncertainty and confusion. Caregivers may be informed regarding emotional dysregulation and that a therapeutic resource may be found in the knowledge that the caregivers have a yearning for a better future for their children.
Collapse
Affiliation(s)
- Lanél Maré
- Department of Psychiatry, University of Pretoria, Pretoria, South Africa
| | - Werdie van Staden
- Centre for Ethics and Philosophy of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Junaid Hassim
- Department of Psychiatry, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
38
|
Exploring the use of the Cognitive Orientation to daily Occupational Performance approach (CO-OP) with children with executive functions deficits after severe acquired brain injury: A single case experimental design study. Ann Phys Rehabil Med 2021; 64:101535. [PMID: 33933689 DOI: 10.1016/j.rehab.2021.101535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/07/2021] [Accepted: 03/16/2021] [Indexed: 11/20/2022]
Abstract
Children with acquired brain injury (ABI) often have cognitive and behavioral impairments that affect participation in everyday activities. Among them, executive function (EF) deficits are frequent. Cognitive Orientation to Daily Occupational Performance (CO-OP) is an individualized treatment that teaches cognitive strategies necessary to support successful performance. Few studies have examined the effectiveness of CO-OP in children with EF deficits after ABI. OBJECTIVES to assess whether the use of CO-OP could be of interest in children with EF deficits after ABI, to improve their occupational performance, their executive functioning in everyday life and their cognitive processes constituting EF. METHODS This was a single case experimental study with multiple baselines across individuals and behaviors. We included 2 children at least 6 months after severe ABI. The children received 14 individual sessions of the CO-OP intervention. Each child set 3 goals by using the Canadian Occupational Performance Measure; 2 goals were trained and the third was a control goal. The achievement of the goals was measured by using repeated measures of Goal Attainment Scales (GASs). Ecological assessments of EF included the Children's Cooking Task and parent and teacher ratings of the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire. RESULTS both children improved their performance on both trained goals (and, to a lesser extent, on untrained goals). We found significant improvement on tests of EF and on the BRIEF questionnaire, reflecting executive functioning in everyday life, at home and at school. CONCLUSIONS these results are encouraging and suggest the feasibility and effectiveness of CO-OP for children with EF deficits after ABI. They should be replicated in a larger number of cases. TRIAL REGISTRATION ClinicalTrials.gov (NCT04718688).
Collapse
|
39
|
Steinhardt F, Dolva AS, Jahnsen R, Ullenhag A. Exploring two subdimensions of participation, involvement and engagement: A scoping review. Scand J Occup Ther 2021; 29:441-463. [PMID: 34242105 DOI: 10.1080/11038128.2021.1950207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The conceptualisation of participation is an ongoing discussion with importance for measurement purposes. The aim of this study was to explore the two subjective subdimensions of participation, involvement and engagement. The purpose was related to measure development within the field of paediatric rehabilitation. METHODS In a scoping review, following the PRISMA-ScR, the databases MEDLINE, PubMed, Academic Research Complete, PsychINFO, and Business Source Complete were searched for publications that described engagement and/or involvement constructs. RESULTS Thirty-nine publications met the inclusion criteria. Involvement could be conceptualised as an unobservable state of motivation, arousal, or interest towards a specific activity or product. Building a consensus over different fields of research, engagement can be seen as the individual's behavioural, cognitive and affective investment during role performance. CONCLUSIONS This scoping review points in a direction that the two subdimensions of participation need to be separated, with involvement being a more stable internal state of interest towards an activity, and engagement referring to the specific behaviour, emotions, and thoughts meanwhile participating in a specific setting. Clear definition of concepts will enhance the development of measures to evaluate rehabilitation interventions in the field of occupational therapy and related fields.
Collapse
Affiliation(s)
- Friedolin Steinhardt
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Anne-Stine Dolva
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Reidun Jahnsen
- Department of Neurosciences for Children, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, CHARM, University of Oslo, Oslo, Norway
| | - Anna Ullenhag
- Department of Health, Care and Social Welfare, Mälardalens University, Sweden
| |
Collapse
|
40
|
Verma S, Agrawal R. Psychotropic Medication Adherence in Children and Adolescents. South Med J 2021; 114:388-394. [PMID: 34215889 DOI: 10.14423/smj.0000000000001276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Researchers believe that almost 20% of children and adolescents struggle with chronic and persistent mental health concerns. Mental health is the leading cause of disability in the United States. Youth can struggle with several impairing mental health disorders, such as attention-deficit/hyperactivity disorder, mood disorders, psychotic disorders, and autism spectrum disorder. Inadequately treated chronic mental illnesses can adversely affect the growing brain profoundly, including academic decline, early school dropout, cognitive deficits, interpersonal relationship concerns, aggression, suicide attempts or completion, substance use disorders, frequent hospital admissions, and inability to maintain employment. Even if diagnosed early in their course of illness, many of these individuals struggle to continue medications as prescribed. The factors predicting adherence to medications are underresearched in children and adolescents. Psychotropic medication compliance is a complicated issue that is tied to various aspects of caring for a minor individual. Hence, it is relevant to discuss factors that are predicted to contribute to noncompliance in this age group. The purpose of this review is to carefully consider the gaps in knowledge, suggesting interventions by using established instruments and clinical strategies to resolve the identified barriers for improving medication adherence. Compliance should be targeted at various levels, including the entire family tree and the treatment team.
Collapse
Affiliation(s)
- Shikha Verma
- From Evolve Treatment Center-PC, Danville, California, and Centerstone of Kentucky, Louisville
| | - Ruchita Agrawal
- From Evolve Treatment Center-PC, Danville, California, and Centerstone of Kentucky, Louisville
| |
Collapse
|
41
|
Melvin K, Meyer C, Scarinci N. What does a family who is "engaged" in early intervention look like? Perspectives of Australian speech-language pathologists. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:236-246. [PMID: 32664748 DOI: 10.1080/17549507.2020.1784279] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To build a description of what engagement in early speech-language pathology intervention looks like, by exploring speech-language pathologists' (SLPs) perceptions of (1) what characteristics best describe families who are "engaged" in early speech-language pathology intervention and (2) which characteristics are most important for engagement. METHOD Group concept mapping, a participatory mixed-methods research approach, was used to represent the perspectives of Australian SLPs working with children aged 0-8 years and their families in early intervention. Using Concept Systems software, participants: (1) brainstormed responses to a focus question (n = 58); (2) grouped statements into categories (n = 34); and (3) rated the importance of each statement (n = 29). RESULT SLPs identified 108 characteristics of engagement in early speech-language pathology intervention, which were grouped into seven key concepts: (1) the family is reliable and ready for therapy; (2) the family has an open, honest relationship with the SLP; (3) the family actively participates and takes initiative; (4) the family works in partnership to plan and set goals together; (5) the family sees and celebrates progress; (6) the family invests in intervention at home; and (7) the family understands intervention and advocates for their child. All aspects of engagement were considered important by participants, with the family-SLP relationship and families continuing to invest in intervention at home being rated most highly. CONCLUSION Results present a picture of engagement which has been informed by stakeholders, and which goes beyond aspects of engagement which have previously been identified in the literature. Families who are engaged in early speech-language pathology intervention are actively invested and involved in intervention in various ways, both inside and outside the clinic room.
Collapse
Affiliation(s)
- Katelyn Melvin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Carly Meyer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
42
|
Herpers PCM, Neumann JEC, Staal WG. Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence. Child Psychiatry Hum Dev 2021; 52:515-532. [PMID: 32748274 PMCID: PMC8113221 DOI: 10.1007/s10578-020-01036-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/28/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022]
Abstract
Auto-aggressive behaviour, especially treatment refractory suicidality in adolescents with psychiatric disorders, may be challenging to clinicians. In search of therapeutic possibilities, we have integrated current opinions regarding causality and interdependency of suicidality and auto-aggressive behaviour across disorders within the HiTOP framework. We propose a developmental model regarding these unsettling behaviours in youths that may help to guide future directions for research and interventions. We argue that the interdependent development of biologic factors, attachment, moral reasoning and emotion regulation in an overprotective environment may lead to social anxiety and later during development to emotion dysregulation and severe internalizing behaviour disorders. To optimize treatment efficacy for both internalizing and externalizing behaviour, we emphasize the importance transdiagnostic interventions, such as addressing non-compliance, restoration of trust between parents and their child, and limitation of avoidance behaviour. These may be seen as higher order interventions within the HiTOP framework.
Collapse
Affiliation(s)
- Pierre C M Herpers
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands.
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands.
| | - Josephine E C Neumann
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands
| | - Wouter G Staal
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Geert Grooteplein 10, Nijmegen, 6525 GA, The Netherlands
- Faculty of Social Sciences, Leiden Institute for Brain and Cognition, Postzone C2-5, P.O. Box 9600, Leiden, 2300 RC, The Netherlands
| |
Collapse
|
43
|
King G, Chiarello LA, Phoenix M, D'Arrigo R, Pinto M. Co-constructing engagement in pediatric rehabilitation: a multiple case study approach. Disabil Rehabil 2021; 44:4429-4440. [PMID: 33866904 DOI: 10.1080/09638288.2021.1910353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To explore engagement principles and contextual conditions in high-engagement therapy sessions involving youth with disabilities and service providers. METHOD From a larger project on therapy engagement, a dyadic case analysis was conducted involving three youth ages 8-15 with disabilities and their service providers. Participants were interviewed about their engagement experiences after high-engagement sessions focusing on speech articulation, transition goals, and physical mobility. Data were analyzed thematically, with an emphasis on engagement principles illustrated by the cases. RESULTS There were four service provider engagement principles: (a) clients differ in what engages them and in how they display engagement (Individual Variation Principle), (b) there are multiple ways to engage clients (Personalizing Principle), (c) engagement is cultivated through relationship (Relationship Principle), and (d) it is important to monitor and be attuned to the client's level of engagement over a session (Monitoring Principle). Service providers' use of engagement strategies varied due to contextual conditions, including therapy type and youths' interests and preferences. CONCLUSIONS The findings indicate the value of providers' awareness of the dynamics of engagement, their use of personalized strategies to engage clients, and the fundamental importance of cultivating a good relationship and monitoring client engagement during therapy.IMPLICATIONS FOR REHABILITATIONService providers may benefit from being aware of common principles underlying the co-construction of engagement between service providers and clients.Service providers can use a variety of personalized strategies to heighten client engagement, and can work to cultivate a positive relationship.It is important to monitor clients' non-verbal and verbal signs of engagement and respond to signs of disengagement during therapy.Contextual conditions affecting service providers' use of engagement strategies include the nature of the therapy being provided and youths' interests and preferences.
Collapse
Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Lisa A Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
| | - Michelle Phoenix
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,School of Rehabilitation Science and CanChild, McMaster University, Hamilton, Canada
| | - Rachel D'Arrigo
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Madhu Pinto
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| |
Collapse
|
44
|
Smith KA, Samuels AE. A scoping review of parental roles in rehabilitation interventions for children with developmental delay, disability, or long-term health condition. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 111:103887. [PMID: 33549932 DOI: 10.1016/j.ridd.2021.103887] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 06/12/2023]
Abstract
The importance of parental roles in rehabilitation interventions (i.e. the tasks and responsibilities assigned to parents in intervention) is widely reported but there is a paucity of information regarding the tasks linked with specific parental roles. A rigorous scoping review was conducted to understand the various roles that parents of children with developmental delays, disabilities, and long-term health conditions perform in intervention and the tasks and responsibilities associated with each role. The results confirm that parents take on distinct intervention roles which can be placed on a continuum from passive to active responsibility. Some parental roles are clearly associated with tasks completed in-session, some are linked with out-of-session tasks while others entail a combination of in-and out-of-session tasks. The in-session tasks linked with the Learner role emerged as central to enabling parents to assume other in-and out-of-session roles. The results also highlight the influence of the parent-professional relationship on the type of roles parents take on in their child's intervention. The findings of the scoping review serve as the initial step in generating items for a tool to measure the type of roles that parents assume in intervention to empirically test the relationship between these roles and parental engagement.
Collapse
Affiliation(s)
- Katherine A Smith
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa.
| | - Alecia E Samuels
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| |
Collapse
|
45
|
Dowell KA, Nielsen SJ. Caregiver engagement in youth partial hospitalization treatment. Clin Child Psychol Psychiatry 2021; 26:355-366. [PMID: 33307741 DOI: 10.1177/1359104520978448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although the importance of caregiver engagement in a child's psychological treatment is well established within outpatient treatment settings, the question remains whether these findings can be generalized to more intensive treatment settings where caregiver engagement may be more challenging to facilitate. A correlational, multi-informant design was used to collect data by caregiver self-report and therapist-report from a sample of 64 caregivers of youth referred for partial hospitalization. Results show that caregivers' attitudinal self-assessment of engagement was not significantly related to their self-report of behavioral engagement (e.g. number of family sessions attended) or therapists' report of caregiver engagement. After controlling for caregiver expectations and therapist ratings of caregiver engagement, only caregiver ratings of attendance at family sessions marginally predicted treatment outcomes, but in the negative direction. Implications for adapting measures of caregiver engagement to intensive treatment settings and its impact on treatment outcomes are discussed.
Collapse
Affiliation(s)
- Kathy A Dowell
- Department of Psychology, University of Minnesota Duluth, Duluth, MN, USA
| | - Summer J Nielsen
- Department of Psychology, University of Minnesota Duluth, Duluth, MN, USA
| |
Collapse
|
46
|
Melvin K, Meyer C, Scarinci N. Exploring the complexity of how families are engaged in early speech-language pathology intervention using video-reflexive ethnography. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:360-373. [PMID: 33577716 DOI: 10.1111/1460-6984.12609] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 12/14/2020] [Accepted: 12/18/2020] [Indexed: 05/23/2023]
Abstract
BACKGROUND Despite being an important aspect of effective early intervention service delivery, 'engagement' has been inconsistently defined in paediatric healthcare. Previous research has identified that engagement in early speech-language pathology intervention is complex and multifaceted. However, more research is needed to understand the ways that different families may engage with intervention in different settings. AIMS To explore the complexity of engagement in early speech-language pathology intervention from the perspectives of both families and their speech-language pathologists (SLPs). METHOD & PROCEDURES Video-reflexive ethnography was used to explore engagement with 21 matched SLP-family dyads in early intervention services. Up to three intervention appointments for each participating family were video recorded. Short video segments were selected and played to participants during individual semi-structured interviews where participants were invited to reflect on the interactions captured (i.e., 'video-reflexive sessions'). Interview data were analysed using thematic analysis. OUTCOMES & RESULTS Results from the interview data were organized into one overarching theme 'Families may have "different levels of engagement"', and four individual themes that reflected how families engage differently in various aspects of intervention, including (1) attending sessions and coming into the room; (2) actively participating in sessions; (3) continuing to actively participate outside sessions; and (4) having open and honest communication with their SLPs. CONCLUSIONS & IMPLICATIONS Families may have different levels of engagement in various aspects of intervention, which contribute to their unique profile of engagement. Findings of this study prompt SLPs to move beyond using blanket statements about whether or not families are engaged, to instead describing in detail how families are uniquely engaged. What this paper adds What is already known on the subject In early speech-language pathology intervention, the term 'engagement' refers to (1) a complex, multifaceted state of families 'being engaged' in intervention both inside and outside sessions; and (2) a relational, co-constructed process where many families 'become engaged' in intervention as they work together with SLPs. Although research has acknowledged engagement may look different for each parent and family, little is known about how families are uniquely engaged in early speech pathology intervention in different settings. What this paper adds to existing knowledge This study is the first to explore engagement from the perspectives of both families and SLPs working together in intervention. Both groups of participants described the complexity of engagement in this setting and acknowledged that families engage differently in different aspects of intervention, which contribute to their unique profile of engagement. What are the potential or actual clinical implications of this work? Being able to identify potential indicators of engagement, such as the ones described in this study, provide opportunities for SLPs to take a reflexive approach to engaging with individual families, in line with principles of family-centred care. Findings of this study therefore prompt SLPs to reflect on how the families they work with are engaged in intervention, and to consider their own role in facilitating engagement. In addition, results highlight the importance of SLPs initiating open conversations with families themselves about how they would like to be engaged in intervention, and what support would be most beneficial to them.
Collapse
Affiliation(s)
- Katelyn Melvin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Carly Meyer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
47
|
King G, Chiarello LA, McLarnon MJW, Ziviani J, Pinto M, Wright FV, Phoenix M. A measure of parent engagement: plan appropriateness, partnering, and positive outcome expectancy in pediatric rehabilitation sessions. Disabil Rehabil 2021; 44:3459-3468. [PMID: 33390023 DOI: 10.1080/09638288.2020.1864036] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To examine the psychometric properties of a parent-report measure of engagement in pediatric rehabilitation. METHOD 113 parents (of children 4 months to 18 years, varying in diagnoses) were recruited from standard outpatient/inpatient, early intervention, and life skills programs, sampled from different sites in Canada, the US, and Australia. Parents completed the Pediatric Rehabilitation Intervention Measure of Engagement-Parent version (PRIME-P) twice, after two therapy sessions approximately two weeks apart. Analyses examined factor structure, internal consistency, and test-retest reliability, and assessed construct validity hypotheses concerning participant characteristics and contextual factors. RESULTS The resulting 11-item PRIME-P has three factors capturing engagement in terms of Plan Appropriateness, Partnering, and Positive Outcome Expectancy. The factors displayed strong internal consistency and test-retest reliability (Partnering demonstrated slightly weaker test-retest reliability). Construct validity was shown by significant associations between the PRIME-P scales and parents' presence versus absence during the sessions, as well as service providers' years of experience. CONCLUSIONS The PRIME-P captures parent engagement as a multifaceted construct involving appropriateness of the therapy plan, a sense of active partnership in the intervention process, and an expectation for a positive outcome. The PRIME-P has promise for research, clinical practice, and educational purposes.IMPLICATIONS FOR REHABILITATIONThe PRIME-P is a psychometrically sound tool that fills a gap in how researchers and practitioners can measure the engagement of parents in the therapy process.To enhance parent engagement, service providers can encourage collaboration in planning, foster a sense of working in partnership, and convey a sense of hope.The findings point to the need to pay attention to parents' beliefs about the therapy plan and outcomes, in addition to their behavioral involvement.The PRIME-P is a promising tool for pediatric rehabilitation that can be used to investigate the role of a crucial, yet poorly understood variable in the therapy process.
Collapse
Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Lisa A Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
| | | | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Madhu Pinto
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - F Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Michelle Phoenix
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,School of Rehabilitation Science and CanChild, McMaster University, Hamilton, Canada
| |
Collapse
|
48
|
Seko Y, King G, Keenan S, Maxwell J, Oh A, Curran CJ. Perceived Impacts of Solution-Focused Coaching Training for Pediatric Rehabilitation Practitioners: A Qualitative Evaluation. Phys Occup Ther Pediatr 2021; 41:340-354. [PMID: 33441052 DOI: 10.1080/01942638.2021.1872758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS This qualitative evaluation study assessed perceived impacts of a solution-focused coaching (SFC) training rolled out in a Canadian pediatric rehabilitation hospital from the perspective of clinical service providers. METHODS Thirteen clinical service providers were interviewed six months after receiving 2-day SFC training. Participants retrospectively described perceived impacts of the training and benefits and challenges pertinent to the implementation of the SFC approach. Interview transcripts were transcribed verbatim and analyzed thematically. RESULTS SFC training was considered making a valuable addition to participants' toolbox, increasing their confidence in developing positive therapeutic alliance with clients, and enhancing their strengths-based orientation. The training was also seen improving team cohesion and promoting collaborative solution-finding among team members. Structural barriers such as time constraints, lack of continuous organizational support and clear expectations around the use of the SFC approach were reported as factors impeding effective clinical adaptation. The need for tailoring the SFC approach to unique service contexts was also reported. CONCLUSIONS Future SFC training initiatives should integrate a team-based approach and a culturally sensitive lens to help providers better assist clients in identifying their unique strengths. Follow-up training and continuous organizational support mechanisms will be vital for facilitating sustainable implementation after the initial training.
Collapse
Affiliation(s)
- Yukari Seko
- School of Professional Communication, Ryerson University, Toronto, Canada.,Bloorview Research Institute, Toronto, Canada
| | - Gillian King
- Bloorview Research Institute, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Sarah Keenan
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Joanne Maxwell
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Anna Oh
- Bloorview Research Institute, Toronto, Canada
| | - C J Curran
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| |
Collapse
|
49
|
King G, McDougall C, Kingsnorth S, Pinto M. Program factors influencing parents' engagement in a friendship-making intervention for youth with disabilities. Disabil Rehabil 2020; 44:1620-1630. [PMID: 33351666 DOI: 10.1080/09638288.2020.1861115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim was to examine parents' experiences of engagement in a friendship-making intervention for youth with physical and developmental disabilities. METHOD This mixed methods study used a convergent parallel design where quantitative and qualitative data were collected concurrently, analyzed independently, and then merged into an overall interpretation. Four parents completed the Pediatric Rehabilitation Intervention Measure of Engagement-Parent version at four points during the 8-week program. They also took part in post-intervention interviews about their engagement-related experiences, including their involvement, interest, and confidence in the parent sessions. RESULTS Parents' engagement experiences were captured in four themes involving the person-intervention fit: the relevance of program content, the usefulness of the content, their behavioral involvement in planning and group discussions, and seeing youth experience success. The themes corroborated the quantitative measurement of engagement and illustrated and elaborated on how program factors influenced engagement. CONCLUSIONS This study indicates the value of including a parent component in a youth friendship-making intervention, and points to the importance of considering relevance, usefulness, behavioral involvement, and success in designing these sessions. The four themes reflect important program factors that may be broadly relevant to the design of group-based interventions for parents of youth with disabilities.IMPLICATIONS FOR REHABILITATIONThe findings indicate the value of including a parent component in youth interventions.Parents are engaged when they feel programs are relevant and useful, are behaviorally involved, and see youth experience success-these factors should be considered in optimal program design.It is important to optimize parent engagement by personalizing content, such as by providing choices and options to increase relevance and decrease burden.Transparent communication about program content and the benefits experienced by other parents will help new parents be more fully informed about what to expect.
Collapse
Affiliation(s)
- Gillian King
- Bloorview Research Institute, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Carolyn McDougall
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Shauna Kingsnorth
- Bloorview Research Institute, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Madhu Pinto
- Bloorview Research Institute, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| |
Collapse
|
50
|
Armstrong EL, Boyd RN, Carty CP, Kentish MJ, Goodlich BI, Horan SA. A qualitative analysis of the experiences of children with cerebral palsy and their caregivers in a goal-directed cycling programme. Disabil Rehabil 2020; 44:2715-2722. [PMID: 33147078 DOI: 10.1080/09638288.2020.1839134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE This qualitative thematic analysis aimed to capture the experiences of children with cerebral palsy (CP) and caregivers who completed an 8-week goal-directed cycling programme, to provide insights on engagement and programme feasibility. METHODS Children with CP (6-18 years, Gross Motor Function Classification Scale (GMFCS) levels II-IV) and caregivers completed semi-structured interviews at the end of the training programme. Interview transcripts were coded by two investigators and systematically organised into themes. A third investigator reviewed the final thematic map. RESULTS 17 interviews were conducted with 29 participants (11 children: 7-14 years). Four themes emerged: facilitators and challenges to programme engagement; perceived outcomes; the functional-electrical stimulation (FES) cycling experience; and previous cycling participation. Engagement was facilitated by the "therapist's connection," "cycling is fun" and "participant driven goal setting," while "getting there" and "time off school" were identified as challenges. Participants positively linked improved physical function to greater independence. The FES-experience was "fun and challenging," and participants had mixed feelings about electrode "stickiness." Previous cycling participation was limited by access to adapted bikes. CONCLUSIONS Children with CP enjoy riding bikes. Facilitators and challenges to engagement were identified that hold practical relevance for clinicians. Environmental and personal factors should be carefully considered when developing future programs, to maximise opportunities for success. CLINICAL TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry - ACTRN12617000644369pIMPLICATIONS FOR REHABILITATIONAdapted cycling is a fun and engaging activity for young people with cerebral palsy.Environmental and personal factors should be carefully considered when prescribing adapted or FES cycling programs to this group.Engagement in adapted and FES-cycling programs can be facilitated by access to loan equipment, a goal-directed focus, and positive therapist-child relationship.Participation in adapted cycling is limited by access to adapted cycling equipment.
Collapse
Affiliation(s)
- Ellen L Armstrong
- School of Allied Health Sciences, Griffith University, Queensland, Australia
| | - Roslyn N Boyd
- The Queensland Cerebral Palsy Rehabilitation Research Centre, Centre for Children's Health Research, The University of Queensland, Queensland, Australia
| | - Christopher P Carty
- School of Allied Health Sciences and Gold Coast Orthopaedic Research Engineering and Education Alliance, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Megan J Kentish
- Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Queensland, Australia
| | - Benjamin I Goodlich
- School of Allied Health Sciences, Griffith University, Queensland, Australia
| | - Sean A Horan
- Menzies Health Institute Queensland and School of Allied Health Sciences, Griffith University, Queensland, Australia
| |
Collapse
|