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Introduction During role-emerging placements students require different support as occupational therapy specific supervision is provided periodically and they cannot model their practice on experienced occupational therapists. This paper describes the development and evaluation of a workbook designed to reinforce the integration of theory with practice and provide an additional resource to support students when a supervisor was not present.Method A social constructionist perspective and action research methodology were used. Participants were 14 final year occupational therapy students and three off-site occupational therapy supervisors. All participants were involved in role-emerging placements in school settings in England. In-depth, semi-structured interviews across four action research cycles informed the development and evaluation of the workbook.Findings While the workbook originally focused on supplementing students’ knowledge of occupational therapy theory, during the action research cycles the focus shifted to consider how educational theory informed workbook design and content. Key features and critical aspects which supported students’ learning were identified.Conclusion The workbook was received positively by students and supervisors. Aspects which were particularly valued included the provision of examples and scenarios which contextualised theory within the placement setting. The workbook was proposed to have scope for use in placements beyond school-based practice.

Introduction: Occupational Performance Coaching is an intervention provided to parents, which targets their goals in occupational performance for themselves and their children. Preliminary evidence points to its effectiveness; however, little is known about parents' experiences of engaging in Occupational Performance Coaching.Method: Within a larger mixed methods study, a purpose-designed survey comprising open and closed questions was used to explore parents' (N = 29) experiences of engaging in Occupational Performance Coaching. The survey targeted their impressions, learning experiences, and perceptions of the impact of Occupational Performance Coaching. Numerical data were analysed descriptively; written comments were analysed using content analysis. In this case all participants were mothers.Findings: Mothers' descriptions of Occupational Performance Coaching were largely positive. Learning experiences included gaining insights about themselves and their children alongside learning specific strategies to support their children's occupational performance. They reported greater understanding of their children and a perception that Occupational Performance Coaching had engendered a calmer, happier emotional tone within the family.Conclusion: Mothers perceived Occupational Performance Coaching as a valuable means to support their children and themselves to attain occupational performance goals. Findings prompt greater attention to coaching approaches and, more widely, the use of transformative learning as a means to enabling occupation.

Introduction: Hand skills are essential for children's occupational performance. The Assessment of Children's Hand Skills is a new assessment that utilizes naturalistic observations to capture children's actual hand-skill performance in everyday contexts. This study aimed to explore intra- and inter-rater reliability of the assessment based on video recordings, which are different from original naturalistic observations.Method: Two raters scored video recordings of 54 hand-skill activities performed by 12 children with developmental disabilities, twice in 2 weeks. Intra- and inter-rater reliability was examined at the individual hand-skill item scores, activity scores, and children's composite scores of the Assessment of Children's Hand Skills.Findings: Intra-rater reliability at item levels was generally acceptable, and both raters exhibited moderate to high agreement between the first and second evaluations (intraclass correlation coefficients = 0.61–0.93) at activity scores and children's composite scores. However, the agreement between the two raters was unacceptable for most hand-skill items and activity scores. After rater effects were adjusted by Rasch analysis in children's composite scores, the inter-rater reliability was improved (intraclass correlation coefficient = 0.81).Conclusion: This study shows that the Assessment of Children's Hand Skills based on video recordings is reliable within the same raters. Further research is required to confirm its inter-rater reliability by involving more training and raters with varied clinical experience.

Objectives: This exploratory study investigated the sensory processing patterns of boys with Duchenne muscular dystrophy (DMD) using the Sensory Profile. It was hypothesised that this group would be different to a typically developing sample of American children in the normative sample of the Sensory Profile. In doing so, the utility of the Sensory Profile for a sample of boys with DMD was investigated.Method: Data were gathered from the caregivers of 37 boys with DMD living in Australia, using the Sensory Profile Caregiver Questionnaire. The means of the DMD boys were compared with the means of American boys without disabilities.Results: Boys with DMD were different to the normative sample in the Auditory processingsection, two of the five sections in the Modulationdomain (Movement affecting activity leveland Sensory input affecting emotional responses) and two of the three sections in the Behaviour and Emotional Responsesdomain (Emotional/ social responsesand Behavioural outcomes of sensory processing).Conclusion: This sample of boys with DMD may have had specific areas of sensory processing difficulties. Further research is needed to identify a more suitable tool for the assessment of children with DMD and to examine further the sensory patterns of boys with DMD.

Introduction: This preliminary study investigated the play skills and frequency of engagement in play of young children with and without motor coordination difficulties.Method: Using a quasi-experimental design with two independent groups, the play of 21 children aged 4–6 years with (n = 11) and without coordination difficulties (n = 10) was assessed using the Revised Knox Preschool Play Scale and the Play Observation Scale, based on 30 minutes of videotape of play at preschool. Motor skills were assessed using the Developmental Coordination Disorder Questionnaire — German and the Movement Assessment Battery for Children — Second Edition.Results: Significant differences were found in developmental play skills between the two groups, specifically in the children's overall play age and in gross and fine motor play, with lower play ages found for children with coordination difficulties. Frequency of engagement and social interaction in play was significantly different: children with coordination difficulties spent more time as onlookers, or in transition, than their typically developing peers. They were more frequently involved in an aggressive incident and had higher frequency of negative affect than the control children during play.Conclusion: Children with coordination difficulties engaged in less mature gross and fine motor play than the control group. Difficulties in social interaction seem to be evident at a younger age than has previously been described. Early identification of these difficulties may provide directions for intervention; however, this needs to be more fully explored with a larger sample.

Purpose: The construction of routines and rituals plays a significant role in the organisation of daily activities and the health and wellbeing of families. Studies have revealed that the pervasive nature of autism spectrum disorder (ASD) influences the development of functional routines and meaningful rituals. However, there is limited information on the extent of this influence on families of children with autism compared with families with typically developing (TD) children.Procedures: The mothers of children aged 2–6 years completed the Family Routines Inventory (FRI) and the Family Ritual Questionnaire (FRQ) to compare the role of routines and rituals in families with TD children (n = 10) and families of children with ASD (n = 12).Findings: The findings revealed higher mean scores across all variables for the TD group compared with the ASD group, except for ‘FRQ Planning’; however, the differences were not significant. The only significant difference between the groups was ‘FRQ vacations' which revealed a higher score (t(20) = −2.30, p = 0.032) in the TD group, suggesting that families in the ASD group may organise and participate in fewer vacations.Conclusion: When addressing the challenges faced by families of children with ASD, occupational therapists must consider the significant role of establishing functional family routines and rituals. These may provide structure and organisation and promote the health and wellbeing of families.

Juvenile idiopathic arthritis (JIA) is used to describe the different subgroups of arthritis in children. JIA is the most common chronic rheumatic condition in children. The long-term consequences are not limited to physical disabilities but also have an impact on the child's social, emotional and cognitive development. Home exercise programmes are a major part of the complex treatment regimen for JIA. Research to date is limited in providing insights into children's perspectives about JIA.This paper describes a qualitative study undertaken to identify children's perceptions about their participation in home exercise programmes. Using semi-structured interviews, the perspectives of 13 children (aged 8–16 years) about their experiences of living with JIA and specifically about participating in therapist-prescribed exercise programmes were investigated.Two major themes highlighted the pervasive impact of JIA on the children's lives. First, the children described living with JIA and associated feelings of ‘being different’. Secondly, they discussed their understanding of home exercise programmes and the barriers and facilitators to participation. Key barriers were having better things to do, time required, laziness, boredom, forgetfulness and pain. Facilitators included the incorporation of exercises into everyday routines, making them fun and having rewards. Clinical implications and avenues for future research are also outlined.

The parents of children with juvenile idiopathic arthritis have been identified as pivotal facilitators of children's involvement in treatment regimens, including home exercise programmes. As such, parents' perspectives regarding the factors that influence participation in their children's treatment regimens, and in particular home exercise programmes, are addressed in this study. In depth, semi-structured interviews were conducted with 16 families. Rigour was ensured through a rich description of participants, peer and member checking, field journals and audit trails.Four key topics related to the process — the experience of the child's diagnosis, community access and participation, treatment regimens and the impact of these regimens on the parent's roles and relationships — and were addressed. Seven key themes emerged, namely the difficult process of diagnosis, the emotional toll, medications, exercises, life revolves around arthritis, parents' relationship with their child and other family members, and parents and paid work. The implications for clinical practice and future research are discussed.

The visual perceptual skills of children are often evaluated by health care and education practitioners. Even though the Test of Visual Perceptual Skills - Revised(TVPS-R) is one of the most frequently used instruments with school-age children, its construct validity has not been evaluated thoroughly. The purpose of the study was to evaluate the scalability/interval level measurement, unidimensionality, lack of differential item functioning (DIF), and hierarchical ordering of items of the TVPS-R and its seven subscales using the Rasch Measurement Model (RMM). The TVPS-R scores from a sample of 356 normally developing children (171 boys and 185 girls), ranging in age from 5 to 11 years, were used to complete the RMM analysis.When the seven individual TVPS-R scales were analysed, they all exhibited adequate measurement properties (scalability/interval level measurement, unidimensionality, lack of DIF, and hierarchical ordering). However, when they were collapsed together to form an overall composite scale of motor-free visual perceptual skills, the TVPS-R items failed to group together to measure a unidimensional construct. In addition, many scale items exhibited RMM misfit or DIF.The results suggest that the seven TVPS-R subscales can be used on an individual basis with clients to generate a profile of their motor-free visual perceptual skills, but that they cannot be summed together to calculate an overall summary motor-free visual perceptual score or perceptual quotient. The TVPS-R composite scale does not exhibit adequate construct validity.

Maintaining relationships and interacting socially are essential aspects of the occupational performance of childhood and adolescence. Social participation occurs during many childhood occupations, such as play and school work. Occupational therapists assess and treat children with difficulties in social participation. Rather than assessing a child's social skills deficits in isolation, the use of occupation-based theoretical models guides clinicians to consider the individual in his or her environments and during occupations. Familiarity with existing models of social competence and available assessment tools provides occupational therapists with the basis for a comprehensive assessment of children.This paper presents an occupational therapy model (the Model of Human Occupation), models of social competence from cognate fields and a range of assessment tools in order to guide occupational therapists in assessing and treating children with social participation difficulties in a more occupation-centred manner. The paper also presents a rationale for the use of multiple methods for a comprehensive assessment of a child's social competence.

The Queensland Occupational Therapy Fieldwork Collaborative (QOTFC), which was founded in 2004, includes representatives from universities, practising occupational therapists, professional registration bodies and key employers, and aims to promote a shared vision for the future of practice placement education (fieldwork) in Queensland, Australia. Strategic alliances between key occupational therapy stakeholders were fostered by the QOTFC to address a shortfall of occupational therapy practice placement education opportunities in Queensland. This paper describes a project that aimed to engage occupational therapy clinicians in localised ‘hubs’ across the state of Queensland, with a view to solving practice placement shortfalls. The project evaluation and outcomes are discussed. The outcomes indicated that ownership of practice placement education across the entire profession is critical, and can be achieved through a strategic and a collective focus of key stakeholders working collaboratively with local professionals.

Cognitive Orientation to daily Occupational Performance (CO-OP) is a cognitive problem-solving approach that has recently been used with children with Asperger's syndrome (AS) to achieve motor-based goals. Children with AS have a marked impairment in social interaction, which is pervasive and continues across the lifespan. Many of these children also experience organisational difficulties. There has been limited research regarding social skills interventions for children with AS. Existing social skills interventions lack evidence for the generalisation and transfer of learned skills to new environments.This paper presents two case studies of children with AS to address both the utility and the potential of CO-OP to enable mastery of social and organisational goals. Two boys, aged 10 and 12, engaged in 10 CO-OP sessions. The Canadian Occupational Performance Measure, the Social Skills Rating Scale and the Performance Quality Rating Scale were used to determine goal achievement pre-intervention and post-intervention. The post-intervention measures showed that both children improved in social and organisational skills, and they generalised and transferred their learning to their home and school environments. Modifications to CO-OP for children with AS, study limitations and recommendations for future research are discussed.

This study investigated the playfulness of 24 children with autistic disorder (AD) and 34 typically developing children aged 3–7 years, in free (unstructured) and adult-facilitated (structured) play conditions within a clinical play environment. Video recordings of play were rated using the Test of Playfulness (Bundy 2003). The data were analysed using repeated measures ANOVA and ANCOVA and qualitative observations.The children with AD were less playful compared with the typically developing children (F = 49.64, p<0.001), even when developmental age was accounted for (F = 28.20, p<0.001). Both groups of children were slightly more playful in a structured environment with adult facilitation (F = 7.72, p = 0.007). Despite statistically significant differences in playfulness between play conditions, considerable overlap in observations for both groups suggests that this may not be as clinically meaningful. When developmental age was accounted for, the play conditions no longer had a significant effect on playfulness (F = 1.54, p = 0.220). The implications of the findings and the limitations of the study are discussed.

This study employed social judgement theory to identify and determine the relative importance of factors influencing occupational therapists' subjective decision making when managing children and adolescents with cerebral palsy and upper limb hypertonicity. An extensive literature review was conducted to identify potential factors that might be used. Two clinical experts were then asked to review and refine these factors. Finally, 12 experienced occupational therapists who had worked with people with cerebral palsy for at least 5 years were asked to add or exclude factors and then to rank them. Thirty-seven factors that might influence therapists' decision making were identified and ranked.The reason for referral and family's goals were ranked as the first and second most important factors respectively. Agreement among therapists was significant, but low (Kendall's W = 0.38; p<0.0001). When participants were divided into two groups, those who were very experienced (mean = 13 years, SD = 6.95) and those with less experience (mean = 5.6 years, SD = 0.55), the ranking of the factors did not differ significantly. These findings are discussed with respect to research in clinical decision making, the training of occupational therapists and the education of students.

The aim of this study was to determine the characteristics and publication practices of English language occupational therapy journals. An adapted version of the Survey of Editors Regarding Publishing Practiceswas posted to the editors of English language occupational therapy journals (n = 14) in September 2001. The response rate was 92.9% (n = 13).Journals were published on average 4.77 times per year and comprised 89% text and 10% advertising. The preferred average length of manuscripts was 20 pages using American Psychological Association format. The average acceptance rate of unsolicited manuscripts was 46.6%. All the journals were peer-reviewed publications and 80% were research oriented. The most frequently cited reasons for rejection of manuscripts were methodology problems, poorly developed idea, poorly written and data interpretation problems. The professional focus of published manuscripts was on research and the clinical foci were on paediatrics, gerontology and physical medicine.The study concludes that there are a variety of publishing opportunities available to occupational therapists. It is essential that prospective authors consult the journal guidelines for authors, including the types of manuscript accepted.

There has been an increase in the use of cognitive frameworks in occupational therapy with children with developmental coordination disorder (DCD). Investigations into the utility of one such cognitive approach, namely Cognitive Orientation to (daily) Occupational Performance (CO-OP), with children with DCD have shown the intervention to be effective with children over 7 years. However, there has been limited research into its utility with younger children.This paper presents two case studies to demonstrate the use of CO-OP with children aged 5–7 years. Two boys with DCD engaged in 10 sessions of CO-OP. These younger children were found to be able to use the global framework (Goal, Plan, Do, Check) to improve their task performance, to develop plans using domain-specific strategies and to engage in checking strategies. Issues relating to attention, motivation and goal setting are discussed in the context of the two case studies.

Paediatric occupational therapists often assess and treat school-age children and youth presenting with visual perceptual dysfunction. It is, therefore, important that occupational therapists use visual perceptual instruments that possess sound measurement properties (such as validity, reliability, responsiveness and clinical utility). The Motor-Free Visual Perception Test – Revised(MVPT-R) is an instrument frequently used by paediatric occupational therapists. Clinicians need to be cognisant of the measurement properties of the assessments they use in order to provide the best level of care for the paediatric clients they serve. Therefore, a review and critique of the MVPT-R is presented.Even though the MVPT-R has been revised recently, little has been done to address issues related to its reliability and validity. Evidence of criterion-related validity and construct validity, in particular, is still lacking. The rationale for measuring motor-free visual perception is also not well developed and needs to be expanded in the MVPT-R manual. In addition, the issue of summing the scores from the five MVPT-R subscales is questionable. What the final MVPT-R summed score really measures in terms of a screening evaluation or diagnosis is also lacking. At this stage, this instrument should be used and interpreted by occupational therapists with caution.

In recent years, there has been an increase in the development of self-report assessments for children, for both clinical and research use. This increase is compatible with the increase in the use of client-centred practice and other frames of reference that give clients – including children – a greater voice in their therapy. Occupation, the focus of therapy, is best understood from the perspective of the child engaged in it (Primeau and Ferguson 1999).There is mounting evidence that the views of children are different from, but as valid as, those of their parents (Sturgess and Ziviani 1996, Bouman et al 1999). The purpose of this paper is to provide a contemporary analysis of self-report assessment for children. An extensive review of the self-report literature found a clear rationale for its use and also evidence about the features of effective self-report tools. The results of this literature review and a critique of some self-report assessments available for young children are included in this paper.

As the main occupation of childhood, play is considered by occupational therapists as an important vehicle for the assessment and treatment of preschool children. For the child with autistic spectrum disorder (ASD), play not only offers a mechanism whereby the severity of the disorder can be ascertained but also enables interventions to be implemented and monitored.This paper aims to summarise the current literature as it relates to the play of children with ASD. By doing so, it alerts the reader to the complexity of the issue of play as a means of assessment and intervention and highlights areas of continuing clinical and research concern.

This paper addresses the changing demands of parenting handicapped and normal children throughout various stages of the life span — Pregnancy, the toddler, childhood and adolescent years, and adult children. Various issues which become critical at each of these stages are discussed and similarities and differences in parenting and child-rearing practices for these two groups are outlined. The paper highlights the fact that occupational therapists have many valuable specialist skills and a broad knowledge base from which to offer assistance to parents grappling with parenting a handicapped child.

This article aims to highlight the contribution occupational therapists can make to comprehensive geriatric care. It emphasizes how the philosophy of the profession, as well as the training graduates receive, equip occupational therapists to aid in the maintenance of health and well-being in elderly patients. The specific skills occupational therapists possess which enable them to make a unique contribution to geriatric treatment teams are detailed.