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Background. Developing client self-advocacy is in occupational therapy's (OT) scope of practice; however, there is limited understanding of if, or how, occupational therapists learn about self-advocacy interventions as well as implement self-advocacy into clinical practice. Objective. This study sought to identify if and how therapists learn about self-advocacy intervention approaches and identify if and how therapists implement self-advocacy into their work with clients. Method. A survey was distributed via email to academic and professional listservs in the United States, and data were collected using REDCap survey software. Descriptive statistics were analyzed data using REDCap/SPSS. Comparative statistics, Kruskal-Wallis's tests, Chi-square tests for independence, and Pearson's correlation tests analyzed differences across groups of respondents. Results. Practicing and licensed occupational therapists (n = 138) across the United States completed the survey. Findings indicate a majority (59.5%) of occupational therapists not learning strategies for addressing or developing client self-advocacy. Of significance, 21.7% of participants had never been exposed to concepts of client self-advocacy in academic or clinical education. Practitioners who did address self-advocacy did so indirectly through teaching-related skills (76.6%). Conclusion. Many clients of OT will need self-advocacy skills in order to address issues of exclusion and discrimination that prohibit full participation in society. Occupational therapists must prioritize incorporating client self-advocacy into curricula and clinical practice. [ABSTRACT FROM AUTHOR]

The purpose of this exploratory case series was to describe the outcomes for both a child-learner and a child-peer after a single manual wheelchair (MWC) skills training session involving child-based peer training techniques, followed by related home-based skills practice. Participants were a 9-year-old with L4–L5 spina bifida (pseudonym: Amari) and a 3-year-old with T10 spina bifida (pseudonym: Mary). Pre-intervention examination included administration of the Wheelchair Skills Test Questionnaire (WST-Q), the MWC short scale within the Mobility domain of the Paediatric Evaluation of Disability – Computer Adapted Test (MWC PEDI-CAT), and the Canadian Occupational Performance Measure (COPM). The peer training session, facilitated by a physical therapy team, involved games and activities involving MWC use. When appropriate, Amari was asked to talk aloud and verbally describe the components of the skills she was performing. Each child and her mother were instructed in specific MWC skills to practice at home over a 3-week period. Both participants' post-intervention WST-Q capacity, confidence, and performance scores increased. Increases in parent-proxy COPM scores indicated clinically meaningful change in all identified occupational performance problems. Mary's total MWC PEDI-CAT post-intervention score increased by 11 points. Both mothers reported that the participation in the activities helped also to improve their child's self-esteem and self-image. Both the participants in this exploratory case appeared to demonstrate improvements in MWC skills, self-esteem, and self-image following a single child-based MWC skills peer training session and related home-based skills practice. Future research involving such peer training methods is warranted. [ABSTRACT FROM AUTHOR]