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This paper investigated the characteristics of mothers of children with a disability who registered for a mental health and wellbeing workshop. The questionnaire measured mental health, health-related behaviours, empowerment, family cohesion, wellbeing and child-related variables. Regression analysis identified factors associated with depressive symptoms and positive wellbeing. Fifty-seven percent of participants (N = 171) had depressive symptoms within the clinical range. Higher symptoms were associated with reduced: empowerment (r = -0.39, p < 0.01); positive-wellbeing (r = -0.66, p < 0.05); and healthy activity (r = -0.41, p < 0.001). Low positive wellbeing ([beta] = 0.55, p < 0.001) was the strongest predictor of depressive symptoms. Family cohesion ([beta] = 0.25, p < 0.001), was the strongest predictor of positive-wellbeing. Future health and wellbeing interventions that support mothers with high care responsibilities should include psycho-education and strategies to address healthy maternal and family-related behaviour changes.

Limited interventions exist that support student's school participation. This paper describes a theoretical model of school participation and the iterative process that led to the development of an intervention that aims to improve the school participation of students on the autism spectrum and their typically developing peers. Literature on autism, school participation and intervention research were integrated to develop a theoretical model. Focus groups, a Delphi study, online surveys, and reference group consultation helped to develop and refine the intervention. A novel school-based intervention was developed. The impetus to develop interventions with a strong theoretical rationale is discussed.

School participation and connectedness have significant implications for student outcomes while at school and in later life. The need to develop evidence-based interventions to proactively support students with autism spectrum disorder (ASD) is imperative. A two-round Delphi technique was used to gain expert consensus to inform the development of a school-based intervention to improve the school participation and connectedness of elementary students with ASD. Seventy-six expert clinicians, educators, and researchers completed Round 1 and 65 completed Round 2. Consensus was achieved on the application of a conceptual framework of participation in Round 1, which informed the theoretical rationale of the intervention. Consensus on the importance of proposed classroom modules and the feasibility of proposed intervention techniques was achieved in Round 2. The process of gaining expert perspectives to develop an evidence-based intervention provides greater confidence that the intervention will be effective in achieving meaningful outcomes for students with ASD.

Healthy Mothers Healthy Families (HMHF) is a program that educates and empowers mothers of children with disabilities to improve health behaviours. Outcomes were investigated in this study. A pre, post-test design was implemented using online questionnaires including the Health promoting activities scale (HPAS) and the Depressional anxiety stress scales (DASS). Mothers (N = 71) experienced improvements in HPAS scores, p < 0.001. Mental health symptomatology reduced: depressive symptoms (p = 0.005), Anxiety symptoms (p = 0.005) and stress (p = 0.002). Wellbeing improved (p < 0.001). Mothers also reported that their child with a disability experienced an increase in quality of life (p = 0.042). Mothers' lifestyles goals improved: managing stress; dietary changes; leisure; self-perception and others. HMHF is an effective intervention with improved health status and outcomes for mothers.

To investigate the effectiveness of interventions that aim to improve the mental health of mothers of children with disabilities. Seven databases were searched. Interventions incorporated primarily cognitive-behavioural, psychoeducation, mindfulness or support-group approaches. The Template-for-Intervention-Description-and-Replication guided descriptions. Meta-analyses using a random effect model of randomized controlled trials assessed intervention effects on parenting stress and mental health. Of the 1591 retrieved papers, 31 met criteria to be appraised and 17 were included in the meta-analysis. Cognitive-behavioural approaches reduced parenting stress [2 studies, n = 64, pooled Standardized-Mean-Difference (SMD) = 0.86, 95% CI (0.43, 1.29)] and improved mental health [3 studies, n = 186, pooled SMD = 1.14, 95% CI (0.12, 2.17)], psychoeducation approaches improved mental health [2 studies, n = 165, SMD = 0.60, 95% CI (0.17, 1.03)]. Cognitive-behavioural and psychoeducation interventions are effective. Further research and clinical guidelines are warranted.

This paper investigated the characteristics of mothers of children with a disability who registered for a mental health and wellbeing workshop. The questionnaire measured mental health, health-related behaviours, empowerment, family cohesion, wellbeing and child-related variables. Regression analysis identified factors associated with depressive symptoms and positive wellbeing. Fifty-seven percent of participants (N = 171) had depressive symptoms within the clinical range. Higher symptoms were associated with reduced: empowerment (r = - .39, p < .01); positive-wellbeing (r = - .66, p < .05); and healthy activity (r = - .41, p < .001). Low positive wellbeing ([beta] = .55, p < .001) was the strongest predictor of depressive symptoms. Family cohesion ([beta] = .25, p < .001), was the strongest predictor of positive-wellbeing. Future health and wellbeing interventions that support mothers with high care responsibilities should include psycho-education and strategies to address healthy maternal and family-related behaviour changes., Author(s): Helen M. Bourke-Taylor [sup.1] , Kahli S. Joyce [sup.1] , Sarah Grzegorczyn [sup.2] , Loredana Tirlea [sup.3] Author Affiliations: (1) grid.1002.3, 0000 0004 1936 7857, Occupational Therapy Department, Faculty [...]

Limited interventions exist that support student's school participation. This paper describes a theoretical model of school participation and the iterative process that led to the development of an intervention that aims to improve the school participation of students on the autism spectrum and their typically developing peers. Literature on autism, school participation and intervention research were integrated to develop a theoretical model. Focus groups, a Delphi study, online surveys, and reference group consultation helped to develop and refine the intervention. A novel school-based intervention was developed. The impetus to develop interventions with a strong theoretical rationale is discussed., Author(s): Amy Hodges [sup.1] , Reinie Cordier [sup.1] [sup.2] , Annette Joosten [sup.1] [sup.3] , Helen Bourke-Taylor [sup.4] Author Affiliations: (1) grid.1032.0, 0000 0004 0375 4078, Curtin School of Allied [...]

Healthy Mothers Healthy Families (HMHF) is a program that educates and empowers mothers of children with disabilities to improve health behaviours. Outcomes were investigated in this study. A pre, post-test design was implemented using online questionnaires including the Health promoting activities scale (HPAS) and the Depressional anxiety stress scales (DASS). Mothers (N = 71) experienced improvements in HPAS scores, p < .001. Mental health symptomatology reduced: depressive symptoms (p = .005), Anxiety symptoms (p = .005) and stress (p = .002). Wellbeing improved (p < .001). Mothers also reported that their child with a disability experienced an increase in quality of life (p = .042). Mothers' lifestyles goals improved: managing stress; dietary changes; leisure; self-perception and others. HMHF is an effective intervention with improved health status and outcomes for mothers., Author(s): Helen M. Bourke-Taylor [sup.1] , Kahli S. Joyce [sup.1] , Sarah Grzegorczyn [sup.2] , Loredana Tirlea [sup.3] Author Affiliations: (1) grid.1002.3, 0000 0004 1936 7857, Occupational Therapy Department, School [...]

Importance: Occupational therapists have the proven capacity to improve outcomes for young adults who are self-managing Type 1 diabetes (T1D). There is insufficient understanding of adolescents' experiences of developing responsibility for diabetes self-management (DSM). Objective: To investigate adolescents' perceptions of sharing responsibility for T1D management at school. Design: This study had a descriptive qualitative design and used semistructured interviews and thematic analysis. It is the second phase of a mixed-methods study with a sequential explanatory design that investigated mechanisms of responsibility-sharing at school. Setting: Secondary school in Australia. Participants: Purposive sample of adolescents (age 15–16 yr) with T1D (N = 11). Results: Adolescents approached the complex occupation of school-based DSM primarily in partnership with their parents, with each adolescent having unique responsibilities while sharing others. Health care professionals and teachers reportedly had minimal involvement. Adolescents described owning most DSM tasks, with their perceptions of building independence limiting the sharing of this responsibility. A heightened sense of risk meant that adolescents were likely to communicate with others in cases of errant blood glucose readings. Current processes commonly resulted in reduced school participation. Conclusions and Relevance: Adolescents valued working responsively and interdependently with their parents to manage T1D at school, which aligns with the occupational therapy model of co-occupation. Effective responsibility-sharing depends on clear, frequent, autonomy-supportive, team-based communications. Our results showed that patterns of communication for determining school-based DSM processes were fragmented and risk focused, with limited adolescent involvement, resulting in strategies that led to students at times being excluded from school activities. Plain-Language Summary: This is the first study to use an occupational lens to examine the way in which adolescents share their responsibility for diabetes care at school. Diabetes self-management in secondary schools occurs more often when adolescents work interdependently with their parents to manage their diabetes. Adolescent involvement in formal school processes and a clearer allocation of team roles and responsibilities would better support health-promoting habits and school participation. This is the first study to use an occupational lens to examine how adolescents share their responsibility for managing their Type 1 diabetes in secondary school. [ABSTRACT FROM AUTHOR]

To investigate the effectiveness of interventions that aim to improve the mental health of mothers of children with disabilities. Seven databases were searched. Interventions incorporated primarily cognitive-behavioural, psychoeducation, mindfulness or support-group approaches. The Template-for-Intervention-Description-and-Replication guided descriptions. Meta-analyses using a random effect model of randomized controlled trials assessed intervention effects on parenting stress and mental health. Of the 1591 retrieved papers, 31 met criteria to be appraised and 17 were included in the meta-analysis. Cognitive-behavioural approaches reduced parenting stress [2 studies, n = 64, pooled Standardized-Mean-Difference (SMD) = 0.86, 95% CI (0.43, 1.29)] and improved mental health [3 studies, n = 186, pooled SMD = 1.14, 95% CI (0.12, 2.17)], psychoeducation approaches improved mental health [2 studies, n = 165, SMD = 0.60, 95% CI (0.17, 1.03)]. Cognitive-behavioural and psychoeducation interventions are effective. Further research and clinical guidelines are warranted., Author(s): Helen M. Bourke-Taylor [sup.1] , Den-Ching Angel Lee [sup.2] , Loredana Tirlea [sup.3] , Kahli Joyce [sup.1] , Prue Morgan [sup.4] , Terrence P. Haines [sup.2] Author Affiliations: (1) [...]

Substantial evidence identifies mothers of children with a disability as having a higher risk for compromised health outcomes and lifestyle restrictions secondary to caring responsibilities. Healthy Mothers Healthy Families (HMHF) is an evidence informed health and empowerment group-based workshop program. Methods: HMHF features health education and lifestyle redesign content. Mixed methods evaluated the program. This paper presents a pretest-postest time series design to evaluate outcomes over 8 months. Results: Mothers reported significant change across 4 time points including participation in healthy activity (p = 0.017), depression, anxiety, stress symptoms (p = 0.017, 0.016, 0.037 respectively) and empowerment (p = 0.009). Conclusion: Coupled with qualitative findings, these results suggest that HMHF is effective at improving health and wellbeing outcomes for mothers of children with a disability.

Introduction: Standardised testing is crucial for autistic children to receive appropriate interventions, necessary services, and funding. Behaviours associated with autism can hinder children's test performance and participation. The 18‐item, two‐page Occupational Therapy Observation Tool–Adjustment Support Details (OTOT‐ASD) is used in conjunction with standardised assessments. The OTOT‐ASD enables the recording of autism‐related behaviours and the reasonable assessment accommodations made to support participation in testing. The current study aims to investigate the content validity and clinical utility of the OTOT‐ASD from occupational therapists' perspectives. Method: A specifically designed online questionnaire was distributed Victoria‐wide to occupational therapists with clinical experience with autistic children. The questionnaire was designed in line with the COnsensus‐based Standards for selection of health Measurement INstruments (COSMIN), including relevance, comprehensiveness, and comprehensibility of items evaluated for content validity. Applicability and clinical usefulness were also investigated. Quantitative data were analysed using descriptive statistics. Results: Seventy‐one occupational therapists responded to the questionnaire and 46 provided a full dataset. Over 96% of the respondents considered documenting behaviours and testing accommodations as important, yet less than 45% reported having resources to record this information. Ninety‐five percent of the respondents perceived the OTOT‐ASD to be useful in clinical practice. Over 70% agreed that OTOT‐ASD items were significantly relevant to practice and comprehensive. To improve comprehensibility, identified items were altered following feedback. Conclusion: The findings suggest that the OTOT‐ASD is clinically useful and content validity is sound. Further research on other psychometric properties of the OTOT‐ASD and users' qualitative experiences in utilising the tool is recommended. [ABSTRACT FROM AUTHOR]

Substantial research identifies mothers of children with a disability as a vulnerable group with compromised health outcomes and restrictions for their own self-care, social, economic and leisure participation. This study investigated perceptions and experiences of mothers following attendance at health education and empowerment workshops (Healthy Mothers Healthy Families). Mixed methods evaluated mothers' experiences. A pragmatic qualitative approach was applied to data analysis of interviews with mothers (N = 19). Four themes emerged: Changes for me; Changes for my family; Wisdom gained; and Worthwhile workshops. Mothers described feeling validated and empowered in this facilitated group intervention and valued education about women's health, tailored research findings, individualised goal setting, time to learn and share with other mothers, and the workshop environment.

Students attending schools today not only learn about formal academic subjects, they also learn social and emotional skills. Whole-school restorative practices (RP) is an approach which can be used to address student misbehaviour when it occurs, and as a holistic method to increase social and emotional learning in students. The aim of this study was to explore the impact of RP on student behaviour from the perspectives of students and teachers. Six schools participated in interviews and focus groups. Students and teachers were asked about the use of RP and the impact on behaviour. Students and teachers identified five main themes: greater harmony, increased empathy towards others, awareness of one's own behaviour and being accountable for that, increased respect, and reflective thinking. These aspects increase students' social skills. This paper discusses a new framework which describes the positive impact of RP on student behaviour and thinking. The findings have broad implications for school communities and highlight the need to move towards more relational behaviour management approaches.

Background: Many children with cerebral palsy learn to use technology to access their environments and communicate; however, minimal research informs practice. Methods: A descriptive qualitative study with purposive sampling recruited 10 therapists (occupational, speech, and physiotherapists) from one early intervention service. Data were collected using semi-structured interviews and were analyzed thematically. Results: Four themes were derived: development of successful movement; positioning and equipment; access methodology and processes; and learning to communicate ("learning nonelectronic communication in parallel with electronic communication"). Conclusion: Practitioners described a multitude of skills and expertise to facilitate switch use in play and electronic communication devices in early childhood.

Introduction: Mothers of children with disabilities report increased maternal stress, compromised mental health and reduced leisure and social participation compared with other mothers. The aim of the study was to explore the similarities and differences between three groups of Chinese mothers of children with disabilities in their caregiving occupations and selected maternal variables. Methods: An online survey collected mothers' demography, caregiving occupations and six maternal measures: frequency in participation in health promoting activities, mental well-being, personal well-being, psychological distress, perceived support and perceived stigma. Descriptive and inferential statistics were used to investigate group similarities and differences, and detect associations between variables. Results: The survey responses of Chinese mothers (N = 261) from Australia (n = 80), Singapore (n = 95) and Taiwan (n = 86) were analysed. Similarities and differences in caregiving occupations were found between groups. The Kruskal–Wallis test showed no differences in maternal variables between groups. There were associations found between some caregiving occupations and maternal variables when mothers were analysed as a single group. Conclusion: The health and well-being of mothers of children with disabilities may be influenced more by their cultural similarities than differences in their socio-political environments. Recognising cultural influences on caregiving occupations is crucial in the delivery of culturally competent and culturally intelligent practice. [ABSTRACT FROM AUTHOR]

Substantial evidence identifies mothers of children with a disability as having a higher risk for compromised health outcomes and lifestyle restrictions secondary to caring responsibilities. Healthy Mothers Healthy Families (HMHF) is an evidence informed health and empowerment group-based workshop program. Methods: HMHF features health education and lifestyle redesign content. Mixed methods evaluated the program. This paper presents a pretest-postest time series design to evaluate outcomes over 8 months. Results: Mothers reported significant change across 4 time points including participation in healthy activity (p = 0.017), depression, anxiety, stress symptoms (p = 0.017, 0.016, 0.037 respectively) and empowerment (p = 0.009). Conclusion: Coupled with qualitative findings, these results suggest that HMHF is effective at improving health and wellbeing outcomes for mothers of children with a disability., Author(s): Helen M Bourke-Taylor [sup.1] , Fiona Jane [sup.2] , Jennifer Peat [sup.3] Author Affiliations: (Aff1) 0000 0004 1936 7857, grid.1002.3, School of Primary and Allied Health Care, Faculty of [...]

Substantial research identifies mothers of children with a disability as a vulnerable group with compromised health outcomes and restrictions for their own self-care, social, economic and leisure participation. This study investigated perceptions and experiences of mothers following attendance at health education and empowerment workshops (Healthy Mothers Healthy Families). Mixed methods evaluated mothers' experiences. A pragmatic qualitative approach was applied to data analysis of interviews with mothers (N = 19). Four themes emerged: Changes for me; Changes for my family; Wisdom gained; and Worthwhile workshops. Mothers described feeling validated and empowered in this facilitated group intervention and valued education about women's health, tailored research findings, individualised goal setting, time to learn and share with other mothers, and the workshop environment., Author(s): Helen M. Bourke-Taylor [sup.1] , Fiona M. Jane [sup.2] Author Affiliations: (Aff1) 0000 0004 1936 7857, grid.1002.3, Occupational Therapy Department, School of Primary and Allied Health Care, Monash University, [...]

Importance: Mothers of children with disabilities experience health disparity. Interventions targeting maternal mental health need to be developed. Objective: To determine the feasibility and preliminary effectiveness of the Healthy Mothers Healthy Families–Health Promoting Activities Coaching (HMHF–HPAC) intervention for mothers to improve participation in healthy activities and mental health and to evaluate outcome measures. Design: Nonrandomized controlled pilot feasibility study with one group who received HMHF–HPAC and a control group. Setting: Pediatric occupational therapy service; on site or telehealth. Participants: Twenty-three mothers completed prequestionnaires; of those, 11 mothers participated in the intervention, and 5 did not (7 withdrew). Intervention: Eleven pediatric occupational therapists were trained to deliver six 10-min sessions of HMHF–HPAC to mothers, integrated into their child's therapy session or separately via telehealth. Outcomes and Measures: Mixed-design analysis of variance explored changes in scores on the Depression Anxiety Stress Scale–21 Items and the Health Promoting Activities Scale. Results: The intervention group reported, on average, significant reductions in depressive symptoms and stress symptoms and significant increases in participation in health-promoting activity. No significant main effect of time was found for these variables in the control group. Conclusions and Relevance: The HMHF–HPAC program is a viable occupational therapy coaching intervention that can be embedded in existing services for families of children with disabilities. Future trials that evaluate the effectiveness of the HMHF–HPAC intervention for mothers of children with disabilities are warranted. What This Article Adds: This article provides support for the feasibility of appropriate and sensitive outcome measures and program content and delivery to implement the novel HMHF–HPAC intervention in further research. Mothers of children with disabilities benefited from integrated HMHF–HPAC delivered by pediatric occupational therapists within the family's existing services. This article provides support for the feasibility and preliminary effectiveness of the novel Healthy Mothers Healthy Families–Health Promoting Activities Coaching (HMHF–HPAC) intervention for mothers of children with disabilities, which can be embedded in existing family services to improve participation in healthy activities and mental health and to evaluate outcome measures. [ABSTRACT FROM AUTHOR]

Aim: Many mothers of children with developmental disabilities are known to experience high levels of stress, and compromised mental health. Research is crucial to better understand and assist mothers with compromised mental health, and ultimately better service families raising and supporting a child with a disability. Method: Data were collected using cross sectional mail-out survey with follow up phone call. Instruments included the Short Form 36 version 2 (SF-36v2) and instruments that measured maternal, child and environmental factors. Descriptive statistics examined characteristics of participants. Correlation, t-tests, and multiple regression analyses were used to identify factors associated with mothers' mental health. Results: Mothers (N = 152) cared for a school-aged child (aged 5-18 years) with high care needs and developmental disabilities including autism spectrum disorder (n = 94); cerebral palsy (n = 29); attention deficit hyperactivity disorder (n = 19). Factors associated with maternal mental health included the child's psychosocial health (r = 0.36) and challenging behaviour (r = -0.33); maternal empowerment (r = 0.40); maternal participation in health promoting activities (r = 0.43); and the child's unmet service needs (r = -0.29). The strongest predictors of maternal mental health in this cross sectional study were maternal participation in healthy activity and empowerment, the child's emotional functioning and unmet service needs. Conclusion: This study identified maternal factors as the most important influence on self reported mental health among this sample of mothers. Findings suggest that service changes that provide mothers with information about their own health and need for health enhancing activities, as well as education that empowers mothers to manage and master their child's disability and needs, may contribute to maternal mental health and well being. (Contains 4 tables.)