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Recent literature has challenged the ways in which occupational therapy has been delivered in mainstream schools but consideration of practice in specialist schools, where all students have special educational needs or disabilities, is limited. This study aimed to address this gap by exploring occupational therapy practice in specialist schools in England. This qualitative study used a phenomenological approach. Data was collected via semi-structured interviews and analysed using thematic analysis. The study had 6 occupational therapist participants. Three themes emerged from the data: Theme 1: “I’m going to be really honest with you, we’re not doing therapy” Theme 2: “We are not entirely part of the school community” Theme 3: “You shouldn’t have to try and make someone else the therapist”. The findings echo studies of occupational therapy in mainstream schools but offer new insights into the focus and delivery of occupational therapy in specialist schools. It is recommended that in England a new model of service provision is developed that integrates occupational therapists into specialist schools, creates more time in the classroom, facilitates therapist-teacher collaboration, and enables a broader scope of practice.

Allied Health Professionals (AHPs) have the capacity to promote healthy behaviours in young children through routine 'contact points', as well as structured weight management programmes. This scoping review aims to evaluate the impact of AHPs in the prevention of obesity in young children. Databases were searched for relevant evidence between 1st January 2000 and 17th January 2022. Eligibility criteria included primary evidence (including, but not limited to; randomized controlled trials, observational studies, service evaluations) evaluating the impact of AHPs on the primary and secondary prevention of obesity in young children (mean age under 5 years old). AHP-related interventions typically demonstrated improvements in outcomes such as nutritional behaviour (e.g. lower sweetened drink intake), with some reductions in screen time. However, changes in weight outcomes (e.g. body mass index (BMI) z-score, BMI) in response to an AHP intervention were inconsistent. There was insufficient data to determine moderating effects, however tentative evidence suggests that those with a lower socioeconomic status or living in an underprivileged area may be more likely to lose weight following an AHP intervention. There was no evidence identified evaluating how AHPs use routine 'contact points' in the prevention of obesity in young children. AHP interventions could be effective in optimizing weight and nutritional outcomes in young children. However, more research is required to determine how routine AHP contact points, across the range of professional groups may be used in the prevention of obesity in young children.

Introduction Mental health disorders and low levels of mental well-being can have a lasting effect on life satisfaction and contribution to society for children and adolescents, yet the effectiveness of occupational therapy interventions is unknown. Methods A mixed methods systematic review was conducted including studies with children and adolescents aged 5–16 years, who had mental health difficulties, that evaluated occupational therapy interventions and focused on participation in everyday occupations as an outcome. Results The nine included studies were generally very low quality. The results could not be pooled due to heterogeneity. For children with Asperger’s syndrome, the Cognitive Orientation to Daily Occupational Performance intervention had clinically significant improvements on occupational performance and social skills. For children with attention deficit hyperactivity disorder, the Ultimate Guide to Play, Language and Friendship intervention improved playfulness and the Cognitive–Functional intervention had a statistically significant improvement on occupational performance and behaviour. Conclusion One intervention used by occupational therapists with children with Asperger’s syndrome and two interventions used with children with attention deficit hyperactivity disorder had some evidence of effect. No evidence was identified for the effectiveness of occupational therapy interventions for children and adolescents with other common mental health conditions.

Background: Young people with neurodisability experience lower levels of mental wellbeing and are at increased risk of mental illness compared to their non-disabled peers. Social participation is recognised as a protective factor against mental illness and a potential pathway to support better mental wellbeing in neurodisability. Method: This co-design study involved young people, parents, and clinicians. First, possible interventions were identified through a rapid systematic evidence review. Any study designs were considered that included people with a neurodisability aged 0-18 years that evaluated a therapy intervention with social participation and mental health outcomes. Titles and abstracts were screened by two reviewers, from the included studies data were extracted and then presented using written summaries. Second, the summaries were discussed and prioritised in stakeholder groups with young people, parents, and clinicians. Groups were audio recorded and framework analysis was used to identify and specify intervention elements and their delivery. Results: The evidence review identified 13870 records, from which 43 were included. These records were published 1994-2017 and reported studies with 4-249 participants aged 16 months – 18 years with a range of neurodisabilities. Five intervention approaches (social skills training, arts, sports, technology, and play) were identified from the review. Two themes emerged from the stakeholder groups: intervention in the real world, feeling judged and feeling safe. The groups prioritised an intervention in real-world social leisure contexts (i.e. existing clubs and groups) using nine key intervention elements (e.g. feedback, positive verbal reinforcement) delivered by club leaders trained by healthcare professionals using five intervention procedures (e.g. a manual, video training). Conclusion: This study has identified core elements of social participation interventions that may improve mental health outcomes in young people with neurodisability, which should now be tested.

Introduction While the Model of Human Occupation Screening Tool has undergone psychometric development and testing and is widely used in mental health practice, only a few small-scale studies to date have examined its use in clinical practice. Method A national survey was conducted with United Kingdom occupational therapists working in mental health settings to evaluate the use of the Model of Human Occupation Screening Tool. The survey included the modified version of the Usefulness, Satisfaction, and Ease of Use (USE) questionnaire and two open-ended questions. The latter were coded through inductive content analysis and all responses were analysed using Statistical Package for the Social Sciences software. Results n=105 questionnaires were analysed. The Model of Human Occupation Screening Tool was found to be a useful tool, with most therapists scoring it favourably on the usefulness (74.7%), ease of use (76.1%), ease of learning (81.2%) and satisfaction (80.6%) subscales. It was praised as a valuable outcome measure, guiding interventions and providing a comprehensive overview of assessed individuals. Time consumption, inaccessible terminology and lack of sensitivity to change were indicated as possible downfalls. Conclusion Therapists valued the Model of Human Occupation Screening Tool as an assessment tool, but more importance should be placed on training to overcome some of the limitations identified here. Also, its suitability to the setting in which it is used should be considered before implementation in practice.

Background: Alcohol use is a significant risk factor for ill-health. Whilst many people complete treatment, only one third maintain their sobriety. Research has suggested that occupational engagement supports early recovery, but its role in sustained recovery is not known. Objectives: This study aimed to explore the occupational lives of individuals in sustained recovery from alcohol dependency. Methodology: An Interpretive Phenomenological Analysis methodology was used, utilising an occupational perspective. Participants were recruited from a substance-use recovery centre. Data was collected through interviews and analysed thematically. Findings: This study had three participants. Four themes emerged: 1. Shaping occupational lives, 2. Shifting coping strategies, 3. Finding a gateway to new social connections and a sense of belonging, 4. Establishing a new role in the context of recovery. Conclusion: Findings suggest that in sustained recovery occupations develop new meanings and purposes which have the potential to support recovery

We present a proof-of-concept edge illumination x-ray phase contrast system where the detector mask has been replaced by an indirect conversion detector in which sensitive and insensitive regions have been obtained by “patterning” the scintillator. This was achieved by creating a free-standing grid with period and aperture size matching that of a typical detector mask and filling the apertures with gadolinium oxysulfide. Images of various samples were collected with both the modified and the original edge illumination systems based on the use of two masks to characterize the performances of this detector design. We found that, despite the proof-of-concept nature of this attempt resulting in a structured detector with suboptimal performance, it allows effective separation of the attenuation and refraction channels through phase retrieval and the visualization of hard-to-detect features such as cartilage through the latter channel, thus demonstrating that the proposed approach holds the potential to lead to improved stability since it will use a single optical element facilitating the design of rotating phase contrast systems or the retrofitting of conventional x-ray systems.

The relationship between the concepts of being and belonging, that is how connecting with oneself (being) interacts with connecting with others (belonging), remains to be studied in detail. In addi...

There is an urgent, agreed need to improve participation outcomes and interventions for children and young people with neurodisability. We worked together with service users and providers to design research into participation outcomes and interventions in neurodisability. We built on existing evidence about participation outcomes and interventions, and the WHO International Classification of Functioning, Disability and Health. We: (1) specified seven participation outcome categories for measurement; (2) prioritised these for improvement: self-care, friends and social, and physical activity ranked the highest; (3) identified eleven potential intervention categories for targeting the top priority, self-care, through eight hypothesised change mechanisms; and agreed for the interventions to be delivered as a ‘Menu of Interventions’ for personalised self-care support; and (4) designed a before-and-after mixed methods feasibility study to evaluate the Menu with children and young people (0-12 years), and their parents and therapists.

The transition to secondary school is a common cause of stress and anxiety, which can be exacerbated by the innate characteristics associated with Asperger syndrome (AS) and high-functioning autism (HFA). This study aimed to explore experiences of the transition to secondary school for students with AS/HFA from the parental perspective. Seventeen parents of children with AS/HFA from the north of England completed an online questionnaire about their child's school transitional experience. Responses indicated that there were a number of factors that influenced the experiences of pupils with AS/HFA at school and the preceding transition, including anxiety, bullying, friendship and support at school. Girls with AS/HFA presented with unique issues not commonly seen in the male dominated condition. The transition to secondary school was seen to encompass a number of difficulties for students with AS/HFA. Health and educational services can learn from the experiences explored in this survey in order to inform future practice.

Occupational formulation is a process of making sense of someone’s circumstances that is informed by occupational theories and concepts. This opinion piece presents occupational formulation as a st...

The question of this review is: what is the effectiveness of occupational therapy on participation in everyday occupations for children and adolescents with mental health difficulties? The objective is to identify the evidence of occupational therapy interventions that are occupation-based and/or occupation-focused.The quantitative component of the review will consider studies that evaluate the effectiveness of occupation-based and/or occupation-focused interventions; the qualitative component of this review will consider studies that investigate the experiences of these interventions, and the textual component of this review will consider publications that describe these occupational therapy interventions.The quantitative objective is to identify the effectiveness of occupational therapy on participation in everyday occupations for children and adolescents with mental health difficulties.The qualitative objective is to identify the experiences of occupational therapy interventions on participation for children and adolescents with mental health difficulties in everyday activities.The textual objective is to identify narrative, text and opinion about occupational therapy interventions on the participation of children and adolescents mental health that have yet to be subjected to empirical analysis.

This mixed-methods study investigated the impact of the Re-Animation Approach, a creative occupational therapy, on the well-being and occupational performance of three male patients in a forensic mental health setting. Quantitative data were gathered through goal attainment scaling (GAS) and qualitative data using semi-structured interviews. GAS t-scores demonstrated an over-achievement of expected outcomes in goals related to improving skills, well-being, and time use. Issues emerging from thematic analysis of the interviews are consistent with the GAS results. The Re-Animation Approach had a positive impact on participants’ health and well-being, addressed a range of occupational needs, and can be graded.

Forty-four Sustainability and Transformation Plans (STPs) were introduced in NHS planning guidance in December 2015. Draft STP’s were published in late 2016. The plans bring together providers, commissioners, local government and third sector organisations to develop and deliver new models of care.1 These models aim to improve the quality, efficiency and sustainability of healthcare services, across England over the next five years. 2 Concerns have been raised about the impact of STPs on GP provision,3 on patient groups,4 and on the number of hospital beds.5 The purpose of this study was to identify the detail relating to rehabilitation, occupational therapy and physiotherapy in STPs. Occupational therapy and physiotherapy are two of 12 professional groups that make up Allied Health Professionals (AHPs). AHPs are the third largest workforce in health and care in England. A recent AHP strategy from NHS England6 has provided a blueprint by and for AHPs to contribute to future services, including STPs. The Chartered Society of Physiotherapy7 have promoted STPs in order to move towards a model of health prevention and a rehabilitation system that supports collaboration and integration across local systems e.g. NHS trusts and local authorities. The Royal College of Occupational Therapists8 agreed that STPs can provide a vehicle for occupational therapists to deliver early action, prevent admission to hospital, and implement a reabling approach that improves patient outcomes and saves money.

The opportunity and ability to continue to enjoy leisure occupations has been identified as a key determinant of psychosocial well-being following the onset of sight loss in later life. While adjustment to the use of audio books has been found to require perseverance, reading remains a common occupation in older adults with sight loss. Research with sighted readers has suggested that book groups can enhance the experience of solitary reading and provide opportunities to develop new social networks, yet there is an absence of similar research with audio book groups. This Interpretive Phenomenological Analysis (IPA) study employed semi-structured interviews to explore how four older-age women with sight loss in the United Kingdom experienced and made sense of participating in audio book groups. Four interrelated themes emerged; sharing occupation with others, friendship and belonging, the role of the librarians, and the contrast with experiences beyond the group. The findings suggest that audio book groups ...