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Background. Delivery of occupational therapy education programs in Canada faced significant disruptions and adaptations because of the COVID-19 pandemic. Curriculum changes were made rapidly under extreme conditions. Purpose. To document and explore changes to curricula (academic and fieldwork), instructional, and assessment methods implemented by Canadian occupational therapy programs in response to the pandemic and capture their perceived impact on student learning. Method. This convergent mixed method design study employed a cross-sectional descriptive survey followed by a member check focus group. Participant recruitment targeted Canadian occupational therapy university program directors, curriculum chairs, and fieldwork coordinators. Findings. Results highlight curriculum modifications included shifting from in-person to online delivery and re-sequencing or deferring in-person components. Fieldwork placements were similarly affected and included adoption of simulations and telepractice. Implications. The development of interpersonal “soft skills” are perceived as being the most disrupted, but the impact of student learning on actual practice is not yet known.

Objectif : produire une traduction en français canadien de l’AMSTAR 2, en affirmer la validité de contenu et en examiner la fidélité interjuges. Méthodologie : selon une approche adaptée de celle proposée par Vallerand, des traductions directes et renversées ont été effectuées. Ensuite, en examinant les traductions, un premier comité d’experts a créé la version expérimentale préliminaire. Celle-ci a été modifiée par un deuxième comité d’experts. Vingt futurs professionnels de la santé ont évalué la nouvelle version avec une échelle d’ambiguïté (de 1 à 7). Les cochercheurs principaux ont examiné les éléments problématiques pour affermir la version préofficielle. Afin d’assurer la validité de contenu, une dernière rétrotraduction a été effectuée, validant une version officielle. Ensuite, 4 juges ont évalué 13 revues systématiques publiées en français à l’aide de la version officielle. Le coefficient kappa a été utilisé afin d’examiner la fidélité interjuges. Résultats : cette adaptation a permis la création d’une version franco-canadienne de l’AMSTAR 2. Son utilisation a démontré très peu d’ambiguïté (moyenne 1,15; ÉT 0,26) et une bonne fidélité interjuges (Kappa global > 0,64). Conclusion : la version franco-canadienne de l’AMSTAR 2 pourrait servir de soutien aux cliniciens, aux éducateurs et aux gestionnaires francophones au Canada lorsqu’ils cherchent à adopter une pratique factuelle.

Background: The aim of this study was to explore the effectiveness of a Cognitive Orientation to daily Occupational Performance (CO-OP) intervention delivered in a group format in a 1-week summer day camp program for children referred for motor coordination difficulties. Transfer of learned skills to self-selected tasks not addressed in the group intervention was also explored. Method: A quasi-experimental one group pretest-posttest design with a 1-month follow-up was used. Changes in nine children’s self-selected occupational performance goals, as well as their sense of self-efficacy for these goals, were determined using nonparametric statistics. Results: Findings indicate a significant performance improvement at both posttest and follow-up, with large effect sizes. Self-efficacy also significantly changed across sessions on tasks directly addressed, with large effect sizes. No statistically significant changes for any of the measures were noted for the tasks that were not addressed during camp. Conclusion: The CO-OP in group format in an intensive 4-day summer day camp was effective in improving performance of self-selected camp goals, as well as self-efficacy, but less effective for transfer of learned skills to other tasks.

Background. In the cognitive orientation to daily occupational performance (CO-OP) approach, parent involvement is critical for transferring skills from therapeutic settings to everyday contexts. Purpose. This study aimed to gain insight into the experience of parents whose children with developmental coordination disorder participated in CO-OP intervention. Method. This consolidation of three small qualitative studies investigating parents’ experience involved an inductive qualitative content analysis of 10 parent interviews and 1 parent focus group. Findings. Four overarching themes emerged as depicting parents’ experience. Although parents recognized the improvements their children made with the intervention, they also expressed several challenges, such as incorporating CO-OP tasks into daily routines, shifting of parent–child relationship and feeling self-efficacious with the approach. Implications. This study highlights that parent observation of intervention sessions is not enough to support parents applying CO-OP at home. Research is needed to understand how to best engage parents in the CO-OP approach.

A family’s health is sustained by its occupational patterns. While it is commonly accepted that a health condition places extra demands on a family’s time or can limit daily occupations, few studies have reported on the occupational patterns of these families. This scoping review provides an overview of the current state of research exploring occupational patterns of families living with a health condition. Publications between 2000 and 2018 indexed in CINAHL, PsycInfo, Medline and Scopus databases were searched. Seventy-seven studies were included in the final content analysis. Findings suggest that families’ occupational patterns are more complex than simply the sum of individual and shared occupational patterns, but consist of interconnected relational aspects of occupations, rarely highlighted in studies. Moreover, testimonies tend to be predominantly from the mother’s perspectives, thereby limiting the scope of understanding of the interdependent nature of families’ occupational patterns. To better understand the complexity and interdependence of families’ occupational patterns, future studies should examine multiple perspectives (parents and children) when studying occupations in a family setting. This can be enabled by the use of a variety of data collection methodologies.

The ability to mentally represent actions is suggested to play a role in the online control of movement in healthy adults. Children's movement imagery ability and online control have been shown to develop at similar nonlinear rates. The current study investigated the relationship between movement imagery and online control in children by comparing implicit and explicit movement imagery measures with the ability to make online trajectory corrections. Imagery ability was a significant predictor of children's online control of movement once general reaching efficiency was controlled for. These findings extend the proposed relationship between movement imagery and online control.

Objectif : le premier but est de produire une traduction franco-canadienne de l'outil AMSTAR et d'examiner la validité de son contenu. Les second et troisième buts sont d'examiner la fiabilité interjuges et la validité de construit factorielle de la version franco-canadienne de l'outil AMSTAR. Méthodes : une approche modifiée de la méthodologie de validation transculturelle de Vallerand (1989) a été adoptée.1 Une traduction renversée parallèle de l'outil AMSTAR2 a d'abord été effectuée à la fois par des professionnelles et de futurs professionnels. Ensuite, un premier comité d'experts (P1) a examiné les versions traduites et a créé l'ébauche expérimentale préliminaire de l'outil AMSTAR. Celle-ci a été évaluée et modifiée par un deuxième comité d'experts (P2). Finalement, 18 futurs professionnels à la maîtrise en physiothérapie ont évalué cette deuxième version expérimentale de l'outil à l'aide d'une échelle d'ambiguïté de 7 points (1 : très clair; 7 : très ambigu). Les cochercheurs principaux ont examiné les éléments problématiques et ont proposé les modifications finales. Vingt revues systématiques publiées en français après l'an 2000 ont été évaluées par quatre juges indépendants à l'aide de la version franco-canadienne de l'outil AMSTAR. Le coefficient de corrélation intraclasse (CCI) et le coefficient kappa ont été utilisés afin d'examiner sa fiabilité interjuges. Le coefficient alpha Cronbach a été calculé pour évaluer la cohérence interne. L'analyse factorielle a été utilisée pour examiner la validité de construit afin de déterminer le nombre de dimensions. Résultats : pour les différents énoncés de la version finale de l'outil AMSTAR, les moyennes sur l'échelle d'ambiguïté varient entre 1,0 et 1,4. Aucun énoncé n'a obtenu une moyenne en deçà de 1,4 démontrant ainsi un niveau élevé de clarté. La fiabilité interjuges (n=4) pour le score total de l'outil AMSTAR est qualifiée de modérée selon le coefficient de corrélation intraclasse d'une valeur de 0,61 (intervalle de confiance [IC] à 95 % : 0,29, 0,97). La fiabilité interjuges est considérée bonne pour 82 % les éléments individuels selon les valeurs de kappa obtenues. La cohérence interne est excellente d'après le coefficient alpha de Cronbach représente une valeur de 0,91 (IC à 95 % : 0,83, 0,99). La version franco-canadienne de l'outil AMSTAR est un outil unidimensionnel confirmé par l'analyse factorielle et les valeurs de communauté supérieures à 0,30. Conclusion : les cinq étapes rigoureuses du processus ont permis de produire une version franco-canadienne valide de l'outil AMSTAR. La version franco-canadienne de l'outil AMSTAR est un outil unidimensionnel qui offre une fiabilité interjuges modérée pour l'ensemble des éléments et une excellente cohérence interne. Cet outil peut s'avérer pertinent pour les professionnels et chercheurs franco-canadiens et pourrait intéresser la francophonie internationale.

International audience; BackgroundThe Developmental Coordination Disorder Questionnaire’07 (DCDQ’07) is a parent-report measure to identify children at risk for Developmental Coordination Disorder (DCD). We developed a French version of the DCDQ’07 (DCDQ-FE) that has shown excellent inter-language reliability (intraclass correlation coefficient (ICC) = 0.91) and is culturally relevant for use in European countries. The aims of this study were to examine the internal consistency, test-retest reliability, construct validity of the Developmental Coordination Disorder Questionnaire-French European (DCDQ-FE), as well as establish a cut-off score.MethodsThe psychometric properties of the DCDQ-FE were examined with a clinical group of 30 children (mean age: 9.4 years, SD = 2.6) and a control group of 43 children (mean age: 9.1 years, SD = 2.4). Their parents (n = 73) filled out the DCDQ-FE at a first sitting and 70 of them filled it out 38 days later in average for test-retest reliability. The children were assessed using the Movement Assessment Battery for Children-2 (MABC-2) so as to measure the convergent validity of the DCDQ-FE. The cut-off score was determined with an additional sample of 42 children according to scores on the MABC-2 (≥ 16th percentile) (n = 115).Results and implicationsInternal consistency of the DCDQ-FE was excellent (Cronbach’s alpha = 0.96) and test-retest reliability was good (ICC = 0.956) with no differences between scores obtained at the two sittings (p > 0.05). Differences in scores between children in the clinical and control groups (Z = -6.58, p < 0.001) provide evidence of construct validity. The correlation obtained between DCDQ-FE and MABC-2 scores (Spearman’s rho correlation coefficient = 0.802, p < 0.001) supports convergent validity. Using a cut-off of 56, overall sensitivity and specificity were 85.0% and 81.6% respectively (area under the curve = 0.896). The DCDQ-FE is a reliable and valid questionnaire for detecting children who are at risk for DCD in a European-French population of children aged 5 to 15 years old.

The ability to perform movement imagery has been shown to influence motor performance and learning in sports and rehabilitation. Self-report questionnaires have been developed to assess movement imagery ability in adults, such as the Movement Imagery Questionnaire 3 (MIQ-3); however, there is a dearth of developmentally appropriate measures for use with children. To address this gap, the focus of this research was to develop an imagery ability questionnaire for children. This process involved adaptation of the MIQ-3 via: i) cognitive interviewing with twenty children, ii) validation with 206 children by examining its factor structure via multitrait-multi method confirmatory factor analysis, and iii) examination of test-retest reliability with 23 children. The findings of Study 1 led to changes to the wording of the questionnaire and modifications of the instructions to successfully adapt the MIQ-3 for children aged 7–12 years. The validation undertaken in Study 2 found that a correlated-traits correlated-uniqueness model provided the best fit to the data. Finally, test-retest reliabilities varied from fair (for external visual imagery) to substantial (for kinesthetic imagery). With respect to ease of imaging, no significant gender or age-group differences were noted. However, significant difference were found among the three imagery modalities (p

Cognitive orientation to daily occupational performance is an intervention approach that is often used with children with developmental coordination disorder, and is usually implemented using an individual intervention format. This practice analysis describes two experiences of the cognitive orientation to daily occupational performance approach, modified for use in a group format: an intensive day-camp, and a weekly after-school club. The group format provided children with various opportunities (for example, helping other children and realizing that different ‘plans’ work for different people) and challenges (for example, maintaining both children's engagement during problem solving and heterogeneity in children's breakdowns). Cognitive orientation to daily occupational performance in a group format is feasible and has the potential to encourage skill acquisition for a greater number of children with developmental coordination disorder.

Objective. Observational learning has been suggested as a potential strategy for improving task performance and self-efficacy with stroke survivors. The present study explored the effectiveness of the use of peer mastery in addition to verbal instructions, to improve the task performance and self-efficacy, of a stroke survivor learning to exit a car. Method. A single-subject A-B-C design including a baseline observation phase (A) followed by two subsequent intervention phases, direct instruction (B) and peer mastery modeling (C), was used. Outcome measures, guided by Zimmerman's self-regulation of learning model, were obtained for task performance, perceived task performance, self-satisfaction, and self-efficacy. Results. While no improvement in task performance followed either intervention, improvements in perceived task performance, self-satisfaction, and self-efficacy were found following direct instruction. Peer mastery significantly strengthened the participant's self-efficacy. Conclusion. Pe...

Although the term self-regulation is appearing more frequently in the occupational therapy literature, the extent to which it is consistently conceptualized is not clear. The aim of this scoping review was to examine how the term self-regulation is used by occupational therapists in research and practice literature. A total of 58 publications that included occupational therapy and self-regulation in the title, key words, or abstract were identified. Self-regulation was not explicitly defined by more than half of the authors. Four theoretical orientations seem to guide conceptualization: synactive development, sensory integration, cognitive–behavioral theory, and self-regulation theory. Conceptualization differed according to the population, levels of strategy use, source of strategy implementation, and desired outcomes. A lack of definitional clarity and conceptual consistency of the term self-regulation was noted. Use of an explicit definition in relation to an identified theoretical framework is recommended to promote intra- and interprofessional communication, education, and research.

The observation of oneself on video that has been edited to show a performance level higher than one can actually perform is a feedforward form of modeling, termed self-modeling (SM; Dowrick, 1999). In this research, gymnasts alternated between viewing and not viewing a SM video during their competitive season. Results showed that gymnasts attained significantly higher beam scores when they viewed the video versus when they did not. No differences in self-efficacy were observed using a quantitative measure; however, a qualitative analysis of interviews based on Zimmerman's (2000) model, indicated that a number of self-regulatory processes, including self-efficacy, were employed.

Self-modeling involves the observation of oneself on an edited videotape to show a desired performance (Dowrick & Dove, 1980). While research has investigated the effects of self-modeling on physical performance and psychological mechanisms in relation to skill acquisition (e.g., Clark & Ste-Marie, 2007), no research to date has used a qualitative approach to examine the thought processes athletes engage in during the viewing of a self-modeling video in a competitive sport environment. The purpose of this study was to explore the self-regulatory processes of ten divers who viewed a self-modeling video during competitions. After competition, the divers were asked four questions relating to the self-modeling video. Zimmerman’s (2000) self-regulation framework was adopted for deductive analysis of the responses to those questions. The results indicated that a number of self-regulatory processes were employed, and they were mainly those in the forethought (75%) and self-reflection (25%) phases of Zimmerman’s model. Directions for future research in self-regulation and self-modeling are discussed. Modeling has been defined as a process where a learner observes a model dem

Introduction Cognitive Orientation to daily Occupational Performance (CO-OP) approach has been shown to be effective for improving the performance of tasks worked on in therapy and the use of cognitive strategies. No study to date seems to have explored its effectiveness for improving performance of untrained tasks (inter-task transfer) in children with Developmental Coordination Disorder (DCD). Objective This study aimed to determine whether CO-OP leads to improved performance in an untrained task. Methods A single-subject design with multiple baselines across skills was adopted, with three replications. Four children with DCD (7–12 years) received 10 sessions of CO-OP intervention where each child worked on three tasks during therapy sessions and a fourth task was identified, but not worked on, to verify inter-task transfer. Task performance was rated over four phases (baseline, intervention, post-intervention, follow-up) using the Performance Quality Rating Scale (PQRS-OD). Graphed data was statistically analyzed using a two or three standard deviation band method. Results Significant improvement was obtained for 11 of 12 tasks worked on during therapy and for two of the four untrained tasks. Conclusion These results indicate that the effectiveness of CO-OP to improve untrained tasks in children merit further exploration.

Item does not contain fulltext The Developmental Coordination Disorder Questionnaire (DCDQ'07) is a Canadian-English instrument recommended for screening children aged 5 to 15 years who are at risk for developmental coordination disorder. While a Canadian-French version of the DCDQ'07 presently exists, a European-French version does not. AIMS: To produce a cross-cultural adaptation of the DCDQ'07 for use in areas of Europe where French is spoken and to test its cultural relevance in French-speaking Switzerland. METHODS: Cross-cultural adaptation was done using established guidelines. Cultural relevance was analyzed with cognitive interviews of thirteen parents of children aged 5.0 to 14.6 years (mean age: 8.5 years, SD = 3.4), using think-aloud and probing techniques. RESULTS: Cultural and linguistic differences were noted between the European-French, the Canadian-French, and the original versions of the DCDQ'07. Despite correct translation and expert committee review, cognitive interviews revealed that certain items of the European-French version were unclear or misinterpreted and further modifications were needed. CONCLUSIONS: After rewording items as a result of the outcomes of the cognitive interview, the European-French version of the DCDQ'07 is culturally appropriate for use in French-speaking Switzerland. Further studies are necessary to determine its psychometric properties.

The current study examined self-as-a-model interventions, with the goal of understanding the thought processes that unfolded when children viewed feedback in this form. To accomplish this, a think aloud protocol (Ericsson & Simon, 1996) was employed with young children ( n =22) who were learning how to swim. The children (mean age=8.3 years) participated in an eight-day intervention program during which time the children were instructed to verbalize all of their thoughts while watching their respective self-as-a-model videos. An exploratory approach was undertaken to discover the emerging themes that arose from the think aloud protocol. The results from this exploratory study showed that the majority of the children's verbalizations were self-evaluative in both a positive (Descriptive Positive), and negative (Descriptive Negative) direction, as well as, being related to future skill improvement (Prescriptive). Overall, the novel introduction of a think aloud protocol provided insight into the thought processes engaged in by children while viewing self-as-a-model videos. These findings provide an interesting starting point for future investigations into children's thought processes during modeling interventions.

The use of metacognition differs with different levels of cognitive ability, but it is not known whether children of different psychomotor abilities use metacognition differently. This study used a think-aloud protocol to compare the active use of metacognition in children with different psychomotor abilities—high skill, average, developmental coordination disorder (DCD)—during a ball-throwing task. Children with DCD did not verbalize fewer or different metacognitive concepts than either the average or high skill children; however, relative to their counterparts, a significant median proportion of the concepts verbalized by children with DCD were found to be inappropriate or inaccurate. These findings reflect ineffective metacognitive processing by children with DCD during a psychomotor task.

The performance quality rating scale (PQRS) is an observational measure of performance quality of client-selected, personally meaningful activities. It has been used inconsistently with different scoring systems, and there have been no formal publications on its psychometric properties. The purpose of this study was to test and compare the psychometric properties of two PQRS scoring systems in two populations.A secondary analysis of video recorded participant-selected activities from previous studies involving either adults living with stroke or children diagnosed with developmental coordination disorder (DCD) was conducted. Three pairs of raters scored the video recorded performances with PQRS operational definitions (PQRS-OD) and a generic rating system (PQRS-G).For inter-rater reliability, PQRS-OD ICCs were substantial, ranging from 0.83 to 0.93; while the PQRS-G ICCs were moderate, ranging from 0.71 to 0.77. Test-retest reliability was substantial,0.80 (ICC), for both rating systems across all rater pairs. Internal responsiveness was high for both rating systems. Convergent validity with the Canadian Occupational Performance Measure (COPM) was inconsistent, with scores ranging from low to moderate.Both scoring systems have demonstrated they are reliable and have good internal responsiveness. The PQRS-OD demonstrated greater consistency across raters and is more sensitive to clinically important change than the PQRS-G and should be used when greater accuracy is required. Further exploration of validity with actual rather than perceived performance measures is required.

There is a high rate of speech recognition software (SRS) abandonment by adolescent students with physical disabilities.This study sought to describe the experience of adolescentstheir parents, who experienced abandonment of SRS.Using a narrative inquiry method, semi-structured interviews were conducted with three adolescents with a physical disability (and two parents). The individual narratives were transcribed and analyzed using plot-solution and three-dimensional space narrative elements.Participants' descriptions of their experiences of abandonment emerged along four descriptive themes: (a) they didn't tell me the whole story, (b) I know how to use it, it's just not worth the time and effort, (c) it's just not the right fit for me or my needs, (d) there's an easier way!Participants believed the SRS was not an adequate fit for their needs or their specific disabilities and so resorted to alternative methods of written communication. A better understanding of the compatibility of the client's needs with the strengthslimitations of the technology, may improve the prescription and intervention process for both therapiststheir clients.

Children with developmental coordination disorder (DCD) experience many occupational performance difficulties in all areas of daily living. For the most part, research has failed to identify an effective treatment approach for these children. Verbal self-guidance (VSG), a new approach, first explored by Wilcox and Polatajko (1993), appears to have good potential in helping children with DCD become competent in the occupations of their choice. The purpose of this study was to carry out a systematic replication of the first VSG study to determine if a different therapist could achieve similar results. Repeating the VSG procedure with four different children, using a single case study design, a different therapist was able to replicate the earlier findings. This provides further evidence of the potential of VSG as an effective approach for enabling children with DCD to surmount their motor challenges.

Objective To create evidence-based guidelines evaluating foot care interventions for the management of juvenile idiopathic arthritis (JIA). Data Sources An electronic literature search of the following databases from database inception to May 2015 was conducted: MEDLINE (Ovid), EMBASE (Ovid), Cochrane CENTRAL, and clinicaltrials.gov. Study Selection The Ottawa Panel selection criteria targeted studies that assessed foot care or foot orthotic interventions for the management of JIA in those aged 0 to ≤18 years. The Physiotherapy Evidence Database scale was used to evaluate study quality, of which only high-quality studies were included (score, ≥5). A total of 362 records were screened, resulting in 3 full-text articles and 1 additional citation containing supplementary information included for the analysis. Data Extraction Two reviewers independently extracted study data (intervention, comparator, outcome, time period, study design) from the included studies by using standardized data extraction forms. Directed by Cochrane Collaboration methodology, the statistical analysis produced figures and graphs representing the strength of intervention outcomes and their corresponding grades (A, B, C+, C, C−, D+, D, D−). Clinical significance was achieved when an improvement of ≥30% between the intervention and control groups was present, whereas P >.05 indicated statistical significance. An expert panel Delphi consensus (≥80%) was required for the endorsement of recommendations. Data Synthesis All included studies were of high quality and analyzed the effects of multidisciplinary foot care, customized foot orthotics, and shoe inserts for the management of JIA. Custom-made foot orthotics and prefabricated shoe inserts displayed the greatest improvement in pain intensity, activity limitation, foot pain, and disability reduction (grades A, C+). Conclusions The use of customized foot orthotics and prefabricated shoe inserts seems to be a good choice for managing foot pain and function in JIA.

Occupational therapists frequently work with clients who are challenged by chronic disabilities that may often lead to handicaps. Consequently, chronicity and possible resulting handicaps are matters of concern for occupational therapists in all domains, including: practice, research and education. In 1980 the World Health Organization put forth a classification scheme to capture the long-term consequences of disease: the International Classification of Impairments, Disabilities, and Handicaps (ICIDH). Its use within occupational therapy was advocated. They showed that the constructs of this classification system mirrored those of occupational therapy's occupational performance model. More recently, a proposal for the revision of the ICIDH (ICIDH-PR) has been advanced. This proposal is consistent with the enablement and occupational competence models. Within this proposed model, occupational therapy is concerned with enabling clients to interact optimally within their chosen environments. This paper presents a brief review of a selected portion of the international literature on the ICIDH and introduces the proposed revision of the ICIDH for occupational therapy. The structure of this proposed classification is compared with the occupational therapy models. The implications that the use of the ICIDH-PR will have for occupational therapy are also addressed.

Background. Parent-report measures, such as the Developmental Coordination Disorder Questionnaire'07 (DCDQ'07), are used to identify developmental coordination disorder (DCD) in children. Early identification of this condition is important to mitigate its social-emotional and health consequences. Unfortunately, few French-language assessments are available to therapists working with francophone populations. Purpose. The aim of this study was to undertake a formal translation of the English DCDQ'07 and begin to examine its psychometric properties. Methods. The translation was done using Beaton, Bombardier, and Guillemin's (2000) guidelines for cross-cultural adaptation. Methodologies described by Haccoun (1987) and Vallerand (1989) were used to address the psychometric qualities of the translation. Findings. The DCDQ'07 and its French translation (DCDQ-FC) are equivalent, with excellent internal consistency and test-retest reliability. Concurrent and construct validity were adequate for a screening measure; however, low sensitivity was obtained with both measures. Implications. The DCDQ-FC is a valid translation for use with a French Canadian population.

Background. Children with autism exhibit difficulties with social interaction and communication skills, and they present with restricted interests and stereotyped patterns of behaviour that affect their daily lives. Floor time play (FTP) is an intervention approach that addresses these issues; however, there are few published studies on its effectiveness. Purpose. This study determines the effectiveness of FTP intervention with a child diagnosed with autism. Methods. A single subject AB design was used with circles of communication as the behaviour indicator for improvement. Visual and statistical analyses were completed. The child's mother kept a daily journal describing FTP intervention sessions at home. Findings. Despite variability in the data, statistical analyses indicate a significant difference between the numbers of circles of communication during the intervention phase as compared with the observation phase. Implications. This study provides preliminary evidence for the use of the FTP approach with a child with autism.

The purpose of this research was to examine whether children would benefit from a feedforward self-modeling (FSM) video and to explore possible explanatory mechanisms for the potential benefits, using a self-regulation framework. To this end, children were involved in learning two five-skill trampoline routines. For one of the routines, a FSM video was provided during acquisition, whereas only verbal instructions were provided for the alternate routine. The FSM involved editing video footage such that it showed the learner performing the trampoline routine at a higher skill level than their current capability. Analyses of the data showed that while physical performance benefits were observed for the routine that was learned with the FSM video, no differences were obtained in relation to the self-regulatory measures. Thus, the FSM video enhanced motor skill acquisition, but this could not be explained by changes to the varied self-regulatory processes examined.

This commentary draws on a recent workshop hosted by the Canadian Children's Rehabilitation Research Network that brought together stakeholders to critically examine assumptions embedded in children's rehabilitation in order to advance current debates and suggest areas for further inquiry.Six issues are discussed: (1) the wisdom of dichotomising 'fix' versus 'function'; (2) the ethics of it might help and it won't hurt' therapy approaches; (3) the emphasis on early intervention rather than a lifespan approach; (4) the challenges of providing care for new rehabilitation populations; (5) discrepancies between performance outcomes and patient satisfaction; and (6) innovative partnerships to support care transitions of adolescents and their families.Issues identified include: finding the right balance between therapies that focus on 'fixing' children versus enhancing function, judicious design of therapy programs as to not overburden children and families, adopting lifespan approaches to meet the needs of multiple 'paediatric' populations, cautious interpretation of measures and approaches that link well-being with physical performance, and the benefits of including parent and youth facilitators on children's rehabilitation teams.Ongoing debate, discussion and research are needed in each of these areas to ensure that rehabilitation services are enhancing the well-being of children and families.

Occupational therapy is now consistently described as a profession concerned with enabling occupation. A crucial step in enabling occupation is understanding the occupational performance of our clients. Dynamic Performance Analysis (DPA) is a new approach to occupational analysis that focuses on the client’s actual performance. DPA, acknowledging that optimal performance is the product of the interaction of person, environment, and occupation, and thus highly individualistic, places the client and his or her occupation, in interaction with the environment, at the center of the analysis process. Embedded in a top–down framework, DPA is a dynamic, iterative process, carried out as the client performs the occupation. The purpose of DPA is to identify where performance breaks down and test out solutions. In this article, the rationale, origins, and basic assumptions of DPA are discussed, and a detailed description of the DPA process together with two clinical examples is presented.