American Journal of Occupational Therapy

Importance: An analysis by the Substance Abuse and Mental Health Services Administration (SAMHSA; 2015a) found that an additional 10,000 mental health care providers will be needed by 2025 to meet the expected growth in demand for treatment of people with mental illness, substance use disorder, or both. Despite being the largest payer of mental health services in the United States, the Medicaid program has extremely low numbers of mental health providers (Frank et al., 2003).

Objective: This Health Policy Perspectives column is a collaboration among academics, clinicians, and students in the fields of occupational therapy and law in an effort to advance state occupational therapy associations’ efforts to gain formal recognition of occupational therapy practitioners as Qualified Mental Health Providers (QMHPs) and/or Qualified Behavioral Health Providers (QBHPs).

Conclusion: Coordination among states to identify barriers and opportunities in this important advocacy effort are needed for continued successful inclusion of occupational therapy practitioners as QMHPs, QBHPs, or both.

What This Article Adds: This column will assist other states in their efforts by providing legislation, strategic advocacy examples, and a course of action.

Coordination among states to identify barriers to and opportunities for occupational therapy practitioners’ recognition as QMHPs and QBHPs is essential to address the projected shortage of mental health service providers.

Importance: Motor vehicle accidents are the leading cause of unintentional deaths of children ages 1 and older, particularly children with health care needs.

Objective: To explore family caregivers’ experiences and current practices while transporting children diagnosed with autism spectrum disorder (ASD).

Design: A concurrent nested mixed-methods approach was used to gain insight into caregiver experiences.

Setting: Participants completed an online Qualtrics survey.

Participants: A convenience sample of 54 caregivers of children with ASD from 17 U.S. states.

Results: Themes that emerged include sensory behaviors of children, education related to child passenger safety, and participation in the community. Statistically significant findings suggest a correlation between caregivers (n = 39) being less likely to participate in activities away from home if the child had attempted to elope (p = .013), displayed aggressive behaviors (p = .005), or demonstrated self-injurious behaviors (p = .001).

Conclusions and Relevance: The findings suggest a correlation between caregivers limiting the distance traveled during vehicular transportation and behavioral safety concerns. If caregivers must limit travel, they may refrain from accessing the community and engaging in leisure pursuits.

What This Article Adds: The findings suggest that therapists who treat children with ASD should be familiar with child passenger safety restraints, particularly for elopement.

Researchers found a correlation between caregivers’ limiting the distance traveled during vehicular transportation and behavioral safety issues, leading to concerns that caregivers may not be fully accessing the community and engaging in leisure pursuits.

Importance: Occupational therapy use in the neurological critical care unit (NCCU) may relate to patient factors, but data about these relationships remain unpublished.

Objective: To examine how patient factors predict NCCU occupational therapy use and intervention types.

Design: Retrospective cohort study of electronic health records data from adults admitted to the NCCU between May 2013 and September 2015.

Setting: NCCU in a large, urban academic hospital.

Participants: Adults (age ≥18 yr; N = 1,134) admitted to the NCCU.

Measures: Using length of stay (LOS), number of comorbidities, Glasgow Coma Scale (GCS) score, gender, age, and racial–ethnic minority status as independent variables, separate regression models identified predictors for each dependent variable: receipt of NCCU occupational therapy, occupational therapy onset (days after admission), and receipt of self-care or home management (ADL–Home); functional activities or cognitive training (Func–Cog); and therapeutic exercise (Ther-Ex).

Results: Four hundred twenty patients (37.0%) received occupational therapy in the NCCU. Receipt of occupational therapy was positively associated with LOS, number of comorbidities, GCS score, and age. Earlier occupational therapy onset was associated with higher GCS score and shorter LOS. Receipt of ADL–Home or Func–Cog interventions was significantly predicted by number of occupational therapy sessions, but patients with longer LOS were less likely to receive ADL–Home interventions. Receipt of Ther-Ex interventions became less likely as GCS score increased.

Conclusions and Relevance: Patients are more likely to receive occupational therapy services if they are older and have a longer NCCU LOS, more comorbidities, and a higher level of consciousness.

What This Article Adds: A patient’s level of consciousness is clearly associated with occupational therapy utilization and hospital outcomes, but it should not be the only factor considered when prioritizing patients for NCCU occupational therapy services. Compared with patients who were more awake and alert, patients with a lower level of consciousness had a later onset of occupational therapy, which suggests an opportunity for NCCU occupational therapists to collaborate with physicians in the modification of sedation protocols to enable early rehabilitation.

Findings indicate that patients with a lower level of consciousness had later onset of occupational therapy, suggesting an opportunity for NCCU occupational therapists to collaborate with physicians in the modification of sedation protocols.

Importance: Care partners report that they are unprepared to manage the care of their loved one during the predischarge rehabilitation process and at the time of transition from hospital to home.

Objective: To link, classify, and describe care partner–reported problems using the International Classification of Functioning, Disability and Health (ICF) to explore care partner experiences during the predischarge rehabilitation process.

Design: We linked meaningful concepts collected during problem-solving training implemented with care partners of patients with sudden-onset conditions to the ICF using a standardized linking technique.

Setting: Health care institution.

Results: Care partner–reported problems were linked to 13 of the 30 ICF chapters. Activities and participation was most frequently addressed, followed by body functions. Care partners most commonly reported problems in the areas of emotional function, major life areas, self-care, domestic life, interpersonal relationships, and sleep functions.

Conclusions and Relevance: The ICF can be used to examine and describe care partners’ health-related experiences. Care partners experience myriad problems related to activities and participation, body functions, environmental factors, and personal health before the care recipient’s initial discharge from the hospital.

What this Article Adds: Care partners’ problems early in the rehabilitation process are complex and interrelated. The ICF can serve as a framework for a systematic approach to identifying care partner needs, as it has for patients with a variety of diagnoses.

Using the ICF to understand care partners’ problems after a sudden-onset condition may provide crucial insight needed to develop effective self-management interventions for care partners in the future.

Importance: Premature infants are not prepared developmentally, physically, or cognitively with the multiple survival skills of the typical newborn.

Objective: To determine whether physical activity generated spontaneously by premature infants stretching against the resistance of “prepod” garments is as effective as exercises provided by therapists in slowing bone density loss.

Design: Preterm very low birth weight infants were placed in two nonrandomized parallel groups according to birth age.

Setting: Infants routinely started in a traditional intense intervention setting and graduated to a special care section with private rooms that allowed parents to remain with their child.

Participants: Healthy infants without medical complications, born between 28 and 32 wk postmenstrual age.

Intervention: The control group received traditional exercises. The experimental group wore a prepod almost 24 hr a day.

Outcomes and Measures: An ultrasound of the tibia was obtained at 31 to 32 wk and 4 wk later. Weight gain, head circumference growth, and length of stay (LOS) were also measured.

Results: Although not statistically significant, the ultrasound results showed that the prepod group had less loss of bone density than the traditional therapy exercise group. The desired outcome was for pods to be as effective at reducing bone loss as traditional exercise, so the results exceeded expectations. The unexpected, and more notable, finding was a striking drop in LOS for the prepod group.

Conclusions and Relevance: Spontaneous exercise by premature infants decreases bone loss and LOS. Better bone health and increased developmental maturity increase the chances of a positive developmental outcome and save the hospital significant expense.

What This Article Adds: The prepod is a simple, cost-effective, noninvasive treatment tool occupational therapy practitioners can use to support a premature infant’s development. This study has considerable potential to affect how infants are served, both developmentally and financially.

Spontaneous physical activity by premature infants stretching against the resistance of “pod” garments was found to decrease bone loss and LOS.

Importance: Evidence of the effectiveness of cognitive activity and preparatory tasks in improving the cognitive skills and functional performance of people with cognitive decline is limited.

Objective: To examine the efficacy of a high-ecological cognitive intervention.

Design: Quasi-experimental, pretest–posttest design with nonequivalent control.

Setting: Community.

Participants: Older adults with mild cognitive impairment from two senior centers.

Intervention: Twelve 90-min weekly group sessions of a high-ecological cognitive intervention using simulated everyday cognitive tasks (experimental group) and of nutrition education (active control group).

Outcomes and Measures: Cognitive skills were measured with the Color Trails Test (CTT), the Contextual Memory Test (CMT; Immediate Recall [CMT–Im] and Delayed Recall [CMT–De] tasks), and the Wechsler Adult Intelligence Scale–Fourth Edition Digit Span subtest (Digits Forward and Digits Backward). Cognitive–functional performance was measured with the Rivermead Behavioural Memory Test–Third Edition (RBMT–3; Immediate Recall [RBMT–3–Im] and Delayed Recall [RBMT–3–De] tasks) and the Cognitive Failures Questionnaire (CFQ).

Results: Thirty-seven participants (M age = 70.84 yr; 70.3% women) met the inclusion criteria for analysis (20 participants in the intervention group, 17 participants in the control group). Multivariate linear regression showed that the intervention group improved significantly more than the control group on the CTT, CMT–Im, and RBMT–3–Im but not on the CMT–De, RBMT–3–De, and CFQ.

Conclusions and Relevance: Twelve 90-min weekly group sessions of a high-ecological cognitive intervention improved attention, executive function, immediate memory, and objective cognitive–functional performance with immediate-memory task demands.

What This Article Adds: Carefully designed and structured simulated everyday cognitive tasks can be used as a cognitive training agent to improve both cognitive skills and objective cognitive–functional performance. The effectiveness of group-based cognitive interventions depends on the skills of occupational therapy practitioners in activity analysis and grading.

Carefully designed and structured simulated everyday cognitive tasks can be used as a training agent to improve both cognitive skills and objective cognitive–functional performance for older adults with mild cognitive impairment.

Importance: Time management is crucial for managing daily activities but is difficult for many people with neurodevelopmental or mental disorders. Few sustainable interventions have addressed time management in daily life.

Objective: To describe the experiences and meaning of attending the Swedish version of the Let’s Get Organized (LGO–S) group intervention.

Design: Qualitative design with interviews 1 to 4 mo after the completed intervention.

Setting: Outpatient psychiatric and adult habilitation clinics.

Participants: Twelve adults with neurodevelopmental or mental disorders.

Intervention: LGO–S, a manual-based group intervention that focuses on time-management skills.

Outcomes and Measures: Semistructured interviews analyzed with qualitative content analysis. All authors took an active part in the analysis process; consensus was reached.

Results: The overarching theme, “a roller-coaster process toward control over time in daily life,” describes the participants’ process during and after intervention. Four main categories describe the meaning of understanding why time management is difficult and how to use tools for improvement, a process of change that was facilitated by the learning environment. Participants described the process as a struggle to take control over time, but they noted that the positive changes in daily life made it worthwhile.

Conclusions and Relevance: Participation had a positive impact on daily life. The opportunity for skills training with support over an extended period, a changed view on failure, and the group format appear to be important success factors.

What This Article Adds: The LGO–S, with its structured training of time-management skills, contributes to occupational therapy practice with an intervention that clients experience as bringing meaningful and positive changes to daily life functioning.

The Swedish version of the LGO, with its structured training of time-management skills, contributes to occupational therapy practice with an intervention that clients experience as bringing meaningful and positive changes to daily life functioning.

Importance: For a person with mild cognitive impairment (MCI) or early-stage dementia, driving is important for independence. However, driving presents safety concerns for both the person and family members. It is important to determine whether occupational therapy interventions can prolong safe driving for this population.

Objective: To determine the effectiveness of occupational therapy interventions to improve driving performance in older people with MCI or early-stage dementia.

Data Sources: We conducted a search of MEDLINE, PsycINFO, CINAHL, and gray literature using Google Scholar.

Study Selection and Data Collection: Studies were included if they evaluated interventions that (1) aimed to improve the driving performance of older people (M age ≥60 yr) with MCI or early-stage dementia and (2) could be designed or delivered by an occupational therapy practitioner who specializes in driving. Citations were reviewed independently by two authors, and quality appraisal was conducted using the Cochrane risk-of-bias guidelines.

Findings: One Level I randomized controlled trial (RCT) and 4 Level III quasi-experimental studies were included; these studies had 231 participants in total with reported M ages of 65.6–72.5 yr. One study evaluated a compensatory approach, whereas the others evaluated a remedial approach. The studies used different measures to assess outcomes and reported mixed effects.

Conclusions and Relevance: Low strength of evidence suggests that occupational therapy interventions may improve the driving performance of older people with MCI or early-stage dementia. More RCTs are needed that include long-term follow-up measures and address clinically important outcomes.

What This Article Adds: In the absence of conclusive evidence from research studies and best practice guidelines, occupational therapy practitioners must rely on their clinical experience and their clients’ abilities. Development of evidence and guidelines in this area is critical. It is also important for practitioners to work closely with clients, families, and interdisciplinary team members to carefully monitor fitness to drive.

Low strength of evidence was found for the use of occupational therapy interventions to improve the driving performance of older people with MCI or early-stage dementia; development of evidence and guidelines in this area is critical.

Importance: The recovery model in mental health involves person-driven care and informed decision making to enhance engagement in meaningful activities and inclusion in society. To facilitate the recovery process, occupational therapy practitioners must support their clients in understanding how their participation in meaningful occupation is intimately related to their health and well-being.

Objective: To explore whether engaging in an occupational reflection intervention on an inpatient psychiatric unit can support the recovery of adults living with serious mental illness (SMI).

Design: Using a phenomenological design, we conducted semistructured interviews to assess whether participation in an occupational reflection intervention supported recovery.

Setting: An inpatient psychiatric unit at a university medical center.

Participants: We recruited 10 adults living with SMI using purposive sampling.

Intervention: Participants engaged in a structured occupational reflection intervention using the Occupational Experience Profile (OEP). The OEP is a time-use diary that captures respondents’ subjective experiences of pleasure, productivity, restoration, and connection in relation to their participation in occupations over 24 hr. Study participants engaged in collaborative analyses regarding their OEP results to explore their subjective experiences in relation to their occupational participation.

Outcomes and Measures: Participant self-report during interviews.

Results: Engaging in structured reflection affected participants’ experiences of recovery by promoting insight into and awareness of how occupations affect mental health, encouraging positive reframing of occupational experience, and facilitating identification of strategies to support recovery and meaningful participation after discharge.

Conclusions and Relevance: Occupational reflection can promote the recovery of adults living with SMI.

What This Article Adds: A structured occupational reflection intervention can help adults living with SMI in inpatient psychiatric units to understand the close relationship between their participation in occupations and their health. This process provides valuable insight to clients regarding how to support their recovery through engagement in meaningful occupation.

Structured occupational reflection can enhance the recovery of adults living with SMI in inpatient psychiatry units.

Importance: Spanish-speaking populations represent a significant percentage of occupational therapy clientele globally. Culturally appropriate Spanish translations of assessments are therefore imperative. This study describes the process of a culturally adapted translation of a set of tests for use with Spanish-speaking pediatric populations.

Objective: To produce a culturally adapted Spanish translation of the Evaluation in Ayres Sensory Integration^® (EASI) for international use.

Method: We used cultural adaptation methodology that included direct and back translations of the EASI by bilingual translators and interviews with pediatric occupational therapists and children ages 3–6 yr from Spain. Linguistic experts helped revise the translations, and pediatric occupational therapy leaders in five Spanish-speaking North and South American countries reviewed the translations for comprehensibility and cultural appropriateness.

Results: Back translations demonstrated equivalence with the original EASI tests except for a few test instructions and scoring criteria. Interviews with occupational therapists and children in Spain revealed some comprehension difficulties for several tests, which were revised in consultation with a linguistic expert. Additional adaptations were made on the basis of recommendations to address cultural differences by occupational therapy leaders from five North and South American countries. Most changes in wording were made in one EASI test (Praxis: Following Directions) that is heavily dependent on language comprehension.

Conclusions and Relevance: We used currently recommended methodologies to develop and adapt a Spanish translation of the EASI for use across diverse cultures.

What This Article Adds: A Spanish translation of the EASI has been developed for use in culturally diverse Spanish-speaking countries around the world.

The authors describe the development of a cultural adaptation of the Evaluation in Ayres Sensory Integration (EASI) for Spanish-speaking populations.

Importance: Rural homebound older adults are a vulnerable population at risk for depression, loneliness, and limited participation, but studies that examine these factors in this population are scarce.

Objective: To describe the degree of depression, loneliness, and activity engagement among rural homebound older adults and determine differences in loneliness and activity engagement between those with and those without self-reported depression.

Design: Cross-sectional survey.

Setting: Two rural counties in south central Indiana.

Participants: Homebound adults ages 60 yr and older who received nutritional or companionship services from a local Area Agency on Aging.

Outcomes and Measures: Depression was measured with an item on the self-report questionnaire and the Geriatric Depression Scale–15. Loneliness was measured with an item on the self-report questionnaire and the UCLA Loneliness Scale. Activity engagement was measured with the Engagement in Meaningful Activities Survey and the Meaningful Activity Participation Assessment.

Results: Ninety-one participants returned surveys, of which 78 were analyzed. Regarding depression, 40% of participants reported having it, but results for the Geriatric Depression Scale–15 showed that 63% were in the indicative or suggestive range for depression. Participants in general reported moderate loneliness and low to moderate engagement in meaningful activities. Those with self-reported depression had significantly higher loneliness and lower activity engagement, particularly in self-care, leisure, and socializing activities.

Conclusions and Relevance: A high proportion of this sample of rural homebound older adults had depression. Those who did tended to have a higher degree of loneliness and lower engagement in meaningful activities.

What This Article Adds: Depression was associated with greater loneliness and lower activity engagement in rural homebound older adults. Occupational therapy practitioners serving rural homebound older adults with depression should consider providing interventions to address loneliness and facilitate activity engagement.

Occupational therapy practitioners serving rural homebound older adults should consider providing interventions to address loneliness and facilitate activity engagement.

Importance: Occupational therapy practitioners can play a pivotal role in supporting breastfeeding mothers as they transition to and form new routines for this occupation.

Objective: To explore whether occupational therapy programming can assist breastfeeding mothers in reaching their personal occupation-based wellness goals.

Design: Mixed-methods design that involved development of an occupational profile and a goal attainment scale (GAS). After the intervention, participants rescored their GAS goals and completed a semistructured exit interview.

Setting: Nonprofit lactation center located in the suburbs of a large mid-Atlantic U.S. city.

Participants: Women recruited through convenience sampling who had been breastfeeding an infant for <6 mo, who were not currently weaning, and who had met with a lactation consultant at least once since giving birth were eligible (N = 17).

Intervention: Group occupational therapy that consisted of 10 weekly 1-hr sessions. Topics were based on occupational profiles, GAS scores, and lactation consultant input.

Outcomes and Measures: Each participant created and scored three goals using the GAS before and after the intervention.

Results: Data from 14 of the 17 participants were analyzed. The average postintervention GAS score was 56.50 (M = 50), indicating that most personal wellness goals were reached. Thematic analysis revealed that occupational therapy programming helped mothers persevere with breastfeeding, feel more confident as new parents, and value both themselves and their baby.

Conclusions and Relevance: There is an increasing role for occupational therapy practitioners in helping new mothers reach their personal wellness goals in ways that support their ability to continue breastfeeding.

What This Article Adds: Maternal wellness and breastfeeding represent an emerging area of practice in which occupational therapy practitioners can provide new mothers with physical, social, and psychological supports that help them maintain self-efficacy related to breastfeeding and other meaningful occupations. This study provides foundational evidence in support of this collaboration.

Maternal wellness and breastfeeding is an emerging area of practice in which occupational therapy practitioners can provide new mothers with supports that help them maintain self-efficacy related to breastfeeding and other meaningful occupations.

Importance: Children with autism spectrum disorder (ASD) may experience sleep difficulties that worsen into adulthood and negatively influence both child and family, yet the experience is not well understood. Understanding the family’s experience can inform occupational therapy providers, future research, and practice guidelines.

Objective: To examine experiences surrounding sleep for families raising a young adult with ASD (YA-ASD).

Design: Qualitative study in the phenomenological tradition of Moustakas (1994). Experienced researchers analyzed transcripts from in-depth, in-person interviews to triangulate data, distill themes, and construct the essence of family experience. Trustworthiness was established through member checking, audit trails, and epoché diaries that were maintained throughout data analyses.

Setting: Community setting (large city in the northeastern United States).

Participants: People who self-identified as living in a family arrangement that included a YA-ASD age 15–21 yr, able to verbally participate in English. Families with children diagnosed with developmental disabilities other than ASD were excluded.

Results: Six eligible families identified through volunteer sampling participated. The participants’ sociodemographic diversity was limited across household income, education level, and ethnicity. All YA-ASD in this study were limited verbally and unable to contribute. Analyses of interview transcripts revealed five themes that form the essence of the families’ experience surrounding sleep.

Conclusions and Relevance: Sleep issues for YA-ASD continue into adulthood and affect the entire family because of continuous co-occupation; occupational therapy support is therefore important for families of YA-ASD. The lack of effective evidence-based interventions supporting the YA-ASD population also reveals an area for growth.

What This Article Adds: The results indicate the importance of addressing sleep for YA-ASD and their families in occupational therapy practice because of its considerable impact on family life.

Because sleep issues have a considerable impact on family life, occupational therapy support is important young adults with ASD and their families.

Importance: Occupational performance limitations (OPLs) are poorly understood sequelae of concussion. This study aimed to establish the need for occupational therapy services for people who have sustained a concussion and to support the profession’s role in facilitating occupational performance for college students experiencing signs and symptoms after concussion.

Objective: To describe the types and frequency of, and assess risk factors for, OPLs in college students after concussion.

Design: Cross-sectional descriptive study.

Setting: Web-based survey on Qualtrics.

Participants: A total of 220 participants completed the survey; of those, 52 (23.6%) self-identified as having sustained a concussion and were further asked about OPLs after the concussion.

Results: Eighty-nine percent (n = 46) of the participants reported an OPL in at least one area, and higher OPL scores were associated with the number of concussion symptoms (r = .34, p = .02) and increased recovery time (≥3 days vs. <3 days, p = .006).

Conclusions and Relevance: College students reporting concussions with more symptoms that persisted for longer periods were more likely to experience occupational performance loss. Frequent OPLs were reported in occupations associated with the participants’ primary role of student. These results indicate a unique need for occupational therapy intervention with students to facilitate their continued success in academic pursuits.

What This Article Adds: People who have sustained a concussion experience OPLs. Occupational therapy has a role in facilitating a return to occupational performance during recovery, especially in helping college students with concussion return to the classroom.

Occupational therapy has a role in facilitating college students' return to occupational performance during concussion recovery.

Importance: Informal caregivers often receive limited training and support, especially in providing assistance with toileting, a physically and emotionally demanding activity of daily living. This increases caregivers’ risk for physical injury and burnout and jeopardizes older adults’ ability to age in place.

Objective: To assess the feasibility, acceptability, and preliminary efficacy of a toileting intervention using an automated bidet to reduce the amount of physical assistance required from caregivers.

Design: Randomized wait-list control feasibility study.

Setting: Caregiver’s home.

Participants: Ten informal caregivers.

Intervention: An occupational therapy intervention to educate and train caregiving dyads to use an automated bidet system.

Outcomes and Measures: Feasibility was measured in terms of recruitment and retention, bidet installation, ability to operate the bidet, acceptability (a process evaluation), preliminary efficacy (physical barriers and impact on caregiver outcomes of performance, satisfaction, and self-efficacy), and adverse events.

Results: All bidets were installed successfully. All caregivers reported that the intervention made toileting easier and increased their confidence. Physical barriers decreased for the treatment group. The bidet had a large effect on self-efficacy for the treatment group.

Conclusions and Relevance: The results suggest that the automated bidet intervention is feasible and acceptable and can have a positive impact on caregiver outcomes when assisting with toileting.

What This Article Adds: A toileting intervention using an automated bidet is feasible and acceptable for caregivers of older adults and can reduce the amount of physical assistance required from caregivers.

A toileting intervention using an automated bidet is feasible and acceptable for caregivers of older adults and can reduce the amount of physical assistance required from caregivers.

Unpaid caregivers are often expected to help family members or friends overcome activity limitations and participation restrictions to successfully age in place. Caregivers assume multiple responsibilities, such as managing their own physical and psychosocial needs and navigating a complex health care system, and many feel ill equipped to fulfill the necessary health care responsibilities for their care recipients. Underprepared caregivers may cause poor outcomes for care recipients. Federal and state policy proposals call attention to the need to better support caregivers, especially as their numbers increase. Occupational therapy practitioners are well positioned to effectively engage caregivers as they navigate the health care system. The occupational therapy process looks broadly at the functional abilities, environmental contexts, and occupational demands that play a pivotal role in successful aging in place for clients and better outcomes for their caregivers. Now is the time to define occupational therapy’s distinct value to this area.

The authors articulate the distinct value of occupational therapy in supporting state and federal policy focused on caregiving and aging in place.

Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association’s (AOTA’s) Evidence-Based Practice Program. In this Evidence Connection article, I describe a case report of a young child receiving early intervention services and outline the occupational therapy evaluation and intervention processes for supporting this child’s activities of daily living in the home and early childhood education setting. Findings from the systematic reviews on this topic were published in the March/April 2020 issue of the American Journal of Occupational Therapy and in AOTA’s Occupational Therapy Practice Guidelines for Early Childhood: Birth–5 Years. Each article in this series summarizes the evidence from the published reviews on a given topic and presents an application of the evidence to a related clinical case. Evidence Connection articles illustrate how the research evidence from the reviews can be used to inform and guide clinical decision making.

The author describes evidence-based evaluation and intervention strategies for a child receiving early intervention services for ADL performance.