Canadian Journal of Occupational Therapy

Background. The environment is essential to occupational participation. However, the involvement and training of occupational therapists in universal accessibility (UA) seems limited. Purpose. To explore the content on UA taught in university occupational therapy programs in Canada. Method. This study adopts a mixed methodology. A survey, including mostly quantitative data, was distributed to occupational therapy programs across Canada, and course syllabi related to UA, providing qualitative data, were requested. Analysis included descriptive statistics and content descriptive analysis. Findings. Thirteen out of 14 programs responded to the survey and five provided course syllabi. While all programs cover UA content, only seven offer specific courses on accessibility. Internships related to UA are offered by seven programs. Some gaps identified include limited knowledge, lack of in-depth content, and limited interprofessional collaboration. There are variations in emphasis on UA and teaching approaches. Boundaries between universal approaches and knowledge of specific disability groups are poorly delineated. UA is unanimously considered essential in the training of occupational therapists. Conclusion. The content in UA is heterogeneous across programs. Consensual definitions of accessibility concepts related to occupational therapy are needed to better define the role of the occupational therapist in this area.

Background. Motor vehicle accident (MVA) injuries can result in persistent impairments which contribute to chronic pain, mental health symptoms, and decreased quality of life. Occupational therapists play a key role in the rehabilitation of those injured in MVAs yet there is lack of evidence to inform occupational therapy practice. An explicit understanding of the factors influencing post-MVA recovery from occupational therapists’ perspectives is needed to inform clinical service delivery. Purpose. This study addressed the following question: From the perspective of occupational therapists, what factors are identified as influencing recovery following a noncatastrophic injury sustained in an MVA? Method. An interpretive descriptive study design was used. Data were collected through semistructured interviews with 10 occupational therapists who provide auto-insurer funded occupational therapy to clients with noncatastrophic injuries from an MVA. Data were analyzed using constant comparative analysis. Results. Physical symptoms and accessibility, acceptance, social support, access to occupational therapy, and navigating the insurance system were factors identified as influencing post-MVA recovery. Conclusion. This study highlights the importance of using a biopsychosocial lens when working with clients post-MVA. Recovery post-MVA needs to be considered in the context of the insurance system, as navigating the insurance system was a predominant factor influencing recovery.

Background. Given the well-documented professional identity challenges experienced by occupational therapists, reinforcing the profession's identity (collective and individual) is crucial for navigating changing environments and optimizing its contribution. The Muriel Driver Memorial Lectureship is an important component of the collective identity of the profession in Canada. Purpose. A professional identity lens was used to trace the evolution of the profession's collective identity in Canada through this lectureship. Method. Using sociological professional identity theory, a documentary longitudinal analysis was conducted on the 43 published lectureship articles (1975–2023), identifying key messages, values, knowledge, and practices. Findings. Eight main themes were identified: professional identity, epistemology, axiology, change and leadership, contribution, history, quality, and technology. The analysis revealed an evolving common base of values (occupation, client-centred, social justice) and knowledge (occupation-centred). Persistent challenges included defining theoretical foundations, resisting the biomedical model, and realizing the social vision in practice. The lectures highlighted occupational therapists’ evolving roles and ability to contribute to and lead change. Conclusion. The lectures provide insights into the evolution of occupational therapy's collective identity in Canada. Despite ongoing challenges, the contemporary context appears to be increasingly favourable for occupational therapists to practise consistent with the collective identity trends identified.

Background. This study explores occupational therapists’ (OTs) perceptions of using the Canadian 24-Hour Movement Guidelines for the Early Years in their practice with preschool-aged clients (aged 3–4 years) with developmental disabilities. Methods. This study captured perspectives of the guidelines from OTs working in Canada via in-depth, virtual interviews (n = 11). Applied, deductive thematic analysis situated in the knowledge, attitudes, behavior framework, which provides a structured approach to understanding and addressing healthcare practitioners’ perspectives on implementing guidelines in practice, was conducted. Findings. Eight themes were identified: awareness and familiarity; agreement; outcome expectancy; self-efficacy; motivation; external—clients; external—guideline use; and external—environment. The results illustrate that while OTs may be motivated to incorporate the guidelines, concerns regarding their rigidity and applicability to diverse client needs hinder application in practice. Conclusion. The study highlights the need for additional resources and training to enhance OTs’ ability to adapt and apply the guidelines effectively, ensuring they meet the individual needs of children with developmental disabilities. This research underscores the potential for OTs to play a crucial role in promoting healthful movement behaviors in early childhood through the tailored application of the guidelines.

Background. Children with Developmental Coordination Disorder (DCD) often experience academic challenges. Although children with DCD are frequently referred to Occupational Therapy (OT) to help alleviate some of their motor and functional challenges, the actual practices of OTs regarding academic activities remain underexplored in this group. Purpose. This study aimed to describe the nature and extent of Canadian OT practices regarding academic activities in children with DCD. Method. A survey was sent to pediatric OTs through national and provincial OT associations and licensing organizations, to gather information on assessment and intervention practices related to core academic activities in children with DCD. Findings. A total of 229 OTs completed the survey (170 females, 74%). Occupational Therapies reported assessing or providing intervention for academic activities, most frequently handwriting (96% assessed and 85% intervened), writing (74% and 65%), mathematics (72% and 68%), and reading (66% and 59%). With respect to intervention services, up to 78% of OTs provided direct intervention, compared to 51% for indirect or consultative services. Conclusion. Most Canadian pediatric OTs typically assess and provide intervention for handwriting and, to a lesser extent, other academic activities. These practices vary depending on work setting and experience.

Description. Les ergothérapeutes accompagnent les personnes et les organisations vers une participation saine au travail. Dans ce contexte, il importe de considérer la multiplicité des identités, comme le genre, l’origine ethnique ou le handicap, dans l’analyse des inégalités et injustices occupationnelles que rencontrent les personnes au travail. Le concept d’intersectionnalité a le potentiel de soutenir les ergothérapeutes, mais il demeure difficile à reconnaitre dans la pratique. But. L’étude avait pour but d’identifier les caractéristiques opérationnelles du concept d’intersectionnalité au travail. Méthodologie. Selon un devis d’examen de la portée, 29 documents issus de disciplines variées ont été sélectionnés. Les données ont été extraites à l’aide d’une grille structurée et analysées selon une approche thématique. Résultats. Les résultats ont permis d’identifier cinq caractéristiques opérationnelles du concept, soit l’interrelation des identités, l’interaction entre désavantages et privilèges, les dynamiques de pouvoir, l’expérience subjective idiosyncratique ainsi que la relation à soi et aux autres. Nos résultats révèlent aussi que ces caractéristiques se doivent d’être considérées dans leur contexte, notamment historique. Conclusion. Cette étude offre un cadre aux ergothérapeutes pour analyser et intervenir dans des situations complexes, contribuant ainsi à promouvoir une participation au travail équitable et juste.

Background. Little is known about assistive device use by young children with cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS) III–V. Purpose. This secondary analysis examined use of mobility, adaptive seating, bathing, and toileting devices in young children participating in a larger power mobility study. Method. Data from 42 participants aged 18–87 months were gathered, using the parent-report Home Use of Technology for CHildren (HUTCH), within the first 3–4 weeks and at the end of the 6-month power mobility loan. Associations were examined between device, time spent in each device and gross motor, manual abilities, and Level of Sitting Scale functional classifications. Results. Age, gross motor function, and manual abilities were associated with use of either a stroller, tilt-in-space, or upright manual wheelchair, while age, postural, and manual abilities were associated with use of wheelchair seating rather than separate adaptive seating or a typical high-chair or booster seat. Children with greater impairments were more likely to use bathing devices, while few used toileting devices. More time was spent by children using tilt-in-space wheelchairs compared with upright wheelchairs or strollers. Conclusion. Statistically significant associations were identified between child profile and use of manual mobility, seating and bathroom devices.

Background Occupational therapists use standardized scales to assess how individuals process and respond to sensory information. Currently, there is limited evidence about the convergent validity between the Adult/Adolescent Sensory History (ASH) and the Sensory Processing Measure 2–Adult Form (SPM-2-Adult). Purpose. The study examined the convergent validity of the ASH and SPM-2-Adult when completed by young adults. Method. Fifty Australian adults aged 21–35 completed the ASH and SPM-2-Adult. Spearman’s rho correlations were used to analyze the data. Results. Most ASH and SPM-2-Adult subscales were significantly associated with correlations ranging from rho = 0.301 to 0.858 (p < .033–.001). Statistically significant correlations were obtained between the SPM-2-Adult Vision subscale and every ASH subscale (rho = 0.322–0.841, p < .023–.001) while the SPM-2-Adult Taste and Smell subscale yielded the most non-significant correlations with the ASH. Most of the statistically significant correlations between the ASH and SPM-2-Adult were in the moderate range. Conclusion. Promising evidence of convergent validity between the ASH and SPM-2-Adult sensory subscales and total scales was demonstrated, whereas the convergent validity findings between the ASH Functional-Problems subscales and the SPM-2-Adult sensory subscales were less robust. This adds to the psychometric body of concurrent validity evidence between the two scales.

Description : La prolongation des arrêts de travail est liée à plusieurs facteurs psychosociaux communs associés aux diagnostics causant les arrêts de travail, exposant la nécessité de disposer d’interventions transdiagnostiques efficaces. REDO®, une approche ergothérapique de groupe a démontré une efficacité en contexte suédois pour favoriser les retours au travail (RAT). But : Les objectifs de la présente étude étaient: (1) Traduire le manuel d’intervention de REDO^® en français; (2) L’adapter au contexte québécois; (3) Concevoir REDO® sous un format hybride; and (4) Réaliser un essai pilote incluant une évaluation d’acceptabilité et de faisabilité. Méthodologie : REDO® a été traduit en utilisant un logiciel professionnel suivi d’une validation de contenu par plusieurs experts. L’adaptation a pris en compte des facteurs contextuels en RAT au Québec. Pour l’essai pilote, un devis mixte avec triangulation a été utilisé incluant différents questionnaires évaluant l’acceptabilité et les changements pré-post et des journaux de bord documentant la faisabilité. Résultats : Six personnes en absence maladie depuis 8 à 23 mois, présentant divers troubles mentaux ou physiques ont réalisé REDO® en entier. Quatre personnes étaient en processus de RAT au suivi post groupe. Des améliorations ont été notées dans l’équilibre de vie et le sentiment d’efficacité face aux obstacles au RAT. L’acceptabilité de l’approche était élevée chez les personnes participantes. Conclusion : Par sa polyvalence, REDO^® offre un réel potentiel pour favoriser le RAT et améliorer la qualité de vie des personnes en arrêt de travail prolongé.