Occupational Science & Occupational Therapy - Journal articles

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Mainstream technology as an occupational therapy tool: technophobe or technogeek?
(College of Occupational Therapists, 2008-06-01) Verdonck, Michèle Claire; Ryan, Susan E.; Health Research Board
Occupational therapists need to embrace the use of mainstream technology in their quest to ensure that therapy remains current and meaningful to their clients. Technology can be useful to improve both functional independence and occupational performance. This opinion piece introduces how occupational therapists can apply mainstream technologies, including information and communication technologies such as the internet, computer software, portable devices and computer games, in their everyday interventions.
Irish occupational therapists' views of electronic assistive technology
(College of Occupational Therapists, 2011-04) Verdonck, Michèle Claire; McCormack, Cathy; Chard, Gill; Health Research Board
Introduction: Electronic assistive technology (EAT) includes computers, environmental control systems and information technology systems and is widely considered to be an important part of present-day life. Method: Fifty-six Irish community occupational therapists completed a questionnaire on EAT. All surveyed were able to identify the benefits of EAT. Results: While respondents reported that they should be able to assess for and prescribe EATs, only a third (19) were able to do so, and half (28) had not been able to do so in the past. Community occupational therapists identified themselves as havinga role in a multidisciplinary team to assess for and prescribe EAT. Conclusion: Results suggest that it is important for occupational therapists to have up-to-date knowledge and training in assistive and computer technologies in order to respond to the occupational needs of clients.
Electronic aids to daily living: be able to do what you want
(Informa Healthcare, 2011-05) Verdonck, Michèle Claire; Chard, Gill; Nolan, Maeve; Health Research Board
Purpose. This study explores the experiences of Irish people with high cervical spinal cord injuries living with electronic aids to daily living (EADL) and the meaning attributed to such systems in the context of participation in everyday life. Method. Qualitative methodology using a phenomenological approach was used to explore the phenomenon of living with EADL. Data were collected using four focus groups of users and nonusers of EADL (n = 15). All participants had high cervical spinal cord injuries (C3-5). Groups were video recorded, transcribed verbatim and analysed using descriptive phenomenological analysis. Findings. Findings revealed key elements of the meaning of living with EADL. Two key themes, time alone and changed relationships are described. These contribute to the super ordinate theme of autonomy. Findings suggest that participants perceived improvements in both anticipated and actual lived experiences with EADL. Themes are interrelated and together represent a summary of the experience of living with environmental controls. The themes described are similar to those found in other spinal injury studies relating to quality of life. Conclusions. Findings highlight differences in life experiences for those with and without EADL and provides motivation to address this difference. Such insights are valuable for both users and providers of EADL.
An affordance perspective on infant play in home settings: a 'just-right environment'
(Barnardos, 2015-09) Lynch, Helen; Hayes, Nóirín
Children learn to be in the world through doing: typically in the form of play, incorporating social connection and interactions. However, not all play is social and not all learning involves people: the physical environment is an essential element that is often taken for granted and under-valued in this whole process. The physical environment is more than just a setting for social play – it also influences play significantly and, therefore, needs to be considered as a core factor in determining good practice in play provision. Few studies have focused on the role of the physical environment in influencing play and learning in early childhood care and education (ECCE) settings and even fewer in home settings. Learning environments have been identified as priority for researching infants’ lives from the National Children’s Strategy and from the knowledge that environments have been a relatively under-explored aspect in early childhood research (CECDE, 2007). Curricular and quality frameworks such as Aistear (National Council for Curriculum and Assessment, 2009) and Síolta (CECDE, 2006) have been developed for the early childhood sector. However, while these are intended to target early childhood learning, it is difficult to ascertain to what extent these guidelines can influence home settings. Furthermore, although home learning environments have been the focus of UK research (e.g. Melhuish, 2010; Melhuish, Phan, Sylva, Siraj-Blatchford, & Taggart, 2008) this is an emergent area of concern in Ireland. Home settings in early childhood contexts include the child’s own home, and other homes where the child may be minded. In Ireland’s national longitudinal study Growing Up in Ireland, statistics show that 73% of families organise informal childcare for their preschool-aged children with relatives or non-relatives in their homes, rather than in centre-based settings (McGinnity, Murray & McNally, 2013). Home settings, consequently, are the primary context for early childhood learning and of significant importance for research. In 2007, the Centre for Early Childhood Care and Education (CECDE) Ireland issued a national call for research to be conducted on learning environments of children in early childhood. It was through this opportunity that my own research journey began. My interest in home settings has come from my background as a children’s occupational therapist. When children fail to thrive, and have struggles to develop, the occupational therapist’s job is to determine the effects on their well-being and development, and the impact on their daily lives. Through evaluating self-regulation, sensory, motor and perceptual development, assessing activity and participation, and task-environment analysis, occupation therapists work to maximise the fit between the infant and the environment to best support learning and development. This requires a close connection with the infant’s family and home setting to determine most accurately, the range and choices of tasks within the environment. For example, for families living in a first-floor apartment with no garden, the potential for the child to learn to ride a bike may be more limited than a family living in a rural setting with a lot of open space around the house. So it becomes an issue of affordances, In addition, knowing about the family matters – it is through the shared family environment that children are enabled to play and learn. This includes family routines, habits, values, attitudes and play activities and preferences. Knowing about the home setting is therefore a vital consideration for effective practice.
Help-seeking behaviors and mental well-being of first year undergraduate university students
(Elsevier Inc., 2016-12-30) Goodwin, John; Behan, Laura; Kelly, Peter; McCarthy, Karen; Horgan, Aine M.
University students demonstrate poor help-seeking behaviors for their mental health, despite often reporting low levels of mental well-being. The aims of this study were to examine the help-seeking intentions and experiences of first year university students in terms of their mental well-being, and to explore these students’ views on formal (e.g. psychiatrists) and informal (e.g. friends) help-seeking. Students from a university in the Republic of Ireland (n=220) completed an online questionnaire which focused on mental well-being and help-seeking behaviors. Almost a third of students had sought help from a mental health professional. Very few students reported availing of university/online supports. Informal sources of help were more popular than formal sources, and those who would avail and had availed of informal sources demonstrated higher well-being scores. Counselors were the source of professional help most widely used. General practitioners, chaplains, social workers, and family therapists were rated the most helpful. Those with low/average well-being scores were less likely to seek help than those with higher scores. Findings indicate the importance of enhancing public knowledge of mental health issues, and for further examination of students’ knowledge of help-seeking resources in order to improve the help-seeking behaviors and mental well-being of this population group.
Exploring the participation of children with Down Syndrome in Handwriting Without Tears
(Taylor & Francis (Routledge), 2017) Patton, Sandra; Hutton, Eve; Froebel College of Education; Down Syndrome Ireland
Children with Down Syndrome typically experience difficulties with attention to task and lack motivation when learning to write. This article provides an evaluation of the HWT (Handwriting Without Tears) method applied as an intervention to promote handwriting among children with Down Syndrome attending mainstream school in the Republic of Ireland. In the absence of standardized measures, a purpose-designed HWT group task participation scale and pre- and postintervention teacher/parent questionnaire were developed by the first author and used to investigate the participation of 40 children with Down Syndrome in HWT activities. Positive changes in participation in HWT activities were recorded in group data and in teacher/parent reports. Tentative findings suggest that hands-on multisensory learning approaches such as HWT may encourage children with Down Syndrome to participate in activities that promote handwriting skills. Further research and the development of robust measures to evaluate handwriting intervention for this population of children is required.
Practices and roles of Irish occupational therapists with adults with intellectual disabilities who access supported employment services
(Emerald Publishing Limited, 2017-02-02) Hynes, Patrick Joseph; Harb, Alia
Purpose: Work is good for one’s health and well-being. Work for people with disabilities should be encouraged because it is therapeutic and improves participation in the society, leading to better health outcomes. It develops interpersonal relationships and enhances life quality. Work is an aspiration for many people with intellectual disability. Within research literature, there appears to be a lack of research into the experience of occupational therapists in Ireland who refer adults with intellectual disabilities to supported employment services. The purpose of this paper was to explore the experience of Irish occupational therapists who refer adults with intellectual disabilities to supported employment services. Design/methodology/approach: Semi-structured, in-depth interviews were conducted with four occupational therapists recruited through the Association of Occupational Therapists of Ireland (AOTI). Data were analysed using thematic analysis. Findings: Themes that emerged were as follows: occupational therapy participants did not directly refer adults to supported employment but received referrals; occupational therapy roles included assessments, task analysis and development of client’s skills are major components of current practice; pragmatics involved factors that facilitate and challenge; and future roles. Originality/value: This paper contributes to occupational therapy practice knowledge by providing a perspective on supported employment in Ireland. Occupational therapists should continue to work in the area of supported employment to support social inclusion and enable participation. Further research with occupational therapists working in this field is required to inform practice.
Play and play occupation: a survey of paediatric occupational therapy practice in Ireland
(Emerald Publishing Limited, 2018) Moore, Alice; Lynch, Helen
Purpose: Play occupation has been identified as an essential part of children’s lives, and it subsequently features in paediatric occupational therapy. However, few studies address the current place of play and play occupation in occupational therapy practice. This study aims to address this gap in knowledge by exploring paediatric occupational therapists’ perspectives on the place of play and play occupation in occupational therapy practice in Ireland. Design/methodology/approach: A cross-sectional online survey was conducted to gather data about the current use of play in the occupational therapy for children under 12 years. Convenience sampling and snowball recruitment techniques were used to recruit paediatric occupational therapists. Data were analysed using descriptive statistics and qualitative content analysis. Findings: In total, 65 therapists responded to the survey (estimated response rate, 32%). Results are organised into four sections: demographics and practice context, play assessment practices, use of play in practice and perceived barriers to play-centred practice. Respondents reported that they valued play as a childhood occupation. However, the survey findings identified that the primary focus was on play as a means to an end. Lack of education on play (research, theory and interventions) and pressures in the workplace have been identified as barriers to play-centred practice. Research limitations/implications: Findings indicate that there is a mismatch between therapists valuing play as an occupation and how play is used in occupational therapy practice. Unless clarifications are made about play occupation as being different to skills acquisition in childhood, play occupation will continue to get overlooked as an authentic concern of occupation-centred practice. Thus, play as occupation deserves further attention from educators, researchers and practitioners as a means of strengthening occupation-centred practice, in particular play-centred practice in the paediatric context. Originality/value: Play has been described as an important occupation in childhood, and consequently, it features in paediatric occupational therapy. However, little is known about the current place of play in occupational therapy practice. This study addresses this gap by considering the current place of play in occupational therapy practice in Ireland.
Ageism and sexuality
(Springer International Publishing AG., 2018) Gewirtz-Meydan, Ateret; Hafford-Letchfield, Trish; Benyamini, Yael; Phelan, Amanda; Jackson, Jeanne; Ayalon, Liat; Ayalon, Liat; Tesch-Römer, Clemens
Sexuality remains important throughout a person’s life, but sexual behavior does not receive the same levels of acceptance at all ages. Older people are challenged by ageist attitudes and perceptions that hinder their sexual expression. They are stereotyped as non-sexual beings who should not, cannot, and do not want to have sexual relationships. Expressing sexuality or engaging in sexual activity in later life is considered by many in society as immoral or perverted. False expectations for older people also stem from ideals of beauty, centralization of the biomedical perspective on sexuality of older adults, and the association of sex with reproduction. Unfortunately, older people internalize many ageist attitudes towards sexuality in later life and become less interested in sex and less sexually active. The following chapter explores attitudes towards sexuality in later life among the media, young people, older people themselves, and care providers. In order to enable older people to express their sexuality and sexual identity freely and fully, awareness of ageist perceptions must be raised and defeated.
Kinesiology taping for breast lymphoedema after breast cancer treatment: A feasibility randomised controlled tria
(IOS Press, 2018-07-17) Collins, Siobhán; Bradley, Nora; Fitzgibbon, Sarah; McVeigh, Joseph G.
PURPOSE: The primary aim of this study was to determine the feasibility of conducting a randomised controlled trial (RCT) to evaluate the effectiveness of kinesiology tape (KT) and usual care versus usual care alone in the treatment of breast lymphoedema (BLE). METHODS: Fourteen participants with BLE were randomly assigned to either the KT and usual care group or usual care alone group. Both groups received three sessions of manual lymphatic drainage (MLD) once per week for three weeks, with the KT group additionally wearing the KT for two seven-day periods in between MLD sessions. Safety and acceptability of the KT were assessed by recording adverse events, skin changes and compliance with KT. Outcomes included were: ease of recruitment, attrition and acceptability of KT, percentage breast tissue water, patient-reported breast heaviness/fullness, breast discomfort and breast redness. RESULTS: Recruitment for this study was an average of 2.8 participants per month. There were no dropouts from either group. No adverse events or major skin side effects were recorded in either group. Minor skin redness was the most common dermal change (n = 5). Compliance with KT was excellent. Percentage tissue water in the worst affected breast quadrant reduced, on average, by 15.14% and 10.43% in both the KT group and the usual care group respectively. CONCLUSION: This feasibility RCT into the use of KT in BLE has shown that recruitment to a larger scale RCT is feasible. It has been demonstrated that KT is a safe and acceptable intervention with no adverse events and minor dermal changes. A large, multi-centred RCT is now necessary to accurately assess the effect of KT in BLE.
Consultations on driving in people with cognitive impairment in primary care: A scoping review of the evidence
(PLoS, 2018-10-15) Sinnott, Carol; Foley, Tony; Forsyth, Justin; McLoughlin, Kathleen; Horgan, Linda; Bradley, Colin P.; Road Safety Authority Ireland; National Institute for Health Research; School for Primary Care Research (SPCR)
Objectives: To review the empirical evidence on approaches used by Primary Care Physicians (PCPs) in fitness to drive (FtD) consultations with people living with cognitive impairment. Design: Scoping review of empirical literature focused on primary studies of any design. Setting: Primary care practice. Participants: PCPs or their equivalent and/ or individuals with cognitive impairment across the spectrum of mild cognitive impairment to dementia. Measurements: Systematic search of Medline, Cinahl, PsychINFO, Academic Search Complete, Psychological and Behavioural Sciences Collection, SocIndex and Social Sciences FT were conducted. Records screened by two reviewers against agreed inclusion criteria. Mixed studies (qualitative and quantitative) were synthesized within overarching themes. Results: Eighteen studies met our inclusion criteria. Synthesized data showed PCPs have mixed feelings on the appropriateness of their role in FtD assessments, with many feeling particularly uncomfortable and lacking confidence in the context of possible cognitive impairment. Reasons include lack of familiarity with legal requirements and local resources; fear of damaging the doctor-patient relationship; and impact on the patient’s quality of life. Patients voiced their desire to maintain agency in planning their driving cessation. Studies evaluating pragmatic educational programmes suggest these can improve physician confidence in FtD consultations. Conclusion: The increasing number of older people affected by cognitive impairment, for whom driving may be a concern, has implications for primary care practice. Addressing the reasons for PCPs lack of comfort in dealing with this issue is essential in order for them to better engage in, collaborative discussion with patients on plans and preferences for driving cessation
A prospective study of consecutive emergency medical admissions to compare a novel automated computer-aided mortality risk score and clinical judgement of patient mortality risk
(BMJ Publishing Group, 2019-06-19) Faisal, Muhammad; Khatoon, Binish; Scally, Andy; Richardson, Donald; Irwin, Sally; Davidson, Rachel; Heseltine, David; Corlett, Alison; Ali, Javed; Hampson, Rebecca; Kesavan, Sandeep; McGonigal, Gerry; Goodman, Karen; Harkness, Michael; Mohammed, Mohammed; National Institute for Health Research
Objectives: To compare the performance of a validated automatic computer-aided risk of mortality (CARM) score versus medical judgement in predicting the risk of in-hospital mortality for patients following emergency medical admission.Design: A prospective study.Setting: Consecutive emergency medical admissions in York hospital.Participants: Elderly medical admissions in one ward were assigned a risk of death at the first post-take ward round by consultant staff over a 2-week period. The consultant medical staff used the same variables to assign a risk of death to the patient as the CARM (age, sex, National Early Warning Score and blood test results) but also had access to the clinical history, examination findings and any immediately available investigations such as ECGs. The performance of the CARM versus consultant medical judgement was compared using the c-statistic and the positive predictive value (PPV).Results: The in-hospital mortality was 31.8% (130/409). For patients with complete blood test results, the c-statistic for CARM was 0.75 (95% CI: 0.69 to 0.81) versus 0.72 (95% CI: 0.66 to 0.78) for medical judgements (p=0.28). For patients with at least one missing blood test result, the c-statistics were similar (medical judgements 0.70 (95% CI: 0.60 to 0.81) vs CARM 0.70 (95% CI: 0.59 to 0.80)). At a 10% mortality risk, the PPV for CARM was higher than medical judgements in patients with complete blood test results, 62.0% (95% CI: 51.2 to 71.9) versus 49.2% (95% CI: 39.8 to 58.5) but not when blood test results were missing, 50.0% (95% CI: 24.7 to 75.3) versus 53.3% (95% CI: 34.3 to 71.7).Conclusions: CARM is comparable with medical judgements in discriminating in-hospital mortality following emergency admission to an elderly care ward. CARM may have a promising role in supporting medical judgements in determining the patient’s risk of death in hospital. Further evaluation of CARM in routine practice is required.
Shifting gears versus sudden stops: Qualitative study of consultations about driving in patients with cognitive impairment
(BMJ Publishing Group, 2019-08-21) Sinnott, Carol; Foley, Tony; Horgan, Linda; McLoughlin, Kathleen; Sheehan, Cormac; Bradley, Colin; Road Safety Authority; National Institute for Health Research
Objective: General practitioners (GPs) report finding consultations on fitness to drive (FtD) in people with cognitive impairment difficult and potentially damaging to the physician–patient relationship. We aimed to explore GP and patient experiences to understand how the negative impacts associated with FtD consultations may be mitigated. Methods: Individual qualitative interviews were conducted with GPs (n=12) and patients/carers (n=6) in Ireland. We recruited a maximum variation sample of GPs using criteria of length of time qualified, practice location and practice size. Patients with cognitive impairment were recruited via driving assessment services and participating general practices. Interviews were audio-recorded, transcribed and analysed thematically by the multidisciplinary research team using an approach informed by the framework method. Results: The issue of FtD arose in consultations in two ways: introduced by GPs to proactively prepare patients for future driving cessation or by patients who urgently needed a medical report for an expiring driving license. The former strategy, implementable by GPs who had strong relational continuity with their patients, helped prevent crisis consultations from arising. The latter scenario became acrimonious if cognition had not been openly discussed with patients previously and was now potentially impacting on their right to drive. Patients called for greater clarity and empathy for the threat of driving cessation from their GPs. Conclusion: GPs used their longitudinal relationship with cognitively impaired patients to reduce the potential for conflict in consultations on FtD. These efforts could be augmented by explicit discussion of cognitive impairment at an earlier stage for all affected patients. Patients would benefit from greater input into planning driving cessation and acknowledgement from their GPs of the impact this may have on their quality of life.
Performance of externally validated enhanced computer-aided versions of the National Early Warning Score in predicting mortality following an emergency admission to hospital in England: a cross-sectional study
(Firenze University Press, 2019-11-02) Faisal, Muhammad; Richardson, Donald; Scally, Andy; Howes, Robin; Beatson, Kevin; Mohammed, Mohammed; Health Foundation; National Institute for Health Research
Objectives: In the English National Health Service, the patient’s vital signs are monitored and summarised into a National Early Warning Score (NEWS) to support clinical decision making, but it does not provide an estimate of the patient’s risk of death. We examine the extent to which the accuracy of NEWS for predicting mortality could be improved by enhanced computer versions of NEWS (cNEWS). Design: Logistic regression model development and external validation study. Setting: Two acute hospitals (YH—York Hospital for model development; NH—Northern Lincolnshire and Goole Hospital for external model validation). Participants: Adult (≥16 years) medical admissions discharged over a 24-month period with electronic NEWS (eNEWS) recorded on admission are used to predict mortality at four time points (in-hospital, 24 hours, 48 hours and 72 hours) using the first electronically recorded NEWS (model M0) versus a cNEWS model which included age+sex (model M1) +subcomponents of NEWS (including diastolic blood pressure) (model M2). Results: The risk of dying in-hospital following emergency medical admission was 5.8% (YH: 2080/35 807) and 5.4% (NH: 1900/35 161). The c-statistics for model M2 in YH for predicting mortality (in-hospital=0.82, 24 hours=0.91, 48 hours=0.88 and 72 hours=0.88) was higher than model M0 (in-hospital=0.74, 24 hours=0.89, 48 hours=0.86 and 72 hours=0.85) with higher Positive Predictive Value (PPVs) for in-hospital mortality (M2 19.3% and M0 16.6%). Similar findings were seen in NH. Model M2 performed better than M0 in almost all major disease subgroups.Conclusions: An externally validated enhanced computer-aided NEWS model (cNEWS) incrementally improves on the performance of a NEWS only model. Since cNEWS places no additional data collection burden on clinicians and is readily automated, it may now be carefully introduced and evaluated to determine if it can improve care in hospitals that have eNEWS systems.
Advancing play participation for all: The challenge of addressing play diversity and inclusion in community parks and playgrounds
(SAGE Publications, 2019-12-05) Lynch, Helen; Moore, Alice; Edwards, Claire; Horgan, Linda; National Disability Authority, Ireland
Introduction: Outdoor parks and playgrounds are important sites of social inclusion in many urban communities. However, these playspaces are often inaccessible and unusable for many children with disabilities. This paper presents findings from a case study of one urban municipality in Ireland. The study aimed to understand play participation in five local playgrounds by exploring the perspectives of play providers and families with diverse abilities, through the lens of universal design. Methods: Multiple qualitative methods were used, including playground audits, walk-and-talk observations, and semi-structured interviews. Four play providers, 12 children, and 10 adult users took part. Inductive analysis was conducted to understand the usability and accessibility of playgrounds from a universal design perspective. Findings: These playgrounds provided high play value for younger children, but low play value for older children and those with disabilities, due to lack of accessibility or usability. While local authorities aimed to provide inclusive playgrounds, they lacked knowledge on universal design for playspaces. Conclusion: Children with disabilities continue to experience exclusion in community playspaces, despite a commitment to inclusion in local authorities. Play providers need support to tailor principles of universal design to playground design. Occupational therapists are ideally situated to collaborate with local authorities on universal design for enhancing children's play participation in community settings.
Can universal design support outdoor play, social participation, and inclusion in public playgrounds? A scoping review
(Taylor & Francis, 2020-12-10) Moore, Alice; Lynch, Helen; Boyle, Bryan; Irish Research Council
Purpose: To synthesize evidence regarding the physical design features and non-physical aspects of public playgrounds that facilitate/hinder outdoor play, social participation, and inclusion; identify design recommendations; and explore the current discourses and concepts around designing for outdoor play, social participation, and inclusion in public playgrounds in the context of Universal Design (UD). Methods: Published studies addressing public playgrounds, inclusion, and design, were identified via a systematic search of eleven databases from health, science, education, and humanities. Results: Fifteen documents met the inclusion criteria. Three main themes were identified concerning physical design features and non-physical aspects of public playgrounds that facilitate/hinder outdoor play, social participation, and inclusion, with associated design recommendations. Although UD is recognized to have the potential to support the design of public playgrounds, no studies examined UD solutions for playgrounds or tested them for effectiveness. Conclusion: We cannot yet determine whether UD can support outdoor play, social participation, and inclusion in public playgrounds. Research to date has mostly focused on understanding usersâ perspectives; future research should continue to be informed by diverse usersâ perspectives to address gaps in knowledge concerning childrenâ s voice from migrants, lower socioeconomic communities, and intergenerational users with disabilities alongside researching design solutions for play. Implications for rehabilitation: Children, particularly children with disabilities and their families, continue to experience marginalization and exclusion in public playgrounds, despite a commitment to inclusion in international treaties. Universal design is recognized to have the potential to support the design of public playgrounds, however, the evidence is currently very sparse. While accessibility is an important consideration for playground design, it does not ensure that play occupations can take place. Extending knowledge on universal design as it applies explicitly to playgrounds and play occupation requires multi- and trans-disciplinary collaboration that includes a play-centered perspective.
Occupational therapy services in school-based practice: a pediatric occupational therapy perspective from Ireland
(Hindawi, 2021-06-16) O'Donoghue, Carol; O'Leary, Jennifer; Lynch, Helen; Tofani, Marco; University College Cork
Purpose. School is a primary setting for pediatric occupational therapy practice, yet little is known about the provision of school-based occupational therapy in many countries internationally. The purpose of this study was to explore current school-based occupational therapy practice for the first time in Ireland to gain insight into current and potential service provision and to identify new directions and potential pathways for development. Methods. This descriptive quantitative study utilized a cross-sectional online survey to gain the perspectives of the population of pediatric occupational therapists working regularly in schools across Ireland. Respondents were recruited through convenience and snowball sampling. Data were analysed through qualitative content analysis and descriptive statistics. Results. The survey elicited 35 responses, yielding a 21.2% estimated response rate. Findings demonstrated that respondents provided therapy services in schools most commonly on a weekly (28.6%) or monthly (34.3%) basis, with only 5.0% working in the same school on a weekly or fortnightly basis. The majority of respondents (54.3%) used a direct therapy approach with a child, rather than coaching or modelling, to primarily address sensory, hand function, or daily living needs. None used a whole class or whole school (universal or tiered) approach. While respondents (54.3%) generally viewed collaborative practice as a strength of school-based practice, they also identified barriers to collaboration in schools. A core barrier is related to how services are constructed across health and education, with differing philosophies of service provision. The majority of respondents (75.0%) reported that they had not received any training to deliver evidence-based practice in therapy provision specific to school-based practice. Implications for Practice. This study indicates that therapists require continual education on evidence-based school practice as it applies in an Irish context. Furthermore, clarification of school therapy roles and service delivery models are required in order to determine how they contrast with traditional clinic roles. This will enable therapists to strengthen the coordination of service delivery between health and educational services to maximize the outcomes of school-based practice.
Fraught with frights or full of fun: perspectives of risky play among six-to-eight-year olds
(Taylor & Francis, 2021-08-20) Hinchion, Sarah; McAuliffe, Ellen; Lynch, Helen; Horizon 2020; H2020 Marie Skłodowska-Curie Actions
Outdoor play provides children with unique opportunities to explore and expand their worlds, and to incorporate risk and challenge into play events. However, international research indicates that children are being exposed to fewer opportunities to engage in outdoor, risky play, while few studies have explored risky play among children aged six-to-eight years in differing cultural contexts. This qualitative study explored children’s perspectives and experiences of outdoor risky play in a rural Irish town. Ten children took part in focus groups, drawings, photography, a child-led tour of the local community and a map-making session. Three themes emerged; Risky play and me, my power to play and ‘sometimes it is kind of worth it!’. Findings suggest that risky play categories evolve as children age, and some new categories surfaced, including risky construction and breaking the rules. Further exploration of risky play is warranted to ascertain its characteristics more fully among this age group.
Universal design for learning in anatomy education of healthcare students: A scoping review
(John Wiley & Sons, Inc., 2021-12-04) Dempsey, Audrey M. K.; Lone, Mutahira; Nolan, Yvonne M.; Hunt, Eithne
There are concerns among healthcare practitioners about poor anatomical knowledge among recent healthcare graduates. Universal Design for Learning (UDL) is a framework developed to enhance students' experience of learning and help students to become motivated learners. This scoping review identified whether UDL has been utilized in third level healthcare education and if so, whether it had been used to enhance student motivation to study anatomy. Seven online databases were searched for studies reporting the use of UDL in the curricula of medical, dental, occupational therapy (OT) or speech and language therapy (SLT) programs. Studies were screened for eligibility with set inclusion criteria. Data were extracted and analyzed. Analysis revealed that UDL was not specifically mentioned in any of the studies thus there are no published studies on UDL being formally applied in healthcare education. However, the authors identified 33 publications that described teaching methods which aligned with UDL in anatomy curricula and a thematic analysis yielded four main themes relating to teaching strategies being employed. Universal design for learning was not mentioned specifically, indicating that educators may not be aware of the educational framework, although they appeared to be utilizing aspects of it in their teaching. The review revealed that there is a lack of research concerning the anatomy education of OT and SLT students. The role of UDL in enhancing motivation to learn anatomy in medical, dental, OT and SLT programs has yet to be explored.
A qualitative study of child participation in decision-making: Exploring rights-based approaches in pediatric occupational therapy
(Public Library of Science, 2021-12-16) O'Connor, Deirdre; Lynch, Helen; Boyle, Bryan
Background: According to Article 12 of the United Nations Convention on the Rights of the Child, therapists are duty-bound to include children in decisions that impact them. Although occupational therapists champion client-centred, collaborative practice, there remains a paucity of studies detailing children’s rights and experiences of decision-making in pediatric occupational therapy. Purpose: This qualitative study described the decision-making experiences of children, parents and therapists in occupational therapy. Methods: Semi-structured interviews were conducted with 17 participants (six children, five parents and six occupational therapists), and data analysed using thematic analysis. Findings: Three themes emerged: 1) Goal-setting experiences; 2) Adults: child-rights gatekeepers or defenders? and 3) Decision-making in context. Findings suggest that decision-making is mostly adult directed, and children’s voices are subsumed by adult-led services, priorities, and agendas. Implications: Children’s rights need to be embedded as an aspect of best practice in providing services that are child-centred in occupational therapy practices and education.

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