Children’s voices: participation in decision-making within the goal setting process in occupational therapy

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O'Connor, Deirdre
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University College Cork
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Introduction: Children’s participation in decision-making remains an under-researched area, especially in the context of Occupational Therapy. Therefore, the principal aim of this research was to explore the experience of children in relation to having their voices heard within goal-setting in Occupational Therapy. This is consistent with Article 12 of the United Nations Convention on the Rights of the Child, 1989) and with Occupational Therapy’s commitments to client-centred practice (World Federation of Occupational Therapy, 2019). Study Design: Informed by the approaches of ethnography, this qualitative study had 17 participants including 6 children, 5 parent(s)/guardian(s) and 6 occupational therapists to gain multiple perspectives from those involved in goal-setting. Semi-structured interviews were conducted with all participants, while a mosaic approach offered children multiple methods to communicate their experience. Findings were analysed using a thematic analysis approach. Findings: On analysis, 3 themes emerged: 1) Where goal setting exists: Experiences of paediatric Occupational Therapy services in an Irish context; 2) Children’s right to be heard: Knowledge, views, attitudes and power and 3) Goal setting processes … power and influence. Findings suggest that Occupational Therapy goals are, for the most part, adult directed and as such children’s voices are subsumed by adult agendas, priorities, and adult-led services. Conclusion: Findings illustrate that despite healthcare professionals valuing the voice of children, children and their parent(s)/guardian(s) are not consistently included in goal-setting. Numerous factors impacting children’s participation in decision-making were found such as awareness and attitudes towards children and their rights as well as the age and ability of children, for example. Few formal guidelines or standards exist as to how to operationalise a child’s right-based approach in practice.
Children's voices , Decision-making , Participation , Occupational therapy
O'Connor, D. M. 2019. Children’s voices: participation in decision-making within the goal setting process in occupational therapy. MRes Thesis, University College Cork.