Conceptualizing school based occupational therapy for Malta: enabling children’s participation in school occupations through collaboration in early years settings
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Date
2021-10-10
Authors
Buhagiar, Nathalie
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Publisher
University College Cork
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Abstract
This thesis explores occupation, participation and occupational therapy schoolbased practice in an early years school setting. It adopts a rights-based approach
that acknowledges the human and moral rights of all children to be educated; a
strengths-based philosophy that moves away from an impairment focus, recognising
the centrality of children, their occupations and the transactions between the
stakeholders within the school environment. The main research questions were:
What are the occupations that children in Maltese early-years classrooms are
participating in? What are the enablers and barriers to children’s participation in
school occupations in Maltese early-years classrooms? How can occupational
therapy involvement in early-years classrooms contribute to children’s participation
in school occupations? The arena was investigated through a qualitative paradigm,
a longitudinal instrumental case study with elements of action theory. It was carried
out in one selected primary mainstream state school and involved the participation
of children and parents, with the educators being the main focus of this study
This was a two-phased study with participation at the core of the conceptual
framework underpinned by Occupational Science and had 3 pillars: The first
exploratory part of the study was underpinned by concepts from Bio-ecological
Systems Theory (Bronfenbrenner, 2007). The second intervention part of the study
was framed within the Social Model of Disability (Oliver, 1998), and the Canadian
Model of Occupational Performance – Engagement (Townsend & Polatajko, 2013).
The data was analysed for its content and through thematic analysis (Braun &
Clarke, 2013). The data were collected over a period of one school year through the
researcher’s weekly presence in the school. Methods used to obtain data included
observation, interviews, focus groups. Such data was supplemented with other
documentary evidence: intervention logs, a reflective journal and research diary, and
discussions with critical friends, children’s photos, school development plans, e mail
correspondence and other recorded feedback.
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The findings of this study identified the social environment as key to
supporting young children’s occupations through connectedness, regular, consistent
presence and involvement of occupational therapy in the school, the building of
relationships and trust, attitudinal factors and knowledge translation between adults:
therapist and educators. The importance of play especially physical play, choice, fun
and movement in daily routines and children’s engagement with peers and
educators were also outcomes of the study. The centrality of educator and parental
involvement through active engagement, were additional significant findings. The
importance of Tier 1 intervention to build educators resilience in delivering their
curriculum was identified whilst Tier 2 intervention provided a way forward in
supporting children with ”hidden” needs. The uniqueness of Tier 3 was namely the
collaboration between the occupational therapist and class teacher in the education
of students with a statement of needs. The primary importance of working with
school leadership was a novel and important finding in this study. Inter-professional
working and education, as well as student education and training, were also
identified as essential for collaborative consultation to be effective in early years
settings.
This research contributes to the international body of evidence on
collaborative consultation and also provides recommendations as to how a model of
school-based occupational therapy tiered intervention for Malta, can be
implemented in Maltese schools, specifically in the early years. In this respect it is
also unique as no other projects or studies have ever addressed this topic in Malta.
Finally, this study suggests the way forward in developing school - centred practice
to support the participation and inclusion for all children in school and society.
Description
Keywords
Children , Participation , Occupation , Educators , Collaboration , Inclusion , Early years , School-based occupational therapy tiered intervention
Citation
Buhagiar, N. 2021. Conceptualizing school based occupational therapy for Malta: enabling children’s participation in school occupations through collaboration in early years settings. PhD Thesis, University College Cork.