Occupational Performance Needs of School-Aged Children with Physical Disabilities in the Community

Abstract

Over the past several years major shifts have occurred in the delivery of therapy services to children with physical disabilities. Services have moved from centre- or clinic-based to schoolbased. Direct care has been supplemented by consultation, and an adaptive model has superseded more traditional remedial approaches. These shifts appear to have been made largely in response to system changes, fiscal constraints and the integration of more students with special needs into the mainstream of education. The changes do not appear to have been driven by client need, but rather therapist and system needs.

The purpose of this study was to increase our understanding of the occupational performance needs of young school-aged children with physical disabilities in the school system and the community, and to identify how therapists can help to meet those needs. Using the Canadian Occupational Performance Measure, 202 parents, teachers and children were interviewed, and their top priority problems were identified. In-depth interviews with 18 parents and teachers provided additional information about needs, ideas for change, and the role that therapists can play in meeting those needs.

The results of this study provide some clear directions for service delivery planning and suggest that the recent trends in practice, although not originally derived from client needs, will support the families and schools in meeting the needs of the children.

Additional information

Notes on contributors

Nancy Pollock

Michael Lepp, PT, is in private practice, Associate Instructor of the Upledger Institute, and Clinical Instructor, Case Western Reserve University School of Dentistry, Cleveland, OH.

Marie McKenzie, MS, OTR, is in private practice. She was Coordinator of Occupational Therapy at Scottish Rite Hospital at the time of this study.

Heather Miller, MS, OTR/L, is currently employed by Madison County Educational Service Center, providing therapy services to the county's pre-schools. This research was completed in partial fulfillment of the requirements of an MS degree at Ohio State University.

Linda Viscardis, BA, is Team Leader and Community Development Worker, Peterborough Family Enrichment Centre. She is Co-Founder of P.R.O.S.P.E.C.T.S., a support and advocacy group for families who have children with special needs.

Debra Stewart, BSc, OT(C), is Occupational Therapist, Erinoak, Serving Young People with Physical Disabilities, Mississauga, ON, and Clinical Lecturer, School of Rehabilitation Science, McMaster University.