Profile of paediatric occupational therapy practice in Eastern Mediterranean countries

Figures & data

Figure 1. The number of therapists participated from each country (^aBahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates; ^bJordan, Lebanon and Palestine; ^cIran and Turkey).

Figure 2. Area where participants had majority of their work experience with children.

Table 1. Demographic characteristics of the study participants (N = 118).

Covariate	n(%)
Age (median)(IQR^a)	27.5 (9)
(mean) (SD)	30.6 (8.6)
Years practicing OT (median)(IQR)	4.0 (6.0)
Years practicing paediatrics OT (median)(IQR)	4.0 (6.0)
Gender
Female	81 (68.6%)
Male	37 (31.4%)
Academic qualification
Bachelor degree	85 (72.0%)
Master degree	25 (21.2%)
Doctoral Degree	8 (6.8%)
Paediatrics specialty certification(^b)
None	44 (37.3%)
Applied behavioural analysis	21 (17.8%)
Neurodevelopmental treatment/ Bobath approach	21 (17.8%)
Play therapy certification	19 (16.1%)
Ayres Sensory integration	51 (43.2%)
Attended conferences/seminars related to paediatrics OT
Yes	103 (87.3%)
No	15 (12.7%)
Frequency of work with interdisciplinary team related to paediatrics OT
Never	18 (15.3%)
Less often	18 (15.3%)
Sometimes	18 (15.3%)
Most of the times	19 (15.1%)
Always	45 (38.1%)

^aInterquartile range.

^bGained accredited postgraduate qualification.

Figure 3. Top seen health conditions.

*Participants selected more than one choice.

Table 2. Models of practice and frames of reference among study participants (N = 118).

Models of practice/ Frames of Reference ^(Table Footnotea)	n(%)
Models used in practice
Canadian Model of Occupational Performance and Engagement (CMOP-E)	55 (46.6%)
Model of Human Occupation (MOHO)	46 (39.0%)
Occupational Adaptation (OA)	30 (25.4%)
Person Environment Occupation (PEO)	58 (49.2%)
Frames of reference used
Ayres Sensory Integration (ASI)	85 (72.0%)
Behavioural Frames of Reference	58 (49.2%)
Biomechanical Frames of Reference	48 (40.7%)
Cognitive Behavioural Frames of Reference	47 (39.8%)
Cognitive Frames of Reference	32 (27.1%)
Developmental Frames of Reference	70 (59.3%)
Motor Control/Learning Frames of Reference	59 (50.0%)
Neurodevelopmental Treatment (NDT)	53 (44.9%)
Rehabilitation Frames of Reference	39 (33.1%)
Reasons for the Models/Frames of Reference used
Area of Practice	64 (54.2%)
Client’s age group	59 (50.0%)
Organisational Rules	11 (9.3%)
Reasons for Referrals	20 (16.9%)
Therapist’s Clinical Reasoning	89 (75.4%)

^(a)Participants have selected more than one choice.

Table 3. Common assessments and reasons for their selection with most frequent areas of occupation and interventions used as reported by study participants (^aN = 118).

Assessment/Reasons/Intervention	n(%)
Most common assessments used in working with children
Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)	27 (22.9%)
Canadian occupational performance measure (COPM)	40 (33.9%)
Clinical observation of motor and postural skills (COMPS)	27 (22.9%)
Gross Motor Functionmmeasure (GMFM)	32 (27.1%)
Non-standard assessment	46 (39%)
Peabody Developmental Motor Scales	37 (31.4%)
Sensory Integration Praxis Test (SIPT)	25 (21.1%)
Sensory Processing Measure (SPM)	30 (25.4%)
Sensory Profile	63 (53.4%)
Wee Functional Independence Measure (Wee-FIM)	33 (28%)
What are the reasons for the selection of assessment used?
Availability at workplace	70 (59.3%)
Familiarity with the assessment	55 (46.6%)
Client-centered	49 (41.5%)
Easy to analyse	43 (36.4%)
Training at university	37 (31.4%)
Training at my workplace	31 (26.3%)
Most frequent areas of occupation that is targeted in treatment
Activities of daily living	101 (85.6%)
Instrumental activities of daily living	33 (28%)
Health management	13 (11%)
Rest and sleep	19 (16.1%)
Education	73 (61.9%)
Work	11 (9.3%)
Play	93 (78.6%)
Leisure	38 (32.2%)
Social participation	83 (70.3%)
Most common interventions used
Cognitive orientation to daily occupational performance (CO-OP)	79 (68.1%)
Constraint induced movement therapy (CIMT)	42 (36.2%)
Cognitive Interventions	54 (46.6%)
Client Education/Teaching	44 (37.9%)
Family Care Centre	39 (33.6)
Handling	41 (35.3%)
Handwriting Interventions	57 (49.1%)
Home Programs	61 (52.6%)
Neuro Developmental Therapy (NDT)	43 (37.1%)
Parent Education	44 (37.9%)
Play Therapy	67 (57.8%)
Sensory Approach	58 (50.0%)
Social Skills Training	37 (31.9%)
Visual Motor Interventions	46 (39.7%)

^aParticipants have selected more than one choice.

Table 4. Associations between facing challenges in implementing EBP and some covariates (N = 118).

Covariate	Face challenges in implementing EBP		P Value
	Yes (n)(%)	No (n)(%)
Age (median)(IQR)	27 (9)	29 (15)	0.069^a
Gender			0.294^a
Female	62 (80.5)	15 (19.5)
Male	33 (89.2)	4 (10.8)
Practice OT (yrs.) (median)(IQR)	4 (8)	6 (15)	0.127^a
Practice POT (yrs.) (median)(IQR)	3 (6)	5.9 (13)	0.081^a
Academic certifications			0.830^c
Bachelor’s degree	66 (81.5)	15 (18.5)
Master’s degree	22 (88.0)	39 (12.0)
Doctoral Degree	7 (87.5)	1 (12.5)
Specialty qualifications			0.305^b
Yes	39 (88.6)	5 (11.4)
No	56 (80.0)	14 (20.0)
Attended conferences/seminars related to paediatrics OT			0.277c^c
Yes	82 (82.0)	18 (18.0)
No	13 (92.9)	1 (7.1)
Frequency of work with interdisciplinary team related to paediatrics OT			0.550^c
Never	14 (82.4)	3 (17.6)
Once every two months	14 (77.8)	4 (22.2)
Every month	17 (94.4)	1 (5.6)
Every two weeks	12 (75.0)	4 (25.0)
Every week	38 (84.4)	7 (15.6)
How often do you base your OT practice on evidence-based practice?			0.035^c
Never	2 (66.7)	1 (33.3)
Less often	7 (77.8)	2 (22.2)
Sometimes	31 (93.9)	2 (6.1)
Most of the times	43 86.0)	7 (14.0)
Always	12 (63.2)	7 (36.8)
Area of practice			0.951^c
School/pre-school system	19 (82.6)	4 (17.4)
Rehabilitation hospital/Centre	53 (81.5)	12 (18.5)
Community based / home care	7 (87.5)	1 (12.5)
Others^d	16 (88.9)	2 (11.1)

^aP value using Mann-Whitney U test; ^bP value based on Pearson chi square test of independence; ^cP value based on Fisher exact test; ^dIncludes (Acute setting, Mental health setting, Private clinic, General hospital).

Table 5. Associations between facing challenges in implementing EBP (yes = 1, no = 0) and some covariates using ^astepwise multiple logistic regression model (N = 118).

Covariate	Estimates
	OR (95%CI)	PV
Gender		0.039
Male	Reference
Female	5.36 (1.088, 26.399)
Practice OT (yrs.)	0.873 (0.795, 0.958)	0.004
Academic qualification		0.126
Bachelor’s degree	Reference
Master’s degree	0.084 (0.003, 2.094)	0.131
Doctoral Degree	0.323 (0.013, 8.500)	0.502
How often do you base your OT practice on evidence-based practice?		0.069
Never	Reference
Less often	1.708 (0.076, 38.153)	0.736
Sometimes	1.699 (0.216, 13.390)	0.615
Most of the times	11.21 (1.72, 73.089)	0.011
Always	4.933 (1.225, 19.873)	0.025

^aThe backward substitution method based on likelihood ratio was implemented with P value to enter 0.25 and P value to exit 0.15.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.