Clinicians’ perspectives on motor learning strategy selection and application in occupational therapy and speech-language pathology interventions for children with acquired brain injury

Abstract

Purpose

Explore occupational therapists’ (OTs) and speech language pathologists’ (SLPs) process of selecting and applying motor learning strategies (MLS) in their interventions for children with acquired brain injury (ABI), and identify similarities and differences between OTs and SLPs in MLS selection and application.

Methods

This qualitative descriptive study involved individual semi-structured interviews with OTs and SLPs from the ABI program at Holland Bloorview Kids Rehabilitation Hospital (Toronto, Canada). Interviews were analyzed using thematic analysis. A modified constant comparison method permitted comparison within and between professions.

Results

Four OTs and three SLPs were interviewed. Four themes were developed: aligning MLS application with the child’s cognitive ability, using MLS to promote success within a single session, adjusting MLS across treatment sessions, and promoting generalization and transfer of motor skills beyond the therapy session. MLS application was predominately based on child-specific factors with task-specific considerations. OTs and SLPs used similar clinical reasoning processes for selecting and applying MLS.

Conclusions

This study provides a greater understanding of OTs’ and SLPs’ clinical reasoning process when applying MLS in pediatric ABI interventions. The similarities in MLS selection and application between disciplines suggest that an interprofessional approach to MLS is suitable for pediatric ABI rehabilitation.

IMPLICATIONS FOR REHABILITATION

• Pediatric occupational therapists and speech language pathologists use a similar process for selecting and applying motor learning strategies (MLS) in their interventions

• Clinicians continually reflect upon and adapt their use of MLS based on each child’s performance, progress, and goals

• Adopting an interprofessional approach to MLS selection and application, including the use of a common MLS language, has the potential to optimize motor outcomes in pediatric acquired brain injury rehabilitation

Keywords:

• Brain injury
• pediatric
• motor learning
• occupational therapy
• speech-language pathology

Acknowledgements

The authors would like to thank the OTs and SLPs in the ABI program at Holland Bloorview Kids Rehabilitation Hospital who participated in this study.

Disclosure statement

The authors have no conflicts of interest to report.

Additional information

Funding

This study was funded by VW’s Holland Bloorview Childrens Foundation Chair in Pediatric Rehabilitation.