Susan M. Cahill, PhD, OTR/L, FAOTA, is Associate Professor and Occupational Therapy Department Chair, MSOT Program, Lewis University, Romeoville, IL.
Stephanie Beisbier, OTD, OTR/L, is Associate Professor, Occupational Therapy Department, Mount Mary University, Milwaukee, WI;
Am J Occup Ther. 2020 Jul/Aug;74(4):7404397010p1-7404397010p48. doi: 10.5014/ajot.2020.744001.
Demand is increasing for activity- and occupation-based interventions to address occupational performance and support maximal participation of children and youth.
This Practice Guideline was developed to guide decision making and support best practices in service delivery for children and youth ages 5-21 yr at home, at school, and in the community.
The results from three systematic reviews (SRs) of activity- and occupation-based interventions for children and youth ages 5-21 yr were reviewed, synthesized, and translated into recommendations for education, practice, and research.
One hundred eighty-five articles were included in the three SRs examining the evidence for interventions to promote activities of daily living, instrumental activities of daily living, play and leisure, and rest and sleep; to improve mental health, positive behavior, and social participation; and to enhance learning, academic achievement, and successful participation in school. The reviews provide evidence for interventions associated with typical concerns addressed by occupational therapy practitioners.
On the basis of the evidence, this guideline recommends that occupational therapy practitioners consistently collaborate with families and caregivers and provide services in the natural context of the desired occupation. The evidence also supports group service models and models that include peer mediation; these models can promote participation across areas of occupation. Skills-based training and therapeutic practice in the context of valued occupations are recommended over isolated sensorimotor approaches. Technology, manualized programs, and sports activities can be effective but should be evaluated and matched to age, diagnosis, and outcomes as guided by the evidence.
When guided by evidence, activity- and occupation-based interventions are effective in promoting participation and enhancing performance in valued occupations of children and youth ages 5-21 yr.
人们越来越需要基于活动和职业的干预措施来解决职业表现问题,并支持儿童和青少年最大限度地参与社会活动。
本实践指南旨在为儿童和青少年(5-21 岁)在家庭、学校和社区中的服务提供决策指导,并支持最佳实践。
对三项针对 5-21 岁儿童和青少年的基于活动和职业的干预措施的系统评价(SR)的结果进行了回顾、综合,并将其转化为促进日常生活活动、工具性日常生活活动、游戏和休闲以及休息和睡眠的建议;改善心理健康、积极行为和社会参与;并加强学习、学业成绩和成功参与学校的建议。
在三项针对促进日常生活活动、工具性日常生活活动、游戏和休闲以及休息和睡眠的干预措施的 SR 中,共纳入了 185 篇文章;改善心理健康、积极行为和社会参与;并加强学习、学业成绩和成功参与学校的建议。综述提供了与职业治疗师通常关注的干预措施相关的证据。
基于证据,本指南建议职业治疗师与家庭和护理人员保持一致的合作关系,并在期望职业的自然环境中提供服务。证据还支持小组服务模式和包括同伴调解在内的模式;这些模式可以促进跨职业领域的参与。在有价值的职业环境中,建议采用技能培训和治疗实践,而不是孤立的感觉运动方法。技术、手册化方案和体育活动可以是有效的,但应根据证据进行评估和匹配到年龄、诊断和结果。
在证据的指导下,基于活动和职业的干预措施可有效促进儿童和青少年(5-21 岁)参与和提高其在有价值职业中的表现。