School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
Department of Health UK (DoH), Belfast, UK.
Child Care Health Dev. 2024 Jan;50(1):e13140. doi: 10.1111/cch.13140. Epub 2023 Jun 9.
Children and young people living in and leaving care are known to have experienced significant childhood adversity and trauma resulting in potentially deleterious impact on their health and well-being across the life course. Studies point to the complex needs of this population who may benefit from allied health professional (AHP)-related support with limited studies located. This review sought to address this gap by systematically scoping empirical literature focused on the provision of AHP support to this cohort of children and young adults to assist an understanding of the service needs for this vulnerable population.
This scoping review followed Arskey and O'Malley's five steps framework (2005) to identify and review relevant literature. A focus on identifying the evidence, challenges and gaps in research relating to AHP support for children and young people living in and leaving care was initially agreed, followed by a systematic search using a combination of three key concepts to identify relevant studies in five AHP disciplinary areas to identify best evidence in the past decade (2011-2021). Study inclusion criteria were based on empirical studies of children and young people living in care (0-17 years) and leaving care (18-25 years). A data extraction table was formulated as a means of charting the data, aligned with the scope and objectives of this review. Finally, data were subsequently collated, synthesised and reported based on key thematic areas emerging from included studies regarding AHP support to children and young people living in and leaving care.
A total of 13 studies met the review inclusion criteria. Included studies reported specifically on speech and language therapist (SLT; n = 5), occupational therapist (OT; n = 3) and arts-based therapies (n = 5). No studies were identified with regard to the use of physiotherapy and dietetics with this population. Results indicated that children and young people living in and leaving care have high rates of speech, language, communication and sensory needs. More rigorous screening, assessment and early intervention were identified as essential for this vulnerable group. Increased multidisciplinary collaboration and OT support for young adults in preparation for transition to independent living was identified as an urgent requirement. Included studies indicate promising results in relation to access to arts-based therapies with particular reference to identity formation for children and young people living in and leaving care.
Although evidence of effectiveness remains limited, AHP service provision (specifically speech and language therapy, occupational therapy and arts-based therapies) has the potential to contribute positively to addressing the complex and interacting needs of this vulnerable population. As a result, it is recommended that AHP service provision is integrated into the collaborative, multidisciplinary care available to children living in and leaving care. More extensive, higher quality research related to the benefits of AHP provision for this population of children and young people is essential to provide a more robust evidence base across the various professional disciplines that constitute allied health provision.
众所周知，生活在和离开照料环境中的儿童和年轻人经历了重大的童年逆境和创伤，这可能对他们一生的健康和幸福产生潜在的不利影响。研究指出，这些人群的需求非常复杂，他们可能需要得到相关专业医疗人员（ Allied Health Professional，AHP）的支持，但目前相关研究较少。本研究旨在通过系统综述关注为这一年龄段的儿童和年轻人提供 AHP 支持的实证文献，来解决这一差距，从而帮助了解这一弱势群体的服务需求。
本研究采用 Arskkey 和 O'Malley 的五步框架（2005 年）来确定和审查相关文献，重点关注确定与儿童和年轻人的 AHP 支持相关的证据、挑战和差距，最初同意这一重点，然后使用三个关键概念的组合进行系统搜索，以确定五个 AHP 学科领域中与生活在和离开照料环境中的儿童和年轻人相关的研究，以确定过去十年（2011-2021 年）的最佳证据。研究纳入标准基于生活在照料环境中的儿童和年轻人（0-17 岁）和离开照料环境的儿童和年轻人（18-25 岁）的实证研究。制定了数据提取表，作为图表数据的一种手段，与本研究的范围和目标保持一致。最后，根据纳入研究中关于生活在和离开照料环境中的儿童和年轻人的 AHP 支持的关键主题领域，对数据进行了整理、综合和报告。
共有 13 项研究符合审查纳入标准。纳入的研究专门报告了言语治疗师（SLT；n=5）、职业治疗师（OT；n=3）和艺术治疗（n=5）。没有关于该人群使用物理治疗和饮食疗法的研究。研究结果表明，生活在和离开照料环境中的儿童和年轻人有很高的言语、语言、沟通和感官需求。研究认为，对这一弱势群体进行更严格的筛查、评估和早期干预至关重要。研究还发现，多学科合作和 OT 支持年轻人为独立生活做准备的需求非常迫切。纳入的研究表明，艺术治疗在帮助生活在和离开照料环境中的儿童和年轻人形成身份认同方面具有良好的效果。
尽管证据的有效性仍然有限，但 AHP 服务的提供（特别是言语治疗、职业治疗和艺术治疗）有可能积极满足这一弱势群体复杂且相互关联的需求。因此，建议将 AHP 服务纳入为生活在和离开照料环境中的儿童提供的协作性、多学科护理中。为了在构成 AHP 服务的各个专业领域提供更强大的循证基础，需要开展更广泛、更高质量的研究，以了解 AHP 服务对这一年龄段儿童和年轻人的益处。
