Collaboration between Public Health and Schools: An Example of an Integrated Community Social Care Model.

Introduction: There is a need to improve public health interventions to promote youth social and emotional development in close collaboration with schools, families and local communities. A close intersectoral collaboration between the regional public health, schools and school boards was established to co-construct and implement "Positive Intervention (PI)" in the Eastern Townships region (Quebec, Canada). This paper describes its implementation according to the "Integrated Community Care (ICC)" framework. Description: PI is a collaborative and personalized intervention leaning toward an integrated community social care model. In fact, PI relies on the close proximity between Public Health and their educational counterpart as well as their individual temporality. However, PI offered mainly social services and its relationships with Primary Care services was not yet a priority. Discussion: The results show that it is possible to develop and implement an intervention promoting positive mental health in children, with and for local organisations. The level of integration between schools and Public Health services achieved after only 6 months of implementation is encouraging. Conclusion: More research is needed to thoroughly document the implementation, social validity, and effects of such an intervention by taking in the point of view of all stakeholders.

Introduction: Il est nécessaire d'améliorer les interventions de santé publique pour promouvoir le développement social et émotionnel des jeunes en étroite collaboration avec les écoles, les familles et les communautés locales. Une telle collaboration intersectorielle entre la santé publique régionale, les écoles et les commissions scolaires a été mise en place pour coconstruire et mettre en œuvre l'Intervention positive (IP) en Estrie (Québec, Canada). Cet article décrit sa mise en œuvre initiale selon le cadre conceptuel des soins de santé et services sociaux intégrés en proximité des communautés. Description: L'IP est une intervention collaborative et personnalisée qui s'inscrit dans un modèle de services sociaux intégrés en proximité des communautés. En fait, l'IP s'appuie sur une forte proximité entre les services de santé publique et les milieux scolaires, ainsi qu'un ajustement à la temporalité des partenaires. Cependant, l'IP offre principalement des services sociaux et ses relations avec les services de soins primaires n'étaient pas encore une priorité. Discussion: Les résultats montrent qu'il est possible de développer et de mettre en œuvre une intervention de promotion de la santé mentale positive chez les enfants, avec et pour les organisations locales. Le niveau d'intégration entre les écoles et les services de santé publique atteint après seulement six mois de mise en œuvre est encourageant. Conclusion: Des recherches supplémentaires sont nécessaires pour documenter de manière approfondie la mise en œuvre, la validité sociale et les effets d'une telle intervention en prenant en compte le point de vue de toutes les parties prenantes.

Building Families' Capacities: Community Forums with Parents and Occupational Therapists.

Background. Parents of a child considered to have special needs are at greater risk of stress and exhaustion. Although many occupational therapy interventions can help these children, they often require significant time and energy from families. Purpose. To document the perspectives of parents and occupational therapists regarding ways to offer services that help build families' capacities without overloading them. Method. A qualitative descriptive design guided online community forums with 41 parents and occupational therapists in Quebec, Canada. Findings. Nine key principles to build the capacities of families without overburdening them were identified. These include being sensitive to possible negative impacts of services, avoiding overwhelming the family with information or recommendations, taking the needed time, highlighting the positive, and offering flexible conditions for services. Implications. Our findings help identify how capacity-building rehabilitation services can be offered to families to optimize positive outcomes and minimize harms.

Acting as Change Agents: Insight Into Québec Occupational Therapists' Current Practice: Actions menées à titre d'agents de changement : aperçu des pratiques actuelles parmi les ergothérapeutes du Québec.

BACKGROUND.: Change agents' actions have been studied mainly from a theoretical perspective. PURPOSE.: This study aimed to empirically identify occupational therapists' actual change agent actions. METHOD.: As part of a research partnership with the Canadian Association of Occupational Therapists-Québec chapter, we conducted this cross-sectional pilot study using an online survey. FINDINGS.: The change agent practices of our 103 participants involve many types of actions but show underinvestment in mass communication. Mass communication actions are more frequent when participants have greater experience, additional academic degrees, and training in change agency. Also, occupational therapists with additional academic degrees and change agency training tend to use a wider variety of actions. Finally, our participants' actions principally target actors in the clinical context, rarely political actors. IMPLICATIONS.: Our results suggest that occupational therapists can and will invest in the full range of change agent actions provided they can acquire the necessary knowledge and skills.

Social change agent training program tailored to occupational therapists' needs: a design-based study protocol.

BACKGROUND: As social change agents (SCAs), occupational therapists (OTs) are expected to defend the rights of their clients, advocate for and with them, and try to influence organizational and political decision-makers. However, OTs do not generally feel equipped to take effective action. The overall goal of this research partnership is to support practising OTs in acquiring the knowledge and skills required to act as SCAs through a specific SCA training program and a toolkit that summarizes the key training points. METHODS: The study will include three iterative phases (conceptualization, implementation and evaluation) and use a participatory process. The design of the training program and toolkit will draw on the expertise of the researchers (theoretical knowledge), a professional provincial partner and study participants (experiential knowledge). To evaluate the training program and toolkit, a self-administered evaluation questionnaire, facilitator observation grid and semi-structured guide designed to facilitate focus group discussions will be used. The quantitative and qualitative data will be analyzed using descriptive statistics and thematic analysis, respectively. The results of the initial implementation and evaluation phases will inform improvement of the training program and toolkit before starting the cycle with the following groups. DISCUSSION: In addition to training about 100 OTs, this study will produce three main benefits: 1) development of two products, namely the SCA training program and toolkit, that are easy to reuse and potentially transferable to other professionals; 2) ownership of these products by the partner through its close involvement in all stages of the study; and 3) development of a sustainable partnership between a team of researchers and a recognized organization with networks across Canada and internationally. These three spin-offs will provide a solid basis for an increasing number of permanent implementation initiatives, in Québec and elsewhere in Canada, not just in occupational therapy but also in other professions.

Recruitment, use, and satisfaction with a web platform supporting families of children with suspected or diagnosed developmental coordination disorder: a randomized feasibility trial.

Objectives. To determine the feasibility of recruiting families of children with suspected or diagnosed developmental coordination disorder (sdDCD) and explore their satisfaction with a web-based intervention Design. A feasibility randomized trial was conducted. Participants were the parents of 5-12-year-old children with sdDCD. The intervention group had access to online resources, group and private forums, and videoconferencing with a therapist. Main outcomes were recruitement and retention rates. Satisfaction was documented through a post-intervention survey and interview. Results. The recruitment rate was seven participants per month (n = 28 participants) and retention rate was 68%. Satisfaction was moderate. No differences in use and satisfaction were observed between groups. Participants formulated recommendations for improving the intervention, including targeting families earlier in the diagnosis process, and pre-scheduling meetings with therapists. Conclusions. This study demonstrated the feasibility of future trials, and highlighted avenues for improvement. Parent involvement during the development of the intervention is discussed at length. Abbreviations: DCD: Developmental Coordination Disorder; sdDCD: suspected or diagnosed Developmental Coordination Disorder; RCT: randomized-controled trial.

Participation and needs of children with developmental coordination disorder at home and in the community: Perceptions of children and parents.

BACKGROUND: The existing literature provides only a partial understanding of the viewpoints of elementary school-aged children with developmental coordination disorder (DCD) regarding their participation and needs. In order to plan and develop health and social services driven by a personalized approach, it is essential to further document their perceptions with those of their parents. AIMS: The aim of the study was to explore the participation and needs of school-aged children with DCD at home and in the community, as perceived by children and parents. METHODS: Participants were ten school-aged children with DCD, from 6 to 13 years old, and their parents, including one couple (n=11). Individual semi-structured interviews were conducted with each participant, except the couple who were interviewed together. RESULTS: Most children and all parents perceived some difficulties at home but few in the community. However, participation and needs varied for each child. Children rarely expressed the same expectations as their parents. While most children did not want more support, parents requested training on DCD. CONCLUSIONS: When planning health and social services for children with DCD, it is recommended to consult all stakeholders, including children, as well as offer indirect interventions, such as training and coaching for parents.

Longitudinal Study of Sensory Features in Children with Autism Spectrum Disorder.

BACKGROUND: Between 45 and 95% of children with Autism Spectrum Disorder (ASD) present sensory features that affect their daily functioning. However, the data in the scientific literature are not conclusive regarding the evolution of sensory features in children with ASD. The main objective of this study was to analyze the sensory features of children within the age of 3-4 (T1) when they received their ASD diagnosis and two years later (T2) when they started school. METHODS: We conducted a prospective cohort study to assess sensory features in 34 children with ASD over time. The data were collected using a standardized assessment tool, the Sensory Profile. RESULTS: Our analyses show that sensory features in children with ASD are stable from the age of three to six years. The stability of sensory scores is independent of correction by covariates, such as cognitive level and autism severity scores. CONCLUSIONS: Children with ASD have sensory features that persist from the time of diagnosis at the age of 3 to 4 years to school age. This persistence of sensory features from an early age underscores the need to support these children and their parents. Sensory features should be detected early and managed to improve functional and psychosocial outcomes.

Handwriting assessment of Franco-Quebec primary school-age students / Évaluation de l'écriture manuelle d'élèves franco-québécois au début du primaire

BACKGROUND: Reasons for referring school-age children to occupational therapy mainly relate to handwriting problems. However, there are no validated tools or reference values for assessing handwriting in francophone children in Canada. PURPOSE: This study aimed to adapt and validate the writing tasks described in an English Canadian handwriting assessment protocol and to develop reference values for handwriting speed for francophone children. METHOD: Three writing tasks from the Handwriting Assessment Protocol-2nd Edition (near-point and far-point copying and dictation) were adapted for Québec French children and administered to 141 Grade 1 ( n = 73) and Grade 2 ( n = 68) students. FINDINGS: Reference values for handwriting speed were obtained for near point and far point copying tasks. IMPLICATIONS: This adapted protocol and these reference values for speed will improve occupational therapy handwriting assessments for the target population.

Ecosystemic needs assessment for children with developmental coordination disorder in elementary school: multiple case studies.

This study explored the needs of children with developmental coordination disorder (DCD) from an ecosystemic viewpoint as part of a theory-driven program evaluation process. A multiple case study needs assessment was conducted. Participants included ten children with DCD, their parents (n = 12), teachers (n = 9), and service providers (n = 6). Data collection involved semi-structured interviews, validated questionnaires, and a review of the children's records. The results support the relevance of using an ecosystemic model to assess the needs of children with DCD in their life and social contexts. More specifically, the results highlight the need to provide additional services at school, such as occupational therapy and special education, as well as information and training regarding DCD for parents and teachers. The results also point to the relevant variables to consider in an intervention program based on theory-driven evaluations. This study shows how employing an ecosystemic frame of reference provides a better understanding of the needs of children with DCD. Future research should document the ecosystemic profiles and evolution of the needs of children with DCD with a larger sample from diverse socioeconomic backgrounds using a longitudinal study design.

Sensori-motor and daily living skills of preschool children with autism spectrum disorders.

Sensori-motor development and performance of daily living skills (DLS) remain little explored in children with autism spectrum disorders (ASD). The objective of this study was to determine the impact of sensori-motor skills on the performance of DLS in preschool children with ASD. Thirty-five children, 3-4 years of age, were recruited and assessed with a battery of diagnostic and clinical tests. Children showed atypical sensory responses, very poor motor and DLS. Sensory avoiding, an excessive reaction to sensory stimuli, and fine motor skills were highly correlated with DLS, even when cognitive performance was taken into account. Sensori-motor deficits have an impact on the autonomy of children with ASD and interventions should aim at improving and supporting the development of sensori-motor skills.