Occupational Therapy Interventions for Children Ages Birth-5 Years.

Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's (AOTA's) Evidence-Based Practice Project. This article presents a case example of a young child with autism spectrum disorder who receives occupational therapy evaluation and intervention in natural environments (home and child care center). Systematic review findings supporting enhancement of key life occupations through interventions to develop cognitive, motor, social-emotional, and self-care skills for young children were published in AOTA's Occupational Therapy Practice Guidelines for Early Childhood: Birth-5 Years (Frolek Clark & Kingsley, 2020) and the March/April 2020 issue of the American Journal of Occupational Therapy (Gronski & Doherty, 2020; Kingsley et al., 2020; Tanner et al., 2020). Each article in the Evidence Connection series applies evidence from the published reviews on a topic to a related case. These articles are designed to promote application of the evidence to practice.

Occupational Therapy Practice Guidelines for Early Childhood: Birth-5 Years.

IMPORTANCE: This Practice Guideline provides stakeholders with a condensed summary of a large number of effectiveness studies. It is a valuable tool for facilitating decision making related to occupational therapy interventions for children ages birth-5 yr. OBJECTIVE: Early childhood (birth-5 yr) is a critical period in which the foundation of key life occupations is developed (e.g., eating, dressing, play, learning, social participation, rest and sleep, and chores). The development of cognitive, motor, social-emotional, and self-care skills is important to support these occupations. This Practice Guideline synthesizes recent systematic reviews (SRs) on these areas of development to promote decision making for and high-quality interventions with this population. METHOD: Four SRs related to cognition, mental health, motor function, and ADLs analyzed studies published from 2010 to 2017 retrieved from six electronic databases (MEDLINE, PsycINFO, CINAHL, ERIC, OTseeker, and Cochrane). RESULTS: A total of 196 articles were included in the SRs, which served as a guide to final clinical recommendations. Case studies describe translation and application to practice. CONCLUSION: and Recommendations: A variety of interventions within the domain of occupational therapy were found to support the development of cognitive, social-emotional, motor, and self-care skills. Although some of these interventions are typically implemented by occupational therapy practitioners, others can be implemented by parents after training or by teams working in preschool settings. These findings should be used to inform evidence-based practice provided by occupational therapy practitioners working in various early childhood settings. WHAT THIS ARTICLE ADDS: This Practice Guideline gives occupational therapy practitioners clear information about which interventions will be effective for specific outcomes. Better intervention choices mean better outcomes for young children and their families.

Becoming Critical Consumers of Evidence in Occupational Therapy for Children and Youth.

This special issue of the American Journal of Occupational Therapy on interventions for children and youth highlights the current developments in and evidence for the effectiveness of occupational therapy interventions and psychometric properties of assessments for children and youth. In this guest editorial, we identify various factors that challenge the implementation of evidence-based strategies in daily clinical practice. We assert that scholars, educators, and practitioners need to address several strategic steps. To facilitate critical consumption of evidence in practice, efforts need to be made to build capacity for evidence production and evidence use through implementation science and to ensure that evidence-based practice is not only taught but also reflectively applied across the educational curriculum and that clinicians are given more access to resources that are easy to translate to daily clinical practice.

Interventions Supporting Mental Health and Positive Behavior in Children Ages Birth-5 Yr: A Systematic Review.

IMPORTANCE: It is critical for providers to use evidence-based interventions to address mental health and behavioral barriers to occupational performance during early childhood. OBJECTIVE: To identify evidence-based interventions within the scope of occupational therapy practice to improve mental health and positive behavior for children ages 0-5 yr and their families. DATA SOURCES: PsycINFO, Cochrane, ERIC, MEDLINE, and OTseeker databases were searched for publications from 2010 through March 2017. STUDY SELECTION AND DATA COLLECTION: This review was completed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Risk of bias was assessed for each article using either A Measurement Tool to Assess Systematic Reviews (AMSTAR) or the Cochrane method. Articles meeting inclusion criteria were critically appraised. FINDINGS: Forty-six articles met inclusion criteria and were organized into three themes: touch-based interventions (n = 9), parent-child interaction therapy (PCIT; n = 4), and instruction-based interventions (n = 33). Statistically significant findings and overall risk of bias supported the use of touch-based interventions, PCIT, and parent training. CONCLUSIONS AND RELEVANCE: The evidence indicates that touch-based interventions can improve infant self-regulation (strong), social behavior, and attachment (moderate) and reduce maternal stress, anxiety, and depression (low). Moderate-strength evidence supports PCIT to improve child behavior. The evidence indicates that parent training can improve parent behavior, maternal-infant attachment (strong), and parent mental health (moderate). Teacher training can improve mental health and behavior (moderate). Group-based parent training and sleep training have insufficient support (low). WHAT THIS ARTICLE ADDS: Occupational therapy professionals working with children younger than age 5 yr can use the results of this systematic review to guide clinical decision making related to mental health and behavioral outcomes.

Evidence for the effectiveness of different service delivery models in early intervention services.

Consideration of the evidence for all aspects of service delivery is a growing relevant concern of occupational therapists, including those providing early intervention to children and families. We conducted a review of the literature to uncover what evidence existed for determining the effectiveness of different service delivery models and methods used to improve occupational performance for children and families who receive early intervention services. Through a comprehensive search, we reviewed and synthesized studies, finding common themes of family-centered and routine-based approaches, service setting, and the inclusion of parent participation and training. Families consistently reported positive perceptions of family-centered and routine-based approaches. Parent participation and training resulted in positive outcomes. No specific setting or method of service delivery was identified as clearly most effective, with most studies reporting combined approaches and environments for interventions.