Collaborative practice with parents in occupational therapy for children: A scoping review.

INTRODUCTION: In childhood intervention, parent-therapist collaboration is central to the family-centred approach. Despite long-standing discussion in occupational therapy literature, the field faces challenges, including inconsistent terminology and difficulties in translating theory into practice. This paper represents the first part of a comprehensive scoping review study aimed at developing foundational concepts for collaborative practices with parents in occupational therapy for children. Therefore, this paper focusses on mapping existing practices, types, and approaches articulated in the literature. METHODS: We searched English-language sources published worldwide from 1998 to 2022 discussing collaborative practices with parents in occupational therapy for children aged 0-10 with any diagnosis, including multidisciplinary practices. Seven databases were searched. Data from peer-reviewed indexed literature, theses and dissertations, and book chapters were extracted and analysed through basic numerical and descriptive analyses before being synthesised into similar categories. The Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic reviews and Meta-Analysis-extension for Scoping Reviews were used. RESULTS: The scoping review yielded 299 papers. Parent-therapist collaboration was prominent in clinics, family homes, schools, and hospitals, particularly during therapy implementation, goal setting, and planning. Most reported practice types included 'interventions with parent engagement', 'parent-directed interventions', and 'parent education'. 'Family-centred', 'occupational-focussed', and 'client-therapist collaborative' approaches were frequently mentioned. There were inconsistencies in the terms used to describe collaborative practice characteristics. CONCLUSION: Over the past 24 years, the collaborative practice literature has expanded and evolved, with parent-therapist collaboration observed across various occupational therapy settings. Inconsistencies in this collaboration across different therapeutic stages were revealed, which could impact intervention success and sustainability. Further research is needed to explore parent-therapist collaboration mechanisms within and across stages. This scoping review also underscores the need for a common framework to guide practice and research. PLAIN LANGUAGE SUMMARY: This literature review explores how occupational therapists and parents work together in childhood intervention. Collaboration is essential for understanding and meeting children's needs within their family and community settings. However, occupational therapists and parents face challenges in applying family-centred practices and using a common language to bridge theory with practice. To address these challenges, we examined 299 papers published between 1998 and 2022 to understand how collaborative practices with parents have been described in the literature. Our review revealed that therapists and parents collaborate across various settings, such as clinics, schools, homes, and hospitals, mainly during therapy sessions, goal setting, and planning interventions. Collaborative practices take different forms. For instance, therapists often encourage parents to actively engage and take the lead in therapy, requiring therapists to recognise and respect parents' priorities and learning preferences. They often develop strategies together to support the child within family routines. While we found several studies on therapist-parent collaboration, the review outlined inconsistencies in how this practice was described and applied, which could affect its success. Therefore, more research is needed to understand the best ways in which collaboration can occur at each stage of therapy. The need for a core guideline for collaborative practice with parents in occupational therapy was also observed. While therapist-parent collaboration is used in occupational therapy for children, there is a clear need to minimise inconsistencies and gaps found in the literature, as well as to ensure a common language to promote intervention quality and success.

Foundational concepts of collaborative practice with parents in occupational therapy for children.

INTRODUCTION: In occupational therapy for children, collaborative practice with parents is crucial for meaningful family-centred interventions, yet it remains undefined and inconsistently addressed. This study aimed to establish foundational concepts for collaborative practice with parents in occupational therapy for children in progressing the field with a universal description. METHODS: This paper encompasses the second dataset of a larger scoping review and a preliminary validation of findings by an advisory panel. Data were gathered from indexed sources on collaborative practice with parents in occupational therapy for children (ages 0-10) using MedLine, PsychInfo, ERIC, Embase, OTSeeker, Scopus, and ProQuest Central. Data were extracted, charted, and descriptively analysed by paired independent reviewers. The Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-extension for Scoping Reviews were used. A draft definition of collaborative practices, developed based on preliminary review findings and an operational definition, was validated by an advisory panel of 13 experienced Australian occupational therapists, whose input was integrated into a final, comprehensive description of collaborative practice. RESULTS: The scoping review encompassed 299 sources, revealing three major components of collaborative practice: 'collaborative practice aims', 'parent-therapist partnership', and 'strategies for collaboration'. The advisory panel endorsed the draft definition, confirmed its professional relevance, and suggested some modifications. CONCLUSION: The major outcome of this study is an evidence-based and discipline-specific preliminary description of collaborative practice with parents in occupational therapy for children. This description provides a common language and foundational concepts for the future development of a collaborative practice framework to guide practice and research. Future studies can explore specific components, exploring their mechanisms and significance. Further expanded validation is required, incorporating the perspectives of a wider community of occupational therapists and families to enhance the description's applicability.

Does the self-reported playfulness of older adults influence their wellbeing? An exploratory study.

Aim: Older adults represent a growing demographic in Australia who are at an increased risk of isolation, loneliness, and experiencing poorer overall health. Thus, the need for understanding factors that influence older adults' wellbeing is important. Emergent research into adult playfulness has shown positive associations with indicators of wellbeing, but limited research has been conducted in older adults (60+). This study investigated whether types of playfulness present in Australian older adults (60+) were predictive of their wellbeing.Method: An online survey was administered (n = 123) using the Other-directed, Light-hearted, Intellectual, Whimsical (OLIW) Playfulness Scale and the PERMA-Profiler wellbeing measure to explore playfulness types and its influence on self-reported wellbeing. Multiple linear regression analysis with bootstrapping was completed to determine if any significant relationships between OLIW and PERMA-Profiler subscales existed.Results: Playfulness was a significant predictor of wellbeing. The OLIW Other-directed subscale (enjoyment of others, using playfulness in tense situations) was the greatest predictor of PERMA-Profiler subscales with OLIW Intellectual and Whimsical subscales making smaller contributions.Conclusion/implications: Playfulness was shown to be a significant contributor to wellbeing in older adults and should be used as a part of occupational therapy intervention, especially when considering social activities.

Australian parents' experiences of owning an autism assistance dog.

Autism assistance dogs (AADs) increase safety for children with autism and their families. Autism assistance dogs can also decrease familial stress and the isolation which families may experience due to fear for their child's safety and judgement from others within the community. Currently there is a paucity of literature on parents' experiences of AADs. Therefore, this study aimed to develop a rich understanding of parents' experiences of owning an AAD. A mixed methods design was utilised, with a qualitative descriptive design and the use of occupational mapping. Eight families were recruited through an Australian AAD programme and participated in semi-structured in-depth interviews throughout 2017. The interviews were analysed thematically. Mobility in the community before and after introduction of the dog was measured using occupational mapping. Families plotted on Google Map printouts the places they frequented before and after placement of their dog. Five major themes emerged from the analysis of the interviews: freedom through restraint; expanding our world; a calming/sensory tool (AAD); "at the end of the day they're dogs"; and, friendship and personal growth. The occupational maps demonstrated a median increase of 8.5 more places and 20.50 km further travelled from home after having the dog for over a year. Families with an AAD experienced an expanded world for the child and their family. Families experienced freedom in the places they could go, decreased isolation due to the safety which the dog provides. Occupational mapping supported the qualitative data, showing increased mobility and decreased isolation of the family. The paradox of freedom through restraint is a new and key finding which requires further exploration. The results provide support for funding and increased awareness of AAD programmes. Future longitudinal comparative studies are needed to explore the long-term impact of AADs on the child and family.

Collaborative practices between parents and primary caregivers in pediatric occupational therapy: a scoping review protocol.

OBJECTIVE: This scoping review aims to identify and describe the available literature on current collaborative practices between parents and primary caregivers in pediatric occupational therapy. The review will also explore the definition of collaborative practices and the therapeutic approaches employed in the literature. INTRODUCTION: The family-centered approach in occupational therapy has proven effective in supporting families' education about their child's condition, as well as intervention strategies. One of the pillars of this approach is parent-therapist collaboration. Collaborative practices enable shared decision-making and mutual engagement between families and professionals. The literature has shown inconsistencies in the definitions, language, and implementation of collaborative practices and family-centered literature. Such inconsistencies have been hindering the transition from traditional service delivery to a family-centered approach. INCLUSION CRITERIA: This review will include studies investigating collaborative practices in pediatric occupational therapy. Accepted studies must include a description of the therapeutic practices undertaken and an explanation of how the collaboration between parents and/or primary caregivers and professionals occurred. All pediatric occupational therapy areas will be considered for inclusion, including practices with other disciplines. However, studies including only adolescents or using child-centered interventions exclusively will be excluded. METHODS: The search will employ indexed terms and keywords in seven databases (MEDLINE, PsyclNFO, ERIC, Embase, OTseeker, Scopus, and ProQuest Central). Eligible sources must be written in English, and will not be limited to date range or location. Data will be extracted, charted, and descriptively analyzed by four reviewers based on JBI recommendations. Study findings will be presented and mapped in tables and diagrams to address the study aims.

Mental health education in occupational therapy professional preparation programs: Alignment between clinician priorities and coverage in university curricula.

BACKGROUND/AIM: Occupational therapy programs must prepare graduates for work in mental health. However, this area of practice is complex and rapidly changing. This study explored the alignment between educational priorities identified by occupational therapists practising in mental health and level of coverage of these topics in occupational therapy programs in Australia and New Zealand. METHODS: Surveys were distributed to heads of all occupational therapy programs across Australia and New Zealand. The survey included educational priorities identified by occupational therapists in mental health from a previous study. Respondents were requested to identify the level of coverage given to each of these priorities within their curriculum. These data were analysed to determine a ranking of educational topics in terms of level of coverage in university programs. RESULTS: Responses were received for 19 programs from 16 universities. Thirty-four topics were given 'High-level coverage' in university programs, and these were compared against the 29 topics classified as 'Essential priorities' by clinicians. Twenty topics were included in both the 'Essential priorities' and 'High-level coverage' categories. Topics considered to be 'Essential priorities' by clinicians which were not given 'High-level coverage' in university programs included the following: mental health fieldwork experiences; risk assessment and management; professional self-care resilience and sensory approaches. CONCLUSION: While there appears to be overall good alignment between mental health curricula and priorities identified by practising occupational therapists, there are some discrepancies. These discrepancies are described and establish a strong foundation for further discussion between clinicians, academics and university administration to support curriculum review and revision.

Weighing up the commitment: a grounded theory of the transition from occupational therapy clinician to academic.

BACKGROUND/AIM: Growth in the number of occupational therapy programmes in Australia has resulted in a critical shortage of academics. When experienced clinicians are recruited into academia, they may find the transition process difficult. The study aimed to explore clinicians' perspectives of what happens when they transition into academia. METHOD: A constructivist grounded theory approach was used in this qualitative research project. Recruitment was conducted using purposive and theoretical sampling from occupational therapy programmes in Australia. Interview transcripts were analysed using constant comparative method through a process of open, axial, selective and theoretical coding. RESULTS: Sixteen participants engaged in semi-structured in-depth interviews. The theory of transition into academia included a process of 'weighing up the commitment' to academia and the core category of 'a good fit for me'. The transition was characterised by the taxing nature of the work, the need to learn multiple aspects of a new role, the different values and beliefs in an academic environment and the amount of time it took to achieve success. Participants underwent a shift in identity to adjust to the academic environment and eventually reached a point where they were able to judge if academia suited them. CONCLUSION: Australian universities have long-standing cultural practices which differ considerably from clinical settings. Transitioning from a clinical to an academic occupational therapy role requires complex adjustments to values, beliefs and identity. The process involved consideration by the new academics of their 'fit' for academia, and how committed they were to stay.

The transition from clinician to academic in nursing and allied health: a qualitative meta-synthesis.

OBJECTIVES: The meta-synthesis provides a collective qualitative understanding of the transition experience from nursing and allied health clinician to academic. This understanding assists the preparation for those making the transition as well as giving guidance to those who have recently commenced in academia. DESIGN: Published qualitative studies about the transition from clinician to academic were systematically selected in order to integrate their findings in a meta-synthesis. DATA SOURCES: Databases searched were CINAHL, EMBASE, MEDLINE, SCOPUS, 'Education Research Complete', and 'Academic Search Premier'. REVIEW METHODS: The search terms used were academ* OR facult* AND transition. The search was further refined by adding the terms qualitative AND clinic* OR practit* OR profession*. Studies were appraised for credibility, neutrality and relevance. Findings along with direct quotes were extracted from the studies and thematic analysis was used within an interpretative framework. RESULTS: Seven studies were included in the meta-synthesis. The included studies were from nursing, physiotherapy, health and social care. The central theme was a shift in identity from clinician to academic which involved a progression through 4 phases over a period of 1- 3years. These phases were; 'feeling new and vulnerable'; 'encountering the unexpected'; 'doing things differently' and 'evolving into an academic'. CONCLUSION: New academics felt unsettled and uncertain in the initial phases of transition. It is proposed that these challenges are related to difficulty extracting tacit knowledge and immersion in a new culture. The change of values and beliefs to adapt to the new culture require a concurrent identity shift which can take up to three years. Newcomers need collegial and institutional guidance with prioritization of tasks to address the multiplicity of the academic role and avoid frustration and disillusionment.

Two ten-billion-solar-mass black holes at the centres of giant elliptical galaxies.

Observational work conducted over the past few decades indicates that all massive galaxies have supermassive black holes at their centres. Although the luminosities and brightness fluctuations of quasars in the early Universe suggest that some were powered by black holes with masses greater than 10 billion solar masses, the remnants of these objects have not been found in the nearby Universe. The giant elliptical galaxy Messier 87 hosts the hitherto most massive known black hole, which has a mass of 6.3 billion solar masses. Here we report that NGC 3842, the brightest galaxy in a cluster at a distance from Earth of 98 megaparsecs, has a central black hole with a mass of 9.7 billion solar masses, and that a black hole of comparable or greater mass is present in NGC 4889, the brightest galaxy in the Coma cluster (at a distance of 103 megaparsecs). These two black holes are significantly more massive than predicted by linearly extrapolating the widely used correlations between black-hole mass and the stellar velocity dispersion or bulge luminosity of the host galaxy. Although these correlations remain useful for predicting black-hole masses in less massive elliptical galaxies, our measurements suggest that different evolutionary processes influence the growth of the largest galaxies and their black holes.