Sensory reactivity (SR) difficulties are characterised by problems regulating an individual's responses to sensory input such that it interferes with occupational performance in daily tasks. South African occupational therapists use assessments developed in the United States to identify SR difficulties in children. These have been found to be inappropriate for the South African context. This study reports on the methodology used to adapt an assessment for use in the Western Cape Province of South Africa. The SPM-2 Child and Preschool caregiver self-report questionnaires and seven tests of the performance-based Evaluation in Ayres Sensory Integration (EASI) that assess SR were identified for adaptation. A qualitative methodology was used to identify challenges using the assessment in a sample of the Western Cape population. Cognitive interviews were conducted with six community members from diverse socioeconomic groupings. Inductive analysis was used to identify and group the emerging themes. The test adaptation was conducted by expert occupational therapists based on these findings. Challenges were grouped into two themes, namely, language challenges, of which there were three subcategories and inappropriate or threatening assessment tasks. Fifty-three changes were made to the assessment. A detailed methodology was developed to adapt a SR assessment for use in the Western Cape Province. Challenges in using the assessment were elicited primarily from community members rather than professionals.

Thirty-seven interviews of Mexican American women who crossed the border into the United States during the era of the Mexican Revolution of 1910 were analyzed using constructivist grounded theory methods. The intent is to expand the occupational therapy profession's occupational consciousness and cultivate cultural humility. Four themes emerged from the data: suffering, work, yearning for an education, and compassion for others. The findings suggest that environmental barriers such as hierarchy (patriarchy and discrimination) and physical barriers (limited access to built environments, lack of nonexploitative work opportunities, and hostile educational institutions) prevented occupational participation. Small acts of resistance through everyday living (finding joy, playing, self-sufficiency, and community organizing) were identified as facilitators of occupational participation. The research findings challenge proposed assumptions found within the occupational therapy literature: (1) humans and occupations exist as separate from their environments, and (2) work, productivity, and leisure contribute positively to health. The Transformative Model of Occupational Therapy is introduced as a decolonized framework that inextricably links individual health to community and global health. The model centers play, social participation, work, and education as occupations that contribute to the common good. These occupations are kept in equilibrium within the Four Pillars of Culture (self-determination, compassion, sustainability, and language) or the cultural values identified and derived from the stories.

Statistics indicate a high prevalence of TBI in South Africa, with many individuals with TBI not returning to work. The lack of return to work among TBI survivors is particularly due to factors such as injury severity, preinjury educational and occupational status, and age at injury. However, in addition to the above factors, there was the COVID-19 pandemic, which resulted in the de-escalation of nonessential outpatient services in order to assist with curbing the spread of the virus. The aim of the article is to explore the experiences and perceptions of TBI survivors about accessing vocational rehabilitation during the COVID-19 pandemic and how this has affected their worker roles. A descriptive, explorative qualitative research design was used, and semistructured interviews were conducted to collect data. The authors subsequently analysed the transcribed data using a thematic analysis approach. The COREQ (consolidated criteria for reporting qualitative research) checklist was used as a reporting guideline. Ten TBI survivors and two individuals working in the public health sector participated in this study. Two semistructured interviews were conducted with each research participant. Three themes emanated from the study, namely, Theme 1: "The barriers to accessing rehabilitation during the COVID-19 pandemic" represents the participants' barriers to accessing rehabilitation programmes throughout the COVID-19 pandemic. Theme 2: "Lack of rehabilitation negatively influenced the individual with TBI occupational performance" describes how the lack of OT rehabilitation during the COVID-19 pandemic impacted the participants' quality of life. Theme 3: "Factors that facilitated access to rehabilitation during the COVID-19 pandemic" describes the factors that facilitated access to OT rehabilitation services during the COVID-19 pandemic. The study found that there were barriers and facilitators to accessing occupational therapy rehabilitation during the COVID-19 pandemic for TBI survivors. More research needs to be conducted to explore the efficacy of telehealth/telemedicine for occupational therapy rehabilitation and the role of the occupational therapist in global pandemics.

Occupational therapists need to comprehensively assess the participation of children with autism spectrum disorder (ASD) in daily activities and evaluate the effectiveness of relevant interventions. Several participation measurement tools have been developed for children with ASD, but these tools require expert involvement, which is a barrier to large-scale surveys. To address these concerns, a caregiver-administered questionnaire-the Participation Questionnaire for Preschoolers (PQP)-was developed. However, this tool could be improved due to its narrow age range of 48-72 months and because the item development process does not reflect the perspectives of children and caregivers. Therefore, we expanded the PQP's target age range to 36-83 months and developed new items that reflect the perspectives of professionals and caregivers. Interviews were conducted with eight experts in supporting children with ASD and 11 caregivers of children with ASD. The interviews were transcribed, and a content analysis was performed. The number of questions was reduced from 51 to 36, and the order of items was changed for clarity. Two of the eight subdomains were removed to clarify the conceptual difference between activity and participation. The updated version of the PQP has two unique features: (1) it can be administered without expert involvement, and (2) it includes items specific to the challenges faced by children with ASD. Future development of the scale and validation of its measurement properties are needed.

The sample for this quasiexperimental pretest-posttest with a two-month follow-up design comprised nine individuals aged between 18 and 55 years, selected using a convenience sampling method. The intervention consisted of a 2-month group leisure participation program, conducted twice a week, followed by a 2-month follow-up period. Primary outcome measures included occupational performance and occupational balance, and secondary outcome measures were leisure participation, quality of life, and drug craving. Outcome measures were assessed three times: preintervention, postintervention, and after the follow-up period. The outcome measures included the Canadian Occupational Performance Measure (COPM), Occupational Balance Questionnaire-11 (OBQ11), Nottingham Leisure Questionnaire (NLQ), 36-Item Short-Form Health Survey (SF-36), and Desire to Drug Questionnaire (DDQ). Data analysis was performed using the Friedman test and Wilcoxon signed-rank test as a post hoc procedure, with a significance level set at 5%.

Basic Activities of Daily Living-Preschool Period Tool BADL-P) is a fast and quick test that does not require a special environment, where activities of daily living (ADLs) in preschool children are questioned. The aim of the study was to conduct a Turkish reliability and cultural adaptation of the BADL-P. The study was conducted among 211 parents of preschool children. Validity was determined using exploratory factor analysis. To determine convergent validity, the Functional Independence Measure for Kids (WeeFIM) scale was used. Cronbach's alpha, intraclass correlation coefficient (ICC), and item-total correlation (ITC) values were calculated to assess the reliability of the BADL-P. Totally, 99 girls and 112 boys, aged 3-6 years, with the children's mean age of 4.50 ± 0.75 years (3 years = 11%, 4 years = 32.1%, 5 years = 52.2%, and 6 years = 4.8%), were included. Exploratory factor analysis revealed that the BADL-P had sufficient fit. The BADL-P was weakly to highly correlated with the WeeFIM ( < 0.05 and < 0.001). Cronbach's alpha and ICC values of the BADL-P were acceptable (0.912 and 0.837, respectively). The ITC values of each item of the BADL-P were also acceptable (ranged from 0.232 to 0.683). Children in the 5-6 age group demonstrated higher scores and exhibited more advanced development in the ADL areas compared to children in the 3-4 age group ( < 0.05). The Turkish version of the BADL-P is valid, reliable, and sensitive to assessing and monitoring the performance of Turkish preschool children in ADL.

Cerebral palsy (CP) is a common motor and postural developmental disability impacting daily activities like toileting. Despite its importance, toileting has often been undervalued in healthcare. This study is aimed at identifying and assessing the level of influence of various factors affecting toileting in individuals with CP using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) framework. The Delphi method was employed to reach a consensus on factors influencing toileting in individuals with CP. One hundred fifty-eight professionals from 17 countries, each with at least 3 years' experience in CP and/or toileting, participated in this two-round study. Ethical approval (IR.IUMS.REC.1400.1111) and informed consent were obtained. The questionnaire, available in Farsi and English, used a Likert scale (5 =  to 1 = ). Factors with 75% agreement and a mean above 3.75 were included in the final list, while those with 50%-75% agreement or a mean between 2.5 and 3.75 proceeded to the second round. Factors were initially identified through a literature review and research team consultation and categorized according to the ICF-CY framework using the ICF 10 RULES. Validation and refinement were done through focus groups with caregivers and experienced professionals to ensure alignment with the framework and methodological rigor. The study highlighted significant factors influencing toileting activities in individuals with CP. Within the ICF-CY framework, "neuromusculoskeletal and movement-related functions" scored highest at 94.5% in "body functions and structures." "Toilet environment" scored 90.5% in "environmental factors." Support and relationship factors scored 82.3%. Attitudes toward "menstruation" ranked highest at 92.9%. Associated deficits with CP ranked top in personal factors at 93.7%. The study identifies key factors influencing toileting activity performance in individuals with CP. "Main caregiver" emerges as a pivotal factor, followed by neuromusculoskeletal functions, personal factors, attitudes toward menstruation, the toilet environment, and support and relationships.

Occupational therapy is a profession with origins rooted in Western values. As culture plays an important role in shaping theory and practice, the curriculum design of academic programs that train future rehabilitation professionals should reflect the local context. As part of an international partnership, a dual-degree graduate program in occupational therapy was established between a Chinese and an American university. A team composed of members from both institutions collaborated on culturally adapting an entry-level master's program in occupational therapy for China, based on a U.S. program, which welcomed its first cohort in September 2019. This article details the timeline and process of program design and adaptation from conception, through implementation to evaluation and revision, with the aim of offering a framework for curriculum adaptation of other academic programs in the U.S. and internationally. The adapted curriculum includes the program mission, vision, and philosophy; the curriculum model with program outcomes and threads; the program scope and sequence; materials and resources; and course-specific objectives, learning activities, and assessments. The authors also share lessons learned through this experience of international collaboration as well as next steps for program evaluation and sustainability. The detailed overview of this international collaboration offers suggestions for individuals and institutions seeking to develop global partnerships and adapt curricula across cultural contexts.

: The present study is aimed at evaluating the effects of the COVID-19 pandemic on Iranian adolescents' participation in various domains of life. The electronic version of the Iranian Adolescent Participation Assessment Tool-COVID-19 (IAPAT-C) was developed and validated for this purpose. : This study was conducted in two phases. In the first phase, the electronic version of the IAPAT-C was developed and validated through a methodological study involving five stages: content validity review, cognitive interviews, item analysis, structural validity assessment using confirmatory factor analysis, and reliability analysis. The tool was adapted from the previously validated IAPAT and revalidated for this study. In the second phase, the effects of COVID-19 on adolescents' participation were evaluated using a longitudinal one group before and after comparative design. The study involved 654 adolescents aged 13-18, and the data were analyzed using SPSS19 and G⁣Power 3 software. : The IAPAT-C evaluates the participation of Iranian adolescents in 54 daily life activities before and after the COVID-19 pandemic. It utilizes a 5-point Likert scale and was validated through an expert panel review for content validity. Additionally, cognitive interviews with six adolescents confirmed its comprehensibility, relevance, and comprehensiveness. Item analysis, based on data from 38 participants, demonstrated strong interitem correlations (0.6-0.94) and excellent internal consistency (Cronbach's alpha > 0.7). The tool's structural validity was supported by confirmatory factor analysis, which showed that the measurement model was a good fit. Convergent and discriminant validity of model constructs were also confirmed. Notably, COVID-19 significantly impacted all aspects of adolescents' lives, except for work. : The electronic version of the IAPAT-C was valid and reliable. COVID-19 significantly affected various aspects of Iranian adolescents' daily lives. Accordingly, it is necessary to provide appropriate interventions and policies for this sensitive class.

This study investigated the treatment methods used by physical and occupational therapists for poststroke paretic upper limbs and the factors influencing their decision-making processes. For the treatment methods of poststroke paretic upper limbs, the respondents were asked to select the most clinically used treatment according to the severity of the patient's condition. For the factors influencing their decision-making processes, the respondents were asked to indicate each determinant using a 5-point Likert scale (1 =  to 5 = ). Six hundred thirty-eight therapists participated in this study. Exploratory factor analysis was used to assess the validity of the questionnaire. The findings indicated task-specific training ( = 333, 52%) as the most popular for mild cases, followed by repetitive facilitative exercise ( = 143, 22.3%) for moderate cases and electrical stimulation ( = 246, 38.4%) for severe cases. This study revealed that evidence about treatment (very strong: = 171 (27.0%), and strong: = 287 (45.0%)) and patient preferences (very strong: = 203 (31.8%), and strong: = 251 (39.3%)) affected decision-making significantly regarding treatment methods for the poststroke paretic upper limb.

Poor fit between the work environment and work expectations is associated with high levels of workplace-related stress. Work stress in occupational therapy has been attributed to the nature of the profession and various other workplace-related factors. Workplace-related stress leading to burnout has been found to be higher in early career occupational therapists with less than 5 years of experience. This study explored workplace factors that result in poor person-work environment fit in six work-life areas in South African early career occupational therapists. A descriptive electronic survey design was used to access a sample of South African 261 occupational therapists with 2-5 years of work experience. The Area of Work-Life Survey (AWS) considers six work-life areas: control, workload, community, rewards, values, and fairness, which were used to collect data. Data were analysed to determine low, moderate, and high work environment fit for workplace factors including employment setting, field of practice, years' experience, time with current organization, and hours worked. Of the six work-life areas, only the scores for workload fell below the norm for the respondents. All six work-life areas were impacted by employment settings, with respondents in public health hospitals and clinics indicating significantly low person-environment fit in most areas. Respondents in physical rehabilitation had a significantly low fit for workload, as did years of experience, length of time with organization, and hours worked. Fairness had a low fit for physical rehabilitation and medicolegal fields of practice. Workload impacted workplace-related stress in respondents with scores below the norm on the AWS for this work-life area. Although some work-related factors affected workplace-related stress, the overall scores for the other work-life areas were above the norm, with only respondents in public service settings and in the field of physical rehabilitation reporting low work environment fit.

This study is aimed at investigating the impact of internal and external attention focus on learning a throwing skill in children with autism, as well as the relationship between working memory and learning rate. Twenty-four children aged 6-8 years with autism were assigned to internal and external attention groups. Participants performed a throwing task while their working memory was assessed using Cornoldi's working memory test. The data was analyzed using ANOVA with repeated measures involving two attention instructions and five blocks during the acquisition stage. An independent -test was conducted during the retention phase. Furthermore, a Pearson correlation test was utilized to explore any potential relationship between working memory and performance in both the acquisition and retention stages. Data analysis revealed no significant difference between the internal and external attention groups during the acquisition phase ( > 0.05), but a significant difference was found in the retention phase ( < 0.05). There was no correlation between working memory and learning outcomes ( > 0.05). The results suggest that internal attention may enhance motor learning in children with autism, and reducing working memory load does not necessarily favor external attention.

Individuals diagnosed with tuberculosis (TB) and multidrug-resistant (MDR) TB may struggle to return to work after they have completed a rehabilitation program. Multidrug-resistant tuberculosis (MDRTB) has been seen as a condition that is resistant to treatment, hence causing individuals to be economically in-active for considerable periods of time. The aim of the current study was to explore the views of individuals living with MDRTB, individuals with TB, and health professionals treating individuals with TB and MDRTB about the development of a vocational rehabilitation program. The researchers used an exploratory descriptive research design, and semistructured interviews were conducted with five key informants and four participants who were diagnosed with pulmonary tuberculosis (PTB) and MDRTB. Thematic analysis was used in order to analyse the study findings. The current study is the second of two articles. The first article focused on barriers and facilitators linked to returning to work for individuals living with TB and MDRTB. The current article focuses on the development of a vocational rehabilitation program. The findings of the original study revealed five themes; however, for the purpose of this article, only two themes will be presented, namely, Theme 1: promoting a holistic model and Theme 2: the use of resources for activity engagement. The latter theme contributed to the participant's view of the development of a vocational rehabilitation program. The study provided a description of the components of a vocational rehabilitation program that has been adapted from the Model of Occupational Self-Efficacy (MOOSE). The above program has been designed for individuals diagnosed with PTB/MDRTB and has the potential to assist them in returning to work. It is suggested that vocational rehabilitation programs be incorporated into general medical programs that focus on improving the functioning of individuals diagnosed with PTB/MDRTB.

Inclusive education has increased the demand for school-based occupational therapy services and has reconceptualised the practice in mainstream schools. Therapists are now expected to work collaboratively with teachers within tiered intervention models to support access and participation of all students, including those with disabilities, within the natural classroom context. School-based occupational therapy has become a specialised area of practice, as therapists work within educational, rather than health, systems and processes. While the growth in demand and expanded scope of practice is positive for the profession, predicted workforce shortages and the necessity for specialised and enhanced practice present significant challenges. The ability of the profession to fully support the demands of an inclusive education system remains unclear. As accurate, up-to-date information on the school-based therapy workforce is the foundation for planning future personnel needs, knowledge of the current state of the workforce is critical. There is a paucity of national data regarding this growing area of practice. The aim of this study is to describe a current profile of school-based occupational therapists to better understand the workforce, practice patterns, and the funding landscape in Australia. A convenient and purposive sample of 108 Australian paediatric occupational therapists working in mainstream primary schools in New South Wales, Queensland, and Victoria was surveyed in this quantitative study, which was analysed using descriptive statistics. Results provide some insights into the workforce and practice of school-based therapy in Australia offering preliminary data for future planning in this important and growing area of paediatric practice. While specific to the local context, results invite cross-national and global comparison to reveal universal trends and localised nuances across diverse settings.

Empirical evidence has confirmed that all types of knowledge (propositional, procedural, personal, and client) contribute to evidence-based practice (EBP) and should be transferred in clinical practice to inform quality service delivery. However, it is unclear how the integration of the types of knowledge that are transferred in clinical practice manifests. Given this gap in understanding, the current research sought to build a conceptual map of knowledge transfer in clinical practice in central South Africa. A qualitative approach was followed, and data to build the conceptual map was obtained from a scoping review that explored the landscape of knowledge transfer in occupational therapy clinical practice, nine semistructured interviews with occupational therapists working in central South Africa, and a Q Method survey. The conceptual map-building process delivered a multidimensional, multidirectional conceptual map consisting of four concepts (theory and research, practice experience, patient-therapist relationship, and patient's voice in clinical practice) and four types of knowledge (propositional, procedural, personal, and client). The results show the integration of the types of knowledge and confirm that knowledge transfer in clinical practice is a complex and ongoing process. The conceptual map, a first of its kind in South Africa, presents empirical evidence of knowledge that is created and transferred in clinical practice in central South Africa. The conceptual map might provide a framework for collaboration amongst all stakeholders, such as patients, occupational therapists, and academics, to produce practice guidelines and occupational outcome measures to support evidence-based clinical practice.

Developing client self-advocacy is in occupational therapy's (OT) scope of practice; however, there is limited understanding of if, or how, occupational therapists learn about self-advocacy interventions as well as implement self-advocacy into clinical practice.

Parenting with a physical disability often brings with it a range of challenges. Occupational therapists are well positioned to support parents to address these challenges, yet occupational therapy research and practice around parenting is relatively scarce. This paper addresses the questions: (1) How should occupational therapists support parenting occupations for people with physical disability? (2) How do parents with physical disability experience occupational therapy? An anonymous survey of 62 parents, primarily mothers, with physical disability about their experiences with parenting challenges and occupational therapy was analysed using both quantitative and qualitative techniques. Parents experienced challenges in engaging in a range of parenting tasks with children over a range of age groups. Parents reported that support was often needed and indicated that occupational therapy could assist them directly with specific parenting goals as well as the more usual biomechanical goals that influence parenting. Yet less than half of participants who received occupational therapy services reported that parenting tasks were addressed, and only one-fifth reported that their goals had been fully met. The data also indicated that the knowledge, skills, and attitudes of occupational therapists with regard to working with parents with disability can be improved. Findings suggest a need to better incorporate parenting occupations in standard occupational therapy training to increase occupational therapists' comfort and competence in working with clients on parenting issues.

Korean university students (KUS) face numerous challenges that can jeopardize their well-being, including academic stress, peer pressure, irregular sleep patterns, unhealthy eating habits, lack of physical exercise, and difficulties in time management, resulting in unhealthy habits and fluctuations in lifestyle. Consequently, there is a growing need for interventions tailored to this population.

The article reports the healing elements of an eclectic life skills programme (ELSP) from the perspective of group members. An ELSP utilising groups was developed to manage clients with mixed diagnostic profiles and different stages of recovery simultaneously. The aim was to explore the healing elements of an ELSP. Maximum variation purposive sampling was used to select six participants for the phenomenological inquiry. Data collection is comprised of observations, semistructured interviews, and reflective journals. Data analysis comprised an inductive thematic analysis. Participants all attended groups offered within the ELSP. They participated in two semistructured interviews: the first interview in the week following admission and the second just before discharge. In addition, they documented their experiences in reflective journals for the duration of their participation. The analogy of a kaleidoscope portrayed the four themes; three pertained to structural dynamics, namely, , , and . The fourth theme, namely, , pertained to personal sense-making by individual group members. The dynamic interplay of healing factors, captured in the themes, facilitated healing. Self-reflection was integral to the creation of a bespoke, facilitated self-learning process with direct application in group members' own lives.

Occupational therapists have long been involved in assistive technology (AT) provision worldwide. AT is recognized by the World Health Organization (WHO) to enhance functioning, independence, and autonomy and ultimately promote well-being for people living with disabilities. With the digitalisation of societies, the everyday lives and occupations of individuals are changing, becoming more reliant on digital solutions. The development of digital assistive technology (DAT) also offers opportunities for people with disabilities to access, interact, and pilot the digital world. However, we do not know how occupational therapists are involved in DAT provision worldwide. A survey was conducted in the global occupational therapist's community in June 2022 to describe DAT provision and the factors influencing it. Occupational therapy practitioners were included ( = 660) in the analysis. In DAT provision, occupational therapists mostly provide advice to people, assess their needs, provide instruction or training, prescribe DAT, and fit DAT to people and their environment. The clients served through DAT provision are most frequently people with neurological impairments, chronic illnesses, sensory impairments, and older people. The reasons for providing DAT focus on education, work, school, and leisure. It is expected that DAT provision will enhance independence, self-esteem, occupational participation, and social relationships. Issues faced by occupational therapists when providing DAT are costs of product and funding schemes, sufficient knowledge, and access to knowledge sources. Survey respondents are mostly from Western countries with access to the Internet and the digital world, including having digital literacy, highlighting the digital divide that exists between world regions and countries, but also within countries worldwide. There is a need to continue research to better understand the issues related to digitalisation and the digital participation of people living with disabilities.

This study explored the administration of goal attainment scaling (GAS) by entry-level occupational therapy (OT) students, examining their competency following minimal training. While GAS is valuable for measuring progress toward individualized client goals, its implementation requires specific skills and training that may challenge entry-level practitioners. Using retrospective data from a study of sensory garments' effects on children with autism spectrum disorder (ASD), we analyzed GAS administration by five entry-level OT students. Students received both indirect training through their curriculum and 3 h of direct research-specific preparation. Using a modified version of the GAS checklist, we evaluated students' competency through video recordings of GAS administration sessions and written GAS. Analysis revealed variable competency levels among students. While overall performance met 82.4% of checklist criteria, individual student competency varied considerably (54.5%-95.4%). Three of five students achieved the established 75% competency threshold. Students consistently met criteria for conceptual goal construction and timeframe specification but struggled with maintaining single dimensions of change and specifying observable behaviors. Entry-level OT students demonstrated varying levels of competency in GAS administration following minimal training. Our findings suggest the need for more comprehensive training in specific aspects of GAS, particularly in scale construction and behavioral specification. These results have important implications for how OT programs prepare students to implement GAS in clinical practice.