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Research Article  |   March 1991
Assessment and Treatment of a Pediatric Patient in Chronic Care: Ethnographic Methods Applied to Occupational Therapy Practice
Author Affiliations
  • Gelya Frank, PhD, is Associate Professor, Department of Occupational Therapy, University of Southern California, 2250 Alcazar Street, CSA 203, Los Angeles, California 90033
  • Esther Huecker, OTR, is an Occupational Therapist, Casa Colina Children’s Services Center, Pomona, California, and a graduate student in the Department of Occupational Therapy, University of Southern California, Los Angeles, California
  • Ruth Segal, MA, OTR, OT(C), is a Staff Occupational Therapist, Queen Street Mental Health Centre, Toronto, Ontario, Canada
  • Susan Forwell, MA, OT(C), is a Program Planner and Instructor, Department of Occupational Therapy, Vancouver General Hospital, Vancouver, British Columbia, Canada
  • Nancy Bagatell, OTR, is an Occupational Therapist, The Center for Neurodevelopmental Studies, Phoenix, Arizona, and a graduate student in the Department of Occupational Therapy, University of Southern California, Los Angeles, California
Article Information
Pediatric Evaluation and Intervention / Research
Research Article   |   March 1991
Assessment and Treatment of a Pediatric Patient in Chronic Care: Ethnographic Methods Applied to Occupational Therapy Practice
American Journal of Occupational Therapy, March 1991, Vol. 45, 252-263. doi:10.5014/ajot.45.3.252
American Journal of Occupational Therapy, March 1991, Vol. 45, 252-263. doi:10.5014/ajot.45.3.252
Abstract

Ethnographic methods were used to examine how an experienced occupational therapist assesses and treats a pediatric patient within a relatively long-term clinical relationship. Treatment goals for this preverbal child with Hirschsprung disease, who began occupational therapy at 22 months of age, included (a) introduction of oral feeding to reduce dependence on total parenteral nutrition through intravenous feeding and (b) facilitation of exploratory play, which had been developmentally delayed during extensive periods of immobilization during medical care. This article shows how the meaning of therapeutic activities changes for the patient over time, as the occupational therapist builds trust through affect attunement, validates his or her empathic interpretations, and develops common understandings with the patient’s family and others within the social and cultural contexts of chronic care.