Ellen S. Cohn, Jessica Kramer, Jamie A. Schub, Teresa May-Benson; Parents’ Explanatory Models and Hopes for Outcomes of Occupational Therapy Using a Sensory Integration Approach. Am J Occup Ther 2014;68(4):454–462. https://doi.org/10.5014/ajot.2014.010843
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© 2019 American Occupational Therapy Association
PURPOSE. To describe parents’ concerns and hopes for their children who would be receiving occupational therapy using a sensory integration approach.
METHOD. Content analysis of 275 parental responses to three open-ended questions on developmental–sensory history intake forms.
FINDINGS. Parents’ descriptions of why they sought for their children were categorized into four overarching concerns about their children’s challenges: self-regulation, interacting with peers, participating in skilled motor activities, and self-confidence. Parents often linked these concerns together, revealing explanatory models of how they make sense of potential relationships among their children’s challenges and how these challenges affect occupational performance. Parents hoped occupational therapy would help their children develop self-understanding and frustration tolerance to self-regulate their behavior in socially acceptable ways.
IMPLICATIONS. Assessment and intervention should explicitly focus on links among self-regulation, social participation, skills, and perceived competence to address parents’ expectations.
Self-regulation is the ability to interpret experiences and adapt one’s emotions and behaviors in a socially acceptable manner.
Social participation is the child’s ability to interact with peers and make and sustain friendships.
Skill development is the development of motor skills for fine and gross activities.
Confidence is a child’s positive feelings of overall worth and competence.
[I would like to see] improved fine/gross motor skills and an ability to write clearly [and] handle self with other children better. He has become much less self-confident over time and is frustrated with self. We are concerned his issues will harm him socially and academically and personally.
lacks self-confidence where her social interactions are concerned. She is also clumsy, tires easily, and is easily frustrated. I would like to see her be able to control herself by calming herself. I would like to see her confident and happy and in control of herself.
I wish he would not be so frustrated when he doesn’t catch on right away with certain motor tasks (writing, drawing). He has difficulty carrying out some motor tasks, especially novel tasks, and resistance to letting anyone show him how to do new things, which makes it tough to learn new things.
[I would like him] to feel good about himself, be able to get through the day with less stress and more enjoyment, specifically to learn to catch a ball and ride a bike. But he won’t try new things that he thinks he may fail at. He calls his body stupid and doesn’t do cool things like the other boys. He also has a temper.
Guidance regarding assessments that might capture concerns of parents and children with regulatory challenges is found in numerous measures, such as the Sensory Processing Measure: Home Form or School Form (Parham, Ecker, Miller Kuhaneck, Henry, & Glennon, 2007) or the Sensory Profile (Dunn, 1999), which help parents and practitioners better understand how sensory processing affects children’s participation in daily life.
The Perceived Efficacy and Goal Setting Scale (Missiuna, Pollock, & Law, 2004) and Child Occupational Self-Assessment (Keller, Kafkes, Basu, Federico, & Kielhofner, 2005) can be used to better understand the effect of regulatory challenges on children’s perceived competence in desired activities and to create collaborative goals with children.
The Alert Program, “How Does Your Engine Run,” uses cognitive and sensory strategies to teach children to monitor and adapt their level of alertness to appropriately match the situation to regulate their behavior (Williams & Shellenberger, 1996).
The Cognitive Orientation to Occupation Performance (CO–OP) is a cognitive-based, performance-based intervention that teaches children to use strategies that support skill acquisition through a process of guided discovery (Polatajko & Mandrich, 2004).
Hahn-Markowitz, Manor, and Maeir (2011) developed the Cog-Fun intervention to teach children with ADHD cognitive strategies to enable occupational performance.
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