Background.Occupational therapists use a range of intervention approaches with children with learning difficulties.Purpose.This study aimed to identify factors influencing therapists' clinical decisions when choosing and combining these interventions.Methods.Seven occupational therapists participated. Data were collected through in-depth interviews, short questionnaires, and therapy observations and analysed thematically.Findings.Therapists used a combination of child, therapist, and service-related factors to individually tailor a combination of intervention techniques drawn from different theoretical approaches. Therapists also used embedded practices with all children to engage and motivate them, promote task mastery, encourage application of strategies at home and school, and evolve intervention through ongoing evaluation.Implications.The child and family's home and school context and, to a lesser extent, the therapist's past experience and service context are primary factors considered when choosing interventions. Therapists continually move between theoretical and practical levels of thinking to best meet each child's needs.
AyresA. J. (1972). Sensory integration and learning disorders. Los Angeles: Western Psychological Services.
2.
BerryJ.RyanS. (2002). Frames of reference: Their use in paediatric occupational therapy. British Journal of Occupational Therapy, 65, 420–427.
3.
ClarkJ.GetchellN.Smiley-OyenA.WhitallJ. (2005). Developmental coordination disorder. Issues, identification, and intervention. Journal of Physical Education, Recreation & Dance, 76 (4), 49–53.
4.
DreyfusH.DreyfusS. (1986). Mind over machine. New York: Free Press.
5.
DuncanE. A. S. (2006). Foundations for practice in occupational therapy. Edinburgh, United Kingdom: Elsevier Churchill Livingstone.
6.
FederK.MajnemerA.SynnesA. (2000). Handwriting: Current trends in occupational therapy practice. Canadian Journal of Occupational Therapy, 67, 197–204.
7.
FlemingM. H. (1991). The therapist with the three-track mind. American Journal of Occupational Therapy, 45, 1007–1014.
8.
GreberC.ZivianiJ.RodgerS. (2007). The Four-Quadrant Model of Facilitated Learning (Part 1). Using teaching-learning approaches in occupational therapy. Australian Occupational Therapy Journal, doi: 10.1111/j.1440-1630.2007.00662.x.
9.
HagedornR. (2001). Foundations for practice in occupational therapy (3rd ed.). Edinburgh, United Kingdom: Churchill Livingstone.
10.
HiggsJ.TitchenA. (2000). Knowledge and reasoning. In HiggsJ.JonesM. (Eds.), Clinical reasoning in the health professions (2nd ed., pp. 23–32). Oxford, United Kingdom: Butterworth-Heinemann.
11.
HumphriesT. W.SniderL.McDougallB. (1997). Therapists' consistency in following their treatment plans for sensory integrative and perceptual-motor therapy. American Journal of Occupational Therapy, 51, 104–113.
12.
MandichA. D.PolatajkoH. J.RodgerS. (2003). Rites of passage: Understanding participation of children with developmental coordination disorder. Human Movement Science, 22, 583–595.
13.
MattinglyC.FlemingM. H. (1994). Clinical reasoning: Forms of inquiry in a therapeutic practice. Philadelphia: F. A. Davis.
14.
MissiunaC.MandichA.PolatajkoH.Malloy-MillerT. (2001) Cognitive orientation to daily occupational performance (COOP): Part I - Theoretical foundations. Physical and Occupational Therapy in Paediatrics, 20 (2/3), 69–81.
15.
NelsonA.CopleyJ.FlaniganK.UnderwoodK. (in press). Occupational therapists prefer combining multiple intervention approaches for children with learning difficulties. Australian Occupational Therapy Journal.
RodgerS.BrownG. T.BrownA. (2005). Profile of paediatric occupational therapy practice in Australia. Australian Occupational Therapy Journal, 52, 311–325.
19.
RogersS.GordonC.SchanzenbackerK.Case-SmithJ. (2001). Common diagnosis in pediatric occupational therapy practice. In Case-SmithJ. (Ed.), Occupational therapy for children (4th ed., pp. 136–189). St Louis, MO: Mosby.
20.
SchönD. (1983). The reflective practitioner: How professionals think in action. New York: Basic Books.
21.
SkinnerR.PiekJ. (2001). Psychosocial implications of poor motor coordination in children and adolescents. Human Movement Science, 20, 73–94.
22.
StorchB. A.EskowK. G. (1996). Theory application by school-based occupational therapists. American Journal of Occupational Therapy, 50, 662–668.
23.
UlinP.RobinsonE.TolleyE. (2005). Qualitative methods in public health. A field guide for applied research. San Francisco: Jossey-Bass.
24.
WallenM.WalkerR. (1995). Occupational therapy practice with children with perceptual-motor dysfunction: Findings of a literature review and survey. Australian Occupational Therapy Journal, 42, 15–25.
