Effectiveness of an Intensive Occupational Therapy Camp for Children

Abstract

Date Presented 03/28/20

Camp Jabiru (CJ) is a naturalistic camp that provides OT through a replicable fidelity process for children with developmental differences. Campers improved their functional performance as measured by the Canadian Occupational Performance Measure (COPM) from both parent and OT ratings. COPM positive change remained stable three months postintervention. The findings suggest the OT intervention provided at CJ via a replicable process has a positive and lasting impact on occupational performance.

Primary Author and Speaker: Tracy Stackhouse

Additional Authors and Speakers: Hannah Burke, Shelly Lane

Contributing Authors: Caroline Hui, Lynette Burke, Beth Osten, Colleen Hacker

PURPOSE: This study evaluated the effectiveness of a pediatric OT intensive camp for children with developmental differences, situated in a naturalistic setting. We examined changes in parent and therapist rated performance and satisfaction on family-centered functional goals; ratings were conducted pre-and post camp.

DESIGN: This study uses a pre-test/post-test repeated measures cohort design. Inclusion criteria: age 8-12 years, accepted to CJ 2019, parents able to complete forms, parental consent, child assent. Exclusion criteria: diagnosis of genetic or metabolic disorder.

METHOD: Once enrolled in camp, research families signed consent and child participants signed assent forms. A parent from each family was interviewed by an OT associated with camp, using the Canadian Occupational Performance Measure (COPM; Law, et al., 2005) to define goals for their camp week. The COPM is a semi-structured interview tool for client-centered goal setting and outcome assessment. Caregivers and therapists rate performance and satisfaction with each goal; ratings range from 1-10 with 1 indicating “not at all” and 10 indicating “completely.” Change scores of 2+ are considered clinically significant.

Goals were established and rated three months prior to camp (T1). Goals were re-rated immediately before camp (T2), immediately following camp (T3), and 3-months post-camp (T4). Campers’ OTs also completed ratings on the first and last days of camp (T2 & T3). Each camper had 2-6 goals. Scores for performance and satisfaction were totaled and divided by the number of goals to obtain total scores for each category; total scores were calculated and used to determine change; this was done for caregiver and OT ratings. Demographic information was collected at baseline.

RESULTS: Thirty-seven children (26 boys and 11 girls) participated in this study, with a mean age of 10.70 (range 8.46-12.94, SD = 1.15). Participant diagnoses represented the camp population and included autism, attention difficulties, anxiety, and a variety of sensory processing challenges.

Caregiver ratings of child performance were analysed with a repeated-measures ANOVA, indicating statistically significant differences between ratings across timepoints (F(2.19, 78.83) = 42.75, p < .001, ηp2 = .54). There was a statistically significant difference in parent ratings at T1, T2, and T3 (p<.001), although parent performance ratings between T1 and T2 were not clinically different (COPM difference 0.51). The difference between T2 and T3 was 1.9 points,approaching clinical significance. Scores at T3 and T4 did not differ. The differences in therapist performance ratings at T2 and T3 were both statistically (F(1, 36) = 93.19, p<.001, ηp2 = .72) and clinically significant. T-test analysis, examining differences in performance change scores between parents and therapists was statistically significant (p<.001).

CONCLUSION: Participants at CJ demonstrated both statistically and clinically significant improvement in parent-established and parent-rated goals immediately following participating in CJ. Improvements in function remained stable 3 months post-camp. Therapist ratings of change immediately before and after camp showed similar, although larger, changes. Findings suggest that the OT intervention at CJ had a positive, lasting impact on goal attainment. This adds to previous findings of efficacy of an intensive camp model (Kinnealey, Koenig, & Huecker, 1999). Further, the findings provide support for a replicable, integrated pediatric OT intervention within a camp setting.

References

Law, M., Baum, C., & Dunn, W. (2005). Measuring occupational performance: Supporting best practice in occupational therapy (2nd ed.). Thorofare, NJ: Slack.

Kinnealey, M., Koenig, K., & Heucker, G. (1999). Changes in special needs children following intensive short-term intervention. Journal of Developmental and Learning Disorders, (3), 85–103. doi.org/10.5014/ajot.2011.09205