Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Evidence highlights the centrality of the family in child development, yet understanding of how families compose everyday life is limited. This study examined the validity of the Engagement in Family Occupation Measure to ensure it represents the scope of family occupations. Ten OTs and 11 families raising children were interviewed. Findings revealed significant discrepancies in valued family occupations between families and OT professionals.
Primary Author and Speaker: Katelyn R. Harris
Additional Authors and Speakers: Katherine Byrne, Elizabeth Werner-DeGrace
PURPOSE: Occupational therapists working with children understand the most influential factor in child development is the family. How a family chooses to compose everyday life influences the opportunities both children with and without disabilities, have for learning and development (Newland, Lawler, Giger, Roh, & Carr, 2015; Rafferty, Griffin, & Robokos, 2010, Smith et al., 2017). Research to date on how families compose day to day life is limited. As such, undetected challenges with composing family life can minimize or potentially mitigate the full potential of OT intervention, resulting in less than favorable outcomes for both child and family. This research project developed a preliminary study of the composition of family occupation titled Engagement in Family Occupation Measure (EFOM), which highlighted eight domains of family occupation from the Occupational Therapy Practice Framework.
DESIGN/METHODS: The purpose of this study was to examine the preliminary measure of family occupational composition, the EFOM, to ensure it validly represented the breadth and scope of meaningful family occupations. To ensure the EFOM included items that are meaningful to the target population, we discerned item importance through interviews of 10 experts in the field of occupational therapy, as well as 11 experts of the experience; families raising children ages 0 to 17 years. We asked both groups of experts to rate the level of importance each item holds in contributing to family occupational engagement on a 10-point scale (i.e., 1 = not important at all, 10 = extremely important to the family). We analyzed data collected from this scale using summary descriptive statistics. We then note items in which the percent agreement was 80% or higher, as well as the items in which the percent disagreement met a p-value of 0.05. The research team then interviewed both groups of experts to understand the appropriateness of the tool for measuring family occupational engagement and to verbalize the mental process entailed in providing such an answer.
RESULTS: The findings of our study suggest that families and professionals agreed that the following family occupation items were very important (reaching 80% agreement): eating swallowing, feeding, toileting, rest, sleep, exploring play, participating in play, social participation in the home, family friendships, roles, and family values. Only 1 family occupation, community social participation, was scored as very important by professionals (80%) and not families (70%) and the difference was not statistically significant (p = 1.0). However, we found it disconcerting that 11/32 items of family occupation were scored as very important to families but not professionals (p < 0.05).
CONCLUSION: Although preliminary, the findings of this study demonstrate a lack of agreement between families and professionals in EFOM item importance. This raises questions regarding an undervaluing of important family occupations by professionals. Conversely, given the advanced knowledge in areas such as neuroscience, child development, psychology and behavioral dynamics, along with the years of professional practice, it may be that occupational therapists have honed the focus of practice to the most important factors of overall development. Given the focus of the tool is to measure the important aspects of how a family occupies their time, further investigation of the importance of family to occupation from more diverse families, including those who have children with disabilities, is warranted. This study illuminates a disturbing difference in perspectives as a potential barrier to family-centered practice and suggests the EFOM as a potential tool for occupational therapists to address this challenge.
References
Newland, L. A., Lawler, M. J., Giger, J. T., Roh, S., & Carr, E. R. (2015). Predictors of children’s subjective well-being in rural communities of the United States. Child Indicators Research, 8, 177–198. https://doi.org/10.1007/s12187-014-9287-x
Rafferty, Y., Griffin, K. W., & Robokos, D. (2010). Maternal depression and parental distress among families in the Early Head Start Research and Evaluation Project: Risk factors within the family setting. Infant Mental Health Journal, 31, 543–569. https://doi.org/10.1002/imhj.20271
Smith, S. L., DeGrace, B., Ciro, C., Bax, A., Hambrick, A., James, J., & Evans, A. (2017). Exploring families' experiences of health: contributions to a model of family health. Psychology, Health & Medicine, 22(10), 1239-1247. https://doi.org/10.1080/13548506.2017.1319069
