Defining Interventions Used to Address Challenging Behaviors in OT Sessions

Abstract

Date Presented 03/23/24

OTPs often work with children who exhibit behaviors that are challenging for adults to manage, often known as challenging behaviors. This study seeks to define how OTPs address challenging behaviors to define the uniqueness of OT interventions.

Primary Author and Speaker: Allison Siksnus

Additional Authors and Speakers: Aimee Piller

Many children exhibit behaviors that can be considered challenging, with a greater prevalence occurring in children with disabilities. These behaviors may exceed what is considered developmentally typical in children and can impact overall health and wellness, social participation, and independence (Watling, 2020). While OTPs are well equipped to address challenging behaviors (CB), there is little known about what interventions are being used by OTPs. The purpose of this study was to define interventions used by OTPs when addressing CB in pediatric clients. The study used a mixed methods design with qualitative observation, qualitative interview, and survey data to define OT interventions used in addressing CB.

METHOD: Participants were observed in an OT session with a child identified as having CB. The researcher performed a follow up interview with the OTP and compared the interview data with observed data fieldnotes. The researchers placed identified interventions into predetermined categories based on OT literature about behavior interventions. A survey with questions designed to examine frequency of defined OT interventions and efficacy of addressing CBs was distributed nationwide with 275 responses. Data from observations/interviews and the survey followed triangulation mixed methods design to determine commonalities. While a variety of interventions were identified as being used, interventions that fit within a sensory integration and processing framework were among the most frequently observed interventions. The concepts of SI were also rated highly in the national survey. In conclusion, OTPs utilize a variety of approaches when addressing challenging behaviors, but SI related interventions are utilized more frequently.

IMPACT STATEMENT: This study indicates that OTPs use SI interventions when addressing CB in children and supports the need for further research of the immediate implications of SI interventions on behavior management.

References

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Schaaf, R. C., Dumont, R. L., Arbesman, M., & May-Benson, T. A. (2018). Efficacy of Occupational Therapy Using Ayres Sensory Integration®: A Systematic Review. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association, 72(1), 7201190010p1–7201190010p10. https://doi.org/10.5014/ajot.2018.028431

Watling, R. (2020). Behavioral approaches. In J. C. O’Brien and H. Miller-Kuhaneck (eds). Case-smith’s occupational therapy for children and adolescents. (8th ed., pp. 550-564). Elsevier.