Objectives. Occupational therapists who work primarily with children were surveyed regarding their skill levels in competencies that define pediatric practice.

Method. The subjects were 90 advanced practitioners who received specially certification in pediatric occupational therapy in 1992 and 52 inexperienced practitioners with 5 or fewer years’ experience. Respondents rated themselves from needs assistance to highly skilled on 94 competencies.

Results. A principle components analysis of the 142 surveys identified six primary constructs that described related areas of skill in the respondents: child evaluation, communication and consultation, working with families, understanding service provision systems, use of assistive technology, and neonatology and feeding. Child evaluation, with emphasis on developmental framework, analysis of sensory integration, and neuromotor function, was the strongest construct; respondents rated it the highest. Communication and consultation with team and family members also received high ratings. The advanced practitioner respondents rated themselves higher than the inexperienced practitioner respondents in 73 of the 80 competencies in the factors identified. The differences were greatest in the competencies of analysis of sensory processing and integration, analysis of neuromotor components, and consultation with other professionals.

Conclusion. Findings suggest that advanced practitioners develop expertise in sensory integration and neuromotor analysis, and that evaluation and consultation are important skill areas in advanced occupational therapy practice.

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