Abstract
The American Occupational Therapy Association (AOTA) Evidence-Based Practice Project has developed a table summarizing the research opportunities on early childhood. The table provides an overview of the state of current available evidence on interventions within the scope of occupational therapy practice and is based on the systematic reviews from the AOTA Evidence-Based Practice Guidelines Series. Researchers, students, and clinicians can use this information in developing innovative research to answer important questions within the occupational therapy field.
Planning a research project requires consideration of many factors. Level of interest and knowledge in a specific area, access to appropriate populations of participants, support of mentors and other researchers, and funding availability all help determine the focus of a future project. An additional component to be considered is whether adequate, up-to-date research has already been completed on a topic; if sufficient evidence is available in a given core area, this area might not be the best choice for another research project.
The best research topic may be one in which either little research has been done or the research to date is insufficient, inconclusive, or mixed. In addition, when research conducted to date provides a low level of evidence and is of limited quality, additional high-quality research in the area is needed.
The “Research Opportunities Table on Early Childhood: Birth Through 5 Years” provides an overview of the state of current available evidence on interventions within the scope of occupational therapy practice. The table is based on the systematic reviews from the AOTA Evidence-Based Practice Guidelines Series. The table lists specific interventions and indicates either that the evidence is sufficient to support the intervention or that moderate, mixed, or few studies support the intervention and therefore it is a priority research area. Please refer to Occupational Therapy Practice Guidelines for Early Childhood: Birth Through 5 Years (Clark & Kingsley, 2013) and the American Journal of Occupational Therapy Special Issue on Occupational Therapy and Early Intervention/Early Childhood (Case-Smith, 2013) for more information on the topic area and the systematic review process.
This table also is posted online for researchers to use to inform the occupational therapy community about their work. The table is linked to Google Drive and offers a place for researchers to include information on recently completed and ongoing research. It is hoped that this information will make the research planning process easier, minimize duplication of research efforts, and stimulate discussions among researchers with similar interests, which can then facilitate the creation of research networks and multisite studies. Researchers, students, and clinicians can use this information in developing innovative research to answer important questions within the occupational therapy field. To add current or ongoing research to the table, visit http://www.aota.org/researchopportunitiestables.
Researchers are also encouraged to enter their projects into AOTA’s Researcher Database at http://myaota.aota.org/research/. This database provides AOTA with information such as relevant clinical settings and populations, International Classification of Functioning, Disability and Health level (World Health Organization, 2001), funder (if any), and key words to help guide research advocacy and policy initiatives.
Theme | Specific Intervention | Strength of Evidence |
Social–Emotional Functioning | ||
Touch-based interventions | Infant massage to improve sleep and relaxation, reduce crying, and reduce hormones affecting stress (no cognitive or behavioral component) | Research sufficient |
Massage before bed to improve attention, reduce restless and impulse behavior, and decrease stereotypical behaviors | Priority research area | |
Kangaroo Care to promote social–emotional development, eye–hand coordination, and speech | Priority research area | |
Relationship-based interventions | Caregiver-facilitated play to reduce anxiety in children and parents and to increase developmentally competent play | Priority research area |
Responsive teaching methods by parents to increase attention, persistence, interest, cooperation, initiation, joint attention, affect, and social–emotional functioning | Priority research area | |
Interactive or play-based activities | Discrete trial combined with either semistructured play sessions or pivotal response training to improve structured play | Research sufficient |
Discrete trial combined with either semistructured play session or pivotal response training to improve symbolic play | Priority research area | |
Naturalistic interventions | Mixed play groups (children with and without disabilities) to improve responsiveness to peers and improve total positive behavior for both groups | Priority research area |
Instruction of preschool pairs in using a computer to increase active waiting, turn taking, and positive affect | Priority research area | |
Visually scheduled and scripted instructor-guided play to improve dyad engagement | Priority research area | |
Instruction-based interventions | Modeling, play-based activities, rehearsal of social behaviors, and prompting to improve social behaviors | Research sufficient |
Direct teaching with video modeling and applied behavior analysis to improve social skills | Research sufficient | |
Pivotal response training and environmental arrangement to prolong social interaction | Research sufficient | |
Social Stories to reduce inappropriate behaviors and increase appropriate behaviors | Priority research area | |
Therapist-selected toys and objects | Social toys to promote cooperative play and positive social outcomes | Priority research area |
Mixed-level play groups for children with disabilities and peers with better play skills to improve social outcomes | Priority research area | |
Feeding, Eating, and Swallowing | ||
Behavioral-based interventions | Behavioral interventions to increase calorie intake | Priority research area |
Behavioral interventions to wean from tube feeding | Priority research area | |
Parent-directed educational interventions | Individualized behavioral feeding intervention to increase physical growth of infants | Priority research area |
Parent education and parent-directed intervention to reduce maternal stress | Priority research area | |
Behavioral interventions to increase food acceptance during mealtimes | Priority research area | |
Parent education and parent-directed intervention to improve mealtime behaviors and reduce problem behaviors | Priority research area | |
Physiological interventions | Oral stimulation programs to increase nonnutritive sucking pressure and quantity of milk ingested during oral feeding | Research sufficient |
Oral stimulation programs, skin-to-skin contact, and sensory–motor and oral–motor interventions to reduce length of hospital stay | Research sufficient | |
Tactile and multisensory interventions to improve nipple feeding | Priority research area | |
Oral stimulation, early introduction of oral feeding, and Votja therapy to improve the transition from tube to oral feeding | Priority research area | |
Cognitive Interventions | ||
Neonatal intensive care unit (NICU) interventions | Use of Newborn Individualized Developmental Care and Assessment Program to improve infant cognitive development | Priority research area |
NICU- and home-based interventions | Multisensory approach addressing auditory, tactile, visual, and vestibular input in the hospital and at home until 2 mo corrected age to improve mental or motor performance | Priority research area |
Use of a parent education program that includes information on behavior, interaction with infants, and activities to promote development | Priority research area | |
Early intervention program for preterm infants to improve cognitive outcomes in infancy and preschool | Priority research area | |
Interventions to promote joint attention | Intervention incorporating joint attention to improve maintenance of coordinated looks and increased acknowledgment of novel objects | Priority research area |
Early intervention program started in the hospital and continued with home visits to improve joint attention and initiation of object requests | Priority research area | |
Discrete trial training and pivotal response training when addressing joint attention to improve social limitations, spontaneous speech, and play skills | Priority research area | |
Comparison of joint attention interventions and interventions using symbolic play and applied behavioral analysis | Priority research area | |
Motor Performance | ||
Developmental interventions for at-risk infants | Caregiver-delivered home program for infants updated at 1, 2, and 3 mo to improve motor performance | Priority research area |
Developmental motor interventions to improve motor outcomes | Priority research area | |
5-wk parent education program that models appropriate motor development | Priority research area | |
Interventions for children with or at risk for cerebral palsy (CP) | Constraint induced movement therapy to improve motor performance | Priority research area |
Neurodevelopmental treatment to improve motor performance | Priority research area | |
Child-focused and context-focused intervention to improve motor performance | Priority research area | |
Conductive education to improve motor performance | Priority research area | |
Visual–motor interventions for children with developmental delays | Therapist-led sensorimotor therapy to improve gross motor functional skills | Priority research area |
Child-led sensorimotor therapy to improve fine motor skills | Priority research area | |
Occupational therapy for preschoolers to improve visual–motor and fine motor skills, manipulation, and motor accuracy | Priority research area | |
Direct or indirect occupational therapy to improve visual–motor skills | Priority research area | |
Service Delivery in Early Childhood | ||
Settings | Interventions at more than one setting (e.g., classroom and home) to improve performance outcomes | Priority research area |
Participation in a Head Start program at age 2 yr rather than 3 yr to reduce maternal depression | Priority research area | |
Longer duration of home-based behavioral treatment to improve outcomes in children with autism or pervasive developmental disorder | Priority research area | |
Routine-based interventions | Family-centered help giving that incorporates support to strengthen the family and improve satisfaction, parenting behavior, personal and family well-being, social support, and child behavior | Priority research area |
Routines-based or contextualized interventions to improve affect and engagement | Priority research area | |
Everyday learning opportunities to improve parenting competence, parental well-being, and parent judgment of child progress | Priority research area | |
Interventions during family routines to extinguish target behaviors and improve generalization of skills | Priority research area | |
Family-centered service delivery to improve satisfaction and reduce family stress | Priority research area | |
Parent training | Parenting programs to improve parent-based outcomes (e.g., parent stress, anxiety, depression) | Research sufficient |
Early Head Start parenting classes to improve cognitive outcomes in early childhood | Priority research area | |
Brief therapist-led parenting education to improve behavioral outcomes in young children | Priority research area | |
Parent training to improve satisfaction and quality of life | Priority research area | |
Community-based parenting group to reduce child difficulty and conduct problems | Priority research area |
Theme | Specific Intervention | Strength of Evidence |
Social–Emotional Functioning | ||
Touch-based interventions | Infant massage to improve sleep and relaxation, reduce crying, and reduce hormones affecting stress (no cognitive or behavioral component) | Research sufficient |
Massage before bed to improve attention, reduce restless and impulse behavior, and decrease stereotypical behaviors | Priority research area | |
Kangaroo Care to promote social–emotional development, eye–hand coordination, and speech | Priority research area | |
Relationship-based interventions | Caregiver-facilitated play to reduce anxiety in children and parents and to increase developmentally competent play | Priority research area |
Responsive teaching methods by parents to increase attention, persistence, interest, cooperation, initiation, joint attention, affect, and social–emotional functioning | Priority research area | |
Interactive or play-based activities | Discrete trial combined with either semistructured play sessions or pivotal response training to improve structured play | Research sufficient |
Discrete trial combined with either semistructured play session or pivotal response training to improve symbolic play | Priority research area | |
Naturalistic interventions | Mixed play groups (children with and without disabilities) to improve responsiveness to peers and improve total positive behavior for both groups | Priority research area |
Instruction of preschool pairs in using a computer to increase active waiting, turn taking, and positive affect | Priority research area | |
Visually scheduled and scripted instructor-guided play to improve dyad engagement | Priority research area | |
Instruction-based interventions | Modeling, play-based activities, rehearsal of social behaviors, and prompting to improve social behaviors | Research sufficient |
Direct teaching with video modeling and applied behavior analysis to improve social skills | Research sufficient | |
Pivotal response training and environmental arrangement to prolong social interaction | Research sufficient | |
Social Stories to reduce inappropriate behaviors and increase appropriate behaviors | Priority research area | |
Therapist-selected toys and objects | Social toys to promote cooperative play and positive social outcomes | Priority research area |
Mixed-level play groups for children with disabilities and peers with better play skills to improve social outcomes | Priority research area | |
Feeding, Eating, and Swallowing | ||
Behavioral-based interventions | Behavioral interventions to increase calorie intake | Priority research area |
Behavioral interventions to wean from tube feeding | Priority research area | |
Parent-directed educational interventions | Individualized behavioral feeding intervention to increase physical growth of infants | Priority research area |
Parent education and parent-directed intervention to reduce maternal stress | Priority research area | |
Behavioral interventions to increase food acceptance during mealtimes | Priority research area | |
Parent education and parent-directed intervention to improve mealtime behaviors and reduce problem behaviors | Priority research area | |
Physiological interventions | Oral stimulation programs to increase nonnutritive sucking pressure and quantity of milk ingested during oral feeding | Research sufficient |
Oral stimulation programs, skin-to-skin contact, and sensory–motor and oral–motor interventions to reduce length of hospital stay | Research sufficient | |
Tactile and multisensory interventions to improve nipple feeding | Priority research area | |
Oral stimulation, early introduction of oral feeding, and Votja therapy to improve the transition from tube to oral feeding | Priority research area | |
Cognitive Interventions | ||
Neonatal intensive care unit (NICU) interventions | Use of Newborn Individualized Developmental Care and Assessment Program to improve infant cognitive development | Priority research area |
NICU- and home-based interventions | Multisensory approach addressing auditory, tactile, visual, and vestibular input in the hospital and at home until 2 mo corrected age to improve mental or motor performance | Priority research area |
Use of a parent education program that includes information on behavior, interaction with infants, and activities to promote development | Priority research area | |
Early intervention program for preterm infants to improve cognitive outcomes in infancy and preschool | Priority research area | |
Interventions to promote joint attention | Intervention incorporating joint attention to improve maintenance of coordinated looks and increased acknowledgment of novel objects | Priority research area |
Early intervention program started in the hospital and continued with home visits to improve joint attention and initiation of object requests | Priority research area | |
Discrete trial training and pivotal response training when addressing joint attention to improve social limitations, spontaneous speech, and play skills | Priority research area | |
Comparison of joint attention interventions and interventions using symbolic play and applied behavioral analysis | Priority research area | |
Motor Performance | ||
Developmental interventions for at-risk infants | Caregiver-delivered home program for infants updated at 1, 2, and 3 mo to improve motor performance | Priority research area |
Developmental motor interventions to improve motor outcomes | Priority research area | |
5-wk parent education program that models appropriate motor development | Priority research area | |
Interventions for children with or at risk for cerebral palsy (CP) | Constraint induced movement therapy to improve motor performance | Priority research area |
Neurodevelopmental treatment to improve motor performance | Priority research area | |
Child-focused and context-focused intervention to improve motor performance | Priority research area | |
Conductive education to improve motor performance | Priority research area | |
Visual–motor interventions for children with developmental delays | Therapist-led sensorimotor therapy to improve gross motor functional skills | Priority research area |
Child-led sensorimotor therapy to improve fine motor skills | Priority research area | |
Occupational therapy for preschoolers to improve visual–motor and fine motor skills, manipulation, and motor accuracy | Priority research area | |
Direct or indirect occupational therapy to improve visual–motor skills | Priority research area | |
Service Delivery in Early Childhood | ||
Settings | Interventions at more than one setting (e.g., classroom and home) to improve performance outcomes | Priority research area |
Participation in a Head Start program at age 2 yr rather than 3 yr to reduce maternal depression | Priority research area | |
Longer duration of home-based behavioral treatment to improve outcomes in children with autism or pervasive developmental disorder | Priority research area | |
Routine-based interventions | Family-centered help giving that incorporates support to strengthen the family and improve satisfaction, parenting behavior, personal and family well-being, social support, and child behavior | Priority research area |
Routines-based or contextualized interventions to improve affect and engagement | Priority research area | |
Everyday learning opportunities to improve parenting competence, parental well-being, and parent judgment of child progress | Priority research area | |
Interventions during family routines to extinguish target behaviors and improve generalization of skills | Priority research area | |
Family-centered service delivery to improve satisfaction and reduce family stress | Priority research area | |
Parent training | Parenting programs to improve parent-based outcomes (e.g., parent stress, anxiety, depression) | Research sufficient |
Early Head Start parenting classes to improve cognitive outcomes in early childhood | Priority research area | |
Brief therapist-led parenting education to improve behavioral outcomes in young children | Priority research area | |
Parent training to improve satisfaction and quality of life | Priority research area | |
Community-based parenting group to reduce child difficulty and conduct problems | Priority research area |
Acknowledgments
AOTA acknowledges the work of Matthew Bernardo (emerging leader mentee) and Melissa Stutzbach (fieldwork student), who participated in the development of the Research Opportunities tables while at the American Occupational Therapy Association in Bethesda, MD. This work is based on the American Journal of Occupational Therapy Special Issue on Occupational Therapy and Early Intervention/Early Childhood (Case-Smith, 2013) and the Occupational Therapy Practice Guidelines for Early Childhood: Birth Through 5 Years (Clark & Kingsley, 2013), all from the AOTA Evidence-Based Practice Project.