Date Presented 04/22/2023

This case series details sibling participation in OT as an approach for including siblings in the OT process. Canadian Occupational Performance Measure and Goal Attainment Scaling ratings in both cases reflect improvements in the siblings’ social participation in play.

Primary Author and Speaker: Laura Zagacki

Contributing Authors: Lisa A. Chiarello

This case series describes occupational therapy (OT) in two families with young children with a physical disability socially participating with their sibling during play. A comparison of case factors shaping siblings’ social participation notes an innovative OT process. Purposive sampling recruited families with a child with a physical disability, between 2 and 12 years old, and a child who is typically developing, between 4 and 8 years old. All participants engaged in the OT process. The parent rated the WeeFIM II and demographic questionnaire. The Sibling Participation in Occupational Therapy (SPOT), an adaptation of Palisano and colleagues (2022) collaborative participation process, guided an assessment of child, sibling, family, and environmental attributes. The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) were rated pre, 6 weeks, and post OT. The participants rated an experience questionnaire. Case descriptions, SPOT details, data from interventions and questionnaires were analyzed and compared. Case 1, a 3-year-old girl with spina bifida, her 4-year-old brother, and mother received 8 sessions. Case 2, an 8-year-old boy with cerebral palsy, his 6-year-old sister, and mother received 6 sessions. For both families, the increase was > 2 in COPM ratings and GAS at least met expected performance. The interventions, encouragement and collaboration to apply abilities, were used most often. Interventions for performance skills differed across cases. Case differences related to children’s ages, interests, and functional abilities. The outcomes supported using SPOT in families who have a child with a physical disability to guide an individualized assessment of the child, sibling, family, and environment and action plan for an occupational outcome. SPOT is significant to pediatric OT as a participation-based approach inclusive of siblings that is consistent with family-centered practice and addressing social participation and play.


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Palisano, R. J., Chiarello, L. A., Vänskä, N., & Sipari, S. (2022). Content validity and utility of the collaborative process for action plans to achieve children’s participation goals. Disabilities, 2(4): 626-640.

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