Importance: Demand is increasing for activity- and occupation-based interventions to address occupational performance and support maximal participation of children and youth. Objective: This Practice Guideline was developed to guide decision making and support best practices in service delivery for children and youth ages 5–21 yr at home, at school, and in the community. Method: The results from three systematic reviews (SRs) of activity- and occupation-based interventions for children and youth ages 5–21 yr were reviewed, synthesized, and translated into recommendations for education, practice, and research. Results: One hundred eighty-five articles were included in the three SRs examining the evidence for interventions to promote activities of daily living, instrumental activities of daily living, play and leisure, and rest and sleep; to improve mental health, positive behavior, and social participation; and to enhance learning, academic achievement, and successful participation in school. The reviews provide evidence for interventions associated with typical concerns addressed by occupational therapy practitioners. Conclusions and Recommendations: On the basis of the evidence, this guideline recommends that occupational therapy practitioners consistently collaborate with families and caregivers and provide services in the natural context of the desired occupation. The evidence also supports group service models and models that include peer mediation; these models can promote participation across areas of occupation. Skills-based training and therapeutic practice in the context of valued occupations are recommended over isolated sensorimotor approaches. Technology, manualized programs, and sports activities can be effective but should be evaluated and matched to age, diagnosis, and outcomes as guided by the evidence. What This Article Adds: When guided by evidence, activity- and occupation-based interventions are effective in promoting participation and enhancing performance in valued occupations of children and youth ages 5–21 yr.

Importance: Children and youth are often challenged to maintain well-being, positive behavior, and social participation. Objective: To identify evidence for occupational therapy interventions for children and youth with and at risk for mental health concerns. Data Sources: Articles published in English-language peer-reviewed journals between January 2010 and March 2017 identified through searches of MEDLINE, PsycINFO, CINAHL, ERIC, OTseeker, and Cochrane databases. Study Selection and Data Collection : The methodology in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to complete the review. Of 5,310 articles screened by title and abstract, 357 were retrieved for full-text review, and 62 met inclusion criteria. Articles describing interventions that were activity or occupation based were included. Conference proceedings, non–peer reviewed publications, dissertations, theses, and presentations were excluded. Findings: Of the 62 studies included in the review, 20 (32%) were Level I studies, 22 (36%) were Level II studies, and 20 (32%) were Level III studies. Articles were categorized by type: outdoor camps, video and computer games, productive occupations and life skills, meditation, animal-assisted interventions, creative arts, play, sports, and yoga. Moderate to strong evidence supports the use of yoga and sports. Moderate-strength evidence supports the use of play and creative arts. Evidence for the use of animal-assisted interventions, meditation, video and computer games, and productive occupations was of low strength. Conclusion and Relevance: Substantial evidence exists to support the use of activity- and occupation-based interventions to address the mental health, behavioral, and social participation concerns of children and youth. Occupational therapy practitioners should match the desired outcome of therapy with the appropriate intervention to provide the best and most effective services to their clients. What This Article Adds: This review provides additional support for the use of activity- and occupation-based interventions (i.e., those that involve active participation) to improve the behavior, social participation, and mental health of children and youth.

As children and youth with diabetes grow up, they become increasingly responsible for controlling and monitoring their condition. We conducted a scoping review to explore the research literature on self-management interventions for children and youth with diabetes. Eleven studies met the inclusion criteria. Some of the studies reviewed combined the participant population so that children with Type 1 as well as children with Type 2 diabetes were included. The majority of the studies focused on children age 14 yr or older and provided self-management education, self-management support, or both. Parent involvement was a key component of the majority of the interventions, and the use of technology was evident in 3 studies. The findings highlight factors that occupational therapy practitioners should consider when working with pediatric diabetes teams to select self-management interventions.

OBJECTIVE. Pediatric occupational therapy practitioners interview parents on a daily basis to gain important patient information and develop collaborative intervention goals. A standardized parent experience was developed to help master’s-level occupational therapy students gain the skills needed to interview parents after their child’s traumatic injury. This article describes the pedagogical approach used to develop the standardized parent experience and reports the students’ general perspectives related to this assignment. METHOD. Outcome data were collected through focus groups (n = 9) and document review (n = 12) and then analyzed for themes. RESULTS. Two main themes emerged from the data: It felt real and It helped me to think deeper. CONCLUSION. A standardized parent experience may help occupational therapy students develop the habits of mind associated with collaboration.

Date Presented 4/17/2015 This study describes perceived levels of involvement in school-based, response to intervention (RtI) initiatives as reported by occupational therapy practitioners from different types of communities. In addition, it identifies differences among practice patterns of rural practitioners compared with those from different communities.

Date Presented 4/17/2015 The purpose of this study was to investigate the effectiveness of a 17-mo, evidence-based practice (EBP) professional development initiative that was developed through collaboration between key stakeholders from a special education cooperative in northern Illinois and university faculty from a nearby occupational therapy program.

OBJECTIVE. To investigate the effects of a 17-mo initiative designed to increase practitioners’ knowledge and skills related to evidence-based practice (EBP) in the schools. METHOD. We evaluated participants’ EBP knowledge and skills at pretest and posttest using the Adapted Fresno Test (AFT) and collected their perceptions through a survey. RESULTS. Participants demonstrated significant improvements in their EBP knowledge and skills after participating in this initiative as measured by changes in AFT scores. A significant difference was noted in scores between pretest (μ = 43.9, SD = 32.67) and posttest (μ = 74.66, SD = 33.99), t(28) = −5.645, p < .001. CONCLUSION. This initiative was influential in increasing school-based practitioners’ EBP knowledge and skills.

OBJECTIVE. We sought to describe occupational therapy practitioners’ perceived levels of preparedness for and involvement in school-based Response to Intervention (RtI) initiatives. METHOD. We mailed a survey to a random sample of 1,000 practitioners from the American Occupational Therapy Association’s Early Intervention and School Systems Special Interest Section. RESULTS. Of 295 returned surveys (29.9% response rate), 19 were excluded because of missing or incomplete data. Three-quarters of respondents (77.6%) reported that their districts implemented RtI. Two-thirds of respondents (66.3%) indicated that lack of resources limited their involvement in RtI; two-thirds (67%) said that district guidelines that describe expectations for practitioners’ involvement would help increase their participation. Many respondents cited the need for continuing education and supported moving from a caseload to a workload model. CONCLUSION. Occupational therapy practitioners would benefit from specific district guidelines outlining the services they are able to provide within the context of RtI.