Occupational therapy has a strong history of embracing concepts of client empowerment. However there is limited literature in the field on how to achieve empowerment, or on how to extend empowerment to the level of the community and social groups and services within it. This article discusses how concepts and strategies of participatory action research, an extension of empowerment theory, can be used to inform service development and evaluation in occupational therapy. The participatory action research approach is illustrated using two case examples of participatory action research programs for persons with chronic fatigue syndrome and individuals with autoimmune deficiency syndrome (AIDS). A critical analysis of the application of this approach to research and practice is provided. Finally, the paper identifies key principles of participatory action research that can be used to guide occupational therapy services and empower both individuals and communities.

Objective. Although occupationally embedded exercise is becoming a recognized topic in occupational therapy research, study of this phenomenon in children has been limited. The present study examined whether play elicits therapeutic patterns of movement through the use of two ABA single-case experiments. It was predicted that in two children with hypotonic cerebral palsy, the addition of a favorite game to the occupational form, or treatment environment, would increase functional vertical neck and back extension. Method. Each subject was positioned in prone on a wedge. During the A phases, each was given verbal directions to hold her head up. During the B phase, a favorite game was introduced. It was predicted that each subject would extend her back and neck in a functional way in order to manipulate and observe the game. The dependent variables were the mean range of neck extension and the mean range of back extension, which were measured by a videotaped, two-dimensional kinematic analysis. Results. The addition of a favorite game to the occupational form improved vertical neck and back extension while discouraging nonfunctional neck hyperextension and fixing postures in both children. Conclusion. Embedding exercise within a play occupation enhanced the prone extension of two children with hypotonic cerebral palsy.

The prone extension postural test is a measurement of vestibular functioning that has been used by occupational therapists in assessing children suspected of having vestibular system deficits. The purpose of this study was to standardize the prone extension postural test because no standardized procedures or normative data were previously available for its administration. Reliability and validity were estimated and normative data gathered on 242 normal children ranging in age from 4 through 8 years. Performance involving duration and score on a qualitative scale was recorded. Four and 5 year olds performed similarly and statistically, and significantly differently from 6, 7, and 8 year olds. When a small group of learning-disabled children was compared to a nondisabled group, the prone extension postural test differentiated between the two groups with the exception of the 4 year olds.