Building capacity for social competence helped create better alignment between the roles of occupational therapist and teacher within the school context and was perceived to contribute to refugee students' overall availability for learning in their new environments. Action research is useful in collaboratively developing programs in emerging areas of practice.
Children with disabilities pose unique challenges for occupational therapists when the value of therapy programmes and the child's individual progress are being evaluated. Children whose development is atypical may make progress through a course of intervention and/or maturation, yet standardised tests frequently used by occupational therapists are often not sensitive enough to detect these changes. In this current climate of economic rationalism and accountability, providing documentary evidence of occupational therapy programme benefits is essential. This paper addresses the utility of goal attainment scaling for objectively and systematically documenting the outcomes of occupational therapy intervention. Goal attainment scaling provides a direct, reliable and accurate method of assessing treatment-induced client change. The process of goal attainment scaling is described and the literature on goal attainment scaling in paediatrics is reviewed. It is concluded that goal attainment scaling is a useful clinical process and measure of therapy programme outcomes for children with disabilities.
Introduction: Appropriate evaluation of health services for First Australians demands culturally responsive goal setting tools that can be used by inter-professional teams. The Australian Therapy Outcome Measure for Indigenous Clients (ATOMIC) is a purpose-designed tool for measuring therapy outcomes for First Australians. The aim of this study was to establish the clinical utility of the ATOMIC by investigating its alignment with the practice perspectives of an inter-professional First Australian health service. Methods: Using action research cycles, 12 occupational therapists and 8 speech pathologists applied two successive versions of the ATOMIC in practice. Focus group feedback after use of the first version (ATOMICv1) prompted adaptations to the tool (ATOMICv2). Therapists participated in four focus groups, two after using ATOMICv1 and two after using ATOMICv2. Focus group transcripts were analysed inductively using a qualitative description approach. Results: Challenges in setting SMART goals early in therapy and defining specific measurement increments in ATOMICv1 led to therapists favouring skill-based goals that were easier to measure rather than broader daily life goals, thereby impacting on occupation-and client-centred practice. ATOMICv2 allowed goal setting at any point in therapy, evaluated goals using visual analogue scales, and gathered evidence for rating goal achievement throughout the therapy process. Therapists found the ATOMICv2 to be a culturally responsive tool that aligned with practice perspectives by foregrounding relationship building, facilitating clinical reasoning, documenting daily life changes, and providing integrated inter-professional care.
Conclusion:The ATOMIC demonstrated good clinical utility in an inter-professional service for First Australian children. It aligned with a culturally responsive practice perspective and captured goal achievement in daily life contexts. Further research is needed to gain client perspectives across the lifespan and to investigate its application by other health professions.
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