Application of the occupational adaptation framework in child and adolescent occupational therapy practice. A case study

Abstract

Background: The occupational adaptation frame of reference asserts that a person's occupational functioning may be improved through positive changes in his/her adaptive processes. This framework's authors advocate that occupational adaptation theory can be applied to practice with clients of all ages (Schultz & Schkade, 1992). Published literature to date has been focused on the application of this framework with adults and adolescents. Method: This paper reviews the major theoretical constructs and guide to practice of occupational adaptation theory whilst interweaving descriptions of its application to a paediatric case study conducted within a child and adolescent mental health unit. Conclusion: While it was shown through the case study that the occupational adaptation frame of reference can guide occupational therapy practice with a child nearing adolescence critical reflections about the experience suggest some challenges for the practitioner and students.

Achieving Best Practice: A Review of Evidence Linked to Occupation-Focused Practice Models

“…Among them, six publications report studies that document the effectiveness of OA-based interventions with clients following a cerebral vascular accident (CVA) (Dolecheck & Schkade, 1999;Gibson & Schkade, 1997;Johnson & Schkade, 2001), following a hip fracture (Buddenberg & Schkade, 1998;Jackson & Schkade, 2001), elderly clients with a variety of chronic illnesses (Spencer, Hersch, Eschenfelder, Fournet, & Murray-Gerzik, 1999), and adolescents with limb deficiencies (Pasek & Schkade, 1996). There are also a number of case examples that demonstrate the application of the OA model with different populations including children and adolescents with mental health problems (Bouteloup & Beltran, 2007), homeless persons (Johnson, 2006), persons with carpal tunnel syndrome (Martin, 2007), older workers (Moyers & Coleman, 1992), community-dwelling elders (Miller et al, 2002), forensic psychiatry (Stelter & Whisner, 2007), home health (Ford, 1995;Schultz & Schkade, 1994), and level II fieldwork students (Coates & Crist, 2004;Garrett & Schkade, 1995;Schkade, 1999). In addition, the OA-related texts and chapters also illustrate OA application with a variety of contexts including school-based settings, fieldwork education, and psychosocial rehabilitation (Ikiugu, 2007;Schkade & McClung, 2001;Schkade & Schultz, 1993, 2003a, 2003bSchultz, 2000Schultz, , 2009Werner, 2007).…”

Occupational adaptation – analyzing the maturity and understanding of the concept through concept analysis

“…Additionally, some authors ascribed the term to a simpler phenomenon of adapting occupations such as reducing the number of steps in the occupation or using modified equipment [32,[47][48][49][50][51]. Case studies were provided in several papers to facilitate understanding of the concept [52][53][54][55][56]. However, in some instances, authors failed to explicitly explain the process or delineate it from other phenomena in their work [36,[57][58][59][60][61][62], potentially compounding confusion around the concept.…”

Feasibility testing of the Occupational Adaptation Practice Guide

“…There is evidence suggesting the efficacy of OA with various populations, including persons with stroke, hip and hand orthopedics and psychosocial conditions (Bouteloup and Beltran, 2007; Buddenberg and Schkade, 1998; Jack and Estes, 2010; Johnson, 2006; Johnson and Schkade, 2001; Moyers and Coleman, 2004; Stelter and Whisner, 2007). Intervention based upon OA has demonstrated positive gains in mobility in persons with chronic stroke (Johnson and Schkade, 2001).…”