Cultural Influences and Occupation‐Centred Practice with Children and Families

Development and evaluation of an occupational therapy program for refugee high school students

“…Over the three cycles, the program implementation shifted from using occupation as ends (working directly on tasks required in the student role) to occupation as means (occupational tasks were used to develop skills and capacities), as this was more appropriate to the cultural context of the students and schools. Nelson and Iwama (2010) emphasised the importance of understanding the cultural context of young people when providing services.…”

Considerations for occupational therapy assessment for Indigenous children in Australia

“…For example, could changes in the departmental policy be implemented so that the need for therapy services can be based on details provided by the child’s teacher? Developing effective relationships with children is the cornerstone of occupation‐centred practice (Nelson & Iwama, 2010). When therapists are given time to form relationships with the child and unobtrusively observe the child’s participation in occupations within the naturalistic environment, the therapist can better generate an overview on whether occupational therapy is essential for the client, and later estimate the funding needed.…”

“…By considering the purpose and context of the assessment, an occupational therapist can decide whether there is a need for the use of an assessment tool (A. Nelson, personal communication, 4 August 2009). One approach may be to use a culturally relevant model such as the Kawa Model (Iwama, 2006) to guide the interview process of understanding the child and his/her occupations (Nelson & Iwama, 2010).…”

“…Once the therapist has decided on the need to use an assessment tool, he/she can consider the choice of assessment. It is important to understand that even though some standardised assessments claim to be culturally relevant for any population, these tools may be embedded in Western ways of knowing about the world and occupation (Nelson & Iwama, 2010). This paper presents examples of assessments that may potentially be useful because they focus on the individual’s performance of occupation rather than comparing the child to the ‘norm’.…”

“…For example, an Indigenous child living in an urban society and attending formal school may need to be assessed differently from one who is living in a rural area. Finally, there is a danger that within the Western way of understanding statistics, epidemiological data and causal relationships, occupational therapists may subconsciously assume that Indigenous children are ‘lacking’ in different facets of life (Nelson & Iwama, 2010). Therefore, a conscious effort should be made to also assess for the strengths of each Indigenous child, such as creativity and resilience.…”