The facilitators and barriers encountered by South African parents regarding sensory integration occupational therapy

Abstract

Differences in parent perceptions regarding occupational therapy using a sensory integration approach to treatment have been noted. The various factors that may influence these perceptions, and how the perceptions may ultimately influence the outcome of the intervention for the child and family were questioned. A phenomenological study revealed a progression that all parents perceived and experienced as the "before", "input" and "after" phases of when their child received occupational therapy/sensory integration (OT/SI). This article focuses specifically on the "input" phase of OT/SI intervention. Method: Participants in this study were nine parents of children with difficulties processing and integrating sensory information, who live in the Western Cape, South Africa. Using a qualitative, phenomenological approach, data were collected during face-to-face interviews, participant observation and researcher's field notes. Findings: The main theme related to this phase of analysis was "Just suddenly everything made so much sense". For most participants, this phase brought to light a better understanding of sensory integration disorder (SID), also known as Sensory Processing Disorder (SPD) and OT/SI. Data analysis identified two subthemes that catalysed expansion in most participants' understanding, which were the role of the occupational therapist, and the OT/SI intervention process. Within these subthemes, the facilitating factors and barriers of OT/ SI intervention emerged. Conclusion: Insight gained from the participants' recommendations and interpretation of findings allowed recommendations to be made within the OT/SI intervention received, in an attempt to overcome the barriers and promote the facilitators that will make a difference to OT/SI in South Africa. the delivery of OT/SI intervention meets the needs of parents and their children in South Africa.

Exploring Therapeutic Relationships in Pediatric Occupational Therapy: A Meta-Ethnography

“…Also, the relationship has strong emotional value. They believe that a climate of trust acts to foster the therapeutic alliance, meaning that trust strengthens engagement and collaboration with the occupational therapist ( Smit et al, 2018 ). When caregivers feel they can trust their therapist, they become more comfortable expressing themselves about therapy and are empowered to change its course ( King et al, 2021 ).…”

“…Experiences based on trust are closely linked with empowerment. A climate of trust and emotional safety allows caregivers to take control and act in the relationship ( Smit et al, 2018 ). Trust is built through consistency and communication ( Keiter Humbert et al, 2020 ).…”

“…The clarity of the communication was also identified as an important factor in the caregivers’ experience ( Kruijsen-Terpstra et al, 2016 ). The use of jargon during discussions or misunderstandings led to negative emotions such as frustration, anxiety, distress, and feelings of incompetence ( Andrews et al, 2013 ; O’Connor et al, 2021 ; Smit et al, 2018 ).…”

“…The theme explored how the therapeutic relationship itself can have more impact than the “activity” of therapy. Interactions with occupational therapists improved empowerment ( Fingerhut et al, 2013 ) and understanding of the family ( Kolehmainen et al, 2010 ; Smit et al, 2018 ). Supportive therapeutic relationships were seen as a key factor in accelerating occupational performance outcomes for the child ( Smit et al, 2018 ) and driving meaningful change ( King et al, 2021 ).…”

“…Interactions with occupational therapists improved empowerment ( Fingerhut et al, 2013 ) and understanding of the family ( Kolehmainen et al, 2010 ; Smit et al, 2018 ). Supportive therapeutic relationships were seen as a key factor in accelerating occupational performance outcomes for the child ( Smit et al, 2018 ) and driving meaningful change ( King et al, 2021 ). Indeed, the relationship fosters collaboration and engagement in therapy.…”