Evidence reviewed as of before 01-01-2021 Author(s): Ogourtsova, T. (PhD OT); Steven, E. (MSc App OT); Iliopoulos, G. (MSc App OT); & Majnemer, A. (PhD, OT, FCAHS)

Introduction

Occupational performance is the ability of a person to be actively engaged in their life activities. These can be  basic tasks of self care or more complex activities, such as work or leisure. A disorder or disease can cause impairments to a person’s body structure or function (including psychological functions) and it can prevent them from executing certain activities independently and/or participating in life situations.

Occupational performance therapy involves therapists taking one of two approaches when treating occupational performance issues in children: 1) Context-focused interventions (which address environmental factors) or 2) child-focused interventions (which address personal factors).

World Health Organization. (2007). ICF-CY, International Classification of Functioning, Disability, and Health: Children & Youth version. Geneva: World Health Organization.

The child-focused intervention approach focuses on body functions and structures as its starting point. Some examples of treatment for children with cerebral palsy (CP) would be applying methods to improve movement patterns, postural control and balance through different therapeutic approaches (e.g NDT). These strategies can be used in isolation or practiced during functional activities.

The context-focused intervention approach focuses on task constraints or environmental limitations (physical and social). Here, the therapist will look at how to adapt a task or eliminate barriers in the environment that could improve the child’s independence.

Both the child-focused and the context-focused approaches aim to improve activity and participation of the child but they differ in how they attempt to reach goals.

Resources

Parent & Family Information

Clinician Information

Children with CP (unilateral/bilateral spastic, dyskinetic, ataxic, mixed)

GMFCS level I-IV

References

  • Kruijsen-Terpstra, A., Ketelaar, M., Verschuren, O., Gorter, J. W., Vos, R. C., Verheijden, J., Jongmans, M. J., & Visser-Meily, A. (2016). Efficacy of three therapy approaches in preschool children with cerebral palsy: a randomized controlled trial. Developmental medicine and child neurology58(7), 758–766. https://doi.org/10.1111/dmcn.12966

  • Law, M. C., Darrah, J., Pollock, N., Wilson, B., Russell, D. J., Walter, S. D., Rosenbaum, P., & Galuppi, B. (2011). Focus on function: a cluster, randomized controlled trial comparing child- versus context-focused intervention for young children with cerebral palsy. Developmental medicine and child neurology53(7), 621–629. https://doi.org/10.1111/j.1469-8749.2011.03962.x

Definitions

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