51

Occupational Therapy Interventions for Adolescents: A

Scoping Review

Clarkson, C1; Boshoff, K1 & Kernot, J1*.

DOI 10.21913/TAHS.v2i1.1575

Abstract

Aim and Background: Occupations are everyday activities that help occupy our time and

provide us with a sense of purpose in life. Adolescence is a unique stage of life when individuals

experience occupational change that assists with preparation for adulthood. Participation in

occupations is linked to health and wellbeing. Existing literature on occupational participation

appears to combine adolescents’ and children’s experiences. Due to the unique nature of

adolescence and an increased focus on service development and re-design for all age groups in

Australia since the implementation of the National Disability Insurance Scheme, this scoping

review sought to explore Occupational Therapy interventions that promote adolescents’

participation in everyday occupations. Design and Methods: A systematic search of eight

databases for peer reviewed papers published between 2008 and 2018 was conducted. The

PRISMA guidelines were used to guide the review processes. Study selection criteria focussed

1
International Centre for Allied Health Evidence, University of South Australia, Adelaide,
Australia
* Correspondence: [email protected]; Tel.: +61-08-83021089
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on Occupational Therapy interventions promoting participation in everyday occupations for

adolescents (between 10 to 19 years of age). The data was charted and synthesised to identify

key features of the interventions. Results: The 26 included studies revealed various intervention

types and adolescent groups. The majority of the interventions targeted adolescents with physical

disabilities and autism spectrum disorder. Many studies focussed on promoting functional

independence in work, personal care, social participation and health management. Features of

interventions include collaborative (with the adolescent and family) intervention goal setting and

evaluation processes, as well as the use of technology. The majority of the papers reported

positive outcomes, however mixed results were also identified. The findings provide guidance

for adolescent service development and re-design by identifying the areas of occupation and

features of programs, documented in Occupational Therapy-specific literature. Future reviews

can extend our understanding further by incorporating by including publications that focus on

assessment and other roles of Occupational Therapists.

Keywords: participation, occupation, Occupational Therapy, adolescents

Introduction

Occupational Therapists work with individuals to promote health and wellbeing through

enabling participation in daily occupations including leisure, self-care, work and education

(Occupational Therapy Australia, 2019). Engagement in meaningful occupations is linked to

health and wellbeing (Christiansen & Townsend, 2014). This is highlighted in The World Health

Organization’s (WHO, 2001) International Classification of Functioning, Disability and Health

Model (ICF) which recognises participation and activity as essential components of health and
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function. The WHO (2001) defines participation as involvement in life situations, which can

affect various domains of function including: communication, self-care and community

involvement.

The WHO (2015) identifies that adolescence occurs between the ages of 10 – 19 years,

but also acknowledge that age is only one factor that delineates this developmental stage, with

social transition also having an important role (this can vary depending on a persons’ social-

cultural background). Adolescence is regarded as a unique stage of human development, when

individuals experience physical, social and emotional changes that aide the transition from

childhood to adulthood (Mui Lim & Jones, 2017). It is also a time when individuals undergo

significant occupation-related development contributing to their changing identity (Mui Lim &

Jones, 2017; Maxey & Bekert, 2017). These occupational changes assist adolescents to develop

the skills to support successful transition into adulthood, including the skills to maintain positive

relationships, gain employment and live independently (Mui Lim & Jones, 2017). Adjustment to

such changes can be challenging for all adolescents, particularly for those with disabilities

(Maxey & Bekert, 2017). Hence it is important that support is provided to facilitate adolescents’

participation in meaningful and developmentally appropriate tasks, where required (e.g. sexual

and reproductive health promotion, pre-vocational training and learning to cook and clean).

When reviewing the Occupational Therapy literature, there appears to be a plethora of

publications that group adolescents with children (e.g. Arbesman et al., 2013; Cahill et al., 2016;

Kreider et al., 2014). To the best of our knowledge, there have been no reviews that address

Occupational Therapy interventions that promote participation specifically for adolescents. In

Australia, funding such as the National Disability Insurance Scheme (NDIS) has led to the

stimulation of service development and re-design for all ages, including those for adolescents.
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Due to renewed focus, as well as the unique, complex nature of adolescence and the importance

of participation in occupations, this scoping review sought to fill this gap by exploring

Occupational Therapy interventions that promote adolescents’ participation in everyday

occupations. By gaining an overview of interventions for adolescents, considerations may be

gained for service development and design. This research was undertaken as part of an Honours

degree.

Methods

A scoping review was used to facilitate the aim of this study: to provide an overview of the

literature, through systematic summarising and mapping, in accordance with Peters et al. (2015).

This review adhered to the following steps (1) defining the review aim and question, (2)

developing suitable inclusion criteria, (3) describing the planned approach (study search,

selection, extraction and charting), (4) searching the literature, (5) selecting the evidence, (6)

extracting the evidence, (7) charting the evidence, (8) summarising the evidence, (9) consulting

experts throughout the process i.e. librarians (Peters et al., 2015). The review was conducted and

reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis

(PRISMA) extension for Scoping Reviews (Tricco et al., 2018). The design was chosen to

answer the following broad research question: What Occupational Therapy interventions have

been reported to promote participation in everyday occupations for adolescents?

Due to the broad nature of scoping reviews, it is important to define the scope of the inquiry

(Peters et al., 2015). This review’s scope included defining the study population (adolescents),

the concept (interventions to promote participation in everyday occupations) and the context (not

specified). The population (P) was specified by age (between 10 to 19 years of age), as defined

by the WHO (2015), to assist with setting some clear operational parameters for study inclusion
 55

and with replication. This review was also inclusive of adolescents with and/or without any kind

of condition or disability to help broadly map the areas of therapy evident in literature. The

concept (C) included studies that described or evaluated Occupational Therapy interventions that

aimed to promote participation in everyday occupations (e.g. leisure, Activities of Daily Living

(ADLs) and Instrumental Activities of Daily Living (IADLs)). This was decided due to the

influence that occupational participation can have on health and wellbeing. It also aligns with the

WHO’s (2001) definition of participation, suggesting that participation relates to involvement in

life situations which can affect various domains of function. For the purpose of this study, we

employed a multifaceted definition of participation, focussing on interventions that explicitly

stated the promotion of occupational participation, engagement and/or performance.

Interventions that focussed on specific skills, body functions or environmental factors were

included if their assessments or outcomes were linked to promoting participation. This was

decided as the WHO (2001) highlights the important dynamic interaction between participation,

environmental factors, body structures, body function, personal factors and activities.

Multidisciplinary interventions were also included in the study if the Occupational Therapy role

and findings were clearly described.

The context (C) for this review included studies published in the last decade (between 2008

and 2018) to capture current literature. This review included studies conducted in any

geographical location, culture or setting if published in English language.

Prior to conducting the review, set inclusion and exclusion criteria were developed to assist

in selecting relevant studies. These are listed below.

Inclusion criteria:

 Describe an adolescent intervention population (between 10 to 19 years of age).

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 Describe or evaluate Occupational Therapy interventions aimed at promoting

participation in everyday occupations.

 Multidisciplinary interventions that include Occupational Therapy input in which

Occupational Therapy contributions can be isolated.

 Studies must be peer reviewed.

 Articles must be published between 2008 and 2018.

Exclusion criteria:

 Studies that do not describe a specific adolescent intervention population (between 10 to

19 years of age).

 Studies without an intervention focus aimed at promoting participation in everyday

occupations.

 Studies focussing on other aspects of the Occupational Therapy role (i.e. assessments,

models and approach articles were excluded).

 Studies not specific to Occupational Therapy or multidisciplinary studies where the

Occupational Therapy contribution cannot be isolated.

 Conference papers, abstracts, commentaries and grey literature.

 Studies published before 2008.

 Studies not published in English language.

Information sources and search strategy

A search strategy was developed with the assistance of an academic university librarian.

Keyword and MeSH terms were created to capture pertinent articles which were consistent with

the thesaurus of each data base. See Table 1 for an outline of the key search terms used. The

following electronic databases were searched: Cochrane, Embase, MEDLINE, OTSeeker, Ovid
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Emcare, PsycINFO, Scopus and Web of Science. The search was run on the 3rd of February

2019. There was no search limit set for the language of the studies, though articles were removed

at full text screening if they were not in English due to time and resource constraints required to

translate them. Grey literature was not searched as peer reviewed papers were considered more

credible in answering the review question. The reference lists of yielded articles were pearled to

locate further relevant studies that may have not been captured from the database searches. All

pearled articles underwent the same study selection processes (described below) as the articles

obtained from the database searches.

Table 1 Key search terms

Population: Concept One: Concept Two:

Adolescen* OT intervention* Activities of daily living
Teen* Occupational therap* Activities of daily life
Youth OT Everyday occupations
Child Everyday activities
Daily roles
Education
Life skills
Work
Employment
Sleep
Leisure
Out of school activities
School
Play
Sport
Social activities
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Study selection

All articles were imported into Covidence© Online Program where duplicates of studies

were removed and the screening process occurred (Covidence, 2016). Two independent

reviewers (either CC, KB or JK) screened the titles, abstracts and full texts to determine if each

article met the appropriate inclusion and exclusion criteria to be included/excluded (Tricco et al.,

2018). Any conflicts or uncertainty that occurred were resolved by a third reviewer or by

discussions to reach full consensus.

Data charting, integration and synthesis

A charting table was created to capture and chart key information from articles (Peters et al.,

2015). The information extracted from the studies included: authors, type of study, year of

publication, country of origin, aim/purpose, participants, area of practice, intervention type, types

of occupations focussed on, intervention setting, outcomes measures and findings. The primary

researcher (CC) extracted the data from the articles and input the data into the charting form. A

second reviewer (KB or JK) then confirmed the data before moving to the next stage. Conflicts

were resolved by discussions between the review team members, which led to full agreement on

the content of the data extraction. The reviewers then identified key features across the literature,

which included the types of interventions used, the occupations focussed on, the client group, the

outcome measures used and the outcomes of the interventions. Two independent reviewers (CC,

KB or JK) categorised and agreed on each type of occupation according to the American

Occupational Therapy Association (AOTA) framework (AOTA, 2014). The quality of the

studies were not appraised as the scoping review aimed to provide a broad overview of the

literature regardless of the evidence quality (Peters et al., 2015).

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Results

Search results

The results from the database and pearling search yielded 3182 articles after duplicates were

removed. The title and abstracts of the 3182 articles were screened for inclusion, this process led

to the exclusion of 2946 articles predominantly due to the study population groups, the article

type and the articles not being intervention focussed. The full text of the remaining 236 articles

were reviewed to ensure that they met the inclusion criteria. Following full text review, 210

articles were excluded as they were either conference abstracts (n=84), or had non-adolescent

populations (n=42), or did not have a clear Occupational Therapy intervention focus (n=35) or

were written in a language other than English (n=24). From the full text screening, 26 articles

were included in the review and underwent data extraction. See Figure 1 for the selection

process, based on the PRISMA – Individual Participant Data Flow Diagram (Moher et al., 2009).
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(n = 210)

Conference abstract (84)

Non adolescent population (42)
Not Occupational Therapy
intervention focus (35)
(n == 26) Non-English (24)
(n 26)
Book or other document (12)
Not participation focus (5)
Commentary/Opinion (4)
Protocol or theoretical model (3)
Theses (1)

(n = 26)

Figure 1: PRISMA 2009 flow diagram (adapted from Moher et al. 2009, p.8)

Descriptive overview of studies included

As outlined in Table 2 (attached as Appendix 1), a majority of the studies were published

between 2014 and 2017 (n=20). The studies were conducted across various countries including

the United States (n=9), Canada (n=5), Australia (n=4), Asia (n=2), New Zealand (n=2), Brazil

(n=1), Netherlands (n=1), Pakistan (n=1) and Ireland (n=1). Five studies were conducted in

multiple settings (e.g. in client’s homes and at school). Overall, the most commonly reported

setting was school (n=14) and was followed by clinic (n=7) and the home (n=6). Four studies

reported a community setting and two reported being conducted in juvenile correction facilities.

A majority of the retrieved studies related to physical disabilities (n=7), followed by autism
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spectrum disorder (n=6). Other conditions included: attention deficit hyperactivity disorder

(n=1), diabetes (n=1), acquired brain injury (n=1), obsessive compulsive disorder (n=1). One

study included various client groups with social, emotional, behavioural and learning difficulties

(n=1). Another included clients with intellectual and/or developmental disabilities (n=1). Seven

studies focussed on health promotion including play and life skill development for incarcerated

adolescents (n=2), emotional wellbeing for students presenting with subclinical symptoms of

mental illness (n=2), school integration for refugees (n=1), physical activity for school students,

(n=1) as well as sexual and reproductive health (n=1). A greater portion of studies reported

interventions that were provided in individual, one on one, settings (n=14) whilst another eleven

studies described a group setting. One paper reported a combination of group and individual

settings.

Various research designs were reported (see Table 2 for a more detailed description)

including mixed methods (n=10), quantitative (n=9), and qualitative (n=6), with one paper being

descriptive in nature (i.e. described the intervention but did not include a formal research

component). The sample size of studies ranged from 1 to 295 with a majority of studies (n=12)

including less than 10 participants and only four studies with over 50 participants. There were

two randomised controlled trials, with pre-post designs (n=11) and multiple baseline designs

(n=2) also featuring.

Key features of the studies

The findings of the study are presented in regard to the different features of the

interventions. Firstly, an overall description of the types of interventions is given, followed by

the occupation types, methods used and the intervention outcomes.

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Types of interventions

While all studies focused on participation, a diverse range of interventions were described,

with environmental modification, transition planning (for adulthood), social participation, upper

limb therapy, behaviour management and mental health promotion featuring. Examples are

provided of how these interventions were linked to participation in occupation.

The most commonly reported type of intervention focussed on environmental modifications

(n=6). However, three of these studies reported the same intervention program, named the

Pathways and Resources for Engagement and Participation (PREP). The PREP intervention

program aims to improve participation in community leisure occupations for clients with

physical disabilities (Anaby et al., 2018; Anaby et al., 2015; Anaby et al., 2017). The PREP

intervention involves working with clients and families to identify and remove environmental

barriers, build upon supports that promote participation and to help families and clients develop

their skill sets to problem solve barriers to participation (Anaby et al., 2018; Anaby et al., 2015;

Anaby et al., 2017).

All six environment focussed papers included a capacity building element, aiming to teach

clients the skills to recognise and remove environmental barriers themselves. Activity

modification was also reported in 50 per cent (n=3) of these environmental based interventions.

For example, the Project Teens Making Environmental and Activity Modifications intervention

involves assessing and modifying activity demands (i.e. the number of rules involved in a game)

to promote participation (Kramer et al., 2014).

Transition planning interventions were also commonly described (n=4), which promote life

skill development to assist in the successful transition from adolescence to adulthood. These

papers focussed on assisting clients in developing pre-vocational skills. Two transition studies
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targeted clients with autism spectrum disorder and focussed on assisting clients in preparing to

leave school (Hatfield et al., 2017; Tomchek et al., 2017). Tomchek et al. (2017) described a goal

and treatment plan that assisted a client in preparing a meal independently. A further two

transition papers utilised play and other activities of client’s interest to promote community

integration for at risk adolescents (Shea & Jackson, 2015; Shea & Siu, 2016).

Social participation was targeted in four papers which all described using social skill

training, with three of these focussing on supporting clients with autism spectrum disorder to

maintain friendships and effectively communicate with others (Cheung et al., 2018; Gutman et

al., 2010; Rodger et al., 2008). One paper reported a refugee client group with a focus on

building social capacity to support school integration (Copley et al., 2011).

Upper limb therapy was reported in two papers. One paper targeted clients with cerebral

palsy and the other focussed on a single client with an acquired brain injury. Although both

papers focussed on improving performance at a body function level, they described outcomes

and assessments that indicated implications for participation in daily tasks (i.e. hand hygiene and

use of communication aids) (Janssen et al., 2012; Wesdock et al., 2008). Wesdock et al. (2008)

reported on hand therapy interventions involving neuromuscular electrical stimulation, muscle

stretching, scar management, taping, splinting and functional exercises (i.e. folding towels,

pinching with tongs, buttoning clothing and carrying items from the fridge). Janssen et al. (2012)

utilised a virtual group therapy program that targeted multidisciplinary goals relating to upper

limb skills, social participation and cognition (i.e. improving bilateral upper limb use,

communication in a group and ability to concentrate in a group activity).

Interventions involving behaviour management techniques were reported (n=2). This

included a Cognitive Behavioural Therapy intervention aimed to assist clients with obsessive
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compulsive disorder to externalise and manage disruptive symptoms and behaviours that affect

participation in social and community occupations (Söchting & Third, 2011). The second paper

described an intervention plan for a client with cerebral palsy and a suspected intellectual

disability, aimed at promoting participation through reinforcement, shaping and behavioural

practice (Mahmood & Jabeen, 2017).

A mental health promotion focus was included in two papers aimed at assisting clients

presenting with mental illness symptoms to develop healthy behaviours, routines, and habits that

support self-esteem and participation (Tokolahi et al., 2016; Tokolahi et al., 2018). Another

paper focused on health promotion, specifically relating to school students’ participation in

sexual and reproductive health education (Gontijo et al., 2016), whilst a further paper reported on

promoting physical activity for students via classroom bicycle desks (Fedewa et al., 2017). Two

papers focussed on building client’s self-management skills with one describing the use of a goal

related occupation-based activities to promote a client’s self-management of their diabetes

(Piven & Duran, 2014). The other reported teaching students with social, emotional, behavioural

and learning difficulties to self-manage their behaviour through sensory integration techniques in

order to improve school participation (Mahmood & Jabeen, 2017). Additional interventions

included ADL training, specifically hand washing via video modelling (n=1) (Campbell et al.,

2015) and an executive function training program using games and activities focussing on

memory, planning and monitoring (n=1) (Chaimaha et al., 2017).

Types of occupations

The types of occupations promoted were categorised by the AOTA framework (AOTA,

2014). The majority of the studies described interventions that had a single occupation focus

(n=15). For example, Cheung et al.’s (2018) paper explores a social-cognitive group program
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designed to promote skill development to support social participation. Over a third (n=11) of the

intervention papers focussed on promoting participation in multiple types of occupations. Rodger

et al.’s (2008) social and organisational skill intervention paper included a range of specific

client goals such as getting ready for school, completing homework and managing behaviour.

Overall, a majority of the papers focussed on promoting participation in IADLs (n=13), with

many of the interventions emphasising independence in activities such as cooking and

maintaining healthy routines. Social participation was also emphasised in over a third of the

articles (n=12), with the majority of these studies being conducted in group settings (n=8) and

four involving clients with autism spectrum disorder. Leisure was targeted in eight articles, with

seven of these reporting clients with physical disabilities and six articles prescribing

environmental modifications. Participation in ADLs was targeted in seven articles and included

personal hygiene tasks (Mahmood & Jabeen, 2017; Rodger et al., 2008; Tomchek et al., 2017;

Wesdock et al., 2008) and dressing (Mahmood & Jabeen, 2017; Rodger et al., 2008; Wesdock et

al., 2008). Education including school participation and integration was emphasised in seven

articles, with two focussing on behaviour management as a means to improve adolescents’

participation in classroom learning (Mac Cobb et al., 2014; Mahmood & Jabeen, 2017). Other

occupations targeted included: work (n=5), in which the development of pre-vocational skills

was focussed, as well as rest and sleep (n=2).

Intervention strategies

Approximately one third (n=9) of the papers reported involving parents directly in the

interventions. For example, the PREP program reported in three studies, involved coaching

parents to recognise environmental barriers and implement strategies to address these (Anaby et

al., 2018; Anaby et al., 2015; Anaby et al., 2017). One paper also reported targeting teachers in
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the intervention to support them to develop classroom systems that promote student self-

regulation (Mac Cobb et al., 2014). Another study included a separate program that involved

educating parents, peers and school staff in problem-solving and strategy development to

promote continuous improvements in executive functioning and academic performance

(Chaimaha et al., 2017).

One common trend across the papers involved technology in the intervention administration

(n=5). Two papers reported using video-modelling methods to teach adolescents personal

hygiene skills (Campbell et al., 2015; Tomchek et al., 2017), whereas Janssen et al. (2012)

described the use of technology to simulate group games in upper limb rehabilitation. Telehealth

defined as the ‘provision of health care to clients via telecommunication’ (Australian

Government Department of Health, 2015) was reported in two articles. Hatfield et al. (2017)

demonstrated the use of the internet to administer a transition to work intervention for

adolescents and their families, while Chaimaha et al. (2017) demonstrated a multimodal delivery

using computer, telephone and paper-based activities.

Outcome measures

Standardised outcome measures were evident in just under half of the articles. A majority of

the reported outcome measures related to goal achievement (n=13). One of the most commonly

reported goal measurements was the Canadian Occupational Performance Measure (COPM)

(n=6). The COPM is a standardised assessment tool that enables clients to rate their own

performance in selected activities (Law et al., 2014). Six articles also reported utilising this tool

to formulate and prioritise intervention goals. The majority of papers described the involvement

of clients in intervention goal setting (n=15). Eight of these studies suggested the involvement of

adolescents, while a further seven revealed both client and family involvement. Another
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standardised tool used included the Goal Attainment Scale (GAS) (n=4) and involved clients

and/or families rating if, and how well, clients’ intervention goals were met. A further two

articles reported measuring goal achievement, however, they did not suggest using a specific

evaluation tool (Hatfield et al., 2017; Tomchek et al., 2017). The Patient Specific Complaints-list

was utilised in one study to assess client’s reported ease or difficulties in tasks and goal

achievement (Janssen et al., 2012).

In addition to these measures of goal achievement, studies reported outcome measures

relating directly to improvements of occupational performance (n=11), including the use of

informal observations of occupational engagement conducted by therapists (n=5). Standardised

performance scales (n=3) including the Participation and Environment Measure for Children and

Youth, the Pediatric Evaluation of Disability Inventory (self-care section) and the Performance

Quality Rating Scale were also utilised. Two papers additionally described the level of

independence in tasks as an indication of performance (Campbell et al., 2015; Tomchek et al.,

2017).

Many studies evaluated interventions from a range of participants’ perspectives including

adolescents themselves (n=10), parents/guardians (n=5), Occupational Therapists (n=5) and

school staff (n=5). Perspectives were commonly obtained using interviews (n=6), questionnaires

(n=5) and surveys (n=2). For example, Hatfield et al. (2017) utilised online surveys to capture

allied health staff, parent and adolescent perspectives of a transition planning intervention.

Outcomes

The majority of the papers reported positive outcomes (n=26). For example, Campbell et

al.’s (2015) executive function focussed intervention was rated with high satisfaction by parents.

In addition, Anaby et al. (2016) reported clinically significant improvements in COPM scores for
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participants following an environmental modification intervention. However, mixed results were

reported in seven papers. For example, Piven and Duran (2014) reported major improvements in

diabetes self-efficacy and exercise behaviours, however, noted declines in illness intrusiveness

ratings and social limitations. These declines reflect the client’s improved understanding of their

condition and its significance (Piven & Duran, 2014). See Table 2 for further details.

Discussion

This scoping review of 26 papers provides a description of various Occupational Therapy

interventions that target adolescents’ participation in daily occupations including work,

education, social participation, ADLs and IADLs. Evidence shows that there is a strong emphasis

on environmental modifications, transition planning, social skill training and upper limb function

that target clients with various conditions including physical disabilities and autism spectrum

disorder. Key features of the interventions were also highlighted such as collaborative goal

setting, parent involvement and the use of technology in intervention administration.

Many studies revealed a strong focus on promoting functional independence in various

occupations. A majority of these articles targeted adolescents’ participation in IADLs and ADLs

including managing healthy routines, feeding, dressing and personal hygiene. Other prominent

foci included the development of pre-vocational skills, social skills and community integration in

order to improve participation. As suggested by Mui Lim and Jones (2017), adolescence is a

period when individuals experience occupational transition and develop the capacity to take on

adult roles and responsibilities including moving out of home, gaining employment and

managing relationships. Hence the articles’ strong emphasis on promoting independence in

occupations such as work, personal care, social participation and health management, support the

occupational transitions occurring during adolescence.

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A common feature across the studies was the use of client self-chosen goals and the

involvement of adolescents in intervention evaluation. Many studies described a collaborative

goal development approach, often facilitated by the COPM, where intervention goals were

formulated with direct involvement of adolescents and their families. Unsurprisingly, a

commonly reported outcome measure included client’s goal achievement indicating that the

interventions were designed to target client’s individual needs. A collaborative, client centred

approach was deemed important during goal setting and intervention planning to promote

clients’ motivation to engage in therapy and to encourage the longevity of outcomes (Enemark

Larsen et al., 2018). Adolescents were frequently involved in the evaluation of interventions,

with many studies aiming to seek their perspectives of intervention programs. Adolescence is a

period when individuals begin to develop the ability and insight to reason rationally and plan for

the future, particularly in contrast to younger children (Moshman, 2011). Hence the involvement

of clients in goal setting and intervention evaluation reflects the cognitive development of

adolescents.

The review indicated a strong emphasis on parent involvement in intervention planning and

evaluation. Parents were commonly described as being involved in goal setting procedures and

their perspectives of interventions, regularly sought. This is consistent with the family centred

practice described in the American Occupational Therapy Association’s (AOTA) (2014) Domain

and Process which is used to guide therapists. The AOTA (2014) suggests that practitioners

should involve caregivers, family members and other stakeholders in identifying and prioritising

goals for intervention. Interestingly, parent collaborative practice appears to be a trend in

Occupational Therapy literature typically addressing young children (Costa et al., 2017;
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Kruijsen-Terpstra et al., 2014). However, this scoping review has also highlighted its prevalence

with adolescents.

The use of technology in intervention administration was also noted in some articles.

Technology, including video modelling and virtual reality, was suggested to be useful in

delivering interventions to adolescents (Campbell et al., 2015; Hatfield et al., 2017; Janssen et

al., 2012, Tomchek et al., 2017). This is an interesting contrast to the common conception that

technology negatively impacts adolescents’ occupational participation, with literature reporting a

link between technology use and increased sedentary behaviour (Rosen et al., 2014). Articles

highlighting Occupational Therapy interventions that address this common societal concern of

technology (as a negative impact) were not found and could be a potential area for future practice

and research. In addition, the use of telehealth with interventions for adolescents (Hatfield et al.,

2017; Chaimaha et al., 2017) is a worthwhile consideration for this client age-group, who may

display more independent and focussed behaviours needed for telehealth sessions, compared to

younger children.

Although the results covered a variety of interventions and occupations that targeted clients

with a range of conditions, it appeared that there were some areas not well documented. For

example, driving and home management occupations were not reportedly targeted in the articles.

Case-Smith and O'Brien (2014) suggest that these are important occupations to consider for this

age group, as individuals during this period begin to learn to drive and develop the skills to

maintain their own home (e.g. cleaning and caring for a garden). There also appeared to be a lack

of emphasis on assisting clients in managing the changes associated with puberty and the

development of self-identity. As these tasks are unique and potentially challenging for

adolescents, particularly those with disabilities, they are important areas to address.
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There appeared to be limited reports of interventions that promoted participation for clients

with mental health conditions or disorders which may commonly occur during adolescence.

Clients with subclinical symptoms of anxiety and depression were reported in two articles. This

might be due to the review’s strict focus on occupational participation and the exclusion of

multidisciplinary articles where the Occupational Therapy contributions could not be isolated.

Furthermore, many of the studies had low participant numbers and there were limited gold

standard robust research designs, such as randomised controlled trials. This may be reflective of

the nature of participants (i.e. people living with illness or disabilities which can have

individual/varied impact) and the settings (rehabilitation or community settings where large

numbers are not possible). Therefore, consideration of other experimental designs such as single

case experimental designs are recommended.

Practice Implications

This review uncovered currently published research in the area of interventions that promote

occupational participation of adolescents, which can guide service development and design for

this age group. In particular, a focus on promoting functional independence, inclusion of the

adolescent and family in goal setting and service evaluation and the use of technology, have been

uncovered.

Review Limitations

This scoping review focussed only on articles that reported participation focussed

interventions, specifically targeting adolescents (aged between 10 to 19 years), i.e. articles

reporting both child and adolescent clients were not considered for this review. Additionally,

only articles published in English language were included. Future reviews that include
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assessments and other roles of Occupational Therapists (such as case management), would

further expand the understanding of existing services to this client group.

Conclusion

This review included 26 studies which revealed a range of intervention types and features

that support adolescents’ participation in everyday occupations. Interventions that focus on

promoting functional independence in the areas of work, personal care, social participation and

health management were uncovered. Features of interventions include parent and adolescent

involvement and the use of technology.

Key Points for Occupational Therapy

 A variety of Occupational Therapy interventions for adolescents have been identified in

this review to guide service development and design.

 A strong intervention focus on functional independence was uncovered.

 A common feature of interventions for adolescents include client and family participation

in goal setting and service evaluation.

 The use of technology was identified as a feature of interventions for adolescents

Conflicts of Interest

There are no conflicts of interest to declare for this study.

Funding Statement

The authors received no specific funding for this research.

 73

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Appendix 1. Table 2 Characteristics of included papers

Author, Aim Study Target Intervention Outcome Results/findi Type of Setting

year and design population Measure(s) ngs Occupati
country and and on
methods sample
size
Anaby, Law, To gain Qualitative N=12  Environment  Semi structured Therapists Leisure Home
Teplicky, & Occupationa . Occupationa al interviews. highlighted the and
Turner, 2015. l Therapists’ l Therapists modifications benefits of communi
Canada. perspectives after to promote providing ty
of the administrati community interventions
Pathways on of PREP leisure within client’s
and to 10 participation own
Resources adolescents  PREP, a 12- environment.
for between 12 week Barriers and
Engagement to 17 years individual facilitators to
and of age with program this method
Participatio physical  Guided by included
n (PREP) disabilities. client chosen physical
approach. goals factors i.e.
 Involved physical
parent and accessibility
client and other
coaching to aspects i.e.
teach them to attitudinal,
identify social and
environmenta institutional
l barriers and factors.
develop
strategies to
remove
these.
Anaby, Law, To assess Mixed N=6  Environment  COPM Clinically Leisure Home
Majnemer, & the methods, adolescents, al and significant and
 82

Feldman effectivenes interrupted 14 to 16 activity  Participation and improvements communi

2016. s of time series years of age modifications Environment in COPM ty
Canada. environment design with to promote Measure for performance
-focussed with pre- physical community Children and scores were
intervention and post- disabilities. leisure Youth evident for all
s on tests. participation  KIDSSCREEN- goals.
participation  Guided by 27 to measure Improvements
of client chosen quality of life in participation
adolescents goals,  Parent patterns and
with developed satisfaction quality of life
physical using the questionnaire. were observed.
disabilities. Canadian Environmental
Occupational barriers related
Performance to transport and
Measure physical
(COPM) accessibility.
 PREP, a 12-
week
individual
program
consisting of
4 to 12
sessions
 Involved
parent and
client
coaching to
teach them to
identify
environmenta
l barriers and
develop
strategies to
remove
these.
 83

Anaby, To explore Qualitative N=12  Environment  Semi-structured Parents Leisure Home

Mercerat, & parents’ . parents of al interviews. highlighted
Tremblay, perspectives adolescents modifications that the
2017. of the PREP between 12 to promote program not
Canada. approach. to 18 years community only facilitated
of age with leisure performance
physical participation success for
disabilities.  PREP, a 12- their children
week in various
individual domains i.e.
program physical, social
consisting of and emotional,
4 to 12 but also
sessions recognised that
 Guided by their own
client and needs were
family met.
chosen goals
 Involved
parent and
client
coaching to
identify
environmenta
l barriers and
develop
strategies to
remove
these.
Anaby, Law, To examine Quantitativ N=28  Environment  COPM. A significant Leisure Home
Feldman, the e, adolescents, al intervention
Majnemer, & effectivenes interrupted 12 to 18 modification effect was
Avery, 2018. s of the time series years of age to promote noted in
Canada. PREP design with community performance of
approach on with moderate leisure all clients and
promoting participation activities.
 84

participation multiple physical  PREP, a 12- Performance

for baselines. disabilities. week continued to
adolescents individual increase after
with program intervention.
physical consisting of Common
disabilities. 4 to 12 functional
sessions challenges
 Involved included
parent and managing
client emotions,
coaching to communicating
teach them to and using
identify hands during
environmenta activities.
l barriers and
develop
strategies to
remove these
 COPM used
to guide goal
development
with clients
and family
Campbell, To explore Quantitativ N=3  Video  The level of All participants Activities School
Morgan, the use of e, multiple adolescents modelling to independence increased their of Daily
Barnett, & video baseline with ASD promote hand revealed using independence Living
Spreat, 2015. modelling to study. aged (one washing task in hand (ADLs)
United States. teach hand 17 and two skills analysis/observati washing.
washing to 19 years of  Included one ons. Two
adolescents age). 10 to 15- participants
with Autism minute demonstrated a
Spectrum individual substantial
Disorder session per increase in
(ASD). week for four hand washing
weeks. skills, whilst
one participant
 85

showed a
modest skill
increase.
Chaimaha, To examine Quantitativ Group 1: Two  Parent and Results Education School
Sriphetchara the e, one N=8 intervention teacher indicated
wut, Lersilp, effectivenes group pre- students programs: satisfaction improved
& Chinchai, s of an test–post- with ADHD (a) Executive questionnaires executive
2017. Asia. executive test design. and function  Clients academic functioning
function Executive training performance via and school
training and Function program: their Grade performance.
collaborativ Deficits, 10  Computer Point Average Statistically
e program, to 12 years and paper Executive function significant
for students of age administered measured using: improvements
with format  Tower of in working
Attention Group 2:  3 x hourly, London-Drexel memory,
Deficit N=8 individual University planning and
Hyperactivit parents, sessions were  Wechsler self-monitoring
y Disorder N=5 conducted Intelligence were
(ADHD). teachers, per week for Scale for demonstrated.
N=1 7 weeks Children- Parents and
principal,  Activities Revised Digit teachers both
N=8 peers targeted Span Subtest indicated high
working  Behaviour satisfaction
memory, Rating Inventory with the
planning and of Executive program.
monitoring Function.
(b)
Collaborative
program for
parents, school
staff, and
peers:
 Using
weekly
phone calls
 86

and
meetings
 Aimed to
train
supporters
in problem
solving and
strategy
developmen
t.
Cheung, Siu, To explore Mixed N=7 male  Friendship  The Chinese Significant Social School
Brown, & Yu, the efficacy methods adolescents Lab, a social- Version Social gains in Theory participati
2018. Asia. of a social- using pre with ASD, cognitive Skills of Mind, on
cognitive and post 12 to 14 group Improvement knowledge and
intervention assessment years of age. intervention System Rating goal
program s. designed to Scales performance
across teach clients  Theory of Mind were observed.
cultural how to think Inventory Further gains
settings. and infer  Goal attainment were reported
regarding using the Goal two months
others Attainment Scale after
 Guided by (GAS) intervention.
client and  Parent Parents noted
parent perspectives via increases in
developed focus group social skill
goals interviews. knowledge and
 Included a frequency of
parent positive social
meeting for behaviour.
future Parents
planning suggested that
 10 x once per a more
week intensive
sessions were program would
used. be beneficial.
 87

Copley, To report Qualitative N=4  A social skill  Questionnaires The program Education School
Turpin, the , action Occupationa intervention and interviews to changed and social
Gordon, & developmen research l Therapists, program reveal considerably participati
McLaren, t of an design. N=9 school aimed to participants across the on
2011. Occupationa staff support perspectives. cycles, from
Australia. l Therapy members. classroom mastery of
program to participation classroom
facilitate and tasks to the
school availability development of
participation for learning social
for students  Group capacities to
from intervention support
refugee program classroom
background guided by participation.
s. client chosen This method
goals. promoted
better
alignment
between the
therapist and
the school
staff.
Fedewa, Abel To Mixed Experimenta  Stationary  The amount of Students using Instrument School
& Erwin, investigate methods l group: bicycle desks time and intensity the bicycle al
2017. United whether with N=11 (FitDesks) in of physical desks Activities
States. stationary randomise Control classrooms activity (via improved their of Daily
bicycle d group:  The accelerometers) engagement in Living
desks assignment N=6 intervention  Miles, resistance, physical (IADLs)
(FitDesks) to control Both groups group used time and calories activity by
used in high and from a high- the desks for burnt measured spending less
school experiment risk school half of their via the FitDesks time in
enhance al group. setting lesson times  Feasibility sedentary
physical (between 14 over a year measured using activity, further
activity. to 18 years  The control student time in
of age). group questionnaires moderate-to-
received no vigorous
 88

change to and teacher physical

N=3 their seating. interviews. activity and
teachers. improved in
each of the
other physical
activity
outcomes.
Participants
noted
advantages and
limitations of
using the desks
but overall
were
favourable of
their use.
Gontijo et al., To describe Qualitative N=58  Sexual and  Adolescent The IADLs School
2016. Brazil. an with pre, adolescents, reproductive questionnaire observations
Occupationa during and 13 to 17 health regarding and feedback
l Therapy post data years of age, promotion, increased suggest that a
intervention collection. enrolled in group knowledge participatory
process basic program with  Observations of method
aimed at education. a student’s involving
sexual and participatory behaviour rapport
reproductive method  Focus group building and
health  Includes interviews to gain dialogue
promotion educative adolescents supports
for activities i.e. perceptions. engagement in
adolescents. puzzles, health
storytelling, promotion
mime and education tasks
board games for adolescents.
 5 x once per Participants
week demonstrated
sessions increased
knowledge of
 89

sexual and
reproductive
health
information.
Gutman et al., To Quantitativ N=1, 14-  An individual  Evaluation of The quality and Social School
2014. United determine if e, baseline, year old motor-based Social Interaction frequency of participati
States. a motor- weekly female with role play, to measure social nonverbal on
based role- and a 3 high social skill skill interaction social skill use
play month functioning program quality and increased
intervention follow up ASD.  Involves frequency. significantly
can enhance case healthy self- i.e. maintaining
social skill report. care habits eye contact and
use in a and social using body
nonverbal skill language. No
adolescent development substantial
with high  4 x once per changes in
functioning week verbal use were
ASD. sessions. observed.
Teachers and
parents
reported
increased self-
initiated
communication
.
Hatfield, To assess Mixed Pilot A:  The BOOST-  Online surveys to The majority of Work Home
Murray, the viability methods, N=6 A™ online capture participants and
Ciccarelli, and pilot study adolescents transition adolescents, rated the clinic
Falkmer, & feasibility of with ASD, planning parents and allied program as an
Falkmer, the Better their program health appropriate,
2017. Outcomes & parents, and aimed to help practitioner’s feasible and
Australia. Successful the preparation perspectives viable
Transitions professional for leaving  Reflection on transition
for Autism s who school by achievement of planning tool.
(BOOST- worked with developing goals. The program
A™) for them. was rated as
 90

adolescents Pilot B: plans for helpful,

with ASD. N=88 allied employment realistic,
health  Individual meaningful,
professional sessions relevant and
s delivered via easy to
(Occupation internet understand.
al  Clients and
Therapists, parents
speech involved in
pathologists, goal setting,
and reviewing
psychologist and forming
s). future plans.
Imms, To Quantitativ N=8  Activity and  GAS Majority Leisure Clinic,
Mathews, determine e, pre-test, adolescents, environment  COPM. achieved their home or
Richmond, the post-test 12 to 19 modification participation communi
Law, & feasibility of pilot study years of age program goals, while ty
Ullenhag, an design. with  Clients and four
2016. environment physical parents demonstrated
Australia. al and impairments involved in less substantial
activity . establishing progress
modificatio goals (via the towards their
n program COPM), goals. The
to promote measuring natural
leisure and environment,
participation addressing government
for environmenta policies and
adolescents l barriers and transport
with building availability
physical activity were most
impairments performance frequently
. skills. identified
 Both group barriers to
and participation.
individual
sessions
 91

delivered for
(8 x once per
week
sessions).
Janssen, To describe Mixed N=1, 18-  The  The Patient Improvements Social Clinic
Verschuren, the use of a methods, year-old GameLaB, a Specific in participati
Levac, Nintendo pre and with an structured Complaints- list communication on
Ermers, & Wii post acquired group to assess client’s were observed
Ketelaar, structured measure brain injury, program that reported ease or i.e. improved
2012. The group case study. hemiparesis, uses a game difficulty in tasks use of speech
Netherlands. therapy in aphasia, format to and achievement techniques and
the behavioural target client of goals. non-verbal
rehabilitatio issues, and developed compensatory
n of an attention goals techniques.
adolescent difficulties.  Focussed on Improved
with an upper limb concentration,
acquired rehabilitation motor control
brain injury. , and use of
compensator affected arm
y training, were
social and demonstrated.
cognitive
performance
 16 x once per
week group
sessions.
 Two
therapists
(physical
therapists,
Occupational
Therapists,
speech and
language
therapists, or
social
 92

workers)
coordinated
sessions.

Kramer, To conduct Mixed N=21  Project  Project TEAM Participants IADLs, School
Roemer, a methods, adolescents, TEAM, knowledge test to showed a leisure and
Liljenquist, comprehens single 15 to 17 group reveal significant work
Shin, & Hart, ive group years of age program adolescents increase in
2014. United formative repeated with  Aims to change in their
States. evaluation measures intellectual teach clients knowledge knowledge of
of the design. and/or to identify  The Child environmental
Project Developmen environmenta Occupational factors and
Teens tal l barriers, Self-Assessment modification
making Disabilities. generate  GAS strategies that
Activity and modification  Observations of influence
Environmen strategies, performance occupational
t and request  Surveys to gain participation.
Modificatio accommodati client No changes in
ns (TEAM) ons in perspectives. applied
self- relation to problem
advocacy client-chosen solving were
program. goals observed.
 Co-led by an Majority of
Occupational participants
Therapist and attained at least
a youth one goal.
specialist. Participants
 2 x sessions enjoyed the
were interactive and
completed applied aspects
per week for however found
14 weeks. some concepts
and materials
difficult to
understand.
 93

Mac Cobb, To develop Mixed N=85  Class group  Student and Majority of Education School
Fitzgerald & a class methods students, 12 program teacher students
Lanigan- group involving to 13 years promoting questionnaires to indicated that
O’Keeffe, program to two of age with behavioural seek their the program
2014. Ireland. promote sequential social, self- perceptions. was enjoyable
behavioural trials. emotional, management and relevant.
managemen behavioural via sensory Students
t for a class and learning integration gained an
with difficulties  Teaches understanding
learning and N=4 students to of their
behavioural teachers understand behaviour and
challenges basic sensory identified self-
in a integration management
secondary theory to strategies and
school regulate their indicated
context of level of intentions to
social alertness in apply their
disadvantag task strategies in
e.  Teachers class. Students
supported to recommended
develop self- that all teachers
regulating be familiar
classroom with the
systems techniques of
the program.
 Trial one
Teachers
included 5 x
suggested that
once per
the content and
week
strategies were
sessions.
appropriate.
Trial two
included 8 x
once per
week
sessions.
 94

Mahmood & To highlight Mixed N=1, 14-  Behaviour  Reports from Improvements ADLs, School
Jabeen 2017. the use of methods, year-old boy modification teacher and were observed IADLs,
Pakistan. behaviour single case with CP and techniques: family in various areas education
therapy study with suspected reinforcemen  Therapists of function and social
techniques pre and mild t, shaping, perceived rating including participati
to devise the post Intellectual chaining and of client’s academia, self- on
managemen assessment Disability behaviour performance and care (i.e.
t plan of a s. practice ability to handwashing)
client with  23 x complete tasks and money
CP. individual independently. concept.
40-minute Less
sessions significant
 Focussed on progress was
improving reported in
independent problem
function solving
skills i.e. activities,
problem- likely due to
solving, client’s lack of
money interest.
concept, fine
motor skills
and tying
shoelaces.
Piven & To examine Mixed N=1, 19-  Occupation-  COPM Major ADLs, Clinic
Duran, 2014. the effect of methods, year-old based, goal Standardised improvements IADLs and
United States. occupation- pre and adolescent directed measures of were reported social
based post-test with Type 2 activities exercise behaviours, in the Diabetes participati
activities to design. Diabetes. targeting condition Self-Efficacy on
improve self- management, Scale, Exercise
diabetes management impact on daily life Behaviour and
self- skills and social in goal
managemen  Collaborative participation: attainment of
t skills in a process  The Exercise targeted
non- guided by the Behaviours behaviours.
Model of questionnaire Declines were
 95

adherent Human  The Diabetes observed on

adolescent. Occupation Self-Efficacy the Adapted
and the Scale Illness
COPM  The Adapted Intrusiveness
framework Illness Ratings and the
 2 x sessions Intrusiveness Social/Role
per week for Ratings Activities
8 weeks  The Social/Role Limitations
Activities Scale, likely a
Limitations result of
Scale. increased
insight into the
condition
intrusiveness
as a result of
therapy.
Rodger, To report Quantitativ N=2 male  Cognitive  COPM Post- ADLs, Clinic
Ireland & the findings e, single adolescents Orientation  Social Skills intervention IADLs,
Vun, 2008. of two case study with ASD to daily Rating Scale measures social
Australia. exploratory design (10 and 12 Occupational  Performance showed participati
case studies with one years of Performance Quality Rating improvements on,
which used replication age). Measure Scale in social and education,
social skill and pre-  10 x once per  Motor organisational rest and
intervention post-tests. week performance was skills and sleep
s with individual rated on a scale transferral of
clients with sessions from 1-10. these skills to
ASD. targeting home and
social or school
organisationa environments.
l client- Both children
chosen goals highly
(developed prioritised
using the social goals
COPM) and some
 Problem organisational
solving goals.
 96

strategies,
role play,
social stories
and anger
management
were used
 Clients and
parents were
also trained
in problem
solving.
Shea & To explore Qualitative N=5 at risk  The  One on one semi- Increased self- IADLs, School,
Jackson, how at-risk , pilot adolescents, Occupational structured advocacy, and education, communi
2015. United adolescents, study. 16 to 18 Therapy interviews used enhanced social ty and
States. respond to years of age Training to gain perception of participati juvenile
client- Program participant participant’s on, leisure detention
centred and (OTTP), a perspectives. future were and work facilities.
occupation- weekly life observed.
based skills group Participants
Occupationa program described the
l Therapy.  Involved intervention as
engaging in a non-
development prescriptive
ally approach that
appropriate validates the
play to individual and
address life may prove
skills i.e. pre- effective in
vocational serving the at-
exploration, risk adolescent
communicati population.
on, self-
management
and
community
access
 97

 Goals and
strategies
were
developed in
collaboration
with client.
Shea & Siu, To explore Mixed N= 295,  The OTTP, a  Occupational Participants IADLs, Juvenile
2016. United the methods incarcerated weekly life engagement reported high leisure, detention
States. engagement pilot study. adolescents, skills group measured using engagement in social centre
of 14 to 18  Involved the Engagement the program. participati
adolescent years of age engaging in in OTTP Over 90% of on and
inmates in development Activities the activities work
structured ally Questionnaire were complete
play appropriate  The Analysis of and relevant to
activities to play to Group Activity the session
support address life Scale (created by topics. Play
interpersona skills i.e. pre- researchers) used activities could
l vocational to assess content be a suitable
relationship exploration, of worksheets way for
s, self- communicati and artwork. Occupational
awareness on, self- Therapists to
and management promote life
community and skill
transition. community acquisition for
access incarcerated
 6 months of adolescents.
once per
week, one-
hour
sessions.
Sochting & To conduct Quantitativ N=7  CBT group Symptoms Measures IADLs and Clinic
Third, 2011. a e, pre and adolescents program measured by: suggested social
Canada. preliminary post-test with OCD,  Conducted  The Yale-Brown clinical participati
evaluation design. 14 to 17 by a clinical Obsessive- improvements on
of the years of age. psychologist Compulsive Scale in OCD
effectivenes and symptoms for 5
 98

s of a Occupational  The Beck of 7

Cognitive Therapist Depression participants.
Behavioural  10 x once per Inventory The results
Treatment week  The Beck supporting a
(CBT) sessions Anxiety group
group  Involved: Inventory treatment
protocol for externalising  Obsessive Beliefs format for
adolescents symptoms by Questionnaire. adolescents
with mindful with OCD.
Obsessive detachment,
Compulsive exposure and
Disorder response
(OCD). prevention,
and
refocusing on
alternative,
constructive
behaviours
following
exposure.
Tokolahi, To describe Qualitative Expert  Emotional  Feedback from Feedback from IADLs, School
Hocking & the . Using opinion wellbeing therapists, participants rest and
Kersten, developmen four steps: phase: N=18 group cultural advisors, was used to sleep, and
2016. New t and reviewing adolescents, intervention adolescents and modify the social
Zealand. content of theory, 11 to 13  8 x 1-hour school staff. program. The participati
an reviewing years of age, sessions  Observations of feedback on
emotional evidence, N=4  Aimed to participation in suggested that
wellbeing, incorporati teaching educate the sessions. overall,
Occupationa ng expert staff, clients about participants
l Therapy opinion N=4 cultural health enjoyed the
program for and advisors, promoting activities and
adolescents trialling. occupations intervention.
with N=7 and how to The program
subclinical Occupationa participate in, proposes that
anxiety. l Therapists balance and adolescents can
Trial phase: sustain these achieve
 99

N=18 in daily positive

adolescents, routines. emotional
10 to 12  Involved: wellbeing by
years of age warm-ups, having the
with sub- skill skills and
clinical development, knowledge to
anxiety. skill practice maintain
and healthy
discussion routines that
about include health
application to promoting
real-life. occupations.
Tokolahi, To Quantitativ N=151  Emotional  COPM Significant IADLs School
Vandal, investigate e, cluster- adolescents, wellbeing  Rosenberg Self positive effects
Kersten, an evidence- randomise 11 to 13 group Esteem Scale of child-rated
Pearson, & based d years of age, intervention Symptoms satisfaction
Hocking, Occupationa controlled presenting  Aim to measured using: with
2018. New l Therapy trial. with early educate  The occupational
Zealand. intervention symptoms clients about Multidimensional performance
designed to of anxiety health Anxiety Scale for and teacher-
increase and promoting Children rated child
participation depression, occupations  The Child anxiety. No
in daily low self- and how to Depression evidence
occupations esteem incorporate Inventory 2nd supported the
to prevent and/or poor these in daily edition effect of the
symptoms participation intervention on
routines  The Revised
of mental in typical  Involved anxiety and
Child Anxiety
illness for occupations. clients and depression
and Depression
adolescents family in symptoms,
Scale
in schools. goal setting self-esteem and
wellbeing.
 8 x once per  School Anxiety Findings
week Scale. suggest that the
sessions
program be
delivered as an
embedded
 100

intervention
involving
parents and
teachers.
Tomchek, To Descriptiv N= 1, 17-  Techniques: Not a formal Not a formal ADLs, School
Koenig, summarise e, single year-old video research study but research study IADLs,
Arbesman, & the evidence case adolescent modelling, outcomes described: but described social
Lieberman, from report. with ASD. visual  Client’s the following: participati
2017. United published supports, participation in improvements on and
States. reviews on phone occupations in social, ADL work
executive reminders,  Level of and
function Goal–Plan– independence in prevocational
targeted Do–Check meal preparation goals and
techniques method,  Social performance
and to problem participation i.e. meal
present the solving observations preparation,
application supports,  Achievement of culinary club
of evidence social skills goals. attendance,
to a clinical group internship
case.  Aims to acquirement
target and friendship
executive formation.
function
skills i.e.
organisation
and time
management
 Uses COPM
to guide
client chosen
goal
development
 3 individual
monthly
sessions
 101

 Included
teacher
collaboration.
Wesdock, To evaluate Pre-post N=3 male  Post-surgical,  GAS Improvements ADLs, Clinic
Kott & hand quantitativ adolescents, individual  The Pediatric were observed IADLs and
Sharps, 2008. function e 11 to 15 hand therapy Evaluation of in client’s wrist education
United States. treatment descriptive years of age  Involved: Disability and finger
planning case study. with neuromuscul Inventory biomechanics
and hemiplegic ar electrical  Jebson-Taylor and active
outcome CP. stimulation, Test of Hand ROM. Post-
documentati stretching, Function surgical
on for taping, scar  Volkman’s therapy was
adolescents management, extrinsic finger perceived to be
with CP. wrist flexor tightness undefined. The
splinting, test and digit surgery and
functional extension undefined
and fine  Examination of therapy
motor joints in the hand approaches
exercises  Goniometric appeared to
 Goals formed measurements of have little
in radial and palmar influence on
collaboration active and participation
with client passive thumb and activity.
and family. web spaces The study
 Strength using indicates that
manual muscle the
testing management
protocol should
 Grip strength
include
using a Jamar
specific
dynamometer
postsurgical
 Palmar and key
therapy plans.
pinch strength
using a B&L
Engineering
pinch gauge
 102

 Stereognosis
using eight items
 Two-point
discrimination
using a Touch-
Test Two-Point
Discriminator
 Passive Range of
Motion (ROM)
tests
 Upper limb
muscle tone using
the Ashworth
scale
 Dystonia,
athetosis rigidity
and spasticity
were observed.