In pediatric occupational therapy, there is insufficient evidence examining assessment tool selection by occupational therapists and how assessment tools contribute to occupation-based practice. To examine the perceptions of occupation-based assessment tool selection by pediatric occupational therapists, a phenomenological research study was conducted with six pediatric occupational therapy practitioners. Three themes emerged from participants’ perspectives: the centrality of occupation, selecting the just right tool, and practice implications. Participants recognized the need to integrate occupation-based assessments into practice but reported decreased opportunities secondary to training, available supplies, lack of awareness of foundational constructs, and organizational expectations. The use of occupation-based assessments positively enhances pediatric occupational therapists’ clinical practice by upholding the core occupational beliefs of the profession throughout all phases of service delivery.

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BACKGROUND: The effectiveness of occupation-based hand therapy and the barriers to the use of occupation-based interventions (OBIs) have been established, but the current experience of hand therapists using OBIs and the extent of the use of OBIs in practice is unknown. OBJECTIVE: This study aimed to identify the frequency that occupational therapists who are Certified Hand Therapists (CHTs) utilized OBIs, how occupational therapists who are CHTs described their application of OBIs, and identify the supports and barriers to the application of OBIs. METHODS: Twenty-nine participants completed a survey that included 27 questions. The questions consisted of close ended, Likert scale, and multiple-choice questions which were analyzed quantitatively, and open-ended questions which were analyzed qualitatively. RESULTS: The majority of the participants, 57.7%, reported implementing OBI at least 75% of the time. Barriers and supports to the use of OBIs reported include a lack of equipment and therapist creativity, and support for the use of OBIs included the therapist’s creativity, support from the facility, the availability of equipment, and the intrinsic motivation of therapists. Descriptions of OBI application included activity simulation, adaptive equipment use, and participation in meaningful activity. CONCLUSION: Although the use of OBIs in hand therapy may be expanding, occupational therapy practitioners and educators have a role to play in overcoming the remaining barriers to occupation-based hand therapy. Additional research is needed to gain further insight into use of occupation-based intervention by occupational therapists who are CHTs and explore the effect of education on promoting the use of OBIs.