Occupation- and Activity-Based Interventions to Improve Performance of Activities of Daily Living, Play, and Leisure for Children and Youth Ages 5 to 21: A Systematic Review

Abstract

Importance: The findings support the use of occupation- and activity-based interventions to improve the occupational participation of children and youth with disabilities. Objective: To examine the effectiveness of occupation- and activity-based interventions to improve participation and performance in activities of daily living (ADLs), play, and leisure in children and youth. Data Sources: MEDLINE, PsycINFO, CINAHL, ERIC, OTseeker, and Cochrane Database of Systematic Reviews; reference lists of retrieved articles; and tables of contents of selected journals were searched to identify peer-reviewed studies published between 2000 and 2017. Study Selection and Data Collection: Studies addressing occupation- and activity-based interventions and outcomes for children ages 5 to 21 were selected and appraised using Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines, evaluated for risk of bias, and synthesized to develop practice recommendations. Findings: Fifteen Level I (meta-analyses, systematic reviews, and randomized controlled trials), 5 Level II (two groups, nonrandomized), and 3 Level III (one group, pretest–posttest, retrospective) studies were examined and categorized by type of intervention and outcome. Each study used occupation- or activity-based interventions and reported ADL, play, or leisure outcomes. Intervention themes identified include supporting engagement in occupations, supporting participation with cognitive supports, and using technology to support occupational participation and performance. Conclusions and Relevance: Strong evidence indicates that engagement in occupations and activities, practice within and across environments, and coaching and feedback improve participation and performance in ADLs and functional mobility. Moderate evidence supports the use of collaborative goal setting, modeling, and guided participation in play and leisure. Moderate evidence also supports technological interventions for ADL, play, and leisure performance. What This Article Adds: Engaging children and youth in occupations and activities; providing guidance in goal direction, planning, and feedback to enhance their participation; coaching caregivers in effective carryover; and providing technology-based intervention can improve the occupational participation and performance of children and youth.

Occupational Therapy Interventions for Children and Youth Ages 5 to 21 Years

“…Play-based activities that involve peers and support the child's use of intrinsic motivation are effective for increasing playfulness. Coaching, peer modeling, and instruction on how and when to use specific skills (e.g., showing empathy) are effective in increasing collaborative play and play engagement (Laverdure & Beisbier, 2021). Caregiver and family…”

“…Successful completion of self-care routines helps them to build confidence and autonomy. Significant positive outcomes are associated with the use of functional tasks to improve children's performance of self-care routines (Laverdure & Beisbier, 2021). Explicit skills training in ADLs and structured practice, including tasks with graded difficulty provided in natural contexts, is effective in supporting development and engagement in self-care skills.…”

“…Caregiver and family involvement is critical to providing occupational therapy services to children, and increased family involvement allows occupational therapy practitioners to model strategies to encourage the child's participation and leads to skill mastery. Caregiver coaching and feedback are particularly effective in promoting children's independence with ADL tasks and reducing the need for caregiver assistance (Laverdure & Beisbier, 2021).…”

“…Statistically significant positive outcomes are associated with the use of play-based interventions to increase the skills associated with children's social participation (Cahill & Beisbier, 2020).Play-based activities that involve peers and support the child's use of intrinsic motivation are effective for increasing playfulness. Coaching, peer modeling, and instruction on how and when to use specific skills (e.g., showing empathy) are effective in increasing collaborative play and play engagement (Laverdure & Beisbier, 2021). Caregiver and family…”

The Application Of Remodeled Glove Puppetry For Children With Developmental Disabilities: A Randomized Trial

“…Children with developmental disabilities (DD) often have impaired motor function. In previous studies, nearly one-fth of the total sample (3608 children with DD) had mild to moderate gross motor and ne motor dysfunction in living, play, and leisure activities [1,2]. For children with DD, intrinsic muscle contracture of the hand is a common deformity associated with exion of the metacarpophalangeal (MP) joint.…”