Occupation as means and ends in early childhood intervention – A scoping review

Sammanfattning: Background: Occupational therapy (OT) plays an important role in providing early childhood interventions for children with developmental delay. While paediatric OT has long been guided by developmental principles, occupation-centred interventions have been promoted during the last decades, but no unifying definition exists about the core features. Aims/Objectives: The aim of this paper is to (a) identify and describe how occupation-based and occupation-focused interventions are demonstrated in paediatric occupational therapy for infants and young children with developmental delay, (b) identify which outcomes these interventions address and (c) analyse which outcome measures are used. Material and Methods: Eight databases and 15 OT journals were searched. Included studies were peer-reviewed primary sources published in English since 1999, selected based on the terminology proposed by Fisher (2013). Nineteen papers met inclusion criteria. Results: Eight occupation-based, two occupation-focused and nine occupation-based and occupation-focused interventions were identified. Outcomes related mainly to occupational and play skill acquisition as well as mastery of co-occupations. A limited number of occupation-focused outcome measures was implemented. Conclusions: Several occupation-centred interventions have been researched. Gaps in knowledge exist regarding measures taking into account (co-)occupational performance and young children’s perspective. Significance: OTs might want to expand their scope of practice to include all occupational domains and increase parent-delivered interventions in natural environments. Measures used should be relevant to occupational performance and take into account the parent’s and children’s view. Use of uniform terminology can aid identification of evidence and clear placement of OT among other professionals.