Occupational Therapy

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Browsing Occupational Therapy by browse.metadata.advisor "Hoosain, Munira"

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    Better when I’m playing developing the playfulness and social play of learners with autism spectrum disorders through play-based occupational therapy
    (Stellenbosch : Stellenbosch University, 2024-03) Rautenbach, Gaby; Plastow, Nicola Ann; Hoosain, Munira; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences.Occupational Therapy.
    ENGLISH SUMMARY: Background: Play is essential to a child’s optimal development; therefore, occupational therapists use it to achieve play-related or functional goals. Without the foundational motivators of playfulness and social play, play engagement and consequently, play skills may be limited. Elements of playfulness, and social play skills may be difficult for children with autism spectrum disorders (ASD) to demonstrate during play engagement. These aspects could perhaps be even more limited in children with ASD who require high levels of support and those living in Low- and middle-income countries (LMIC) such as South Africa. Play-based occupational therapy interventions could improve playfulness and social play of learners with ASD, resulting in more opportunities for practicing play and social skills, therefore influencing overall occupational performance and satisfaction. Objectives: This study aimed to determine the effectiveness of play-based interventions through two phases. Phase one involved a systematic review of literature investigating the effect of play-based occupational therapy interventions on the playfulness, social play, and occupational performance of learners with ASD. Phase two outlines a study protocol which aims to evaluate the effect of a play-based intervention on the playfulness, social play, and occupational performance of learners with ASD in Gauteng, South Africa. Methods: Phase one used a systematic review of 12 quantitative studies, following PRISMA guidelines, to explore the effect of play-based interventions on playfulness and social play and strategies contributing to successful interventions. It was registered with PROSPERO (CRD42022349695). The databases PubMed, EBSCOhost, OT seeker, Scopus, Sabinet, Cochrane, and ProQuest were searched, and 12 eligible studies were assessed for methodological quality and intervention reporting quality using the JBI and TIDieR checklists, respectively. Phase two was informed by the results of phase one. The study will use a within-subject-repeated-measures design to implement the Playbox Africa Intervention with learners (aged 3-8 years) who have ASD, in a school in Johannesburg, Gauteng. The Test of Playfulness (ToP) and modified version of the Canadian Occupational Performance Measure (M-COPM) will be outcome measures for playfulness, social play, and occupational performance. The protocol follows the SPIRIT (2013) guidelines for interventions. Results: The systematic review found moderate to strong evidence for 11 of the 12 studies, that play-based interventions improve the playfulness and social play of learners with ASD. Six key principles to developing successful interventions were highlighted, as well as the Playboxes Joint Play Approach which demonstrated high feasibility. It was found that only one study was conducted in an LMIC (Anu et al., 2019) and only two studies involved learners with high support needs (Dionne & Martini, 2011; Fabrizi, 2015). These aspects informed the intervention protocol which was developed by incorporating the most recent evidence regarding play-based interventions, and culturally adapting an existing intervention to the study context, according to the TIDieR checklist requirements. A product of Phase 2 is the development of Playbox Africa, a culturally adapted and evidence-informed elaboration of the Playboxes Joint Play Approach (Marwick et al., 2021). Conclusion and Recommendations: Play-based interventions can improve playfulness and social play if certain principles are followed. These include combining social, free, and structured play, using caregivers to model the play, toys of interest and video-modelling, and considering the level of support of the learners, as well as the duration of the intervention. There remains a significant gap between theoretical knowledge regarding play interventions and implementation in practice and research. It is imperative that play-based interventions targeting playfulness and social play are further researched and implemented, especially for children with ASD who have high support needs, in LMIC.
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    The feasibility of occupational therapy visual art groups for children (8 – 12 years) with learning differences in a low-resource setting in the Western Cape, South Africa
    (Stellenbosch : Stellenbosch University, 2024-03) Conolly, Naomi Beth; Hoosain, Munira; Plastow, Nicola Ann; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY: Introduction: There has been a worldwide increase in the prevalence of learning differences, increasing the demand for feasible and effective services that support these children’s development and functioning. However, very few children have access to specialised individual interventions. Art is a well-known therapeutic medium that has the advantage of being adaptable to different clients, cultures, and settings, to develop prerequisite skills required for individual growth and participation in everyday life. Group interventions may be more feasible for low-resource settings regarding time, human resources, and costs. However, feasibility testing is needed before high-quality effectiveness evaluations can be recommended for art group programs in low-resource settings. Aim: To determine the feasibility of occupational therapy visual art groups for children aged 8 to 12 years with learning differences in a low-resource setting in the Western Cape, South Africa by 1) synthesising the available international research and 2) conducting a feasibility study. Methods and analysis: The systematic review was structured according to the PRISMA 2020 systematic review reporting guidelines, and registered on PROSPERO. Eight electronic databases were screened for eligible primary data sources, with no limiters. Two independent reviewers completed the title/ abstract and then full-text screening phases, using Rayyan software. The feasibility study used a case series design with convenience sampling to select eight participants (aged 8 to 12 years) with learning difference/s within a low-resource community in the Western Cape, South Africa. The SPIRIT guidelines for interventional trials were used to improve reporting. Participants attended eight weekly 45-minute visual art groups designed by the primary author. Feasibility was assessed in terms of demand, acceptability, and practicality through Likert-scale measures during caregiver interviews. Limited efficacy was evaluated using the Creative Participation Assessment (CPA), the Canadian Occupational Performance Measure (COPM) with caregivers, and the Child Occupational Self-Assessment (COSA) with participants. Results: All 20 articles included in the systematic review reported effectiveness outcomes, indicating decreased problem behaviours, and improved emotional well-being, social interaction, self-expression, cognitive and motor development, and caregiver attachment for children with learning differences. The heterogeneity of the data prevented a meta-analysis of effectiveness outcomes. Six articles reported feasibility criteria. Evidence synthesis led to the AR3T principles, which serve as a framework to guide the development of the art group intervention. The pilot study found the intervention was in demand, acceptable, and practical, and could be effectively implemented in the low-resource community selected for the study. The data also showed signs of limited efficacy, as participants made a clinically and statistically significant improvement in their level of creative participation (CPA) and occupational performance (COPM) from pre- to post-intervention. The COSA showed trends of improvement, especially for older children, but the results did not reach significance. Conclusion: Art group interventions have the potential to be a feasible and effective low-resource intervention that can be utilised to promote the development of children affected by learning differences. Further feasibility and effectiveness testing with larger sample sizes are required to refine the intervention and determine the extent of its therapeutic effect.