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How Can You Incorporate Evidence-Based Approaches/Interventions Into Your Pediatric OT Practice ?

OT Intervention Strategies Backed up by Research

*Visit AOTA, AOTA’s EBP Toolkit, NBCOT, library journal articles databases, AJOT, and reliable third party websites to learn about the latest research. This list provides examples and is not exclusive.

OT Practice Guidelines for Children and Youth Ages 5–21 Years

This guideline recommends that "occupational therapy practitioners consistently collaborate with families and caregivers and provide services in the natural context of the desired occupation. The evidence also supports group service models and models that include peer mediation; these models can promote participation across areas of occupation. Skills-based training and therapeutic practice in the context of valued occupations are recommended over isolated sensorimotor approaches. Technology, manualized programs, and sports activities can be effective but should be evaluated and matched to age, diagnosis, and outcomes". 

Cahill, S. M., Beisbier, S. (2020). Occupational Therapy Practice Guidelines for Children and Youth Ages 5–21 Years. American Journal of Occupational Therapy, Vol. 74(4), 7404397010p1–7404397010p48.


Reflex Integration

"Primitive reflex retention was related to difficulties in handwriting. This suggests that some children with poor handwriting may benefit from reflex integration intervention to foster good handwriting. However, reflex integration should not be provided alone, instead being added to an occupation-based intervention, such as typical handwriting instruction"

Richards, L., Avery, R., Gray, S., Price, R. (2022). Relationship of Retained Primitive Reflexes and Handwriting Difficulty in Elementary-Age Children. Am J Occup Ther, Vol. 76(Supplement_1). doi:


Sensory Integration Therapy

"Occupational therapists currently use a variety of sensory interventions to address attention and self-regulation." "Sensory Integration Therapy and massage interventions had the highest quality of evidence, both receiving a moderate score."

Roberge, N., Crasta, J. L. (2022). A systematic review of sensory interventions for children with autism: The effects on attention and self-regulation. Am J Occup Ther, Vol. 76(Supplement_1). doi:


Effectiveness of Pediatric Occupational Therapy for Children with Disabilities

A systematic review summarizing the best-available intervention evidence for children with disabilities, to assist families and therapists choose effective care. A traffic light evidence alert system rating was used to classify effectiveness of interventions for feeding therapy, motor outcomes, behavioral outcomes, cognitive outcomes, pain, mental health, sleep, and function. "Green light" interventions represent high-quality of evidence in regard to effectiveness, including interventions such as parent education, CIMT, home program, handwriting-task practice, goal directed training, life and social skills training, and ABA.

Novak, I., & Honan, I. (2019). Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review. Australian Occupational Therapy Journal, 66(3), 258–273.


Interventions to Improve Children's Academic Participation

A systematic review summarizing 46 studies to examine the effectiveness of interventions within the scope of occupational therapy practice to improve academic participation of children and youth ages 5–21 yr. A low/moderate/strong system rating was used to classify effectiveness of interventions for 1) participation in classroom, motivation in literacy, and 3) handwriting. It was found that there is "low strength of evidence supports the use of weighted vests and stability balls, and moderate strength of evidence supports the use of yoga to enhance educational participation. Moderate strength of evidence supports the use of creative activities, parent-mediated interventions, and peer-supported interventions to enhance literacy participation. Strong evidence supports therapeutic practice for handwriting intervention."

Grajo, L. C., Candler, C., & Sarafian, A. (2020). Interventions within the scope of occupational therapy to improve children's academic participation: A systematic review. The American Journal of Occupational Therapy , 74(2), 7402180030p1–7402180030p32.


Interventions for Handwriting Skills in 4-6 Year Old Children

A systematic review aiming to evaluate the current evidence of occupational therapy interventions in handwriting skills for 4–6 year old children. "The review found no randomized control trial study design pertaining to the reviewed area. However, it can be seen that occupational therapy interventions for writing skills in 4–6 year old children managed to increase the targeted skills. The results were similar across samples with or without disabilities. An effective integration of occupational therapy interventions into educational curriculum was found to save both time and cost."

Kadar, M., Wan Yunus, F., Tan, E., Chai, S. C., Razaob Razab, N. A., & Mohamat Kasim, D. H. (2020). A systematic review of occupational therapy intervention for handwriting skills in 4-6-year-old children. Australian Occupational Therapy Journal, 67(1), 3–12.

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